Current Opinion in Obstetrics & Gynecology最新文献_第2页

A review of menopause in transgender and gender diverse individuals.

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2025-04-01 Epub Date: 2025-02-25 DOI: 10.1097/GCO.0000000000001013

Carly E Kelley, Danit Ariel

{"title":"A review of menopause in transgender and gender diverse individuals.","authors":"Carly E Kelley, Danit Ariel","doi":"10.1097/GCO.0000000000001013","DOIUrl":"10.1097/GCO.0000000000001013","url":null,"abstract":"Purpose of review: This review aims to provide a comprehensive overview of the specific challenges, health considerations, and healthcare needs of transgender and gender diverse (TGD) people navigating menopause, highlighting the intersection of gender identity, hormone treatment, and age-related changes.Recent findings: Research on menopause in TGD individuals is lacking, without guidelines to support clinical management. This is the first review of its type to summarize the described impact of the menopausal transition on TGD individuals, the potential long-term risks associated with both gender-affirming hormone therapy and the intersectionality with aging, and how these risks may impact hormone management and overall comprehensive care.Summary: By drawing on the shared principles of cisgender menopausal hormone therapy and gender-affirming hormone therapy, providers are well positioned to apply their expertise to support the TGD population during menopause. We recommend using shared decision-making, culturally competent care, and a strong understanding of the biological, personal, and social experiences of TGD people that do not necessarily conform to stereotypically ciswoman experiences.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"83-96"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460835","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

Menopause and mental health.

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2025-04-01 Epub Date: 2025-02-25 DOI: 10.1097/GCO.0000000000001014

Karen Horst, Nicole Cirino, Karen E Adams

{"title":"Menopause and mental health.","authors":"Karen Horst, Nicole Cirino, Karen E Adams","doi":"10.1097/GCO.0000000000001014","DOIUrl":"10.1097/GCO.0000000000001014","url":null,"abstract":"Purpose of review: This review discusses mental health changes commonly experienced by individuals during the menopause transition (MT). The pathophysiology of the MT, the chronology and type of mental health symptoms arising from this pathophysiology, and evidence-based options for treating midlife patients are discussed. This review concludes with treatment options to enable clinicians to more effectively counsel, recognize and treat symptoms during the MT.Recent findings: The MT begins earlier than previously understood with mood and cognitive issues as common initial mental health symptoms significantly impacting quality of life. These symptoms are due to profound changes in the brain's structure, connectivity, energy metabolism, and inflammation linked to perimenopausal hormone shifts. Hormone therapy, psychiatric medication, psychotherapy, and lifestyle adjustments all play a role in the management of mental health symptoms arising during the MT. Lack of both obstetrician and gynecologist and mental health clinician awareness can leave patients undertreated and vulnerable to nonevidence-based approaches.Summary: Patients in the MT are at increased risk for mental health issues, both preexisting and new onset. The OB/GYN clinician plays a key role in recognizing and addressing these conditions to improve health outcomes in midlife women.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"102-110"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460839","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

Sleep disturbance and menopause. 睡眠障碍和更年期。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2025-04-01 Epub Date: 2025-01-17 DOI: 10.1097/GCO.0000000000001012

Nicole E Carmona, Natalie L Solomon, Karen E Adams

{"title":"Sleep disturbance and menopause.","authors":"Nicole E Carmona, Natalie L Solomon, Karen E Adams","doi":"10.1097/GCO.0000000000001012","DOIUrl":"10.1097/GCO.0000000000001012","url":null,"abstract":"Purpose of review: Sleep problems are among the most prevalent and bothersome symptoms of menopause. This review characterizes menopausal sleep disturbances, describes biopsychosocial predictors, and summarizes the evidence supporting pharmacological and nonpharmacological treatment options.Recent findings: Recent studies found that sleep changes are early indicators of perimenopause and sought to disentangle the respective impacts of menopausal status, hot flashes (HFs), and changes in reproductive hormones on peri-/postmenopausal sleep problems. Both HFs and reproductive hormones predicted sleep problems, but neither solely accounted for the myriad changes in sleep, thus highlighting the contribution of additional biopsychosocial risk factors. Inconsistencies across studies were likely due to differences in study design and methodology, participants' menopausal stage, and the presence of sleep complaints. Recent studies support the use of psychological (cognitive-behavioral therapy for insomnia) and pharmacological (e.g., neurokinin B antagonists) treatments in addition to hormone therapy.Summary: Sleep problems are common and of critical import to women during the menopausal transition, significantly influencing treatment preferences and satisfaction. Thus, sleep problems should be routinely assessed from a biopsychosocial perspective and treated with evidence-based interventions throughout menopause. Treatment selection should be based on diagnosis and careful assessment.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"75-82"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016836","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

New concepts and difficulties with progesterone supplementation in the luteal phase: Erratum.

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2025-04-01 Epub Date: 2025-02-25 DOI: 10.1097/GCO.0000000000001007

引用次数: 0

Subclinical hypothyroidism in pregnancy: an evolving and controversial landscape.

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2025-04-01 Epub Date: 2025-02-25 DOI: 10.1097/GCO.0000000000001019

Laurel Aberle, Caroline T Nguyen

{"title":"Subclinical hypothyroidism in pregnancy: an evolving and controversial landscape.","authors":"Laurel Aberle, Caroline T Nguyen","doi":"10.1097/GCO.0000000000001019","DOIUrl":"10.1097/GCO.0000000000001019","url":null,"abstract":"Purpose of review: This review aims to elucidate the developments in subclinical hypothyroidism (SCH) in pregnancy effects, management, and treatment. While mostly focusing on recent research, landmark studies are briefly reviewed to highlight major developments since their publication.Recent findings: Research has continued to show an increased risk of adverse outcomes in pregnant women with SCH, with recent research showing an increased risk of both impaired glucose tolerance and hypertensive disorders of pregnancy. Research has continued to show unclear effects of SCH on neonatal outcomes, specifically in offsprings' intellectual development and ability. The benefit of treatment of SCH continues to be unclear; however, data suggest that treatment for thyroid stimulating hormone (TSH) 2.5-4 mU/l regardless of thyroid peroxidase antibodies status and TSH 4-10 mU/l in later pregnancy has not shown maternal or neonatal benefit.Summary: With varying guidelines and inconsistent research outcomes, it is not surprising that SCH practices differ widely. Further research, with uniform definitions and criteria of SCH, is needed to elucidate the optimal management and treatment of this common pregnancy condition. Additionally, further research specifically aimed at optimizing TSH in preconception and early pregnancy is needed.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"60-65"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460855","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

Strategies to avoid recurrence of intrauterine adhesions after hysteroscopic adhesiolysis. 避免宫腔镜粘连分解术后宫腔内粘连复发的策略。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2025-04-01 DOI: 10.1097/GCO.0000000000001029

Monica M Jackson, Kathryn A Edmonds, Candice E Jones-Cox

{"title":"Strategies to avoid recurrence of intrauterine adhesions after hysteroscopic adhesiolysis.","authors":"Monica M Jackson, Kathryn A Edmonds, Candice E Jones-Cox","doi":"10.1097/GCO.0000000000001029","DOIUrl":"10.1097/GCO.0000000000001029","url":null,"abstract":"Purpose of review: Intrauterine adhesions (IUA) are fibrous bands of scar tissue within the uterine cavity resulting from trauma to the endometrium. Despite treatment with hysteroscopic lysis of IUA, recurrence rates are substantial, ranging from 3 to 25%. Practice patterns can differ widely regarding intraoperative and postoperative interventions. Our goal is to review current literature that explores strategies to decrease recurrence of IUA.Recent findings: This literature review examines intraoperative recommendations regarding surgical technique for lysis of IUA, intrauterine placement of mechanical barriers like a balloon or an intrauterine device, and use of substances like hyaluronic acid, platelet-rich plasma, and amnion graft. Postoperative techniques including hormonal medications after lysis of IUA, medications that increase vascular flow to the uterus, and second-look hysteroscopy are also explored.Summary: Various intraoperative and postoperative interventions show promise in reducing IUA reformation after hysteroscopic lysis of adhesions. What remains to be explored are implications of preventive therapy on pregnancy rate and live birth rate. Additionally, the optimal combination of therapy for preventing IUA recurrence has yet to be established. Further research is essential to determine the most effective strategies for preventing IUA reformation and optimizing long-term reproductive health.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765744","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

Late bloomers: exploring the reproductive potential of day 7 embryos.

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2025-03-25 DOI: 10.1097/GCO.0000000000001021

Blake Vessa, Jason Franasiak

{"title":"Late bloomers: exploring the reproductive potential of day 7 embryos.","authors":"Blake Vessa, Jason Franasiak","doi":"10.1097/GCO.0000000000001021","DOIUrl":"https://doi.org/10.1097/GCO.0000000000001021","url":null,"abstract":"Purpose of review: The purpose of this review is to evaluate the reproductive potential of day 7 embryos. With effective cryopreservation and subsequent frozen embryo transfers, extended blastocyst culture to day 7 is now possible. However, assessing the true reproductive potential of day 7 embryos is essential to adequately counsel patients on the expected pregnancy and live birth rates in comparison to embryos that reach the blastocyst stage on day 5 or day 6.Recent findings: Day 7 embryos have a lower blastulation rate and higher aneuploidy rate compared with day 5 and day 6 embryos. Although day 7 blastocysts comprise less than 10% of usable embryos for transfer, recent studies have repeatedly demonstrated lower, but not negligible, pregnancy and live birth rates with day 7 embryo transfers. Based on the current literature reviewed in this paper, the clinical pregnancy rates for euploid day 7 embryos appear to be between 16.7 and 52.6%, whereas the live birth rates are between 21.5 and 46%. Therefore, while the blastulation and pregnancy rates are lower and the aneuploidy rates are higher, euploid day 7 embryos have reproductive potential.Summary: While recent data supports reduced reproductive potential of euploid day 7 embryos when compared with the success rates of day 5 and 6 embryos, their associated pregnancy and live birth rates are nonzero and still represent a viable option for certain patients.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765646","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

Impact of body weight on IVF: pathophysiology, outcomes, and clinical considerations.

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2025-03-25 DOI: 10.1097/GCO.0000000000001023

Nicole M Sekula, Murat Basar, Lubna Pal

{"title":"Impact of body weight on IVF: pathophysiology, outcomes, and clinical considerations.","authors":"Nicole M Sekula, Murat Basar, Lubna Pal","doi":"10.1097/GCO.0000000000001023","DOIUrl":"https://doi.org/10.1097/GCO.0000000000001023","url":null,"abstract":"Purpose of review: This study aimed to examine if excess body weight impacts the outcomes of IVF treatment cycles.Recent findings: While data on the effect and/or association of excess weight on IVF outcomes continue to produce mixed results, recent studies stratifying analyses by age are yielding clarity on a detrimental potential of obesity on IVF outcomes. Specifically, IVF outcomes in the third decade of life are susceptible to adverse implications of excess weight, as reflected in lower clinical pregnancy and live birth rates. Plausible pathogenic mechanisms underlying the detrimental impact of excess weight on IVF outcomes include inflammation, DNA repair, insulin resistance, and the targets of such mechanisms that include the spectrum of players critical to reproductive success, including the oocyte, sperm, embryo, and uterine receptivity.Summary: The detrimental implications of excess weight on IVF outcomes are more pronounced by age, and inflammatory processes seem to be particularly relevant to the interplay of weight excess, adiposity, and IVF cycle outcomes.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765632","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

The genetics of preimplantation embryonic arrest: the role of aneuploidies.

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2025-03-24 DOI: 10.1097/GCO.0000000000001020

Ludovica Picchetta, Katharina Spath, Antonio Capalbo, Christian Simon Ottolini

{"title":"The genetics of preimplantation embryonic arrest: the role of aneuploidies.","authors":"Ludovica Picchetta, Katharina Spath, Antonio Capalbo, Christian Simon Ottolini","doi":"10.1097/GCO.0000000000001020","DOIUrl":"https://doi.org/10.1097/GCO.0000000000001020","url":null,"abstract":"Purpose of the review: Aneuploidy is a major cause of embryonic arrest. While meiotic aneuploidies, especially maternal, are a well-documented cause of embryo and fetal arrest, increasing evidence highlights the crucial role played by mitotic aneuploidies. This review explores the molecular and cellular pathways underlying these abnormalities, focusing on abnormal cleavage, chromatin cohesion, spindle stability, maternal effect genes, and mitochondria.Recent findings: Approximately half of human embryos cease development in vitro or shortly after transfer to the uterus. Genetic investigation of these embryos has highlighted that 90% of these exhibit aneuploidies. Surprisingly, most of these arise from errors during the early mitotic divisions of preimplantation embryos. These findings strongly correlate with disruptions of early cleavage possibly due to faulty spindle assembly or mitochondrial dysfunction during the in-vitro development. Moreover, maternal effects, such as faulty meiotic recombination and variants in maternal effect genes involved in the subcortical maternal complex, may further predispose the embryo to high rates of chromosomal imbalance.Summary: Meiotic and mitotic aneuploidies play a significant role in embryo arrest, yet their molecular and cellular origin are not well understood. Investigating these pathways may lead to interventions that could be developed to improve success rates with IVF or even fertility rates in general.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756070","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

Antibody-drug conjugates as targeted therapy for treating gynecologic cancers: update 2025. 抗体药物结合物作为治疗妇科癌症的靶向疗法：2025 年更新。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2025-02-01 Epub Date: 2024-11-04 DOI: 10.1097/GCO.0000000000001002

Jordyn Silverstein, Beth Karlan, Nasim Herrington, Gottfried Konecny

{"title":"Antibody-drug conjugates as targeted therapy for treating gynecologic cancers: update 2025.","authors":"Jordyn Silverstein, Beth Karlan, Nasim Herrington, Gottfried Konecny","doi":"10.1097/GCO.0000000000001002","DOIUrl":"10.1097/GCO.0000000000001002","url":null,"abstract":"Purpose of review: Provide the most up-to-date information on the dynamic landscape of antibody-drug conjugates (ADCs) in gynecologic cancers. We discuss the latest research that supports the approved ADCs and outline the ongoing trials and preliminary results that may lead to ADC approvals in the future. Current gaps in knowledge and areas for future research are discussed.Recent findings: ADCs are rapidly changing the landscape of gynecologic cancer care. Three ADCs are currently FDA approved and used routinely in clinical practice, with many more currently in clinical development. The most common ADC target is folate receptor alpha of which there are 8 different folate receptor targeting ADCs in development. Other targets under investigation include trophoblast cell surface antigen-2 (Trop-2), claudin-6 (CLDN6), cadherin-6 (CDH6), nectin-4, HER-2 and B7-H4. ADCs can cause new and unique adverse effects, including ocular toxicities and interstitial lung disease.Summary: ADCs offer the opportunity for a more effective and personalized treatment approach for gynecologic cancer patients. Side effects must be closely monitored, and preventive measures must be followed to maximize benefit and minimize toxicity. A better understanding of the role of target proteins as biomarkers to predict response to ADCs will be critical for successful clinical implementation of ADCs and further research in this area is necessary.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"5-15"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11676621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0