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Minimally invasive approach to the management of tubo-ovarian abscesses
Purpose of review The purpose of this publication is to review the most up-to-date literature regarding the pathogenesis, diagnosis and management of tubo-ovarian abscesses. Recent findings Prior to the advent of broad-spectrum antibiotics, tubo-ovarian abscesses necessitated total abdominal hysterectomy and bilateral salpingo-oophorectomy. Although it carries a risk of treatment failure, antibiotic therapy enabled fertility-sparing treatment for many women. Recent studies have identified key predictors for antibiotic treatment failure, including age, BMI and abscess diameter. C-reactive protein was also found t...
Source: Current Opinion in Obstetrics and Gynecology - July 9, 2021 Category: OBGYN Tags: MINIMALLY INVASIVE GYNECOLOGIC PROCEDURES: Edited by Matthew T. Siedhoff and Nisse V. Clark Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Obstetrics and Gynecology)
Source: Current Opinion in Obstetrics and Gynecology - July 9, 2021 Category: OBGYN Tags: EDITORIAL INTRODUCTIONS Source Type: research

Emerging follicular activation strategies to treat women with poor ovarian response and primary ovarian insufficiency
This article reviews three of the most recent and cutting-edge strategies that are currently being investigated to address the issues of poor ovarian response (POR) and primary ovarian insufficiency (POI). Recent findings Publications revealing the mechanism of mechanical disruption of the Hippo signaling pathway paved the way to studies on its potential application for fertility treatments. This, in combination with Akt stimulation, resulted in live births and ongoing pregnancies in women with POI. Building on previous reports on the effects of bone marrow transplants on fertility after chemotherapy, another approa...
Source: Current Opinion in Obstetrics and Gynecology - May 1, 2021 Category: OBGYN Tags: FERTILITY, IVF AND REPRODUCTIVE GENETICS: Edited by Emre Seli and Juan A. Garcia Velasco Source Type: research

Endometrial stem cells: origin, biological function, and therapeutic applications for reproductive disorders
Purpose of review Endometrial stem cells (ESCs) are multipotent cells that are thought to originate locally in the endometrium as well as in the bone marrow (BM). They have remarkable plasticity and hold promise as an autologous source for regenerative medicine. This review focuses on recent studies that have advanced our understanding of the biology and function of ESCs and BM-derived stem cells (BMDSCs) as related to physiological reproductive processes and pathologies. Moreover, it reviews recent data on potential therapeutic applications of stem cells to endometrial disorders that lead to reproductive failure. R...
Source: Current Opinion in Obstetrics and Gynecology - May 1, 2021 Category: OBGYN Tags: FERTILITY, IVF AND REPRODUCTIVE GENETICS: Edited by Emre Seli and Juan A. Garcia Velasco Source Type: research

Assisted reproductive technology for women with endometriosis, a clinically oriented review
Purpose of review To discuss optimal management of an assisted reproductive technology (ART) cycle in women with endometriosis. Recent findings New studies involving euploid embryo transfers provide more insight on the etiology of endometriosis-associated infertility. Oocyte competence to reach live birth seems unlikely to be affected by the disease. Routine medical or surgical treatment prior to an ART cycle does not appear beneficial. Short gonadotropin releasing hormone (GnRH) antagonist or progestin primed ovarian stimulation protocols seem to be proper first choices, depending on the intention for a fresh e...
Source: Current Opinion in Obstetrics and Gynecology - May 1, 2021 Category: OBGYN Tags: FERTILITY, IVF AND REPRODUCTIVE GENETICS: Edited by Emre Seli and Juan A. Garcia Velasco Source Type: research

Understanding oocyte ageing: can we influence the process as clinicians?
Purpose of review Oocyte quality is rate-limiting for pregnancy success and declines with age. Here, I review animal-study evidence showing dramatic reversal of oocyte ageing with mitochondrial nutrients and explore clinical evidence related to their usage. Recent findings Oocyte ageing is strongly tied to mitochondrial dysfunction and oxidative stress. Quality-defining events occur over a protracted period (2—3 months in humans) when oocyte volume increases over 100-fold. Treating mice during the growth phase with mitochondrial modifiers such as CoQ10 combats oocyte ageing. Exciting new work shows that raisin...
Source: Current Opinion in Obstetrics and Gynecology - May 1, 2021 Category: OBGYN Tags: FERTILITY, IVF AND REPRODUCTIVE GENETICS: Edited by Emre Seli and Juan A. Garcia Velasco Source Type: research

Suboptimal response to GnRH agonist trigger: causes and practical management
Purpose of review GnRH agonist products are used extensively worldwide to trigger ovulation and final oocyte maturation in in vitro fertilization cycles. The purpose of this article is to outline possible causes for a suboptimal response to the GnRH agonist trigger. Recent findings Risk factors for such a suboptimal response include prolonged hormonal contraceptive use, previous GnRHa-induced pituitary downregulation, a hypogonadotropic/hypogonadal condition, patient error, environmental conditions that may damage the GnRHa product used, GnRH and luteinizing hormone (LH) receptors polymorphisms, low baseline LH ...
Source: Current Opinion in Obstetrics and Gynecology - May 1, 2021 Category: OBGYN Tags: FERTILITY, IVF AND REPRODUCTIVE GENETICS: Edited by Emre Seli and Juan A. Garcia Velasco Source Type: research

Recurrent implantation failure: how common is it?
Purpose of review To clarify a lingering issue, the true incidence of repeated implantation failures (RIF) in women undergoing successive frozen euploid single embryo transfers (FE-SET). Recent findings As not all Assisted reproductive techinique (ART) attempts are crowned by success, it has been questioned since incept of ART whether failures resulted from an embryonic or endometrial cause. RIF has received no precise definition but a trend has existed toward setting a more stringent definition, as reproductive biology has become more effective and ART success rates improved. No scientific society has yet conve...
Source: Current Opinion in Obstetrics and Gynecology - May 1, 2021 Category: OBGYN Tags: FERTILITY, IVF AND REPRODUCTIVE GENETICS: Edited by Emre Seli and Juan A. Garcia Velasco Source Type: research

Ectopic pregnancies and endometrial microbiota
Purpose of the review In recent years there has been significant progress in the study of endometrial microbiota. This line of investigation has not been free of controversy and discussion. It is a key for clinicians involved to remain updated with the most recent findings in microbiome and its clinical implications to be able to offer patients all possible treatments. Recent findings The existence of endometrial microbiota now seems undisputed. Current lines of work are centered on dysbiosis and its connection to other pathologies. It is in the field of assisted reproductive technology where this research plays...
Source: Current Opinion in Obstetrics and Gynecology - May 1, 2021 Category: OBGYN Tags: FERTILITY, IVF AND REPRODUCTIVE GENETICS: Edited by Emre Seli and Juan A. Garcia Velasco Source Type: research

New concepts and difficulties with progesterone supplementation in the luteal phase
Purpose of review Management of the luteal phase (LP) in assisted reproductive cycles has aroused interest in recent years. The reason is that it seems that the individualization of LP support may be necessary, since the concept of ‘one size fits all’ does not apply to this treatment. Recent findings Studies carried out in hormone replacement therapy cycles (also called artificial cycles) have shown that serum levels of progesterone (P) are related to pregnancy outcomes. This represents a milestone in the management of artificial cycles (AC), because until a few years ago it was believed that serum levels di...
Source: Current Opinion in Obstetrics and Gynecology - May 1, 2021 Category: OBGYN Tags: FERTILITY, IVF AND REPRODUCTIVE GENETICS: Edited by Emre Seli and Juan A. Garcia Velasco Source Type: research

IVF and the exogenous progesterone-free luteal phase
This article summarizes several approaches of the exogenous progesterone-free luteal support in IVF. Recent findings Triggering ovulation with GnRH agonist may serve as an alternative to hCG, with well established advantages. In addition, the luteal phase can be individualized in order to achieve a more physiologic hormonal milieu, and a more patient friendly treatment, alleviating the burden of a lengthy exogenous progesterone therapy. Summary GnRH agonist trigger followed by a ‘freeze all’ policy is undoubtedly the best approach towards the ‘OHSS-free clinic’. If fresh embryo transfer is considered ...
Source: Current Opinion in Obstetrics and Gynecology - May 1, 2021 Category: OBGYN Tags: FERTILITY, IVF AND REPRODUCTIVE GENETICS: Edited by Emre Seli and Juan A. Garcia Velasco Source Type: research

Noninvasive prenatal testing in women undergoing in vitro fertilization with preimplantation genetic testing
Purpose of review To discuss the utilization, performance, and interpretation of noninvasive prenatal testing (NIPT) results in women achieving pregnancy through in vitro fertilization (IVF) and preimplantation genetic testing for aneuploidy (PGT-A). Recent findings Although PGT-A is a highly accurate method for the selection of euploid embryos the possibility for error still exists. Many women pursue NIPT after conception via IVF with or without PGT-A, whereas some forgo prenatal screening all together. Recent evidence suggests that the prevalence of a positive NIPT following PGT-A is low, and the positive pred...
Source: Current Opinion in Obstetrics and Gynecology - May 1, 2021 Category: OBGYN Tags: FERTILITY, IVF AND REPRODUCTIVE GENETICS: Edited by Emre Seli and Juan A. Garcia Velasco Source Type: research

Technical factors to consider when developing an Expanded Carrier Screening platform
Purpose of review Expanded Carrier Screening (ECS) is a genetic test able to detect carriers for a large number of autosomal recessive and X-linked diseases. Its clinical utilization is increasing but some technical aspects for its implementation are still controversial. Recent findings In the current literature, several aspects of ECS panel implementation have been addressed. One of the most relevant topics involves which genes/pathologies should be included in an optimized ECS panel and which variants should be reported. Summary Here, we review the best practice criteria to refine and improve clinical u...
Source: Current Opinion in Obstetrics and Gynecology - May 1, 2021 Category: OBGYN Tags: FERTILITY, IVF AND REPRODUCTIVE GENETICS: Edited by Emre Seli and Juan A. Garcia Velasco Source Type: research

Analysis of female demographics in the United States: life expectancy, education, employment, family building decisions, and fertility service utilization
Purpose of review To discuss changes in female demographic parameters in the US and associated increase in utilization of fertility services. Recent findings Fractions of women earning bachelor's, master's, and doctoral degrees increased from 1970 to 2018 (32.6 vs 64.8; 7.9 vs 27.3; 0.54 vs 5.7 per 10,000 women; P  (Source: Current Opinion in Obstetrics and Gynecology)
Source: Current Opinion in Obstetrics and Gynecology - May 1, 2021 Category: OBGYN Tags: FERTILITY, IVF AND REPRODUCTIVE GENETICS: Edited by Emre Seli and Juan A. Garcia Velasco Source Type: research

Influence of social determinants on fertility: a critical review
Purpose of review Intrinsic factors, such as age, weight and lifestyle habits, together with extrinsic factors, such as socioeconomic level, must be considered when it comes to reproductive healthcare. Over the last few years, studies that attempt to respond to the participation and interaction of these factors in subfertility have been published; however, some questions remain unanswered. Recent findings Although there are little modifiable factors for women, it is possible to influence other factors, such as behavioural or cultural factors in order to minimize fertility problems; however, they are often highly...
Source: Current Opinion in Obstetrics and Gynecology - May 1, 2021 Category: OBGYN Tags: FERTILITY, IVF AND REPRODUCTIVE GENETICS: Edited by Emre Seli and Juan A. Garcia Velasco Source Type: research