Office hysteroscopy in pre- and post-menopausal women: a predictive model.

OBJECTIVES: To assess the variables associated with success of office hysteroscopy (OH) in pre-menopausal and post-menopausal women and to develop a clinical model for predicting the outcome of OH. METHODS: This is a retrospective cohort study of consecutive patients (n = 3181) referred for an OH to a tertiary care university hospital between January 2018 and March 2020. Multivariate logistic regression analysis was used to investigate the variables for predicting the success of OH in all patients and in pre-menopausal and in post-menopausal patients separately. The logistic regression analysis of each variable was applied to develop a predictive model. RESULTS: The overall success rate of the procedure was 92.2%; 95.4% in pre-menopausal women and 87.6% in post-menopausal women. In the general population, independent predictors of procedure success were previous vaginally delivery and hysteroscopy, while previous cervical or uterine surgery were associated with incomplete OH. In the pre-menopausal group, the independent predictors of failure were treatment with GnRH, estroprogestins and infertility. In 89% of cases, our developed model was able to predict whether an OH would be successful in a particular patient. ROC analysis showed an area under the curve of 0.8746 (95% CI: 0.85354-0.89557). CONCLUSIONS: The present study demonstrates the development of a simple and reliable clinical model for the identification of both pre-menopausal and menopausal patients with a high chance of OH success.

Analysis of estrogen receptor (ERalpha and ERbeta) and progesterone receptor (PR) polymorphisms in uterine leiomyomas.

BACKGROUND: Leiomyomas are the most common tumors in women, found in up to 30% of women in active reproductive life. These tumors are estrogen- and progestin-responsive. In fact, they do not occur before menarche, undergoing rapid increase in size during pregnancy with consequent fetal wastage. Conversely, they can regress or even calcify after menopause or castration. Given the central role of sex steroids in uterus trophism, estrogen and progesterone receptors are important mediators of hormonal bioeffects, and the genes encoding these receptors become easy candidates for uterine proliferative disorders. MATERIAL/METHODS: We examined the distribution of common polymorphisms of ERalpha, ERbeta and PR genes in 413 Caucasian females: 225 post-menopausal healthy controls and 188 premenopausal women affected by uterine leiomyomas. The polymorphisms were evaluated both in constitutive and tissue DNA by PCR amplification, specific endonuclease digestion, and then detection with agarose or polyacrylamide gel electrophoresis. RESULTS: The observed allele frequencies did not deviate from the expected Hardy-Weinberg distribution in our population. In case-control analysis, no variant frequency of the studied genes differed significantly between control subjects and patients. CONCLUSIONS: Polymorphisms in the genes encoding for ERalpha, ERbeta and PR did not correlate with the occurrence of uterine leiomyomas in our Caucasian population.