FS Reports最新文献

{"title":"Impact of demographic and clinical factors on elagolix plus add-back therapy effects on patient-reported nonbleeding symptoms in women with heavy menstrual bleeding and uterine fibroids: a post hoc analysis of data from two clinical trials","authors":"","doi":"10.1016/j.xfre.2024.06.002","DOIUrl":"10.1016/j.xfre.2024.06.002","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate the efficacy of elagolix plus add-back therapy (estradiol [1 mg] and norethindrone acetate [0.5 mg] once daily) on patient-reported nonbleeding symptoms and menstrual bleeding associated with uterine fibroids (UFs) across different subpopulations.</p></div><div><h3>Design</h3><p>Post hoc analysis of two phase 3 clinical trials—Elaris UF-1 and UF-2.</p></div><div><h3>Setting</h3><p>A total of 76 (UF-1) and 77 (UF-2) US clinical sites.</p></div><div><h3>Patient(s)</h3><p>Women (N = 591) with UFs and heavy menstrual bleeding.</p></div><div><h3>Intervention(s)</h3><p>Elagolix (300 mg) twice daily with add-back therapy (the indicated dose for UF-associated heavy menstrual bleeding) vs. placebo for 6 months.</p></div><div><h3>Main Outcome Measure(s)</h3><p>“Very much improved” or “much improved” change in nonbleeding symptoms (abdominal/pelvic pain, abdominal/pelvic pressure/cramping, back pain, and abdominal bloating) and menstrual bleeding measured using a Patient Global Impression of Change scale. Improvements were assessed in subpopulations stratified using baseline characteristics (age, race [self-reported], body mass index, and International Federation of Gynecology and Obstetrics fibroid classification).</p></div><div><h3>Result(s)</h3><p>Across subpopulations, differences favored elagolix plus add-back therapy (vs. placebo) for most symptoms at month 1 and all symptoms at months 3 as well as 6. In patients with characteristics commonly associated with high disease burden (age &gt;40 years, Black/African American), those treated with elagolix plus add-back therapy reported significantly greater improvements vs. placebo at months 1–6 (<em>P</em>&lt;.05) for all nonbleeding and bleeding symptoms (<em>P</em>≤.05).</p></div><div><h3>Conclusion(s)</h3><p>Premenopausal women with heavy menstrual bleeding and UFs receiving elagolix plus add-back therapy experienced significant improvements in nonbleeding as well as bleeding symptoms from months 1–6, regardless of baseline characteristics.</p></div><div><h3>Clinical Trial Registration Number</h3><p>NCT02654054 and NCT02691494.</p></div>","PeriodicalId":34409,"journal":{"name":"FS Reports","volume":"5 3","pages":"Pages 285-295"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666334124000734/pdfft?md5=cc38af74c44775138d3bc776b91f6de5&pid=1-s2.0-S2666334124000734-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141397269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Which obstetrics-gynecology residency programs are training future reproductive endocrinology and infertility fellows? An observational study","authors":"Zachary S. Anderson M.D. ,&nbsp;Erika P. New M.D. ,&nbsp;Aaron D. Masjedi M.D. ,&nbsp;M. Blake Evans D.O.","doi":"10.1016/j.xfre.2024.07.003","DOIUrl":"10.1016/j.xfre.2024.07.003","url":null,"abstract":"<div><h3>Objective</h3><p>To identify where reproductive endocrinology and infertility (REI) fellows trained for residency.</p></div><div><h3>Design</h3><p>Observational, cross-sectional study.</p></div><div><h3>Setting</h3><p>Not applicable.</p></div><div><h3>Subject(s)</h3><p>Reproductive endocrinology and infertility fellows.</p></div><div><h3>Intervention(s)</h3><p>Not applicable.</p></div><div><h3>Main Outcome Measure(s)</h3><p>Percentage of fellows who completed residency training at an institution with an REI fellowship program.</p></div><div><h3>Result(s)</h3><p>A total of 289 fellows were identified among the graduating fellowship classes from 2023–2027. Of those fellows, 69.9% completed residency at an institution that had an associated REI fellowship program, and 19.7% remained at the same institution for residency and fellowship. In the last 5 years, 34.4% of obstetrics and gynecology residency programs have had at least 1 resident enter REI fellowship.</p></div><div><h3>Conclusion(s)</h3><p>Most matriculated REI fellow physicians train at residency programs that have an associated REI fellowship program.</p></div>","PeriodicalId":34409,"journal":{"name":"FS Reports","volume":"5 3","pages":"Pages 259-262"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666334124000801/pdfft?md5=09add9b4b973c7481ea8804553c4576b&pid=1-s2.0-S2666334124000801-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141850548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum progesterone concentration in frozen embryo transfer preparation: how (and if) we should measure it","authors":"Allison A. Eubanks M.D. ,&nbsp;Dominque de Ziegler M.D. ,&nbsp;Kate Devine M.D.","doi":"10.1016/j.xfre.2024.08.004","DOIUrl":"10.1016/j.xfre.2024.08.004","url":null,"abstract":"","PeriodicalId":34409,"journal":{"name":"FS Reports","volume":"5 3","pages":"Pages 248-249"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666334124000850/pdfft?md5=6213d972fcdf79142bff67f8c2389980&pid=1-s2.0-S2666334124000850-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142240965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transvaginal radiofrequency ablation: a therapeutic option for managing symptomatic uterine fibroids in women with reproductive desires","authors":"Ma Eugenia Marín Martínez M.D. ,&nbsp;Sara Cruz-Melguizo M.D., Ph.D. ,&nbsp;Gema Vaquero Argüello M.D. ,&nbsp;Virginia Engels Calvo M.D., Ph.D. ,&nbsp;Ma Luisa De la Cruz Conty Ph.D. ,&nbsp;Tirso Pérez Medina M.D., Ph.D.","doi":"10.1016/j.xfre.2024.07.001","DOIUrl":"10.1016/j.xfre.2024.07.001","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate whether transvaginal radiofrequency (RF) ablation of fibroids is a technique that can be offered to women with reproductive desires.</p></div><div><h3>Design</h3><p>Unicentric, prospective, observational study.</p></div><div><h3>Setting</h3><p>University Hospital.</p></div><div><h3>Patient(s)</h3><p>Twenty-seven individuals who desired to become mothers after undergoing RF ablation for symptomatic fibroids.</p></div><div><h3>Intervention(s)</h3><p>Transvaginal RF ablation for symptomatic fibroids with a maximum total volume of 145 cm³.</p></div><div><h3>Main Outcome Measure(s)</h3><p>The reduction in the size of the fibroids, improvement of symptoms, and reproductive outcomes during the 24 months after the ablation. For patients who achieved pregnancy, we assessed the type of conception, course of gestation, type of delivery, neonatal outcomes, and occurrence of both maternal and fetal complications.</p></div><div><h3>Result(s)</h3><p>A statistically significant reduction in symptoms related to the fibroids 6 months after the ablation was demonstrated through the implementation of the Symptom Severity Scale. No patient required hospitalization after the procedure, and on average from the third day after intervention, they resumed their work activities without the need for analgesics. Among those patients who attempted pregnancy during the 24-month follow-up period, 73.68 % (14/19) achieved motherhood. There were no cases of uterine rupture, premature birth, or intrauterine fetal death.</p></div><div><h3>Conclusion(s)</h3><p>Radiofrequency ablation for fibroids seems to be a promising, safe, and low-complexity alternative that does not appear to interfere with the development of a normal term gestation.</p></div>","PeriodicalId":34409,"journal":{"name":"FS Reports","volume":"5 3","pages":"Pages 320-327"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666334124000783/pdfft?md5=90a85168e256639444f1170c5361da76&pid=1-s2.0-S2666334124000783-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141697177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reviewers of the Year 2023. F&S Reports celebrates excellence in our world class reviewers","authors":"","doi":"10.1016/j.xfre.2024.07.004","DOIUrl":"10.1016/j.xfre.2024.07.004","url":null,"abstract":"","PeriodicalId":34409,"journal":{"name":"FS Reports","volume":"5 3","pages":"Pages 231-232"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666334124000813/pdfft?md5=2b084e87a9d7f90d08e2b2b3212a65ae&pid=1-s2.0-S2666334124000813-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142240902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mifepristone: from the public eye to the reproductive endocrinology and infertility specialists’ eye","authors":"Vinita M. Alexander M.D., M.S.C.I.","doi":"10.1016/j.xfre.2024.08.008","DOIUrl":"10.1016/j.xfre.2024.08.008","url":null,"abstract":"","PeriodicalId":34409,"journal":{"name":"FS Reports","volume":"5 3","pages":"Page 250"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666334124000898/pdfft?md5=0d7c61e51bc3c7d5021ead0806904127&pid=1-s2.0-S2666334124000898-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142240899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initially categorized 46,XY embryo transfer ending with 45,X products of conception—a case report and a review of discordant result management","authors":"","doi":"10.1016/j.xfre.2024.05.006","DOIUrl":"10.1016/j.xfre.2024.05.006","url":null,"abstract":"<div><h3>Objective</h3><p>To report a case of an initially categorized euploid male embryo screened using preimplantation genetic testing (PGT) resulting in miscarriage and testing of products of conception consistent with Turner syndrome, and to discuss additional workup and considerations in cases of discrepancy.</p></div><div><h3>Design</h3><p>Case report.</p></div><div><h3>Setting</h3><p>University fertility clinic.</p></div><div><h3>Intervention</h3><p>Frozen single embryo transfer of a euploid male embryo.</p></div><div><h3>Patient(s)</h3><p>A couple seeking procreative management for a female partner having a balanced translocation 46,XX,t(14;16)(q21;q21) diagnosed after the couple’s previous child passed because of segmental duplication in chromosomes 14 and 16 and pursued in vitro fertilization treatment for PGT for structural rearrangements.</p></div><div><h3>Main Outcome Measure(s)</h3><p>Miscarriage with discordant chromosomal microarray result.</p></div><div><h3>Result(s)</h3><p>Couple conceived with the transfer of a euploid male embryo. After the initial confirmation of pregnancy, repeat imaging indicated a missed abortion. Dilation and curettage were performed, and the products of conception were sent for chromosomal microarray. Results indicated Turner syndrome (45,X). Follow-up short tandem repeat analysis confirmed the products of conception were from the tested embryo. After reevaluation of the data, copy number variations below the reporting threshold for the sex chromosomes were observable and compatible with mosaic 45,X/46,XY.</p></div><div><h3>Conclusion(s)</h3><p>The limitations of PGT should be kept in mind when counseling patients because of both the sample provided by biopsy, the sequencing platforms and the laboratory pipeline for diagnosis. We recommend that patients be counseled about these limitations and offered antenatal and postnatal testing as indicated. When discrepancies are seen after PGT, collaboration with the reference laboratory and additional testing with short tandem repeat analysis should be considered when possible.</p></div>","PeriodicalId":34409,"journal":{"name":"FS Reports","volume":"5 3","pages":"Pages 328-332"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666334124000576/pdfft?md5=8cff55ff1e503dd3fe2e27407cc928a1&pid=1-s2.0-S2666334124000576-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141136922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of early pregnancy loss by reproductive endocrinologists: does access to mifepristone matter?","authors":"","doi":"10.1016/j.xfre.2024.05.005","DOIUrl":"10.1016/j.xfre.2024.05.005","url":null,"abstract":"<div><h3>Objective</h3><p>To describe patterns and variations in the medical and procedural management of early pregnancy loss (EPL) among reproductive endocrinology and infertility specialists, with attention to mifepristone use.</p></div><div><h3>Design</h3><p>Cross-sectional.</p></div><div><h3>Setting</h3><p>Online survey.</p></div><div><h3>Patients</h3><p>Society for Reproductive Endocrinology and Infertility members.</p></div><div><h3>Intervention</h3><p>Not applicable.</p></div><div><h3>Main Outcome Measure</h3><p>Preferred management for EPL.</p></div><div><h3>Results</h3><p>Of 101 completed surveys (response rate: 12.2%), 70.3% of respondents reported diagnosing EPL at least once per week. Half (50.5%) of respondents preferred medical management compared with 27.7% who preferred procedural management and 21.8% who preferred expectant management. Approximately one-quarter (26.7%) of respondents offer mifepristone for medical management of EPL. The most common reason cited for not prescribing mifepristone was a lack of access to the medication. Mifepristone prescribers were more likely to work in a hospital or university setting than private practice. Increasing years in practice was also associated with mifepristone use. The use of mifepristone for EPL did not vary by the respondent’s age, gender, prior abortion training, or practice region.</p></div><div><h3>Conclusion</h3><p>The most effective method of medical management uses both mifepristone and misoprostol. However, nearly three-quarters of reproductive endocrinology and infertility physicians do not offer mifepristone, which may be linked to access issues.</p></div>","PeriodicalId":34409,"journal":{"name":"FS Reports","volume":"5 3","pages":"Pages 252-258"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666334124000564/pdfft?md5=167091ab4208492b454d64de377feb59&pid=1-s2.0-S2666334124000564-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141142230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lack of adequate counseling about pregnancy complications in patients with polycystic ovary syndrome: a cross-sectional survey study","authors":"","doi":"10.1016/j.xfre.2024.05.004","DOIUrl":"10.1016/j.xfre.2024.05.004","url":null,"abstract":"<div><h3>Objective</h3><p>To assess the counseling experiences of patients with polycystic ovary syndrome (PCOS) related to obstetric complications and preconception management of comorbidities.</p></div><div><h3>Design</h3><p>Cross-sectional survey study.</p></div><div><h3>Setting</h3><p>Not applicable.</p></div><div><h3>Patient(s)</h3><p>Patients with PCOS with a history of or attempt at pregnancy.</p></div><div><h3>Intervention(s)</h3><p>Not applicable.</p></div><div><h3>Main Outcome Measure(s)</h3><p>Demographic characteristics, medical history, and counseling experiences.</p></div><div><h3>Result(s)</h3><p>Of the 302 respondents, 72.9% had a previous pregnancy, with 66.8% reporting complications during pregnancy. Of the entire cohort, 52.7% received preconception counseling on PCOS-related obstetric complications, and 41.5% were satisfied with their counseling experience. Five percent were counseled on related postpartum complications, and 43.4% received counseling about prepregnancy weight management, with the minority satisfied with their counseling. Among the respondents with existing comorbidities including hypertension, diabetes, and anxiety or depression, the minority received counseling on their preconception management. Although there were no racial disparities in the overall counseling of pregnancy complications, more black patients were counseled about preeclampsia, cesarean section, and preterm birth than white patients. Of the patients who had a single provider managing their PCOS care, 78.6% who saw a reproductive endocrinologist, 53.2% who saw a general gynecologist, and 35.0% who saw a primary care physician reported receiving counseling on related pregnancy complications.</p></div><div><h3>Conclusion(s)</h3><p>Despite the high prevalence of obstetric complications associated with PCOS, our study revealed inadequate patient counseling about both the antepartum and postpartum periods and preconception management of existing comorbidities. Our findings highlight the urgent need to increase provider education and patient awareness to optimize maternal and neonatal outcomes.</p></div>","PeriodicalId":34409,"journal":{"name":"FS Reports","volume":"5 3","pages":"Pages 312-319"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666334124000552/pdfft?md5=50ded24996e346fbaefc4a8e2a174203&pid=1-s2.0-S2666334124000552-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141133130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Race and ethnicity expression in reproductive endocrinology and infertility research studies compared with other obstetrics and gynecology subspecialty studies","authors":"","doi":"10.1016/j.xfre.2024.06.001","DOIUrl":"10.1016/j.xfre.2024.06.001","url":null,"abstract":"<div><h3>Objective</h3><p>To compare the percentage of patients per race and ethnicity group in the most cited reproductive endocrinology and infertility studies with the most cited studies in 3 other obstetrics and gynecology (OBGYN) subspecialties: gynecologic oncology, urogynecology (URO), and maternal-fetal medicine.</p></div><div><h3>Design</h3><p>Retrospective cohort study.</p></div><div><h3>Setting</h3><p>Not applicable.</p></div><div><h3>Patient(s)</h3><p>Patients previously recruited in research studies.</p></div><div><h3>Intervention(s)</h3><p>None.</p></div><div><h3>Main Outcome Measure(s)</h3><p>Expression of minorities in research studies.</p></div><div><h3>Result(s)</h3><p>Individual searches were conducted for the most cited articles in OBGYN subspecialties until 50 studies met the inclusion criteria for each OBGYN subspecialty. A total of 29,821,148 patients were included and compared between subspecialty and US Census data. Reproductive endocrinology and infertility studies had the highest percentage of White patients (80.5%), although URO studies had fewer Black patients (6.6%) compared with other subspecialties. Reproductive endocrinology and infertility studies had the lowest percentage of Hispanic patients (4.9%), yet more Asian patients were present in URO studies (3.3%) than in other subspecialties. Gynecologic oncology studies were most likely to have missing data in race expression (19.3%). Comparing study types, retrospective studies had the highest percentage of White patients (61.9%), although randomized controlled trials had the lowest expression of Hispanic patients (8.8%).</p></div><div><h3>Conclusion(s)</h3><p>Reproductive endocrinology and infertility studies featured the highest rates of White patients compared with other OBGYN subspecialty studies, although URO studies had the lowest rates of Black patients. Randomized controlled trials featured higher rates of White patients and lower levels of Hispanic patients compared with US Census data.</p></div>","PeriodicalId":34409,"journal":{"name":"FS Reports","volume":"5 3","pages":"Pages 304-311"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666334124000722/pdfft?md5=3da65dc63eeee52dcd5f0289d4887068&pid=1-s2.0-S2666334124000722-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141411197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}