Gynecologic and Obstetric Investigation最新文献

{"title":"Effect of SEMA3F on proliferation, migration and ferroptosis of endometrial stromal cells in patients with endometriosis.","authors":"Yi Zheng, Yu Zhou, Caizhi Wang, Shuyu Liu","doi":"10.1159/000545947","DOIUrl":"https://doi.org/10.1159/000545947","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to examine the impact of semaphorin-3F (SEMA3F) on the proliferation, migration and ferroptosis of endometrial stromal cells in patients with endometriosis (EMS).</p><p><strong>Methods: </strong>This study collected ectopic endometriotic tissues from 30 patients with EMS (EMS group) and eutopic endometrial tissues from 30 patients in the control group who underwent hysterectomy due to uterine fibroids. The ectopic endometriotic tissues were sourced from the cystic walls of ovarian endometriomas in women with EMS. RT-qPCR and western blotting were adopted to evaluate SEMA3F expression of endometrial tissues. Endometrial stromal cells (ESCs) were isolated from ectopic endometriotic tissues and divided into the oe-NC group, oe-SEMA3F group, and a blank group (non-transfected). SEMA3F expression in cells was quantified by RT-qPCR and western blotting. Cell proliferation was quantified with the CCK-8 assay, and migration and invasion were analyzed via the Transwell method. Ferroptosis markers (Fe2+, MDA, GSH) and ferroptosis-related proteins (ACSL4, PTGS2) were evaluated with western blotting, and inflammatory factors (IL-6, TNF-α) were measured using ELISA.</p><p><strong>Results: </strong>Levels of both mRNA and protein in SEMA3F were lower in the ectopic endometriotic endometrial tissue of EMS patients compared to controls. Overexpression of SEMA3F in ESCs from patients with EMS reduced cellular activity, migration, and invasion. Additionally, Fe2+, MDA, and other ferroptosis markers were significantly reduced, while GSH levels increased. Ferroptosis-related protein expression (ACSL4, PTGS2) was suppressed, and inflammatory factor levels (IL-6, TNF-α) decreased.</p><p><strong>Conclusion: </strong>SEMA3F may regulate the development of EMS by affecting the proliferation, invasion, migration, as well as ferroptosis of ESCs from patients with EMS.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"1-18"},"PeriodicalIF":2.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral Drospirenone/Estetrol as Rapid and Random Start Endometrial Preparation before Office Hysteroscopic Polypectomy: a Multicenter, Prospective, Randomized Controlled Trial.","authors":"Andrea Etrusco, Vittorio Agrifoglio, Vito Chiantera, Giuseppe Russo, Tullio Golia D'Augè, Marco Monti, Andrea Giannini, Gaetano Riemma, Giuseppe Scibilia, Basilio Pecorino, Antonio D'Amato, Antonio Simone Laganà","doi":"10.1159/000546077","DOIUrl":"https://doi.org/10.1159/000546077","url":null,"abstract":"<p><strong>Objectives: </strong>Endometrial preparation provides significant surgical benefits prior to hysteroscopic procedures. However, there is still no consensus on the optimal presurgical protocol. Although there is evidence on rapid preparation, there are currently no studies on rapid endometrial preparation using combined oral contraceptives initiated at a 'random' time in the menstrual cycle. The aim of the present trial was to evaluate the use of oral drospirenone/estetrol in random start rapid preparation of endometrium before office hysteroscopic polypectomy.</p><p><strong>Design: </strong>In this multicenter, prospective, randomized controlled trial, 80 women scheduled for polypectomy were randomly assigned to intervention (n= 40) or control (n= 40) groups.</p><p><strong>Participants/materials, setting, methods: </strong>The intervention group received oral drospirenone/estetrol (3mg/14.2mg/day) for 14 days, starting at any menstrual cycle point (random start). Controls underwent polypectomy on cycle days 8-11 without any prior pharmacological intervention. Results Pre- and post-procedure, endometrial thickness was significantly lower in the drospirenone/estetrol group (p< 0.001), and patients showed more hypotrophic/atrophic endometrial patterns (p< 0.001). Operative time, distension medium usage, incomplete resections, and bleeding during polypectomy were significantly lower in the drospirenone/estetrol group (p< 0.001). Endometrial preparation quality, uterine cavity visualization, and procedure satisfaction were higher in the drospirenone/estetrol group (p< 0.001). Furthermore, patients in the drospirenone/estetrol group experienced less pain during (p< 0.001) and after the procedure (p< 0.001), requiring fewer analgesics (p< 0.001) and shorter post-procedure discharge time (p = 0.01) than controls. Limitations Limited sample size; possible variability due to different hysteroscopists, caused by the multicenter nature of the study; hysteroscopists were unmasked to treatment allocation; absence of a cost-effectiveness analysis. Conclusions Treatment with drospirenone/estetrol could provide rapid, satisfactory and low-cost endometrial preparation before office polypectomy, improving surgical performance and patient compliance.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"1-17"},"PeriodicalIF":2.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the systemic inflammatory indices on birth weight: A prospective observational study.","authors":"Marco La Verde, Rossella Molitierno, Maria Maddalena Marrapodi, Mario Fordellone, Antonio Simone Laganà, Marica Palma, Antonella Petillo, Gaetano Riemma, Maria Giovanna Vastarella, Pasquale De Franciscis","doi":"10.1159/000545591","DOIUrl":"https://doi.org/10.1159/000545591","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Objectives Several studies explored the role of maternal systemic inflammation indices during pregnancy. Different conditions, such as gestational hypertension, preeclampsia, and gestational diabetes, are associated with abnormal systemic inflammation indices. However, there is a lack of research on the impact of systemic inflammation indices on fetal growth in physiological pregnancies. The objective of this study is to explore the potential associations between birth weight, length, and head circumference with a group of systemic inflammatory indices, namely Platelet-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR), the Mean Platelet Volume-to-Lymphocyte Ratio (MPVLR), Monocyte-Lymphocyte Ratio (MLR), Systemic Immune-Inflammation Index (SII) and Systemic Inflammation Response Index (SIRI). Design Full-term, physiological pregnancies admitted to a tertiary center from November 2019 until February 2021 were included in a prospective observational study. We excluded pregnancies affected by gestational or pregestational diabetes, chronic hypertension, gestational hypertension, pre-eclampsia/eclampsia, fetal growth restriction, preterm delivery or premature rupture of membranes, multiple pregnancies, and malformed fetuses. Socio-demographic characteristics, clinical data, and complete blood count were recorded. Materials and methods: Continuous variables were reported as either the means and standard deviation or median and interquartile ranges (IQRs) according to their distribution, as assessed by the Shapiro-Wilk normality test. Categorical variables were reported as percentages. To measure the linear association between continuous variables, the Pearson correlation test was used if variables had a normal distribution. Otherwise, Spearman's rank correlation test was calculated. To obtain an inflammatory latent score a principal component analysis (PCA) was performed on NLR, PLR, MPVLR, MLR, SII and SIRI. Results: 264 pregnant women came to our observation before the delivery. After the exclusion criteria, 199 pregnant were included. The Spearman's rank correlation test showed a high correlation among the indices. Then, a PCA was performed to a composite indicator of inflammatory score. The first principal component was selected, with a proportion of explained variance equal to 73.11%. The contributions of variables suggested to exclude from the score the MLR index. From the linear regression models, results denoted that the inflammatory score negatively affects the birth weight (β=-42.60, 95%CI [-76.91, -8.28]) and the head circumference (β=-0.14, 95%CI [-0.24, -0.04]); whereas, the effect of the score on the birth length is not statistically significant at 5% (β=-0.12, 95%CI [-0.27,0.02]). Limitations This research's main limitation is the lack of data about the indirect inflammatory markers during the first and second trimesters of pregnancy. In addition, no neonatal outcomes were scheduled, such as NICU hospitalization for the","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"1-16"},"PeriodicalIF":2.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erb's Palsy: Visual Diagnosis in Art before Medical History?","authors":"Pien E J de Ruiter, Stella A Bult, Jeroen R Dijkstra, Thomas M van Gulik","doi":"10.1159/000546120","DOIUrl":"https://doi.org/10.1159/000546120","url":null,"abstract":"<p><p>Background Close observation is fundamental to both art and medicine, although both disciplines use it in different ways. As doctors need to practise observation of their patients every day, visual arts are increasingly used for the development of observational skills within the medical curriculum [1-4]. This is particularly useful for students and residents in surgery or in specializations with a surgical component such as gynecology and obstetrics, where close observation of anatomical structures and radiological imaging is essential in providing quality care [5]. Conversely, artists - through close observation - have depicted the world around them for decades. As a result, they might have unintentionally pictured medical abnormalities, before conditions were officially described in the medical world. Several authors have described medical findings in artworks throughout history, such as the visual diagnosis of Erb's palsy. [5-8]. Objectives The aim of this paper is to identify and describe depictions of Erb's palsy in art history. Methods Authors observed and analyzed several paintings in the Rijksmuseum in the Netherlands on visual medical abnormalities corresponding to obstetrical birth injuries. Additionally, in September 2024 a Pub Med search was conducted using the terms \"erbs palsy\", \"birth injuries\", \"brachial plexus neuropathies\" and \"art\". The paintings of three articles concerning the depiction of Erb's palsy in art were included. A standardized table was constructed in collaboration with medical specialists and used to analyze clinical features of Erb's palsy in the artworks. Outcomes PubMed search resulted in three different articles concerning the possible diagnosis of Erb's Palsy in a painting of Albrecht Dürer, i.e.Madonna and Child (1505). In total, five different paintings from the sixteenth and seventeenth century were analyzed regarding the presence of clinical features of Erb's Palsy. Three paintings matched six out of seven of the clinical criteria, as stated in the standardized table. Two paintings matched five out of seven clinical criteria of Erb's palsy. It should be noted that the art-historical principles of the so called 'Renaissance elbow' and the technique of 'foreshortening' might have contributed to the depiction of incorrect anatomical features, as a result of artistic freedom rather than the depiction of medical abnormalities. Conclusions This paper suggests that artists' close observations could possibly have led to depictions of Erb's palsy centuries before the condition was formally described in the medical profession. The findings serve as a reminder that close observation is essential for the work of medical professionals and highlight how art can contribute to training the clinical eye of medical students, residents, and doctors.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"1-27"},"PeriodicalIF":2.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dietary Supplements for Endometriosis-Associated Pain: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials.","authors":"Noemi Salmeri, Alessia Ragusi, Camilla Buffo, Edgardo Somigliana, Paola Viganò, Paolo Vercellini","doi":"10.1159/000545414","DOIUrl":"https://doi.org/10.1159/000545414","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;In recent years, dietary supplements have emerged as popular \"natural\" alternatives to conventional pharmacological treatments for various conditions, including endometriosis. The growing popularity of supplements for endometriosis-associated pain, fueled by an expanding and minimally regulated market, underscores the need for robust evidence of efficacy, as a prerequisite for any consideration on effectiveness. This meta-analysis synthesizes evidence from randomized, placebo-controlled trials (RCTs), the gold standard in evidence-based medicine, to assess the efficacy of dietary supplements in endometriosis-associated pain.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A systematic search of PubMed, Embase, Scopus, and the Cochrane Library was conducted up to November 5th, 2024, in adherence to PRISMA 2020 guidelines. Two independent reviewers screened studies using PICOS criteria: reproductive-age women with endometriosis (Population), dietary supplements (Intervention), placebo (Comparator), and pain-related outcomes (Outcomes), assessed in placebo-controlled RCTs adhering to CONSORT standards (Study type). Three pain domains were evaluated: i) symptom severity (visual analogue scale (VAS) for pelvic pain, dysmenorrhea, dyspareunia), ii) pain catastrophizing, and iii) quality of life (QoL), as measured by the Short Form-12 Health Survey (SF-12) and the Endometriosis Health Profile-30 (EHP-30). Risk of bias was assessed using the Cochrane RoB2 tool. Random-effects models were used to calculate pooled mean differences (MD) and 95% confidence intervals (CIs). Statistical heterogeneity was assessed with the I² statistic, and subgroup analyses explored clinically relevant confounders. Sensitivity analyses excluded studies with conflicts of interest or trustworthiness issues, as defined by the Obstetrics and Gynecology Editors' Integrity Group (OGEIG). Publication bias was evaluated using Egger's test, Begg's test, and the trim-and-fill method. All analyses were conducted using STATA version 18.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Nine RCTs (n=545 subjects; 274 in the treatment group and 271 in the placebo group) were included. Only three met the 'absolute' OGEIG trustworthiness criteria. No significant differences were observed between supplements and placebo for pelvic pain (pooled MD: -1.1; 95% CI, -3.0 to 0.8; I²=96.1%), dysmenorrhea (pooled MD: -2.0; 95% CI, -4.4 to 0.5; I²=93.8%), or dyspareunia (pooled MD: -2.0; 95% CI, -4.9 to 0.9; I²=96.5%). These findings remained consistent when the analysis was restricted to studies without conflicts of interest, those authored by researchers with no retractions, and those meeting OGEIG trustworthiness criteria. Subgroup analyses reduced heterogeneity and confirmed no significant benefits. Pain catastrophizing and quality-of-life measures showed little to no improvement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;While limited evidence precludes definitive conclusions about specific dietary suppl","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"1-21"},"PeriodicalIF":2.0,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Accuracy of Endometrial Thickness in Identifying Retained Products of Conception and Tailored Hysteroscopic Management: A Retrospective Study.","authors":"Alex Kalendaryov, Avishalom Sharon, Inshirah Sgayer, Susana Mustafa Mikhail, Lior Lowenstein, Ala Aiob","doi":"10.1159/000545637","DOIUrl":"10.1159/000545637","url":null,"abstract":"<p><strong>Objectives: </strong>Retained products of conception (RPOC) can occur after delivery, abortion, or uterine evacuation, presenting diagnostic challenges. This study aimed to assess the diagnostic accuracy of transvaginal ultrasound (TVS) endometrial thickness measurements for identifying RPOC and propose tailored hysteroscopic management strategies.</p><p><strong>Design: </strong>This is a retrospective cohort study.</p><p><strong>Participants and setting: </strong>A total of 226 women with suspected RPOC underwent hysteroscopy between 2018 and 2021 at the Galilee Medical Center.</p><p><strong>Methods: </strong>Endometrial thickness was measured by TVS, and diagnostic metrics, including sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), were calculated.</p><p><strong>Results: </strong>The mean endometrial thickness was 1.6 cm (0.7-6 cm). The overall PPV for RPOC was 79.2%, with a false-positive rate of 20.7%. A cut-off of 1.49 cm yielded a sensitivity of 69.8%, specificity of 59.6%, PPV of 86.8%, and NPV of 34.1%. Women with thickness >1.49 cm had a threefold increased likelihood of RPOC. Stratifying by endometrial thickness showed PPVs of 54.5% (<10 mm), 76.5% (10-20 mm), and 98.0% (>20 mm).</p><p><strong>Limitations: </strong>Retrospective design may introduce selection bias, and findings require validation in larger, prospective studies.</p><p><strong>Conclusions: </strong>An endometrial thickness above 1.49 cm significantly increases the likelihood of RPOC confirmation. RPOC can occur in asymptomatic women with associated risk factors. TVS endometrial thickness measurements are effective for diagnosing and managing these cases, and stratification further enhances diagnostic accuracy.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"1-6"},"PeriodicalIF":2.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In vitro Effects of ABT-263, a BH3 Mimetic, on Fibrotic Phenotype in Endometriotic and Endometrial Stromal Cells.","authors":"Sachiko Matsuzaki, Jean-Luc Pouly, Michel Canis","doi":"10.1159/000545555","DOIUrl":"10.1159/000545555","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;A recent study has shown that myofibroblasts are primed for apoptosis when survival pathways are inhibited under fibrosis. This knowledge of apoptosis priming led to the development of methods to induce apoptosis specifically in myofibroblasts by blocking specific pro-survival proteins of the BCL-2 family with small molecules that mimic the function of the BH3-only proteins, termed BH3 mimetics. The current study aimed to investigate the in vitro effects of ABT-263 (navitoclax), a BH3 mimetic, alone and in combination with oestrogen and/or progesterone, on fibrosis in endometriotic and endometrial stromal cells.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;This is a prospective study using immunocytochemistry with primary cultured human cells. Participants/Materials: Primary culture of stromal cells was obtained from endometrial and/or endometriotic tissues (deep infiltrating endometriosis of 28 patients) and those of women who underwent tubal ligation or reversal as \"true\" healthy controls (n = 22).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;The study was conducted in a gynaecological research laboratory.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Double immunofluorescence staining for Ki-67 and α-smooth muscle actin (αSMA) or collagen type I (Col I) and αSMA was performed to investigate the in vitro effects of ABT-263, alone and in combination with oestrogen and/or progesterone, on fibrosis in endometriotic and endometrial stromal cells. The total cellular proliferation index (T-PI) (percentage of Ki-67-positive cells among the total number of 4,6-diamidino-2-phenylindole  (DAPI)-stained nuclei), fibroblast proliferation index (Fb-PI) (percentage of Ki-67-positive and αSMA + stress fibre-negative cells among the total number of DAPI-stained nuclei), myofibroblast proliferation index (Myo-PI) (percentage of Ki-67-positive and αSMA + stress fibres-positive cells among the total number of DAPI-stained nuclei), myofibroblast index (Myo-I) (percentage of cells with αSMA + stress fibres among the total number of DAPI-stained nuclei), total collagen index (T-Col-I) (percentage of Col I + cells among the total number of DAPI-stained nuclei), collagen in myofibroblasts index (Myo-Col-I) (percentage of Col I + cells among the total number of myofibroblasts), and collagen in fibroblasts index (Fb-Col-I) (percentage of Col I + cells among the total number of fibroblasts) were calculated from 10 random high-power (×400) fields through each section.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The present in vitro experiments showed that targeting myofibroblasts by ABT-263 (navitoclax), a BH3 mimetic, in endometriosis resulted in decreased proliferation (Myo-PI) and numbers of collagen type I-expressing myofibroblasts (Myo-Col-I), and total number of collagen type I-expressing cells (T-Col-I), but increased proliferation (Fb-PI) and numbers of collagen type I-expressing fibroblasts (Fb-Col-I).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations: &lt;/strong&gt;First, we did not conduct any mechanistic stud","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"1-9"},"PeriodicalIF":2.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endometriosis, Raynaud's Syndrome, and Migraine: A Retrospective Study of 12 Million Women.","authors":"Hormoz Nassiri Kigloo, Eva Suarthana, Tina C Montreuil, Mohammad Jamal, Togas Tulandi","doi":"10.1159/000545204","DOIUrl":"10.1159/000545204","url":null,"abstract":"<p><strong>Objective: </strong>Our study focused on evaluating a possible relationship between endometriosis, Raynaud's syndrome, or migraine among women.</p><p><strong>Design: </strong>This was a cross-sectional population-based study. Participants/Materials; Setting; Methods: We used 12,684,067 hospitalized patient records in the Healthcare Cost and Utilization Project (HCUP) database between 2007 and 2014. We calculated the prevalence of endometriosis, Raynaud's syndrome, and migraine. We also evaluated the possible role of depression, anxiety, and autoimmune diseases to eliminate confounding factors. Unadjusted and adjusted multivariate logistic regressions were applied to evaluate the relationship between variables.</p><p><strong>Results: </strong>Unadjusted analysis revealed a strong association between endometriosis and Raynaud's syndrome and migraine (OR = 2.491; 95% CI: 1.677-3.699). After adjusting for sociodemographic characteristics as well as depression and anxiety, the association remained significant (OR = 1.779; 95% CI: 1.166-2.716). Among younger patients aged 18-35 with endometriosis, the associations were stronger with Raynaud's syndrome (adjusted OR = 1.61, 95% CI = 1.20-2.16) and migraine (adjusted OR = 2.59, 95% CI = 2.47-2.72).</p><p><strong>Limitations: </strong>The HCUP database is cross-sectional in nature, and hence, we could not establish the temporal relationship between endometriosis, Raynaud's syndrome, and migraine. Also, the severity of endometriosis and the treatment received by the patients were not included in the dataset, and it prevented us from investigating the role of potential confounding factors.</p><p><strong>Conclusion: </strong>Our study suggests an association between endometriosis, Raynaud's syndrome, and migraine. It is possible that these conditions share a similar mechanism possibly vascular reaction and endothelial dysfunction related to chronic inflammation.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"1-9"},"PeriodicalIF":2.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12112891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between Luteinizing Hormone/Chorionic Gonadotropin Receptor Polymorphisms and Assisted Reproductive Technology Outcomes: A Systematic Review and Meta-Analysis.","authors":"Sha Liu, Qi Cao, Yijing Zhou, Jiaming Zhou, Yang Hu, Yuanyuan Hu, Tian Tang","doi":"10.1159/000545556","DOIUrl":"10.1159/000545556","url":null,"abstract":"<p><strong>Introduction: </strong>Variants of the luteinizing hormone/chorionic gonadotropin receptor (LHCGR) gene have been investigated for their close associations with assisted reproductive technology (ART) outcomes. However, available data are controversial. This meta-analysis aimed to elucidate the associations of LHCGR N312S polymorphism (rs2293275) with ART outcomes.</p><p><strong>Methods: </strong>A thorough search was performed in the databases of PubMed, EMBASE, Web of Science, and Cochrane Library from their inception to July 19, 2024. The analysis included five studies, encompassing 2,692 patients with infertility and subfertility. RevMan 5.4 was used for further comprehensive data analysis.</p><p><strong>Results: </strong>In this study, A allele homozygotes encoded asparagine (N/N), and G allele homozygotes encoded serine (S/S). The number of oocytes retrieved was higher in AA homozygotes than in GG homozygotes (mean difference [MD] 1.07, 95% confidence interval [CI] 0.09-2.05, I2 = 7%, p = 0.03) or AG heterozygotes (MD 1.26, 95% CI 0.32-2.20, I2 = 45%, p = 0.008). The number of mature oocytes and the distribution of the LHCGR (rs2293275) genotype (MD 0.60, 95% CI -0.25 to 1.45, I2 = 49%, p = 0.17; MD 0.85, 95% CI 0.02-1.68, I2 = 76%, p = 0.05; MD -0.36, 95% CI -1.20 to 0.49, I2 = 56%, p = 0.41) were not significantly different. G allele homozygotes and heterozygotes exhibited an increasing trend in the number of clinical pregnancies compared with A allele homozygotes (odds ratio [OR] 1.69, 95% CI 1.21-2.36, I2 = 0%, p = 0.002; OR 1.30, 95% CI 1.09-1.54, I2 = 0%, p = 0.003).</p><p><strong>Conclusion: </strong>This study revealed associations of LHCGR polymorphism with ART outcomes, implying that the LHCGR N312S polymorphism (rs2293275) may serve as a predictor of certain ART outcomes.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"1-11"},"PeriodicalIF":2.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Laparoscopic Cystectomy for Ovarian Endometrioma on Anti-Müllerian Hormone Levels: A Systematic Review and Meta-Analysis.","authors":"Caitlyn Murdock, Luis Sanchez-Ramos, Jordan Asher McKinney, Aakriti R Carrubba, Gregory Lewis","doi":"10.1159/000545230","DOIUrl":"10.1159/000545230","url":null,"abstract":"<p><strong>Introduction: </strong>Endometriosis is a condition that leads to a chronic inflammatory state, which has been associated with pelvic pain and infertility. Ovarian endometriomas are commonly treated via laparoscopic cystectomy; however, there is some debate on the degree of ovarian damage after cystectomy. The aim of this systematic review and meta-analysis is to conduct a thorough assessment of postoperative anti-Müllerian hormone levels, a marker of ovarian reserve, after laparoscopic cystectomy for endometriomas.</p><p><strong>Methods: </strong>We conducted a search of PubMed, EMBASE, Web of Science, Google Scholar, and Science Direct from inception to March 31, 2024. We included randomized and non-randomized studies that assessed pre- and postoperative anti-Müllerian hormone levels after ovarian cystectomy for endometriomas. Outcomes of interest included the differences in anti-Müllerian hormone levels assessed within 1 month prior to surgery and up to 18 months postoperatively. These outcomes were categorized as short term (up to 6 weeks), medium term (7 weeks to 6 months), and long term (6 months to 18 months). Randomized and observational studies were pooled together for analysis as only the intervention arm from the randomized trials was included in the meta-analysis. Continuous variables were extracted as means and standard deviations to produce a pooled weighted mean difference with 95% confidence intervals were calculated using a random-effects model.</p><p><strong>Results: </strong>Of the 2,396 articles identified, 30 studies were included. Primary outcomes showed a statistically significant (p < 0.001) decrease in anti-Müllerian hormone in the postoperative short-term period (-1.39 ng/mL, 95% CI: -2.01 to -0.76), medium-term period (-1.13 ng/mL [95% CI: -1.4 to -0.87]), and long-term period (-2.12 ng/mL [95% CI: -2.61 to -1.63]). There was no significant difference when comparing anti-Müllerian hormone levels in the short-term versus long-term period across all groups. There was no significant difference when comparing long-term unilateral and bilateral cystectomies on anti-Müllerian hormone levels postoperatively.</p><p><strong>Conclusions: </strong>This systematic review and meta-analysis highlights that there is a decline in serum AMH levels following laparoscopic cystectomy for endometriomas, suggesting a potential adverse impact on ovarian reserve. This outcome emphasizes the need to incorporate discussions about the implications of surgery on fertility into preoperative counseling.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"1-15"},"PeriodicalIF":2.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}