Tubal factor infertility: which is the possible role of tubal microbiota? A fresh look to a busy corner focusing on the potential role of hysteroscopy

Introduction Infertility has recently become a major health problem, affecting 15-30% of the reproductive age population [1].  Diseases and conditions that may damage women’s reproductive system and cause infertility include: abnormalities of uterine development, genital system inflammation, previous gynecological surgery, endometriosis, fibroids, endometrial and cervical polyps, and various environmental factors and harmful lifestyle habits [2-8]. […]

Therapeutic approaches for vasomotor symptoms and sleep disorders in menopausal women

Introduction Aging, socio and economic factors, health status (e.g. — cardiovascular diseases), vasomotor symptoms (VMS), hormonal variation, and psychiatric illness (depression and anxiety), have been identified as potential causes of sleep disorders during the menopausal transition (perimenopause), menopause and postmenopause [1-8]. VMS such as hot flushes (HF)/sweating affect 80% of women during the peri- and […]

Purified and specific cytoplasm pollen extract for the treatment of vasomotor menopausal symptoms: a review

Introduction The average age of menopause is 51 years and women’s life expectancy exceed 80 years; this means that a woman could live two thirds of her life in menopause. This physiological phase of life is characterized by a decline in estrogen and progesterone levels, which lead to the onset of typical symptoms, such as […]

Retrospective cohort study: urinary estradiol and precocious puberty. Does a correlation exist?

Introduction Precocious puberty is commonly defined as the onset of secondary sexual characteristics in females before the age of 8 (2 to 2.5 standard deviations earlier than population norms) or as accelerated development before the age of 9 [1]. The incidence of precocious puberty in girls varies across populations. Central precocious puberty (CPP) is also […]

Association of posterior reversible encephalopathy syndrome with gonadotropin-releasing hormone antagonist and iron therapy for anemia and uterine myoma

Introduction Posterior reversible encephalopathy syndrome (PRES) is a clinically reversible neurotoxic condition characterized by loss of consciousness, visual disturbances, seizures, headaches, confusion, vomiting, and cortical blindness [1]. PRES can be caused by several clinical conditions, including immunosuppression, chemotherapy, hypertension, renal damage, and infection [1-4]. The incidence of PRES is low, and the condition is predominantly […]

ISGE Statement on Purified and Specific Cytoplasmic Pollen Extract, PureCyTonin® as a non-hormonal alternative for the treatment of menopausal symptoms

Introduction Menopause, the absence of a menstrual period for a year, is due to a decline in estrogen and progesterone production by the ovaries [1,2]. About 60% to 80% of women experience menopause symptoms, most commonly vasomotor symptoms (VMS) and sleep disorders [3]. They can start years before, during the menopausal transition. Studies indicate that […]

Does administration of additional FSH at time of ovulation trigger benefit patients undergoing IVF with PGT-A?

Introduction The mammalian ovulatory cycle requires an elegant interplay between several hormones, including sequences leading to the gonadotropin surge, triggering oocyte maturation and ovulation [1]. Ovulation has been attributed primarily to luteinizing hormone (LH) activity, while follicle stimulating hormone (FSH) has been shown to be responsible for follicular growth and development, and other peri-ovulatory events […]

Abnormal uterine bleeding in adolescents: causes, challenges and concerns

Introduction Abnormal uterine bleeding (AUB) is defined as irregularities in the menstrual cycle involving menstrual volume, duration, frequency and regularity in a non-pregnant woman. It is the most common gynaecologic complaint of adolescents admitted to a hospital, affecting up to 20% of reproductive-aged females, with a higher incidence during the adolescence [1]. AUB is an […]

Female infertility as a result of stress-related hormonal changes

Introduction Infertility, defined as the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse, according to World Health Organization’s statistics refers to 48 million couples and 186 million individuals globally [1]. Based on wide cohort-studies performed in recent years in the United States, chronic stress is considered as a potential […]

Multiple complications associated with prolonged depot medroxyprogesterone acetate treatment. Case report and mini-review of literature

Introduction Depot medroxyprogesterone acetate (DMPA) is a contraceptive administered by intramuscular (dose of 150 mg/mL) or subcutaneous (dose of 104mg/0.65 mL) injection. These formulations are slowly released into the circulation from the injection site, thus DMPA is given every three months. It is known that medroxyprogesterone acetate inhibits the secretion of luteinizing hormone (LH) peak […]

Cost-effectiveness of the three commonly used endometrial preparation methods in women undergoing frozen embryo transfer: a propensity- score matched study

Introduction Cryopreservation of human embryos was first described in 1983 [1]. Since then, the proportion of frozen embryo transfers (FET) has been increasing in the field of assisted reproduction technology (ART) [2]. This rise in the number of FETs can be ascribed to refinement in embryo vitrification methods resulting in improved post-thaw embryo survival rates […]

HIE (hepatic insulin extraction) index in overweight/obese PCOS patients with or without familial diabetes

Introduction Polycystic ovary syndrome (PCOS) is a very frequent gynecologic and endocrine disease that affects 5–25% of fertile women [1,2]. It is widely known that PCOS is diagnosed in the presence of at least 2 of the 3 diagnostic criteria established at the American Society for Reproductive Medicine and European Society for Human Reproduction and […]

A relationship between menstrual phase and regularity, sleep duration and biopsychosocial symptoms among college students: a prospective observational study

Introduction With the tendency toward younger menarche, lower birth rates, and longer lives, contemporary women spend far more of their lives menstruating than their ancestors did. According to Mishell [1], women have approximately 481 menstrual cycles during their reproductive years. With an average adjustment of 22 months for two pregnancies and postpartum periods, many women […]

The interplay between androgens and adipocytes: the foundation of comorbidities of polycystic ovary syndrome

Introduction Polycystic ovary syndrome (PCOS) is a complex endocrine disorder characterized by oligo-anovulation, hyperandrogenism, and polycystic ovaries on ultrasound. Frequently, PCOS is accompanied by carbohydrate and lipid metabolism disturbances and inflammatory abnormalities that lead to an increased risk of development of cardiovascular disease (CVD) [1-3]. Higher levels of circulating androgens occur in 70-80% of women […]

Successful treatment of a difficult case of uterine fibroid with subsequent live birth: case report

Background Among the main causes of declining reproductive function and performance in fertile women, uterine fibroids (UFs) play the most significant role. They are the most common benign tumours of the female reproductive system [1-3], consisting of myogenic elements and the stromal component of the myometrium [4]. Despite the development and availability of modern diagnostic […]

Ultrasound functional evaluation of the puborectalis muscle and anal sphincter apparatus in patients with deep infiltrating endometriosis

Introduction Endometriosis is a disease defined by the presence of endometrial glands and stroma outside of the endometrial cavity, causing chronic inflammation [1]. Deep infiltrating endometriosis (DIE) is considered its most severe form, with lesions extending underneath the peritoneum and affecting pelvic organs – such as the bowel, the ureters and the bladder – and […]

Changes in serum testosterone during the menstrual cycle – an integrative systematic review of published literature

Introduction Androgens in the female reproductive system In women of reproductive age, dehydroepiandrosterone sulfate (DHEAS), dehydroepiandrosterone (DHEA), androstenedione, testosterone (T) and dihydrotestosterone (DHT) are found in the circulation, but only testosterone and DHT are able to activate androgen receptors. DHEAS, DHEA and androstenedione are considered prohormones, requiring conversion into T or DHT to express their […]

Clinical features of the endometrium in postmenopausal women

Introduction Background In recent years, endometrial cancer has been found to be the second most common gynecological malignancy in China, after cervical cancer [1]. Endometrial cancer is usually characterized by a thickened endometrium, found on transvaginal ultrasonography (TVS) in postmenopausal women with or without abnormal uterine bleeding [2].  Measurement of endometrial thickness (ET) using TVS is […]

Effects of acute aerobic exercise and menstrual cycle on immune responses in young women

Introduction Exercise is one of the methods to prevent metabolic syndrome, which includes diabetes, hypertension and hyperlipidaemia. However, exercise has a higher risk for an increase of inflammation and production of reactive oxygen species. Exercise can also cause immune system impairments, muscle damage and an increased susceptibility to infection. According to Nieman (1993), athletes who […]

Variations in cytokine profiles between parous and nulliparous adult women

Introduction In pregnancy, the fetus can be regarded as an allogenic graft that requires careful adjustment of the maternal immune system [1]. Temporary immune suppression is a normal mechanism during fetal development and tissue repair. The immune suppression that occurs during pregnancy is a dynamic modulation involving feto-maternal immunological cross-talk that protects the fetus from […]

Cutaneous manifestations of estrogen excess and deficiency

Introduction In women, there are three circulating forms of estrogen with varying potencies. The most potent is estradiol, produced primarily by the ovaries, with a small percentage coming from the extra glandular conversion of testosterone to androstenedione. Estrone is mainly synthesized through peripheral conversion of androstenedione by the enzyme aromatase, while estriol, produced by the […]

Detection and treatment of some endometrial receptivity disorders – a way to improve fertility rates

Introduction Endometrial receptivity and implantation failure remains an unsolved enigma of the 20 million years of human life on our planet. Way of life, work or occupation, eating habits, re­lationship with partner, exposure to environmental toxins, physical activities etc., influence endocrine, psychological, immunological systems, changing the genome and influencing endometrial receptivity. Endometrial receptivity is orchestrat­ed […]

Different Approaches to Hormone Replacement Therapy in Women with Premature Ovarian Insufficiency

Introduction Premature ovarian insufficiency (POI) refers to a decrease in ovarian function before the age of 40 and it affects approximately 1% of all women 1. Estradiol is frequently decreased (below 50 pmol/L) in affected women, while gonadotropins are elevated; women report menstrual changes ranging from irregular cycles to amenorrhea 2. In the literature, various […]

Embryo diapause as replicated by Assisted Reproductive Technologies (ART): modern applications of an ancient species survival mechanism

Introduction Diapause, a survival mechanism that represents an intermediate step between fertilization and embryo implantation, is reported to occur in >130 mammalian species. Delayed implantation extends gestation duration in 70% of eutherian and ~30% of marsupial species 1. Although the embryo transits and reaches the uterus, it does not implant. The length of the implantation […]

Hormonal contraception and vulvodynia: an update

Introduction Hormonal contraception is currently one of the world’s most prescribed drug treatments. Although the advent of hormonal contraception allowed women to separate their sexual and reproductive lives, some women decline the use of hormonal contraception because of health concerns or fear of side effects. Recent studies have shown that hormonal contraception may increase the […]