Current and Future Medical Therapies for Adenomyosis
Semin Reprod Med DOI: 10.1055/s-0040-1719016There is no approved medical therapy for adenomyosis and limited evidence to guide treatments in part due to the complexity of nonhistologic diagnosis and the prevalence of concomitant gynecologic conditions. Most available evidence focuses on the treatment of heavy menstrual bleeding, painful menses, and pelvic pain. Data evaluating fertility outcomes, sexual function, and quality of life following treatment are lacking. Additionally, there is no disease-specific measure of quality of life for adenomyosis. The levonorgestrel-releasing intrauterine system appears to be the most e...
Source: Seminars in Reproductive Medicine - October 29, 2020 Category: Reproduction Medicine Authors: Cope, Adela G. Ainsworth, Alessandra J. Stewart, Elizabeth A. Tags: Review Article Source Type: research
Epidemiology of Adenomyosis
Semin Reprod Med DOI: 10.1055/s-0040-1718920Adenomyosis, characterized by the presence of endometrial glands and stroma within the myometrium, can have a substantial impact on the quality of women's lives. Despite this, the epidemiologic research on this condition lags considerably behind that of other noncancerous reproductive health conditions. The lack of progress and knowledge is due in part to the challenges in designing valid epidemiologic studies, since the diagnosis of adenomyosis historically has been limited to the examination of uterine specimens from hysterectomy. This review describes the available data on the...
Source: Seminars in Reproductive Medicine - October 26, 2020 Category: Reproduction Medicine Authors: Upson, Kristen Missmer, Stacey A. Tags: Review Article Source Type: research
Animal Models of Adenomyosis
Semin Reprod Med DOI: 10.1055/s-0040-1718741Adenomyosis is a nonmalignant uterine disorder in which endometrial tissue exists within and grows into the myometrium. Animal models have generated limited insight into the still-unclear pathogenesis of adenomyosis, provided a platform for preclinical screening of many drugs and compounds with potential as therapeutics, and elucidated mechanisms underlying the pain and fertility issues that occur in many women with the disease. Spontaneous adenomyosis has been studied in nonhuman primates, primarily in the form of case reports. Adenomyosis is routinely experimentally induced in ...
Source: Seminars in Reproductive Medicine - October 26, 2020 Category: Reproduction Medicine Authors: Marquardt, Ryan M. Jeong, Jae-Wook Fazleabas, Asgerally T. Tags: Review Article Source Type: research
The Male Is Significantly Implicated as the Cause of Unexplained Infertility
Semin Reprod Med DOI: 10.1055/s-0040-1718941Male infertility is recognized as a relatively common, complex condition, generated by a broad array of environmental and genetic factors. Historical reliance on the conventional semen profile has tended to underestimate the true contribution of “the male factor” to human infertility. This review highlights the importance of genetic and epigenetic factors in the etiology of male infertility, identifying a range of mutations responsible for primary testicular failure and impaired fertilizing potential. More than three quarters of all de novo mutations arise in the male germlin...
Source: Seminars in Reproductive Medicine - October 21, 2020 Category: Reproduction Medicine Authors: Aitken, Robert John Tags: Review Article Source Type: research
Does Laparoscopy and Hysteroscopy Have a Place in the Diagnosis of Unexplained Infertility?
Semin Reprod Med DOI: 10.1055/s-0040-1718942The standard fertility workup includes assessment of ovulation, semen analysis, and evaluation of tubal patency. If the fertility workup is found to be normal, a diagnosis of unexplained infertility is made. The role of laparoscopy in fertility workup has been a matter of debate. The current review presents the evidence for and against laparoscopy and hysteroscopy during fertility workup and subsequently prior to fertility treatment. After appraising the literature, we found the role of diagnostic laparoscopy in fertility workup is limited and is dependent on factors like prevale...
Source: Seminars in Reproductive Medicine - October 20, 2020 Category: Reproduction Medicine Authors: Kamath, Mohan S. Rikken, Judith F.W. Bosteels, Jan Tags: Review Article Source Type: research
Pathology and Pathogenesis of Adenomyosis
Semin Reprod Med DOI: 10.1055/s-0040-1718922Adenomyosis represents a unique pathophysiological condition in which normal-appearing endometrial mucosa resides within myometrium and is thus protected from menstrual shedding. The resulting ectopic presence of endometrial tissue composed of glands and stroma is thought to affect normal contractile function and peristalsis of uterine smooth muscle, causing menometrorrhagia, infertility, and adverse obstetric outcomes. Since the first description of adenomyosis more than 150 years ago, pathologists have studied this lesion by examining tissue specimens, and have proposed multipl...
Source: Seminars in Reproductive Medicine - October 20, 2020 Category: Reproduction Medicine Authors: Antero, Maria Facadio Ayhan, Ayse Segars, James Shih, Ie-Ming Tags: Review Article Source Type: research
Interdisciplinary Teams in Endometriosis Care
Semin Reprod Med DOI: 10.1055/s-0040-1718943Endometriosis-associated chronic pelvic pain can at times be a complex problem that is resistant to standard medical and surgical therapies. Multiple comorbidities and central sensitization may be at play and must be recognized with the help of a thorough history and physical examination. If a complex pain problem is identified, most endometriosis expert reviews and guidelines recommend multidisciplinary care. However, there are no specific recommendations about what should be the components of this approach and how that type of team care should be delivered. There is evidence sh...
Source: Seminars in Reproductive Medicine - October 20, 2020 Category: Reproduction Medicine Authors: Allaire, Catherine Long, Alicia Jean Bedaiwy, Mohamed A. Yong, Paul J. Tags: Review Article Source Type: research
Impairment of Uterine Contractility Is Associated with Unexplained Infertility
Semin Reprod Med DOI: 10.1055/s-0040-1716409The uterine junctional zone represents the juncture between endometrium and myometrium. The junctional zone is hormonally dependent and displays continuous peristaltic activity throughout the menstrual cycle in the nonpregnant state which is concerned with sperm transport and embryo implantation. Peristalsis may be observed using various invasive and noninvasive modalities, of which ultrasound is the most readily applied in the clinical setting. Women with pelvic pathology display alterations in uterine peristalsis which may contribute to infertility. Characterization of peristal...
Source: Seminars in Reproductive Medicine - October 14, 2020 Category: Reproduction Medicine Authors: Hunt, Sarah Abdallah, Karim S. Ng, Ernest Rombauts, Luk Vollenhoven, Beverley Mol, Ben W. Tags: Review Article Source Type: research
How and Why to Define Unexplained Infertility?
Semin Reprod Med DOI: 10.1055/s-0040-1718709Unexplained infertility represents up to 30% of all cases of infertility. It is a diagnosis of exclusion, where no cause for infertility may be identified in the investigation of the couple, be it anovulation, fallopian tube blockage, or severe male factor. Unexplained infertility therefore cannot be considered a diagnosis to which a specific treatment is directed, rather that it indicates a failure to reach a diagnosis of the true cause of infertility. In this review, we explore the evidence base and potential limitations of the current routine infertility assessment. We also ai...
Source: Seminars in Reproductive Medicine - October 14, 2020 Category: Reproduction Medicine Authors: Abdallah, Karim S. Hunt, Sarah Abdullah, Sayed A. Mol, Ben W.J. Youssef, Mohamed A. Tags: Review Article Source Type: research
Adenomyosis: Mechanisms and Pathogenesis
Semin Reprod Med DOI: 10.1055/s-0040-1716687Adenomyosis is a common disorder of the uterus, and is associated with an enlarged uterus, heavy menstrual bleeding (HMB), pelvic pain, and infertility. It is characterized by endometrial epithelial cells and stromal fibroblasts abnormally found in the myometrium where they elicit hyperplasia and hypertrophy of surrounding smooth muscle cells. While both the mechanistic processes and the pathogenesis of adenomyosis are uncertain, several theories have been put forward addressing how this disease develops. These include intrinsic or induced (1) microtrauma of the endometrial–myo...
Source: Seminars in Reproductive Medicine - October 8, 2020 Category: Reproduction Medicine Authors: Zhai, Junyu Vannuccini, Silvia Petraglia, Felice Giudice, Linda C. Tags: Review Article Source Type: research
Reproductive Health Needs of the Military and Veterans
Semin Reprod Med DOI: 10.1055/s-0040-1714120 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents | Full text (Source: Seminars in Reproductive Medicine)
Source: Seminars in Reproductive Medicine - July 20, 2020 Category: Reproduction Medicine Authors: Christy, Alicia Y. Tags: Preface Source Type: research
Is Patient Advocacy the Solution to Physician Burnout?
Semin Reprod Med DOI: 10.1055/s-0040-1713428Physician burnout has been on the rise over the last several decades in a variety of specialties, leading to high rates of physician suicide and poor health outcomes for patients. As leaders in healthcare attempt to combat this issue through mental health initiatives and changes in medical training policies, we propose patient advocacy as a powerful technique to combat physician burnout and restore autonomy, purpose, and meaning into physicians' lives. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents | ...
Source: Seminars in Reproductive Medicine - July 9, 2020 Category: Reproduction Medicine Authors: Jeelani, Roohi Lieberman, Daniel Chen, Serena H. Tags: Review Article Source Type: research
Reproductive Health Needs of the Military and Veterans, Part 3
Semin Reprod Med DOI: 10.1055/s-0040-1714767 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents | Full text (Source: Seminars in Reproductive Medicine)
Source: Seminars in Reproductive Medicine - July 8, 2020 Category: Reproduction Medicine Authors: Segars, James H. Tags: Introduction Source Type: research
Obstetric Outcomes in Military Servicewomen: Emerging Knowledge, Considerations, and Gaps
Semin Reprod Med DOI: 10.1055/s-0040-1712929The number of women in the U.S. military is dramatically increasing. Similarly, the roles of active-duty women are greatly expanding, thus exposing them to new occupational risks. Determining the impact of pregnancy outcomes for women while in the military is difficult due to changing exposures over time, difficulty in utilizing appropriate comparison groups, and the lack of prospective investigations. Despite these limitations, it was concerning that the available data suggest that servicewomen delivering within 6 months of their first deployment have an increased preterm birth ...
Source: Seminars in Reproductive Medicine - June 24, 2020 Category: Reproduction Medicine Authors: Mezwa, Kathryn Adelsheim, Lee Markenson, Glenn Tags: Review Article Source Type: research
Postdeployment Fertility Challenges and Treatment in the Modern Era
Semin Reprod Med DOI: 10.1055/s-0040-1713430Current war-fighting environments have shifted dramatically over the past decade, and with this change, new types of injuries are afflicting American soldiers. Operative Enduring Freedom and Operation Iraqi Freedom have noted an increased use of sophisticated improvised explosive devices by adversaries. Injuries not frequently seen in previous conflict are dismounted complex blast injuries, which involve multiple proximal amputations, pelvic fractures, and extensive perineal wounds. Thus, an unforeseen consequence of the decreased mortality rate after these complex blast injuries...
Source: Seminars in Reproductive Medicine - June 24, 2020 Category: Reproduction Medicine Authors: Lentscher, Jessica A. Combs, Joshua C. Walker, Karrie Young, Christopher M. Chason, Rebecca Tags: Review Article Source Type: research
