Journal of gynecology obstetrics and human reproduction最新文献

Objective

Methods

Results

Conclusion

Objective

We aimed to conduct a comprehensive meta-analysis of the association between methionine synthase reductase (MTRR) c.66A>G variant and recurrent pregnancy loss (RPL) susceptibility.

Methods

We conducted a comprehensive systematic search of literature published before February 25, 2023 using PubMed, Embase, Web of Science, and Cochrane Library. Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of the included studies. The odds ratio (OR) was used to estimate the association between MTRR c.66A>G variant and RPL susceptibility. The I squared (I²) statistic and Q statistic were used to assess the heterogeneity among the included studies. And Begg's test and Egger's regression were then used to test the existence of publication bias.

Results

In this meta-analysis, we included 10 studies comprising 1842 RPL cases and 2173 healthy pregnant women to investigate the relationship between MTRR c.66A>G variants and the susceptibility of RPL. In the overall population analysis, MTRR c.66A>G variant was not significantly associated with the risk of RPL in different comparison models. Since 9 of the included studies were conducted in Asia, we performed analyses separately for Asian populations, including a total of 1855 cases and 2127 controls. Results showed, in Asian populations, there is no significant correlation between c.66A>G variant and the risk of RPL. Subgroup analyses according to ethnicity and country yielded similar results.

Conclusion

Our findings suggested that the MTRR c.66A>G variant was not significantly associated with the risk of RPL.

Research question

The legislation allowing unmarried women to undergo medically assisted reproduction (MAR) with sperm donation was adopted in France on August 2, 2021. This major advancement, and its impact on French society, led us to a closer examination of the requests made by unmarried women and the outcomes of ART attempts.

Design

A retrospective single center cohort study was conducted in a fertility center in Paris, France. All unmarried women and women in heterosexual couple seeking for MAR using sperm donation between September 2021 and October 2022 were included. Medical and socio-demographic data, as well as details and outcomes of MAR attempts were analyzed until October 31, 2023.

Results

Two hundred seventy-two unmarried women and 76 women in heterosexual couple were included. Results were compared between the two groups. Unmarried women were significantly older, with a significant decrease in anti-Müllerian hormone (AMH) and antral follicle count (AFC). They also exhibited a higher prevalence of gynecological pathologies associated with infertility, such as endometriosis. Unmarried women were more likely to work in intermediate occupations, whereas women in heterosexual couple more often had employee status. Among unmarried women who had undergone at least one MAR attempt by October 31, 2023, significantly lower cumulative early and ongoing pregnancy rates were observed.

Conclusions

Female age appears to play a major role in the likehood of pregnancy and live birth. It is therefore crucial to inform women initiating the process of MAR with sperm donation that success is not guaranteed.

Background

Although vulvar Paget's Disease (VPD) is a rare skin cancer associated with an excellent prognosis, high recurrence rates are associated with impaired quality of life.

Objectives

Our objective was to investigate the epidemiological and clinical features of VPD diagnosed in a French administrative area (Franche Comté).

Methods

This retrospective study investigated clinical, histologic, therapeutic and follow-up data of patients with VPD diagnosed between 1981 and 2021, including data from the Doubs cancer registry.

Results

Among the 21 patients included (19 intra-epithelial and 2 invasive VPD), the median time to diagnosis was 24 months [0–110 months], with a median age of 72 years [38–88 years]. An associated cancer was present in 6 patients (29 %). At 5 years of follow-up, the recurrence rate was 26 %, but then increased to 42 % after a median follow-up of 145 months [31–503 months]. Among the 14 patients first surgically treated, incomplete resection (positive margins) was observed in all patients (100 %), associated with a postoperative recurrence rate of 86 % which was much higher than the rate observed in patients first topically treated (20 %). Postoperative adjuvant therapy (surgical revision, laser, imiquimod) significantly increased the recurrence-free survival (p < 0.001).

Conclusions

Postoperative recurrence of VPD is frequent, mainly after 5 years, proving the importance of prolonged follow-up. Recurrence-free survival was significantly higher after postoperative adjuvant treatment.

This article has been retracted: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/locate/withdrawalpolicy).

This article has been retracted at the request of the Editor-in-Chief and the journal's Ethics Committee.

After post-publication investigation, issues related to the following were identified in the article:

• •

  Significant inconsistencies between the manuscript published in the journal, the protocol registered in ClinicalTrials and an ASRM abstract published in October 2017 (https://doi.org/10.1016/j.fertnstert.2017.07.216) concerning the number of treatment arms, the number of patients included and the authors.

• •

  Many similarities with the manuscript of another randomized controlled trial published in 2017 in the journal Contraception (Abbas AM, Abdellah MS, Khalaf M, Bahloul M, Abdellah NH, Ali MK, Abdelmagied AM. Effect of cervical lidocaine-prilocaine cream on pain perception during copper T380A intrauterine device insertion among parous women: A randomized double-blind controlled trial. Contraception. 2017 Mar;95(3):251-6. https://doi.org/10.1016/j.contraception.2016.10.011), in particular the table of women's characteristics (Table 2), even though these are 2 different populations.

To facilitate a thorough examination and ensure the accuracy of the information reported in the article, the authors were asked for the raw data of the article.

In the absence of an answer from the authors in relation to the raw data, a decision to retract the article was made in accordance with the journal's commitment to upholding the highest standards of scientific integrity and accuracy in published research.

Prof. Ahmed Abbas does not agree with the retraction and disputes the grounds for it.

Background

Binder phenotype (BP) is a term used to define a form of maxillo-nasal dysplasia defined by the presence of flattened nose, verticalized nasal bones, and retrusion of the maxilla (BP triad). This facial anomaly can be associated with other anomalies in both genetic and acquired conditions as well as in isolation. This systematic review aimed to summarize the antenatal findings, maternal and obstetrics characteristics as well as the obstetrics and neonatal outcomes of all cases of BP diagnosed in utero.

Methods

According to the PRISMA statement, we conducted a systematic review of the literatures to identify all the Binder phenotype cases diagnosed antenatally. We extracted and summarized obstetrics and neonatal characteristics of each study, including our case report.

Main findings

We identified a total of 47 cases of BP. The median gestational age at diagnosis was 23 weeks. BP was associated with other skeletal or non-skeletal anomalies in all cases apart from six confirmed to be isolated. Respiratory distress syndrome was observed in 12 neonates and in 18 cases BP was one of the clinical findings of chondrodysplasia punctata X-linked.

Conclusion

BP is often associated with other fetal defects; however, when isolated, BP seems to have good obstetrics and neonatal outcomes. In fetuses with apparent isolated BP at midtrimester, genetic testing with fluorescence in situ hybridization (FISH) for ARSE deletion can be offered for CDPX1 diagnosis while exome sequencing may be more informative in cases where a syndromic condition is suspected. Lastly, BP per se is associated with a higher risk of respiratory distress syndrome and feeding difficulties.

Introduction

Metroplasty is a procedure used by some teams to correct certain uterine anomalies to improve fertility outcomes. Our goal was to evaluate hysteroscopic metroplasty in the management of nulliparous and infertile patients with a uterine anomalies.

Material and methods

We conducted a single-center, retrospective, observational study of women who underwent hysteroscopic metroplasty for infertility between January 1, 2015 and December 31, 2019. The primary endpoint was the occurrence of a live birth at 18 months post-surgery. The secondary endpoint was to identify predictive factors for the success of the procedure, in particular ultrasound criteria, and live-birth rate during total follow up.

Results

We included 43 nulliparous patients with an average of 5.2±-2.4 years of primary infertility, including 84.2 % patients who had at least one IVF cycle prior to the surgery. The mean age was 37±5 years. The post-surgery live-birth rate was 27.9 % at 18 months and 53.5 % during the total postoperative follow-up (mean follow-up 4.5 ± 1 years). Pregnancies were obtained spontaneously after surgery for 8/28 (28.6 %) patients who were undergoing assisted reproduction technology before surgery. No intra- or postoperative complications were recorded. We did not identify any predictive ultrasound factors, pre- or postoperatively, for a live birth at 18 months post-surgery.

Discussion

Hysteroscopic metroplasty appears to improve the chances of a live birth in a population of nulliparous and infertile patients with at least one uterine pathology. Spontaneous pregnancy can occur after hysteroscopic metroplasty. The Congenital-Ultrasound-Malformation-by-Expert ultrasound criteria do not appear to be predictive of post-surgery outcomes.