Minerva obstetrics and gynecology最新文献

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Ovulation induction in anovulatory PCOS women. 多囊卵巢综合症无排卵妇女的排卵诱导。
IF 1.6
Minerva obstetrics and gynecology Pub Date : 2025-03-06 DOI: 10.23736/S2724-606X.24.05633-1
Marialaura Diamanti, Antonio La Marca
{"title":"Ovulation induction in anovulatory PCOS women.","authors":"Marialaura Diamanti, Antonio La Marca","doi":"10.23736/S2724-606X.24.05633-1","DOIUrl":"10.23736/S2724-606X.24.05633-1","url":null,"abstract":"<p><p>Polycystic ovary syndrome (PCOS) is a prevalent endocrine-metabolic disorder characterized by hyperandrogenism, chronic anovulation, and polycystic ovarian morphology, affecting 6-10% of women during their reproductive years. It is a leading cause of female infertility, impacting up to 40% of cases. First described in 1935, PCOS manifests with various clinical features, including hirsutism, amenorrhea, and metabolic disturbances. Additionally, PCOS patients exhibit hormonal imbalances and ovarian dysfunction, contributing to the overall clinical picture. Notably, PCOS is linked to metabolic comorbidities like hepatic steatosis, glucose intolerance, dyslipidemia, type 2 diabetes mellitus (T2DM), and hypertension. This review explores the key aspects of PCOS, providing an overview of ovulation induction strategies, including lifestyle modifications, pharmacological interventions, and emerging approaches. The review synthesizes findings from relevant studies. Effective management of PCOS necessitates early detection and intervention to prevent progression to severe health conditions. Evidence underscores the importance of addressing oxidative stress and low-grade inflammation in treatment plans. A holistic approach, including individualized medication, diet, and lifestyle modifications, is crucial for improving insulin resistance, promoting weight loss, enhancing ovulation rates, and addressing broader metabolic concerns. Key therapeutic strategies include insulin sensitizers like metformin, ovulation induction agents like clomiphene citrate (CC) and aromatase inhibitors (AIs) such as letrozole, and the use of gonadotropins for resistant cases. Combining these treatments with dietary and lifestyle interventions, such as an anti-inflammatory diet, nutritional education, and personalized exercise programs, can enhance treatment outcomes. Through an integrated approach, significant improvements in metabolic health and reproductive function for women with PCOS are possible.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Induction of labor with repeated prostaglandin administration after failure of dinoprostone vaginal insert: a retrospective study comparing dinoprostone and misoprostol. 地诺前列酮阴道插入剂失败后重复使用前列腺素引产:一项比较地诺前列酮和米索前列醇的回顾性研究。
IF 1.6
Minerva obstetrics and gynecology Pub Date : 2025-02-01 Epub Date: 2024-01-30 DOI: 10.23736/S2724-606X.23.05414-3
Matteo Mancarella, Diego Costa Torro, Giulia Moggio, Valentina E Bounous, Nicoletta Biglia
{"title":"Induction of labor with repeated prostaglandin administration after failure of dinoprostone vaginal insert: a retrospective study comparing dinoprostone and misoprostol.","authors":"Matteo Mancarella, Diego Costa Torro, Giulia Moggio, Valentina E Bounous, Nicoletta Biglia","doi":"10.23736/S2724-606X.23.05414-3","DOIUrl":"10.23736/S2724-606X.23.05414-3","url":null,"abstract":"<p><strong>Background: </strong>Induction of labor in women with unfavorable cervix can be started with cervical ripening by dinoprostone vaginal insert. In cases of unsuccessful response, management is unclear: a possible option is a repeated induction with prostaglandins. The aim of this study was to assess the results of a second induction by either dinoprostone or misoprostol, comparing those treatments.</p><p><strong>Methods: </strong>A retrospective analysis was carried out on a cohort of 109 women with unsuccesful response to a first attempt of induction with dinoprostone vaginal insert, who required a second stimulation by either dinoprostone vaginal gel (56 patients) or oral misoprostol (53 patients). The outcomes assessed where the rates of active labor and vaginal delivery, and secondarily maternal and perinatal adverse events.</p><p><strong>Results: </strong>Overall 70.6% of patients reached active labor and 62.4% had a vaginal delivery; the efficacy of the double induction was similar for dinoprostone vaginal gel and oral misoprostol, with active labor in 69.6% and 71.7% (P=0.83), and vaginal delivery in 62.5% and 62.3% of patients (P=0.99) respectively. The incidence of adverse events was low, with no perinatal complications and similar rates of maternal complications, notably major post-partum hemorrhage in 1.8% and 3.8% of patients (P=0.61) for dinoprostone and misoprostol respectively.</p><p><strong>Conclusions: </strong>Dinoprostone vaginal gel and oral misoprostol as a second cycle of induction appear to be both effective in achieving active labor and vaginal delivery after failure of dinoprostone vaginal insert, without a significant rate of adverse events.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"19-26"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139576205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Computerized cardiotocography and fetal heart response to maternal coffee intake: a prospective study. 计算机心动图和胎儿心脏对母体咖啡摄入量的反应:一项前瞻性研究。
IF 1.6
Minerva obstetrics and gynecology Pub Date : 2025-02-01 Epub Date: 2024-07-30 DOI: 10.23736/S2724-606X.24.05406-X
Marco La Verde, Maria G Vastarella, Fabiana Savoia, Carlo Capristo, Maria M Marrapodi, Marina Tesorone, Davide Lettieri, Pasquale De Franciscis, Nicola Colacurci, Maddalena Morlando
{"title":"Computerized cardiotocography and fetal heart response to maternal coffee intake: a prospective study.","authors":"Marco La Verde, Maria G Vastarella, Fabiana Savoia, Carlo Capristo, Maria M Marrapodi, Marina Tesorone, Davide Lettieri, Pasquale De Franciscis, Nicola Colacurci, Maddalena Morlando","doi":"10.23736/S2724-606X.24.05406-X","DOIUrl":"10.23736/S2724-606X.24.05406-X","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to determine the effect of caffeine on fetal heart rate (FHR) as determined by computerized cardiotocography (cCTG) parameters.</p><p><strong>Methods: </strong>Term pregnancies that performed a fetal antepartum cCTG were included. Two physicians recorded coffee habits before the cCTG, and pregnant women were divided into two groups: the coffee group and the control group. Furthermore, cCTG' parameters were compared between the two groups.</p><p><strong>Results: </strong>One hundred thirty-four pregnant women were enrolled. Based on maternal coffee habits, 82 pregnant women were allocated to the coffee group, while 52 were in the control group. The two groups shared similar demographic and obstetric characteristics. The mean daily coffee intake was 1.4±0.6 cups. Coffee group fetuses evidenced a lower FHR baseline, 135±9.9 bpm, versus the control group, 138±8.0 bpm, (P value = 0.03). Other cCTG parameters did not show statistical differences. Multivariate analysis demonstrated no confounding factors. A subanalysis that evaluated the daily amount of coffee consumed or the half-life of caffeine found no difference in cCTG measures.</p><p><strong>Conclusions: </strong>Maternal caffeine consumption did not influence fetal cardiac reactivity after absorption.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"4-11"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141792820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The use of combined hormonal contraceptive for in-vitro fertilization cycle priming is not associated with decreased pregnancy rate in frozen embryo transfer cycles: a cohort study. 在体外受精周期初始阶段使用复合激素避孕药与冷冻胚胎移植周期妊娠率下降无关:一项队列研究。
IF 1.6
Minerva obstetrics and gynecology Pub Date : 2025-02-01 Epub Date: 2024-01-11 DOI: 10.23736/S2724-606X.23.05408-8
Kristy K Cho, Chen Jing, Niamh M Tallon
{"title":"The use of combined hormonal contraceptive for in-vitro fertilization cycle priming is not associated with decreased pregnancy rate in frozen embryo transfer cycles: a cohort study.","authors":"Kristy K Cho, Chen Jing, Niamh M Tallon","doi":"10.23736/S2724-606X.23.05408-8","DOIUrl":"10.23736/S2724-606X.23.05408-8","url":null,"abstract":"<p><strong>Background: </strong>The objectives of this study are to evaluate the cycle outcomes from IVF treatment preceded by oral contraceptive pills (OCP) priming compared to estradiol pretreatment and to determine if there is a role for OCP priming for those undergoing frozen embryo transfers.</p><p><strong>Methods: </strong>The study took place at a university-affiliated fertility center in Canada. The study included in-vitro fertilization (IVF) antagonist cycles from Jan 2016 to Jun 2019. Those with protocol deviation or treatment cancellation were excluded.</p><p><strong>Results: </strong>There were 2237 cycles by 1958 patients; 27% of cycles utilized OCP priming. The average age in the OCP group was 34 years old compared to 36.5 in the estradiol group (P<0.01). AMH was reported in 43% of patients and was 3.7ng/mL in the OCP group versus 2.2 ng/mL in the estradiol group (P<0.01). The number of oocytes (15.2 vs. 12.5) and number of blastocysts (4.6 vs. 3.3) were higher in the OCP group (P all <0.01). After adjusting for age and AMH with linear regression for the 978 cycles with recorded AMH (24% with OCP prime), a significantly higher number of oocytes (13.8 vs. 11.9, P=0.002) was still noted in the OCP group. There were 866 euploid embryo transfer cycles (28% with OCP prime). There were no significant differences in implantation (77% vs. 76%) or ongoing pregnancy rates (56% vs. 54%) between those who had a frozen embryo transfer after OCP primed compared to estradiol primed stimulation cycles (P all >0.6).</p><p><strong>Conclusions: </strong>There were no differences in pregnancy outcomes from euploid frozen blastocyst transfers after OCP primed antagonist cycles compared to estradiol pretreatment. In fact, the use of OCP pretreatment was associated with increased oocyte yield, keeping in mind demographic differences with the OCP pretreatment group being younger with higher anti-Müllerian hormone and a higher prevalence of PCOS. Thus, OCP priming should still be considered in specific populations, such as those with oligo-ovulation or adequate ovarian reserve.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"12-18"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139425082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Highlights of the January-February 2025 issue. 2025年1月至2月期的亮点。
IF 1.6
Minerva obstetrics and gynecology Pub Date : 2025-02-01 DOI: 10.23736/S2724-606X.25.05768-9
Antonio La Marca
{"title":"Highlights of the January-February 2025 issue.","authors":"Antonio La Marca","doi":"10.23736/S2724-606X.25.05768-9","DOIUrl":"https://doi.org/10.23736/S2724-606X.25.05768-9","url":null,"abstract":"","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":"77 1","pages":"1-3"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
What's new on female genital mutilation/cutting? Recent findings about urogynecologic complications, psychological issues, and obstetric outcomes. 切割女性生殖器官有什么新进展?关于泌尿妇科并发症、心理问题和产科结局的最新发现。
IF 1.6
Minerva obstetrics and gynecology Pub Date : 2025-02-01 Epub Date: 2023-08-04 DOI: 10.23736/S2724-606X.23.05344-7
Alessandro Libretti, Christian Corsini, Valentino Remorgida
{"title":"What's new on female genital mutilation/cutting? Recent findings about urogynecologic complications, psychological issues, and obstetric outcomes.","authors":"Alessandro Libretti, Christian Corsini, Valentino Remorgida","doi":"10.23736/S2724-606X.23.05344-7","DOIUrl":"10.23736/S2724-606X.23.05344-7","url":null,"abstract":"<p><p>Female genital mutilation/cutting (FGM/C or FGM) are injuries to the female genital organs for non-medical reasons. Every year, over 4 million girls are at risk of FGM. Complications of this practice are very common and some of them are still under investigation. The purpose of this short narrative review is to highlight and summarize the main ones. Psychologic and psychiatric sequelae, chronic vulvar pain, urogenital symptoms, pelvic organs prolapse, sexual disfunction, cervical dysplasia and infections resulted as chronic sequalae of FGM. Severe pain, excessive bleeding, and tissues swelling are acute consequences of FGM. Rates of caesarean section, time of second stage of delivery, post-partum blood loss (but not major hemorrhage), peri-clitoral and perineal injuries and episiotomy rates are higher in pregnant women with FGM, when compared with those non victims of mutilation. The female genital mutilation practice is often cause of severe urogynecologic, psychologic and obstetrics sequelae. Although several studies have been carried out on FMG complications and treatments, long term sequelae are still very common and deserve major attention and further research.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"56-61"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9925493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Insights on obstetric outcomes in pregnant individuals with Marfan Syndrome: evidence from the National Inpatient Sample. 对患有马凡氏综合征的孕妇产科结果的观察:来自全国住院病人样本的证据。
IF 1.6
Minerva obstetrics and gynecology Pub Date : 2025-02-01 Epub Date: 2024-03-27 DOI: 10.23736/S2724-606X.23.05425-8
Saeed Baradwan, Majed S Alshahrani, Khalid Khadawardi, Maha Tulbah, Osama Alomar, Abdullah Alyousef, Ibtihal A Bukhari, Ahmed Abu-Zaid
{"title":"Insights on obstetric outcomes in pregnant individuals with Marfan Syndrome: evidence from the National Inpatient Sample.","authors":"Saeed Baradwan, Majed S Alshahrani, Khalid Khadawardi, Maha Tulbah, Osama Alomar, Abdullah Alyousef, Ibtihal A Bukhari, Ahmed Abu-Zaid","doi":"10.23736/S2724-606X.23.05425-8","DOIUrl":"10.23736/S2724-606X.23.05425-8","url":null,"abstract":"<p><strong>Background: </strong>We investigated the potential association between Marfan Syndrome (MFS) and adverse obstetric outcomes using the National Inpatient Sample (NIS) database.</p><p><strong>Methods: </strong>We utilized the International Classification of Diseases (ICD-10) system to identify relevant codes and extracted data from the NIS database covering the period 2016-2019. Descriptive statistics and χ<sup>2</sup> tests were employed to summarize and compare baseline characteristics. Univariate and multivariate regression analyses (adjusted for age, race, hospital region, smoking status, and alcohol misuse) were conducted to evaluate association between MFS and adverse obstetric outcomes. The regression analyses were summarized as Odds Ratios (OR) with 95% confidence intervals (CI).</p><p><strong>Results: </strong>Among the 2,854,149 pregnant individuals, 179 had MFS. Baseline characteristics revealed significant associations between MFS and age, race, and hospital location. Univariate analysis showed MFS individuals had significantly increased risks of amniotic fluid/membrane abnormalities (AFAs, OR=1.64, 95% CI: 1.01-2.68, P=0.045) and postpartum hemorrhage (PPH, OR=3.73, 95% CI: 2.41-5.78, P<0.001). Several obstetric outcomes showed some trends towards increased (multiple gestation, placenta previa, and preterm labor) and decreased (premature rupture of membrane, gestational diabetes, and preeclampsia) obstetric risks with MFS; however, they were not statistically significant. Multivariate analysis showed MFS was significantly associated with increased risks of AFAs (adjusted OR=1.68, 95% CI: 1.03-2.74, P=0.037) and PPH (adjusted OR=3.62, 95% CI: 2.31-5.68, P<0.001).</p><p><strong>Conclusions: </strong>MFS is associated with increased risks of adverse obstetric outcomes, specifically AFAs and PPH. These results highlight the importance of monitoring these specific pregnancy outcomes in MFS individuals to ensure optimal maternal-fetal health.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"27-33"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140293948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Intrauterine device use in adolescence: a narrative review. 青春期宫内节育器的使用:叙述性综述。
IF 1.6
Minerva obstetrics and gynecology Pub Date : 2025-02-01 Epub Date: 2024-10-08 DOI: 10.23736/S2724-606X.24.05405-8
Aikaterini Zoi, Anastasia Vatopoulou, Xara Skentou, Orestis Tsonis, Georgia Galaziou, Nikoleta Koutalia, Kalypso Margariti, Eftychia Chatzisavva, Minas Paschopoulos, Fani Gkrozou
{"title":"Intrauterine device use in adolescence: a narrative review.","authors":"Aikaterini Zoi, Anastasia Vatopoulou, Xara Skentou, Orestis Tsonis, Georgia Galaziou, Nikoleta Koutalia, Kalypso Margariti, Eftychia Chatzisavva, Minas Paschopoulos, Fani Gkrozou","doi":"10.23736/S2724-606X.24.05405-8","DOIUrl":"10.23736/S2724-606X.24.05405-8","url":null,"abstract":"<p><p>Contraceptive use in adolescence remains a challenging issue. Adolescents are at high risk of unintended pregnancies and sexual transmitted infections. During the past few decades intrauterine devices are recommended from global health organization, including the American Academy of Pediatrics, American College of Obstetricians and Gynecologists and World Health Organization as a method of contraception for adolescents. Intrauterine devices are part of the long-acting reversible contraceptives (LARCs) and include the copper bearing device (CU-IUD) and the levonorgestrel intrauterine system (LNG-IUS). IUDs are a safe and effective contraceptive method for adolescents with a failure rate less than 1%. Their use is not limited only in contraception. LNG-IUS 52 mg is approved for treating heavy menstrual bleeding and protection from endometrial hyperplasia in women receiving hormone replacement therapy. It can also be an effective tool in the management of dysmenorrhea, while CU-IUD can provide emergency contraception. Nevertheless, IUDs remain underutilized in this group of population. Adolescents' lack of proper education about contraception and sexual behavior creates myths and misconceptions about the possible side effects and the suitability of IUDs in this age group. Furthermore, health care providers remain skeptical and hesitate to suggest IUDs to adolescents. Other barriers including high cost, concern about confidentiality and difficulties in access contribute to its limited use. It is of high importance to eliminate barriers and offer more accessible contraceptive services to adolescents.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"45-55"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Immune biomarkers in cases of recurrent pregnancy loss and recurrent implantation failure. 复发性妊娠丢失和复发性植入失败病例中的免疫生物标志物。
IF 1.6
Minerva obstetrics and gynecology Pub Date : 2025-02-01 Epub Date: 2024-12-20 DOI: 10.23736/S2724-606X.24.05549-0
Marcelo B Cavalcante, Manoel Sarno, Ricardo Barini
{"title":"Immune biomarkers in cases of recurrent pregnancy loss and recurrent implantation failure.","authors":"Marcelo B Cavalcante, Manoel Sarno, Ricardo Barini","doi":"10.23736/S2724-606X.24.05549-0","DOIUrl":"10.23736/S2724-606X.24.05549-0","url":null,"abstract":"<p><p>Reproductive failures, such as recurrent pregnancy loss (RPL) and recurrent implantation failures (RIF) are a major challenge for reproductive medicine. The current management of RPL and RIF cases identifies some causes for unsuccessful pregnancy in up to half of patients. Several studies have suggested that immune disorders are responsible for an important portion of unexplained cases of RPL and RIF. Moreover, the immune abnormalities responsible for reproductive failures can be classified into disorders related to autoimmunity and changes in cellular immunity. Antiphospholipid syndrome (APS), testing for antiphospholipid (aPL) antibodies, antinuclear antibodies, and antithyroid antibodies are identified as biomarkers of autoimmunity that can predict reproductive failure. The cellular immune response in cases of RPL and RIF can be investigated through the study of natural killer (NK) cells (uterine and peripheral blood) and T lymphocytes (T helper [Th]-1, Th-2, regulatory T and Th-17 cells). Several types of laboratory assays have been used to evaluate the endometrial immune microenvironment, such as the endometrial immune profile and decidualization score. However, the effectiveness of the treatment of RPL and RIF with immunomodulatory drugs has not yet been confirmed. Recently, a group of experts from the International Federation of Gynecology and Obstetrics and the European Society of Human Reproduction and Embryology recommended the investigation of some immune factors and treatment with immunosuppressants in women with RPL. In conclusion, it is important to consider immune abnormalities when managing women with RPL and RIF. The use of immunotherapies must be personalized and based on a specific diagnosis to obtain favorable outcomes.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"34-44"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pathophysiology and diagnostic criteria of PCOS. 多囊卵巢综合征的病理生理及诊断标准。
IF 1.6
Minerva obstetrics and gynecology Pub Date : 2025-01-30 DOI: 10.23736/S2724-606X.24.05612-4
Anna Capozzi, Michele Vignali, Giovanni Scambia, Stefano Lello
{"title":"Pathophysiology and diagnostic criteria of PCOS.","authors":"Anna Capozzi, Michele Vignali, Giovanni Scambia, Stefano Lello","doi":"10.23736/S2724-606X.24.05612-4","DOIUrl":"https://doi.org/10.23736/S2724-606X.24.05612-4","url":null,"abstract":"<p><strong>Introduction: </strong>Polycystic ovary syndrome (PCOS) is a heterogeneous endocrine-metabolic syndrome mainly characterized by ovarian dysfunction, which is only one manifestation of a more complex syndrome with a significant systemic impact.</p><p><strong>Evidence acquisition: </strong>We review scientific literature on the pathophysiology and diagnosis of PCOS evaluating the most relevant data from original articles, reviews and meta-analyses published until June 2024.</p><p><strong>Evidence synthesis: </strong>From a pathophysiological point of view, the concurrence of both metabolic aspects, such as insulin resistance and obesity, and hormonal alterations, such as hyperandrogenemia, might produce the most relevant clinical signs and/symptoms of this syndrome, for instance menstrual irregularities, hair loss, acne and hirsutism. In the latest years, many pieces of evidence highlighted the importance of family history and genetics in the development of the syndrome during adolescence and adult life. According to the available data, hypovitaminosis D could play a detrimental role in the pathogenesis and clinical manifestations of PCOS.</p><p><strong>Conclusions: </strong>PCOS is a challenging endocrine and metabolic dysfunction, due to its different expression among women and to the difficulty in obtaining an accurate diagnosis. The most appropriate approach to women affected by PCOS should involve a multi-step strategy, taking into account the characteristics of each patient, in order to identify the best non-pharmacologic and pharmacologic approach to manage both short- and medium-, and long-term sequelae.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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