Background : Both objective and subjective transvaginal sonography (TVS) methods are used to assess the degree of myometrial invasion (MI). Subjective TVS assessment of MI ( < 50% or > 50%) may be as good or better than any objective measurement technique. The aim of this study is to examine the ultrasound characteristics of endometrial cancer (EC) in two groups of patients; with myometrial invasion less and greater than 50%. Methods : This is a prospective cohort study included 60 female patients with pathohistologically (PHD) proven endometrial cancer. Patients were divided into two groups, after surgery and PHD assessment of MI degree, into those with less and more than 50% MI. The degree of MI was performed by subjective assessment ( < 50% and > 50%). Results : The frequency of anteroposterior (AP) diameter of EC greater than 2 cm was statistically significantly higher in the group of subjects with MI > 50% ( p < 0.00001). The volume of EC in the group of patients with MI > 50% is statistically significantly higher, with a difference of 10.48 milliliters compared to the group of subjects with MI < 50% ( p < 0.00014). The difference in the average distance of the EC from the serosa is 0.11 cm between the two examined groups and is statistically significant ( p = 0.0394). The kappa concordance coefficient for the subjective TVS method versus the PHD finding was statistically significant ( p < 0.001), and was kappa = 0.72. Analysis of the diagnostic accuracy showed that the subjective TVS method compared to the gold standard in the diagnosis of MI > 50% has a good diagnostic value: accuracy = 0.87; sensitivity = 0.77; specificity = 0.94; positive predictive value = 0.91; negative predictive value = 0.84; positive likelihood ratio = 13.08; negative likelihood ratio = 0.25. According to the subjective method of TVS, the degree of MI was overestimated in 5.9% of respondents, underestimated in 23.1%. Conclusions : The three dimensions, as well as the volume of endometrial cancer, obtained by TVS, are significantly higher in subjects with > 50% myometrial invasion; there is also a significantly higher frequency of EC diameter greater than 2 cm in the group of subjects with > 50% myometrial invasion.
{"title":"Ultrasound Characteristics of Myometrial Invasion in Endometrial Carcinoma: A Prospective Cohort Study","authors":"A. Cerovac, D. Habek, Zlatko Hrgović","doi":"10.31083/j.ceog5102050","DOIUrl":"https://doi.org/10.31083/j.ceog5102050","url":null,"abstract":"Background : Both objective and subjective transvaginal sonography (TVS) methods are used to assess the degree of myometrial invasion (MI). Subjective TVS assessment of MI ( < 50% or > 50%) may be as good or better than any objective measurement technique. The aim of this study is to examine the ultrasound characteristics of endometrial cancer (EC) in two groups of patients; with myometrial invasion less and greater than 50%. Methods : This is a prospective cohort study included 60 female patients with pathohistologically (PHD) proven endometrial cancer. Patients were divided into two groups, after surgery and PHD assessment of MI degree, into those with less and more than 50% MI. The degree of MI was performed by subjective assessment ( < 50% and > 50%). Results : The frequency of anteroposterior (AP) diameter of EC greater than 2 cm was statistically significantly higher in the group of subjects with MI > 50% ( p < 0.00001). The volume of EC in the group of patients with MI > 50% is statistically significantly higher, with a difference of 10.48 milliliters compared to the group of subjects with MI < 50% ( p < 0.00014). The difference in the average distance of the EC from the serosa is 0.11 cm between the two examined groups and is statistically significant ( p = 0.0394). The kappa concordance coefficient for the subjective TVS method versus the PHD finding was statistically significant ( p < 0.001), and was kappa = 0.72. Analysis of the diagnostic accuracy showed that the subjective TVS method compared to the gold standard in the diagnosis of MI > 50% has a good diagnostic value: accuracy = 0.87; sensitivity = 0.77; specificity = 0.94; positive predictive value = 0.91; negative predictive value = 0.84; positive likelihood ratio = 13.08; negative likelihood ratio = 0.25. According to the subjective method of TVS, the degree of MI was overestimated in 5.9% of respondents, underestimated in 23.1%. Conclusions : The three dimensions, as well as the volume of endometrial cancer, obtained by TVS, are significantly higher in subjects with > 50% myometrial invasion; there is also a significantly higher frequency of EC diameter greater than 2 cm in the group of subjects with > 50% myometrial invasion.","PeriodicalId":505527,"journal":{"name":"Clinical and Experimental Obstetrics & Gynecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140435633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Haochong He, Xiue Huang, Bijun Yu, Ye Liu, Shuyuan Mai, Ouyang Le, Qiaoling Zhang, Xiaoying Yan
Background : Stress urinary incontinence (SUI) is a commonly occurring urological disorder in females, particularly among the elderly population. Females with SUI often experience significant stigma associated with their condition. This study aimed to investigate the current status of stigma among elderly females with SUI and analyze its heterogeneous subtypes. Methods : The Stigma Scale for Chronic Illness (SSCI) was used to survey 245 participants in two tertiary hospitals in Guangdong from November 2021 to September 2022. Latent profile analysis was employed to create a classification model, and variance and correlation analyses were conducted to assess the influencing factors. Results : A total of 245 elderly females with SUI participated in the survey. They had an average stigma score of 83.70 ± 13.88, consisting of self-stigma (48.64 ± 8.04) and perceived stigma (35.06 ± 6.80) scores. Latent profile analysis identified three distinct and comparable subtypes: the low-self-low-perceived group (14.69%), the high-self-medium-perceived group (49.38%), and the high-self-high-perceived group (35.91%). These subtypes exhibited statistically significant differences in all dimensions and the overall stigma score ( p < 0.05) and were found to be correlated with the patient’s level of education, marital status, drinking habits, number of chronic illnesses, presence of diabetes, and frequency of urinary leakage ( p < 0.05). Conclusion : This study demonstrates that elderly females with SUI face elevated levels of stigma, and it reveals distinct classification characteristics among them. Additionally, it emphasizes the importance of providing specific support and attention to individuals with higher levels of education, increased fluid intake, marital status, severe urinary leakage, and diabetes.
背景：压力性尿失禁（SUI）是女性常见的泌尿系统疾病，尤其是在老年人群中。患有压力性尿失禁的女性通常会因这种疾病而遭受严重的耻辱感。本研究旨在调查患有 SUI 的老年女性的污名化现状，并分析其不同的亚型。方法：采用慢性病污名化量表（SSCI），于 2021 年 11 月至 2022 年 9 月对广东省两家三甲医院的 245 名参与者进行了调查。采用潜在特征分析建立分类模型，并通过方差分析和相关分析评估影响因素。结果：共有 245 名患有 SUI 的老年女性参与了调查。她们的平均耻辱感得分为 83.70 ± 13.88，包括自我耻辱感（48.64 ± 8.04）和感知耻辱感（35.06 ± 6.80）。通过潜在特征分析，发现了三个不同且具有可比性的亚型：低自我-低感知组（14.69%）、高自我-中感知组（49.38%）和高自我-高感知组（35.91%）。这些亚型在所有维度和污名化总分上均表现出显著的统计学差异（P < 0.05），并与患者的教育水平、婚姻状况、饮酒习惯、慢性病数量、是否患有糖尿病以及漏尿频率相关（P < 0.05）。结论：本研究表明，患有 SUI 的老年女性面临着更高程度的耻辱感，并揭示了她们之间不同的分类特征。此外，研究还强调了为受教育程度较高、液体摄入量增加、婚姻状况、严重漏尿和糖尿病患者提供特别支持和关注的重要性。
{"title":"Stigma in Elderly Females with Stress Urinary Incontinence: A Latent Profile Analysis","authors":"Haochong He, Xiue Huang, Bijun Yu, Ye Liu, Shuyuan Mai, Ouyang Le, Qiaoling Zhang, Xiaoying Yan","doi":"10.31083/j.ceog5102053","DOIUrl":"https://doi.org/10.31083/j.ceog5102053","url":null,"abstract":"Background : Stress urinary incontinence (SUI) is a commonly occurring urological disorder in females, particularly among the elderly population. Females with SUI often experience significant stigma associated with their condition. This study aimed to investigate the current status of stigma among elderly females with SUI and analyze its heterogeneous subtypes. Methods : The Stigma Scale for Chronic Illness (SSCI) was used to survey 245 participants in two tertiary hospitals in Guangdong from November 2021 to September 2022. Latent profile analysis was employed to create a classification model, and variance and correlation analyses were conducted to assess the influencing factors. Results : A total of 245 elderly females with SUI participated in the survey. They had an average stigma score of 83.70 ± 13.88, consisting of self-stigma (48.64 ± 8.04) and perceived stigma (35.06 ± 6.80) scores. Latent profile analysis identified three distinct and comparable subtypes: the low-self-low-perceived group (14.69%), the high-self-medium-perceived group (49.38%), and the high-self-high-perceived group (35.91%). These subtypes exhibited statistically significant differences in all dimensions and the overall stigma score ( p < 0.05) and were found to be correlated with the patient’s level of education, marital status, drinking habits, number of chronic illnesses, presence of diabetes, and frequency of urinary leakage ( p < 0.05). Conclusion : This study demonstrates that elderly females with SUI face elevated levels of stigma, and it reveals distinct classification characteristics among them. Additionally, it emphasizes the importance of providing specific support and attention to individuals with higher levels of education, increased fluid intake, marital status, severe urinary leakage, and diabetes.","PeriodicalId":505527,"journal":{"name":"Clinical and Experimental Obstetrics & Gynecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140437178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background : Endometriosis (EM), a gynecological disorder that is dependent on estrogen and causes inflammation, is prevalent among women of reproductive age and is considered a chronic condition. The involvement of noncoding RNAs in exosomes is crucial for the progression of EM. This study aimed to determine exosomal microRNA (miRNA) biomarkers in EM. Methods : Exosomes were isolated and characterized from the plasma of patients with EM and controls. Exosomal miRNA was sequenced using microarrays. EM-related differential miRNAs (DE-miRNAs) were identified using analysis of differential miRNA expression and weighted coexpression network analysis. The common pairs of long noncoding RNA (lncRNA)-miRNA and miRNA-mRNA were determined. Cytoscape was used to establish the regulatory network of characteristic genes known as competitive endogenous RNA (ceRNA), and the hub miRNAs, hub mRNAs, and hub lncRNAs were identified. Results : We isolated plasma exosomes from 10 control and 10 EM patients. We obtained a total of 50 DE-miRNAs, consisting of 7 miRNAs that were upregulated and 43 miRNAs that were downregulated. A network of ceRNA regulation was constructed using the diagnostic miRNAs, which revealed a total of 36 lncRNAs, 20 miRNAs, and 264 mRNAs associated with EM. Additionally, 10 lncRNAs (GAS5, MALAT1, FGD5-AS1, HCG18, SNHG16, XIST, OIP5-AS1, NEAT1, KCNQ1OT1, and SNHG12), 10 miRNAs (hsa-miR-361-5p, hsa-miR-19b-3p, hsa-let-7f-5p, hsa-miR-23a-3p, hsa-miR-199a-3p, hsa-miR-18a-5p, hsa-miR-221-3p, hsa-miR-17-5, hsa-miR-27a-3, and hsa-miR-25-3p), and 10 mRNAs (GALC, ETNK1, RNF4, SOX4, ZBTB18, SPRY2, RUNX1, MYLIP, BTG2, and MAP2K4) were identified as hub molecules. Conclusions : Thirty plasma exosomal miRNA markers associated with endometriosis were identified and reported. The miRNAs were associated with the promotion of proliferation in mesenchymal cells, as well as the tumor necrosis factor (TNF) and Toll-like receptor signaling pathways, and the differentiation of T helper 1 (Th1) and Th2 cells. These biological processes and pathways could potentially play a significant role in the pathogenesis and progression of EM. The potential clinical value of these miRNAs indicates potential targets for diagnosing and treating endometriosis while also offering new insights into the molecular mechanisms of the disease.
{"title":"Identification of a Serum Exosome-Derived lncRNA‒miRNA‒mRNA ceRNA Network in Patients with Endometriosis","authors":"Yan Huang, Deyu Zhang, Yingfang Zhou, Chao Peng","doi":"10.31083/j.ceog5102051","DOIUrl":"https://doi.org/10.31083/j.ceog5102051","url":null,"abstract":"Background : Endometriosis (EM), a gynecological disorder that is dependent on estrogen and causes inflammation, is prevalent among women of reproductive age and is considered a chronic condition. The involvement of noncoding RNAs in exosomes is crucial for the progression of EM. This study aimed to determine exosomal microRNA (miRNA) biomarkers in EM. Methods : Exosomes were isolated and characterized from the plasma of patients with EM and controls. Exosomal miRNA was sequenced using microarrays. EM-related differential miRNAs (DE-miRNAs) were identified using analysis of differential miRNA expression and weighted coexpression network analysis. The common pairs of long noncoding RNA (lncRNA)-miRNA and miRNA-mRNA were determined. Cytoscape was used to establish the regulatory network of characteristic genes known as competitive endogenous RNA (ceRNA), and the hub miRNAs, hub mRNAs, and hub lncRNAs were identified. Results : We isolated plasma exosomes from 10 control and 10 EM patients. We obtained a total of 50 DE-miRNAs, consisting of 7 miRNAs that were upregulated and 43 miRNAs that were downregulated. A network of ceRNA regulation was constructed using the diagnostic miRNAs, which revealed a total of 36 lncRNAs, 20 miRNAs, and 264 mRNAs associated with EM. Additionally, 10 lncRNAs (GAS5, MALAT1, FGD5-AS1, HCG18, SNHG16, XIST, OIP5-AS1, NEAT1, KCNQ1OT1, and SNHG12), 10 miRNAs (hsa-miR-361-5p, hsa-miR-19b-3p, hsa-let-7f-5p, hsa-miR-23a-3p, hsa-miR-199a-3p, hsa-miR-18a-5p, hsa-miR-221-3p, hsa-miR-17-5, hsa-miR-27a-3, and hsa-miR-25-3p), and 10 mRNAs (GALC, ETNK1, RNF4, SOX4, ZBTB18, SPRY2, RUNX1, MYLIP, BTG2, and MAP2K4) were identified as hub molecules. Conclusions : Thirty plasma exosomal miRNA markers associated with endometriosis were identified and reported. The miRNAs were associated with the promotion of proliferation in mesenchymal cells, as well as the tumor necrosis factor (TNF) and Toll-like receptor signaling pathways, and the differentiation of T helper 1 (Th1) and Th2 cells. These biological processes and pathways could potentially play a significant role in the pathogenesis and progression of EM. The potential clinical value of these miRNAs indicates potential targets for diagnosing and treating endometriosis while also offering new insights into the molecular mechanisms of the disease.","PeriodicalId":505527,"journal":{"name":"Clinical and Experimental Obstetrics & Gynecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140438172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Wongwananuruk, Arisa Kongcharoensukying, P. Pramyothin, S. Indhavivadhana, P. Tanmahasamut, M. Rattanachaiyanont, K. Techatraisak, S. Angsuwathana, Nutchaya Sa-ngaareekul, Nichamon Pingkul, P. Chantrapanichkul
Background : The body fat in polycystic ovary syndrome (PCOS) women is mostly centrally distributed and is associated with insulin resistance, diabetes mellitus, and hyperandrogenemia. This study compared the fat distributions of Thai PCOS and non-PCOS women, and it investigated the association between body fat distribution in PCOS women with glucose tolerance and serum androgens. Methods : The PCOS and non-PCOS groups each had 60 women. The body mass indexes (BMI) of the groups were matched. Blood tests and fat distributions were compared between group. Results : The mean age of the non-PCOS group was significantly higher than that of the PCOS group (30.85 ± 6.41 vs . 25.95 ± 5.16 years; p -value < 0.001). The glucose level after a 2-hour, 75-gram, oral glucose tolerance test (75-g OGTT) of the PCOS group, and its insulin resistance, triglyceride, low-density lipoprotein, total testosterone, free testosterone, and dehydroepiandrosterone sulphate levels, were significantly higher than the corresponding values of the non-PCOS group. The fat distribution patterns of the 2 groups were generally not significantly different. The level of fat distributed in the arms was significantly elevated among PCOS women with abnormal 75-g OGTT values. The fat distributions of PCOS women, regardless of hyperandrogenemia status, did not significantly differ. Conclusions : No significant differences in fat distribution were observed between the PCOS and non-PCOS groups. PCOS participants with abnormal 75-g OGTT levels had a higher proportion of arm-fat compared to those with normal results. There were no discernible differences in fat distribution patterns between PCOS women with hyperandrogenemia and those with normal androgen levels.
{"title":"Body Fat Distribution in Thai Reproductive-Aged Polycystic Ovary Syndrome Women Compared with Non-Polycystic Ovary Syndrome Women","authors":"T. Wongwananuruk, Arisa Kongcharoensukying, P. Pramyothin, S. Indhavivadhana, P. Tanmahasamut, M. Rattanachaiyanont, K. Techatraisak, S. Angsuwathana, Nutchaya Sa-ngaareekul, Nichamon Pingkul, P. Chantrapanichkul","doi":"10.31083/j.ceog5102052","DOIUrl":"https://doi.org/10.31083/j.ceog5102052","url":null,"abstract":"Background : The body fat in polycystic ovary syndrome (PCOS) women is mostly centrally distributed and is associated with insulin resistance, diabetes mellitus, and hyperandrogenemia. This study compared the fat distributions of Thai PCOS and non-PCOS women, and it investigated the association between body fat distribution in PCOS women with glucose tolerance and serum androgens. Methods : The PCOS and non-PCOS groups each had 60 women. The body mass indexes (BMI) of the groups were matched. Blood tests and fat distributions were compared between group. Results : The mean age of the non-PCOS group was significantly higher than that of the PCOS group (30.85 ± 6.41 vs . 25.95 ± 5.16 years; p -value < 0.001). The glucose level after a 2-hour, 75-gram, oral glucose tolerance test (75-g OGTT) of the PCOS group, and its insulin resistance, triglyceride, low-density lipoprotein, total testosterone, free testosterone, and dehydroepiandrosterone sulphate levels, were significantly higher than the corresponding values of the non-PCOS group. The fat distribution patterns of the 2 groups were generally not significantly different. The level of fat distributed in the arms was significantly elevated among PCOS women with abnormal 75-g OGTT values. The fat distributions of PCOS women, regardless of hyperandrogenemia status, did not significantly differ. Conclusions : No significant differences in fat distribution were observed between the PCOS and non-PCOS groups. PCOS participants with abnormal 75-g OGTT levels had a higher proportion of arm-fat compared to those with normal results. There were no discernible differences in fat distribution patterns between PCOS women with hyperandrogenemia and those with normal androgen levels.","PeriodicalId":505527,"journal":{"name":"Clinical and Experimental Obstetrics & Gynecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140436416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background : A major challenge in reproductive medicine is repeated implantation failure (RIF). Possible benefits of platelet-rich plasma (PRP) for pregnancy outcomes are still uncertain, and more evidence is required to properly evaluate this. The current meta-analysis was therefore carried out to assess the impact of intrauterine PRP infusion on pregnancy outcomes in women with RIF. Methods : Various databases (Web of Science, PubMed, Cochrane Library, Embase) were screened for English-language papers that investigated the effect of PRP treatment on pregnancy outcomes in RIF women who underwent in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). This effect was analyzed in both frozen-thawed and fresh cycles. These studies involved randomized controlled trial (RCT) and quasi-experimental (non-randomized experimental) studies, but excluded case-control, case series, self-control, cross-sectional studies. The Newcastle-Ottawa Scale was employed to determine study quality. Risk ratios (RRs) were calculated for dichotomous outcome variables, and weighted mean difference (WMD) with 95% confidence interval (95% CI) for continuous outcome variables. These were performed under fixed-or random-effect models. Results : This meta-analysis evaluated 15 articles from the literature. Improved pregnancy outcomes were observed in RIF women who received PRP, including higher rates of implantation, clinical pregnancy and live birth compared to control patients. Conclusions : The results of this study indicate that PRP could be a useful treatment strategy for RIF patients and those with a thin endometrium. Additional large RCTs are required to identify the subpopulation of women who could derive the maximum benefit from PRP.
{"title":"Effect of Autologous Platelet-Rich Plasma Therapy on the Pregnancy Outcomes of Women with Repeated Implantation Failure: A Systematic Review and Meta-Analysis","authors":"Tingting Ma, Yan Pu","doi":"10.31083/j.ceog5102048","DOIUrl":"https://doi.org/10.31083/j.ceog5102048","url":null,"abstract":"Background : A major challenge in reproductive medicine is repeated implantation failure (RIF). Possible benefits of platelet-rich plasma (PRP) for pregnancy outcomes are still uncertain, and more evidence is required to properly evaluate this. The current meta-analysis was therefore carried out to assess the impact of intrauterine PRP infusion on pregnancy outcomes in women with RIF. Methods : Various databases (Web of Science, PubMed, Cochrane Library, Embase) were screened for English-language papers that investigated the effect of PRP treatment on pregnancy outcomes in RIF women who underwent in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). This effect was analyzed in both frozen-thawed and fresh cycles. These studies involved randomized controlled trial (RCT) and quasi-experimental (non-randomized experimental) studies, but excluded case-control, case series, self-control, cross-sectional studies. The Newcastle-Ottawa Scale was employed to determine study quality. Risk ratios (RRs) were calculated for dichotomous outcome variables, and weighted mean difference (WMD) with 95% confidence interval (95% CI) for continuous outcome variables. These were performed under fixed-or random-effect models. Results : This meta-analysis evaluated 15 articles from the literature. Improved pregnancy outcomes were observed in RIF women who received PRP, including higher rates of implantation, clinical pregnancy and live birth compared to control patients. Conclusions : The results of this study indicate that PRP could be a useful treatment strategy for RIF patients and those with a thin endometrium. Additional large RCTs are required to identify the subpopulation of women who could derive the maximum benefit from PRP.","PeriodicalId":505527,"journal":{"name":"Clinical and Experimental Obstetrics & Gynecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140439908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background : In clinical practice, discordance between anti-müllerian hormone (AMH) and antral follicle count (AFC) presents a recurring challenge. Such discordance can potentially lead to inappropriate clinical decisions, thereby diminishing the clinician’s confidence in managing a patient’s long-term journey through assisted reproductive technology (ART). This study aims to clarify such discordance and identify the more reliable marker between the two, analyzing ART outcomes among Korean infertility patients with AMH and AFC discordance; furthermore, the study elaborates data to evaluate possible patient-related factors contributing to discordance. Methods : This retrospective observational study involved 225 infertile women who underwent their first controlled ovarian stimulation treatment followed by embryo transfer. These patients were categorized into three groups: the congruent (Con) group with predicted AMH according to AFC within 50% prediction interval; the higher-than-predicted (HTP) group with predicted AMH above upper boundary of 50% prediction interval according to AFC; the lower-than-predicted (LTP) group with predicted AMH below lower boundary of 50% prediction interval according to AFC. Variables in the comparative analysis of these three groups focused on ART outcomes. Results : The HTP group which had younger patients with lower dose of follicle stimulation hormone (FSH) achieved better ART outcomes than the LTP group. After adjusting for factors affecting ovarian response such as age, body mass index (BMI), AFC, and total dose FSH usage, the HTP group still demonstrated significantly superior results in terms of the oocyte yield, good-quality embryo rates, and pregnancy rate compared to the LTP group. In the logistic regression analysis, age was not a significant patient factor affecting the ART outcomes; however, the patient’s status of polycystic ovary syndrome (PCOS) was significantly associated with the AMH-AFC discordance, with an odds ratio (OR) of 1.24. Conclusions : Serum AMH provided the more accurate prediction of the patient’s ovarian reserve, especially when the discordance between AMH and AFC was present; more favorable ART outcomes were observed in the patients with the higher AMH measurement than the statistically expected value from their AFC. In addition, the presence of PCOS could be considered as one of the significant factors contributing to such discordance between AMH and AFC.
背景：在临床实践中，抗缪勒氏管激素（AMH）和前卵泡计数（AFC）之间的不一致是一个反复出现的难题。这种不一致有可能导致不恰当的临床决策，从而削弱临床医生通过辅助生殖技术（ART）管理患者长期病程的信心。本研究旨在澄清这种不一致，并找出二者之间更可靠的标志物，分析韩国不孕症患者AMH和AFC不一致的ART结果；此外，本研究还详细阐述了评估导致不一致的可能患者相关因素的数据。方法：该回顾性观察研究涉及 225 名接受首次控制性卵巢刺激治疗后进行胚胎移植的不孕妇女。这些患者被分为三组：根据AFC预测AMH在50%预测区间内的一致（Con）组；根据AFC预测AMH高于50%预测区间上限的高于预测（HTP）组；根据AFC预测AMH低于50%预测区间下限的低于预测（LTP）组。这三组的比较分析变量主要集中在抗逆转录病毒疗法的结果上。结果：HTP 组患者更年轻，卵泡刺激素（FSH）剂量更低，与 LTP 组相比，HTP 组的 ART 效果更好。在调整了年龄、体重指数（BMI）、AFC、FSH 总剂量等影响卵巢反应的因素后，HTP 组在卵母细胞产量、优质胚胎率和妊娠率方面仍明显优于 LTP 组。在逻辑回归分析中，年龄不是影响 ART 结果的重要患者因素；然而，患者的多囊卵巢综合征（PCOS）状态与 AMH-AFC 不一致有显著相关性，几率比（OR）为 1.24。结论 ：血清 AMH 能更准确地预测患者的卵巢储备功能，尤其是在 AMH 与 AFC 不一致的情况下；AMH 测量值高于 AFC 统计预期值的患者的 ART 结果更理想。此外，多囊卵巢综合症也是导致 AMH 和 AFC 不一致的重要因素之一。
{"title":"Which Ovarian Reserve Marker is More Reliable in IVF Patients with AMH and AFC Discordance?","authors":"Eun-Hee Yu, H. J. Lee, J. Joo, Yong Jin Na","doi":"10.31083/j.ceog5102049","DOIUrl":"https://doi.org/10.31083/j.ceog5102049","url":null,"abstract":"Background : In clinical practice, discordance between anti-müllerian hormone (AMH) and antral follicle count (AFC) presents a recurring challenge. Such discordance can potentially lead to inappropriate clinical decisions, thereby diminishing the clinician’s confidence in managing a patient’s long-term journey through assisted reproductive technology (ART). This study aims to clarify such discordance and identify the more reliable marker between the two, analyzing ART outcomes among Korean infertility patients with AMH and AFC discordance; furthermore, the study elaborates data to evaluate possible patient-related factors contributing to discordance. Methods : This retrospective observational study involved 225 infertile women who underwent their first controlled ovarian stimulation treatment followed by embryo transfer. These patients were categorized into three groups: the congruent (Con) group with predicted AMH according to AFC within 50% prediction interval; the higher-than-predicted (HTP) group with predicted AMH above upper boundary of 50% prediction interval according to AFC; the lower-than-predicted (LTP) group with predicted AMH below lower boundary of 50% prediction interval according to AFC. Variables in the comparative analysis of these three groups focused on ART outcomes. Results : The HTP group which had younger patients with lower dose of follicle stimulation hormone (FSH) achieved better ART outcomes than the LTP group. After adjusting for factors affecting ovarian response such as age, body mass index (BMI), AFC, and total dose FSH usage, the HTP group still demonstrated significantly superior results in terms of the oocyte yield, good-quality embryo rates, and pregnancy rate compared to the LTP group. In the logistic regression analysis, age was not a significant patient factor affecting the ART outcomes; however, the patient’s status of polycystic ovary syndrome (PCOS) was significantly associated with the AMH-AFC discordance, with an odds ratio (OR) of 1.24. Conclusions : Serum AMH provided the more accurate prediction of the patient’s ovarian reserve, especially when the discordance between AMH and AFC was present; more favorable ART outcomes were observed in the patients with the higher AMH measurement than the statistically expected value from their AFC. In addition, the presence of PCOS could be considered as one of the significant factors contributing to such discordance between AMH and AFC.","PeriodicalId":505527,"journal":{"name":"Clinical and Experimental Obstetrics & Gynecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140441400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Ishikawa, K. Nakayama, S. Razia, Hitomi Yamashita, T. Ishibashi, Kosuke Kanno, Seiya Sato, Satoru Kyo
Background : This study aimed to compare the oncologic and surgical outcomes of patients treated with robot-assisted modified radical hysterectomy (RAMRH) and total laparoscopic modified radical hysterectomy (TLMRH) for endometrial cancer (EC) with those of patients treated with abdominal modified radical hysterectomy (AMRH). Methods : We performed a retrospective analysis of 133 patients with early-stage EC who underwent different surgical approaches (RAMRH, n = 14; TLMRH, n = 94; AMRH, n = 25) between 2018 and 2021 at Shimane University Hospital. The data on clinical outcomes, including estimated blood loss, duration of surgery, duration of hospital stay, and number of dissected lymph nodes were collected from the patients’ electronic medical records. Kaplan–Meier curves were used to plot survival data, and log-rank tests were used to determine the statistical significance of differences in survival rates. Results : RAMRH showed the lowest bleeding volume (RAMRH: 95 ± 123.21 mL; TLMRH: 140.74 ± 172.60 mL; AMRH: 482.6 ± 429 mL) and shortest hospital stay (RAMRH: 6.43 ± 1.09 days; TLMRH: 7.30 ± 3.39 days; AMRH: 9.88 ± 2.65 days) among the three groups. The number of dissected lymph nodes tended to be higher in the RAMRH group than that in the TLMRH or AMRH group. The different surgical approaches did not correlate with progression-free survival and overall survival. Conclusions : Both RAMRH and TLMRH are safe, feasible, innovative, and minimally invasive surgical alternatives to AMRH for patients with EC.
{"title":"Comparison of Oncological and Surgical Outcomes of Robot-Assisted, Laparoscopic Modified Radical Hysterectomy and Laparotomy for Endometrial Cancer","authors":"M. Ishikawa, K. Nakayama, S. Razia, Hitomi Yamashita, T. Ishibashi, Kosuke Kanno, Seiya Sato, Satoru Kyo","doi":"10.31083/j.ceog5102047","DOIUrl":"https://doi.org/10.31083/j.ceog5102047","url":null,"abstract":"Background : This study aimed to compare the oncologic and surgical outcomes of patients treated with robot-assisted modified radical hysterectomy (RAMRH) and total laparoscopic modified radical hysterectomy (TLMRH) for endometrial cancer (EC) with those of patients treated with abdominal modified radical hysterectomy (AMRH). Methods : We performed a retrospective analysis of 133 patients with early-stage EC who underwent different surgical approaches (RAMRH, n = 14; TLMRH, n = 94; AMRH, n = 25) between 2018 and 2021 at Shimane University Hospital. The data on clinical outcomes, including estimated blood loss, duration of surgery, duration of hospital stay, and number of dissected lymph nodes were collected from the patients’ electronic medical records. Kaplan–Meier curves were used to plot survival data, and log-rank tests were used to determine the statistical significance of differences in survival rates. Results : RAMRH showed the lowest bleeding volume (RAMRH: 95 ± 123.21 mL; TLMRH: 140.74 ± 172.60 mL; AMRH: 482.6 ± 429 mL) and shortest hospital stay (RAMRH: 6.43 ± 1.09 days; TLMRH: 7.30 ± 3.39 days; AMRH: 9.88 ± 2.65 days) among the three groups. The number of dissected lymph nodes tended to be higher in the RAMRH group than that in the TLMRH or AMRH group. The different surgical approaches did not correlate with progression-free survival and overall survival. Conclusions : Both RAMRH and TLMRH are safe, feasible, innovative, and minimally invasive surgical alternatives to AMRH for patients with EC.","PeriodicalId":505527,"journal":{"name":"Clinical and Experimental Obstetrics & Gynecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140438971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shaohui Chen, Shugen Zhou, Yuanhong Chen, Rongju Liu
Background : Low bone mineral density (BMD) is the hallmark of osteoporosis, postmenopausal women are more likely to have microarchitectural deterioration and fracture risks. This study aimed to determine the relationship between serum creatinine (sCr) levels and osteoporosis in women who are early postmenopausal. Methods : There were 335 early postmenopausal women (age 40–60 years) in Dongguan, China, included in this cross-sectional study. BMD in the lumbar spine, femoral neck, and trochanter was measured using dual-energy X-ray absorptiometry (DXA) and assessed using multivariable-adjusted logistic regression models based on sCr levels obtained during the first DXA examination. Results : Without osteoporosis patients had significantly higher sCr levels than osteoporosis patients. Overall, 75 (22.4%) participants (age, 51.3 ± 5.2 years) had osteoporosis. The median sCr level was 55.9 ± 9.6 µmol/L (range, 29.0–94.0 µmol/L). sCr levels increased by 1 µmol/L, while the risk of osteoporosis decreased by 4% (odds ratio [OR], 0.96; 95% confidence interval [95% CI], 0.93–0.99), when menopause duration, menopause rating scale, body mass index, smoking habits, alcohol consumption, activity status, serum uric acid, and serum urea nitrogen were considered. Participants in the highest sCr quantile were at low risk for osteoporosis compared with those in the lowest quantile (OR, 0.46; 95% CI, 0.22–0.94). Based on subgroup and sensitivity analyses, this association remained stable. Conclusions : The sCr levels of early postmenopausal women are negatively associated with BMD, independent of age, menopause duration, and serum uric acid levels. As a marker of bone health, sCr may be a valuable indicator of skeletal muscle mass and provide evidence for future osteoporosis markers.
{"title":"Association between Serum Creatinine and Osteoporosis in Early Postmenopausal Women: A Cross-Sectional Study","authors":"Shaohui Chen, Shugen Zhou, Yuanhong Chen, Rongju Liu","doi":"10.31083/j.ceog5102046","DOIUrl":"https://doi.org/10.31083/j.ceog5102046","url":null,"abstract":"Background : Low bone mineral density (BMD) is the hallmark of osteoporosis, postmenopausal women are more likely to have microarchitectural deterioration and fracture risks. This study aimed to determine the relationship between serum creatinine (sCr) levels and osteoporosis in women who are early postmenopausal. Methods : There were 335 early postmenopausal women (age 40–60 years) in Dongguan, China, included in this cross-sectional study. BMD in the lumbar spine, femoral neck, and trochanter was measured using dual-energy X-ray absorptiometry (DXA) and assessed using multivariable-adjusted logistic regression models based on sCr levels obtained during the first DXA examination. Results : Without osteoporosis patients had significantly higher sCr levels than osteoporosis patients. Overall, 75 (22.4%) participants (age, 51.3 ± 5.2 years) had osteoporosis. The median sCr level was 55.9 ± 9.6 µmol/L (range, 29.0–94.0 µmol/L). sCr levels increased by 1 µmol/L, while the risk of osteoporosis decreased by 4% (odds ratio [OR], 0.96; 95% confidence interval [95% CI], 0.93–0.99), when menopause duration, menopause rating scale, body mass index, smoking habits, alcohol consumption, activity status, serum uric acid, and serum urea nitrogen were considered. Participants in the highest sCr quantile were at low risk for osteoporosis compared with those in the lowest quantile (OR, 0.46; 95% CI, 0.22–0.94). Based on subgroup and sensitivity analyses, this association remained stable. Conclusions : The sCr levels of early postmenopausal women are negatively associated with BMD, independent of age, menopause duration, and serum uric acid levels. As a marker of bone health, sCr may be a valuable indicator of skeletal muscle mass and provide evidence for future osteoporosis markers.","PeriodicalId":505527,"journal":{"name":"Clinical and Experimental Obstetrics & Gynecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140439631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background : Candida albicans (C. albicans) and Candida glabrata (C. glabrata ) are mainly associated with vulvovaginal candidiasis (VVC). Management of VVC caused by C. glabrata is particularly challenging due to its inherent reduced susceptibility to fluconazole. In this prospective laboratory-based cohort study, we investigated the effect of pH on in vitro susceptibility of Candida spp. isolates to fluconazole and flucytosine. Methods : Vaginal isolates of C. glabrata , C. albicans , Candida tropicalis (C. tropicalis) and Candida parapsilosis (C. parapsilosis) were tested for susceptibility to fluconazole and flucytosine by Epsilometer test (ETEST) strips on Roswell
{"title":"A Pilot Study Showing Fluconazole and Flucytosine Activities against Candida glabrata are Affected by Low pH: Implications for the Treatment of Recurrent Vulvovaginal Candidiasis","authors":"Ziauddin Khan, Suhail Ahmad, Mohammad Asadzadeh","doi":"10.31083/j.ceog5102039","DOIUrl":"https://doi.org/10.31083/j.ceog5102039","url":null,"abstract":"Background : Candida albicans (C. albicans) and Candida glabrata (C. glabrata ) are mainly associated with vulvovaginal candidiasis (VVC). Management of VVC caused by C. glabrata is particularly challenging due to its inherent reduced susceptibility to fluconazole. In this prospective laboratory-based cohort study, we investigated the effect of pH on in vitro susceptibility of Candida spp. isolates to fluconazole and flucytosine. Methods : Vaginal isolates of C. glabrata , C. albicans , Candida tropicalis (C. tropicalis) and Candida parapsilosis (C. parapsilosis) were tested for susceptibility to fluconazole and flucytosine by Epsilometer test (ETEST) strips on Roswell","PeriodicalId":505527,"journal":{"name":"Clinical and Experimental Obstetrics & Gynecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140442871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Can Luo, Fuping Yue, Ling Mei, Yueyue Chen, Xiaoyu Niu
{"title":"Efficacy of Fractional CO2 Laser Versus Intravaginal Estrogen for Controlling the Genitourinary Syndrome of Menopause (GSM) Especially Sexual Dysfunctions—A Systematic Review and Meta-Analysis","authors":"Can Luo, Fuping Yue, Ling Mei, Yueyue Chen, Xiaoyu Niu","doi":"10.31083/j.ceog5102040","DOIUrl":"https://doi.org/10.31083/j.ceog5102040","url":null,"abstract":"","PeriodicalId":505527,"journal":{"name":"Clinical and Experimental Obstetrics & Gynecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140443750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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