Journal of pediatric and adolescent gynecology最新文献

{"title":"59. IUD Insertion in Out-of-OR Sedation Clinic in the Adolescent Population","authors":"Abigail Iseyemi ,&nbsp;Hava Starkman ,&nbsp;Tobias Everett ,&nbsp;Heather Millar ,&nbsp;Lisa Allen","doi":"10.1016/j.jpag.2025.01.092","DOIUrl":"10.1016/j.jpag.2025.01.092","url":null,"abstract":"<div><h3>Background</h3><div>Hormonal Intrauterine Devices (IUDs) are important contraceptives and treatment for adolescent menstrual disorders. However, uptake may be limited in adolescents in the clinic setting for concerns that it may be painful and anxiety-provoking. Pediatric and Adolescent Gynecology at SickKids Hospital offers IUD insertion under anesthetic in the operating room (OR) but wait times are long. The primary goal of this study is to assess the implementation of an out-of-OR sedation program for IUD insertion on wait times. Secondary goals are to assess if a sedation program increases the likelihood of selecting an IUD, reduces anxiety and provides a positive insertion experience.</div></div><div><h3>Methods</h3><div>This is a retrospective review of IUD insertions in a tertiary institution in 3 settings: clinic, OR and a sedation clinic. OR cases occurred between June 2022 - June 2023, and sedation cases from June 2023 - June 2024. Wait times (days) were calculated from booking date to procedure date. Data was extracted from the electronic medical record. Patients under age 18 seeking IUD insertion were included. Exclusion criteria for sedation were BMI ≥30 due to anaesthetic limitations, severe developmental disability, and patients consented before roll out of sedation (June 2023). A brief survey is in progress for the sedation and clinic setting, to assess patient experience. Quality Improvement approval was obtained through SickKids Hospital. Descriptive statistics were used to summarize patient characteristics, with p-values ≤0.05 statistically significant. Analysis was performed using SPSS Statistics software.</div></div><div><h3>Results</h3><div>83 patients met inclusion criteria, (N=9 clinic, N=37 OR, and N=37 sedation). There were significant differences between BMI, age, and sexual history for each setting. Due to anaesthetic protocols, BMI in the clinic and the OR was higher than in sedation (p = 0.007). Patients were older in the sedation group (M = 16.05) compared to the OR (M = 15.35), (p =0.044). Most patients in clinic (88.9%) were sexually active, higher compared to OR and sedation (p&lt; 0.001). Procedure wait time was lower in sedation (M = 66.05 days) compared to the OR (M =172.00 days), (p&lt; 0.001). There was no difference in diagnosis for OR vs sedation in terms of menstrual indications for IUD insertion. Primary sedatives were ketamine and midazolam for sedation (97%), and propofol and dexmedetomidine for OR (41%). Complication rates and comorbidities were similar between groups. Survey results are pending.</div></div><div><h3>Conclusions</h3><div>The sedation program significantly improves access to care with shorter wait times. This supports broader adoption of sedation programs to enhance gynecologic care for adolescents.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 2","pages":"Page 257"},"PeriodicalIF":1.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520123","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":"44. Follicular findings in autoimmune oophoritis: 2 cases from the NIH ovarian tissue cryopreservation protocol","authors":"Carolyn Brookhart ,&nbsp;Jacqueline Maher ,&nbsp;Veronica Gomez-Lobo","doi":"10.1016/j.jpag.2025.01.077","DOIUrl":"10.1016/j.jpag.2025.01.077","url":null,"abstract":"<div><h3>Background</h3><div>Autoimmune oophoritis and subsequent diminished ovarian reserve (DOR) or premature ovarian insufficiency (POI) is a rare cause of subfertility, representing approximately 4% of spontaneous POI. It often coexists with thyroid and/or adrenal autoimmunity, or can be a part of Polyglandular Autoimmune Syndrome (APS), Type I and Type II. The purpose of this study is to describe several cases of autoimmune DOR/POI in children/adolescents, as well as their ovarian tissue findings to help inform management of this rare condition.</div></div><div><h3>Case</h3><div>Patient A is a 16-year-old female with a history of Factor V Leiden heterozygous, who was diagnosed with POI during workup of sudden alopecia with labs notable for elevated FSH (129 mIU/mL) and undetectable estradiol. She was also noted to have anti-thyroid peroxidase antibodies, anti-thyroglobulin antibodies, and anti-adrenal antibodies, raising concern for polyglandular autoimmune failure. Menarche occurred at age 12 and she had regular menses, which became lighter but ongoing the time of her diagnosis. She underwent laparoscopic right oophorectomy and ovarian tissue cryopreservation. Ovarian histology demonstrated no ovarian follicles. Patient B is a 13-year-old who initially presented with weight loss, palpitations, and secondary amenorrhea. Menarche occurred at age 11 with subsequent regular menses until an abrupt stop at 13 years old. Labs demonstrated hyperthyroidism due to Grave's disease (TSH &lt; 0.005 mIU/L, T4 15.8 mcg/dL, thyroid-stimulating immunoglobulin 413 IU/L) and hypergonadotropic hypogonadism consistent with POI (FSH 59.3 mIU/mL, LH 15.5 IU/L. estradiol 8 pg/mL, AMH 0.01 ng/m). She underwent laparoscopic right oophorectomy and ovarian tissue cryopreservation. Ovarian histology demonstrated no ovarian follicles.</div></div><div><h3>Comments</h3><div>This study demonstrated no follicles in either of the subjects with POI due to autoimmune oophoritis. It is possible that the absence of follicles represents generally worse outcomes of ovarian tissue cryopreservation for patients with autoimmune POI compared to other causes of POI. That said, little is known about the chronology of this condition, and earlier detection and recognition of autoimmune oophoritis might allow for improved fertility outcomes. Notably both of these patients were post-pubertal. It is unknown if fertility preservation outcomes for patients with autoimmune POI differ by pubertal status. More studies are needed to determine who are optimal candidates for ovarian tissue cryopreservation, especially for rare causes of POI like autoimmune oophoritis.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 2","pages":"Pages 249-250"},"PeriodicalIF":1.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520213","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":"47. Giant Mucinous Cystadenoma in a Young Transgender Man: Case Report","authors":"Salman Ali Jan ,&nbsp;Laura Rekedal ,&nbsp;Greta Magerowski ,&nbsp;Diana Robillard ,&nbsp;Margaret Griffith ,&nbsp;Eleanor Parker","doi":"10.1016/j.jpag.2025.01.080","DOIUrl":"10.1016/j.jpag.2025.01.080","url":null,"abstract":"<div><h3>Background</h3><div>Mucinous cystadenomas are among the most common ovarian neoplasms in child and adolescent patients, but giant ovarian cysts measuring &gt;15cm remain rare. To date, no cases have been reported among transmasculine patients on hormone replacement therapy with testosterone. This case aims to provide insight on the preoperative and intra-operative considerations in this patient population.</div></div><div><h3>Case</h3><div>This 19-year-old transgender patient presented for gender-affirming mastectomy but was referred preoperatively to the emergency department for evaluation of new, rapid-onset abdominal distention. Imaging showed a 17 × 26 × 36cm septated, cystic pelvic mass suspected to be of ovarian origin. Serum tumor markers were normal, and a benign pelvic mass was suspected. Gender affirming hysterectomy and bilateral salpingo-oophorectomy were discussed pre-operatively, and the patient ultimately decided to preserve future fertility yet was amenable to staging for oncologic benefit in the event a malignancy was identified. Exploratory laparotomy was initiated with a 4cm midline vertical incision and the cystic mass was encountered upon peritoneal entry. A controlled drainage was attempted via needle aspiration following the application of skin glue, wound protector and retention suture (Figure 1). Given concern for minimal spillage of cyst contents intra-operatively, as well as difficulty accessing the multiple loculations within the large mass, the incision was ultimately extended to 10cm and the mass was decompressed via suction to a volume of 7850mL. The cyst was externalized (Figure 2) and found to originate from the left ovary, while the right adnexa were normal in appearance. A unilateral salpingo-oophorectomy was performed, and pathology was suspected to be benign on frozen section. The final pathology confirmed benign mucinous cystadenoma with associated mural granulation tissue and an endometriotic cyst. Cytologic analysis of peritoneal washings was negative for malignancy.</div></div><div><h3>Comments</h3><div>Large cystic ovarian tumors with loculated morphology require special surgical considerations. While minimally invasive approaches are generally preferred, we advise a modest approach to drainage unless imaging is unequivocal. We recommend shared preoperative decision-making that addresses the risk of borderline and malignant pathology, as well as the transgender patient's goals for gender affirmation and future fertility. For patients undergoing surgery that will delay other gender-affirming care, it is imperative to provide clear communication about how surgical management may affect time to care.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 2","pages":"Page 251"},"PeriodicalIF":1.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520216","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":"61. Labial Endometriosis in a Pre-Menarchal Patient","authors":"Nikita Sood ,&nbsp;Erin E Barlow","doi":"10.1016/j.jpag.2025.01.094","DOIUrl":"10.1016/j.jpag.2025.01.094","url":null,"abstract":"<div><h3>Background</h3><div>The prevalence of endometriosis in adolescent populations is difficult to ascertain, with some studies estimating that almost 40% of post-menarchal adolescents with pelvic pain have endometriosis. Reports of endometriosis in pre-menarchal patients are even more limited and highlight a still-evolving understanding of the pathogenesis of the disease. No prior documented case has described labial endometriosis in a pre-menarchal female.</div></div><div><h3>Case</h3><div>An 11 year old pre-menarchal patient presented to the emergency room (ER) with a tender vulvar mass. The mass had been present for several weeks and was increasingly painful. She was afebrile, had no associated symptoms, and denied recent trauma to the area. On exam, a 6 × 6 cm mass was noted on the right labia minora with mild tenderness to palpation but no surrounding erythema or swelling. The patient was noted to have Tanner Stage 2 breast and pubic hair development. The presumed diagnosis was a hematoma and she was discharged by the ER team with planned follow up with Pediatric and Adolescent Gynecology for consultation. The patient presented again 2.5 weeks later with increased pain and size of the labial mass. She continued to be afebrile and without associated symptoms. Labial ultrasound demonstrated a 5 × 4.5 × 3 cm multi-septated structure with concentric solid and vascular components. Pelvic MRI also showed a 4.9 × 4.5 × 5 cm multiseptated cystic structure. Presumed diagnosis was a super-infected hair follicle and plan was made for incision and drainage in the operating room. Grossly, the mass was noted to be well-encapsulated, consistent with an encapsulated hematoma with a cystic wall structure and septations. Due to proximity to the clitoral hood, a small amount of capsule was left in situ and a Penrose drain was left in place. The mass was sent to pathology which reported hemosiderin-laden macrophages and CD10 positive stromal cells suggestive of endometriosis.</div></div><div><h3>Comments</h3><div>This report presents the first case of labial endometriosis in a pre-menarchal patient. Vulvar/perineal endometriosis is generally rare, with other cases in post-menarchal adolescents typically associated with recent vulvar trauma not seen in this case. In general, endometriosis is considered to be a progressive disease associated with menses, which highlights the atypical nature of this case. Though multiple theories exist as to the pathogenesis of the disease, the theory of retrograde menstruation is widely accepted. This case, however, suggests that alternate theories such as coelomic metaplasia or mullerian embryonic rests may also contribute.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 2","pages":"Page 258"},"PeriodicalIF":1.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520617","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":"Nongestational Ovarian Choriocarcinoma with Precocious Puberty in a 7-Year-Old Girl: A Rare Case Report.","authors":"Kako Ono, Reina Hoshi, Takayuki Hirano, Yosuke Watanabe, Shumpei Goto, Takashi Hosokawa, Shuichiro Uehara","doi":"10.1016/j.jpag.2025.02.007","DOIUrl":"10.1016/j.jpag.2025.02.007","url":null,"abstract":"<p><strong>Background: </strong>Nongestational ovarian choriocarcinoma (NGOC) is extremely rare, particularly in the pediatric population. Few case reports have discussed NGOC with precocious puberty and mentioned both tumor markers (β-human chorionic gonadotropin [hCG], alpha-fetoprotein, CA125) and the dynamics of gonadotropic and gonadal hormones.</p><p><strong>Case: </strong>A 7-year-old girl presented with early puberty and an abdominal mass. Laboratory tests revealed elevated estradiol, β-hCG, and CA125 levels, with suppressed luteinizing hormone and follicle-stimulating hormone. She was diagnosed with ovarian choriocarcinoma and precocious puberty. Following tumor resection, her hormone levels normalized, and symptoms resolved.</p><p><strong>Conclusion: </strong>Pediatric ovarian choriocarcinomas are rare and may present with precocious puberty. Comprehensive endocrine evaluation, including serum hormone assays, is essential for diagnosis. Hormonal profiles in pediatric patients may differ from those in adults, with estradiol levels often being markedly elevated compared to age-specific reference ranges, and progesterone levels being relatively low.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531542","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":"Paraovarian Cysts in Pediatrics: Retrospective Analysis of Diagnostic and Laparoscopic Treatment in a Single Institution.","authors":"Małgorzata Fryczek, Olga Szymon, Marcin Maślanka, Bartosz Bogusz, Wojciech Górecki","doi":"10.1016/j.jpag.2025.02.005","DOIUrl":"10.1016/j.jpag.2025.02.005","url":null,"abstract":"<p><strong>Purpose: </strong>This study presents a 24-year single-center experience in treating pediatric paraovarian tumors. It examines their key characteristics and discusses diagnostic and management considerations.</p><p><strong>Methods: </strong>We performed a retrospective analysis of medical records for pediatric patients who underwent surgery for an adnexal mass from January 2000 to April 2024. The inclusion criteria were based on intraoperative diagnoses of paraovarian cysts, which were later confirmed by final surgical pathology reports.</p><p><strong>Results: </strong>Seventy-one patients operated on for paraovarian cysts were identified. Their ages ranged from 10 to 18 years, with a median age of 15 years. The primary complaint was abdominal pain, reported by 47 patients (66%). This pain was attributed to adnexal torsion in 29 cases (41%) and the presence of a mass in 19 cases (27%). Mass effects were observed in six patients (8%). Preoperative diagnoses were correct in 52% of the cases, while intraoperative accuracy reached 99%. None of the patients showed signs of malignant transformations. The preferred surgical approach was laparoscopy, which was performed on 59 patients (83%). Adnexal-sparing surgery was conducted in 70 patients, while one patient required adnexectomy following spontaneous subtotal amputation due to torsion.</p><p><strong>Conclusion: </strong>Accurately identifying paraovarian cysts during surgery is essential for effective management and adnexal preservation. Due to the risk of torsion, surgical intervention should be considered even for small and asymptomatic paraovarian cysts. In cases where there is uncertainty, laparoscopy is a valuable tool for both diagnosis and treatment. Laparoscopic excision is a feasible, less invasive, and safe approach to treatment.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515758","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":"Isolated Inhibin-Producing Granulosa Cell Tumor Causing Primary Amenorrhea: A Case Report.","authors":"Meridith P Pollie, Benjamin Peipert, Sarah Kim, Monica A Mainigi","doi":"10.1016/j.jpag.2025.02.006","DOIUrl":"10.1016/j.jpag.2025.02.006","url":null,"abstract":"<p><strong>Background: </strong>Juvenile granulosa cell tumors (JGCTs) are the most common pediatric ovarian sex cord-stromal tumor. Because most granulosa cell tumors are hormonally active, patients commonly present with signs and symptoms of endocrine dysfunction, including precocious puberty and menstrual irregularities. Most patients with JGCTs present with stage I disease confined to the ovary that can be managed with surgical excision alone with a favorable prognosis.</p><p><strong>Case: </strong>A 15-year-old girl presented with primary amenorrhea. Evaluation revealed suppressed follicle-stimulating hormone, elevated luteinizing hormone, normal estradiol, and a markedly elevated inhibin B, and pelvic ultrasound and magnetic resonance imaging showed a mildly enlarged right ovary with a 1.6-cm \"ovarian follicle.\" After consultation with gynecologic oncology, the patient underwent right salpingo-oophorectomy with histopathologic findings consistent with JGCT. Menarche subsequently occurred 2 months after surgery.</p><p><strong>Summary and conclusion: </strong>Differences in GCT endocrine function, as well as the stage of pubertal development when the tumor develops, may lead to a variety of clinical presentations. It is important to consider inhibin-producing JGCT on the differential diagnosis for pediatric and adolescent patients presenting with amenorrhea.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492381","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":"\"Stop Gaslighting Your Patients\": A Quantitative and Qualitative Analysis of User Experiences of IUDs on TikTok.","authors":"Rachel H Allen, Soobin Song, Grace M Weir, Katharine O White","doi":"10.1016/j.jpag.2025.02.003","DOIUrl":"10.1016/j.jpag.2025.02.003","url":null,"abstract":"<p><strong>Study objective: </strong>TikTok is a social media platform where patients can access and share information about intrauterine devices (IUDs). The primary objective of this study was to identify prominent themes of creators' experiences with IUDs on TikTok.</p><p><strong>Methods: </strong>We conducted a quantitative and qualitative assessment of eligible videos that appeared when searching for \"IUD\" on the TikTok platform between July 2019 and August 2022. Eligible videos contained content relevant to IUDs and were spoken and/or written in English.</p><p><strong>Results: </strong>Of the 354 videos that met inclusion criteria, the majority were created by users without healthcare expertise (77%) and mentioned personal experiences with IUDs (68%). However, videos that were educational (27%) or created by users with healthcare expertise (23%) averaged more likes and views than other video types. Common content areas included IUD insertion (45%), side effects (31%), and removal (25%). Perceived gaps in knowledge about the insertion procedure and feeling that providers did not adequately prepare patients for the procedure contributed to dissatisfaction with IUD insertion and motivated creators to share their experiences on TikTok. Video creators often relied on information that they found on TikTok to educate themselves about the IUD insertion process and expressed frustration at unacceptable levels of pain during insertion.</p><p><strong>Conclusion: </strong>Healthcare providers should be aware that adolescent patients who use TikTok have likely seen videos depicting negative experiences with IUDs and be prepared to address patients' concerns, particularly regarding IUD insertion. Additionally, healthcare providers may use TikTok to educate users about IUDs.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408484","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":"Current Practices in Fertility-Based Counseling Among Individuals With Turner Syndrome: A Retrospective Study.","authors":"Gabriela Beroukhim, Rama Kastury, Kerri A Davidson, Jenna Bergmann, Alla Vash-Margita","doi":"10.1016/j.jpag.2025.02.002","DOIUrl":"10.1016/j.jpag.2025.02.002","url":null,"abstract":"<p><strong>Study objective: </strong>To evaluate current practices and examine patient and provider characteristics associated with delivery of fertility-based counseling and pursuit of autologous oocyte cryopreservation or embryo cryopreservation among individuals with Turner syndrome (TS) at a large academic institution.</p><p><strong>Methods: </strong>A retrospective study was conducted between January 2010 and December 2020, involving phenotypically female individuals aged 0-26 years with TS.</p><p><strong>Results: </strong>Of 108 included individuals with TS, 65 (60.19%) were classified as monosomy X, and 43 (39.81%) were classified as having TS with another karyotype. Individuals with monosomy X were more likely to have cardiac anomalies, hypertension, and low bone density compared to individuals with TS with other karyotypes. Rates of other comorbidities were similar between groups. Thirty patients (27.78%) received fertility and/or fertility preservation (FP) counseling, of which six (5.56%) pursued autologous assisted reproduction technology (ART). A multidisciplinary group of providers offered counseling. Individuals with other TS karyotypes were more likely to receive counseling compared to individuals with monosomy X (43.59% vs 22.03%, P = .027). Counseling was significantly associated with pursuing ART (20.00% vs 0%, P < .001). Other factors, such as race, ethnicity, and cardiac anomalies, were not associated with the receipt of counseling.</p><p><strong>Conclusion: </strong>Approximately one-third of individuals with TS received fertility and/or FP counseling, and only few pursued controlled ovarian hyperstimulation. Our large cohort study underscores the need for standardized, system-wide measures to deliver fertility counseling to individuals with TS, including the development of a dedicated multidisciplinary program. Further investigations are necessary to evaluate the effectiveness of proficiency in delivering FP counseling to individuals with TS.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374198","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":"FIGIJ Advocacy Statement on Violence Against Women and Girls in Conflict, Humanitarian Settings, and War SituationsEndorsed by NASPAG.","authors":"Michalina Drejza, Angela Aguilar, Anastasia Vatopoulou, Clara Di Nunzio, Daniela Ivanova Panova, Ellen S Rome, Judith Simms-Cendan, Mariela Orti, Yasmin Jayasinghe, Marisa Labovsky","doi":"10.1016/j.jpag.2025.01.175","DOIUrl":"10.1016/j.jpag.2025.01.175","url":null,"abstract":"<p><p>The International Federation of Pediatric and Adolescent Gynecology (FIGIJ) recognizes the severe impact of conflict, humanitarian crises, and war on the health and safety of women and girls. These settings exacerbate the risk of gender-based violence (GBV), including sexual violence, exploitation, and abuse, with long-lasting consequences on survivors' physical and mental well-being. Adolescent girls are particularly vulnerable, facing heightened risks of forced marriage, trafficking, and disrupted access to education and healthcare. FIGIJ calls for urgent, coordinated global action to prevent and respond to GBV in these contexts. This advocacy statement outlines key recommendations, including strengthening legal frameworks, enhancing healthcare and psychosocial support, improving inter-agency coordination, and prioritizing data collection and research. Through these measures, FIGIJ aims to empower women and girls, protect their rights, and promote sustainable, survivor-centered solutions to mitigate the impact of violence in conflict and humanitarian settings.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365189","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}