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Seminars in Reproductive Medicine

Alexander L Vlasak, Amelia Schaub, Margaret E Robin Barry, Alice S Rhoton-Vlasak
The brain is the central controller of reproduction and the menstrual cycle. Reproductive endocrinologists spend their days treating patients with perturbations in reproduction as a result of pituitary diseases and manipulate pituitary hormones to enhance fertility and quality of life. Microscopic neuroanatomical images will allow a better understanding of how a tumor in the pituitary might affect vision, or a mass in the brain might cause amenorrhea. Clinical correlations that are taught every day become much clearer once the anatomical relationships are explored...
January 3, 2019: Seminars in Reproductive Medicine
Laren Riesche, Marisa S Bartolomei
As the biological bridge between mother and fetus, the placenta is not only important for the health of the mother and fetus during pregnancy but it also impacts the lifelong health of the fetus. Assisted reproductive technologies (ARTs) involve procedures and exposures that are not characteristic of in vivo reproduction. Moreover, ART procedures occur when the gametes and embryos are undergoing extensive epigenetic reprogramming. Thus, the oxidative, thermal, and mechanical stress that ART procedures introduce can impact the biological processes of placental growth, development, and function with potentially long-lasting health effects for the offspring...
May 2018: Seminars in Reproductive Medicine
Yetunde Ibrahim, Jim Hotaling
Sperm epigenetic programming is tailored to meet the need of this specialized cell, which include its interaction with the oocyte during fertilization and early embryo development. The unique nature of the sperm epigenome has resulted in multiple studies investigating how perturbations in epigenetics might impact male fertility and early embryo development. In addition, sperm epigenetics appear to be altered by specific environmental exposures, which could provide a link for investigating the role of these triggers in somatic health of off springs produced...
May 2018: Seminars in Reproductive Medicine
Anthony M DeAngelis, Anne E Martini, Carter M Owen
Assisted reproductive technology (ART) is responsible for 1.7% of births in the United States annually. Despite a large number of studies promoting the efficacy and safety of these practices, there have been reports of imprinting disorders occurring at higher frequencies in children born through ART. Driven by findings in animal studies, it has been postulated that various ART procedures employed at critical points in embryonic development may predispose the genomic imprinting process to errors. Alterations in DNA methylation patterns at imprinting control centers have been reported by some studies to occur more frequently in children with imprinting disorders conceived by ART compared with spontaneous conception, though these findings are not consistently demonstrated and controversy has surrounded the strength of these associations...
May 2018: Seminars in Reproductive Medicine
Sneha Mani, Monica Mainigi
Assisted reproductive technologies (ARTs) lead to an increased risk for pregnancy complications, congenital abnormalities, and specific imprinting disorders. Epigenetic dysfunction is thought to be one common mechanism which may be affecting these outcomes. The timing of multiple ART interventions overlaps with developmental time periods that are particularly vulnerable to epigenetic change. In vitro embryo culture is known to impact blastocyst development, in vitro fertilization (IVF) success rates, as well as neonatal outcomes...
May 2018: Seminars in Reproductive Medicine
Paolo Rinaudo, Amanda Adeleye
The use of assisted reproductive technologies (ARTs) has increased significantly in recent years. While this is partially due to improved access for infertile patients, another contribution to the growth of ART utilization is represented by individuals without infertility, who electively chose to freeze their gametes and embryos for future use, before ever attempting conception spontaneously. Overall, the safety of ART for parents and children is well described and the risks are modest. However, while long-term health consequences for offspring as postulated by the Developmental Origin of Health and Disease (DOHaD) hypothesis are unknown, numerous animal studies suggest a predisposition for chronic diseases like hypertension and glucose intolerance...
May 2018: Seminars in Reproductive Medicine
Scott J Morin, Emre Seli
The majority of offspring born following assisted reproductive technology (ART) achieve equivalent development milestones and demonstrate comparable health as spontaneously conceived children. Yet, multiple studies have suggested offspring conceived with ART have slightly increased risk of metabolic derangements, cardiovascular disease, and malignancy. However, the associations observed in these studies often inadequately control for a variety of confounding variables, such as multiple gestation, premature birth, and low birth weight...
May 2018: Seminars in Reproductive Medicine
Edwina H Yeung, Keewan Kim, Alexandra Purdue-Smithe, Griffith Bell, Jessica Zolton, Akhgar Ghassabian, Yassaman Vafai, Sonia L Robinson, Sunni L Mumford
Concerns remain about the health of children conceived by infertility treatment. Studies to date have predominantly not identified substantial long-term health effects after accounting for plurality, which is reassuring given the increasing numbers of children conceived by infertility treatment worldwide. However, as technological advances in treatment arise, ongoing studies remain critical for monitoring health effects. To study whether the techniques used in infertility treatment cause health differences, however, remains challenging due to identification of an appropriate comparison group, heterogeneous treatment, and confounding by the underlying causes of infertility...
May 2018: Seminars in Reproductive Medicine
Olivia J Carpinello, Alan H DeCherney, Micah J Hill
Since Barker's publication of "The fetal and infant origins of adult disease" in 1990, significant emphasis has been placed on the intrauterine environment and its effect on adult disease. Historical events such as the Dutch Famine and the 1918 Flu Pandemic have provided organic data about the epigenetic changes that can result from famine, infection, and stress. Mechanisms that allow for intrauterine survival may predispose to adult disease states when the fetus enters a world of abundance. As the field of in vitro fertilization (IVF) has developed and evolved, little attention has been paid to subtle yet significant differences in IVF offspring...
May 2018: Seminars in Reproductive Medicine
Micah J Hill
No abstract text is available yet for this article.
May 2018: Seminars in Reproductive Medicine
James H Segars
No abstract text is available yet for this article.
May 2018: Seminars in Reproductive Medicine
Lindsey N Valentine, Timothy A Deimling
Chronic pelvic pain is a complex condition with peripheral and central mechanisms of pain. Successful nonsurgical management typically relies on a multimodal approach, with integration of both pharmacologic and nonpharmacologic interventions. This article reviews nonpharmacologic therapies including pelvic floor physical therapy, dietary modifications, psychotherapy, and acupuncture. These interventions are low risk and should be incorporated into treatment for chronic pelvic pain, as they show promise for successful symptom relief in many overlapping chronic pain conditions...
March 2018: Seminars in Reproductive Medicine
Sadie E Smith, Jill M Eckert
Chronic pelvic pain (CPP) is a recurring and/or constant pain of at least six months duration that has resulted in either functional or psychological disability that can require interventional treatments. Chronic pelvic pain can be visceral, somatic, neuropathic, or a combination. Patients with CPP often suffer from concurrent bowel or bladder dysfunction, sexual dysfunction, depression, and anxiety. The complexity of chronic pelvic pain can be challenging to treat, which can lead to frustration for both patients and their physicians...
March 2018: Seminars in Reproductive Medicine
Teresa Tam, Elliot M Levine
A variety of conditions can give rise to the perception of painful sexual intercourse in women with pelvic pain. Female sexual dysfunction may stem from psychological, medical such as endocrinological disturbances, and gynecological pathologies. This article provides a discussion of various conditions, offering diagnostic and therapeutic measures to consider in women with pelvic pain experiencing sexual dysfunction. Treatment and management options are also reviewed.
March 2018: Seminars in Reproductive Medicine
Jin Hee Kim, Esther Han
Endometriosis is a nonmalignant gynecologic disorder that can have a significant impact on a woman's quality of life with pelvic pain and possible lasting effects on one's fertility. Symptoms, when present, can be severe and affect many organ systems including the gastrointestinal and urinary systems. Other etiologies of pelvic pain must be ruled out and/or need to be addressed concurrently for optimal patient care. There are numerous medical and surgical treatment options available that have been shown to be beneficial for endometriosis-related pelvic pain...
March 2018: Seminars in Reproductive Medicine
Christina M Johnson, Gretchen E H Makai
Fibromyalgia and irritable bowel syndrome are common disorders which often coexist in women with chronic pelvic pain. Like pelvic pain, these disorders describe symptoms without pathologic findings. Women with chronic pelvic pain have a higher prevalence of fibromyalgia (4-31%) and irritable bowel syndrome (8-41%) than the general population. Aberrant pain processing and psychosocial stressors are implicated in the co-occurrence of these pain syndromes (chronic overlapping pain conditions), but active epidemiologic, psychosocial, and neurobiologic research is ongoing...
March 2018: Seminars in Reproductive Medicine
Ioana Marcu, E Cristian Campian, Frank F Tu
Interstitial cystitis/bladder pain syndrome is an uncommon but potentially devastating pelvic pain disorder affecting both women and men. This condition is often confusable and comorbid with other pelvic pain disorders. Although our understanding of the underlying pathophysiology is growing, the exact longitudinal course by which peripheral and central aberrations involving the bladder mucosa, peripheral inflammation, and central dysregulation of bladder sensitivity create painful bladder symptoms remains an area in need of further study...
March 2018: Seminars in Reproductive Medicine
Noam Smorgick, Sawsan As-Sanie
Dysmenorrhea and noncyclic pelvic pain (chronic pelvic pain) are common in adolescents. The evaluation of teens with dysmenorrhea or chronic pelvic pain is aimed to diagnose possible gynecologic conditions (endometriosis, pelvic inflammatory disease, ovarian cysts, and obstruction of the reproductive tract) and nongynecologic conditions (irritable bowel syndrome, interstitial cystitis, and myofascial pain). The management of chronic pelvic pain in adolescents is often more complex than in adult women because both the adolescent and her parents are counseled and addressed, and her long-term emotional and physical health, fertility, and sexuality are considered...
March 2018: Seminars in Reproductive Medicine
Georgine Lamvu, Jorge Carrillo, Kathryn Witzeman, Meryl Alappattu
Persistent pelvic pain conditions are common and affect nearly 25% of the female U.S. population. In a sizable proportion of pelvic pain patients, the pain is caused by musculoskeletal dysfunction; yet, healthcare providers do not routinely evaluate patients for musculoskeletal etiologies. This article provides an overview of the pathophysiology of persistent pelvic pain, as it relates to musculoskeletal disorders. The symptomatology, anatomy, evaluation, and treatment of these disorders are summarized specifically for healthcare providers (including gynecologists) who do not have pelvic musculoskeletal expertise...
March 2018: Seminars in Reproductive Medicine
Jessica Chandler, Elena Wagner, Kristin Riley
Chronic pelvic pain is a condition defined by pelvic pain for more than six months which is severe enough to cause functional disability or require treatment. When pain becomes a chronic condition, it is more challenging to evaluate and treat. Chronic pelvic pain patients often have multiple factors contributing to their pain. Here, we review the approach to the evaluation of chronic female pelvic pain. It is important to establish a trusting patient-physician relationship. When evaluating a female patient with chronic pelvic pain, an in-depth history and targeted physical exam can localize contributors to pain...
March 2018: Seminars in Reproductive Medicine
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