European Journal of Obstetrics and Gynecology and Reproductive Biology: X最新文献

{"title":"Results of relugolix/estradiol/norethisterone acetate combination therapy in real-world clinical practice: Effectiveness, tolerability, and factors influencing discontinuation","authors":"A. Santalla-Hernández,&nbsp;M. Naveiro-Fuentes,&nbsp;N. Esquinas-Orellana,&nbsp;LM Benítez-Cejas,&nbsp;M. García-Rivera,&nbsp;J. Fernández-Parra","doi":"10.1016/j.eurox.2025.100442","DOIUrl":"10.1016/j.eurox.2025.100442","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the real-world effectiveness, safety, and tolerability of relugolix/estradiol/norethisterone acetate combination therapy (relugolix CT) for managing symptomatic uterine fibroids in routine gynaecological practice.</div></div><div><h3>Methods</h3><div>A retrospective, observational study was conducted at a tertiary hospital in Spain between June 2023 and January 2025. Adult women with symptomatic uterine fibroids treated with relugolix CT were included, either as a long-term treatment or preoperative management. Clinical outcomes were assessed at baseline, 6 months, and in a subset of patients, at 12 months. Primary endpoints included changes in total bleeding days, heavy menstrual bleeding (HMB) days, and UFS-QoL symptom severity scores (SSS), as well as treatment adherence and adverse events.</div></div><div><h3>Results</h3><div>Among the 142 women who initiated treatment, Relugolix CT significantly reduced total bleeding days (from 12 to 2.2), HMB days (from 7.1 to 0.4), and UFS-QoL SSS (from 27.9 to 15.1) at 6 months (p &lt; 0.05). Amenorrhea was achieved in 52.7 % at 6 months and 66 % at 12 months. Better clinical outcomes were linked to continued treatment. Adverse events were reported in 34.5 % of patients, primarily abdominal pain and vasomotor symptoms. Bone densitometry at 12 months showed no osteoporosis and mild osteopenia in a few patients. Discontinuation was most commonly due to planned surgery or perceived lack of efficacy.</div></div><div><h3>Conclusion</h3><div>Relugolix CT demonstrates strong real-world effectiveness and tolerability for managing symptomatic uterine fibroids, with marked improvements in bleeding and quality of life, and a favourable safety profile.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"29 ","pages":"Article 100442"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926455","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}

{"title":"Ultrasound-guided quadratus lumboum block versus transversus abdominis plane block for post-operative analgesia in patients undergoing total abdominal hysterectomy: A systematic review and meta-analysis","authors":"Hossein Jalilzadeh ,&nbsp;Amirali Farshid ,&nbsp;Mahla Esmaeili ,&nbsp;Yasaman Tamaddon ,&nbsp;Sanam Faizabadi ,&nbsp;Neda Hashemi ,&nbsp;Kimia Mohammadi ,&nbsp;Arash Saberian ,&nbsp;Soroush Yousefi ,&nbsp;Elahe Ahsan ,&nbsp;Rasoul Hossein Zadeh ,&nbsp;Reza Hossein Zadeh ,&nbsp;Mahdyieh Naziri ,&nbsp;Niloofar Deravi","doi":"10.1016/j.eurox.2025.100441","DOIUrl":"10.1016/j.eurox.2025.100441","url":null,"abstract":"<div><h3>Purpose</h3><div>Total abdominal hysterectomy is associated with moderate to severe postoperative pain, often requiring multimodal analgesic strategies. This meta-analysis compares the efficacy of ultrasound-guided quadratus lumborum block (QLB) versus transversus abdominis plane (TAP) block for pain control in this setting.</div></div><div><h3>Methods</h3><div>A systematic search was conducted in January 2025 across PubMed, Scopus, and Web of Science, restricted to English-language publications. Study selection and data extraction followed standard protocols and PRISMA guidelines, with screening performed in two phases and study quality rigorously assessed. Outcomes were synthesized using random-effects meta-analysis, and risk of bias was evaluated.</div></div><div><h3>Results</h3><div>Eight randomized controlled trials (RCTs), encompassing 623 patients, met eligibility criteria and were included in the analysis. QLB was associated with significantly lower postoperative pain scores compared to TAP at 12 h (Hedges’ g = −4.48; 95 % CI: −8.04 to −0.92; p = 0.01) and 24 h (Hedges’ g = −4.16; 95 % CI: −7.56 to −0.77; p = 0.02). No significant differences were observed in duration of analgesia (Hedges’ g = 0.64; p = 0.65) or surgery time (Hedges’ g = 0.02; p = 0.86). Notable, persistent heterogeneity was present across most outcomes. Subgroup and sensitivity analyses did not identify determinants for this variation, and publication bias assessment by trim-and-fill indicated robust primary findings. However, the review was limited by restriction to selected databases, exclusion of gray literature, and inclusion of English-language studies only.</div></div><div><h3>Conclusion</h3><div>Ultrasound-guided QLB may provide superior analgesia to TAP block following total abdominal hysterectomy. Nonetheless, substantial between-study heterogeneity and database/language restrictions limit the generalizability of these findings. Future large-scale, high-quality trials—incorporating standardized endpoints, broader database searching, non-English studies, and gray literature—are warranted to further clarify the optimal regional analgesic approach post-TAH.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"29 ","pages":"Article 100441"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926456","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}

{"title":"Trimester-specific reference intervals for serum N-acetyl-β-D-glucosaminidase in healthy pregnant women in Hainan, China","authors":"Fen Zhou,&nbsp;Yichuan Wang,&nbsp;Ying Zheng,&nbsp;Desheng Wang,&nbsp;Meng Chang,&nbsp;Shichuan Wang","doi":"10.1016/j.eurox.2026.100444","DOIUrl":"10.1016/j.eurox.2026.100444","url":null,"abstract":"<div><div>The absence of gestational age-specific reference intervals for serum N-acetyl-β-<span>D</span>-glucosaminidase (NAG) in pregnant women may lead to clinical misinterpretation. This study aimed to establish trimester-specific reference intervals for serum NAG in healthy pregnant women from Hainan, China, and to characterize its dynamic changes throughout gestation. In this cross-sectional study, 2416 healthy women with singleton pregnancies were stratified by gestational age into three groups: first trimester (1–12 +6 weeks; <em>n</em> = 1295), second trimester (13–27 +6 weeks; <em>n</em> = 670), and third trimester (28–40 weeks; <em>n</em> = 451). Serum NAG levels were measured, and trimester-specific reference intervals were established using the 2.5th to 97.5th percentiles. Serum NAG concentrations increased significantly with advancing gestation (<em>P</em> &lt; 0.0001). The established reference intervals were 12.0–40.0 U/L for the first trimester, 16.0–63.2 U/L for the second trimester, and 29.3–107.0 U/L for the third trimester—all substantially higher than those of the non-pregnant control group (8.0–23.4 U/L). The median NAG level in the third trimester (56.2 U/L) represented a 143 % increase compared to the first trimester (22.5 U/L). This study provides the first gestational age-specific reference intervals for serum NAG in pregnant women in a tropical region of China. The findings confirm that physiological NAG levels increase progressively with gestational age. The use of non-pregnant reference intervals in clinical practice may lead to misclassification of renal function during pregnancy, underscoring the necessity of adopting trimester-specific reference standards in prenatal laboratory settings.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"29 ","pages":"Article 100444"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077968","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}

{"title":"The effect of laser-assisted hatching on clinical outcomes of frozen-thawed embryo transfer at different embryo ages","authors":"Min-Min Ou ,&nbsp;Bi-Yun Liao ,&nbsp;Xing-Hong Chen ,&nbsp;Lin-Lin Hu ,&nbsp;Yu-Lan Lu ,&nbsp;Hai-Mei Qin ,&nbsp;Jun-Li Wang ,&nbsp;Yu-Xia Wei","doi":"10.1016/j.eurox.2026.100448","DOIUrl":"10.1016/j.eurox.2026.100448","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the impact of laser-assisted hatching (LAH) on clinical outcomes in patients undergoing frozen-thawed embryo transfer (FET) cycles with embryos at different developmental stages.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of 2208 patients who underwent vitrification-thawed FET at our reproductive center between October 2018 and June 2024, with some patients contributing multiple cycles. Patients were stratified by embryonic developmental stage into cleavage-stage FET (n = 793) and blastocyst-stage FET (n = 1415) groups. Each group was further subdivided based on post-thawing LAH implementation: Non-LAH and LAH subgroups (cleavage-stage: Non-LAH (n = 363) vs. LAH (n = 430); blastocyst-stage: Non-LAH (n = 532) vs. LAH (n = 883)). Embryological parameters and clinical outcomes were compared across subgroups. Binary logistic regression analysis was performed to assess the impact of LAH on live birth rates after adjusting for confounding factors.</div></div><div><h3>Results</h3><div>In cleavage-stage FET, LAH group had higher clinical pregnancy rate (39.3% vs 27.5%), implantation rate (25.2% vs 17.7%) and live birth rate (25.8% vs 19.8%) than Non-LAH group (P &lt; 0.05), but lower multiple pregnancy rate (5.9% vs 15.0%, P &lt; 0.05). In blastocyst-stage FET, the LAH group had a higher clinical pregnancy rate (67.6% vs 58.5%) and implantation rate (65.0% vs 52.3%) than the Non-LAH group (P &lt; 0.001). There were no statistically significant differences in the miscarriage rate, birth defect rate, and singleton birth weight between the LAH group and the Non-LAH group of different embryo ages (P &gt; 0.05). Binary logistic regression analysis showed that after adjusting for confounding factors, LAH could increase the live birth rate of patients with cleavage FET (OR=1.529, 95% CI=1.081–2.162, P = 0.016). However, it had no effect on the live birth rate of FET patients at the blastocyst stage (OR=0.988, 95% CI=0.794–1.230, P = 0.914).</div></div><div><h3>Conclusion</h3><div>In the FET cycles, LAH can improve the live birth rate of patients undergoing cleavage-stage FET, especially for women aged ≥ 35 years or those with ≤ 2 previous transfers, but has no significant effect on the live birth rate of patients undergoing blastocyst-stage FET. LAH did not increase the risk of perinatal outcomes in either the cleavage-stage or blastocyst-stage embryo transfer.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"29 ","pages":"Article 100448"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147395503","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}

{"title":"Perinatal outcomes after increased fetal movement as counted by a fetal movement acceleration measurement recorder","authors":"Eiji Ryo,&nbsp;Hideo Kamata,&nbsp;Keita Yatsuki,&nbsp;Takashi Kosaka,&nbsp;Kazunori Nagasaka","doi":"10.1016/j.eurox.2025.100428","DOIUrl":"10.1016/j.eurox.2025.100428","url":null,"abstract":"<div><h3>Introduction</h3><div>There is no consensus in perinatal medicine about what increased fetal movement means.</div></div><div><h3>Objective</h3><div>Our purpose was to study the relationship between perinatal outcomes and an increase in gross fetal movement as counted by an objective method.</div></div><div><h3>Methods</h3><div>This was a prospective cohort study. A total of 471 pregnant women recorded fetal movement with a fetal movement acceleration measurement recorder at night weekly after 28 weeks. The ratio of 10-second epochs with fetal movement to all epochs was calculated as a fetal movement parameter when movement could be recorded for more than 4 h on one night. If the parameter was above the 90th percentile on the previously made reference curve, it was defined as increased movement. Women who showed the increased fetal movement at least once were classified into a study group, and the other women were classified into a control group. Perinatal abnormalities between the two groups were compared with the Chi-square test or Fisher’s exact test.</div></div><div><h3>Results</h3><div>A total of 13,931 h were recorded from 390 women, including 74 and 316 women, respectively, in the study and control groups. There were fewer preterm births (1.4 %), non-cephalic presentations at delivery (0 %), and Cesarean deliveries (25.7 %) in the study group than in the control group (15.5 %, 6.0 %, and 39.9 %; p = 0.0003, 0.031, and 0.024, respectively). There were no significant differences in the other perinatal outcomes.</div></div><div><h3>Conclusion</h3><div>An increase in long-term gross fetal movement has a protective effect against preterm birth, non-cephalic presentation at birth, and Cesarean delivery.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"28 ","pages":"Article 100428"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145098017","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}

{"title":"Neuroendocrine carcinoma of the cervix (NECC): A retrospective study of 175 Chinese patients","authors":"Ning Su ,&nbsp;Xiao Li ,&nbsp;Dian Wang ,&nbsp;Min Wang ,&nbsp;Shuping Yan ,&nbsp;Haifeng Qiu","doi":"10.1016/j.eurox.2025.100434","DOIUrl":"10.1016/j.eurox.2025.100434","url":null,"abstract":"<div><h3>Purpose</h3><div>Neuroendocrine carcinoma of the cervix (NECC) is rare and aggressive. We analyzed a dual-center Chinese cohort to describe clinicopathologic features, outcomes, and treatment patterns, and to identify prognostic factors.</div></div><div><h3>Methods</h3><div>We retrospectively included patients with pathologically confirmed NECC treated from June 2012 to June 2021. Variables included age at diagnosis, symptoms, high-risk human papillomavirus (hrHPV), FIGO 2009/2018 stage, tumor histology, tumor diameter, depth of stromal invasion (DOI), lymphovascular space invasion (LVSI), lymph-node metastasis (LNM), and treatments. Follow-up followed NCCN guidance. Survival was assessed using Kaplan–Meier and Cox regression.</div></div><div><h3>Results</h3><div>We analyzed 175 patients. hrHPV was positive in 54.3 % (95/175); 84.0 % (147/175) presented with abnormal vaginal bleeding. By FIGO 2018, 39.4 % (69/175) had stage IIB–IVB disease. On univariable Cox regression analysis, younger age, higher FIGO stage (2009 and 2018), pure NECC histology, deeper DOI, larger tumor diameter, and positive LNM were associated with worse survival. In contrast, multivariable Cox regression analysis revealed that FIGO 2009 stage and DOI were independent predictors of both progression-free survival (PFS) and overall survival (OS); tumor histology was independently associated with OS. Survival did not differ between abdominal and laparoscopic radical hysterectomy. Among surgically treated patients, adjuvant radiotherapy did not improve PFS or OS across early-stage, locally advanced, or late-stage subgroups.</div></div><div><h3>Conclusions</h3><div>In this cohort, primary-tumor factors—especially DOI—and FIGO 2009 stage were independent prognostic factors, whereas surgical route and postoperative radiotherapy showed no survival benefit; these findings can inform staging considerations and treatment decisions for NECC.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"28 ","pages":"Article 100434"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466709","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}

{"title":"Adherence to evidence-based intrapartum care practices and influencing factors among obstetric care providers in Ethiopia: A systematic review and meta-analysis","authors":"Gemeda Wakgari Kitil ,&nbsp;Abiy Tasew Dubale","doi":"10.1016/j.eurox.2025.100431","DOIUrl":"10.1016/j.eurox.2025.100431","url":null,"abstract":"<div><h3>Background</h3><div>Globally standardized evidence-based intrapartum care practices are essential for enhancing health outcomes for mothers and newborns. Despite recent advancements, Ethiopia grapples with significant challenges in maternal healthcare, with the implementation of evidence-based intrapartum practices falling below recognized standards. To address this gap, our systematic review and meta-analysis investigate existing literature to unveil the current state of evidence-based intrapartum care practices and identify contributing factors in Ethiopia.</div></div><div><h3>Methods</h3><div>This study focused on Ethiopian research and adhered to the PRISMA checklist. Thirteen relevant studies were identified through databases such as Google Scholar, Web of Science, PubMed, and Scopus. Using STATA version 14, we systematically extracted data employing a checklist. Heterogeneity was evaluated using I2 tests and the Cochrane Q test statistic. To assess publication bias, a funnel plot, Begg's test, and Egger's weighted regression were employed.</div></div><div><h3>Results</h3><div>In this systematic review and meta-analysis, 1770 research articles were identified, with thirteen studies meeting eligibility criteria for analysis. The pooled prevalence of evidence-based intrapartum care practices was 49.50 % (95 % CI: 39.02–59.98). Factors significantly associated with these practices included good knowledge (OR = 2.64, 95 % CI: 2.04–3.41), in-service training related to intrapartum practice (OR = 2.38, 95 % CI: 1.55–3.64), positive attitudes towards intrapartum care practice (OR = 2.68, 95 % CI: 1.78–4.03), a higher number of obstetric care providers per shift (OR = 2.54, 95 % CI: 1.27–5.10), and educational attainment at the level of Master's degree and above (OR = 4.92, 95 % CI: 2.45–9.91).</div></div><div><h3>Conclusion</h3><div>This study reveals that despite recognizing the importance of evidence-based intrapartum practices, only half of the observed obstetric care providers apply them. Factors influencing their application include knowledge, in-service training, attitudes, staffing, and education. Recommendations include continuous knowledge enhancement, reinforced in-service training, and psychological support. Optimizing staffing and creating pathways for advanced degrees are also proposed to improve evidence-based intrapartum care practices.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"28 ","pages":"Article 100431"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145119442","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}

{"title":"Spontaneous regression rate of high-grade cervical lesions in women under 35 at Dijon University Hospital: Incidence and predictive factors","authors":"TRONCHE Perrine,&nbsp;BOUIT Camille,&nbsp;AHO Serge,&nbsp;DOUVIER Serge,&nbsp;KADHEL Philippe","doi":"10.1016/j.eurox.2025.100436","DOIUrl":"10.1016/j.eurox.2025.100436","url":null,"abstract":"<div><h3>Introduction</h3><div>According to current guidelines, women with CIN 2/3 should undergo a conization procedure. However, for young patients with small lesions, it is possible to consider therapeutic abstention with close monitoring while awaiting potential spontaneous regression. The objectives of this study were to evaluate the regression rate of CIN 2/3 lesions over 24 months of follow-up in women under the age of 35 and to identify predictive factors for spontaneous healing.</div></div><div><h3>Methods</h3><div>This was a retrospective observational study based on data from patients diagnosed with CIN 2 or CIN 3 who underwent close monitoring every 6 months via colposcopy, for a maximum follow-up period of 24 months between May 2008 and May 2024. The primary endpoint was the rate of spontaneous regression of high-grade lesions.</div></div><div><h3>Results</h3><div>104 patients, with a mean age of 27.8 years, were included. Cervical intraepithelial neoplasia spontaneously regressed in 37 patients (35.6 %, <em>95 % CI: 26.4 % – 45.5 %</em>) after a median follow-up of 25.22 months. In multivariate analysis, patients with a lesion limited to a single quadrant were more likely to experience spontaneous healing (<em>OR = 2.98 [1.21–7.34], p = 0.017</em>). No other presumed predictive factors were found to significantly influence spontaneous regression. 2 patients had an in-situ cancer at conization, performed after surveillance and no cases of invasive cancer were described.</div></div><div><h3>Conclusion</h3><div>The results of the study are consistent with the literature and support the possibility of 24-month surveillance of patients with a high-grade lesion, especially given the low risk of progression to more severe disease within two years.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"28 ","pages":"Article 100436"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623826","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}

{"title":"Expert transvaginal ultrasound is determinant for diagnosing pelvic conditions after recurrent implantation failure in IVF","authors":"Aikaterini Selntigia ,&nbsp;Consuelo Russo ,&nbsp;Daniele Farsetti ,&nbsp;Giulia Monaco ,&nbsp;Elvira Nocita ,&nbsp;Sara Valeriani ,&nbsp;Federica Iacobini ,&nbsp;Caterina Exacoustos","doi":"10.1016/j.eurox.2025.100438","DOIUrl":"10.1016/j.eurox.2025.100438","url":null,"abstract":"<div><h3>Objective</h3><div>Recurrent implantation failure (RIF) is a clinical phenomenon characterized by a lack of implantation after several embryo-transfers. The aim of this study was to evaluate missing pelvic pathologies in patients with RIF, following at least two embryo-transfers of good-quality blastocyst, using a dedicated transvaginal ultrasound (TVS) performed by experienced specialists.</div></div><div><h3>Methods</h3><div>This retrospective study included patients with RIF who were admitted to the Gynecological Ultrasound Unit of the University of Rome 'Tor Vergata' between 2020 and 2024 for a second-opinion ultrasound. Only patients with transfers of euploid blastocysts and/or blastocysts from oocytes donation were included. All patients underwent 2D, 3D and Power-Doppler transvaginal examination to evaluate all possible pelvic pathologies.</div></div><div><h3>Results</h3><div>The study included 152 patients who met the inclusion criteria. Pathological pelvic findings were identified in 45 of 152 women during the initial TVS scans performed at the IVF centres before ET, whereas expert TVS evaluation at our center after RIF diagnosed pelvic pathology in 129 of 152 cases (p &lt; 0.0001). Significant differences were observed for all pathological ultrasound findings between the initial IVF center scan and the expert TVS, except for isthmocele. In particular, the lowest overall agreement (OA), Cohen’s Kappa (K) and positive percent agreement (PPA) was described regarding the diagnosis of adenomyosis, uterine malformations, hydrosalpinx and deep infiltrated endometriosis.</div></div><div><h3>Conclusion</h3><div>Our study revealed a significant discrepancy in the diagnosis of ultrasound-detectable pelvic pathologies between IVF centres and our expert gynecological ultrasound unit. This difference highlights the potential underdiagnosis of critical pelvic conditions when ultrasound is performed by not expert sonographers in IVF centres.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"28 ","pages":"Article 100438"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145680825","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}

{"title":"Curcumin, a bioactive supplement for premenstrual syndrome and dysmenorrhea: A systematic review of randomised clinical trials","authors":"Oadi N. Shrateh ,&nbsp;Areesha Jawed ,&nbsp;Muhammad Hamza Shuja ,&nbsp;Kanwal Ashok Kumar ,&nbsp;Syeda Tayyaba Rehan ,&nbsp;Sondos Abdelrhman ,&nbsp;Mashhour Naasan ,&nbsp;Nor Azlia Abdul Wahab","doi":"10.1016/j.eurox.2025.100432","DOIUrl":"10.1016/j.eurox.2025.100432","url":null,"abstract":"<div><h3>Introduction</h3><div>The anti-inflammatory nature of curcumin suggests its potential to modulate the body's inflammatory processes, offering a novel avenue for mitigating heightened inflammatory responses often observed in conditions like PMS and dysmenorrhea.</div></div><div><h3>Methods</h3><div>MEDLINE, Cochrane Central, ScienceDirect, Web of Science, CINAHL, ClinicalTrials.gov, and Google Scholar from their inception to November 12, 2023. The review was conducted according to the Cochrane Handbook for Systematic Reviews of Interventions. The outcomes of interest encompassed evaluating the severity of PMS symptoms and dysmenorrhea, including physical symptoms, behavioral symptoms, mood symptoms. Additionally, the study focused on assessing inflammatory biomarkers, Iron profile and Vitamin D status as other outcomes.</div></div><div><h3>Results</h3><div>Ten randomized controlled trials have evaluated the effectiveness of curcumin in reducing premenstrual syndrome and dysmenorrhea symptoms in women. These studies used various scales such as the Premenstrual Syndrome Screening Tool (PSST) and visual analog scale. Out of ten trials, six of them reported a significant decrease in PMS and dysmenorrhea symptoms. Additionally, six studies evaluated curcumin's association with inflammatory markers, hematological parameters, iron profile, Vitamin D, and sleep patterns. This demonstrated significant association between curcumin and inflammatory markers (nitric oxide metabolites, BDNF, IgE, Il-10, IL-12, hs-CRP), and vitamin D status.</div></div><div><h3>Conclusion</h3><div>The findings of this systematic review suggest that curcumin holds promise in the management of PMS and dysmenorrhea. However, further research is needed to establish optimal dosages and treatment durations, considering potential interactions with iron metabolism. The results encourage the exploration of curcumin as a complementary approach in enhancing the overall well-being of individuals affected by these menstrual conditions.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"28 ","pages":"Article 100432"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466710","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}