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Inside Front Cover - Affiliations and First page of TOC 内部封面-附属机构和第一页的TOC
IF 3.5 2区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2025-11-01 DOI: 10.1016/S1472-6483(25)00582-6
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引用次数: 0
'Is The Coexistence of Diminished Ovarian Reserve and Severe Male Factor Infertility A Clinically Significant Entity?'' 卵巢储备功能减退与严重男性因素性不育症共存是否具有临床意义?''
IF 3.5 2区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2025-11-01 DOI: 10.1016/j.rbmo.2025.105326
Fatma Tunc , Recep Onur Karabacak , Ismail Guler

OBJECTIVE

To evaluate the available evidence on the coexistence of severe male factor infertility and diminished ovarian reserve, as observed in infertile couples.

MATERIALS AND METHODS

Between July 2022 and June 2023, data were retrospectively collected from the female partners of 79 men with severe male factor infertility and 84 men with normal semen parameters who underwent IVF. The demographic characteristics of the participants were comparable between the groups. The study group (group 1) consisted of female partners of men diagnosed with severe oligospermia (n=79), whereas the control group (group 2) comprised partners of men with normal semen parameters (n=84). There were 101 women(61,9%) with normal overian reserve tests and 62 women (38,1%) with diminished ovarian reserve. Demographic data, personal information, and second-day hormone levels were obtained through retrospective review of medical records.

RESULTS

The association between severe male factor infertility and diminished ovarian reserve was evaluated using the chi-square test, which demonstrated no statistically significant relationship (p=0.2). The mean follicle-stimulating hormone (FSH) level was 8.9±4.2 mIU/mL in group 1 and 10±6.2 mIU/mL in group 2, with significantly higher levels observed in group 2 (p=0.05). Luteinizing hormone (LH) levels were also significantly higher in group 2 (6.5±2.9 mIU/mL) compared to Group 1 (5.2 ± 2.1 mIU/mL) (p=0.006). The mean anti-Müllerian hormone (AMH) levels were comparable between the two groups (2.5±2.4 ng/mL in group 1 vs. 2.5±2.7 ng/mL in group 2), showing no statistically significant difference (p=0.3). Similarly, the mean basal antral follicle count was slightly higher in group 1 (10.2±6.3) compared to group 2 (9.2±6.5), but the difference did not reach statistical significance (p=0.4).

CONCLUSIONS

The fertility parameters of infertile male partners were within the expected normal range. Contrary to expectations, these women were found to have increased fertility potential and a higher oocyte count.

IMPACT STATEMENT

Although the coexistence of severe oligospermia and diminished ovarian reserve is often observed in clinical settings, our findings reveal an unexpected pattern: infertile male partners tended to exhibit normal or even enhanced fertility parameters when paired with females with low ovarian reserve. This paradoxical association offers new perspectives on couple-based infertility dynamics and may influence future diagnostic and treatment approaches in assisted reproduction.
目的评价在不育夫妇中观察到的严重男性因素不育和卵巢储备减少共存的现有证据。材料与方法在2022年7月至2023年6月期间,回顾性收集79名严重男性因素不育男性和84名精液参数正常的男性接受体外受精的女性伴侣的数据。两组参与者的人口统计学特征具有可比性。研究组(第一组)由诊断为严重少精症的男性的女性伴侣组成(n=79),而对照组(第二组)由精液参数正常的男性伴侣组成(n=84)。有101名妇女(61.9%)卵巢储备试验正常,62名妇女(38.1%)卵巢储备减少。通过对医疗记录的回顾性回顾,获得了人口统计数据、个人信息和第二天的激素水平。结果采用卡方检验评价严重男性因素不孕症与卵巢储备功能下降的相关性,两者间无统计学意义(p=0.2)。1组平均促卵泡激素(FSH)水平为8.9±4.2 mIU/mL, 2组平均FSH水平为10±6.2 mIU/mL, 2组显著高于对照组(p=0.05)。2组黄体生成素(LH)水平(6.5±2.9 mIU/mL)显著高于1组(5.2±2.1 mIU/mL) (p=0.006)。两组患者的平均抗勒氏激素(AMH)水平相当(1组为2.5±2.4 ng/mL, 2组为2.5±2.7 ng/mL),差异无统计学意义(p=0.3)。同样,1组平均基础窦卵泡计数(10.2±6.3)略高于2组(9.2±6.5),但差异无统计学意义(p=0.4)。结论男性不育伴侣的生育指标均在正常范围内。与预期相反,这些女性被发现有更高的生育潜力和更高的卵母细胞计数。尽管在临床环境中经常观察到严重少精症和卵巢储备能力下降的共存,但我们的研究结果揭示了一个意想不到的模式:当与卵巢储备能力低的女性配对时,不育的男性伴侣往往表现出正常甚至增强的生育参数。这种矛盾的关联为夫妻不育动力学提供了新的视角,并可能影响未来辅助生殖的诊断和治疗方法。
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引用次数: 0
Front Matter - Continued TOC 正面物质-继续TOC
IF 3.5 2区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2025-11-01 DOI: 10.1016/S1472-6483(25)00555-3
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引用次数: 0
Erratum Regarding Previously Published Articles 关于先前发表的文章的勘误
IF 3.5 2区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2025-11-01 DOI: 10.1016/j.rbmo.2025.105276
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引用次数: 0
Inside Front Cover - Affiliations and First page of TOC 内部封面-附属机构和第一页的TOC
IF 3.5 2区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2025-11-01 DOI: 10.1016/S1472-6483(25)00554-1
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引用次数: 0
Progestogen Hypersensitivity Following IVF: A Case of Cutaneous and Systemic Reaction in Early Pregnancy 体外受精后的孕激素过敏:妊娠早期皮肤和全身反应一例
IF 3.5 2区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2025-11-01 DOI: 10.1016/j.rbmo.2025.105333
Elif Unal , Burcin Karamustafaoglu Balci , Osman Gul , Tugba Atci

OBJECTIVE

Progesterone hypersensitivity is a rare condition with heterogeneous manifestations, including urticaria, angioedema, wheezing, and less common findings such as erythema multiforme and vesiculobullous lesions. It may result from endogenous or exogenous progesterone, with high-dose use in IVF increasing risk. We present a case of hypersensitivity in early pregnancy following IVF.

MATERIALS AND METHODS

A 26-year-old woman with secondary infertility underwent IVF with an antagonist protocol and recombinant FSH. Sixteen oocytes were retrieved, 13 fertilized, and two embryos transferred, resulting in a single intrauterine pregnancy; two embryos were cryopreserved. Luteal support included intramuscular progesterone (50 mg twice daily). At 8 weeks, she developed widespread erythematous urticarial plaques and arthralgia. Loratadine was started, and progesterone discontinued. Worsening symptoms necessitated systemic corticosteroid therapy (prednisolone 60 mg/day), tapered and stopped by day 15, leading to gradual resolution. Punch biopsy revealed mild perivascular inflammatory infiltrate with sparse eosinophils; direct immunofluorescence was negative for IgG, IgA, IgM, and C3, excluding vasculitis and supporting non-specific hypersensitivity. The pregnancy progressed uneventfully, culminating in cesarean delivery of a healthy 4000 g male infant at term.

RESULTS

Progestogen hypersensitivity (PH) is rare and often underdiagnosed. In this case, the absence of allergic history, symptom onset during therapy, and clinical improvement after discontinuation of progesterone support a drug-induced reaction. Diagnosis relies on clinical suspicion, temporal correlation, and therapeutic response.

CONCLUSIONS

Clinicians should consider PH in IVF patients presenting with unexplained dermatologic or systemic symptoms. Early recognition and multidisciplinary management are essential for maternal comfort and optimal pregnancy outcomes.

IMPACT STATEMENT

This case emphasizes the importance of recognizing hypersensitivity to exogenous progesterone in assisted reproduction, enabling timely diagnosis and individualized care.
目的黄体酮过敏是一种罕见的异质症状,包括荨麻疹、血管性水肿、喘息,以及不太常见的多形性红斑和小囊性病变。它可能是由内源性或外源性黄体酮引起的,在体外受精中使用大剂量黄体酮会增加风险。我们提出一例超敏反应在早期妊娠后试管婴儿。材料与方法一名26岁的继发性不孕症女性接受体外受精,采用拮抗剂方案和重组卵泡刺激素。取出16个卵母细胞,13个受精,两个胚胎移植,导致单次宫内妊娠;两个胚胎被冷冻保存。黄体支持包括肌注黄体酮(50 mg,每日两次)。8周时,她出现了广泛的红斑性荨麻疹斑块和关节痛。开始使用氯雷他定,停止使用黄体酮。症状恶化需要全身皮质类固醇治疗(强的松龙60 mg/天),到第15天逐渐减少并停止治疗,导致症状逐渐消退。穿刺活检显示轻度血管周围炎性浸润伴稀疏嗜酸性粒细胞;直接免疫荧光检测IgG、IgA、IgM和C3均阴性,排除血管炎和支持非特异性超敏反应。妊娠进展顺利,最终剖宫产下一名健康的4000 g足月男婴。结果孕激素超敏症(PH)罕见且常被误诊。在这种情况下,没有过敏史,治疗期间出现症状,停药后临床改善支持药物诱导的反应。诊断依赖于临床怀疑、时间相关性和治疗反应。结论临床医生应考虑出现不明原因皮肤或全身症状的体外受精患者的PH。早期识别和多学科管理对产妇舒适和最佳妊娠结局至关重要。影响声明:本病例强调了在辅助生殖中认识到外源性孕酮过敏的重要性,从而能够及时诊断和个性化护理。
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引用次数: 0
The Impact of Vaginal Microbiota on IVF Success 阴道微生物群对体外受精成功的影响
IF 3.5 2区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2025-11-01 DOI: 10.1016/j.rbmo.2025.105329
Goncagul Kından

OBJECTIVE

The vaginal microbiota plays a vital role in female reproductive health. Recent studies have shown that a Lactobacillus-dominant vaginal microbiota provides a more favorable reproductive environment and may enhance implantation success, especially in assisted reproductive technologies. This study aims to evaluate the relationship between the composition of the vaginal microbiota and in vitro fertilization (IVF) success, emphasizing its potential as a modifiable and predictive biomarker in infertility treatment.To investigate the effect of vaginal microbiota composition on clinical pregnancy rates and implantation success in infertile women undergoing IVF treatment.

MATERIALS AND METHODS

A prospective observational study was conducted with 50 infertile women undergoing IVF treatment at a tertiary reproductive medicine center between January 2023 and December 2024. Vaginal swab samples were obtained from all participants one week prior to embryo transfer. Microbial DNA was extracted and analyzed using 16S rRNA gene sequencing to determine microbiota composition. Participants were classified into two groups based on dominant bacterial taxa: Group A (Lactobacillus-dominant microbiota, n=30) and Group B (non-Lactobacillus-dominant microbiota, n=20). Primary outcomes were clinical pregnancy rate and implantation success, confirmed by serum β-hCG and transvaginal ultrasound. Statistical analysis was performed using the Chi-square test, with significance set at p<0.05.

RESULTS

Group A demonstrated significantly higher outcomes, with a clinical pregnancy rate of 53% and implantation success of 70%. In contrast, Group B had lower rates of 25% and 42%, respectively. These differences were statistically significant (p<0.01). The findings suggest that a Lactobacillus-dominant vaginal microbiota positively influences the intrauterine environment, enhancing embryo implantation and pregnancy chances.

CONCLUSIONS

This study supports the growing body of evidence that vaginal microbiota is a crucial factor in IVF outcomes. A Lactobacillus-dominant microbiota appears to create a protective and receptive uterine environment, facilitating successful embryo implantation. Integrating vaginal microbiota profiling into the pre-IVF assessment protocol may provide a novel, personalized approach to fertility treatment. Further large-scale studies are needed to validate these results and explore interventions that modulate microbiota composition to improve reproductive outcomes.

IMPACT STATEMENT

Vaginal microbiota may improve IVF success.
目的阴道微生物群在女性生殖健康中起着至关重要的作用。最近的研究表明,以乳酸杆菌为主的阴道微生物群提供了更有利的生殖环境,并可能提高着床成功率,特别是在辅助生殖技术中。本研究旨在评估阴道微生物群组成与体外受精(IVF)成功之间的关系,强调其作为不孕症治疗中可改变和预测的生物标志物的潜力。探讨阴道菌群组成对接受体外受精治疗的不孕症妇女临床妊娠率和着床成功率的影响。材料与方法对2023年1月至2024年12月在某三级生殖医学中心接受体外受精治疗的50名不孕妇女进行了一项前瞻性观察研究。在胚胎移植前一周从所有参与者获得阴道拭子样本。提取微生物DNA,采用16S rRNA基因测序分析微生物群组成。根据优势菌群将参与者分为两组:A组(乳酸菌优势菌群,n=30)和B组(非乳酸菌优势菌群,n=20)。主要结局是临床妊娠率和着床成功率,由血清β-hCG和经阴道超声证实。采用卡方检验进行统计学分析,显著性设置为p<;0.05。结果A组临床妊娠率为53%,着床成功率为70%。相比之下,B组的发病率较低,分别为25%和42%。这些差异具有统计学意义(p<0.01)。研究结果表明,以乳酸杆菌为主的阴道微生物群积极影响宫内环境,提高胚胎着床和妊娠机会。结论:越来越多的证据表明,阴道微生物群是体外受精结果的关键因素。乳酸菌为主的微生物群似乎创造了一个保护性和接受性的子宫环境,促进了胚胎的成功着床。将阴道微生物群分析纳入体外受精前评估方案可能为生育治疗提供一种新颖、个性化的方法。需要进一步的大规模研究来验证这些结果,并探索调节微生物群组成以改善生殖结果的干预措施。影响声明:阴道微生物群可能提高试管婴儿成功率。
{"title":"The Impact of Vaginal Microbiota on IVF Success","authors":"Goncagul Kından","doi":"10.1016/j.rbmo.2025.105329","DOIUrl":"10.1016/j.rbmo.2025.105329","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>The vaginal microbiota plays a vital role in female reproductive health. Recent studies have shown that a Lactobacillus-dominant vaginal microbiota provides a more favorable reproductive environment and may enhance implantation success, especially in assisted reproductive technologies. This study aims to evaluate the relationship between the composition of the vaginal microbiota and in vitro fertilization (IVF) success, emphasizing its potential as a modifiable and predictive biomarker in infertility treatment.To investigate the effect of vaginal microbiota composition on clinical pregnancy rates and implantation success in infertile women undergoing IVF treatment.</div></div><div><h3>MATERIALS AND METHODS</h3><div>A prospective observational study was conducted with 50 infertile women undergoing IVF treatment at a tertiary reproductive medicine center between January 2023 and December 2024. Vaginal swab samples were obtained from all participants one week prior to embryo transfer. Microbial DNA was extracted and analyzed using 16S rRNA gene sequencing to determine microbiota composition. Participants were classified into two groups based on dominant bacterial taxa: Group A (Lactobacillus-dominant microbiota, n=30) and Group B (non-Lactobacillus-dominant microbiota, n=20). Primary outcomes were clinical pregnancy rate and implantation success, confirmed by serum β-hCG and transvaginal ultrasound. Statistical analysis was performed using the Chi-square test, with significance set at p&lt;0.05.</div></div><div><h3>RESULTS</h3><div>Group A demonstrated significantly higher outcomes, with a clinical pregnancy rate of 53% and implantation success of 70%. In contrast, Group B had lower rates of 25% and 42%, respectively. These differences were statistically significant (p&lt;0.01). The findings suggest that a Lactobacillus-dominant vaginal microbiota positively influences the intrauterine environment, enhancing embryo implantation and pregnancy chances.</div></div><div><h3>CONCLUSIONS</h3><div>This study supports the growing body of evidence that vaginal microbiota is a crucial factor in IVF outcomes. A Lactobacillus-dominant microbiota appears to create a protective and receptive uterine environment, facilitating successful embryo implantation. Integrating vaginal microbiota profiling into the pre-IVF assessment protocol may provide a novel, personalized approach to fertility treatment. Further large-scale studies are needed to validate these results and explore interventions that modulate microbiota composition to improve reproductive outcomes.</div></div><div><h3>IMPACT STATEMENT</h3><div>Vaginal microbiota may improve IVF success.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"51 ","pages":"Article 105329"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Pregnancies Achieved by ART Are Prone to Be High-Risk Pregnancies: Is Referral to a Tertiary Center Required? 通过抗逆转录病毒治疗获得的妊娠容易成为高危妊娠:是否需要转诊到三级中心?
IF 3.5 2区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2025-11-01 DOI: 10.1016/j.rbmo.2025.105320
Sakine Rahimli Ocakoglu , Zeliha Atak , Ozlem Ozgun Uyaniklar , Serenat Eris Yalcin

OBJECTIVE

Fertility specialists commonly refer patients to obstetricians after detecting a biochemical or clinical pregnancy. However, a significant number of patients do not reach the stage of live birth, which is one of the most critical indicators of IVF success. This underscores the importance of pregnancy monitoring and management in the success of fertility treatments. This study aims to evaluate whether pregnancies conceived through ART should be classified as high-risk and, if so, whether systematic referral from fertility units to tertiary perinatology centers improves maternal–fetal care.

MATERIALS AND METHODS

This retrospective cohort study included 109 IVF pregnancies managed at Bursa City Hospital between August 2019 and January 2025. Data on maternal characteristics, comorbidities, and first-trimester screening were collected from electronic records. The primary outcome was referral to perinatology; secondary outcomes included live birth, preterm delivery, and neonatal status. Patients were grouped based on perinatology referral status.

RESULTS

The median maternal age was 31 years and median gravida was 1. Comorbidities were present in 46.8% and multiple gestations in 35.8% of cases. Cerclage was applied in 7.3%, and 42.2% had normal aneuploidy screening results, while 57.8% were not screened. Live birth occurred in 74.3%, preterm delivery in 33%, and 54.1% of patients required perinatology referral. Although maternal age did not differ between referral and non-referral groups (p = 0.292), gravida number was higher in the referral group (2 vs. 1; p = 0.047). Comorbidities (64.4% vs. 26%; p < 0.001) and threatened preterm labor (60.4% vs. 9.3%; p < 0.001) were significantly more frequent in the referral group. Comorbidities increased referral risk 3.43 times (95% CI: 1.23–9.54; p = 0.018), and threatened preterm labor increased it 13.32 times (95% CI: 3.34–53.12; p < 0.001). Other factors did not significantly affect referral status.

CONCLUSIONS

More than half of ART pregnancies in this tertiary setting required specialist perinatology input, due to maternal comorbidities and early signs of preterm labor. Integrating fertility clinics with tertiary centers and establishing clear referral pathways may improve outcomes by enabling early identification and management of high-risk cases.

IMPACT STATEMENT

This study supports classifying ART pregnancies as high-risk and emphasizes the need for structured referral to tertiary perinatology centers to improve maternal and neonatal outcomes.
目的生殖专家通常在发现生化或临床妊娠后将患者转介给产科医生。然而,相当数量的患者没有达到活产阶段,这是试管婴儿成功的最关键指标之一。这强调了妊娠监测和管理对生育治疗成功的重要性。本研究的目的是评估是否应该将通过抗逆转录病毒技术怀孕的妊娠归类为高风险,如果是,是否从生育单位系统转诊到三级围产中心可以改善母胎护理。材料和方法本回顾性队列研究包括2019年8月至2025年1月期间在布尔萨市医院进行的109例体外受精妊娠。从电子记录中收集有关产妇特征、合并症和妊娠早期筛查的数据。主要结局是转诊到围产期;次要结局包括活产、早产和新生儿状态。根据围产儿转诊情况对患者进行分组。结果产妇年龄中位数为31岁,妊娠期中位数为1岁。46.8%的病例存在合并症,35.8%的病例存在多胎妊娠。7.3%采用环切术,42.2%非整倍体筛查结果正常,57.8%未筛查。活产率为74.3%,早产率为33%,54.1%的患者需要围产期转诊。转介组与非转介组产妇年龄差异无统计学意义(p = 0.292),但转介组妊娠数明显高于转介组(p = 0.047)。合并症(64.4% vs. 26%; p < 0.001)和先兆早产(60.4% vs. 9.3%; p < 0.001)在转诊组明显更频繁。合并症使转诊风险增加3.43倍(95% CI: 1.23-9.54; p = 0.018),有早产危险的转诊风险增加13.32倍(95% CI: 3.34-53.12; p < 0.001)。其他因素对转诊状态无显著影响。结论:由于产妇的合并症和早产的早期迹象,在这个三级机构中,超过一半的ART妊娠需要围产期专家的介入。将生育诊所与三级中心结合起来,建立明确的转诊途径,可以通过早期识别和管理高危病例来改善结果。影响声明:本研究支持将ART妊娠分类为高危妊娠,并强调需要有组织地转诊到三级围产期中心,以改善孕产妇和新生儿的预后。
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引用次数: 0
Pelvic Floor Imaging and Function in Women with Premature Ovarian Insufficiency 卵巢功能不全妇女盆底造影与功能
IF 3.5 2区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2025-11-01 DOI: 10.1016/j.rbmo.2025.105324
Seda Ates , Ceren Unal , Seyma Haskoylu Sahin , Ozgur Oktem , Serdar Aydin

OBJECTIVE

Premature ovarian insufficiency (POI) causes long-term estrogen deficiency, leading to stiffer fascia, muscle atrophy, and pelvic floor weakening. As POI occurs early in life, it offers a unique model to study estrogen-related pelvic floor changes independent of aging. This study aimed to: assess PFM function in POI using the PERFECT scheme(Power, Endurance, Repetition, Fast contractions, Every Contraction Timed); quantify levator ani morphology and dynamic response using four-dimensional transperineal ultrasound(TPUS); and assess the effect of systemic estrogen replacement therapy (ERT) in the POI cohort.

MATERIALS AND METHODS

A prospective, cross-sectional, case–control study was conducted with 40 POI patients and 40 age-matched eumenorrheic controls. Pelvic floor performance was graded with the PERFECT scheme. TPUS quantified the levator hiatus’ anteroposterior (AP) diameter and area at rest, maximal voluntary contraction, and Valsalva. Delta values (e.g., ∆HA Rest→Contraction) were computed, statistical comparisons included Welch’s t-test, Fisher’s exact test, and Pearson correlation(α = 0.05). The POI group was stratified by ERT use (ERT-Yes n = 22; ERT-No n = 18).

RESULTS

Women with POI had higher BMI and parity despite matching for age. PERFECT grading revealed a lower repetition capacity in POI, whereas power, endurance and fast contractions did not differ. TPUS demonstrated a consistently wider levator hiatus in POI at rest and during contraction, confirming structural widening(Table). Greater hiatal narrowing from rest to contraction correlated modestly with higher power and endurance scores. Within POI, ERT users showed slightly greater sagittal narrowing during contraction, but all other delta and biometry variables were unchanged.

CONCLUSIONS

POI is characterized by significant morphological levator widening without concomitant loss of contractile strength. Early estrogen deficiency appears to remodel pelvic-floor structure before functional compromise. Correlations between hiatal narrowing and PERFECT scores suggest that TPUS-derived delta metrics capture physiologically relevant muscle recruitment. The marginal contraction benefit observed in ERT users implies that systemic estrogen may slow but not reverse established morphological change.

IMPACT STATEMENT

TPUS-detected hiatal enlargement could therefore serve as an early marker for targeted pelvic-floor physiotherapy and longitudinal monitoring in women with POI.
目的卵巢功能不全(POI)引起长期雌激素缺乏,导致筋膜变硬、肌肉萎缩、盆底变弱。由于POI发生在生命早期,它提供了一个独特的模型来研究雌激素相关的盆底变化,而不受年龄的影响。本研究旨在:使用PERFECT方案(力量,耐力,重复,快速收缩,每次收缩定时)评估POI的PFM功能;利用四维经会阴超声(TPUS)定量提肛肌形态和动态响应;并评估系统性雌激素替代疗法(ERT)在POI队列中的效果。材料与方法对40例POI患者和40例年龄匹配的痛经对照组进行了一项前瞻性、横断面、病例对照研究。采用PERFECT方案对盆底性能进行评分。tpu量化提上睑肌裂孔的正后方(AP)直径和静止时的面积、最大自主收缩和Valsalva。计算δ值(例如,∆HA休息→收缩),统计比较包括Welch t检验、Fisher精确检验和Pearson相关(α = 0.05)。POI组采用ERT分层(ERT- yes n = 22;ERT- no n = 18)。结果尽管年龄匹配,但POI女性的BMI和胎次均较高。PERFECT评分显示POI的重复能力较低,而力量,耐力和快速收缩没有差异。tpu在POI静止和收缩时表现出持续较宽的提上睑肌间隙,证实了结构增宽(表)。从休息到收缩的裂孔缩小程度越大,与更高的力量和耐力得分有适度的相关性。在POI中,ERT使用者在收缩期间表现出略大的矢状面狭窄,但所有其他delta和生物计量变量不变。结论spoi的特点是提上睑肌明显扩大,但不伴有收缩强度的损失。早期雌激素缺乏似乎在功能损害之前重塑骨盆底结构。裂孔狭窄和PERFECT评分之间的相关性表明,tpu衍生的delta指标捕获了生理学上相关的肌肉恢复。在ERT使用者中观察到的边际收缩益处表明,全身雌激素可能减缓但不能逆转既定的形态变化。影响声明:因此,tpu检测到的裂孔扩大可以作为POI女性骨盆底物理治疗和纵向监测的早期标志。
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引用次数: 0
Beyond Cosmetic Implications: Hirsutism as a Determinant of Health Perception in Women with PCOS 多毛症是多囊卵巢综合征女性健康感知的决定因素
IF 3.5 2区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2025-11-01 DOI: 10.1016/j.rbmo.2025.105313
Aslihan Yurtkal , Mujde Canday , Özde Sakarya

OBJECTIVE

Polycystic ovary syndrome (PCOS) is a complex and heterogeneous condition that spans endocrinology, reproduction, metabolism and mental health. This study highlights the overlooked psychosocial burden of hirsutism, a visible sign of hyperandrogenism, on women’s perceived health and quality of life. Though a hallmark of PCOS, its impact extends beyond appearance, influencing identity and social functioning beyond what clinical measures can capture. This study compares SF-36 scores in PCOS patients with and without hirsutism to assess whether the symptom independently contributes to reduced physical and mental well-being.

MATERIALS AND METHODS

This cross-sectional study included 118 women newly diagnosed with PCOS based on the 2018 International Guideline, an update of the 2003 Rotterdam criteria. All participants completed the SF-36 questionnaire to assess health-related quality of life (HRQoL) prior to receiving diagnostic information. Participants were grouped by the presence or absence of hirsutism and SF-36 subscale scores were compared accordingly.

RESULTS

A total of 118 women diagnosed with PCOS were evaluated. Participants with hirsutism reported significantly lower scores in the Physical Functioning (p=0.030),General Health (p=0.007),Vitality (p=0.031) and Mental Health (p=0.024) domains of the SF-36 questionnaire compared to those without hirsutism. Other subscales did not show statistically significant differences. These results indicate that hirsutism is associated with reduced physical and psychological well-being in women with PCOS.

CONCLUSIONS

Our findings indicate that hirsutism is independently associated with reduced HRQoL in women with PCOS, even in the absence of overt metabolic dysfunction. This suggests that hirsutism is not merely a cosmetic concern but a significant determinant of overall well-being. In the era of precision medicine,these results call for a more comprehensive, symptom-focused approach to PCOS that addresses both physical and psychosocial dimensions. Recognizing and managing the burden of visible androgen excess should be a central component of individualized care. Future research should explore how symptom patterns, cultural context, and coping styles shape the lived experience of PCOS to better inform holistic interventions.

IMPACT STATEMENT

This study reveals that hirsutism significantly impairs multiple aspects of quality of life in women with PCOS, reinforcing the need for comprehensive, patient-centered approaches that address both metabolic and psychosocial domains of the syndrome.
目的多囊卵巢综合征(PCOS)是一种复杂的异质性疾病,涉及内分泌、生殖、代谢和心理健康等多个领域。这项研究强调了被忽视的多毛症的社会心理负担,这是雄激素过多的明显迹象,对妇女的健康和生活质量有影响。虽然多囊卵巢综合征的一个标志,其影响超出了外观,影响身份和社会功能超出了临床措施可以捕捉。本研究比较了多囊卵巢综合征(PCOS)患者伴多毛症和不伴多毛症的SF-36评分,以评估该症状是否独立导致身心健康下降。材料和方法本横断面研究纳入118名新诊断为多囊卵巢综合征的妇女,该研究基于2018年国际指南,该指南是2003年鹿特丹标准的更新。所有参与者在接受诊断信息之前完成SF-36问卷,以评估健康相关生活质量(HRQoL)。参与者根据是否存在多毛症进行分组,并相应地比较SF-36分量表得分。结果共对118例诊断为PCOS的女性进行了sa评估。与没有多毛症的参与者相比,有多毛症的参与者在SF-36问卷的身体功能(p=0.030)、一般健康(p=0.007)、活力(p=0.031)和心理健康(p=0.024)领域的得分明显较低。其他分量表差异无统计学意义。这些结果表明,多毛症与多囊卵巢综合征妇女的生理和心理健康状况下降有关。结论:研究结果表明,即使在没有明显代谢功能障碍的情况下,多囊卵巢综合征女性的多毛症与HRQoL降低独立相关。这表明多毛症不仅仅是一个美容问题,而且是整体健康的重要决定因素。在精准医疗时代,这些结果要求对多囊卵巢综合征采取更全面、以症状为重点的治疗方法,从生理和心理两方面着手。认识和管理可见的雄激素过量的负担应该是个体化护理的核心组成部分。未来的研究应探讨症状模式、文化背景和应对方式如何塑造多囊卵巢综合征的生活经历,以更好地为整体干预提供信息。影响声明:本研究表明,多毛症显著损害多囊卵巢综合征(PCOS)女性生活质量的多个方面,加强了对综合的、以患者为中心的方法的需求,以解决该综合征的代谢和社会心理领域。
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Reproductive biomedicine online
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