International Journal of Gynecology & Obstetrics最新文献

{"title":"Determinants of post-cesarean delivery surgical site infection in Mekelle public hospitals, Tigray, North Ethiopia, in 2024.","authors":"Seble Shiferaw, Mihretab Mehari, Kahsay Zenebe, Birhane Gebrezgher, Addisu Yeshambel Wassie","doi":"10.1002/ijgo.70095","DOIUrl":"https://doi.org/10.1002/ijgo.70095","url":null,"abstract":"<p><strong>Background: </strong>Due to the increased frequency of cesarean deliveries, the number of women with surgical site infections (SSIs) is rising. Surgical site infections remain a concern in low-resource countries, despite the implementation of prevention and control measures, as they lead to extended hospital stays and significant additional costs for the patient. While studies on SSIs exist in the developing world and Africa, to the best of our knowledge, there is limited research specifically examining their determinants, particularly in Ethiopia.</p><p><strong>Objective: </strong>This study aimed to assess the determinants of SSI after cesarean delivery in Mekelle public hospitals, Northern Ethiopia.</p><p><strong>Methods: </strong>An institutional-based retrospective chart review case-control study was conducted from February 18, 2021, to March 14, 2021, using maternal records from July 8, 2018, to July 7, 2020. The required sample size was 237 (158 controls and 79 cases). Data were collected using a pretested and structured checklist with systematic sampling, then entered into EpiData 3.5.1 and analyzed using SPSS version 23. Binary logistic regression and multivariable logistic regression were used to determine the association of independent variables with the dependent variable. Variables with P-values <0.25 in bivariate logistic regression were exported to multivariable analysis, and variables with P-values <0.05 in multivariable analysis were considered significantly associated with the outcome variable.</p><p><strong>Results: </strong>The multivariable logistic regression revealed the significant determinants of post-cesarean delivery SSI were ruptured membranes before cesarean delivery (adjusted odds ratio [AOR] = 4.7, 95% confidence interval [CI] = 2.02, 10.91), prolonged operation time (AOR = 3.24, 95% CI = 1.19, 8.78), estimated blood loss greater than 500 mL (AOR = 4.7, 95% CI = 2.16, 10.40), and postoperation hemoglobin level of <11 g/dL (AOR = 4.2, 95% CI = 1.94, 9.20).</p><p><strong>Conclusion: </strong>This study revealed that the determinants for developing post-cesarean delivery SSI were ruptured membranes before cesarean delivery, prolonged operation time, estimated blood loss greater than 500 mL, and postoperative hemoglobin levels less than 11 g/dL. Therefore, mothers with identified risk factors should receive preventive measures during the postoperative period until SSI is ruled out.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical features and surgical options of obstructed hemivagina and ipsilateral renal agenesis (OHVIRA) syndrome: A systematic review and a meta-analysis of prevalence.","authors":"Emma Bonetti, Gloria Anderson, Simona Duranti, Federico Ferrari, Franco Odicino, Antonia Testa, Francesco Fanfani, Giovanni Scambia, Ursula Catena","doi":"10.1002/ijgo.70164","DOIUrl":"https://doi.org/10.1002/ijgo.70164","url":null,"abstract":"<p><strong>Background: </strong>OHVIRA syndrome, a urogenital malformation, lacks standardized management. Narrative reviews exist, but there is no a comprehensive meta-analysis.</p><p><strong>Objectives: </strong>The aim of this first systematic review and meta-analysis is to evaluate the current literature and inform management strategies.</p><p><strong>Search strategy: </strong>We searched Scopus, Medline, Embase and Web of Science, up to March 2024.</p><p><strong>Selection criteria: </strong>Case series, case reviews, and longitudinal studies on patients with OHVIRA syndrome.</p><p><strong>Data collection and analysis: </strong>Data were extracted and meta-analyzed using R software.</p><p><strong>Main results: </strong>In all, 35 studies (1988-2022) with 526 patients were included. Average symptom onset was 14.45 years, and diagnosis at 16.36 years suggests potential delays. The most common symptoms were abdominal pain (67%, 95% CI 54-77, I² = 66%) and dysmenorrhea (64%, 95% CI 55-72, I² = 46%). Ultrasound (86%, 95% CI 76-92, I² = 58%) and pelvic magnetic resonance imaging (61%, 95% CI 46-74, I² = 72%) were primary imaging modalities. Hematocolpos (55%, 95% CI 42-67, I² = 53%) and hematometra (53%, 95% CI 37-69, I² = 70%) were frequent findings. Pelvic endometriosis, a major long-term complication, affected 20% of patients. Vaginal septum resection (83%, 95% CI 75-89, I² = 48%) was the most common surgical treatment, often accompanied by laparoscopic endometriosis excision. Hysteroscopic septum resection emerged as a minimally invasive option (78%, 95% CI 46-93, I² = 54%), with high success rate.</p><p><strong>Conclusions: </strong>Early diagnosis and surgery are crucial to prevent complications. Vaginal septum resection remains the gold standard, while hysteroscopy offers a promising minimally invasive alternative.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ovarian reserve and IVF/ICSI outcomes after various laparoscopic approaches in infertility patients with endometriomas and suspected compromised ovarian reserve: A retrospective study.","authors":"Huaying Yu, Jianmin Chen, Jieyu Wang, Fang Hong, Songying Zhang, Liaobing Xin","doi":"10.1002/ijgo.70168","DOIUrl":"https://doi.org/10.1002/ijgo.70168","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To assess the ovarian reserve and in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) outcomes after various laparoscopic approaches in infertile patients with endometriomas and suspected compromised ovarian reserve, and the operated and non-operated/healthy ovaries were also compared, aiming to determine the most appropriate laparoscopic approach for each patient.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 132 infertile patients with endometriomas and suspected compromised ovarian reserve (anti-Müllerian hormone [AMH] &lt;2.0 ng/mL or antral follicle count [AFC] &lt;8) were treated by various laparoscopic approaches at the Sir Run Run Shaw Hospital from January 2021 to December 2023, followed by IVF/ICSI. Patients were divided into three groups-group A (n = 33) received anhydrous alcohol instillation, group B (n = 65) underwent fenestration/coagulation, and group C (n = 34) underwent ovarian cystectomy. The clinical characteristics, ovarian reserve, and IVF/ICSI outcomes were evaluated among the three groups. The operated side and non-operated/healthy side in patients undergoing initial surgery were also compared.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The proportion of bilateral endometriomas was higher in group A (63.6%, 21/33) than in group B (40.0%, 26/65) and group C (32.4%, 11/34) (P = 0.023). There was no statistically significant difference in serum AMH in group A before and after surgery (median 1.32 [0.84-1.86 ng/mL] vs. 1.13 [0.59-1.86 ng/mL], P = 0.098). However, significant postoperative decreases were observed in groups B (median 1.30 [0.97-1.76 ng/mL] vs. 0.91 [0.50-1.23 ng/mL], P = 0.009) and C (median 1.52 [1.02-1.81 ng/mL] vs. 1.15 [0.76-1.67 ng/mL], P = 0.006). In group C, the follicle-stimulating hormone/luteinizing hormone ratio also increased postoperatively (median 1.75 [1.33-2.50] vs. 2.29 [1.84-3.61], P = 0.005), while no significant differences were seen in groups A (median 1.72 [1.56-2.80] vs. 2.89 [1.89-3.54], P = 0.096) and B (median 2.14 [1.67-2.82] vs. 2.37 [1.83-3.03], P = 0.189). The clinical pregnancy rate was significantly higher in group A than in group C (60.6%, 20/33 vs. 36.4%, 12/33; P = 0.042), but not significantly different between groups A and B (60.6%, 20/33 vs. 46.9%, 30/64; P = 0.143) or groups B and C (P = 0.220). Compared with the control group, there was a statistically significant difference in preoperative AFC in the group anhydrous ethanol instillation side (median 4.0 [2.0-5.0] vs. 2.0 [0.75-3.25], P &lt; 0.001), the group fenestration/coagulation side (median 2.0 [0-3.0] vs. 2.0 [0.75-3.25], P &lt; 0.001), and the group ovarian cystectomy side (median 2.0 [0-4.0] vs. 2.0 [0.75-3.25], P = 0.003), with no significant differences among the three groups themselves. Compared with the control group, significant differences were also observed between the group fenestration/coagulation side (median 2.0 [1.0-3.75] vs. 2.0 [1.0-3.0], P = 0.014) and the group ovarian cystectom","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cesarean and maternal mortality: Risk factor and indication bias.","authors":"John Jairo Zuleta-Tobón, Juan Sebastián López-Martínez","doi":"10.1002/ijgo.70119","DOIUrl":"https://doi.org/10.1002/ijgo.70119","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the influence of cesarean section on maternal death and discern the effect of indication bias on this association.</p><p><strong>Methods: </strong>A retrospective analysis of case series. All deaths confirmed by the official Epidemiological Surveillance Committee as maternal deaths and involving termination of pregnancy by cesarean section in Antioquia, Colombia, during the period 2011-2020 were included. Two researchers independently analyzed all the records, and, by consensus, classified the relationship as directly related, associated, and no association.</p><p><strong>Results: </strong>The maternal mortality rate for Antioquia was 40.7 deaths per 100 000 live births over the period studied, 48.6 per 100 000 cesarean sections, and 17.9 per 100 000 vaginal deliveries, a crude relative risk of cesarean of 2.7 (95% CI 2.1-3.7); 58.9% of deaths had no association, 13.5% were directly related, and 21.5% were associated with cesarean section. In 6.5% of cases, the association could not be assessed. There is an overlap between the maternal conditions and indications for cesarean section and the assessment of the association between death and cesarean section. Reasons for considering no association were that the underlying cause of death occurred after cesarean section (2), occurred in perimortem women (6), or occurred in women who were critically ill due to obstetric complications (2), underlying medical conditions (26), or pregnancy-related conditions (27).</p><p><strong>Conclusion: </strong>To control for indication bias, it is necessary to identify the influence of cesarean section on the chain of events leading to death in each case because there is no predictable and consistent pattern of indications for cesarean section that might also cause death.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cytologic DNA methylation for managing minimally abnormal cervical cancer screening results.","authors":"Xiao Shang, Linghua Kong, Yan You, Huanwen Wu, Yuligh Liou, Xitong Jin, Pei Liu, Jinghe Lang, Lei Li","doi":"10.1002/ijgo.70167","DOIUrl":"https://doi.org/10.1002/ijgo.70167","url":null,"abstract":"<p><strong>Objectives: </strong>To explore the role of a DNA methylation assay for managing minimally abnormal cervical cancer screening results in a prospective cohort undergoing opportunistic cervical cancer screening.</p><p><strong>Methods: </strong>In the cohort of the METHY2 and METHY3 screening studies of women undergoing opportunistic cervical cancer screening, cervical cytology samples were sent for high-risk human papillomavirus (hrHPV) DNA assays, cytologic pathology and methylation assays of PAX1/JAM3 (CISCER). This study evaluated the discriminative power of CISCER in managing women with minimally abnormal cervical cancer screening results for CIN3+. Absolute CIN3+ risks and colposcopy referrals within one screening round were calculated.</p><p><strong>Results: </strong>A total of 1857 women with minimally abnormal cervical cancer findings had cervical histologic outcomes and were included in the analysis. In women with a minimally abnormal cervical cancer result, the sensitivity and specificity of CISCER was 74.9% (95% confidence interval [CI], 68.3%-81.4%) and 89.1% (95% CI 87.6%-90.6%) for detecting CIN3+. CISCER analysis discriminated well for minimally abnormal cervical cancer results, yielding a CIN3+ risk of 40.5% (95% CI 34.9%-46.2%) after a positive result and a CIN3+ risk of 2.7% (95% CI 2.0%-3.6%) after a negative result.</p><p><strong>Conclusions: </strong>In women with a minimally abnormal cervical cancer screening result, the CISCER provides excellent detection of CIN3+. The use of CISCER in women with a minimally abnormal cervical cancer screening result can lead to a substantial reduction in the number of direct colposcopy referrals.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gestational diabetes mellitus and vascular malperfusion lesions in the placenta: A systematic review and meta-analysis.","authors":"Amrita Arcot, Rachel E Walker, Kelly Gallagher, Jeffery A Goldstein, Alison D Gernand","doi":"10.1002/ijgo.70127","DOIUrl":"https://doi.org/10.1002/ijgo.70127","url":null,"abstract":"<p><strong>Background: </strong>Gestational diabetes mellitus (GDM) can result in increased placental lesions related to high maternal blood glucose, but these relationships are not well understood.</p><p><strong>Objective: </strong>To examine the relationship between GDM and placental vascular malperfusion lesions: accelerated villous maturation, increased syncytial knots, delayed villous maturation, and increased fibrin deposition.</p><p><strong>Search strategy: </strong>PubMed, BIOSIS, and Web of Science databases were systematically searched for full-text articles in English from inception until August 21, 2024.</p><p><strong>Selection criteria: </strong>Our inclusion criteria were randomized controlled trials, case-control, cohort, and cross-sectional studies that examined the relationship between GDM and selected placental vascular malperfusion lesions. The outcome must have been reported as a total proportion.</p><p><strong>Data collection and analysis: </strong>We included all eligible studies in narrative synthesis. If an outcome of interest was in at least three studies, we calculated the odds ratios (ORs) by GDM diagnosis, with 95% confidence intervals (CIs), using mixed-effects logistic regression with random study effects. We evaluated the risk of bias with the Newcastle-Ottawa Scale.</p><p><strong>Main results: </strong>We screened 151 studies, of which eight were included (n = 1291), and six met the criteria for meta-analysis (n = 561). Unadjusted odds (95% CI) of delayed villous maturation were six-fold higher (OR: 6.37 [3.28-12.37]) in pregnancies with GDM than in those without GDM. The narrative synthesis of the literature found higher proportions of increased syncytial knots, delayed villous maturation, and increased fibrin deposition, but not accelerated villous maturation, in pregnancies with versus without GDM.</p><p><strong>Conclusions: </strong>GDM was associated with a higher risk of three placental malperfusion lesions, although there is a small number of studies in this area. Future investigations should examine if these vascular malperfusions are associated with adverse pregnancy outcomes often linked with GDM.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathology results of risk-reducing salpingo-oophorectomy in BRCA1/2 carriers and long-term clinical outcomes.","authors":"Wisam Assaf, Amalfi Qarawani, Yousef Abboud, Eiman Shalabna, Chen Nahshon, Ariel Zilberlicht, Ari Reiss, Meirav Schmidt, Yakir Segev","doi":"10.1002/ijgo.70110","DOIUrl":"https://doi.org/10.1002/ijgo.70110","url":null,"abstract":"<p><strong>Introduction: </strong>BRCA1/2 mutation carriers have a lifetime ovarian cancer risk of 40%-45% for BRCA1 and 15%-20% for BRCA2. The most effective risk-reduction strategy for women with known BRCA mutations remains bilateral risk-reducing salpingo-oophorectomy (RRSO), which reduces the risk by 80%. The primary objective of this study is to assess the long-term incidence of primary peritoneal carcinoma (PPC) following RRSO and to evaluate the occurrence of premalignant and malignant lesions.</p><p><strong>Methods: </strong>This retrospective cohort study followed BRCA1/2-positive patients who underwent RRSO, using data from two medical centers in Haifa Israel between 2002 and 2023. Data collected included demographic characteristics and pathology results post-surgery. Outcomes included rates of occult cancer (OC), serous tubal intraepithelial carcinoma (STIC), and PPC.</p><p><strong>Results: </strong>A total of 214 women underwent RRSO. Of these, 126 (58.8%) had a BRCA1 mutation, 76 (35.5%) had a BRCA2 mutation, and 12 (5.6%) carried both BRCA1 and BRCA2 mutations. During a mean follow-up of 122.4 months (SD ± 84.0), three patients (1.5%) developed PPC. OC was identified in 13 patients (6.1%) during RRSO. Out of the 13 OC patients, eight (61.5%) were classified as stage 1. The overall survival for the OC population was 117.2 ± 55.9 months. STIC was detected in two patients.</p><p><strong>Conclusion: </strong>In this large retrospective analysis of BRCA carriers who underwent RRSO, we confirmed that long-term follow-up is crucial for BRCA mutation carriers undergoing RRSO, as malignancies can still arise over time. In our study, the incidence of PPC was 1.5%, highlighting the need for extended surveillance. These findings underscore the importance of meticulous surgical protocols, expert pathology review, and ongoing monitoring to optimize patient outcomes.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intracranial fetal teratoma: Case report and literature review.","authors":"Laura Pérez Burrel, Francisco Arias Lotto, Ricardo Ángel Pérez Fernández-Pacheco, María Sánchez Pérez, Aimee Van der Biezen, María Del Carmen Viñuela Benéitez","doi":"10.1002/ijgo.70150","DOIUrl":"https://doi.org/10.1002/ijgo.70150","url":null,"abstract":"<p><p>Fetal intracranial tumors are rare. Teratoma is the most common subtype, and it is particularly associated with poor prognosis. This article describes a case of fetal intracranial teratoma diagnosed at 31 + 6 weeks by ultrasound detection of macrocephaly and brain distortion. Due to the poor prognosis and after the advice of obstetricians and neonatologists, the couple decided to terminate the pregnancy. Feticide and cesarean section were performed under general anesthesia with difficult fetal extraction requiring cephalocentesis. In addition to the presentation of the case, a review of the cases published in the literature in the last 42 years was carried out. Together with two of our own cases, a total of 81 cases of intracranial fetal teratoma were collected. A statistical analysis was carried out with the different variables collected, the results of which could help clinicians when informing patients with pregnancies complicated by this type of tumor.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in the understanding and management of leiomyomatosis peritonealis disseminata: A narrative review.","authors":"Xiaoyue Xu, Naiyu Liu, Shuxi Liu, Xiaoting Fang, Hong Chen","doi":"10.1002/ijgo.70154","DOIUrl":"https://doi.org/10.1002/ijgo.70154","url":null,"abstract":"<p><p>Leiomyomatosis peritonealis disseminata (LPD) is a rare gynecologic disorder characterized by the presence of multiple smooth muscle nodules dispersed across the peritoneal surface. While its precise cause remains unknown, studies indicate a role for hormonal, genetic, and molecular influences in disease progression. Advances in imaging, particularly magnetic resonance imaging (MRI) and computed tomography (CT), have enhanced diagnostic precision by differentiating LPD from malignancies, while immunohistochemical markers like smooth muscle actin (SMA), desmin, and estrogen/progesterone receptors (ER/PR) offer valuable pathologic insights. Management strategies include hormonal therapy (e.g., gonadotropin-releasing hormone [GnRH] agonists) and surgical intervention, with treatment plans tailored to disease severity and patient-specific factors. Emerging research suggests the potential role of targeted molecular therapies in managing refractory cases. Despite these advances, LPD remains a complex condition, and further research is needed to clarify its pathogenesis, identify reliable biomarkers, and establish standardized treatment protocols. This review synthesizes current knowledge on LPD to enhance clinical awareness and guide future research on its pathogenesis, biomarkers, and treatment strategies.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel endometrial receptivity test increases clinical pregnancy and live birth rates in patients with recurrent implantation failure: Secondary analysis of a prospective clinical trial.","authors":"Yu Zheng, Na Xu, Biao Chen, Jun Dai, Jian Bai, Bo Huang, Lei Jin, Xiyuan Dong, Zhou Li","doi":"10.1002/ijgo.70157","DOIUrl":"https://doi.org/10.1002/ijgo.70157","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the efficiency of endometrial receptivity testing (ERT) in improving pregnancy outcomes for patients with recurrent implantation failure (RIF), and to investigate the incidence of implantation window displacement.</p><p><strong>Methods: </strong>Conducted between April 2021 and August 2022, at a university-affiliated reproductive center, the study included 85 RIF patients who had failed to achieve pregnancy after three embryo transfers. As part of a multicenter prospective cohort study (ChiCTR2200059342), 45 patients underwent ERT-guided frozen single blastocyst transfer, while 40 received standard treatment without ERT. Endometrial preparation was performed using a hormone replacement therapy (HRT) protocol in the cycle preceding transfer. Endometrial sampling for ERT, including RNA sequencing, artificial intelligence, and discriminant analysis of endometrial receptivity, was conducted on day 5 after progesterone administration to determine the implantation window. The same HRT protocol was used in the transfer cycle, with embryo transfer timed according to the ERT-calculated window.</p><p><strong>Results: </strong>Our data showed that 28.07% of patients exhibited a displaced implantation window, all characterized by pre-receptive endometrium. The ERT group had significantly higher clinical pregnancy rates (57.78% vs. 35.00%, p = 0.036) and live birth rates (53.33% vs. 30.00%, p = 0.030) compared with the non-ERT group.</p><p><strong>Conclusion: </strong>Our findings suggest that approximately one-third of RIF occurrences may be due to endometrial factors, and ERT-guided personalized embryo transfer significantly improves pregnancy outcomes, underscoring its value in reproductive medicine.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}