Best practice & research. Clinical obstetrics & gynaecology最新文献

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The road to hormonal male contraception: End in sight? 男性荷尔蒙避孕之路：终结在望？

Best practice & research. Clinical obstetrics & gynaecology

Pub Date : 2024-09-24 DOI: 10.1016/j.bpobgyn.2024.102559

R A Anderson, J J Reynolds-Wright

The concept of a hormonal approach that sufficiently and reversibly suppresses spermatogenesis to the level required for effective contraception has been developed and tested over several decades. The reality of achieving this has been confirmed using both testosterone alone and combination methods using a progestogen with a physiological dose of testosterone, necessary to replace the lack of endogenous testosterone production by the suppressed testes. A range of both long-acting and self-administered combination methods are effective, including injection, implant and gel methods of administration, with up to 95% of men achieving sufficient spermatogenic suppression. New steroids are also being trialled. Surveys show the widespread willingness of men and their female partners to use novel male methods, suggesting the potential of this approach to contribute to global family planning and sustainable development goals. This approach to contraception can clearly be effective, and needs to move from relatively small scale testing to large scale pre-marketing trials: only then can information about long-term safety and real-world acceptability be obtained.

几十年来，人们一直在发展和试验一种激素方法，这种方法能充分和可逆地抑制精子生成，使其达到有效避孕所需的水平。无论是单独使用睾酮，还是使用孕激素与生理剂量的睾酮的联合方法，都证实了实现这一目标的现实性，而生理剂量的睾酮是替代受抑制的睾丸所缺乏的内源性睾酮分泌所必需的。一系列长效和自服的组合方法都很有效，包括注射、植入和凝胶给药方法，多达 95% 的男性可获得足够的生精抑制效果。新的类固醇也在试用中。调查显示，男性及其女性伴侣普遍愿意使用新型男性避孕方法，这表明这种方法有可能为全球计划生育和可持续发展目标做出贡献。这种避孕方法显然是有效的，需要从相对较小规模的试验转向大规模的上市前试验：只有这样，才能获得有关长期安全性和现实世界可接受性的信息。

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引用次数: 0

Genome sequencing in the prenatal diagnosis of structural malformations in the fetus. 基因组测序在胎儿结构畸形产前诊断中的应用。

Best practice & research. Clinical obstetrics & gynaecology

Pub Date : 2024-09-13 DOI: 10.1016/j.bpobgyn.2024.102539

Matthew Hoi Kin Chau, Mahesh Choolani, Zirui Dong, Ye Cao, Kwong Wai Choy

Prenatal genetic diagnosis has undergone two pivotal paradigm shifts, initially with the introduction of chromosomal microarray and subsequently with the advent of next-generation sequencing technologies (NGS). NGS technology has given rise to a multitude of applications, with gene panels, exome sequencing (ES), and genome sequencing (GS) emerging as highly promising tests for prenatal genetic investigations. These advanced approaches have demonstrated superior diagnostic rates when compared to conventional testing methods, showcasing the evolution and enhancement of prenatal genetic screening and diagnostic capabilities. With these ground-breaking innovations, NGS technologies have the potential to replace current standard practice in prenatal diagnosis. With the increasing use of prenatal sequencing, the need for better education and guidance on their applications grows. This chapter aims to illustrate the detection scope and feasibility of various NGS-based methods that are currently used in prenatal diagnosis.

产前基因诊断经历了两次关键的模式转变，最初是染色体微阵列的引入，随后是新一代测序技术（NGS）的出现。NGS 技术产生了多种应用，基因面板、外显子组测序（ES）和基因组测序（GS）成为产前基因调查中极具前景的检测方法。与传统检测方法相比，这些先进方法的诊断率更高，展示了产前基因筛查和诊断能力的发展和提高。凭借这些突破性创新，NGS 技术有可能取代目前产前诊断的标准做法。随着产前测序应用的不断增加，对其应用的更好教育和指导的需求也与日俱增。本章旨在说明目前产前诊断中使用的各种基于 NGS 的方法的检测范围和可行性。

引用次数: 0

Beyond the surface: Does stage I-II endometriosis impact fertility? Exploring the challenges of mild disease. 超越表面：I-II 期子宫内膜异位症会影响生育吗？探索轻度疾病的挑战。

Best practice & research. Clinical obstetrics & gynaecology

Pub Date : 2024-09-01 Epub Date: 2024-05-09 DOI: 10.1016/j.bpobgyn.2024.102501

Begum Aydogan Mathyk, Esra Cetin, Youssef Youssef, Anthony N Imudia, Diana Encalada Soto, Emad Mikhail, Gaby Moawad

Endometriosis is one of the most common gynecologic conditions that women face throughout their lives. Despite advances in technology, diagnosis and treatment of this relapsing and remitting condition is still challenging for many women. This review focuses on literature pertaining to minimal/mild (stage I/II) endometriosis and its impact on fertility. The effectiveness of medical interventions to improve infertility and obstetric outcomes in both natural and assisted reproductive technologies cycles remains debated. The recent ESHRE guidelines suggests that operative laparoscopy could be considered for rASRM stage I/II endometriosis as it improves ongoing pregnancy rates.

子宫内膜异位症是妇女一生中最常见的妇科疾病之一。尽管技术在不断进步，但对许多妇女来说，诊断和治疗这种复发和缓解性疾病仍是一项挑战。本综述主要关注与轻微/轻度（I/II 期）子宫内膜异位症及其对生育的影响有关的文献。在自然周期和辅助生殖技术周期中，医疗干预对改善不孕症和产科结果的有效性仍存在争议。最近的 ESHRE 指南建议，可考虑对 rASRM I/II 期子宫内膜异位症进行腹腔镜手术，因为它能提高持续妊娠率。

引用次数: 0

Endometriosis related infertility. 与子宫内膜异位症有关的不孕症。

Best practice & research. Clinical obstetrics & gynaecology

Pub Date : 2024-05-01 DOI: 10.1016/j.bpobgyn.2024.102504

Simone Ferrero

引用次数: 0

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