Pub Date : 2025-02-01DOI: 10.1016/j.fertnstert.2024.08.331
Vasanti Jadva Ph.D. , Catherine Jones Ph.D. , Sophie Zadeh Ph.D.
<div><h3>Objective</h3><div>To understand how the Donor Conception Identity Questionnaire (DCIQ) correlates with mental health and explore differences in the DCIQ between donor conceived people who were actively searching for donor connections to those who were not and those who had found their donor connections to those who had not.</div></div><div><h3>Design</h3><div>Cross-sectional survey.</div></div><div><h3>Subjects</h3><div>A total of 88 donor conceived adults ranging in age from 18 to 70 (mean, 34.27 years; median, 31 years). A total of 39 participants were actively searching for their donor connections, and 49 were not.</div></div><div><h3>Exposure</h3><div>Donor conception identity was measured using a questionnaire and scores were correlated with existing measures of mental health.</div></div><div><h3>Main Outcome Measure(s)</h3><div>Participants completed the DCIQ and measures of well-being, satisfaction with life, identity, pride, and stigma.</div></div><div><h3>Result(s)</h3><div>Factor analysis of items from the DCIQ identified four domains: concern and preoccupation; internalized stigma; pride and acceptance; and openness and understanding. The identified factors correlated with scales of psychological and social well-being. Active searchers scored higher than non-active searchers on “concern and preoccupation” and “internalized stigma”. Donor conceived individuals who had found their donor connections scored lower on “internalized stigma” and higher on “openness and understanding” compared with those who had not found their donor connections.</div></div><div><h3>Conclusion(s)</h3><div>The findings of the present study show that scores on the DCIQ correlate with existing measures of psychological and social well-being. Furthermore, donor conceived individuals searching for their donor connections differ from those not actively searching on key domains of the DCIQ. Implications for future avenues of study and support for donor conceived people are discussed.</div></div><div><div>Cuestionario de Identidad de Concepción por donante: asociaciones con la salud mental y la búsqueda y el encuentro de conexiones con donantes</div></div><div><h3>Objetivo</h3><div>comprender cómo el Cuestionario de Identidad de Concepción por Donante (DCIQ) se correlaciona con la salud mental y explorar las diferencias en el DCIQ entre las personas concebidas por donación que estaban buscando activamente conexiones con donantes y las que no, así como aquellas que habían encontrado sus conexiones con donantes y las que no.</div></div><div><h3>Diseño</h3><div>una encuesta transversal.</div></div><div><h3>Lugar</h3><div>encuesta realizada en línea en el Reino Unido.</div></div><div><h3>Paciente(s)</h3><div>Un total de 88 adultos concebidos por donación, con edades comprendidas entre los 18 y los 70 años (media, 34.27 años; mediana, 31 años). Un total de 39 pacientes estaban activamente buscado sus conexiones con donantes y 49, no.</div></div><div><h3>Intervenci
{"title":"The Donor Conception Identity Questionnaire: associations with mental health and searching for and finding donor connections","authors":"Vasanti Jadva Ph.D. , Catherine Jones Ph.D. , Sophie Zadeh Ph.D.","doi":"10.1016/j.fertnstert.2024.08.331","DOIUrl":"10.1016/j.fertnstert.2024.08.331","url":null,"abstract":"<div><h3>Objective</h3><div>To understand how the Donor Conception Identity Questionnaire (DCIQ) correlates with mental health and explore differences in the DCIQ between donor conceived people who were actively searching for donor connections to those who were not and those who had found their donor connections to those who had not.</div></div><div><h3>Design</h3><div>Cross-sectional survey.</div></div><div><h3>Subjects</h3><div>A total of 88 donor conceived adults ranging in age from 18 to 70 (mean, 34.27 years; median, 31 years). A total of 39 participants were actively searching for their donor connections, and 49 were not.</div></div><div><h3>Exposure</h3><div>Donor conception identity was measured using a questionnaire and scores were correlated with existing measures of mental health.</div></div><div><h3>Main Outcome Measure(s)</h3><div>Participants completed the DCIQ and measures of well-being, satisfaction with life, identity, pride, and stigma.</div></div><div><h3>Result(s)</h3><div>Factor analysis of items from the DCIQ identified four domains: concern and preoccupation; internalized stigma; pride and acceptance; and openness and understanding. The identified factors correlated with scales of psychological and social well-being. Active searchers scored higher than non-active searchers on “concern and preoccupation” and “internalized stigma”. Donor conceived individuals who had found their donor connections scored lower on “internalized stigma” and higher on “openness and understanding” compared with those who had not found their donor connections.</div></div><div><h3>Conclusion(s)</h3><div>The findings of the present study show that scores on the DCIQ correlate with existing measures of psychological and social well-being. Furthermore, donor conceived individuals searching for their donor connections differ from those not actively searching on key domains of the DCIQ. Implications for future avenues of study and support for donor conceived people are discussed.</div></div><div><div>Cuestionario de Identidad de Concepción por donante: asociaciones con la salud mental y la búsqueda y el encuentro de conexiones con donantes</div></div><div><h3>Objetivo</h3><div>comprender cómo el Cuestionario de Identidad de Concepción por Donante (DCIQ) se correlaciona con la salud mental y explorar las diferencias en el DCIQ entre las personas concebidas por donación que estaban buscando activamente conexiones con donantes y las que no, así como aquellas que habían encontrado sus conexiones con donantes y las que no.</div></div><div><h3>Diseño</h3><div>una encuesta transversal.</div></div><div><h3>Lugar</h3><div>encuesta realizada en línea en el Reino Unido.</div></div><div><h3>Paciente(s)</h3><div>Un total de 88 adultos concebidos por donación, con edades comprendidas entre los 18 y los 70 años (media, 34.27 años; mediana, 31 años). Un total de 39 pacientes estaban activamente buscado sus conexiones con donantes y 49, no.</div></div><div><h3>Intervenci","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"123 2","pages":"Pages 322-332"},"PeriodicalIF":6.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142055329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.fertnstert.2024.08.353
Stefano Palomba M.D., Donatella Caserta M.D.
{"title":"Follitropin delta: is further evidence needed?","authors":"Stefano Palomba M.D., Donatella Caserta M.D.","doi":"10.1016/j.fertnstert.2024.08.353","DOIUrl":"10.1016/j.fertnstert.2024.08.353","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"123 2","pages":"Page 373"},"PeriodicalIF":6.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div><h3>Objective</h3><div>To assess changes in morphology and size of endometriomas during pregnancy and after delivery.</div></div><div><h3>Design</h3><div>This was a prospective observational cohort study performed during 2013–2024 at a tertiary care center (Ultrasound Unit, Department of Obstetrics and Gynecology, Skane University Hospital, Malmo, Sweden). Women were offered repeated ultrasound examinations every month during pregnancy and thereafter at 3 and 12 months after delivery. Ultrasound examinations were performed either transvaginally or transabdominally depending on the gestational week and assessability of the ovaries.</div></div><div><h3>Subjects</h3><div>Pregnant women with an ovarian cyst suggestive of endometrioma based on subjective assessment were eligible and those with the pregnancy that continued beyond gestational age of 22 weeks were included. In total, 57 women were included.</div></div><div><h3>Exposure</h3><div>Pregnancy.</div></div><div><h3>Main Outcome Measure(s)</h3><div>Changes in morphology (cyst type, cyst content, and signs of decidualization) and size of the endometrioma and the largest solid component were assessed during follow-up ultrasound examinations.</div></div><div><h3>Result(s)</h3><div>During pregnancy, endometriomas changed in morphology in 42/57 women (74%; 95% confidence interval [CI], 60–84) and decreased in size in 42/57 women (74%; 95% CI, 60–84). Decidualization of endometrioma was observed in 33/57 women (58%; 95% CI, 44–71) and was detected first time at gestational age of 17 weeks (median, interquartile range, 15–22; range, 6–29). The size of endometriomas decreased although the size of solid components increased from gestational age of 22<sup>+0</sup> weeks. Signs of decidualization disappeared after delivery.</div></div><div><h3>Conclusion(s)</h3><div>Three out of four endometriomas undergo morphological changes during pregnancy. Decidualized endometrioma may mimic borderline malignancy, however, changes regress after delivery. Knowing the natural behavior of endometriomas during pregnancy is crucial to reducing the risk of misclassification of endometriomas as malignant masses. Follow-up ultrasound examination after delivery helps to reassure the benign nature of the cyst.</div></div><div><div>Cambios morfológicos de los endometriomas durante el embarazo y después del parto detectados mediante ecografía.</div></div><div><h3>Objetivo</h3><div>Evaluar los cambios en la morfología y el tamaño de los endometriomas durante el embarazo y después del parto.</div></div><div><h3>Diseño</h3><div>Estudio observacional prospectivo de cohorte realizado entre 2013 y 2024 en un centro de atención terciaria (Unidad de Ultrasonido, Departamento de Obstetricia y Ginecología, Hospital Universitario de Skane, Malmö, Suecia). A las mujeres se les ofrecieron exámenes repetidos de ultrasonido cada mes durante el embarazo y posteriormente a los 3 y 12 meses tras el parto. Las ecografías se realizaron por vía
{"title":"Morphological changes of endometriomas during pregnancy and after delivery detected using ultrasound","authors":"Sofie Orlov M.D. , Povilas Sladkevicius M.D., Ph.D. , Isis Rivano Eckerdal M.D. , Ligita Jokubkiene M.D., Ph.D.","doi":"10.1016/j.fertnstert.2024.08.355","DOIUrl":"10.1016/j.fertnstert.2024.08.355","url":null,"abstract":"<div><h3>Objective</h3><div>To assess changes in morphology and size of endometriomas during pregnancy and after delivery.</div></div><div><h3>Design</h3><div>This was a prospective observational cohort study performed during 2013–2024 at a tertiary care center (Ultrasound Unit, Department of Obstetrics and Gynecology, Skane University Hospital, Malmo, Sweden). Women were offered repeated ultrasound examinations every month during pregnancy and thereafter at 3 and 12 months after delivery. Ultrasound examinations were performed either transvaginally or transabdominally depending on the gestational week and assessability of the ovaries.</div></div><div><h3>Subjects</h3><div>Pregnant women with an ovarian cyst suggestive of endometrioma based on subjective assessment were eligible and those with the pregnancy that continued beyond gestational age of 22 weeks were included. In total, 57 women were included.</div></div><div><h3>Exposure</h3><div>Pregnancy.</div></div><div><h3>Main Outcome Measure(s)</h3><div>Changes in morphology (cyst type, cyst content, and signs of decidualization) and size of the endometrioma and the largest solid component were assessed during follow-up ultrasound examinations.</div></div><div><h3>Result(s)</h3><div>During pregnancy, endometriomas changed in morphology in 42/57 women (74%; 95% confidence interval [CI], 60–84) and decreased in size in 42/57 women (74%; 95% CI, 60–84). Decidualization of endometrioma was observed in 33/57 women (58%; 95% CI, 44–71) and was detected first time at gestational age of 17 weeks (median, interquartile range, 15–22; range, 6–29). The size of endometriomas decreased although the size of solid components increased from gestational age of 22<sup>+0</sup> weeks. Signs of decidualization disappeared after delivery.</div></div><div><h3>Conclusion(s)</h3><div>Three out of four endometriomas undergo morphological changes during pregnancy. Decidualized endometrioma may mimic borderline malignancy, however, changes regress after delivery. Knowing the natural behavior of endometriomas during pregnancy is crucial to reducing the risk of misclassification of endometriomas as malignant masses. Follow-up ultrasound examination after delivery helps to reassure the benign nature of the cyst.</div></div><div><div>Cambios morfológicos de los endometriomas durante el embarazo y después del parto detectados mediante ecografía.</div></div><div><h3>Objetivo</h3><div>Evaluar los cambios en la morfología y el tamaño de los endometriomas durante el embarazo y después del parto.</div></div><div><h3>Diseño</h3><div>Estudio observacional prospectivo de cohorte realizado entre 2013 y 2024 en un centro de atención terciaria (Unidad de Ultrasonido, Departamento de Obstetricia y Ginecología, Hospital Universitario de Skane, Malmö, Suecia). A las mujeres se les ofrecieron exámenes repetidos de ultrasonido cada mes durante el embarazo y posteriormente a los 3 y 12 meses tras el parto. Las ecografías se realizaron por vía ","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"123 2","pages":"Pages 211-220"},"PeriodicalIF":6.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.fertnstert.2024.08.354
Hortense Everaere M.D. , Virginie Simon M.D. , Anne Bachelot M.D., Ph.D. , Maxime Leroy B.S. , Christine Decanter M.D. , Didier Dewailly M.D. , Sophie Catteau-Jonard M.D., Ph.D. , Geoffroy Robin M.D.
<div><h3>Objective</h3><div>To compare the ongoing pregnancy rate per initiated cycle between patients with functional hypothalamic amenorrhea (FHA) and patients with congenital hypogonadotropic hypogonadism (CHH) treated with pulsatile gonadotropin-releasing hormone (GnRH) administration.</div></div><div><h3>Design</h3><div>Retrospective monocentric cohort study conducted at the University Hospital of Lille from 2004 to 2022.</div></div><div><h3>Subjects</h3><div>A total of 141 patients diagnosed with central suprapituitary amenorrhea during infertility evaluation and subsequently treated with pulsatile GnRH therapy. 111 and 30 patients were diagnosed with FHA or CHH, respectively.</div></div><div><h3>Exposure</h3><div>Pulsatile GnRH administration.</div></div><div><h3>Main Outcome Measure(s)</h3><div>Ongoing pregnancy rate per initiated cycle.</div></div><div><h3>Result(s)</h3><div>Ongoing pregnancy rates per initiated cycle were comparable between groups: 21.5% in the FHA group vs. 22% in the CHH group. Comparison of baseline characteristics showed a more pronounced follicle-stimulating hormone (FSH) deficiency in patients with CHH than in those with FHA: 2.55 (0.6–4.92) vs. 4.80 (3.90–5.70) UI/L. Within the CHH group, basal FSH level was positively associated with the occurrence of ongoing pregnancies (odds ratio, 1.57; 95% confidence interval, 1.11–2.22). In the CHH group, the duration of treatment was higher than in the FHA group: 23.59 (± 8.02) vs. 18.16 (± 7.66) days.</div></div><div><h3>Conclusion(s)</h3><div>The baseline FSH level is lower in patients with CHH than in patients with FHA. The lower the FSH, the lower the chance of pregnancy in patients with CHH. These patients also require more days of GnRH administration. However, the rate of ongoing pregnancies is comparable between the two groups.</div></div><div><div>Terapia hormonal pulsátil liberadora de gonadotropina: Comparación de la eficacia entre la amenorrea hipotalámica funcional y el hipogonadismo hipogonadotrópico congénito</div></div><div><h3>Objetivo</h3><div>Comparar la tasa de embarazo en curso por ciclo iniciado entre pacientes con amenorrea hipotalámica funcional (AHF) y pacientes con hipogonadismo hipogonadotrópico congénito (HHC) tratadas con administración pulsátil de hormona liberadora de gonadotropina (GnRH).</div></div><div><h3>Diseño</h3><div>Estudio de cohorte retrospectivo monocéntrico llevado a cabo en la Universidad Hospital de Lille desde el 2004 al 2022.</div></div><div><h3>Escenario</h3><div>Universidad Hospital de Lille, Departamento de Ginecología Endocrina.</div></div><div><h3>Paciente(s)</h3><div>Un total de 141 pacientes diagnosticas con amenorrea suprapituitaria central durante la evaluación por infertilidad y subsecuentemente tratadas con terapía pulsátil de GnRH. 111 y 30 pacientes fueron diagnosticas con AHF y HHC, respectivamente.</div></div><div><h3>Intervención(es)</h3><div>Administración pulsátil de GnRH.</div></div><div><h3>Medida de result
{"title":"Pulsatile gonadotropin-releasing hormone therapy: comparison of efficacy between functional hypothalamic amenorrhea and congenital hypogonadotropic hypogonadism","authors":"Hortense Everaere M.D. , Virginie Simon M.D. , Anne Bachelot M.D., Ph.D. , Maxime Leroy B.S. , Christine Decanter M.D. , Didier Dewailly M.D. , Sophie Catteau-Jonard M.D., Ph.D. , Geoffroy Robin M.D.","doi":"10.1016/j.fertnstert.2024.08.354","DOIUrl":"10.1016/j.fertnstert.2024.08.354","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the ongoing pregnancy rate per initiated cycle between patients with functional hypothalamic amenorrhea (FHA) and patients with congenital hypogonadotropic hypogonadism (CHH) treated with pulsatile gonadotropin-releasing hormone (GnRH) administration.</div></div><div><h3>Design</h3><div>Retrospective monocentric cohort study conducted at the University Hospital of Lille from 2004 to 2022.</div></div><div><h3>Subjects</h3><div>A total of 141 patients diagnosed with central suprapituitary amenorrhea during infertility evaluation and subsequently treated with pulsatile GnRH therapy. 111 and 30 patients were diagnosed with FHA or CHH, respectively.</div></div><div><h3>Exposure</h3><div>Pulsatile GnRH administration.</div></div><div><h3>Main Outcome Measure(s)</h3><div>Ongoing pregnancy rate per initiated cycle.</div></div><div><h3>Result(s)</h3><div>Ongoing pregnancy rates per initiated cycle were comparable between groups: 21.5% in the FHA group vs. 22% in the CHH group. Comparison of baseline characteristics showed a more pronounced follicle-stimulating hormone (FSH) deficiency in patients with CHH than in those with FHA: 2.55 (0.6–4.92) vs. 4.80 (3.90–5.70) UI/L. Within the CHH group, basal FSH level was positively associated with the occurrence of ongoing pregnancies (odds ratio, 1.57; 95% confidence interval, 1.11–2.22). In the CHH group, the duration of treatment was higher than in the FHA group: 23.59 (± 8.02) vs. 18.16 (± 7.66) days.</div></div><div><h3>Conclusion(s)</h3><div>The baseline FSH level is lower in patients with CHH than in patients with FHA. The lower the FSH, the lower the chance of pregnancy in patients with CHH. These patients also require more days of GnRH administration. However, the rate of ongoing pregnancies is comparable between the two groups.</div></div><div><div>Terapia hormonal pulsátil liberadora de gonadotropina: Comparación de la eficacia entre la amenorrea hipotalámica funcional y el hipogonadismo hipogonadotrópico congénito</div></div><div><h3>Objetivo</h3><div>Comparar la tasa de embarazo en curso por ciclo iniciado entre pacientes con amenorrea hipotalámica funcional (AHF) y pacientes con hipogonadismo hipogonadotrópico congénito (HHC) tratadas con administración pulsátil de hormona liberadora de gonadotropina (GnRH).</div></div><div><h3>Diseño</h3><div>Estudio de cohorte retrospectivo monocéntrico llevado a cabo en la Universidad Hospital de Lille desde el 2004 al 2022.</div></div><div><h3>Escenario</h3><div>Universidad Hospital de Lille, Departamento de Ginecología Endocrina.</div></div><div><h3>Paciente(s)</h3><div>Un total de 141 pacientes diagnosticas con amenorrea suprapituitaria central durante la evaluación por infertilidad y subsecuentemente tratadas con terapía pulsátil de GnRH. 111 y 30 pacientes fueron diagnosticas con AHF y HHC, respectivamente.</div></div><div><h3>Intervención(es)</h3><div>Administración pulsátil de GnRH.</div></div><div><h3>Medida de result","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"123 2","pages":"Pages 270-279"},"PeriodicalIF":6.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.fertnstert.2024.09.026
Shunshun Cao M.Sc. , Yangyang Hu M.Sc.
{"title":"From breast cancer to fertility outcomes: increasing understanding of urgent fertility preservation","authors":"Shunshun Cao M.Sc. , Yangyang Hu M.Sc.","doi":"10.1016/j.fertnstert.2024.09.026","DOIUrl":"10.1016/j.fertnstert.2024.09.026","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"123 2","pages":"Page 375"},"PeriodicalIF":6.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.fertnstert.2024.09.013
Felipe Arbelaez M.D. , Hee-Koung Joeng Ph.D. , Azher Hussain Ph.D. , Sheila Sunga Ph.D. , Yanfen Guan M.S. , Akshita Chawla Ph.D. , Francisco Carmona M.D. , Christopher Lines Ph.D. , Geraldine Mendizabal M.D.
<div><h3>Objective</h3><div>To evaluate the P2X3 receptor antagonist, gefapixant, for treating moderate-to-severe endometriosis-related pain.</div></div><div><h3>Design</h3><div>Randomized, double-blind, phase 2, and proof-of-concept trial.</div></div><div><h3>Subjects</h3><div>Premenopausal women age 18–49 years with moderate-to-severe endometriosis-related pain who were not using hormonal treatment.</div></div><div><h3>Intervention(s)</h3><div>Gefapixant (45-mg twice daily) or placebo over two menstrual cycles.</div></div><div><h3>Main outcome measure(s)</h3><div>Participants rated peak pelvic pain severity daily on a 0 (no pain) – 10 (extremely severe pain) scale. The primary endpoint was change from baseline in average daily peak pelvic pain severity during treatment cycle 2.</div></div><div><h3>Result(s)</h3><div>All 187 participants randomized (gefapixant, N = 94; placebo, N = 93) took ≥1 dose of investigational treatment and all but six in each treatment group completed the trial. The model-based least-squares mean reduction from baseline in average daily peak pelvic pain severity during treatment cycle 2 was –2.2 for gefapixant and –1.7 for placebo (difference, –0.5; 95% confidence interval, –1.01 to 0.03). In secondary analyses, the difference between gefapixant and placebo in peak pelvic pain severity reduction from baseline on menstrual days was –0.6 (95% confidence interval, –1.18 to –0.06) and –0.5 (95% confidence interval, –1.04 to 0.03) on nonmenstrual days. Taste-related adverse events were reported in 31.9% of participants for gefapixant vs. 4.3% for placebo. Pharmacokinetic assessments at months 1 and 2 clinic visits indicated that of the 94 participants in the gefapixant group, 39 had detectable levels of gefapixant in the blood for both assessments although 38 had no detectable levels for ≥1 assessment.</div></div><div><h3>Conclusion(s)</h3><div>Gefapixant (45-mg twice daily) was not shown to be superior to placebo in reducing endometriosis-related pain, although the results directionally favored gefapixant. This trial result should be considered inconclusive given possible issues with treatment compliance.</div></div><div><h3>Clinical Trial Registration Number</h3><div>NCT03654326.</div></div><div><div>Ensayo Aleatorizado, controlado, prueba de concepto de gefapixant para el dolor relacionado con la endometriosis</div></div><div><h3>Objetivo</h3><div>Evaluar el receptor antagonista del P2X3, gefapixant, para el tratamiento del dolor moderado a severo relacionado con la endometriosis.</div></div><div><h3>Diseño</h3><div>ensayo aleatorizado, doble ciego, de fase 2 y de prueba de concepto.</div></div><div><h3>Ámbito</h3><div>Pacientes ambulatorios en hospitales, centros médicos o sitios de investigación clínica.</div></div><div><h3>Paciente(s)</h3><div>Mujeres premenopáusicas de 18 a 49 años con dolor relacionado con la endometriosis de moderado a severo que no estaban usando tratamiento hormonal.</div></div><div><h3>Intervenció
{"title":"Randomized, controlled, proof-of-concept trial of gefapixant for endometriosis-related pain","authors":"Felipe Arbelaez M.D. , Hee-Koung Joeng Ph.D. , Azher Hussain Ph.D. , Sheila Sunga Ph.D. , Yanfen Guan M.S. , Akshita Chawla Ph.D. , Francisco Carmona M.D. , Christopher Lines Ph.D. , Geraldine Mendizabal M.D.","doi":"10.1016/j.fertnstert.2024.09.013","DOIUrl":"10.1016/j.fertnstert.2024.09.013","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the P2X3 receptor antagonist, gefapixant, for treating moderate-to-severe endometriosis-related pain.</div></div><div><h3>Design</h3><div>Randomized, double-blind, phase 2, and proof-of-concept trial.</div></div><div><h3>Subjects</h3><div>Premenopausal women age 18–49 years with moderate-to-severe endometriosis-related pain who were not using hormonal treatment.</div></div><div><h3>Intervention(s)</h3><div>Gefapixant (45-mg twice daily) or placebo over two menstrual cycles.</div></div><div><h3>Main outcome measure(s)</h3><div>Participants rated peak pelvic pain severity daily on a 0 (no pain) – 10 (extremely severe pain) scale. The primary endpoint was change from baseline in average daily peak pelvic pain severity during treatment cycle 2.</div></div><div><h3>Result(s)</h3><div>All 187 participants randomized (gefapixant, N = 94; placebo, N = 93) took ≥1 dose of investigational treatment and all but six in each treatment group completed the trial. The model-based least-squares mean reduction from baseline in average daily peak pelvic pain severity during treatment cycle 2 was –2.2 for gefapixant and –1.7 for placebo (difference, –0.5; 95% confidence interval, –1.01 to 0.03). In secondary analyses, the difference between gefapixant and placebo in peak pelvic pain severity reduction from baseline on menstrual days was –0.6 (95% confidence interval, –1.18 to –0.06) and –0.5 (95% confidence interval, –1.04 to 0.03) on nonmenstrual days. Taste-related adverse events were reported in 31.9% of participants for gefapixant vs. 4.3% for placebo. Pharmacokinetic assessments at months 1 and 2 clinic visits indicated that of the 94 participants in the gefapixant group, 39 had detectable levels of gefapixant in the blood for both assessments although 38 had no detectable levels for ≥1 assessment.</div></div><div><h3>Conclusion(s)</h3><div>Gefapixant (45-mg twice daily) was not shown to be superior to placebo in reducing endometriosis-related pain, although the results directionally favored gefapixant. This trial result should be considered inconclusive given possible issues with treatment compliance.</div></div><div><h3>Clinical Trial Registration Number</h3><div>NCT03654326.</div></div><div><div>Ensayo Aleatorizado, controlado, prueba de concepto de gefapixant para el dolor relacionado con la endometriosis</div></div><div><h3>Objetivo</h3><div>Evaluar el receptor antagonista del P2X3, gefapixant, para el tratamiento del dolor moderado a severo relacionado con la endometriosis.</div></div><div><h3>Diseño</h3><div>ensayo aleatorizado, doble ciego, de fase 2 y de prueba de concepto.</div></div><div><h3>Ámbito</h3><div>Pacientes ambulatorios en hospitales, centros médicos o sitios de investigación clínica.</div></div><div><h3>Paciente(s)</h3><div>Mujeres premenopáusicas de 18 a 49 años con dolor relacionado con la endometriosis de moderado a severo que no estaban usando tratamiento hormonal.</div></div><div><h3>Intervenció","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"123 2","pages":"Pages 280-288"},"PeriodicalIF":6.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.fertnstert.2024.08.342
Kim van der Ham M.D. , Federica Barbagallo M.D. , Emiliya van Schilfgaarde B.Sc. , Marla E. Lujan Ph.D. , Joop S.E. Laven Ph.D. , Yvonne V. Louwers Ph.D.
<div><h3>Objective</h3><div>To study the value of current definitions for follicle number per ovary and ovarian volume in the diagnosis of polycystic ovary syndrome (PCOS).</div></div><div><h3>Design</h3><div>Cross-sectional study.</div></div><div><h3>Subjects</h3><div>Women diagnosed with PCOS after standardized screening were eligible for inclusion in the PCOS group. Women without PCOS who underwent the same screening, had regular menstrual cycles, normal hormonal values, and no other endocrine pathology were eligible for inclusion.</div></div><div><h3>Exposure</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measure(s)</h3><div>Follicle number per ovary and ovarian volume in women with PCOS, stratified by age. Linear regression models to investigate the influence of body mass index (BMI) on follicle number per ovary and ovarian volume. Differences in follicle number per ovary and ovarian volume between the PCOS phenotypes and the additional value of ovarian volume compared with follicle number per ovary.</div></div><div><h3>Result(s)</h3><div>A total of 2,492 women (16–50 years) with PCOS and 152 women without PCOS were included. Most women with PCOS up to age of 35 exhibit a follicle number per ovary ≥20 (87.8%–100%) (using an ultrasound transducer ≥8 MHz) or ≥12 (95.1%–98.6%) (using a transducer <8 MHz), followed by a decline in follicle number per ovary >35 years. Median ovarian volume was below the 10 mL cutoff in every age group, for both ultrasound transducers. Follicle number per ovary and ovarian volume were higher in women with PCOS compared with women without PCOS in every age category. In our cohort, 13/2,297 women with PCOS (0.6%) would not have received the diagnosis if ovarian volume was not considered a marker for polycystic ovarian morphology. For both ultrasound transducers, women with phenotype A (ovulatory dysfunction + hyperandrogenism + polycystic ovarian morphology) exhibited the highest follicle number per ovary and ovarian volume, followed by phenotype D (ovulatory dysfunction + polycystic ovarian morphology), then phenotype C (hyperandrogenism + polycystic ovarian morphology), and then phenotype B (ovulatory dysfunction + hyperandrogenism). No clinically significant correlation between BMI and follicle number per ovary or ovarian volume was observed.</div></div><div><h3>Conclusion(s)</h3><div>Criteria to define follicle number per ovary should be established per age category, as follicle number per ovary decreases with age. Ovarian volume shows a less clear decline with age and has a lower discriminative power, and therefore could be excluded from the diagnostic criteria. Follicle number per ovary does not need to be stratified by BMI.</div></div><div><div>El valor adicional de los marcadores ecográficos en el diagnóstico del síndrome de ovario poliquístico</div></div><div><h3>Objetivo</h3><div>Estudiar el valor de las definiciones actuales del número de folículos por ovario y el volumen ovárico en el di
{"title":"The additional value of ultrasound markers in the diagnosis of polycystic ovary syndrome","authors":"Kim van der Ham M.D. , Federica Barbagallo M.D. , Emiliya van Schilfgaarde B.Sc. , Marla E. Lujan Ph.D. , Joop S.E. Laven Ph.D. , Yvonne V. Louwers Ph.D.","doi":"10.1016/j.fertnstert.2024.08.342","DOIUrl":"10.1016/j.fertnstert.2024.08.342","url":null,"abstract":"<div><h3>Objective</h3><div>To study the value of current definitions for follicle number per ovary and ovarian volume in the diagnosis of polycystic ovary syndrome (PCOS).</div></div><div><h3>Design</h3><div>Cross-sectional study.</div></div><div><h3>Subjects</h3><div>Women diagnosed with PCOS after standardized screening were eligible for inclusion in the PCOS group. Women without PCOS who underwent the same screening, had regular menstrual cycles, normal hormonal values, and no other endocrine pathology were eligible for inclusion.</div></div><div><h3>Exposure</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measure(s)</h3><div>Follicle number per ovary and ovarian volume in women with PCOS, stratified by age. Linear regression models to investigate the influence of body mass index (BMI) on follicle number per ovary and ovarian volume. Differences in follicle number per ovary and ovarian volume between the PCOS phenotypes and the additional value of ovarian volume compared with follicle number per ovary.</div></div><div><h3>Result(s)</h3><div>A total of 2,492 women (16–50 years) with PCOS and 152 women without PCOS were included. Most women with PCOS up to age of 35 exhibit a follicle number per ovary ≥20 (87.8%–100%) (using an ultrasound transducer ≥8 MHz) or ≥12 (95.1%–98.6%) (using a transducer <8 MHz), followed by a decline in follicle number per ovary >35 years. Median ovarian volume was below the 10 mL cutoff in every age group, for both ultrasound transducers. Follicle number per ovary and ovarian volume were higher in women with PCOS compared with women without PCOS in every age category. In our cohort, 13/2,297 women with PCOS (0.6%) would not have received the diagnosis if ovarian volume was not considered a marker for polycystic ovarian morphology. For both ultrasound transducers, women with phenotype A (ovulatory dysfunction + hyperandrogenism + polycystic ovarian morphology) exhibited the highest follicle number per ovary and ovarian volume, followed by phenotype D (ovulatory dysfunction + polycystic ovarian morphology), then phenotype C (hyperandrogenism + polycystic ovarian morphology), and then phenotype B (ovulatory dysfunction + hyperandrogenism). No clinically significant correlation between BMI and follicle number per ovary or ovarian volume was observed.</div></div><div><h3>Conclusion(s)</h3><div>Criteria to define follicle number per ovary should be established per age category, as follicle number per ovary decreases with age. Ovarian volume shows a less clear decline with age and has a lower discriminative power, and therefore could be excluded from the diagnostic criteria. Follicle number per ovary does not need to be stratified by BMI.</div></div><div><div>El valor adicional de los marcadores ecográficos en el diagnóstico del síndrome de ovario poliquístico</div></div><div><h3>Objetivo</h3><div>Estudiar el valor de las definiciones actuales del número de folículos por ovario y el volumen ovárico en el di","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"123 2","pages":"Pages 342-349"},"PeriodicalIF":6.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.fertnstert.2024.11.015
Jose Carugno M.D. , Amira Quevedo M.D. , Nash S. Moawad M.D., M.S.
{"title":"A long road ahead: medical management for endometriosis-related pain. Just keep looking","authors":"Jose Carugno M.D. , Amira Quevedo M.D. , Nash S. Moawad M.D., M.S.","doi":"10.1016/j.fertnstert.2024.11.015","DOIUrl":"10.1016/j.fertnstert.2024.11.015","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"123 2","pages":"Pages 237-238"},"PeriodicalIF":6.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.fertnstert.2024.11.023
Seifeldin Sadek M.D. , Amanda M. Ryan M.D. , Amr S. El Haraki M.D.
{"title":"Unveiling the burden of hypoestrogenism","authors":"Seifeldin Sadek M.D. , Amanda M. Ryan M.D. , Amr S. El Haraki M.D.","doi":"10.1016/j.fertnstert.2024.11.023","DOIUrl":"10.1016/j.fertnstert.2024.11.023","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"123 2","pages":"Pages 241-242"},"PeriodicalIF":6.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.fertnstert.2024.11.027
Mary P. Riddle Ph.D.
{"title":"Highlighting the importance of identity formation and the implications for psychological well-being among donor conceived individuals","authors":"Mary P. Riddle Ph.D.","doi":"10.1016/j.fertnstert.2024.11.027","DOIUrl":"10.1016/j.fertnstert.2024.11.027","url":null,"abstract":"","PeriodicalId":12275,"journal":{"name":"Fertility and sterility","volume":"123 2","pages":"Pages 245-246"},"PeriodicalIF":6.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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