The effects of COVID-19 lockdown on lifestyle and emotional state in women undergoing assisted reproductive technology: Results of an Italian survey.

PURPOSE: On March 8, 2020, the Italian Government implemented extraordinary measures to limit viral transmission of COV-19/SARS-CoV-2. We evaluated the impact of COVID-19 lockdown on lifestyle and emotional state in women planning infertility treatments. BASIC PROCEDURES: We performed a quantitative research study using a web-based survey, in 140 women referred to Assisted Reproductive Technologies Center. MAIN FINDINGS: We observed changes in body weight during lockdown in 80 % of women, and a significant increase in BMI in comparison to that observed before (p=.001). We observed a high percentage of non-adherence to the Mediterranean pattern during lockdown due to higher frequency of consumption of sweet/pastries, cheese and meat, rather than fruit, vegetables and legumes. Before lockdown 36.4 % women were snack consumers while during lockdown 55 % (p=.002). By considering individuals' attitude to snack consumption, we observed an increase related to boredom (p=<.0001) and anxiety (p=.05) during lockdown. Increased levels of anxiety and sadness were observed in about 30 %, and of boredom in 25 %. The percentage of women worried about their planning infertility treatment was more than 50 %. PRINCIPAL CONCLUSIONS: Quarantine-related restrictions strongly influenced lifestyle psychological behavior leading to an increased burden of cardiovascular disease.

Should the myometrial free margin still be considered a limiting factor for hysteroscopic resection of submucous fibroids? A possible answer to an old question.

OBJECTIVE: To evaluate the feasibility of the hysteroscopic resection of type II submucous fibroids regardless of the myometrial free margin separating them from the serosa and to report the dynamic changes the margin undergoes after the various phases of resection. DESIGN: A prospective observational study. SETTING: A tertiary-level university hospital. PATIENT(S): Thirteen women with single type II submucous fibroids of ≤ 5 cm in diameter regardless of the myometrial free margin. INTERVENTION(S): Hysteroscopic myomectomy and ultrasound evaluation of myometrial free margin before and after each phase of the procedure. MAIN OUTCOME MEASURE(S): The possibility of a complete one-step resection, the incidence of intraoperative or postoperative complications, and the analysis of the dynamic changes occurring in myometrial free margin. RESULT(S): Complete resection was performed successfully in all patients. No complications were registered. The myometrial free margin decreased on the distension of the uterine cavity and then increased progressively and significantly after the various phases of resection. CONCLUSION(S): In selected cases and in experienced hands, hysteroscopic myomectomy of type II submucous fibroids may be performed successfully and safely regardless of the myometrial free margin. Myometrial free margin increases progressively with each step of the procedure probably leading to an increasing margin of safety.

Laparoscopic treatment of interstitial twin pregnancy.

OBJECTIVE: To describe a conservative management by laparoscopy of an unusual interstitial twin pregnancy. DESIGN: Case report. SETTING: University hospital. PATIENT(S): A 27-year-old woman, pregnant at 6th week of amenorrhea with interstitial twin pregnancy. INTERVENTION(S): The woman was submitted to two- and three-dimensional transvaginal ultrasound and to diagnostic hysteroscopy. Subsequently, we performed a laparoscopic procedure: conical exeresis of the uterine cornu using a monopolar hook without involving the uterine cavity. MAIN OUTCOME MEASURE(S): Conservation of the uterus, fertility preservation. RESULT(S): Successful conservative treatment of interstitial twin pregnancy. CONCLUSION(S): Conservative laparoscopic surgery can be used successfully in hemodynamically stable patients with an interstitial pregnancy.