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Paper IV
Published in Justin C Konje, Complete Revision Guide for MRCOG Part 3, 2020
Mrs ST is 57 years old and had breast cancer 4 years ago. She is on 20 mg of tamoxifen and presented with postmenopausal bleeding. An endometrial biopsy was performed. Histology is reported as widespread presence of chronic inflammatory cells and no evidence of atypia
DRCOG MCQs for Circuit A Questions
Published in Una F. Coales, DRCOG: Practice MCQs and OSCEs: How to Pass First Time three Complete MCQ Practice Exams (180 MCQs) Three Complete OSCE Practice Papers (60 Questions) Detailed Answers and Tips, 2020
Tuberculosis of the genital tract: Tuberculous salpingitis often results in female sterility.May be diagnosed by endometrial biopsy.Genital tuberculosis often occurs in older women with half being postmenopausal.Can result in congenital tuberculosis if untreated during pregnancy.Diagnosis is made by culture of acid-fast bacilli.
Habitual Abortion
Published in E. Nigel Harris, Thomas Exner, Graham R. V. Hughes, Ronald A. Asherson, Phospholipid-Binding Antibodies, 2020
Dwight D. Pridham, Christine L. Cook
Endometrial biopsy is an office procedure. Some discomfort is to be expected, but this can be minimized by patient education, the use of slender flexible plastic catheters (i.e., Pipelle, Z-sampler). We instruct our patients to take 800 mg of ibuprofen one hour prior to the procedure. Endometrial sampling can be optimized if performed on the 26th or 27th cycle day. Home urine tests for the midcycle LH surge can allow prediction of the appropriate day for sampling. Culturing for endometrial mycoplasm or chlamydia can be carried out on the same specimen if appropriate media are available.
Comparison of microbial profiles and viral status along the vagina-cervix-endometrium continuum of infertile patients
Published in Systems Biology in Reproductive Medicine, 2023
Mark Jain, Elena Mladova, Anna Dobychina, Karina Kirillova, Anna Shichanina, Daniil Anokhin, Liya Scherbakova, Larisa Samokhodskaya, Olga Panina
The study included 100 infertile patients at a private, assisted reproduction clinic. The criterion for infertility was an inability to conceive for more than one year of unprotected intercourse. Patient recruitment took place between January 2021 and June 2022. All enrolled participants were scheduled for hysteroscopy with endometrial biopsy as part of their treatment on days 5–12 of the menstrual cycle. Histological and immunohistochemical (CD138 and CD56 immunostaining) analysis of endometrial biomaterial was outsourced to a private laboratory. The diagnostic criterion for chronic endometritis was ≥5 CD138+ cells in at least 1 out of 30 HPF (Li et al. 2021). All patients confirmed that they had not taken any antibiotics for at least three months prior to study inclusion, and they were not diagnosed with any sexually transmitted disease for the same period. The clinical and demographic characteristics of the subjects are provided in Table 2.
Diagnosis and medical management of abnormal premenopausal and postmenopausal bleeding
Published in Climacteric, 2023
The Society of Obstetricians and Gynaecologists of Canada (SOGC) guidelines recommend routine endometrial biopsy in women with AUB age 40 years and older, or younger if risk factors such as obesity, nulliparity, polycystic ovary syndrome, diabetes or hereditary non-polyposis colorectal cancer are present [2]. A recent Canadian study has suggested that the risk of malignant or pre-malignant pathology in low-risk women up to the age of 49 ages is very low, suggesting that age alone should be removed as an indication for endometrial biopsy [8]. The National Institute for Health and Care Excellence (NICE) in the UK recommends directed endometrial biopsy at the time of hysteroscopy for women at high risk of endometrial pathology (including traditional risk factors, as well as those on tamoxifen or who have failed empiric medical management), while stating that blind endometrial biopsy should not be offered to women with heavy menstrual bleeding [3]. The American College of Obstetricians and Gynecologists (ACOG) recommends endometrial biopsy starting at age 45 years for investigation of AUB, and at younger ages if risk factors are present [9]. Organizations recommending blind endometrial biopsy uniformly favor in-office aspiration techniques [6].
Identification of key genes, regulatory factors, and drug target genes of recurrent implantation failure (RIF)
Published in Gynecological Endocrinology, 2020
We obtained the endometrial gene expression profiles of RIF women from National Center for Biotechnology Information (NCBI) Gene Expression Omnibus (GEO, http://www.ncbi.nlm.nih.gov/geo/) database (ID: GSE58144) based on the GPL15789 A-UMCU-HS44K-2.0 platform [11]. A total of 115 samples were collected, including 43 RIF and 72 controls. The control group referred to healthy women who had successful pregnant within the first three cycles of IVF or ICSI treatment. The inclusion criteria of RIF was ≥3 failed IVF/ICSI therapies or replacement ≥10 embryos without a successful pregnancy (including frozen-thawed cycles). A positive human chorionic gonadotropin serum test or a positive urine test was defined pregnancy [2]. Exclusion criteria: women meeting the definition for RIF were excluded if implantation failure could be explained by other factors: i.e. poor embryo quality, poor ovarian response, known disturbances in the uterine cavity or endometrial pathology [2]. The endometrial biopsy was performed 6 or 7 days after the putative luteinizing hormone surge in a natural (non-treatment) cycle in patients and controls. Biopsies were collected using an endometrium sampling device under sterile conditions. Then, total RNA was isolated from individual tissue samples and gene expression profiling was performed [2].