Endometriosis
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Adenomyosis in Infertile Women: Prevalence and the Role of 3D Ultrasound As a Marker of Severity of the Disease J
Puente et al. Reproductive Biology and Endocrinology (2016) 14:60 DOI 10.1186/s12958-016-0185-6 RESEARCH Open Access Adenomyosis in infertile women: prevalence and the role of 3D ultrasound as a marker of severity of the disease J. M. Puente1*, A. Fabris1, J. Patel1, A. Patel1, M. Cerrillo1, A. Requena1 and J. A. Garcia-Velasco2* Abstract Background: Adenomyosis is linked to infertility, but the mechanisms behind this relationship are not clearly established. Similarly, the impact of adenomyosis on ART outcome is not fully understood. Our main objective was to use ultrasound imaging to investigate adenomyosis prevalence and severity in a population of infertile women, as well as specifically among women experiencing recurrent miscarriages (RM) or repeated implantation failure (RIF) in ART. Methods: Cross-sectional study conducted in 1015 patients undergoing ART from January 2009 to December 2013 and referred for 3D ultrasound to complete study prior to initiating an ART cycle, or after ≥3 IVF failures or ≥2 miscarriages at diagnostic imaging unit at university-affiliated private IVF unit. Adenomyosis was diagnosed in presence of globular uterine configuration, myometrial anterior-posterior asymmetry, heterogeneous myometrial echotexture, poor definition of the endometrial-myometrial interface (junction zone) or subendometrial cysts. Shape of endometrial cavity was classified in three categories: 1.-normal (triangular morphology); 2.- moderate distortion of the triangular aspect and 3.- “pseudo T-shaped” morphology. Results: The prevalence of adenomyosis was 24.4 % (n =248)[29.7%(94/316)inwomenaged≥40 y.o and 22 % (154/ 699) in women aged <40 y.o., p = 0.003)]. Its prevalence was higher in those cases of recurrent pregnancy loss [38.2 % (26/68) vs 22.3 % (172/769), p < 0.005] and previous ART failure [34.7 % (107/308) vs 24.4 % (248/1015), p < 0.0001]. -
Different Influences of Endometriosis and Pelvic Inflammatory Disease On
International Journal of Environmental Research and Public Health Article Different Influences of Endometriosis and Pelvic Inflammatory Disease on the Occurrence of Ovarian Cancer Jing-Yang Huang 1,2,†, Shun-Fa Yang 1,2 , Pei-Ju Wu 1,3,†, Chun-Hao Wang 4,†, Chih-Hsin Tang 5,6,7 and Po-Hui Wang 1,2,3,8,* 1 Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan; [email protected] (J.-Y.H.); [email protected] (S.-F.Y.); [email protected] (P.-J.W.) 2 Department of Medical Research, Chung Shan Medical University Hospital, Taichung 402, Taiwan 3 Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung 402, Taiwan 4 Department of Medicine, National Taiwan University, Taipei 106, Taiwan; [email protected] 5 School of Medicine, China Medical University, Taichung 404, Taiwan; [email protected] 6 Chinese Medicine Research Center, China Medical University, Taichung 404, Taiwan 7 Department of Medical Laboratory Science and Biotechnology, College of Medical and Health Science, Asia University, Taichung 413, Taiwan 8 School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan * Correspondence: [email protected] † Equal contributions as first authors. Abstract: To compare the rate and risk of ovarian cancer in patients with endometriosis or pelvic inflammatory disease (PID). A nationwide population cohort research compared the risk of ovarian cancer in 135,236 age-matched comparison females, 114,726 PID patients, and 20,510 endometriosis patients out of 982,495 females between 1 January 2002 and 31 December 2014 and ended on the date Citation: Huang, J.-Y.; Yang, S.-F.; of confirmation of ovarian cancer, death, or 31 December 2014. -
Dysmenorrhoea
[ Color index: Important | Notes| Extra | Video Case ] Editing file link Dysmenorrhoea Objectives: ➢ Define dysmenorrhea and distinguish primary from secondary dysmenorrhea ➢ • Describe the pathophysiology and identify the etiology ➢ • Discuss the steps in the evaluation and management options References : Hacker and moore, Kaplan 2018, 428 boklet ,433 , video case Done by: Omar Alqahtani Revised by: Khaled Al Jedia DYSMENORRHEA Definition: dysmenorrhea is a painful menstruation it could be primary or secondary Primary dysmenorrhea Definition: Primary dysmenorrhea refers to recurrent, crampy lower abdominal pain, along with nausea, vomiting, and diarrhea, that occurs during menstruation in the absence of pelvic pathology. It is the most common gynecologic complaint among adolescent girls. Characteristic: The onset of pain generally does not occur until ovulatory menstrual cycles are established. Maturation of the hypothalamic-pituitary-gonadal axis leading to ovulation occurs in half of the teenagers within 2 years post-menarche, and the majority of the remainder by 5 years post-menarche. (so mostly it’s occur 2-5 years after first menstrual period) • The symptoms typically begin several hours prior to the onset of menstruation and continue for 1 to 3 days. • The severity of the disorder can be categorized by a grading system based on the degree of menstrual pain, the presence of systemic symptoms, and impact on daily activities Pathophysiology Symptoms appear to be caused by excess production of endometrial prostaglandin F2α resulting from the spiral arteriolar constriction and necrosis that follow progesterone withdrawal as the corpus luteum involutes. The prostaglandins cause dysrhythmic uterine contractions, hypercontractility, and increased uterine muscle tone, leading to uterine ischemia. -
Infertility Diagnosis and Treatment
UnitedHealthcare® Oxford Clinical Policy Infertility Diagnosis and Treatment Policy Number: INFERTILITY 008.12 T2 Effective Date: July 1, 2021 Instructions for Use Table of Contents Page Related Policies Coverage Rationale ....................................................................... 1 • Follicle Stimulating Hormone (FSH) Gonadotropins Documentation Requirements ...................................................... 2 • Human Menopausal Gonadotropins (hMG) Definitions ...................................................................................... 3 • Preimplantation Genetic Testing Prior Authorization Requirements ................................................ 3 Applicable Codes .......................................................................... 3 Related Optum Clinical Guideline Description of Services ................................................................. 3 • Fertility Solutions Medical Necessity Clinical Benefit Considerations .................................................................. 7 Guideline: Infertility Clinical Evidence ........................................................................... 8 U.S. Food and Drug Administration ........................................... 14 References ................................................................................... 15 Policy History/Revision Information ........................................... 18 Instructions for Use ..................................................................... 18 Coverage Rationale See Benefit Considerations -
An Unusual Cause of Chronic Low Back Pain
Yunus Durmaz et al. / International Journal Of Advances In Case Reports, 2015;2(23):1425-1426. e - ISSN - 2349 - 8005 INTERNATIONAL JOURNAL OF ADVANCES IN CASE REPORTS Journal homepage: www.mcmed.us/journal/ijacr RETROVERTED UTERUS: AN UNUSUAL CAUSE OF CHRONIC LOW BACK PAIN Yunus Durmaz1, Ilker Ilhanli2*, Kıvanc Cengiz3 1Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Mehmet Akif Inan Training and Research Hospital, Sanlıurfa, Turkey. 2Department of Physical Medicine and Rehabilitation, School of Medicine, University of Giresun, Giresun, Turkey. 3Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Sivas Numune Hospital, Sivas, Turkey. Corresponding Author:- Ilker ILHANLI E-mail: [email protected] Article Info ABSTRACT Received 15/09/2015 Retroverted uterus can be associated with chronic low back pain. Physicians should keep in mind this Revised 27/10/2015 cause of chronic low back pain for the premenopausal women. Here we presented two female patients Accepted 2/11/2015 at the ages of 21 and 28; they were diagnosed as retroverted uterus by Magnetic Resonance Imaging with any other cause of chronic low back pain. Key words: Retroverted uterus; Low back pain; Magnetic resonance imaging. INTRODUCTION Retrovertion is an anatomical variation of the too. She reported any trauma or family history of uterus which can be associated with low back pain, as well spondyloarthropathy. There was no radiculopathy sign or as the chronic pelvic pain. Also it can cause congestive muscle spasm. She didn’t meet the criteria of fibromyalgia. dysmenorrhea, deep dyspareunia, and bladder and bowel Lomber Schober test was normal. Straight leg raising, symptoms [1]. -
Recurrent Miscarriage
Elizabeth Taylor, MD, FRCSC, Mohammed Bedaiwy, MD, PhD, Mahmoud Iwes, MD Recurrent miscarriage Management of pregnancy loss includes investigating causes, addressing modifiable risk factors, and providing supportive care in the first trimester of pregnancy. ABSTRACT: Early miscarriages are arly miscarriage has been re Genetic causes those occurring within the first 12 ported to occur in 17% to 31% The risk of miscarriage increases completed weeks of gestation. Re- E of pregnancies,1,2 and is de with maternal age. At age 20 to 24 current miscarriage, defined as two fined as a nonviable intrauterine the risk is approximately 10%, with or more consecutive pregnancy loss- pregnancy with either an empty ges risk increasing to nearly 80% by age es, affects 3% of couples trying to tational sac or a gestational sac con 45.5 The relationship between mis conceive and can cause consider- taining an embryo or fetus without carriage risk and maternal age can be able distress. The risk of miscarriage fetal heart activity within the first explained by the increasing rate of oo increases with maternal age. Genet- 12 completed weeks of gestation.3 cyte aneuploidy that occurs as women ic abnormalities, uterine anomalies, Recurrent miscarriage occurs in 3% grow older. In one study, oocytes and endocrine dysfunction can all of couples trying to conceive. The examined during in vitro fertilization lead to miscarriage. Other causes of American Society for Reproductive (IVF) treatment had only a 10% risk miscarriage are autoimmune disor- Medicine (ASRM) defines recurrent of being aneuploid in women younger ders such as antiphospholipid syn- miscarriage as two or more failed than age 35, but by age 43 the risk of drome and chronic endometritis. -
Male Infertility and Risk of Nonmalignant Chronic Diseases: a Systematic Review of the Epidemiological Evidence
282 Male Infertility and Risk of Nonmalignant Chronic Diseases: A Systematic Review of the Epidemiological Evidence Clara Helene Glazer, MD1 Jens Peter Bonde, MD, DMSc, PhD1 Michael L. Eisenberg, MD2 Aleksander Giwercman, MD, DMSc, PhD3 Katia Keglberg Hærvig, MSc1 Susie Rimborg4 Ditte Vassard, MSc5 Anja Pinborg, MD, DMSc, PhD6 Lone Schmidt, MD, DMSc, PhD5 Elvira Vaclavik Bräuner, PhD1,7 1 Department of Occupational and Environmental Medicine, Address for correspondence Clara Helene Glazer, MD, Department of Bispebjerg University Hospital, Copenhagen NV, Denmark Occupational and Environmental Medicine, Bispebjerg University 2 Departments of Urology and Obstetrics/Gynecology, Stanford Hospital, Copenhagen NV, Denmark University School of Medicine, Stanford, California (e-mail: [email protected]). 3 Department of Translational Medicine, Molecular Reproductive Medicine, Lund University, Lund, Sweden 4 Faculty Library of Natural and Health Sciences, University of Copenhagen, Copenhagen K, Denmark 5 Department of Public Health, University of Copenhagen, Copenhagen, Denmark 6 Department of Obstetrics/Gynaecology, Copenhagen University Hospital, Hvidovre, Denmark 7 Mental Health Center Ballerup, Ballerup, Denmark Semin Reprod Med 2017;35:282–290 Abstract The association between male infertility and increased risk of certain cancers is well studied. Less is known about the long-term risk of nonmalignant diseases in men with decreased fertility. A systemic literature review was performed on the epidemiologic evidence of male infertility as a precursor for increased risk of diabetes, cardiovascular diseases, and all-cause mortality. PubMed and Embase were searched from January 1, 1980, to September 1, 2016, to identify epidemiological studies reporting associations between male infertility and the outcomes of interest. Animal studies, case reports, reviews, studies not providing an accurate reference group, and studies including Downloaded by: Stanford University. -
Diagnostic Evaluation of the Infertile Female: a Committee Opinion
Diagnostic evaluation of the infertile female: a committee opinion Practice Committee of the American Society for Reproductive Medicine American Society for Reproductive Medicine, Birmingham, Alabama Diagnostic evaluation for infertility in women should be conducted in a systematic, expeditious, and cost-effective manner to identify all relevant factors with initial emphasis on the least invasive methods for detection of the most common causes of infertility. The purpose of this committee opinion is to provide a critical review of the current methods and procedures for the evaluation of the infertile female, and it replaces the document of the same name, last published in 2012 (Fertil Steril 2012;98:302–7). (Fertil SterilÒ 2015;103:e44–50. Ó2015 by American Society for Reproductive Medicine.) Key Words: Infertility, oocyte, ovarian reserve, unexplained, conception Use your smartphone to scan this QR code Earn online CME credit related to this document at www.asrm.org/elearn and connect to the discussion forum for Discuss: You can discuss this article with its authors and with other ASRM members at http:// this article now.* fertstertforum.com/asrmpraccom-diagnostic-evaluation-infertile-female/ * Download a free QR code scanner by searching for “QR scanner” in your smartphone’s app store or app marketplace. diagnostic evaluation for infer- of the male partner are described in a Pregnancy history (gravidity, parity, tility is indicated for women separate document (5). Women who pregnancy outcome, and associated A who fail to achieve a successful are planning to attempt pregnancy via complications) pregnancy after 12 months or more of insemination with sperm from a known Previous methods of contraception regular unprotected intercourse (1). -
Understanding Endometriosis - Information Pack
Understanding Endometriosis - Information Pack What is endometriosis? Endometriosis (pronounced en- doh – mee – tree – oh – sis) is the name given to the condition where cells like the ones in the lining of the womb (uterus) are found elsewhere in the body. Every month a woman’s body goes through hormonal changes. Hormones are naturally released which cause the lining of the womb to increase in preparation for a fertilized egg. If pregnancy does not occur, this lining will break down and bleed – this is then released from the body as a period. Endometriosis cells react in the same way – except that they are located outside the womb. During the monthly cycle hormones stimulate the endometriosis, causing it to grow, then break down and bleed. This internal bleeding, unlike a period, has no way of leaving the body. This leads to inflammation, pain, and the formation of scar tissue (adhesions). Endometriosis is not an infection. Endometrial tissue can also be found in the ovary, Endometriosis is not contagious. where it can form cysts, called ‘chocolate cysts’ Endometriosis is not cancer. because of their appearance. Endometriosis is most commonly found inside the pelvis, around the ovaries, the fallopian tubes, on the outside of the womb or the ligaments (which hold the womb in place), or the area between your rectum and your womb, called the Pouch of Douglas. It can also be found on the bowel, the bladder, the intestines, the vagina and the rectum. You can also have endometrial tissue that grows in the muscle layer of the wall of the womb (this is another condition called adenomyosis). -
Age and Fertility: a Guide for Patients
Age and Fertility A Guide for Patients PATIENT INFORMATION SERIES Published by the American Society for Reproductive Medicine under the direction of the Patient Education Committee and the Publications Committee. No portion herein may be reproduced in any form without written permission. This booklet is in no way intended to replace, dictate or fully define evaluation and treatment by a qualified physician. It is intended solely as an aid for patients seeking general information on issues in reproductive medicine. Copyright © 2012 by the American Society for Reproductive Medicine AMERICAN SOCIETY FOR REPRODUCTIVE MEDICINE Age and Fertility A Guide for Patients Revised 2012 A glossary of italicized words is located at the end of this booklet. INTRODUCTION Fertility changes with age. Both males and females become fertile in their teens following puberty. For girls, the beginning of their reproductive years is marked by the onset of ovulation and menstruation. It is commonly understood that after menopause women are no longer able to become pregnant. Generally, reproductive potential decreases as women get older, and fertility can be expected to end 5 to 10 years before menopause. In today’s society, age-related infertility is becoming more common because, for a variety of reasons, many women wait until their 30s to begin their families. Even though women today are healthier and taking better care of themselves than ever before, improved health in later life does not offset the natural age-related decline in fertility. It is important to understand that fertility declines as a woman ages due to the normal age- related decrease in the number of eggs that remain in her ovaries. -
DYSMENNORHEA Dysmenorrhea Or Painful Menstruation Can Be Defined
ARYA AYURVEDIC PANCHAKARMA CENTRE DYSMENNORHEA Dysmenorrhea or painful menstruation can be defined as cramps in the lower abdomen before or during the menstruation which can be so severe that hinder the women´s routine activity. The pain starts from the lower abdomen and radiates to low back and the inner thighs. Other symptoms include nausea, vomiting, diarrhoea, headache or fatigue. It is the most common gynaecological problem among the women. CLASSIFICATION It can be broadly classified into: 1. Primary dysmenorrhea (spasmodic dysmenorrhea), the painful menstruation that is not related to any pelvic disease. 2. Secondary dysmenorrhea (congestive dysmenorrhea), defined as pain during menstruation that is caused to any underlying problems in the uterus such as pelvic inflammatory disease, uterine fibroid, ovarian cyst, etc. SIGNS AND SYMPTOMS The clinical features of Primary Dysmenorrhea are as follows: • Onset shortly after menarche (after 6 months) • Usual duration of 48-72 hours (often starting several hours before or just after the menstrual flow) • Cramping or labour like pain • Constant lower abdomen pain that radiates to low back and thigh • Often unremarkable pelvic examination findings • The pain may diminishes as the age progress or after childbirth The clinical feature of Secondary Dysmenorrhea is as follows: • Usually dysmenorrhea begins after 20s or after previously related painless cycles. • Heavy menstrual flow or irregular bleeding Copyright: Dr.Niveedha Bhadran, ARYA AYURVEDIC PANCHAKARMA CENRE ARYA AYURVEDIC PANCHAKARMA CENTRE • Poor response to NSAIDS or oral contraceptives • Pelvic abnormality on pelvic examination finding • Infertility • Dyspareunia (painful sexual intercourse) • Abnormal vaginal discharge If the symptoms are severe then vomiting, loose stools, fatigue may often accompany them. -
World-Renowned Expert in Infertility Presents Findings to European
World-Renowned Expert in Infertility Presents Findings to European Conference After Two Recurrent Miscarriages, Patients Should be Thoroughly Evaluated for Risk Factors Dr. William Kutteh, M.D., one of the world’s leading researchers in recurrent pregnancy loss (RPL), was invited to present his latest discoveries to theEuropean Society of Human Reproduction and Embryology (ESHRE). Dr. Kutteh’s research on recurrent pregnancy loss calls for early intervention after the second miscarriage, a change in how physicians currently treat the condition. RPL is defined as three or more consecutive miscarriages that occur before the 20th week of pregnancy. In the general population, miscarriage occurs in 20 percent of all pregnancies, but recurrent miscarriage occurs in only 5 percent of all women seeking pregnancy. Dr. Kutteh’s study, the largest of its kind on recurrent miscarriage, scientifically proved what many physicians intrinsically knew. The 2010 study, published in Fertility and Sterility-- Diagnostic Factors Identified in 1020 Women with Two Versus Three or More Recurrent Pregnancy Losses--found that even after only two pregnancy losses, a definitive cause for RPL could be determined in two-thirds of patients in the study. Dr. Kutteh’s research showed that there was no statistical difference in women with RPL who had two pregnancy losses, and those who had three or more losses, proving that earlier intervention was appropriate. Patients with RPL are now encouraged to begin testing for known risk factors for infertility after the second miscarriage. Determining Risk Factors for Recurrent Miscarriage Recurrent miscarriage causes include anatomic, hormonal, autoimmune, infectious, genetic, or hematologic issues. Expeditiously determining the causes of miscarriage can lead to more targeted treatment, and for 67 percent of patients, a successful full-term pregnancy.