Obstetrical & Gynecological Survey最新文献

{"title":"Cell-Free DNA Screening for Single-Gene Disorders: Erratum.","authors":"Brighton S Goodhue, Sky E Dainty, Neeta Vora, Jeffrey A Kuller, Matthew R Grace","doi":"10.1097/OGX.0000000000001657","DOIUrl":"https://doi.org/10.1097/OGX.0000000000001657","url":null,"abstract":"","PeriodicalId":19409,"journal":{"name":"Obstetrical & Gynecological Survey","volume":"81 10","pages":"512"},"PeriodicalIF":4.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128428","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":"Inclusive Fertility Treatment: Reproductive Options for LGBTQ+ Families.","authors":"Esther Wu, Danielle Strom, Robert A Roman","doi":"10.1097/OGX.0000000000001600","DOIUrl":"https://doi.org/10.1097/OGX.0000000000001600","url":null,"abstract":"<p><strong>Importance: </strong>As access to and research in LGBTQ+ family building continue to expand, clinicians must be familiar with the evolving literature to effectively counsel patients regarding reproductive options. Unique considerations in this population include selection of donor gametes, comparative efficacy of fertility treatments, use of third-party reproduction, and appropriate timing of cessation and resumption of gender-affirming hormone therapy (GAHT). National organizations, including the American Society for Reproductive Medicine (ASRM), have published guidance addressing the distinct needs of LGBTQ+ individuals pursuing family building.</p><p><strong>Objective: </strong>To review available family-building options for LGBTQ+ individuals and their partners in the United States, with a focus on fertility treatments and assisted reproductive technology (ART), and to highlight barriers to care encountered by this population.</p><p><strong>Evidence acquisition: </strong>A narrative review of obstetrics and gynecology- and LGBTQ-focused research articles and clinical practice guidelines was conducted. Literature searches using relevant keywords related to LGBTQ+ individuals, same-sex couples, transgender and gender-diverse populations, and family building were performed in PubMed and limited to English-language publications.</p><p><strong>Results: </strong>Multiple fertility and ART options exist for LGBTQ+ individuals desiring a genetic connection with their children. Same-sex female couples may pursue donor intrauterine insemination (IUI), in vitro fertilization (IVF), or reciprocal IVF, with pregnancy outcomes comparable to or exceeding those of heterosexual counterparts. Same-sex male couples commonly pursue gestational surrogacy using donor oocytes and a gestational carrier. Transgender and gender-diverse individuals may utilize similar fertility treatments, including IUI, IVF, fertility preservation, and third-party reproduction, with additional considerations related to GAHT.</p><p><strong>Conclusions and relevance: </strong>LGBTQ+ individuals have a broad range of family-building options. Increasing clinician familiarity with these pathways is essential to provide informed counseling, mitigate barriers to care, and facilitate timely referral to fertility specialists.</p>","PeriodicalId":19409,"journal":{"name":"Obstetrical & Gynecological Survey","volume":"81 10","pages":"505-511"},"PeriodicalIF":4.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128407","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":"Management of Monochorionic Twins: A Comprehensive Review of Major Guidelines.","authors":"Sonia Giouleka, Ioannis Tsakiridis, Georgios Michos, Eirini Boureka, Sofoklis Stavros, Anastasios Potiris, Apostolos Mamopoulos, Ioannis Kalogiannidis, Petya Chaveeva, Themistoklis Dagklis","doi":"10.1097/OGX.0000000000001599","DOIUrl":"https://doi.org/10.1097/OGX.0000000000001599","url":null,"abstract":"<p><strong>Importance: </strong>Monochorionic (MC) twin pregnancies are at risk of unique fetal and obstetric complications, which require increased surveillance and specific interventions to minimize the associated neonatal morbidity and mortality.</p><p><strong>Objective: </strong>This review aimed to evaluate and compare the most recently published influential guidelines on the management of monochorionic twin pregnancies.</p><p><strong>Evidence acquisition: </strong>A comparative review of guidelines from the Royal College of Obstetricians and Gynaecologists (RCOG), the Society of Obstetricians and Gynaecologists of Canada (SOGC), the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), the International Federation of Gynecology and Obstetrics (FIGO), and the International Society of Ultrasound in Obstetrics and Gynaecology (ISUOG) was carried out.</p><p><strong>Results: </strong>All the reviewed guidelines recommend the determination of chorionicity and amnionicity in the first trimester, along with the precise labeling of the twins and confirmation of the gestational age based on the crown-rump length of the larger twin or the dates of assisted reproductive techniques. They also encourage the performance of aneuploidy screening during the first trimester, using either a combined nuchal translucency and biochemical markers test or cfDNA. A detailed anatomy scan is recommended, with emphasis on the fetal cardiac assessment. There is agreement on the recommended ultrasonographic surveillance protocol, the diagnostic criteria of TTTS, TAPS, and TRAP, the optimal timing of delivery in case of uncomplicated MC twins, and the need for earlier delivery in case of complications or MCMA twins. All the reviewed medical societies provide similar recommendations regarding the management of pregnancies complicated by TTTS, TAPS, discordant fetal anomaly, and demise of one co-twin. Minor discrepancies were identified regarding the diagnosis and management of sFGR, the routine assessment of cervical length, as well as the first-line aneuploidy screening method.</p><p><strong>Conclusions: </strong>Multiple pregnancies pose significant maternal, fetal, and obstetric risks compared with singleton pregnancies, with MC twins being at the highest risk of adverse perinatal outcomes, particularly in the absence of increased surveillance or therapeutic interventions. The development and implementation of consistent international evidence-based practice guidelines for the prompt diagnosis and management of MC twin pregnancies and their associated complications may contribute to more favorable outcomes.</p>","PeriodicalId":19409,"journal":{"name":"Obstetrical & Gynecological Survey","volume":"81 10","pages":"491-504"},"PeriodicalIF":4.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128421","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":"Nonalcoholic Steatohepatitis (NASH) and Nonalcoholic Fatty Liver Disease (NALFD) in Pregnancy: A Narrative Review.","authors":"Lindsey B Sward, Amy M Phillips, Anna C Thurlby, Jasmine Cooper, Tommy W Wagner, Everett F Magann","doi":"10.1097/OGX.0000000000001579","DOIUrl":"https://doi.org/10.1097/OGX.0000000000001579","url":null,"abstract":"<p><strong>Importance: </strong>Nonalcoholic steatohepatitis/nonalcoholic fatty liver disease (NASH/NALFD) is coupled with a substantial risk of morbidity and mortality and is increasingly identified as a comorbidity in pregnancy. Information about the effect of NAFLD on pregnancy and perinatal outcomes is incomplete.</p><p><strong>Objectives: </strong>This review examines the etiology, pathophysiology, risk factors, diagnosis, management, maternal and perinatal outcomes, and recurrence risk in pregnancies complicated by NASH/NALFD.</p><p><strong>Evidence acquisition: </strong>Electronic databases searched were (PUBMED and Embase). The search terms used were \"pregnancy\" OR \"perinatal care\" AND \"nonalcoholic steatohepatitis\" OR \"NASH\" OR \"NALFD\" OR \"nonalcoholic fatty liver disease. The search was limited to the English language, but not to the years searched.</p><p><strong>Results: </strong>There were 515 abstracts identified, of which 73 are the basis of this review. NAFLD is seen as the hepatic manifestation of the metabolic syndrome (abdominal obesity, low HDL cholesterol, elevated fasting glucose, overweight/obese body mass index). The overall prevalence among pregnant women with NAFLD from a large prospective study was 14%. Consistent risk factors of NAFLD in pregnancy include prepregnancy obesity, metabolic syndrome, type 2 diabetes, and polycystic ovarian syndrome. Diagnosis is confirmed by steatosis, ballooning, and inflammation on liver biopsy. Treatment is primarily weight reduction and lifestyle modifications. Maternal complications during pregnancy include gestational diabetes, hypertension, cesarean delivery, postpartum hemorrhage, and congestive heart failure. Fetal complications include spontaneous abortion, fetal growth restriction, large-for-gestational-age neonates, and preterm birth.</p><p><strong>Conclusions: </strong>The increase in NAFLD in pregnancy parallels the increase in maternal obesity and metabolic syndrome. Unfavorable pregnancy outcomes include hypertensive disorders of pregnancy, cesarean delivery, postpartum hemorrhage, congestive heart failure, early pregnancy losses, fetal growth restriction, large neonates, and preterm deliveries. Management primarily consists of weight reduction and lifestyle modifications.</p><p><strong>Relevance: </strong>The escalating rate of overweight or obese women who become pregnant and the neonates of these women, both of which are being diagnosed with NAFLD at an increasing rate, is very worrisome. Particularly since our only current treatment is weight reduction and lifestyle modifications, neither of which, to date, has been very successful in maternal weight reduction.</p>","PeriodicalId":19409,"journal":{"name":"Obstetrical & Gynecological Survey","volume":"81 9","pages":"449-457"},"PeriodicalIF":4.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Wilson Disease on the Female Reproductive System.","authors":"Andrea Gorodezky, Sara I Jones, Jeffrey A Kuller, Sarah K Dotters-Katz, Matthew R Grace","doi":"10.1097/OGX.0000000000001578","DOIUrl":"https://doi.org/10.1097/OGX.0000000000001578","url":null,"abstract":"<p><strong>Importance: </strong>Wilson disease (WD) is a rare genetic disorder that results in an accumulation of excess copper and can severely impact quality of life through its effects on numerous organ systems. Less is understood, however, about how WD alters the female reproductive system, where its impact is suspected to be wide-ranging.</p><p><strong>Objective: </strong>To provide an overview of the impact of WD on various aspects of women's health, including menstruation, fertility, pregnancy, and menopause. Key considerations and recommendations for management are highlighted throughout.</p><p><strong>Evidence acquisition: </strong>Articles were obtained through a literature search of PubMed and Google Scholar.</p><p><strong>Results: </strong>WD impacts multiple aspects of women's health. WD may lead to delayed menarche, amenorrhea, and decreased fertility. Timely treatment can largely diminish these effects. WD's neuropsychiatric and hepatic manifestations, along with its respective medical therapy, may lead to higher rates of sexual dysfunction. There are many safe contraceptive options available for patients with WD. Treatment should be continued throughout pregnancy, although there are no conclusive guidelines. The safety of breastfeeding in patients with WD is under-studied. Lastly, WD is not known to directly impact menopause.</p><p><strong>Conclusions: </strong>Complete care of female patients with WD requires consideration of its impact on various stages of the reproductive lifespan. Thus, an interdisciplinary team is an important component of optimizing care. Primary research in the field remains limited, and further studies are necessary to advance evidence-based care.</p><p><strong>Relevance: </strong>This review highlights the latest evidence regarding how WD affects women's health, along with recommendations for best management.</p>","PeriodicalId":19409,"journal":{"name":"Obstetrical & Gynecological Survey","volume":"81 9","pages":"443-448"},"PeriodicalIF":4.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892114","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":"Congenital Diaphragmatic Hernia: A Review of Evaluation and Management.","authors":"Sara I Jones, Felix R De Bie, Rachel L Wood, Brita K Boyd, Ryan M Antiel, Jeffrey A Kuller","doi":"10.1097/OGX.0000000000001588","DOIUrl":"https://doi.org/10.1097/OGX.0000000000001588","url":null,"abstract":"<p><strong>Importance: </strong>Congenital diaphragmatic hernia (CDH) has significant implications for neonatal morbidity and mortality that require multidisciplinary antenatal and post-delivery care.</p><p><strong>Objective: </strong>To describe the current evidence behind the etiology, diagnosis, and management of congenital diaphragmatic hernia, with specific attention to risk stratification, multidisciplinary management strategies, fetal cardiovascular morbidity, genetic evaluation, and surgical management of this condition.</p><p><strong>Evidence acquisition: </strong>Evidence for this review was acquired through a comprehensive search of PubMed-indexed articles using MeSH terms and text to search for concepts related to \"Congenital Diaphragmatic Hernia,\" \"prenatal diagnosis,\" \"genetics,\" \"fetal therapy,\" \"embryology,\" \"extracorporeal life support,\" \"surgical management,\" \"prognosis,\" and their synonyms.</p><p><strong>Results: </strong>Neonatal survival and long-term outcomes vary by severity of CDH and are primarily driven by the development of pulmonary hypoplasia. Various factors, including the amount of measurable fetal lung tissue, stomach and liver position, side (right vs. left) of CDH, underlying genetic diagnoses, and concomitant anomalies (especially cardiac) contribute to the prognosis in the setting of prenatally diagnosed CDH. Given the need for multidisciplinary care coordination and anticipated postnatal surgical management, patients identified with a CDH in their fetus should be referred to a tertiary center for antenatal surveillance and delivery.</p><p><strong>Conclusions and relevance: </strong>CDH is associated with high morbidity and mortality; continued attention to prenatal diagnosis and multidisciplinary management of this condition may help improve the quality of life for affected patients.</p>","PeriodicalId":19409,"journal":{"name":"Obstetrical & Gynecological Survey","volume":"81 9","pages":"458-463"},"PeriodicalIF":4.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891863","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":"Preoperative Hyperglycemia in GYN Surgery: Perioperative Considerations.","authors":"Tahireh Markert, Samantha Kaplan, Alison Weidner, Annika Sinha","doi":"10.1097/OGX.0000000000001577","DOIUrl":"https://doi.org/10.1097/OGX.0000000000001577","url":null,"abstract":"<p><strong>Importance: </strong>There is not clear consensus on perioperative A1C goals in gynecologic (GYN) surgery.</p><p><strong>Objective: </strong>To review current literature regarding glycemic control and postoperative outcomes for major GYN surgery for benign, urogynecologic, or oncologic indications.</p><p><strong>Evidence acquisition: </strong>Review conducted using the following databases: MEDLINE via PubMed, Embase via Elsevier, and the Web of Science Core Collection via Clarivate. Included studies were peer-reviewed articles published (1990-current) that examined postoperative complications following major GYN surgery, including hysterectomy, myomectomy, debulking, adnexal mass, vulvectomy, sacrocolpopexy, and percutaneous neurostimulator implants. Data extracted included study design, demographic data, type of surgery, complications, and measure of glycemic control.</p><p><strong>Results: </strong>Of 698 studies, 14 were included: 4 in benign GYN literature, 3 in urogynecology literature, and 7 in GYN oncology literature. In benign GYN literature, hemoglobin A1C values greater than 9% were directly associated with surgical site infection (SSI). In urogynecology, A1C greater than 8% was associated with increased urinary tract infections, wound separation, midurethral sling failure, and composite complications. Finally, in GYN oncology, an A1C greater than or equal to 7% was associated with decreased recurrence-free survival and cancer-specific survival. Preoperative glucose above 110 mg/dL was associated with increased risk of deep vein thrombosis (DVT) in ovarian cancer patients and risk of SSI in endometrial cancer patients.</p><p><strong>Conclusions and relevance: </strong>High preoperative A1C is associated with worse postoperative outcomes in the setting of major GYN surgeries. Here we provide guidelines by GYN subspecialty.</p>","PeriodicalId":19409,"journal":{"name":"Obstetrical & Gynecological Survey","volume":"81 8","pages":"406-413"},"PeriodicalIF":4.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148685370","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":"From Survival to Recovery: Long-Term Sequelae of Severe Maternal Morbidity and Obstetric Critical Illness.","authors":"Brooke E Schroeder, Jeffrey A Kuller, Amanda Craig, Sarah K Dotters-Katz, Deepshikha Ashana","doi":"10.1097/OGX.0000000000001576","DOIUrl":"https://doi.org/10.1097/OGX.0000000000001576","url":null,"abstract":"<p><strong>Importance: </strong>Severe maternal morbidity (SMM) and obstetric critical illness are rising in the United States and contribute to striking maternal health disparities. While the acute complications of severe maternal morbidity are well documented, the long-term physical and psychosocial consequences remain understudied.</p><p><strong>Objective: </strong>To conduct a narrative review of the long-term consequences of severe maternal morbidity, including obstetric critical illness, and interventions for improving health outcomes.</p><p><strong>Evidence acquisition: </strong>Original and review articles were identified using a structured search strategy in PubMed and relevant OpenEvidence searches; pertinent articles were reviewed.</p><p><strong>Results: </strong>Severe maternal morbidity and obstetric ICU admission are associated with increased risks of hospital readmission, chronic cardiovascular and renal disease, psychiatric sequelae, including posttraumatic stress disorder, reduced quality of life, and adverse reproductive outcomes. Specific maternal morbidity conditions, such as hypertensive disorders of pregnancy, peripartum cardiomyopathy, postpartum hemorrhage, and peripartum hysterectomy, each carry distinct long-term health risks. Interventions including multidisciplinary specialty clinics, structured care transitions to primary care providers, psychosocial screening and support, and expansion of postpartum Medicaid coverage show promise in improving maternal health outcomes and reducing disparities. However, implementation remains inconsistent, and longitudinal data are needed.</p><p><strong>Conclusions: </strong>Survivors of severe maternal morbidity experience significant long-term health burdens that extend beyond the postpartum period. Holistic, multidisciplinary models of follow-up and expanded health policy initiatives are needed to address gaps in care and improve long-term maternal outcomes.</p><p><strong>Relevance: </strong>This review offers an overview of the literature about the long-term consequences of severe maternal morbidity and obstetric critical illness.</p>","PeriodicalId":19409,"journal":{"name":"Obstetrical & Gynecological Survey","volume":"81 8","pages":"397-405"},"PeriodicalIF":4.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148685408","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":"Clinical Nuances of Preterm Prelabor Rupture of Membranes: A Literature Review.","authors":"Adwoa A Baffoe-Bonnie, Sara Jones, Elizabeth Livingston, Jeffrey A Kuller, Sarah K Dotters-Katz","doi":"10.1097/OGX.0000000000001575","DOIUrl":"https://doi.org/10.1097/OGX.0000000000001575","url":null,"abstract":"<p><strong>Importance: </strong>Preterm premature rupture of membranes (PPROM) presents significant challenges in obstetric care, particularly due to its association with both maternal and neonatal morbidity. Management becomes even more complex when PPROM occurs in the context of coexisting maternal conditions or atypical clinical scenarios.</p><p><strong>Objective: </strong>To review common clinical challenges in the management of PPROM and summarize the available evidence on outcomes and current recommendations.</p><p><strong>Evidence acquisition: </strong>A comprehensive literature search was conducted using PubMed to identify relevant studies, systematic reviews, and practice guidelines. Articles addressing PPROM complicated by concurrent maternal, fetal, or obstetric conditions were reviewed and synthesized.</p><p><strong>Results: </strong>Evidence remains limited in many nuanced clinical scenarios involving PPROM. Studies suggest that outcomes and management may differ in cases of PPROM occurring near the limit of viability, with coexisting infections (eg, HSV or HIV), in the setting of cerclage, or in twin gestations. Although guidelines support expectant management of otherwise uncomplicated cases occurring at <34 0/7 weeks' gestation, individualization of care is often necessary. Factors such as gestational age, presence of infection or labor, cerclage status, and maternal comorbidities influence decision-making. Shared decision-making is critical, and emerging tools, such as amniotic fluid biomarkers, may aid in guiding clinical choices.</p><p><strong>Conclusions: </strong>PPROM management must be tailored to the clinical context. While general recommendations exist, special scenarios require individualized care based on available evidence and patient values.</p><p><strong>Relevance: </strong>This review provides insight into management strategies and expected outcomes in complex cases of PPROM, supporting clinicians in navigating less straightforward presentations.</p>","PeriodicalId":19409,"journal":{"name":"Obstetrical & Gynecological Survey","volume":"81 7","pages":"361-369"},"PeriodicalIF":4.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148397245","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":"A New Perspective on Endometriosis: How Gut and Reproductive Tract Microbiota Influence Disease Progression?","authors":"Han Yan, Yunhua Yi, Jichan Nie","doi":"10.1097/OGX.0000000000001557","DOIUrl":"10.1097/OGX.0000000000001557","url":null,"abstract":"<p><strong>Importance: </strong>Endometriosis, a chronic inflammatory condition affecting 10% of reproductive-aged individuals, remains underdiagnosed and poorly managed due to a limited understanding of its pathogenesis. Emerging evidence highlights the gut and reproductive tract microbiota as key modulators of estrogen metabolism, immune dysregulation, and inflammation, offering novel insights into disease mechanisms and therapeutic opportunities.</p><p><strong>Objective: </strong>To synthesize current evidence on the mechanistic roles of microbiota in endometriosis pathogenesis, evaluate the diagnostic and therapeutic potential of microbial biomarkers and microbiota-targeted interventions, and identify priorities for translational research.</p><p><strong>Evidence acquisition: </strong>A systematic review of PubMed, Scopus, and Web of Science databases identified preclinical and clinical studies exploring microbiota-endometriosis interactions. The search strategy incorporated the terms \"endometriosis\" in combination with \"microbiota,\" \"reproductive tract,\" and \"gut\" to investigate microbial associations within gastrointestinal and reproductive systems in the context of the disease.</p><p><strong>Results: </strong>Dysbiotic microbial profiles, characterized by reduced Lactobacillus and elevated Fannyhessea species, correlate with altered estrogen metabolism, pro-inflammatory cytokine production (eg, IL-6, TNF-α), and impaired immune surveillance in endometriosis. Preclinical studies demonstrate that probiotics and FMT attenuate lesion growth and inflammation in animal models, though human data remain limited. Noninvasive microbial signatures show promise for diagnostic applications, while causal validation in germ-free models and personalized microbiota-based therapies represent critical research gaps.</p><p><strong>Conclusions: </strong>The microbiota modulates endometriosis progression through hormonal, immune, and inflammatory pathways. Microbial biomarkers and therapies may improve diagnosis and treatment but require rigorous clinical validation.</p><p><strong>Relevance: </strong>Advancing microbiota research could enable noninvasive diagnostics, precision therapies, and prevention strategies.</p>","PeriodicalId":19409,"journal":{"name":"Obstetrical & Gynecological Survey","volume":"81 7","pages":"355-360"},"PeriodicalIF":4.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148397300","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}