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Current Opinion in Obstetrics & Gynecology

Sydney Kaye Willis, Elizabeth Elliott Hatch, Lauren Anne Wise
PURPOSE OF REVIEW: Sleep disturbances are increasing in prevalence in North America. There is growing evidence that poor sleep quality and short sleep duration may adversely affect circadian rhythms, which in turn may affect female reproduction. The objective of this review is to evaluate recent literature on the association between sleep disturbances and female reproduction. RECENT FINDINGS: There is accumulating evidence that sleep quality and duration are important for female reproduction, but epidemiologic research is limited...
May 6, 2019: Current Opinion in Obstetrics & Gynecology
Patricia Overcarsh, Cynthia Arvizo, Lara Harvey
PURPOSE OF REVIEW: Informed consent is frequently used interchangeably with obtaining a signature on a form. This oversimplification shifts the value from the process of informed consent to the documentation. This review focuses on the recommended components of the consent process, barriers encountered, factors influencing patient satisfaction, attempts to improve the consent practice, and considerations in special populations. RECENT FINDINGS: The process of informed consent is key to promoting shared decision-making and patient autonomy...
April 30, 2019: Current Opinion in Obstetrics & Gynecology
Megan Schmidt, Lauren Ditrio, Britta Shute, Danielle Luciano
PURPOSE OF REVIEW: Over 1.4 million adults are identified as transgender in 2014. Many of these individuals have undergone, or plan to undergo, gender-affirming surgery. This review summarizes the medical and surgical options available for the transgender population and reviews screening guidelines and fertility preservation options. In addition, it highlights the role gynecologists have in caring for this population. RECENT FINDINGS: Gynecologists perform certain gender-affirming surgeries, such as hysterectomies and bilateral salpingooophorectomies...
April 30, 2019: Current Opinion in Obstetrics & Gynecology
Sydney Chang, Alan B Copperman
PURPOSE OF REVIEW: To briefly summarize what is known regarding hyperprolactinemia and prolactin-secreting tumors, and review recent findings. RECENT FINDINGS: Prolactin was previously thought to inhibit secretion of gonadotropin-releasing hormone (GnRH) by directly inhibiting the firing of GnRH neurons, resulting in hypogonadotropic hypogonadism and infertility. However, kisspeptin has recently been implicated as the mediator of hyperprolactinemia-induced infertility, by acting upstream of the GnRH neurons as an integrator of endocrine signals...
April 30, 2019: Current Opinion in Obstetrics & Gynecology
Isabel S Eisner, Ruchi K Wadhwa, Keith T Downing, Pankaj K Singhal
PURPOSE OF REVIEW: The current article aims to briefly review recent literature on bowel injury in gynecologic surgery with a focus on minimally invasive techniques, strategies for prevention, and management of injury. RECENT FINDINGS: Recent reviews describe a low incidence of bowel injury that is likely affected by low rates of reporting and inconsistent definitions. The major risk factor for bowel injury is adhesive disease, and assessment and prevention techniques for the presence of adhesive disease are evolving...
April 30, 2019: Current Opinion in Obstetrics & Gynecology
Kristen Pepin, Himabindu Reddy, Nisse V Clark
PURPOSE OF REVIEW: To review important considerations in the counseling and management of women over the age of 40 desiring a myomectomy for symptomatic fibroids. RECENT FINDINGS: Women in the late reproductive and perimenopausal years may choose a myomectomy over a hysterectomy for reasons of fertility preservation or a personal desire to retain their uterus. Data suggest that laparoscopic myomectomy is a low-risk procedure that can be offered to older women, though the age-related risk of uterine malignancy must be evaluated...
April 22, 2019: Current Opinion in Obstetrics & Gynecology
Tanya Glenn, Amy L Harris, Steven R Lindheim
PURPOSE OF REVIEW: The association between obesity and infertility has gained increasing provider and public awareness. The purpose of this review is to outline the recent research into the pathophysiology regarding obesity and its impact of reproductive function in both women and men. RECENT FINDINGS: A BMI more than 25 has a detrimental impact on the hypothalamus-pituitary-gonadal (HPG) axis in both men and women, leading to alterations of HPG hormones, gametogenesis, as well as an increase in inflammation and lipotoxicity from excessive adipose tissue...
April 22, 2019: Current Opinion in Obstetrics & Gynecology
Jordan S Klebanoff, Cherie Q Marfori, Caitlin F Ingraham, Catherine Z Wu, Gaby N Moawad
PURPOSE OF REVIEW: Bleeding at the time of benign gynecologic surgery, as well as from benign gynecologic conditions, is a major source of morbidity for many women. Few nonhormonal medical options exist for the treatment of heavy menstrual bleeding, and to reduce surgical bleeding during major gynecologic surgery. Interest in Tranexamic acid (TXA) as a means to reduce surgical blood loss has been growing across many surgical specialties. This review focuses on applications for TXA as a means to reduce heavy menstrual bleeding (HMB) as well as to reduce surgical bleeding during benign gynecologic surgery...
April 22, 2019: Current Opinion in Obstetrics & Gynecology
Jessica Traylor, Angela Chaudhari, Susan Tsai, Magdy P Milad
PURPOSE OF REVIEW: Use of patient-reported outcome measures in clinical practice and research is becoming more prevalent and reflects initiatives to center the patient in healthcare delivery and outcomes assessment. The purpose of this review is to provide a summary description of selected, validated tools used to assess outcomes related to several benign gynecologic conditions: abnormal uterine bleeding, fibroids and endometriosis. RECENT FINDINGS: Given the availability of several validated instruments to assess patient outcomes in benign gynecology, there is still significant heterogeneity in tools used in trials...
April 9, 2019: Current Opinion in Obstetrics & Gynecology
Michelle Louie, Janelle K Moulder, Kelly Wright, Matthew Siedhoff
PURPOSE OF REVIEW: We seek to define the Millennial generation and identify strengths that can be employed to improve medical and surgical education and career development. We outline how generational traits can be incorporated into adult learning theory, offer suggestions for modernizing traditional teaching and mentorship models, and discuss why Millennials are ideally positioned to succeed in 21st century medicine. RECENT FINDINGS: Millennials (born ∼1981 to 1996) have several consistently identified traits that should be considered when teaching trainees and mentoring junior faculty...
April 9, 2019: Current Opinion in Obstetrics & Gynecology
Yoshio Yoshida
PURPOSE OF REVIEW: Gynecologic cancer patients of elderly has been increasing rapidly. Useful information on older patients, especially, with recurrent gynecological cancer is extremely limited. RECENT FINDINGS: A unified concept for assessing treatment risk was proposed when providing cancer treatment to older patients. Fit: patients capable of withstanding the same standard treatment as healthy younger patients; Vulnerable: patients incapable of withstanding the same standard treatment as healthy younger patients, but capable of undergoing some sort of treatment; and Frail: patients incapable of withstanding the same standard treatment as healthy younger patients, and also unsuitable to undergo any kind of active treatment...
April 2, 2019: Current Opinion in Obstetrics & Gynecology
Brian J Morris
PURPOSE OF REVIEW: This review updates progress in the human papillomavirus (HPV)-based revolution in cervical screening and vaccination predicted to eventually eliminate cervical cancer. RECENT FINDINGS: HPV PCR, patented by the author in 1987, has recently begun to replace cytology for primary cervical screening. I highlight the findings from large randomized clinical trials that have brought about this change, and progress with implementation. Australia was the first to introduce a national, publicly-funded HPV PCR-based program of primary screening, on 1 December 2017...
April 2, 2019: Current Opinion in Obstetrics & Gynecology
Nidhi Saraiya, Marilou Corpuz
PURPOSE OF REVIEW: Corynebacterium kroppenstedtii is a difficult pathogen associated with granulomatous mastitis and recurrent breast abscesses. Despite over a dozen studies, there is no guidance on surgical interventions, steroid use, or dosing or duration of antibiotic treatment. RECENT FINDINGS: Initially seen in predominantly Maori and Pacific Islander multiparous, postlactating women, C. kroppenstedtii breast infection has since been reported throughout the world, including in nulliparous women...
April 2, 2019: Current Opinion in Obstetrics & Gynecology
Natalia Basile, Ibrahim Elkhatib, Marcos Meseguer
PURPOSE OF REVIEW: The study of embryonic development through conventional microscopy has contributed significantly to the success of IVF. However, clinical pregnancy rates per transfer remain as low as 30% according to the latest records of European society if human reproduction and society if assisted reproduction. Considering the increased need to reduce the number of multiple pregnancies, the embryologist is required to improve embryo selection methods to reduce the number of embryos transferred and identify those with the highest implantation potential...
March 28, 2019: Current Opinion in Obstetrics & Gynecology
Jacky Boivin
PURPOSE OF REVIEW: To review latest findings about the impact of fertility care on emotional distress and effect of distress on treatment outcome. RECENT FINDINGS: Treatment failure and long agonist protocols are associated with increased emotional distress during treatment. Screening tools can be used to identify men and women at risk of emotional maladjustment at the start of fertility treatment and people unlikely to need emotional support during or after treatment...
March 18, 2019: Current Opinion in Obstetrics & Gynecology
Andres Reig, Emre Seli
PURPOSE OF REVIEW: To examine the existing literature in regards to the relationship between assisted reproductive technologies (ART) and low birth weight (LBW). RECENT FINDINGS: In 2017, Martin et al. reported on the incidence of low birth weight in relation to the number of embryos transferred, and showed that incidence of low birth weight in singletons correlates with number of embryos transferred. Meanwhile, several studies have shown increased weight of singletons born after frozen embryo transfers compared with fresh embryo transfers...
March 18, 2019: Current Opinion in Obstetrics & Gynecology
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No abstract text is available yet for this article.
June 2019: Current Opinion in Obstetrics & Gynecology
Florence Belva, Maryse Bonduelle, Herman Tournaye
PURPOSE OF REVIEW: The impact of intracytoplasmic sperm injection (ICSI), on the reproductive health of the offspring is largely unknown. Here we provide a comprehensive overview of the endocrine and reproductive profile in boys and young male adults born after ICSI using ejaculated spermatozoa alleviating male factor infertility in their parents. RECENT FINDINGS: Levels of testosterone, anti-Müllerian hormone and inhibin B were found comparable in prepubertal and pubertal boys conceived by ICSI when compared with levels in boys conceived spontaneously...
June 2019: Current Opinion in Obstetrics & Gynecology
Pedro Montoya-Botero, Jorge Rodriguez-Purata, Nikolaos P Polyzos
PURPOSE OF REVIEW: The purpose of this review is to provide an overview of androgen supplementation in ART with the most updated evidence, from animal studies to its clinical applications in poor ovarian responders (POR) and the future studies to be published. RECENT FINDINGS: Animal studies, has shown that testosterone supplementation, can be an option to increase the recruitable follicular pool in POR. However, the potential mechanism of action, dose, and duration of treatment is still under investigation...
June 2019: Current Opinion in Obstetrics & Gynecology
Sarah S Osmundson, Jea Young Min, Carlos G Grijalva
PURPOSE OF REVIEW: Overprescribing opioids contributes to the epidemic of drug overdoses and deaths in the United States. Opioids are commonly prescribed after childbirth especially after caesarean, the most common major surgery. This review summarizes recent literature on patterns of opioid overprescribing and consumption after childbirth, the relationship between opioid prescribing and chronic opioid use, and interventions that can help reduce overprescribing. RECENT FINDINGS: It is estimated that more than 80% of women fill opioid prescriptions after caesarean birth and about 54% of women after vaginal birth, although these figures vary greatly by geographical location and setting...
April 2019: Current Opinion in Obstetrics & Gynecology
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