Archives of Gynecology and Obstetrics最新文献

{"title":"Perinatal bereavement rooms: a narrative review of physical space in perinatal grief.","authors":"Ruby Castilla-Puentes, Azul F Isidoro, Alfonsina Orosito, Samantha Eaton, Manuela Goyeneche, Liliana González Cabrales, Gabriela Santaella","doi":"10.1007/s00404-025-08175-4","DOIUrl":"https://doi.org/10.1007/s00404-025-08175-4","url":null,"abstract":"<p><strong>Background: </strong>Perinatal loss is a profoundly complex form of grief, often linked to heightened risk of prolonged bereavement and adverse mental health outcomes. Perinatal grief rooms-private, supportive spaces within healthcare settings-aim to help families process their loss, spend time with their baby, and create meaningful memories in a respectful environment. While bereavement care has received growing attention, the role of the physical environment in supporting grief remains underexplored.</p><p><strong>Objective: </strong>To synthesize current evidence on how dedicated physical spaces can support individuals and families after perinatal loss, and to identify priorities for research, design standards, and interdisciplinary collaboration.</p><p><strong>Methods: </strong>A narrative review was conducted in accordance with PRISMA-ScR guidelines. Literature searches were performed across PubMed, PsycINFO, Medline (OVID), Embase, ScienceDirect, SCOPUS, SciELO, and Google Scholar using terms, such as \"perinatal grief rooms\", \"bereavement rooms\", \"angel suites\", \"butterfly suites\", \"snowdrop suites\", \"cloud rooms\", \"designated units for perinatal loss\", and \"birthing + bereavement suites\". The review examined (1) the current role of physical spaces in the perinatal loss experience, and (2) how their availability and design may influence grief outcomes.</p><p><strong>Results: </strong>Of the 17 articles meeting inclusion criteria, only 4 (24%) referenced bereavement rooms, and just 3 (18%) noted the need for formal protocols-without offering concrete examples. No studies evaluated implementation, design standards, or measurable impact on grief, mental health, or family well-being. This lack of empirical evidence and standardized guidance underscores a critical gap that limits integration of therapeutic environments into perinatal bereavement care.</p><p><strong>Conclusion: </strong>Despite increasing recognition of the importance of bereavement care, dedicated grief rooms remain under-researched and inconsistently implemented. Advancing this field will require rigorously designed studies, development of design standards, and collaborative partnerships among healthcare providers, researchers, policymakers, and design experts to ensure equitable access to therapeutic spaces for grieving families.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of discordant tubal blockage on clinical pregnancy rates: a retrospective cohort study.","authors":"Franziska Elisabeth Bormann, Marlene Hager, Sophie Luise Thieme, John Preston Parry, Johannes Ott","doi":"10.1007/s00404-025-08186-1","DOIUrl":"https://doi.org/10.1007/s00404-025-08186-1","url":null,"abstract":"<p><strong>Purpose: </strong>To present recent data on discordant tubal blockage (DTB), its influence on pregnancy rates and how women should gage their fertility when screening and diagnostic tests don't always agree.</p><p><strong>Methods: </strong>This retrospective cohort study included 78 infertile women, who underwent tubal patency assessment between January 2016 and June 2024 at the Clinical Division of Gynecological Endocrinology and Reproductive Medicine, Medical University of Vienna. Tubal patency was assessed twice. Initial assessment of tubal patency had been performed by hysterosalpingo-contrast sonography (HyCoSy) or hysterosalpingography (HSG) and had suggested bilateral occlusion in the DTB group (n = 38) and bilateral patency in controls (n = 38). Bilateral patency was found in all patients during subsequent laparoscopic chromopertubation. The primary outcome parameter was the clinical pregnancy rate within 6 months.</p><p><strong>Results: </strong>The basic patient characteristics showed no significant differences between the DTB and the control groups. Clinical pregnancy was found in 47.4% (18/38) of control patients (patent tubes) and in 21.1% (8/38) of DTB patients (p = 0.029) over 6 months of follow-ups. In a multivariate model, younger age [odds ratio (OR), 0.856, p = 0.013] and bilateral patency (OR 4.210, p = 0.010) in both examinations (control group) were associated with higher clinical pregnancy rates.</p><p><strong>Conclusion: </strong>DTB reflects lower fecundity even when subsequent patency is demonstrated. Tubal patency following prior occlusion should not be grounds for complete reassurance, and given lower odds of pregnancy, such patients may be warranted a faster transition to ART given the decreased efficacy of other methods.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reductive stress and the role of antioxidants in male infertility: a narrative review.","authors":"Efthalia Moustakli, Panagiotis Christopoulos, Anastasios Potiris, Athanasios Zikopoulos, Alkis Matsas, Ioannis Arkoulis, Despoina Mavrogianni, Eirini Drakaki, Athanasios Zachariou, Peter Drakakis, Sofoklis Stavros","doi":"10.1007/s00404-025-08184-3","DOIUrl":"https://doi.org/10.1007/s00404-025-08184-3","url":null,"abstract":"<p><strong>Background: </strong>The ability of antioxidant therapy to mitigate oxidative stress (OS)-induced sperm function impairment makes it a popular treatment for male infertility. Reductive stress (RS), a condition characterized by an overcompensation in redox balance that favors reduction over oxidation, may be brought on by excessive or extended antioxidant use, according to mounting evidence. The purpose of this review is to examine the processes by which an excess of antioxidants causes RS and to evaluate any potential negative impacts on men's reproductive health.</p><p><strong>Methods: </strong>A comprehensive overview of recent clinical and experimental studies focused on the effects of excessive antioxidant use on redox biology, mitochondrial function, spermatogenesis, and sperm quality.</p><p><strong>Results: </strong>RS has been shown to affect sperm growth and function, interfere with cellular signaling, and damage mitochondrial integrity. Antioxidants are commonly employed, although there are currently no clear clinical guidelines or biomarkers for diagnosis to monitor redox equilibrium.</p><p><strong>Conclusions: </strong>In male infertility treatments based on antioxidants, RS poses a paradoxical risk. A personalized, balanced approach to antioxidant therapy is essential, alongside the development of biomarkers and standardized protocols to ensure redox homeostasis and avoid potential harm.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare case of stage four uterovaginal prolapse with vaginal tungiasis in a postmenopausal woman.","authors":"Wondu Belayneh Dejen, Mihiretu Tesfamariam Goshu","doi":"10.1007/s00404-025-08180-7","DOIUrl":"https://doi.org/10.1007/s00404-025-08180-7","url":null,"abstract":"<p><p>Tungiasis is an ectoparasitic skin infestation caused by Tunga penetrans, predominantly affecting impoverished communities. In most cases, lesions are confined to the foot. Our case involves a 65-year-old para 8 woman who presented with a non-reducible stage four uterovaginal prolapse of 1-month duration, associated with intense vaginal itching. Examination revealed multiple nodules with whitish discs and central dark points on the prolapsed posterior vaginal wall. Under spinal anesthesia, surgical removal of embedded fleas was performed, followed by vaginal hysterectomy, bilateral salpingectomy, complete colpocleisis, and perineorrhaphy. The patient was stable postoperatively and discharged on the third day. This case highlights the rare occurrence of vaginal tungiasis complicating pelvic organ prolapse in elderly women and emphasize the importance of thorough evaluation and surgical management in endemic settings.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How embryo retention affects assisted reproductive technology outcomes: a systematic review and meta-analysis.","authors":"Arezoo Maleki-Hajiagha, Rana Karimi, Neda Emami, Fardin Amidi","doi":"10.1007/s00404-025-08185-2","DOIUrl":"https://doi.org/10.1007/s00404-025-08185-2","url":null,"abstract":"<p><strong>Background: </strong>Retransferring retained embryos during the embryo transfer (ET) procedure has raised concerns about its adverse effects on assisted reproductive technology (ART) outcomes. Technical challenges associated with embryo retention (ER) may compromise implantation success and lead to increased complications.</p><p><strong>Objective: </strong>This systematic review and meta-analysis aimed to evaluate the impact of retransferring retained embryos on key ART outcomes, including clinical pregnancy rate (CPR), biochemical pregnancy rate (BPR), ectopic pregnancy rate (EP), miscarriage rate (MR), and live birth rate (LBR).</p><p><strong>Methods: </strong>We conducted a systematic search in PubMed, Scopus, and Cochrane databases from inception to April 11, 2025. ART outcomes were extracted and pooled Mantel-Haenszel odds ratios (OR) with 95% confidence intervals (CI) were calculated under both fixed- and random-effects models. Subgroup analyses were performed based on study design (matched versus non-matched retrospective cohorts) and ET technique (afterload versus direct). Sensitivity analyses were conducted by excluding studies with high or very high risk of bias, as determined by the ROBINS-E tool.</p><p><strong>Results: </strong>The overall analysis demonstrated that retransferring retained embryos was associated with a significant reduction in CPR (OR ≈ 0.75, 95% CI: 0.64-0.89, p < 0.001) and LBR, while substantially increasing the risk of EP (OR ≈ 2.36, p = 0.036). Subgroup analysis showed that studies with matched designs and those using the afterload ET technique exhibited more pronounced negative outcomes. Sensitivity analyses confirmed the robustness of the primary findings.</p><p><strong>Conclusion: </strong>ER negatively impacts ART success, lowering clinical pregnancy and live birth rates and elevating the risk of ectopic pregnancy. These findings highlight the critical need to refine ET protocols and further investigate the biological mechanisms underlying ER. Future well-designed, prospective studies with standardized methodologies are warranted to optimize ER management and improve clinical outcomes.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing women's health: innovative applications of sacral neuromodulation in pelvic floor dysfunctions.","authors":"Jing Fu, Zhong Li, Jianlin Pu, YaDong Liu, Qiuyue Mao, Chunlan Li, Li Li, Xuesong Gai","doi":"10.1007/s00404-025-08182-5","DOIUrl":"https://doi.org/10.1007/s00404-025-08182-5","url":null,"abstract":"<p><p>Female pelvic floor dysfunctions (PFDs), a global health issue, encompass a range of lower urinary tract and bowel dysfunctions, including urinary incontinence, urinary retention, fecal incontinence, constipation, pelvic pain, and sexual dysfunction. PFDs exhibit high prevalence rates and prolonged recovery periods, resulting in significant economic burdens for patients and healthcare systems. Recently, sacral neuromodulation (SNM) has emerged as a minimally invasive, safe, and effective neuromodulatory intervention, representing a significant advance in the management of refractory PFDs. This technology modulates the sacral nerve reflex pathways through an implanted electrode, enabling simultaneous improvement of multiple PFD symptoms. It is specifically indicated for conditions including overactive bladder, non-obstructive urinary retention, and fecal incontinence, with potential therapeutic benefits extending to chronic pelvic pain, sexual dysfunction, and neurogenic bladder. This paper systematically reviews the underlying mechanisms and technological advancements of SNM, providing a comprehensive analysis of its established applications (overactive bladder, non-obstructive urinary retention, fecal incontinence) and examining emerging uses in other PFD domains. Furthermore, incorporating technological innovations and long-term follow-up data, this paper explores the optimization of indications, safety protocols, and future research avenues for SNM, offering a comprehensive outlook on clinical practice and prospective developments.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is fondaparinux safe for use during pregnancy? A state-of-the-art review of current evidence.","authors":"Yuexiao Wu, Yurou Ji, Siqi Wang, Yayi Hu, Dan Shan","doi":"10.1007/s00404-025-08181-6","DOIUrl":"https://doi.org/10.1007/s00404-025-08181-6","url":null,"abstract":"<p><p>Fondaparinux, a synthetic pentasaccharide, represents the smallest heparin-based molecule and functions as a potent selective indirect inhibitor of activated factor Xa. Its high bioavailability, ease of dosing, and favorable tolerability profile render it an ideal antithrombotic agent for pregnant patients who are intolerant to unfractionated heparin (UFH) and low-molecular-weight heparins (LMWHs). Recent studies have highlighted the advancements in the use of fondaparinux in pregnant patients over the past decades. This research provides a comprehensive summary of the safety profiles of fondaparinux, noting that its application in pregnant women may elevate the risk of bleeding events during pregnancy and postpartum. Caution is advised when administering fondaparinux to patients with renal insufficiency. The advantages of fondaparinux include a lower risk of thrombocytopenia, liver injury, allergic reactions, and osteopenia compared with UFH and LMWHs. Although fondaparinux can cross the placental barrier and be detected in the umbilical-cord blood, real-world data have not established a direct association between fondaparinux and teratogenicity or adverse fetal outcomes. Overall, fondaparinux appears to be a viable option for certain groups of pregnant patients requiring anticoagulation. However, further research is warranted to provide deeper insights into the benefits and risks associated with fondaparinux use in this population. The long-term effects of intrauterine exposure to fondaparinux remain an important area for future investigation.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145038973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of diagnostic laparoscopy on resectability and treatment strategy in FIGO III-IV ovarian cancer.","authors":"H Endres, D Dayan, F Ebner, S Huwer, D Jakob, M Medl, L Yagcioglu, I Juhasz-Boess, F A Taran, L Jung","doi":"10.1007/s00404-025-08173-6","DOIUrl":"https://doi.org/10.1007/s00404-025-08173-6","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the clinical utility of diagnostic laparoscopy in guiding treatment strategy and surgical outcomes for patients with advanced-stage ovarian cancer, specifically regarding operability assessment and the likelihood of complete cytoreduction.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed 183 patients with histologically confirmed International Federation of Gynecology and Obstetrics (FIGO) stage III-IV ovarian cancer treated with curative intent between January 2018 and December 2023 at a tertiary referral center. Patients were divided into two groups: those who underwent diagnostic laparoscopy prior to primary treatment (n = 80) and those managed without laparoscopy (n = 103). Laparoscopy was selectively employed when operability was uncertain. The primary outcome was the rate of complete macroscopic tumor resection. Secondary endpoints included intraoperative inoperability, neoadjuvant chemotherapy (NACT) rates, and surgical complexity. Statistical analyses included chi-square tests and predictive value calculations.</p><p><strong>Results: </strong>Complete macroscopic resection was achieved in 57.5% of patients in the laparoscopy group compared to 68.0% in the control group. Among FIGO III cases, complete resection was lower in the laparoscopy group (63.0% vs. 77.0%), while rates were similar for FIGO IV (53.8% vs. 54.8%). Diagnostic laparoscopy had a positive predictive value of 59% and was a statistically significant, albeit weak, predictor of operability (p = 0.003, phi = 0.13). Patients in the laparoscopy group were more frequently triaged to NACT (78.8% vs. 50.5%). Intraoperative inoperability was also higher (29% vs. 14%).</p><p><strong>Conclusion: </strong>Diagnostic laparoscopy influenced treatment strategy by increasing NACT use and reducing non-beneficial surgeries. Though it did not improve overall cytoreduction rates, it enabled personalized treatment planning, especially in patients with ambiguous resectability, thereby potentially lowering surgical morbidity.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145028837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuropathic-like pain affects pain perception in patients with deep endometriosis: an observational study.","authors":"Carolina Dolci, Estelle Jean Dit Gautier, Lucie Lannez, Gilles Lebuffe, Jean Michel Wattier, Chrystele Rubod","doi":"10.1007/s00404-025-08178-1","DOIUrl":"https://doi.org/10.1007/s00404-025-08178-1","url":null,"abstract":"<p><strong>Purpose: </strong>Endometriosis is a chronic, hormone-dependent disease affecting up to 10% of women of reproductive age, often associated with chronic pelvic pain (CPP). Neuropathic pain has been increasingly recognized as a significant component in a subset of patients with CPP related to endometriosis. The study objective was to assess the prevalence of neuropathic-like pain in women with deep endometriosis (DE) and CPP, and to analyze its influence on pain perception and quality of life.</p><p><strong>Methods: </strong>Retrospective monocentric cohort study included 149 women with DE and CPP treated at a tertiary pain center between 2013 and 2017. Pain characteristics were assessed using validated tools, including the DN4 questionnaire for neuropathic pain, the abridged Saint-Antoine Pain Questionnaire (QDSA) for sensory and emotional dimensions of pain, and the EQ-VAS for quality of life. Psychological factors, including anxiety, depression, and catastrophizing, were also evaluated.</p><p><strong>Results: </strong>Neuropathic-like pain was identified in 36% of patients. These patients reported significantly higher global and minimum pain intensity (p < 0.01, p < 0.01), greater emotional (QDSA affective subscore, p < 0.05) and sensory (QDSA sensory subscore, p < 0.001) pain impact, and higher catastrophizing scores (p < 0.001). Quality of life was notably impaired (p < 0.05). Neuropathic-like pain was not associated with the stage of endometriosis or surgical complexity. Anxiety and depression scores did not differ significantly between the two groups (p = 0.47 and p = 0.52, respectively).</p><p><strong>Conclusions: </strong>Neuropathic-like pain was retrieved in over one-third of patients with DE and CPP, contributing to greater pain intensity, emotional distress, and reduced quality of life. Systematic screening for neuropathic-like pain and tailored multidisciplinary care are essential to optimize pain management.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145028820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of progestin-only drospirenone-based pills in hyperandrogenic women with polycystic ovary syndrome.","authors":"Alice Diterlizzi, Anna Tropea, Eleonora De Luca, Cristina Guerriero, Annamaria Merola, Giovanna Notaristefano, Ambra Moricone, Martina Policriti, Monia Ranalli, Anastasyia Samasiuk, Tullio Ghi, Antonio Lanzone, Rosanna Apa","doi":"10.1007/s00404-025-08083-7","DOIUrl":"https://doi.org/10.1007/s00404-025-08083-7","url":null,"abstract":"<p><strong>Purpose: </strong>Polycystic ovarian syndrome (PCOS) is a common endocrine-metabolic disorder affecting about 10% of reproductive-age women. Characterized by hyperandrogenism and ovulatory dysfunction, PCOS often involves metabolic features due to insulin resistance. Traditional treatment with combined oral contraceptive pills (COCP) effectively manages hyperandrogenism and menstrual irregularities. However, drospirenone-only pills (DRSP) may offer a viable alternative for patients who cannot take estrogen-based contraceptives due to cardiovascular risks or personal preference, owing to drospirenone's antiandrogenic properties and improved bleeding profile. This study aimed to evaluate the effects of DRSP-only pills on hyperandrogenism in PCOS patients. Secondary objectives included assessing changes in metabolic and hormonal features and bleeding profiles during therapy.</p><p><strong>Materials and methods: </strong>This monocentric observational retrospective study included 25 hyperandrogenic PCOS patients, aged 16 to 35, treated at Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome. Patients were prescribed DRSP-only therapy for 6 months. Clinical evaluations included ultrasonography, hormonal assays, and dermatological assessments using the Comprehensive Acne Severity Scale (CASS) and the modified Ferriman-Gallwey (mFG) score. Statistical analysis was performed using the two-tailed Wilcoxon test, with significance set at p < 0.05.</p><p><strong>Results: </strong>After 6 months of DRSP-only therapy, there was a significant reduction in CASS scores (2.4-1.8, p = 0.02) and mFG scores (12.31-6.31, p = 0.0053). In addition, significant reductions in 17-OH-progesterone (0.6-0.3 ng/ml, p = 0.03) and basal LH levels (5.8-3.55 UI/ml, p = 0.01) were observed. A trend toward a reduction in CRP levels (1.6-0.5 mg/l, p = 0.06) was noted. Any worsening in metabolic parameters was noted. Bleeding patterns were consistent with literature, with initial spotting decreasing over time.</p><p><strong>Conclusions: </strong>This study showed that a 6-month drospirenone (DRSP)-only therapy significantly reduced hyperandrogenism symptoms, such as acne and hirsutism, in PCOS patients. It also lowered 17-OH-progesterone levels and showed a trend of reduced CRP values. Bleeding patterns were consistent with those in existing literature. We recommend DRSP-only therapy as a suitable option for PCOS patients with hyperandrogenism who cannot use combined oral contraceptives (COCs), as well as to minimize the metabolic risks of estrogen.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145028801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}