Current Opinion in Obstetrics & Gynecology最新文献_第10页

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":"Purpose of review: 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).Recent findings: 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.Summary: 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.","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

Not all platelet-rich plasma are created equal. 并非所有的富血小板血浆都是一样的。

IF 2.1 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2024-06-01 Epub Date: 2024-02-05 DOI: 10.1097/GCO.0000000000000944

Manuel Muñoz Cantero

{"title":"Not all platelet-rich plasma are created equal.","authors":"Manuel Muñoz Cantero","doi":"10.1097/GCO.0000000000000944","DOIUrl":"10.1097/GCO.0000000000000944","url":null,"abstract":"Purpose of review: This review aims to elucidate potential variations in clinical outcomes resulting from the use of different types of platelet-rich plasma (PRPs) in reproductive medicine. It seeks to explore the reasons behind the diverse results reported in various studies and assess the general features distinguishing different PRP formulations.Recent findings: PRPs have found applications across diverse medical fields, generating controversy due to the variability in outcomes. The field of reproductive medicine, despite its limited published studies, is encountering a similar challenge as it integrates these treatments.Summary: The multitude of PRP product brands in the market, coupled with 'home-made' PRPs, poses a significant barrier to establishing a common protocol for the preparation of standardized PRP products. This impediment hinders widespread adoption by clinicians, particularly in endometrial or ovarian treatments. Drawing from evidence in other medical disciplines, this review endeavors to compile essential characteristics that PRPs must possess, aiming to mitigate the impact of variables affecting results in forthcoming studies.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"118-123"},"PeriodicalIF":2.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139704096","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

Walking on thin endometrium. 在薄薄的子宫内膜上行走

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2024-06-01 Epub Date: 2024-03-20 DOI: 10.1097/GCO.0000000000000948

Baris Ata, Begum Mathyk, Savci Telek, Erkan Kalafat

引用次数: 0

An update on the current indications for in vitro maturation. 体外成熟的最新适应症。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2024-06-01 Epub Date: 2024-01-31 DOI: 10.1097/GCO.0000000000000942

Vu N-A Ho, Tuong M Ho, Lan N Vuong, Juan García-Velasco

{"title":"An update on the current indications for in vitro maturation.","authors":"Vu N-A Ho, Tuong M Ho, Lan N Vuong, Juan García-Velasco","doi":"10.1097/GCO.0000000000000942","DOIUrl":"10.1097/GCO.0000000000000942","url":null,"abstract":"Purpose of review: In vitro maturation has become a significant component of modern assisted reproductive techniques. Published data have been supported for the safety and effectiveness of in vitro maturation treatment. In recent years, potential indications for in vitro maturation (IVM) have been a topic of interest and investigation.Recent findings: Significant improvements in technique enhancement and data publication for evaluating the efficacy of IVM have been achieved. Recent studies have shown that IVM could offer several advantages over in vitro fertilization. Currently, there are growing indications for IVM beyond the commonly mentioned indication of infertile women with polycystic ovary syndrome. Additionally, some potential candidates might have significant advantages for IVM, such as women diagnosed with gonadotropin resistance ovary syndrome or those seeking fertility preservation. With a better understanding of IVM, from basic science to clinical practice, it can be applied safely, effectively, and affordably to a broader range of patients, making it a more accessible and patient-friendly option.Summary: Despite the possibly acknowledged limitations, the potential of in vitro maturation cannot be denied. As this technique becomes increasingly accessible to patients and more continuous efforts are dedicated to advancing this technique, the impact of in vitro maturation is expected.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"173-180"},"PeriodicalIF":2.2,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139652239","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

Advancements in the application of uterine ultrasound elastography. 子宫超声弹性成像技术的应用进展。

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.0000000000000949

Francesca Barrett, Stephanie Willson, Marie Werner

{"title":"Advancements in the application of uterine ultrasound elastography.","authors":"Francesca Barrett, Stephanie Willson, Marie Werner","doi":"10.1097/GCO.0000000000000949","DOIUrl":"10.1097/GCO.0000000000000949","url":null,"abstract":"Purpose of review: This article reviews recent advances in ultrasound elastography in diagnosing and evaluating the normal nongravid uterus and the infertile uterus in the gynecologic patient.Recent findings: Focusing on the most recent primary literature, studies have demonstrated new findings among a breadth of gynecologic clinical settings. Studies in the nongravid uterus have found that menopausal status, age, and menstrual phase have not been associated with changes in uterine tissue stiffness. Focusing on myometrial disease, there have been conflicting data regarding the ability to distinguish uterine fibroids from adenomyosis. One area of expanding research surrounding uterine elastography includes the infertile population, where ongoing studies attempt to provide a predictive model using shear wave elastography (SWE) in patients undergoing in-vitro fertilization.Summary: Ultrasound elastography has become an increasingly studied and utilized tool in assessing physiologic and pathologic processes in the field of gynecology. Evaluating tissue stiffness through strain and SWE can serve to improve diagnosis of various uterine and cervical lesions, as well as prognosticate outcomes after fertility treatments. This growing area of research will continue to establish the role and application of ultrasound elastography into clinical practice.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":"36 3","pages":"181-185"},"PeriodicalIF":2.2,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140866839","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 : 2024-06-01 Epub Date: 2024-04-25 DOI: 10.1097/GCO.0000000000000954

引用次数: 0

Poor ovarian response classification systems in the clinical setting - time for an update? 临床环境中的卵巢不良反应分类系统--是时候更新了？

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2024-06-01 Epub Date: 2024-03-27 DOI: 10.1097/GCO.0000000000000950

Andres Reig, Emre Seli

{"title":"Poor ovarian response classification systems in the clinical setting - time for an update?","authors":"Andres Reig, Emre Seli","doi":"10.1097/GCO.0000000000000950","DOIUrl":"10.1097/GCO.0000000000000950","url":null,"abstract":"Purpose of review: Poor ovarian response (POR) remains a key challenge to the success of assisted reproductive technology. Here, we offer a comprehensive review of the two main classification systems for POR, discussing their promises and pitfalls, evaluating their performance, and exploring potential avenues for improving upon these definitions of POR.Recent findings: The Bologna criteria represented the first meaningful attempt to create a universal POR definition. Subsequently, the POSEIDON classification system was published to provide a more nuanced view of POR, classifying patients into four groups based on age and ovarian reserve markers. A recent study evaluated the likelihood of achieving at least one euploid embryo for transfer and found that, indeed, these classification systems are effective predictors of this outcome.While these criteria provide an effective counseling tool, several limitations - not considering underlying conditions, selecting somewhat arbitrary cutoffs, and evaluating the number of oocytes retrieved regardless of maturity - highlight the importance of improving upon these systems to create a more useful tool to more accurately predict ovarian response for clinical and research purposes.Summary: In the era of personalized medicine, it is time to reconsider whether diagnostic criteria for a continuous metric such as ovarian response should be based on meeting all-or-nothing thresholds for specific parameters.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":"36 3","pages":"192-199"},"PeriodicalIF":2.2,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872109","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 : 2024-04-01 Epub Date: 2024-02-29 DOI: 10.1097/GCO.0000000000000937

引用次数: 0

The evolving landscape of antibody-drug conjugates in ovarian cancer: new drugs for a new era. 卵巢癌抗体药物共轭物的演变：新时代的新药物。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2024-04-01 Epub Date: 2024-01-02 DOI: 10.1097/GCO.0000000000000934

David García-Illescas, Roberta Mazzeo, Carmen García-Durán, Ana Oaknin

{"title":"The evolving landscape of antibody-drug conjugates in ovarian cancer: new drugs for a new era.","authors":"David García-Illescas, Roberta Mazzeo, Carmen García-Durán, Ana Oaknin","doi":"10.1097/GCO.0000000000000934","DOIUrl":"10.1097/GCO.0000000000000934","url":null,"abstract":"Purpose of review: This review addresses the emerging role of antibody-drug conjugates (ADCs) in the treatment of ovarian cancer, a field marked by a high need for more effective and targeted therapies. Given the recent advancements in ADC technology and the ongoing challenges in treating ovarian cancer, particularly in late-stage and recurrent cases, this review is both timely and relevant. It synthesizes current research findings and clinical trial data, highlighting the potential of ADCs to revolutionize ovarian cancer treatment.Recent findings: The review covers key themes including the mechanism of action of ADCs, their specificity in targeting ovarian cancer cells, recent clinical trial outcomes, advancements in ADC design for improved efficacy and reduced toxicity, and strategies to overcome drug resistance in ovarian cancer. It also addresses the heterogeneity of ovarian cancer and the implications for personalized ADC therapies.Summary: The review underscores the potential of ADCs to significantly impact clinical practice, offering a more effective and personalized treatment approach for ovarian cancer patients. The review suggests a paradigm shift in the treatment of this malignancy, emphasizing the need for further research and development in this area.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"104-111"},"PeriodicalIF":2.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139089451","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

Pharmacotherapy for opioid use disorder in pregnancy. 妊娠期阿片类药物使用障碍的药物治疗。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2024-04-01 Epub Date: 2024-01-05 DOI: 10.1097/GCO.0000000000000932

Cassandra J Trammel, Julia Whitley, Jeannie C Kelly

{"title":"Pharmacotherapy for opioid use disorder in pregnancy.","authors":"Cassandra J Trammel, Julia Whitley, Jeannie C Kelly","doi":"10.1097/GCO.0000000000000932","DOIUrl":"10.1097/GCO.0000000000000932","url":null,"abstract":"Purpose of review: Opioid use disorder (OUD) in pregnancy has significantly increased in the last decade, impacting 8.2 per 1000 deliveries. OUD carries significant risk of morbidity and mortality for both the birthing person and neonate, but outcomes for both are improved with opioid agonist treatment (OAT). Here, we describe the recommended forms of OAT in pregnancy, updates to the literature, and alternate OAT strategies, and share practical peripartum considerations for patients on OAT.Recent findings: Recent studies comparing buprenorphine and methadone have reaffirmed previous findings that buprenorphine is associated with superior outcomes for the neonate, without clear differences in morbidity or mortality for the birthing person. Optimal initiation and dosing of OAT remains unclear, with several recent studies evaluating methods of initiation, as well as a potential role for higher and more rapid dosing in the fentanyl era. Alternative products such as buprenorphine-naloxone and extended-release buprenorphine are of significant research interest, though randomized prospective data are not yet available.Summary: Buprenorphine and methadone are standard of care for treatment of OUD during pregnancy, and multiple patient factors impact the optimal choice. Insufficient data exist to recommend alternative agents as a primary strategy currently. All patients with OUD in pregnancy should be counseled regarding OAT.Video: http://links.lww.com/COOG/A94.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"74-80"},"PeriodicalIF":2.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139405370","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