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Current Opinion in Obstetrics & Gynecology最新文献

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Recruiting and cultivating future leaders in laboratory science. 招募和培养实验室科学领域的未来领袖。
IF 2.2 4区 医学
Current Opinion in Obstetrics & Gynecology Pub Date : 2024-08-01 Epub Date: 2024-04-29 DOI: 10.1097/GCO.0000000000000957
Alison Bartolucci, Charlene Alouf, Marlane Angle, Sangita Jindal
{"title":"Recruiting and cultivating future leaders in laboratory science.","authors":"Alison Bartolucci, Charlene Alouf, Marlane Angle, Sangita Jindal","doi":"10.1097/GCO.0000000000000957","DOIUrl":"10.1097/GCO.0000000000000957","url":null,"abstract":"<p><strong>Purpose of review: </strong>Technological in-vitro fertilization (IVF) advancements originate in the embryology laboratory, and are accompanied by increased regulatory oversight and risk management. Stakes have never been higher or the need greater for the recruitment and cultivation of leaders in laboratory science to navigate the direction of IVF. Current thought leaders in state-of-the-art laboratories must prioritize this mission to optimize and preserve the future of IVF.</p><p><strong>Recent findings: </strong>Leaders in laboratory science must be able to speak to patients, the lay public, business leaders, scientific colleagues and clinical embryologists. While technically gifted, laboratory leaders may benefit from leadership training. Recruitment of scientists into IVF is currently challenging due to a lack of branding and no clear pipeline for new scientists to enter the field. Once recruited however, cultivation of new leaders requires coaching and skill acquisition over time, in order to create multifaceted laboratory leadership.</p><p><strong>Summary: </strong>Laboratory leaders are typically recruited based on education and experience to lead teams of embryologists. These leaders will adopt new technologies in the laboratory. Therefore, laboratory leaders play a powerful role in IVF requiring leadership skills ultimately driving patient outcomes. These laboratory directors must possess innate leadership abilities or learn how to lead their teams.</p>","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"218-222"},"PeriodicalIF":2.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873809","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}
引用次数: 0
Holistic approach to care for patients with endometriosis. 子宫内膜异位症患者的整体护理方法。
IF 2.2 4区 医学
Current Opinion in Obstetrics & Gynecology Pub Date : 2024-08-01 Epub Date: 2024-05-21 DOI: 10.1097/GCO.0000000000000970
Andrea Molina, Ashlie Carter, Lacy Alexander, Arpit Davé, Kristin Riley
{"title":"Holistic approach to care for patients with endometriosis.","authors":"Andrea Molina, Ashlie Carter, Lacy Alexander, Arpit Davé, Kristin Riley","doi":"10.1097/GCO.0000000000000970","DOIUrl":"10.1097/GCO.0000000000000970","url":null,"abstract":"<p><strong>Purpose of review: </strong>Endometriosis is a chronic, often debilitating, disease which is typically managed with surgery and hormonal medications. However, many patients feel they lack agency when managing endometriosis symptoms. The purpose of this review is to discuss the mental and physical management strategies, the long-term health consequences, and the role of a multidisciplinary team in the treatment of endometriosis.</p><p><strong>Recent findings: </strong>Evidence is becoming more robust regarding the role of complementary care and physical activity in the management of endometriosis. Health risks such as infertility are well known and newer evidence is evolving regarding perinatal and cardiovascular health risks. There are also trends towards multiple specialist involvement in the care of endometriosis and the benefit of interdisciplinary collaboration.</p><p><strong>Summary: </strong>Endometriosis is a frequently recurrent condition requiring not only meticulous medical and surgical care, but also coordinated longitudinal disease management and impact mitigation. Gynecologists should be aware of the short-term and long-term implications of the disease to empower patients on the management of their overall health.</p>","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"266-272"},"PeriodicalIF":2.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141263633","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}
引用次数: 0
Cutting-edge care: unleashing artificial intelligence's potential in gynecologic surgery. 尖端护理：释放人工智能在妇科手术中的潜能。
IF 2.2 4区 医学
Current Opinion in Obstetrics & Gynecology Pub Date : 2024-08-01 Epub Date: 2024-06-12 DOI: 10.1097/GCO.0000000000000971
Marie-Claire Leaf, Kelsey Musselman, Karen C Wang
{"title":"Cutting-edge care: unleashing artificial intelligence's potential in gynecologic surgery.","authors":"Marie-Claire Leaf, Kelsey Musselman, Karen C Wang","doi":"10.1097/GCO.0000000000000971","DOIUrl":"10.1097/GCO.0000000000000971","url":null,"abstract":"<p><strong>Purpose of review: </strong>Artificial intelligence (AI) is now integrated in our daily life. It has also been incorporated in medicine with algorithms to diagnose, recommend treatment options, and estimate prognosis.</p><p><strong>Recent findings: </strong>AI in surgery differs from virtual AI used for clinical application. Physical AI in the form of computer vision and augmented reality is used to improve surgeon's skills, performance, and patient outcomes.</p><p><strong>Summary: </strong>Several applications of AI and augmented reality are utilized in gynecologic surgery. AI's potential use can be found in all phases of surgery: preoperatively, intra-operatively, and postoperatively. Its current benefits are for improving accuracy, surgeon's precision, and reducing complications.</p>","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"255-259"},"PeriodicalIF":2.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141312297","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}
引用次数: 0
Myofascial pelvic pain: the forgotten player in chronic pelvic pain. 肌筋膜性骨盆痛：慢性骨盆痛中被遗忘的角色。
IF 2.2 4区 医学
Current Opinion in Obstetrics & Gynecology Pub Date : 2024-08-01 Epub Date: 2024-05-21 DOI: 10.1097/GCO.0000000000000966
Golnaz Namazi, Navya Chauhan, Stephanie Handler
{"title":"Myofascial pelvic pain: the forgotten player in chronic pelvic pain.","authors":"Golnaz Namazi, Navya Chauhan, Stephanie Handler","doi":"10.1097/GCO.0000000000000966","DOIUrl":"10.1097/GCO.0000000000000966","url":null,"abstract":"<p><strong>Purpose of review: </strong>In this review article, we discuss myofascial-related chronic pelvic pain, pathophysiology, symptomology, and management options.</p><p><strong>Recent findings: </strong>Despite high prevalence of myofascial pelvic pain, screening is not routinely performed by providers. Treatment modalities include pelvic floor physical therapy, pelvic floor trigger point injections with anesthetics or botulinum toxin A and cryotherapy. Other adjunct modalities, such as muscle relaxants and intravaginal benzodiazepines, are used, but data regarding their effectiveness is sparse.</p><p><strong>Summary: </strong>Myofascial pelvic pain is an important, though overlooked component of chronic pelvic pain. Multimodal, multidisciplinary approach including patient education, pelvic floor physical therapy, and trigger point injections is the mainstay of the management of myofascial pelvic pain.</p>","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"273-281"},"PeriodicalIF":2.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141263634","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}
引用次数: 0
Editorial introductions. 编辑介绍。
IF 2.2 4区 医学
Current Opinion in Obstetrics & Gynecology Pub Date : 2024-08-01 Epub Date: 2024-06-27 DOI: 10.1097/GCO.0000000000000973
{"title":"Editorial introductions.","authors":"","doi":"10.1097/GCO.0000000000000973","DOIUrl":"10.1097/GCO.0000000000000973","url":null,"abstract":"","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":"36 4","pages":"v-vi"},"PeriodicalIF":2.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176035","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}
引用次数: 0
Emerging data on diagnosis and management of uterine isthmoceles: a rapid review. 子宫峡部畸形诊断和管理的新数据：快速回顾。
IF 2.2 4区 医学
Current Opinion in Obstetrics & Gynecology Pub Date : 2024-08-01 Epub Date: 2024-05-23 DOI: 10.1097/GCO.0000000000000967
Elizabeth N Cook, Nicholas Jesse, Lara Harvey
{"title":"Emerging data on diagnosis and management of uterine isthmoceles: a rapid review.","authors":"Elizabeth N Cook, Nicholas Jesse, Lara Harvey","doi":"10.1097/GCO.0000000000000967","DOIUrl":"10.1097/GCO.0000000000000967","url":null,"abstract":"<p><strong>Purpose of review: </strong>With a rising number of cesarean sections, the prevalence of uterine isthmoceles is increasing. We performed a rapid review to assess the most recent data on the diagnosis and management of uterine isthmoceles over the past 18 months to identify current trends and directions for continued research.</p><p><strong>Recent findings: </strong>A comprehensive search was conducted in PubMed (NLM), Embase (Ovid), CINAHL (EBSCOhost) to find English written articles discussing the diagnosis or management of uterine isthmoceles published in the previous 18 months. Data extraction was performed on one hundred articles that met inclusion criteria.</p><p><strong>Summary: </strong>This rapid review highlights agreement regarding diagnostic methods, symptoms, and recommended treatment paths for patients with symptomatic uterine niches. However, the diversity in definitions hampers the capacity to formulate detailed conclusions regarding the features of uterine niches and their impact on women's health.</p>","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"313-323"},"PeriodicalIF":2.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141263631","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}
引用次数: 0
Progestin-primed ovarian stimulation. 孕激素刺激卵巢。
IF 2.2 4区 医学
Current Opinion in Obstetrics & Gynecology Pub Date : 2024-06-01 Epub Date: 2024-01-30 DOI: 10.1097/GCO.0000000000000941
Juan Giles, Fabio Cruz, Juan A Garcia-Velasco
{"title":"Progestin-primed ovarian stimulation.","authors":"Juan Giles, Fabio Cruz, Juan A Garcia-Velasco","doi":"10.1097/GCO.0000000000000941","DOIUrl":"10.1097/GCO.0000000000000941","url":null,"abstract":"<p><strong>Purpose of review: </strong>The use of progestins as pituitary suppressors has increased progressively, along with more detailed indications for their use, thereby consolidating an alternative approach to the personalization of ovarian stimulation.</p><p><strong>Recent findings: </strong>Based on the ability of progesterone to inhibit ovulation, progestins have been used in ovarian stimulation (OS) follicular protocols to prevent a luteinizing hormone surge in patients undergoing in vitro fertilization (IVF), as an alternative to gonadotropin-releasing hormone (GnRH) analogue administration. This review explores the different types of progestogen protocols and their efficacy depending on the type of population or reproductive procedure in which they are administered and in comparison with that of GnRH analogues. Their effect on oocytes and embryos and their safety and cost-effectiveness are also analyzed.</p><p><strong>Summary: </strong>Progestins have proven their effectiveness as a gonadotropin adjuvant in terms of ovarian response, reproductive outcome, and safety. In addition, they offer the convenience of oral administration and a lower cost than GnRH analogues. Whereas oocytes or embryos should be vitrified as it displaces the receptive period with the consequent asynchrony between embryo and endometrium. The evidence endorses progestins as a more friendly approach to OS, especially when frozen-thawed embryo transfer is planned.</p>","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"165-172"},"PeriodicalIF":2.2,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139652241","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}
引用次数: 0
GnRH agonist trigger in poor prognosis patients undergoing a multicycle approach through DuoStim or consecutive stimulations: a SWOT analysis. 通过 DuoStim 或连续刺激对预后不良患者进行多周期治疗的 GnRH 激动剂触发：SWOT 分析。
IF 2.1 4区 医学
Current Opinion in Obstetrics & Gynecology Pub Date : 2024-06-01 Epub Date: 2024-03-26 DOI: 10.1097/GCO.0000000000000947
Alberto Vaiarelli, Alessandro Ruffa, María Cerrillo, Juan Antonio García-Velasco
{"title":"GnRH agonist trigger in poor prognosis patients undergoing a multicycle approach through DuoStim or consecutive stimulations: a SWOT analysis.","authors":"Alberto Vaiarelli, Alessandro Ruffa, María Cerrillo, Juan Antonio García-Velasco","doi":"10.1097/GCO.0000000000000947","DOIUrl":"10.1097/GCO.0000000000000947","url":null,"abstract":"<p><strong>Purpose of review: </strong>Identify the most recent and significant evidence regarding the ovulation trigger within the framework of a multicycle approach through DuoStim, providing valuable insights for improving treatment strategies in patients with a poor prognosis.</p><p><strong>Recent findings: </strong>The trigger method plays a pivotal role in optimizing in-vitro fertilization (IVF) stimulation, influencing oocyte retrieval and maturation rates, as well as follicle recruitment in consecutive ovarian stimulations such as double stimulation. Decision-making involves multiple factors and, while guidelines exist for conventional stimulation, specific recommendations for the multicycle approach are not well established.</p><p><strong>Summary: </strong>The different methods for inducing oocyte maturation underscore the need for personalization of IVF protocols. The GnRH agonist trigger induces rapid luteolysis and establishes favorable hormonal conditions that do not adversely affect the recruitment of consecutive follicular waves in the context of DuoStim. It serves as a valid alternative to hCG in freeze-all cycles. This strategy might enhance the safety and flexibility of ovarian stimulations with no impact on oocyte competence and IVF efficacy.</p>","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":"36 3","pages":"124-133"},"PeriodicalIF":2.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868981","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}
引用次数: 0
Abstinence for sperm sample collection and ART outcome: an unsubstantiated myth. 禁欲采集精子样本与抗逆转录病毒疗法的结果：一个未经证实的神话。
IF 2.2 4区 医学
Current Opinion in Obstetrics & Gynecology Pub Date : 2024-06-01 Epub Date: 2024-03-26 DOI: 10.1097/GCO.0000000000000946
Peter N Schlegel
{"title":"Abstinence for sperm sample collection and ART outcome: an unsubstantiated myth.","authors":"Peter N Schlegel","doi":"10.1097/GCO.0000000000000946","DOIUrl":"10.1097/GCO.0000000000000946","url":null,"abstract":"<p><strong>Purpose of review: </strong>Semen analysis is a basic component of male evaluation. Reproductive centers typically instruct men to provide a semen specimen based on recommendations from WHO Standard for semen examination. Evidence that these recommendations optimize sperm reproductive capacity is lacking. Existing data to optimize sperm quality with shorter abstinence were reviewed.</p><p><strong>Recent findings: </strong>Several recent studies have reviewed the effects of shorter ejaculatory abstinence of semen quality and assisted reproductive technology (ART) outcomes. Shorter abstinence was defined as 1 h-1 day in one review, and <4 h in the other systematic meta-analysis and review.</p><p><strong>Summary: </strong>Prior instructions for male patients have not been designed to optimize fertility potential for semen analyses. Optimal sperm quality is obtained by instructing men to have a short abstinence (certainly <1 day, and preferably <4 h) for semen specimens used for in vitro fertilization (assisted reproduction).</p>","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":"36 3","pages":"113-117"},"PeriodicalIF":2.2,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868980","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}
引用次数: 0
Ideal frozen embryo transfer regime. 理想的冷冻胚胎移植制度
IF 2.1 4区 医学
Current Opinion in Obstetrics & Gynecology Pub Date : 2024-06-01 Epub Date: 2024-01-31 DOI: 10.1097/GCO.0000000000000943
Juan Castillo, Shahar Kol
{"title":"Ideal frozen embryo transfer regime.","authors":"Juan Castillo, Shahar Kol","doi":"10.1097/GCO.0000000000000943","DOIUrl":"10.1097/GCO.0000000000000943","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review aims to compare evidence on four criteria (embryo implantation, obstetric outcomes, patient convenience, and IVF-unit efficiency) by analyzing published research on different endometrial preparation methods for frozen embryo transfer (FET).</p><p><strong>Recent findings: </strong>While the artificial-FET cycle provides advantages in scheduling and implantation, it falls short in ensuring optimal obstetric outcomes. In contrast, natural-FET ensures embryo implantation conditions if ovulation is correctly identified. Supplementing with exogenous progesterone shields against low corpus luteum progesterone secretion, crucial for positive obstetric outcomes. In mNC-FET, ovulation is hCG-triggered, closely resembling natural cycles and reducing monitoring visits for enhanced patient convenience.Letrozole is a recommended option for anovulatory patients, preserving endometrial thickness. It is cost-effective, less likely to induce multifollicular development than gonadotropins, and better tolerated.In a novel approach, the natural-proliferative-phase-FET initiates progesterone in an unmediated ovulatory cycle at 7 mm endometrial thickness, combining the benefits of a natural proliferative endometrium with the convenience of scheduled artificial cycles.</p><p><strong>Summary: </strong>The artificial cycle offers scheduling advantages, but may compromise obstetric outcomes. Natural FET relies on accurate ovulation timing for successful implantation. mNC-FET simplifies the process using hCG induction, minimizing clinic visits for improved convenience. Letrozole is highlighted as a cost-effective and well tolerated option in anovulatory patients. A recent innovative approach combines elements of natural and artificial cycles, showing promise for FET procedures.</p>","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"148-154"},"PeriodicalIF":2.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139652240","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}
引用次数: 0
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