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Endometritis
Published in Carlos Simón, Carmen Rubio, Handbook of Genetic Diagnostic Technologies in Reproductive Medicine, 2022
Ettore Cicinelli, Rossana Cicinelli, Carla Mariaflavia Santarsiero, Amerigo Vitagliano
Hysteroscopy is a technique which must only be carried out by gynecologists and it allows a thorough exploration of the uterine cavity. Fluid hysteroscopy has been shown to be an effective technique to detect CE, based on the detection of the so-called subtle or small lesions (7). The most characteristic lesions are micropolyps that can be easily recognized by fluid hysteroscopy as small or subtle lesions floating on the endometrial surface. Recently, using a Delphi procedure, we have defined the main diagnostic criteria for CE using hysteroscopy, namely micropolyps, hyperemia, mucosal edema, hemorrhagic spots, and “strawberry” pattern, with high inter-observer agreement (36).
Paper 2
Published in Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw, The Final FRCR, 2020
Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw
A 31 year old female patient has an MRI pelvis following a completed miscarriage. The sonographer in the early pregnancy assessment unit was concerned about a uterine anomaly and so an MRI was arranged. The uterine cavity is bisected by soft tissue extending to the internal cervical os. The external fundal uterine contour is convex. There is one cervix, one vagina and two ovaries and fallopian tubes.
Adenomyomectomy
Published in Rooma Sinha, Arnold P. Advincula, Kurian Joseph, FIBROID UTERUS Surgical Challenges in Minimal Access Surgery, 2020
Anshumala Shukla Kulkarni, Fouzia Hayat
This procedure involves asymmetric dissection of the uterus longitudinally, using a round-type loop electrode and a high-frequency cutter, followed by retracting the uterine fundus upward using a silk suture and then cutting the uterine adenomyoma into slices. From the incision, the myometrium is dissected diagonally as if hollowing out the uterine cavity. It is followed by a transverse incision to open the uterine cavity. As the index finger is inserted into the uterine cavity, the adenomyosis lesion is excised to more than 5 mm of the inner myometrium. The lesion is then excised to more than 5 mm of the serosal myometrium on the left uterine side. Afterward, the uterine cavity is sutured and closed, followed by uterine reconstruction, and the left side covers the right side. The serosa is continuously sutured using the same suture to rejoin the uterus. To date, 1349 patients have undergone this technique. Postoperative spontaneous uterine rupture was seen in five cases in this series [12].
Animal models in intrauterine adhesion research
Published in Journal of Obstetrics and Gynaecology, 2022
Shanshan Liang, Yanlan Huang, Yanfen Xia, Shuang Liang, Qiaoling Wu, Zhifu Zhi
Intrauterine adhesion (IUA), also known as Asherman’s syndrome, is a gynaecological disease caused by surgeries and infections, and can lead to partial or total occlusion of the uterine cavity. It has been reported that approximately 90% of IUA occur after carrying out uterine surgical procedures. For example, it is well known that dilation and curettage (D&C) and hysteroscopy are risk factors for the development of IUA, with increased risk associated with multiple procedures or acute curettage (Salazar et al. 2017; Lee et al. 2021). The exploration of IUA currently continues, primarily with the development of animal models. The establishment of a suitable animal model can not only be used to study the pathogenesis of IUA but also to explore the mechanism of different treatments for IUA, including the regeneration of damaged endometrium, prevention of adhesion, and improvement of fertility. The establishment of an animal model is ultimately for clinical service, and it provides a theoretical basis for improving the quality of life and fertility of patients with IUA. Therefore, in this review, we summarise recent advances in the development of animal models of experimental IUA—as well as potential limitations—in order to provide a reference for the selection of appropriate animal models for follow-up research.
Supernumerary embryos, do they show the cycle success in a fresh embryo transfer? A retrospective analysis
Published in Gynecological Endocrinology, 2021
Kiper Aslan, Isil Kasapoglu, Cihan Cakir, Berrin Avci, Gurkan Uncu
Infertile patients who underwent single, fresh, and day 5 blastocyst embryo transfer were selected. Patients with advanced age >40 years., diminished ovarian reserve due to Bologna Criteria (Anti-mullerian hormone <1.1 ng/ml, antral follicle count <7) were excluded. Also, patients with uterine abnormality (fibroid, Asherman syndrome, endometrial polyp, thin endometrium, adenomyosis, uterine cavity abnormality) were excluded to optimize the endometrial factor. Each woman was only included once in the study to avoid bias. All patients were stimulated either by the antagonist, agonist, or micro-dose flare-up protocol. Between 150 and 450 units of daily gonadotropin were used based on body mass index and ovarian reserve. The trigger was done with 250 mcg recombinant hCG when at least three follicles reach 17 mm. Oocyte retrieval was done 34–36 h after hCG injection, under general anesthesia. All metaphase-two oocytes were fertilized by intracytoplasmic sperm injection, as per our routine. Day 5 Blastocyst, Gardner A, or B [10] stage single embryo transfer was done for all patients. The other available embryos were frozen with the vitrification method. The luteal phase was supported with vaginal 8% progesterone gel twice a day, starting on the evening of oocyte retrieval and continued until a negative pregnancy test or detection of fetal cardiac activity. A Positive pregnancy test was defined as serum beta-hCG level >10 IU/l on the 12th day after embryo transfer.
Endometriosis-associated cancer
Published in Climacteric, 2021
The association between endometriosis and cancer has been studied for a number of years. Endometriosis is a disease in which endometrial tissue develops outside the original uterine cavity for which a number of etiological factors have been ascribed. Over the last few decades, significant data have accumulated to support the thought that some gynecologic cancers originate from endometriosis. Sampson first published a report in 1927 alluding to malignancy associated with endometriosis, wherein he described specific criteria for endometriosis-associated ovarian cancers [1]. His original criteria included the following:Endometriosis in association or in close proximity to the cancer.No other primary tumor site must exist.Histology of the tumor must be consistent with an endometrial origin.