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Current Opinion in Obstetrics & Gynecology

Cynthia Arvizo, Etoi Garrison
PURPOSE OF REVIEW: Although the business world has long recognized the benefits of diversity and inclusion and the effects of unconscious bias, the discourse is just now gaining traction in the medical field. In addition, many businesses have developed key initiatives to address unconscious bias in the workplace. RECENT FINDINGS: In the medical field, diversity leads to improved health outcomes, increased access to healthcare by the underserved and more innovation...
August 13, 2019: Current Opinion in Obstetrics & Gynecology
Megan Wancura, Jennifer M McCracken, Emily Steen, Elizabeth Cosgriff-Hernandez, Sundeep Keswani, Julie C-E Hakim
PURPOSE OF REVIEW: The current review highlights the complexity of the pediatric and adolescent gynecology subspecialty as well as the recent and exciting opportunities for innovation within the field. RECENT FINDINGS: The opportunities for concept, treatment, instrument, and knowledge-transfer innovation to better serve the specific needs of pediatric gynecology patients include novel approaches to neovagina creation using magnets, improving postoperative vaginal wound healing through newly designed and degradable vaginal stents, and complex Mullerian reconstructive surgical planning using virtual reality immersive experiential training...
July 31, 2019: Current Opinion in Obstetrics & Gynecology
Alla Vash-Margita, Marsha K Guess
PURPOSE OF REVIEW: Scientific advancements have led to enhanced clarity about the interrelationship between urinary tract pathology and functional bowel disturbances. The present article will review the current literature regarding the cause, pathophysiology, diagnosis, and treatment of lower urinary tract dysfunction and abnormal bowel habits in young and adolescent girls. RECENT FINDINGS: Complex neurological, physiological mechanisms and functional behaviors exist that contribute to the development of coexisting urinary symptoms and defecatory disorders in young and adolescent girls...
July 29, 2019: Current Opinion in Obstetrics & Gynecology
Anam Khaja, Nirupama DeSilva
PURPOSE OF REVIEW: This article will provide an overview on female breast development and focus on common abnormalities of growth, the emerging role of breast self-awareness, and discuss trends in the evaluation and treatment of the breast masses and disorders most often encountered in the female adolescent population. RECENT FINDINGS: Although the embryology of breast development is unchanged, data are emerging on the role of environmental factors on the timing of puberty and thelarche...
July 25, 2019: Current Opinion in Obstetrics & Gynecology
Gaby Moawad, Paul Tyan, Michelle Louie
PURPOSE OF REVIEW: Artificial intelligence and augmented reality have been progressively incorporated into our daily life. Technological advancements have resulted in the permeation of similar systems into medical practice. RECENT FINDINGS: Both artificial intelligence and augmented reality are being increasingly incorporated into the practice of modern medicine to optimize decision making and ultimately improve patient outcomes. SUMMARY: Artificial intelligence has already been incorporated into many areas of medical practice but has been slow to catch on in clinical gynecology...
June 26, 2019: Current Opinion in Obstetrics & Gynecology
Justin Tan, Paul Yong, Mohamed A Bedaiwy
PURPOSE OF REVIEW: The purpose of this review is to summarize and highlight recent critical advances in the diagnosis, classification, and management of adenomyosis. RECENT FINDINGS: Recent studies have clarified the specific mechanism through which adenomyotic lesions invade the underlying myometrium by epithelial-mesenchymal transition. Correlation studies using diagnostic MRI also strongly support the hypothesis of a different pathogenesis between the inner and outer myometrium forms of adenomyosis...
June 11, 2019: Current Opinion in Obstetrics & Gynecology
Esther S Han, Chetna Arora, Jin Hee J Kim, Hye-Chun Hur, Arnold P Advincula
PURPOSE OF REVIEW: This review highlights the complexity of caring for gynecologic patients who refuse blood transfusion and discusses the importance of early, targeted perioperative and intraoperative medical optimization. We review alternative interventions and the importance of medical management to minimize blood loss and maximize hematopoiesis, particularly in gynecologic patients who may have significant uterine bleeding. The review also focuses on intraoperative interventions and surgical techniques to prevent and control surgical blood loss...
May 22, 2019: Current Opinion in Obstetrics & Gynecology
Camille Ladanyi, Sarah Boyd, Peter Sticco, Shanti Mohling
PURPOSE OF REVIEW: Postmenopausal endometriosis is a gynecologic disease, affecting 2-5% of postmenopausal woman. Current literature assessing the prevalence, pathogenesis, and treatment of this uncommon condition is limited, stressing the necessity for future research. This review examines the current literature on postmenopausal endometriosis to help inform clinical decision-making and point to novel approaches for treatment and management. RECENT FINDINGS: Although one unifying theory to explain the pathogenesis of endometriotic lesions has not been elucidated, estrogen dependence is central to the pathophysiological process...
August 2019: 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...
August 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...
August 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...
August 2019: Current Opinion in Obstetrics & Gynecology
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June 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...
June 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...
June 2019: Current Opinion in Obstetrics & Gynecology
Molly B Moravek
PURPOSE OF REVIEW: To provide an overview of the current state of knowledge of fertility risks of gender-affirming therapy, review fertility preservation options for transgender individuals and ways to minimize gender dysphoria during fertility treatment, and identify gaps in knowledge. RECENT FINDINGS: Recent studies have corroborated older data that gender-affirming hormone therapy creates histopathological changes in the gonads; however, the newer data suggests that some function of the gametes may be preserved...
June 2019: Current Opinion in Obstetrics & Gynecology
Baris Ata, Ayse Seyhan, Emre Seli
PURPOSE OF REVIEW: Diminished ovarian reserve, in general, implies a quantitative decline in the oocyte pool. However, whether this quantitative decline is necessarily accompanied by a qualitative decline, remains to be determined. RECENT FINDINGS: Studies of natural conception suggest that fecundity of women with a quantitative decline in ovarian reserve is similar to age-matched women with normal ovarian reserve. Data on rates of pregnancy loss and fetal chromosomal abnormality do not consistently suggest a decline in oocyte quality in women who has a lower ovarian reserve...
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
Sonia Herraiz, Nuria Pellicer, Mónica Romeu, Antonio Pellicer
PURPOSE OF REVIEW: We review the techniques recently tested in both animal models and humans to provide a state-of-the-art on adult stem cell ovarian transplant to achieve ovarian rejuvenation in patients with diminished ovarian reserves. RECENT FINDINGS: As the firsts reports of spontaneous pregnancies achieved after bone marrow transplantation in oncologic women with primary ovarian insufficiency, increasing evidence supports the regenerative effects of stem cell-based therapies in the ovarian niche...
June 2019: Current Opinion in Obstetrics & Gynecology
Barbara Lawrenz, Carol Coughlan, Human M Fatemi
PURPOSE OF REVIEW: The aim of this review is to summarize the different aspects of luteal phase deficiency in IVF treatment and the possibilities of individualized luteal phase support. RECENT FINDINGS: After the application of human chorionic gonadotrophin (hCG) for final oocyte maturation, the vaginal route for progesterone administration is sufficient to maintain an adequate luteal phase support. New data point toward the possibility of oral medication; however, those data have yet to be confirmed in larger studies...
June 2019: Current Opinion in Obstetrics & Gynecology
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