Fertility and sterility
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Fertility and sterility · Jun 2015
Review Meta AnalysisEffectiveness and feasibility of hysteroscopic sterilization techniques: a systematic review and meta-analysis.
To assess whether hysteroscopic sterilization is feasible and effective in preventing pregnancy. Secondarily, to identify risk factors for failure of hysteroscopic sterilization. ⋯ Sterilization by hysteroscopy seems feasible, but the effectiveness and risk factors for failure of sterilization remain unclear owing to the poor-quality evidence. Both currently applied hysteroscopic sterilization techniques and the coming new techniques must be evaluated properly for feasibility and effectiveness. Appropriate RCTs and observational studies with sufficient power and complete and long-term (>10 years) follow-up data on unintended pregnancies and complications are needed.
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Fertility and sterility · May 2015
Review Meta AnalysisEffect of vitamin D supplementation during pregnancy on maternal and neonatal outcomes: a systematic review and meta-analysis of randomized controlled trials.
To assess the effects of vitamin D supplementation during pregnancy on obstetric outcomes and birth variables. ⋯ Vitamin D supplementation during pregnancy was associated with increased circulating 25(OH)D levels, birth weight, and birth length, and was not associated with other maternal and neonatal outcomes. Larger, better-designed RCTs evaluating clinically relevant outcomes are necessary to reach a definitive conclusion.
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Fertility and sterility · Sep 2014
ReviewWith the advent of selective progesterone receptor modulators, what is the place of myoma surgery in current practice?
Uterine fibroids are the most common benign uterine tumors. This review examines the different management strategies, involving mainly surgery, and evaluates them in the light of new developments with selective progesterone receptor modulators. ⋯ On the other hand, recent studies have demonstrated the efficacy of ulipristal acetate in the medical management of myomas. Analyzing the respective advantages of both medical and surgical therapy, we propose new guidelines for the management of fibroids that take into account the most important symptoms (bleeding, infertility) and the age of the patients.
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Studies on the phenotypes of women and men with mutations disrupting estrogen biosynthesis and action have significantly advanced our knowledge of the physiologic roles of estrogen in humans. Aromatase deficiency results from autosomal recessive inheritance of mutations in the CYP19A1 gene. It gives rise to ambiguous genitalia in 46,XX fetuses. ⋯ Although estrogen has been shown to be essential for normal sperm production and function in mice, its role in fertility is not clear in men. Thus far, one man and an unrelated woman with estrogen resistance due to mutations in the estrogen receptor α (ESR1) gene have been described. Their clinical presentations are similar to that of aromatase-deficient men and women.
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Female sexual dysfunctions include a group of sexual complaints and disorders affecting women of all ages, and stemming from a heterogeneous array of etiologies and contributing factors. The classification system for sexual dysfunctions in the woman has evolved from a linear categorization of sexual desire, arousal, orgasm, and pain disorders to one that is more complex and overlapping. ⋯ Physicians should be open to discussing sexual problems with women, and may make use of validated questionnaires in the office setting. Evaluation tools available for assessing sexual function in the woman are in use in the research setting, as are physiological measures of assessment.