Seminars in reproductive medicine最新文献_第2页

Menopause and Body Composition: A Complex Field. 更年期和身体组成：一个复杂的领域。

IF 1.9 3区医学

Seminars in reproductive medicine Pub Date : 2025-06-09 DOI: 10.1055/s-0045-1809531

Hanna-Kaarina Juppi, Jari E Karppinen, Eija K Laakkonen

{"title":"Menopause and Body Composition: A Complex Field.","authors":"Hanna-Kaarina Juppi, Jari E Karppinen, Eija K Laakkonen","doi":"10.1055/s-0045-1809531","DOIUrl":"https://doi.org/10.1055/s-0045-1809531","url":null,"abstract":"Given that menopause affects about half of the world's midlife population, it is crucial to understand its impact beyond traditional menopausal symptomology. For instance, many women, while transitioning through menopause, experience profound changes in body composition. These changes may contribute to postmenopausal reductions in metabolic health. This narrative review explores the influence of menopause on skeletal muscle and adipose tissue, highlighting the decline in muscle mass and strength and the gain and redistribution of adipose tissue, particularly the increase in visceral adiposity. Although menopausal changes in body composition are seemingly extensively studied, the longitudinal studies are not that common, and the precise mechanisms driving body composition changes remain unclear, with uncertainties surrounding the roles of hormonal shifts compared with regular aging, energy balance, and lifestyle factors. Notably, it remains debated whether menopause or estrogen meaningfully influences resting energy expenditure. The review also considers the potential mitigating effects of menopausal hormone therapy and regular exercise. Understanding these changes is essential for developing effective strategies to support women's health during and after menopause.","PeriodicalId":21661,"journal":{"name":"Seminars in reproductive medicine","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258870","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}

引用次数: 0

Progestogens in Menopausal Hormone Therapy: A Double-Edged Sword. 绝经期激素治疗中的孕激素：一把双刃剑。

IF 1.9 3区医学

Seminars in reproductive medicine Pub Date : 2025-05-16 DOI: 10.1055/s-0045-1809186

Olavi Ylikorkala, Johanna M Joensuu, Heli Siitonen, Tomi S Mikkola

{"title":"Progestogens in Menopausal Hormone Therapy: A Double-Edged Sword.","authors":"Olavi Ylikorkala, Johanna M Joensuu, Heli Siitonen, Tomi S Mikkola","doi":"10.1055/s-0045-1809186","DOIUrl":"https://doi.org/10.1055/s-0045-1809186","url":null,"abstract":"Progestogens (norethisterone acetate, medroxyprogesterone acetate, dydrogesterone, micronized progesterone, levonorgestrel, drospirenone, and trimegestone) added to estrogen for endometrial protection are reviewed. They can be given orally or vaginally, norethisterone acetate can also be given transdermally, and levonorgestrel can be given through the intrauterine route. Sequential use of progestogens protects the endometrium if exposure lasts for at least 12 days/month; longer intervals are not safe. Continuous use of progestogens, whether oral, transdermal, or intrauterine, provides the most effective protection. Progestogen addition is accompanied with significant elevations in breast cancer risk, the largest drawback of progestogen use, and dydrogesterone, micronized progesterone, and a levonorgestrel intrauterine device may be safest in this regard. Progestogens also double deep vein thrombosis risk and diminish the positive effect of estrogen on colorectal cancer and vascular health. Recent data imply a neutral effect of progestogens in combination with estrogen on Alzheimer's disease risk, but the risk of vascular dementia is decreased. In conclusion, progestogens are a double-edged sword, effectively protecting the endometrium but causing several side effects and reducing many estrogen-induced benefits. With modern endometrial diagnostic tools, the safety of low-dose unopposed estrogen regimens should be assessed in a prospective controlled trial in women with an intact uterus.","PeriodicalId":21661,"journal":{"name":"Seminars in reproductive medicine","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086592","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}

引用次数: 0

Fertility Challenges Facing Women with Early-Stage Endometrial Cancer. 早期子宫内膜癌妇女面临的生育挑战。

IF 1.4 3区医学

Seminars in reproductive medicine Pub Date : 2025-03-01 Epub Date: 2025-06-06 DOI: 10.1055/s-0045-1809532

Kirsten Tryde Macklon

引用次数: 0

Fertility-Sparing Treatment in Young Women Diagnosed with Endometrial Cancer: Review of Safety, Pregnancy Outcomes, and Current Recommendations. 诊断为子宫内膜癌的年轻女性保留生育能力的治疗：安全性、妊娠结局和当前建议的回顾。

IF 1.4 3区医学

Seminars in reproductive medicine Pub Date : 2025-03-01 Epub Date: 2025-05-02 DOI: 10.1055/s-0045-1809041

Anna Mathilde Yde, Signe Frahm Bjørn, Kirsten Louise Tryde Macklon

{"title":"Fertility-Sparing Treatment in Young Women Diagnosed with Endometrial Cancer: Review of Safety, Pregnancy Outcomes, and Current Recommendations.","authors":"Anna Mathilde Yde, Signe Frahm Bjørn, Kirsten Louise Tryde Macklon","doi":"10.1055/s-0045-1809041","DOIUrl":"10.1055/s-0045-1809041","url":null,"abstract":"With the rising incidence of endometrial cancer, including among young women, and the trend of increasing age among first-time mothers, the need for safe and effective fertility-sparing treatments for endometrial cancer and atypical endometrial hyperplasia has become crucial. Focusing on studies from the past decade, this review synthesizes findings on the safety and outcomes of fertility-sparing treatments for endometrial cancer and atypical endometrial hyperplasia and provides an overview of current treatment recommendations. Fertility-sparing treatment, including hysteroscopic tumor resection followed by hormonal therapy with oral progestins and/or the insertion of a levonorgestrel-releasing intrauterine device, can be offered to a selected group of women of reproductive age who wish to preserve their ability to become pregnant in the future. The safety of conservative treatment for women diagnosed with Stage 1A, Grade 1 endometrial cancer without myometrial invasion is high; however, current evidence on the safety of this treatment for women with Grade 1, Stage 2 endometrial cancer is limited. Even though the success rate in terms of pregnancies and deliveries is high, it is not as high as in the general population, and women should be informed of the potential need for assisted reproductive technology.","PeriodicalId":21661,"journal":{"name":"Seminars in reproductive medicine","volume":" ","pages":"47-53"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051338","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}

引用次数: 0

Fertility Following Fertility-Sparing Surgery for Borderline Ovarian Tumors. 边缘性卵巢肿瘤保留生育能力手术后的生育能力。

IF 1.4 3区医学

Seminars in reproductive medicine Pub Date : 2025-03-01 Epub Date: 2025-07-23 DOI: 10.1055/s-0045-1810420

Stefan Cosyns, Michel De Vos

{"title":"Fertility Following Fertility-Sparing Surgery for Borderline Ovarian Tumors.","authors":"Stefan Cosyns, Michel De Vos","doi":"10.1055/s-0045-1810420","DOIUrl":"10.1055/s-0045-1810420","url":null,"abstract":"Borderline ovarian tumors (BOTs) are commonly diagnosed in women of reproductive age, raising concerns about the impact of surgical management on fertility. This review explores the role of fertility-sparing surgery (FSS) and fertility preservation (FP) strategies in young women diagnosed with BOTs. While FSS carries a slightly higher risk of recurrence compared to bilateral salpingo-oophorectomy, there is growing evidence supporting the safety of FSS, with no adverse effects on 10-year overall survival. In light of this, recent multidisciplinary guidelines recommend FSS for BOT at all stages. A significant proportion of women with BOTs report infertility prior to diagnosis, suggesting a possible pathophysiological link between reduced reproductive fitness and the development of BOT. The potential association between ovarian stimulation (OS) and an increased risk of BOT remains controversial, with current evidence failing to establish a definitive causal link. For women with recurrent stage I BOT and no evidence of peritoneal disease on imaging, OS followed by oocyte retrieval is a viable option before definitive surgery. Notably, a history of BOT does not significantly affect pregnancy outcomes following IVF. FP counseling is essential to tailor treatment plans that address both oncological and reproductive needs in patients undergoing FSS for BOT.","PeriodicalId":21661,"journal":{"name":"Seminars in reproductive medicine","volume":" ","pages":"23-31"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699389","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}

引用次数: 0

After Radical Trachelectomy: Reproductive and Obstetrical Outcomes of Fertility-Sparing Surgery for Cervical Cancer. 根治性气管切除术后：保留生育能力的宫颈癌手术的生殖和产科结果。

IF 1.4 3区医学

Seminars in reproductive medicine Pub Date : 2025-03-01 Epub Date: 2025-04-17 DOI: 10.1055/s-0045-1808092

Sinor Soltanizadeh, Mikkel Rosendahl, Ligita Paskeviciute Frøding, Signe Frahm Bjørn, Berit Jul Mosgaard, Claus Høgdall

{"title":"After Radical Trachelectomy: Reproductive and Obstetrical Outcomes of Fertility-Sparing Surgery for Cervical Cancer.","authors":"Sinor Soltanizadeh, Mikkel Rosendahl, Ligita Paskeviciute Frøding, Signe Frahm Bjørn, Berit Jul Mosgaard, Claus Høgdall","doi":"10.1055/s-0045-1808092","DOIUrl":"10.1055/s-0045-1808092","url":null,"abstract":"Radical trachelectomy has become an accepted fertility-sparing treatment for patients with early-stage cervical cancer. Despite its oncological safety, radical trachelectomy is associated with persistent sexual dysfunction and voiding issues, complicating long-term quality of life. Fertility outcomes demonstrate overall pregnancy rates ranging from 25.7-73%, with less radical procedures such as conization and simple trachelectomy reporting higher pregnancy rates compared with radical trachelectomy. Assisted reproductive treatments might be necessary due to complications such as cervical stenosis. During pregnancy, there is an elevated risk of miscarriage, preterm delivery, and premature rupture of membranes due to cervical shortening. However, less radical fertility-sparing procedures such as conization and simple trachelectomy demonstrate lower preterm delivery rates. Prophylactic cerclage, as well as close monitoring of cervical length during pregnancy, is essential, and cesarean section remains the recommended method of delivery. Recent studies suggest that less radical fertility-sparing procedures may provide comparable oncological safety while reducing complications, highlighting the need to reevaluate surgical approaches. This review provides an overview of reproductive and obstetrical outcomes in patients after treatment for early-stage cervical cancer with trachelectomy. This review additionally emphasizes the need for further research to refine fertility-sparing strategies.","PeriodicalId":21661,"journal":{"name":"Seminars in reproductive medicine","volume":" ","pages":"11-15"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028402","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}

引用次数: 0

Gynecological Cancers. 妇科癌症。

IF 1.4 3区医学

Seminars in reproductive medicine Pub Date : 2025-03-01 Epub Date: 2025-10-01 DOI: 10.1055/s-0045-1811707

Kathleen M Hoeger, Terhi T Piltonen

引用次数: 0

The Safety of Hormone Replacement Therapy in Gynecological Cancer Survivors. 激素替代疗法在妇科癌症幸存者中的安全性。

IF 1.4 3区医学

Seminars in reproductive medicine Pub Date : 2025-03-01 Epub Date: 2025-03-18 DOI: 10.1055/s-0045-1802985

Victoria Dodhia, Ying Cheong

{"title":"The Safety of Hormone Replacement Therapy in Gynecological Cancer Survivors.","authors":"Victoria Dodhia, Ying Cheong","doi":"10.1055/s-0045-1802985","DOIUrl":"10.1055/s-0045-1802985","url":null,"abstract":"Treatment of gynecological cancers often induces a premature menopause. Plus advancing treatments mean more gynecological cancer survivors are living to physiological menopause. Hormone replacement therapy (HRT) has proven substantial long-term benefits in physiological menopause and premature menopause particularly. We aimed to evaluate the current evidence on the safety of HRT in gynecological cancer survivors to help clinicians counsel these patients. HRT is not contraindicated in most gynecological cancer survivors, as evidence available often shows safety or even benefit with HRT use. However, HRT is contraindicated in a few cancers-in low-grade serous ovarian carcinoma, high-risk endometrial carcinoma, and some uterine sarcomas. Caution is advised in high-grade serous, late-stage endometrioid, and granulosa ovarian carcinomas when there is substandard evidence demonstrating safety, but also a theoretical harm present. Due to deficient large randomized controlled trials and methodological biases being present in most studies, HRT use needs to be individualized in most cancers-ovarian carcinomas, endometrial carcinomas, and cervical adenocarcinomas. Justification for HRT use is strong, and HRT is not contraindicated in most gynecological cancers due to largely reassuring evidence. More robust long-term data are needed for further reliable guidance for clinicians and patients.","PeriodicalId":21661,"journal":{"name":"Seminars in reproductive medicine","volume":" ","pages":"54-68"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658580","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}

引用次数: 0

Candidates for Fertility-Sparing Surgery in Case of Ovarian Cancer. 卵巢癌保留生育能力手术的候选者。

IF 1.4 3区医学

Seminars in reproductive medicine Pub Date : 2025-03-01 Epub Date: 2025-04-28 DOI: 10.1055/s-0045-1808243

Myriam Gracia, María Alonso-Espías, Ignacio Zapardiel

{"title":"Candidates for Fertility-Sparing Surgery in Case of Ovarian Cancer.","authors":"Myriam Gracia, María Alonso-Espías, Ignacio Zapardiel","doi":"10.1055/s-0045-1808243","DOIUrl":"10.1055/s-0045-1808243","url":null,"abstract":"Ovarian cancer, a leading cause of gynecological cancer mortality, often affects women of reproductive age. Fertility-sparing surgery (FSS) has emerged as a viable option for selected patients with early-stage ovarian cancer who wish to preserve fertility. Patient and tumor selection criteria focus on preserving ovarian function and reproductive potential without compromising oncological safety. Optimal candidates are young, premenopausal women with disease confined to one ovary and favorable prognostic factors such as early FIGO stage, specific histologic subtypes, and good overall health. FSS typically involves unilateral salpingo-oophorectomy while preserving the uterus and contralateral ovary, achieving survival outcomes comparable to radical surgery in early-stage low-grade tumors. However, its application in higher-risk cases requires cautious evaluation. Multidisciplinary management, involving gynecologic oncologists and reproductive specialists, is essential for successful implementation of FSS, ensuring both oncological safety and preservation of reproductive potential. Long-term follow-up is critical to monitor recurrence and assess reproductive outcomes. Pregnancy after FSS is feasible, with timing guided by cancer type, stage, and individual circumstances. This review summarizes the current knowledge on FSS in ovarian cancer, emphasizing its relevance and the need for further research to refine patient selection and ensure optimal outcomes.","PeriodicalId":21661,"journal":{"name":"Seminars in reproductive medicine","volume":" ","pages":"32-40"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982955","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}

引用次数: 0

Reproduction and Gynecological Cancers. 生殖和妇科癌症。

IF 1.4 3区医学

Seminars in reproductive medicine Pub Date : 2025-03-01 Epub Date: 2025-10-01 DOI: 10.1055/s-0045-1811634

Kirsten Tryde Macklon

引用次数: 0