A critical analysis of the impact of endocrine disruptors as a possible etiology of primary ovarian insufficiency.

Primary ovarian insufficiency is a cause of infertility that affects about 1% of women under 40 years old, and is considered as idiopathic in 75% of cases. This review aims to carry out a critical synthesis of the knowledge of the chemical agents likely to affect follicular stock in humans and / or animals, by direct toxicity to follicles, or by increasing their recruitments. For the majority of toxic agents, only experimental data are currently available. We propose a strategy to encourage progress in identifying occupational factors responsible for premature ovarian failure.

The impact of dehydroepiandrosterone in poor ovarian responders on assisted reproduction technology treatment.

One in six couples worldwide will experience at least one infertility problem during their reproductive years. Between 5.6% and 35.1% of women will exhibit poor ovarian response. A variety of methods have been applied to improve ovarian response, including dehydroepiandrosterone. In the ovaries, dehydroepiandrosterone promotes follicular development and granulosa cell proliferation by increasing intraovarian androgen concentrations while simultaneously enhancing the level of follicular insulin-like growth factor-1, which promotes folliculogenesis. Dehydroepiandrosterone supplementation may improve in vitro fertilization outcomes and ovarian response in patients with poor ovarian response. However, a few questions still loom over the effectiveness of dehydroepiandrosterone.

Avaliação crítica do papel da citologia cervical em meio líquido no rastreamento do câncer do colo uterino / Critical evaluation of the role of liquid based cervical cytology in screening for cervical cancer

A citologia cervical em meio líquido (CML) foi aprovada pela Administração de Drogas e Alimentos dos EUA (Food and Drug Administration - FDA) com objetivo de reduzir as falhas da citologia cervical convencional (CC). Segundo a literatura atual, a CML aumenta a sensibilidade da citologia cervical, a adequabilidade das amostras e diminui o número de esfregaços insatisfatórios quando comparada com a CC. Embora alguns países tenham legitimado o modelo de CML no rastreio de neoplasia do colo do útero, há controvérsias a respeito da escolha do melhor método de exame citopatológico cervical. Dessa forma, o objetivo da presente revisão é avaliar o impacto da introdução da CML em termos de eficácia, custos, conhecimento técnico necessário e implicações para a sua introdução.(AU)

The liquid based cervical cytology has been approved by the Food and Drug Administration (FDA) in order to reduce failures of conventional cervical cytology (CC). According to current literature, CML increases the sensitivity of cervical cytology, the suitability of the samples and reduce the number of poor smears compared with CC. Although some countries have legitimized the CML model in screening cancer of the cervix, there is a controversy about the choice of the best cervical Pap smear method. Thus, the aim of the current review is to evaluate the impact of the introduction of CML in terms of effectiveness, costs, necessary technical knowledge and implications of its introduction.(AU)