Gynecologic and Obstetric Investigation最新文献

{"title":"Factors Influencing the Success of Breech External Cephalic Version and Their Impact on Delivery Mode and Maternal-Neonatal Outcomes.","authors":"Jufang Guo, Xuelin Bai, Chaolin Li, Haiyan Liu, Anqun Xie, Zengzhen Lai, Xuelian Du","doi":"10.1159/000549236","DOIUrl":"10.1159/000549236","url":null,"abstract":"<p><strong>Objectives: </strong>This prospective cohort study aimed to identify key factors influencing the success rate of external cephalic version (ECV) and to evaluate its impact on the mode of delivery and maternal-neonatal outcomes.</p><p><strong>Design: </strong>A prospective cohort study was conducted. Participants/Materials: The study enrolled 62 pregnant women with singleton breech presentations at or beyond 37 weeks of gestation who consented to undergo ECV. A convenience sample of 12 women with cephalic presentations was also enrolled as a control group for outcome comparison.</p><p><strong>Setting: </strong>The study was conducted at the Department of Obstetrics and Child Health Hospital, Jinniu District Maternal and Child Health Hospital, Chengdu, China.</p><p><strong>Methods: </strong>Participants were divided into ECV success (n = 51) and failure (n = 11) groups based on procedural outcome. Baseline characteristics were compared, and predictors of ECV success were analyzed using univariable logistic regression. Maternal and neonatal outcomes were compared between the success group and the control group.</p><p><strong>Results: </strong>Five independent predictors of ECV success were identified: lower maternal body mass index (BMI) at delivery (odds ratio [OR] = 0.816, 95% confidence interval [CI]: 0.662-0.991; p = 0.042), prior spontaneous vaginal delivery (OR = 8.250, 95% CI: 1.879-58.080; p = 0.012), non-posterior placental location (OR = 0.171, 95% CI: 0.034-0.678; p = 0.017), higher amniotic fluid index (OR = 1.442, 95% CI: 1.053-2.185; p = 0.048), and fewer ECV attempts (OR = 0.174, 95% CI: 0.059-0.375; p = 0.001). The ECV success group had a significantly higher vaginal delivery rate (81% vs. 0%; p = 0.012) and a lower cesarean delivery rate (19% vs. 100%) compared to the failure group. Neonates in the success group exhibited higher birth weights (3,266.4 ± 352.54 g vs. 3,063.2 ± 202.93 g; p = 0.017). Outcomes in the success group were comparable to the cephalic-presentation control group, except for a higher rate of labor induction (33.3% vs. 0%, p = 0.050).</p><p><strong>Limitations: </strong>The main limitations of this study include its modest sample size, single-center design, and the lack of long-term follow-up data on maternal and neonatal outcomes post-ECV.</p><p><strong>Conclusions: </strong>ECV is an effective intervention for reducing cesarean delivery rates in breech presentations. Success is associated with lower maternal BMI, a history of vaginal delivery, favorable placental location, adequate amniotic fluid, and fewer procedural attempts. These findings support the integration of patient-specific factors into clinical protocols to optimize ECV success and improve perinatal outcomes.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"322-330"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145376897","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":"Comment on \"Diagnostic Accuracy of MRI Using the #Enzian Classification in Endometriosis: A Single-Center Retrospective Cohort Study\".","authors":"Zeeshan Solangi, Rachana Mehta, Ranjana Sah","doi":"10.1159/000548292","DOIUrl":"10.1159/000548292","url":null,"abstract":"","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"380-381"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023137","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":"Maternal and Perinatal Outcomes Associated with Intrapartum Antibiotic Regimens in Women with Prolonged Membrane Rupture and Unknown Group B Streptococcus Status: A Retrospective Comparative Study.","authors":"Raneen Abu Shqara, Shany Or, Gabriela Goldinfeld, Lior Lowenstein, Maya Frank Wolf","doi":"10.1159/000546792","DOIUrl":"10.1159/000546792","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;p&gt;Objectives: The aim of the study was to compare maternal, neonatal, and microbiological outcomes among patients with unknown group B Streptococcus (GBS) status and prolonged rupture of membranes (ROM ≥18 h) who received intrapartum prophylaxis with either ampicillin or clindamycin.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;A retrospective comparative cohort.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials: &lt;/strong&gt;A total of 1,507 term singleton pregnancies with ROM ≥18 h and unknown GBS colonization status were included in the study: 1,418 received ampicillin, and 89 received clindamycin due to reported penicillin allergy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;The study was conducted in a tertiary university-affiliated hospital in northern Israel, from March 2020 to May 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Patients were stratified by antibiotic regimen. The co-primary outcomes were clinical chorioamnionitis and neonatal intensive care unit (NICU) admission. Secondary outcomes included maternal complications (intrapartum fever, endometritis, cesarean delivery) and neonatal morbidities (Apgar &lt;7, cord pH &lt;7.1, respiratory distress, and ventilation support). Post-delivery chorioamniotic membrane swabs were cultured. Multivariate logistic regression was used to identify independent predictors of outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Compared to ampicillin, clindamycin treatment was associated with higher rates of clinical chorioamnionitis (14.6% vs. 2.3%, p &lt; 0.001), intrapartum fever (28.1% vs. 4.1%, p &lt; 0.001), maternal sepsis (2.2% vs. 0.3%, p = 0.011), puerperal endometritis (13.5% vs. 2.6%, p &lt; 0.001), cesarean delivery (36.0% vs. 18.1%, p &lt; 0.001), and postpartum antibiotic use (14.6% vs. 5.4%, p &lt; 0.001). Among neonates of patients treated with clindamycin compared to ampicillin, the rates were higher for NICU admission (19.1% vs. 4.4%, p &lt; 0.001), Apgar &lt;7 at 5 min (4.5% vs. 0.8%, p = 0.001), cord pH &lt;7.1 (7.9% vs. 2.0%, p &lt; 0.001), respiratory distress (13.5% vs. 5.4%, p &lt; 0.001), and ventilation support (invasive 2.2% vs. 0.2%, p = 0.019; non-invasive 7.9% vs. 1.1%, p &lt; 0.001). Hypoxic brain injury occurred more frequently in the clindamycin group (2.2% vs. 0.1%, p = 0.016). GBS was isolated more often in chorioamniotic cultures of patients treated with clindamycin (19.1% vs. 1.1%, p &lt; 0.001). In multivariable analysis, clindamycin treatment (adjusted odds ratio [aOR] 7.7, 95% CI: 3.8-15.5, p &lt; 0.001) and artificial ROM (aOR 2.6, 95% CI: 1.1-6.3, p = 0.031) were independently associated with clinical chorioamnionitis. Clindamycin treatment was also independently associated with NICU admission (aOR 3.71, 95% CI: 1.9-7.1, p &lt; 0.001). Other factors associated with NICU admission were the presence of meconium-stained amniotic fluid (aOR 3.28, 95% CI: 1.7-6.2, p &lt; 0.001), clinical chorioamnionitis (aOR 3.11, 95% CI: 1.3-7.2, p = 0.009), and umbilical cord pH &lt;7.1 (aOR 4.76, 95% CI: 1.9-11.4, p &lt; 0.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations: &lt;/strong&gt;Limitations include the retrosp","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"172-179"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274720","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":"Endometrial Metabolism of 17β-Estradiol during the Window of Implantation in Women with Recurrent Implantation Failure.","authors":"Linda B P M Stevens Brentjens, Bert Delvoux, Janneke E den Hartog, Darina Obukhova, Sofia Xanthoulea, Andrea Romano, Ron J T van Golde","doi":"10.1159/000546442","DOIUrl":"10.1159/000546442","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;p&gt;Objectives: Alterations in 17β-estradiol metabolism are known to potentially impair endometrial receptivity. Previous pioneering studies have investigated the role of endometrial steroid metabolism by determining steroid hormone levels and steroid-metabolizing enzyme activity in endometrial biopsies of patients undergoing IVF. The activity of oxidative and reductive 17β-hydroxysteroid dehydrogenases (17β-HSDs), which catalyze the interconversion between estrone and 17β-estradiol, was found to be similar between IVF patients who - after fresh embryo transfer in the cycle following endometrial biopsy - did and did not become pregnant. However, inhibition of the reductive enzyme 17β-hydroxysteroid dehydrogenase type 1 (17β-HSD1), the most prominent 17β-HSD type in 17β-estradiol formation, was found to differ between groups. The primary objective of this study was to determine oxidative and reductive 17β-HSD enzyme activity in the endometrium of two well-defined groups: IVF patients with recurrent implantation failure (RIF) and control patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;This is a prospective observational study of IVF patients with RIF (n = 52) and controls (n = 25). Patients undergoing treatment because of pre-implantation genetic testing, a severe male factor, or bilateral tubal pathology were recruited as controls since these conditions did not suggest an endometrial contribution to infertility.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants/materials, setting, methods: &lt;/strong&gt;Endometrial biopsies were obtained 5-8 days after a positive urine ovulation test in a natural cycle using a Pipelle catheter. Activity of oxidative and reductive enzymes, inhibition of 17β-HSD1, 5, 7, and 12, and immunostaining of 17β-HSD7 were performed. The formation of 17β-estradiol by reduction of estrone (reductive enzymes), formation of estrone by oxidation of 17β-estradiol (oxidative enzymes), and inhibition of specific 17β-HSD enzymes were determined using high-performance liquid chromatography. Formalin-fixed paraffin-embedded tissue was used for immunostaining. The Student's t test and Mann-Whitney U test were used for statistical analysis. Multivariate analysis was used to determine the influence of confounders.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;No differences were found in activity of oxidative and reductive 17β-HSD enzymes in RIF patients and controls. Combined inhibition of 17β-HSD5, 7, and 12 was significantly lower in the RIF group compared to controls (p = 0.04). Inhibition of 17β-HSD1 and 17β-HSD7 combined was also significantly lower (more production of 17β-estradiol remained) in the RIF group compared to controls (p &lt; 0.01). However, solely inhibiting 17β-HSD1 or 17β-HSD7 showed no significant difference between groups. Immunostaining revealed the expression of 17β-HSD7 in all endometrial samples.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations: &lt;/strong&gt;Results should be interpreted carefully due to possible cycle-to-cycle variation, challenges to translate in vitro findings to b","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"151-162"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12215175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077603","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":"S1PR4 Promotes Cell Viability, Invasion, and Glycolysis via the Mammalian Target of Rapamycin Signaling Pathway in Endometriosis.","authors":"Huizhi Yuan, Zhongju Xie, Minqing Feng, Jianying Zheng, Rong Geng, Cankun Zhou, Qunxiu Lao, Xiaobin Huang","doi":"10.1159/000546571","DOIUrl":"10.1159/000546571","url":null,"abstract":"<p><strong>Objective: </strong>Endometriosis is a chronic gynecological disorder that can cause infertility in women of reproductive age, and its clinical treatment still faces significant challenges. However, the pathogenesis of endometriosis remains unclear.</p><p><strong>Methods: </strong>S1PR4 knockdown and overexpression were constructed in primary ectopic endometrial stromal cells (EESCs) with or without the glycolysis inhibitor 2-deoxy-D-glucose and normal endometrial stromal cells (ESCs) with or without the mTOR signaling pathway inhibitor AZD8055, respectively. CCK-8 and Transwell assays were used to evaluate the viability and invasive capabilities. The cellular glycolytic capacity was assessed by measuring the extracellular acidification rate and lactate levels in the cell culture supernatant. An endometriosis mouse model was established in vivo, and histopathological changes in the endometrium were analyzed by hematoxylin-eosin staining. The expression of S1PR4, LDHA, and p-mTOR in endometrium and ESCs was assessed using qRT-PCR, Western blotting, or immunofluorescence.</p><p><strong>Results: </strong>Glycolytic levels were increased in EESCs, and inhibiting glycolysis in vitro reduced the viability and invasive capabilities of EESCs, as well as suppressed the growth of ectopic lesions in vivo. S1PR4 was abnormally overexpressed in endometriosis, and knocking down S1PR4 inhibited the viability, invasion, and glycolysis of EESCs, along with downregulation of p-mTOR expression. Conversely, overexpression of S1PR4 promoted the viability, invasion, and glycolysis of ESCs via the mTOR signaling pathway.</p><p><strong>Conclusions: </strong>In endometriosis, S1PR4 enhances cellular glycolysis by activating the mTOR signaling pathway, thereby promoting the viability and invasion of EESCs.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"186-198"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325485","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":"Cytolytic Vaginosis in Women with Vaginitis: Prevalence, Diagnosis, and Treatment.","authors":"Selda Kömeç, Can Tercan, Ayşe Nur Ceylan, Mehmet Akif Durmuş, Gizem Şirin Donbaloğlu, Mustafa Derya Aydın","doi":"10.1159/000548768","DOIUrl":"10.1159/000548768","url":null,"abstract":"<p><strong>Objectives: </strong>Vaginitis is an inflammatory condition of the vagina, which often manifests with symptoms like discharge, foul odor, and pruritus. The most commonly recognized forms are candidiasis, bacterial vaginosis (BV), and trichomoniasis, but conditions like cytolytic vaginosis (CV) remain under-recognized and frequently misdiagnosed in clinical practice despite its notable prevalence. This study aims to evaluate the prevalence of CV in patients with vaginitis, assess the specificity of the diagnostic criteria for CV, and investigate the efficacy of CV treatments.</p><p><strong>Design: </strong>This study is a prospective diagnostic study. Participants/Materials, Setting: A total of 81 patients (aged 20-55 years) with symptoms of vaginitis, and 30 control participants without these symptoms were enrolled.</p><p><strong>Methods: </strong>Vaginal samples were analyzed for Trichomonas vaginalis, vulvovaginal candidiasis (VVC), and BV and CV. Vaginal samples were evaluated using Gram staining, pH measurement, and microbiological culture to identify causative agents. CV was diagnosed based on the low vaginal pH, presence of abundant lactobacilli, cytolysis of the vaginal epithelium, false clue cells, and naked nuclei in Gram staining.</p><p><strong>Results: </strong>The study found that CV was the most prevalent diagnosis, accounting for 32.1% of cases. This was followed by BV (22.2%) and VVC (14.8%). The most common symptoms among CV patients were vaginal discharge, pruritus, and dysuria. Vaginal discharge characteristics did not significantly distinguish CV from other forms of vaginitis. A recurrence rate of 61.5% was observed in CV patients, highlighting the recurrent nature of the condition. Sodium bicarbonate sitz baths effectively relieved symptoms in many patients (58.8%).</p><p><strong>Limitations: </strong>The number of patients receiving treatment is low, and the treatment follow-ups could have been conducted over a longer period, considering the menstrual cycle.</p><p><strong>Conclusions: </strong>The study highlights the diagnostic challenge of CV, where common symptoms overlap with other forms of vaginitis, leading to potential treatment failures. CV treatment, including NaHCO₃ sitz baths, showed moderate efficacy, but further research is needed to establish more effective therapeutic strategies. Our findings underscore the importance of considering CV in the differential diagnosis of vaginitis as it remains an overlooked condition that significantly contributes to recurrent vaginitis. Further studies with larger sample sizes and better treatment protocols are needed to enhance the management of this condition.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"305-311"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228435","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":"Retraction Statement.","authors":"","doi":"10.1159/000552219","DOIUrl":"10.1159/000552219","url":null,"abstract":"<p><p>The article \"Use of Intramuscular Progesterone versus Intravenous Albumin for the Prevention of Ovarian Hyperstimulation Syndrome\" [Gynecol Obstet Invest. 2000;50(3):182-185; https://doi.org/10.1159/000010306] by Loredana Costabile, Vittorio Unfer, Claudio Manna, Sandro Gerli, Dario Rossetti and Gian Carlo Di Renzo has been retracted by the Publisher and the Editors.After publication of this article, concerns were raised about the uneven group sizes following randomization, the reported rate of pregnancy following transfer, which was higher than described in contemporary global statistics, and the significant difference between groups in the number of oocytes retrieved, though the differential intervention occurred post-retrieval. These raised concerns about the study's randomization. When asked to comment, the authors stated that they cannot address the concerns due to the fact that the article was published more than 25 years ago and data and documents are no longer available.The concerns raised and the authors' response were reviewed by the Editors. As the concerns, which may impact the reliability of findings presented in the article, cannot be addressed or resolved, and due to the relevance of the difference between the groups for the conclusions of the study, the article is being retracted.Vittorio Unfer does not agree to the retraction. Sandro Gerli stated that he bears no responsibility for this article. The remaining authors did not respond to the notification about this retraction within the timeframe specified.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"484"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148053914","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":"Association of Low-Dose Oxytocin with Pain Intensity and Delivery Outcomes among Primiparas Who Delivered Vaginally with Epidural Block Analgesia.","authors":"Fuxue Tang, Zhijie Zhang, Peikun Han","doi":"10.1159/000546524","DOIUrl":"10.1159/000546524","url":null,"abstract":"<p><strong>Objective: </strong>This paper aimed to evaluate the influence of low-dose oxytocin (LDO) on pain intensity and delivery outcomes in primiparas who delivered vaginally with epidural block analgesia (EBA).</p><p><strong>Methods: </strong>A total of 150 primiparas were retrospectively collected, and finally, 120 cases were included. They were divided into a control group (n = 60, received EBA) and an oxytocin group (n = 60, received EBA combined with LDO). Analgesic onset time, analgesic duration, time to flatus, and time to first bowel movement were compared. Pain intensity was assessed using the Visual Analog Scale (VAS) at pre-analgesia, cervical dilation of 3 cm, and fetal delivery. Serum levels of cortisol (Cor), norepinephrine (NE), and C-reactive protein (CRP) before and 24 h post-delivery, postpartum bleeding, Apgar scores, delivery outcomes, and adverse reactions were compared.</p><p><strong>Results: </strong>The oxytocin group had shorter times for gas passage and first bowel movement, as well as shorter durations of the first, second, and third stages of labor (p < 0.05). VAS scores at cervical dilation of 3 cm and fetal delivery were lower than pre-analgesia in both groups (p < 0.05), with no inter-group differences at each time point (p > 0.05). Serum Cor and NE decreased, while CRP increased at 24 h postpartum (p < 0.05), with no inter-group differences (p > 0.05). The oxytocin group had less postpartum bleeding at 2 h (p < 0.05), a higher natural delivery rate, and a lower incidence of uterine atony (p < 0.05), with no significant difference in Apgar scores (p > 0.05).</p><p><strong>Conclusion: </strong>EBA with LDO shortens labor duration, promotes gastrointestinal recovery, reduces uterine atony, postpartum hemorrhage, and vaginal assistive delivery rates, without affecting analgesia or stress response.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"259-266"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325482","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":"Endometrial Transcriptome Changes following Short-Term Liraglutide Treatment in Infertile Women with Polycystic Ovarian Syndrome and Obesity.","authors":"Vesna Salamun, Luca Lovrecic, Ales Maver, Borut Peterlin, Helena Ban Frangez, Gaetano Riemma, Antonio Simone Laganà, Rok Herman, Andrej Janez, Eda Vrtacnik Bokal, Mojca Jensterle","doi":"10.1159/000547513","DOIUrl":"10.1159/000547513","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of the study was to evaluate whether the use of a 12-week liraglutide treatment changes the endometrial gene expression during the implantation window in infertile obese women with polycystic ovarian syndrome (PCOS) undergoing in vitro fertilization (IVF).</p><p><strong>Design: </strong>A cross-sectional study involving treated and non-treated subjects was conducted.</p><p><strong>Participants: </strong>Infertile women with PCOS and BMI ≥30 kg/m2 participated in the study.</p><p><strong>Setting: </strong>The study was conducted at a tertiary-care university hospital.</p><p><strong>Methods: </strong>Endometrial biopsies were collected from 20 infertile women during the implantation window, 1 month prior to entering the IVF procedure. Endometrium transcriptome of 10 participants, who had been pretreated with low-dose liraglutide 1.2 mg QD for 12 weeks and achieved at least a 5% reduction in body weight, was compared to endometrium transcriptome of 10 treatment-naive participants, who had a stable body weight over the last 12 weeks. Next-generation sequencing was conducted to analyze RNA from the samples. The resulting data were processed to discern key canonical pathways and predict activations or inhibitions. Gene networks were constructed based on established published associations.</p><p><strong>Results: </strong>Gene Set Analysis (GSA) identified a total of 17 canonical pathways that were significantly differentially expressed between the two groups. The most important canonical pathways included GLP-1 receptor activation, modulation of inflammation and oxidative stress response, alterations in glucose homeostasis, and energy consumption, with YWHAG being a notable central gene in the associated network. The results indicate a possible involvement of the AKT pathway in the liraglutide mode of action.</p><p><strong>Limitations: </strong>The main limitations include its cross-sectional design and considerable number of upregulated and downregulated genes.</p><p><strong>Conclusions: </strong>Short-term low-dose liraglutide treatment prior to IVF was associated with changes in the endometrial transcriptome that could potentially be important for improving endometrial receptivity and fertility in women with obesity and PCOS.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"241-250"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690042","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":"10.1159/000545414","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;p&gt;Introduction: 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 5, 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, 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 (MDs) 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 supplements,","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"101-114"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12158398/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}