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Thoracic and diaphragmatic endometriosis: an overview of diagnosis and surgical treatment
Purpose of review Thoracic endometriosis is a rare disease that can lead to a variety of clinical manifestations. There are currently no guidelines for optimal diagnosis and management of the disease. The purpose of this review is to provide an overview of the diagnosis and surgical treatment of thoracic endometriosis. Recent findings Various imaging modalities, including computed tomography (CT), MRI and ultrasound, have been reported in the detection of thoracic endometriosis. MRI is the most sensitive imaging study and may aid in preoperative planning. Histopathology of a biopsied lesion remains the gold stan...
Source: Current Opinion in Obstetrics and Gynecology - August 1, 2022 Category: OBGYN Tags: MINIMALLY INVASIVE GYNECOLOGIC PROCEDURES: Edited by Matthew T. Siedhoff and Nisse V. Clark Source Type: research

Adnexal torsion: a review of diagnosis and management strategies
Purpose of review Adnexal torsion remains a diagnostic challenge heavily reliant on high clinical suspicion, with patient presentation and imaging used as adjuncts to aid in its diagnosis. This review summarizes diagnostic and management techniques of adnexal torsion to assist providers when encountering this surgical emergency. Recent findings Common findings of adnexal torsion include abdominal pain, nausea, vomiting, and adnexal mass or ovarian enlargement. An elevated neutrophil to lymphocyte ratio may be useful for diagnosis. A ’whirlpool’ sign, ’follicular ring’ sign, enlarged/edematous ovary, and ...
Source: Current Opinion in Obstetrics and Gynecology - August 1, 2022 Category: OBGYN Tags: MINIMALLY INVASIVE GYNECOLOGIC PROCEDURES: Edited by Matthew T. Siedhoff and Nisse V. Clark Source Type: research

The role of minimally invasive gynecologic surgeons in the era of subspecialties: when to refer and consult
This article reviews the evidence regarding common disorders and procedures and their outcomes, and posits a basis for MIGS referral. Recent findings In instances where intraoperative and perioperative features may pose clinical challenges to the surgeon and ultimately the patient, the literature suggests the following scenarios may have adverse outcomes, and therefore, benefit from the skills of MIGS subspecialists: fibroids – at least five myomas, myoma size at least 9 cm, and suspected myoma weight at least 500 g; endometriosis – presence of endometrioma(s), suspected stage III/IV endometriosis, and requi...
Source: Current Opinion in Obstetrics and Gynecology - August 1, 2022 Category: OBGYN Tags: MINIMALLY INVASIVE GYNECOLOGIC PROCEDURES: Edited by Matthew T. Siedhoff and Nisse V. Clark Source Type: research

Obesity and reproduction
The objective of this review is to highlight the recent literature on how obesity affects reproductive capacity in men and women. Recent findings The relationship between fertility and obesity is complex and involves the hypothalamic-pituitary-ovarian axis, neuroendocrine systems and adipose tissue. The exact pathophysiology of how obesity lowers fertility rates is unknown, but is likely multifactorial involving anovulation, insulin resistance and alterations in gonadotropins. In addition, there is controversy on whether oocyte quality or endometrial receptivity plays a larger role in obese infertile women. Data on ...
Source: Current Opinion in Obstetrics and Gynecology - August 1, 2022 Category: OBGYN Tags: REPRODUCTIVE ENDOCRINOLOGY: Edited by Ruben Alvero Source Type: research

Intravaginal embryo culture: a successful alternative to standard IVF that may improve access to care
Purpose of review To discuss existing literature and current use of intravaginal culture (IVC) as an option for patients seeking fertility therapies. Recent findings IVC is the combination of oocytes and sperm with culture media in a sealed device that is placed vaginally and left in place while fertilization and early embryo development occurs. Studies show that IVC is safe, well-tolerated, and has similar outcomes in patients as compared to standard in vitro fertilization techniques (conventional insemination and/or intracytoplasmic sperm injection). The new device, INVOcell, while recommended by the FDA for m...
Source: Current Opinion in Obstetrics and Gynecology - August 1, 2022 Category: OBGYN Tags: REPRODUCTIVE ENDOCRINOLOGY: Edited by Ruben Alvero Source Type: research

Training for the future
Purpose of review The aim of this study was to review the evolving field of Reproductive Endocrinology and Infertility (REI) and describe the current and future challenges REI fellowship programmes in the United States are facing. Recent findings The field of REI continues to rapidly evolve largely due to the tremendous advances within the assisted reproductive technologies (ARTs). Alongside this evolution, there is a lessening emphasis on graduates being proficient in all aspects of REI. Ongoing revisions to the REI fellowship structure reflect these changes in technology and contemporary practice patterns. ...
Source: Current Opinion in Obstetrics and Gynecology - August 1, 2022 Category: OBGYN Tags: REPRODUCTIVE ENDOCRINOLOGY: Edited by Ruben Alvero Source Type: research

The current and future state of surgery in reproductive endocrinology
Purpose of review The last decade has witnessed a radical change in the field of reproductive surgery. The increasing success of in-vitro fertilization (IVF) has caused a huge shift in emphasis with many downstream consequences. This review outlines the changes and provides insight into the future of reproductive surgery. Recent findings With compelling evidence that IVF overcomes the detrimental effects of endometriosis on infertility and with two new oral medications available for management of endometriosis, momentum is shifting towards nonsurgical management of endometriosis. There is increasing recognition ...
Source: Current Opinion in Obstetrics and Gynecology - August 1, 2022 Category: OBGYN Tags: REPRODUCTIVE ENDOCRINOLOGY: Edited by Ruben Alvero Source Type: research

Current trends in artificial intelligence in reproductive endocrinology
Purpose of review Artificial Intelligence, a tool that integrates computer science and machine learning to mimic human decision-making processes, is transforming the world and changing the way we live. Recently, the healthcare industry has gradually adopted artificial intelligence in many applications and obtained some degree of success. In this review, we summarize the current applications of artificial intelligence in Reproductive Endocrinology, in both laboratory and clinical settings. Recent findings Artificial Intelligence has been used to select the embryos with high implantation potential, proper ploidy s...
Source: Current Opinion in Obstetrics and Gynecology - August 1, 2022 Category: OBGYN Tags: REPRODUCTIVE ENDOCRINOLOGY: Edited by Ruben Alvero Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Obstetrics and Gynecology)
Source: Current Opinion in Obstetrics and Gynecology - August 1, 2022 Category: OBGYN Tags: EDITORIAL INTRODUCTIONS Source Type: research

Telomeres, aging and reproduction
Purpose of review Women's fertility decay starts at the mid 30 s. However, the current delay of childbearing leads to ovarian aging and the need of assisted reproduction technologies (ART). Telomere biology is one of the main pathways involved in organismal aging. Thus, this review will focus on the knowledge acquired during the last 2 years about the telomere pathway and its influence on female fertility and the consequences for the newborn. Recent findings New research on telomere biology reaffirms the relationship of telomere attrition and female infertility. Shorter maternal telomeres, which could be agg...
Source: Current Opinion in Obstetrics and Gynecology - May 31, 2022 Category: OBGYN Tags: FERTILITY, IVF AND REPRODUCTIVE GENETICS: Edited by Emre Seli and Juan A. Garcia Velasco Source Type: research

The true incidence of recurrent implantation failure
Purpose of review To review the merits and limitations of current definitions of recurrent implantation failure (RIF), how they translate into estimates of incidence and to summarize how emerging concepts of individualizing the recognition of this condition can assist in changing the way RIF is identified, studied and managed. Recent findings The notion of a one size fits all definition of RIF is seen to be of limited clinical value, as the individual risk of repeated IVF failure has many determinants and causes. Novel approaches provide a means of identifying ‘actionable’ RIF in individual patients. Summ...
Source: Current Opinion in Obstetrics and Gynecology - May 31, 2022 Category: OBGYN Tags: FERTILITY, IVF AND REPRODUCTIVE GENETICS: Edited by Emre Seli and Juan A. Garcia Velasco Source Type: research

Racial disparities in access to reproductive health and fertility care in the United States
Purpose of review To examine the status of racial and ethnic inequalities in fertility care in the United States (U.S.) at inception of 2022. This review highlights addressable underpinnings for the prevalent differentials in access to and utilization of infertility treatments and underscores gaps in preventive care as key contributors to racial and ethnic disparities in risk burden for subfertility and infertility. Recent findings Significant gaps in access to and utilization of fertility care are consistently reported among racial and ethnic minorities, particularly Black and Hispanic women. Access to and util...
Source: Current Opinion in Obstetrics and Gynecology - May 31, 2022 Category: OBGYN Tags: FERTILITY, IVF AND REPRODUCTIVE GENETICS: Edited by Emre Seli and Juan A. Garcia Velasco Source Type: research

The use of intraovarian injection of autologous platelet rich plasma (PRP) in patients with poor ovarian response and premature ovarian insufficiency
This article reviews the latest literature on the effect of PRP on markers of ovarian reserve, oocyte and embryo yield, and live birth for these poor prognosis patients. Recent findings Several case series and one prospective trial have demonstrated improvements in markers of ovarian reserve in patients with POI and POR and improved oocyte and embryo yields in patients with POR. These studies report multiple live births in patients who had previously failed treatment. The positive effects of PRP persist throughout the literature despite the fact that multiple protocols for preparing and injecting PRP exist, with no ...
Source: Current Opinion in Obstetrics and Gynecology - May 31, 2022 Category: OBGYN Tags: FERTILITY, IVF AND REPRODUCTIVE GENETICS: Edited by Emre Seli and Juan A. Garcia Velasco Source Type: research

Microbiome as a predictor of implantation
Purpose of review Review the latest research on the female urogenital microbiome as a predictor of successful implantation. Recent findings Lactobacillus crispatus seems to be beneficial species in a healthy female genital tract, although the presence of anaerobic bacteria and their impact has yet to be determined. The vaginal microbiome is associated with assisted reproductive technology (ART) outcome in terms of successful implantation and pregnancy. Approaches restoring a dysbiotic vaginal microbiome seem promising. It is questionable if a unique endometrial microbiome exists, given the low bacterial biomass,...
Source: Current Opinion in Obstetrics and Gynecology - May 31, 2022 Category: OBGYN Tags: FERTILITY, IVF AND REPRODUCTIVE GENETICS: Edited by Emre Seli and Juan A. Garcia Velasco Source Type: research

BMI and miscarriage after IVF
Purpose of review To summarize recent findings related to the risk of miscarriage in women with elevated BMI undergoing IVF, and the mechanisms involved in said risk. Recent findings Miscarriage rates are increased in overweight and obese women in both natural and assisted reproduction. Oocyte and embryo quality assessed according to classic morphological static parameters does not seem to be affected by excessive female body weight. Despite the initial lack of consensus between studies regarding embryo morphokinetics in obese women, blastocyst formation and quality have recently been shown to be similar across ...
Source: Current Opinion in Obstetrics and Gynecology - May 31, 2022 Category: OBGYN Tags: FERTILITY, IVF AND REPRODUCTIVE GENETICS: Edited by Emre Seli and Juan A. Garcia Velasco Source Type: research