Dietary Curcumin Intake and Its Effects on the Transcriptome and Metabolome of Drosophila melanogaster.

Curcumin, a polyphenol derived from Curcuma longa, used as a dietary spice, has garnered attention for its therapeutic potential, including antioxidant, anti-inflammatory, and antimicrobial properties. Despite its known benefits, the precise mechanisms underlying curcumin's effects on consumers remain unclear. To address this gap, we employed the genetic model Drosophila melanogaster and leveraged two omics tools-transcriptomics and metabolomics. Our investigation revealed alterations in 1043 genes and 73 metabolites upon supplementing curcumin into the diet. Notably, we observed genetic modulation in pathways related to antioxidants, carbohydrates, and lipids, as well as genes associated with gustatory perception and reproductive processes. Metabolites implicated in carbohydrate metabolism, amino acid biosynthesis, and biomarkers linked to the prevention of neurodegenerative diseases such as schizophrenia, Alzheimer's, and aging were also identified. The study highlighted a strong correlation between the curcumin diet, antioxidant mechanisms, and amino acid metabolism. Conversely, a lower correlation was observed between carbohydrate metabolism and cholesterol biosynthesis. This research highlights the impact of curcumin on the diet, influencing perception, fertility, and molecular wellness. Furthermore, it directs future studies toward a more focused exploration of the specific effects of curcumin consumption.

Woolly mutation with the Get02 locus overcomes the polygenic nature of trichome-based pest resistance in tomato.

Type-IV glandular trichomes, which only occur in the juvenile developmental phase of the cultivated tomato (Solanum lycopersicum), produce acylsugars that broadly protect against arthropod herbivory. Previously, we introgressed the capacity to retain type-IV trichomes in the adult phase from the wild tomato, Solanum galapagense, into the cultivated species cv. Micro-Tom (MT). The resulting MT-Galapagos enhanced trichome (MT-Get) introgression line contained 5 loci associated with enhancing the density of type-IV trichomes in adult plants. We genetically dissected MT-Get and obtained a subline containing only the locus on Chromosome 2 (MT-Get02). This genotype displayed about half the density of type-IV trichomes compared to the wild progenitor. However, when we stacked the gain-of-function allele of WOOLLY, which encodes a homeodomain leucine zipper IV transcription factor, Get02/Wo exhibited double the number of type-IV trichomes compared to S. galapagense. This discovery corroborates previous reports positioning WOOLLY as a master regulator of trichome development. Acylsugar levels in Get02/Wo were comparable to the wild progenitor, although the composition of acylsugar types differed, especially regarding fewer types with medium-length acyl chains. Agronomical parameters of Get02/Wo, including yield, were comparable to MT. Pest resistance assays showed enhanced protection against silverleaf whitefly (Bemisia tabaci), tobacco hornworm (Manduca sexta), and the fungus Septoria lycopersici. However, resistance levels did not reach those of the wild progenitor, suggesting the specificity of acylsugar types in the pest resistance mechanism. Our findings in trichome-mediated resistance advance the development of robust, naturally resistant tomato varieties, harnessing the potential of natural genetic variation. Moreover, by manipulating only 2 loci, we achieved exceptional results for a highly complex, polygenic trait, such as herbivory resistance in tomato.

Drosophila melanogaster as a Translational Model System to Explore the Impact of Phytochemicals on Human Health.

Fruits, vegetables, and spices are natural sources of bioactive phytochemicals, such as polyphenols, carotenoids, flavonoids, curcuminoids, terpenoids, and capsaicinoids, possessing multiple health benefits and relatively low toxicity. These compounds found in the diet play a central role in organism development and fitness. Given the complexity of the whole-body response to dietary changes, invertebrate model organisms can be valuable tools to examine the interplay between genes, signaling pathways, and metabolism. Drosophila melanogaster, an invertebrate model with its extensively studied genome, has more than 70% gene homology to humans and has been used as a model system in biological studies for a long time. The notable advantages of Drosophila as a model system, such as their low maintenance cost, high reproductive rate, short generation time and lifespan, and the high similarity of metabolic pathways between Drosophila and mammals, have encouraged the use of Drosophila in the context of screening and evaluating the impact of phytochemicals present in the diet. Here, we review the benefits of Drosophila as a model system for use in the study of phytochemical ingestion and describe the previously reported effects of phytochemical consumption in Drosophila.

Trombosis de seno venoso en paciente en puerperio mediato. Reporte de caso / Venous sinus thrombosis in a patient during the immediate puerperium. Case report

Resumen ANTECEDENTES: La trombosis del seno venoso representa el 1% de los eventos vasculares cerebrales; su incidencia es de 5 casos por cada millón de habitantes y su mortalidad es del 10%. Los senos sagital superior y venoso transversal son los más afectados. El embarazo es un factor de riesgo especial pues la trombosis se registra en el 0.01% de las gestaciones. CASO CLÍNICO: Paciente de 40 años, primigesta, con embarazo gemelar bicorial biamniótico de 33.6 semanas. Se ingresó al servicio de Urgencias debido al diagnóstico de preeclampsia con criterios de severidad, con presión arterial de 160-100 mmHg y transaminasemia. Se le indicó tratamiento antihipertensivo y sulfato de magnesio intravenoso. Se decidió la finalización del embarazo por cesárea. Al cuarto día poscesárea tuvo disminución de la fuerza en ambos brazos, pérdida del tono muscular en los miembros pélvicos, cefalea holocraneana y alteración del estado de alerta (Glasgow de 14). Mediante resonancia magnética se evidenció la oclusión del seno longitudinal superior e isquemia en la región parieto occipital izquierda. Se le administraron anticoagulantes y analgésicos con los que evolucionó adecuadamente; se dio de alta sin complicaciones. CONCLUSIONES: La trombosis del seno venoso implica un reto cuando no se tiene una alta sospecha diagnóstica en pacientes con signos y síntomas neurológicos y, más aún, cuando se agregan factores de riesgo protrombóticos, como el embarazo y el puerperio. El diagnóstico oportuno brinda la oportunidad de iniciar el tratamiento adecuado y disminuir los síntomas y comorbilidades.

Abstract BACKGROUND: Venous sinus thrombosis accounts for 1% of cerebral vascular events; its incidence is 5 cases per million population and its mortality is 10%. The superior sagittal and transverse venous sinuses are the most affected. Pregnancy is a special risk factor since thrombosis is registered in 0.01% of pregnancies. CLINICAL CASE: A 40-year-old primigravida patient with a 33.6 week biamniotic twin pregnancy. She was admitted to the Emergency Department due to the diagnosis of preeclampsia with severity criteria, with blood pressure of 160-100 mmHg and transaminasemia. She was prescribed antihypertensive treatment and intravenous magnesium sulfate. It was decided to terminate the pregnancy by cesarean section. On the fourth post-cesarean day she had decreased strength in both arms, loss of muscle tone in the pelvic limbs, holocranial headache and altered alertness (Glasgow of 14). Magnetic resonance imaging showed occlusion of the superior longitudinal sinus and ischemia in the left parietooccipital region. He was administered anticoagulants and analgesics with which he evolved adequately; he was discharged without complications. CONCLUSIONS: Venous sinus thrombosis implies a challenge when there is no high diagnostic suspicion in patients with neurological signs and symptoms and, even more so, when prothrombotic risk factors are added, such as pregnancy and puerperium. Timely diagnosis provides the opportunity to initiate appropriate treatment and reduce symptoms and comorbidities.

Altered chromatin conformation and transcriptional regulation in watermelon following genome doubling.

Polyploidy has played a crucial role in plant evolution, development and function. Synthetic autopolyploid represents an ideal system to investigate the effects of polyploidization on transcriptional regulation. In this study, we deciphered the impact of genome duplication at phenotypic and molecular levels in watermelon. Overall, 88% of the genes in tetraploid watermelon followed a >1:1 dosage effect, and accordingly, differentially expressed genes were largely upregulated. In addition, a great number of hypomethylated regions (1688) were identified in an isogenic tetraploid watermelon. These differentially methylated regions were localized in promoters and intergenic regions and near transcriptional start sites of the identified upregulated genes, which enhances the importance of methylation in gene regulation. These changes were reflected in sophisticated higher-order chromatin structures. The genome doubling caused switching of 108 A and 626 B compartments that harbored genes associated with growth, development and stress responses.

Duplicación de imagen ultrasonográfica de feto único intrauterino que emula un gemelo inexistente: reporte de un caso / Ultrasonographic image duplication of an intrauterine unique fetus mimicking non-existing twin: case report

Resumen ANTECEDENTES: En Obstetricia, las imágenes en espejo son artefactos ecográficos infrecuentes que, potencialmente, pueden confundirse con embarazos heterotópicos y propiciar errores diagnósticos e intervenciones iatrógenas. Estas imágenes ficticias se generan por la existencia de una superficie reflectora como, por ejemplo, el intestino distendido o la vejiga repleta. CASO CLÍNICO: Paciente de 39 años, con embarazo por fertilización in vitro, que asiste a evaluación ecográfica del primer trimestre. En la ecografía de rutina a las 11 semanas se observó una imagen en espejo y en la resonancia magnética: útero gestante con una estructura retrouterina hipoecoica, sin feto en el interior. La imagen ecográfica en espejo volvió a reproducirse en el tercer trimestre. El embarazo llegó a término y finalizó por vía abdominal, sin que pudieran demostrarse las estructuras que se advirtieron en la resonancia magnética. CONCLUSIONES: Las imágenes en espejo se han reportado en ultrasonidos de diversas localizaciones pero pocos en la Obstetricia. Todo hizo suponer que la superficie reflectora fue la estructura hipoecoica retrouterina observada, transitoriamente, en la resonancia magnética.

Abstract BACKGROUND: In obstetrics, ultrasonic artifactual mirror images are infrequent, but potentially dangerous since they can be mistakenly interpreted as heterotopic pregnancies, precluding diagnostic errors and iatrogenic interventions. These images require a reflection surface such as dilated bowl or plenty bladder to be generated. OBJECTIVE: We report a first trimester scan ghost twin, diagnosed since first trimester of pregnancy. CLINICAL CASE: 39-year-old patient, with pregnancy due to in vitro fertilization, who attends ultrasound evaluation of the first trimester. Routine ultrasound at 11 weeks showed a mirror image and magnetic resonance imaging: a pregnant uterus with a hypoechoic retrouterine structure, with no fetus inside. The ultrasound mirror image reproduced again in the third trimester. The pregnancy came to an end and ended by abdominal route, without being able to demonstrate the structures that were noticed on the MRI. CONCLUSION: Very few reports of obstetric ultrasound mirror images have been reported. We hypothesize that the transient retrouterine hypoecogenic structure observed by MRI was the reflective surface that create the ghost twin image.

¿Cuál es el punto de corte más significativo de hormona antimülleriana como predictor de la respuesta ovárica, tasa de embarazo y nacido vivo? / What is the most significant cutting point of antimüllerian hormone as a predictor of the ovarian response, pregnancy rate and living born?

Resumen OBJETIVO: Evaluar la eficacia de la hormona antimülleriana en la predicción de la respuesta ovárica, tasa de embarazo y nacido vivo. MATERIALES Y MÉTODOS: Estudio retrospectivo, analítico y observacional efectuado para evaluar los ciclos de estimulación ovárica de pacientes atendidas entre el 1 de enero de 2010 y el 30 de junio de 2017 en el Centro de Reproducción Hisparep. Criterios de inclusión: límites de edad 20 y 44 años y tener ciclos menstruales regulares. Criterios de exclusión: factor masculino alterado, cavidad uterina alterada, trastornos endocrinos, antecedente de daño ovárico. Variables de estudio: concentraciones de hormona antimülleriana, ovocitos recuperados, maduros, fecundados, embriones, tasa de embarazo y nacido vivo. Las variables cuantitativas se analizaron mediante una comparación de medias con t de Student, las variables porcentuales mediante comparación de percentiles. RESULTADOS: Se evaluaron 223 ciclos, divididos en grupos según diferentes puntos de corte. En cualquier punto de corte la hormona antimülleriana predice mayor recuperación de ovocitos maduros y fecundados: 1.25 ng/mL fue el punto de corte más significativo porque predijo mayor obtención de embriones. Se observó relación entre las tasas de embarazo clínico y nacido vivo, aunque su poder predictivo fue débil. Tomar como referencia un punto de corte de 0.5 ng/mL parece predecir bajas probabilidades de nacido vivo. CONCLUSIONES: La hormona antimülleriana fue el mejor marcador de respuesta ovárica; el punto de corte más significativo fue el de 1.25 ng/mL. Hacen falta más estudios para evaluar su eficacia como predictor de bajas tasas de nacido vivo.

Abstract OBJECTIVE: To evaluate the efficacy of antimülleriana hormone in prediction of the ovarian response, pregnancy rate and live birth. MATERIALS AND METHODS: In this retrospective, analytical and observational study, ovarian stimulation cycles were evaluated at the Hisparep Reproduction Center, in a period from January 1, 2010 to June 30, 2017, the inclusion criteria were; Age from 20 to 44 years and regular menstrual cycles. The exclusion criteria; altered male factor, altered uterine cavity, endocrine disorders, antecedent of ovarian damage. The study variables; antimüllerian hormone, oocytes recovered, mature, fertilized, embryos, pregnancy rate and live birth. The quantitative variables were analyzed by means of a comparison of means, using the Student's T test, the percentage variables by means of comparison of percentiles. RESULTS: 223 cycles were evaluated, divided into groups using different cut points. It was determined that Antimullerian Hormone predicts a greater recovery of mature and fertilized oocytes using any cut point, we consider that 1.25 ng / mL was the most significant cutoff point, since it predicts higher embryo obtaining, relationship was observed in pregnancy rates clinical and live birth, although its predictive power is weak, however, using a cutoff of 0.5 ng / mL seems to predict low odds of live birth CONCLUSIONS: Antimullerian hormone is the best marker of ovarian response, we consider that 1.25 ng /mL is the most significant cut-off point, more studies are needed to evaluate its efficacy as a predictor of low rates of live birth.

Resultados en ciclos de FIV-ICSI adicionando hormona luteinizante recombinante a la hormona folículo estimulante recombinante con menotropinas durante la estimulación ovárica en pacientes mayores de 35 años / Results in IVF-ICSI cycles adding luteinizing hormone recombinant to follicle stimulating hormone recombinant with menotropins during ovarian stimulation in patients over 35 years-old

Resumen OBJETIVO Evaluar los resultados en ciclos de FIV-ICSI de dos protocolos de estimulación ovárica en mujeres mayores de 35 años e investigar si agregar hormona luteinizante recombinante a FSH-r en un protocolo de estimulación mejora la respuesta ovárica y, en consecuencia, las tasas de embarazo en este grupo poblacional. MATERIALES Y MÉTODOS Estudio longitudinal, observacional y retrospectivo efectuado en pacientes de la Clínica de Reproducción Hisparep del Hospital Español con diagnóstico de infertilidad, mayores de 35 años, que recibieron un ciclo de hiperestimulación ovárica controlada con FIV-ICSI durante el periodo 2014-2016. El análisis estadístico se efectuó con la prueba de t de Student para muestras independientes. Los estudios se analizaron con el paquete estadístico SPSS IBM, versión 22. RESULTADOS Se analizaron 201 mujeres con infertilidad, mayores de 35 años. El grupo 1 (n = 101) de FIV-ICSI recibió estimulación con hormona folículo estimulante recombinante y hormona luteinizante recombinante 2:1 con menotropinas (Pergoveris® y Merapur®) a partir del segundo día del ciclo. El grupo 2 (n = 100) recibió hormona folículo estimulante recombinante y menotropinas (Gonal F® y Merapur®); en ambos esquemas se utilizó antagonista de GnRH a partir del día 7 del ciclo. La media de ovocitos aspirados fue de 7.5 en el grupo 1 y 9.1 en el grupo 2 (p = 0.058). La media de ovocitos maduros fue 6.2 en el Grupo 1 vs 7.4 en el grupo 2 (p = 0.085). La tasa de fecundación en el grupo 1 fue de 57 vs 67% en el grupo 2 (p = 0.045). En el grupo 1 la tasa de implantación por embrión transferido en fresco fue 24.1 vs 10.3% en el Grupo 2 (p = 0.40), la tasa de recién nacido vivo fue de 30% en el Grupo 1 vs 20.6% en el Grupo 2. La media de embriones vitrificados en el Grupo 1 fue 1.47 vs 1.38 en el Grupo 2. CONCLUSIONES La probable ventaja de la complementación con hormona folículo estimulante recombinante durante la estimulación ovárica en mujeres mayores de 35 años es de interés y se requiere su evaluación en estudios posteriores.

Abstract OBJECTIVE To evaluate the reproductive effects when recombinant luteinizing hormone is added and to compare two stimulation schemes by number of aspirated oocytes, mature oocytes, fertilization and implantation rates, live newborn and number of vitrified embryos. MATERIALS AND METHODS Longitudinal, observational and retrospective study carried out in patients of the Hisparep Reproduction Clinic of the Spanish Hospital with diagnosis of infertility, over 35 years old, who received a controlled ovarian hyperstimulation cycle with IVF-ICSI during the period 2014-2016. The statistical analysis was carried out with the Student t test for independent samples. The studies were analyzed with the IBM SPSS statistical package, version 22. RESULTS We analyzed 201 women with infertility, over 35 years of age. Group 1 (n = 101) of IVF-ICSI received stimulation with recombinant follicle-stimulating hormone and recombinant luteinizing hormone 2: 1 with menotropins (Pergoveris® and Merapur®) from the second day of the cycle. Group 2 (n = 100) received recombinant follicle stimulating hormone and menotropins (Gonal F® and Merapur®); in both schemes, GnRH antagonist was used from day 7 of the cycle. The average number of aspirated oocytes was 7.5 in Group 1 and 9.1 in Group 2 (p = 0.058). Mean mature oocytes were 6.2 in Group 1 vs 7.4 in Group 2 (p = 0.085). The fertilization rate in group 1 was 57 vs. 67% in Group 2 (p = 0.045). In Group 1 the implantation rate per embryo transferred fresh was 24.1 vs 10.3% in Group 2 (p = 0.40), the live newborn rate was 30% in Group 1 vs 20.6% in Group 2. The mean number of vitrified embryos in Group 1 was 1.47 vs 1.38 in Group 2. CONCLUSIONS The probable advantage of supplementation with recombinant follicle-stimulating hormone during ovarian stimulation in women over 35 years of age is of interest and its evaluation is required in subsequent studies.

Consecuencias en la reproducción luego de la histeroscopia operatoria previa a la transferencia embrionaria en pacientes infértiles / Reproductive impact of operative hysteroscopy in patients with infertility, previous embryo transfer

Resumen Objetivo: Determinar si la histeroscopia operatoria mejora los resultados reproductivos en pacientes a quienes se efectúa transferencia embrionaria y reportar los hallazgos histeroscópicos más frecuentes, previos a la transferencia de embriones. Materiales y métodos: Estudio retrospectivo, observacional y longitudinal efectuado en pacientes con diagnóstico de infertilidad de la Clínica de Reproducción Asistida Hisparep que recibieron ciclos de FIV-ICSI con histeroscopia previa a la transferencia embrionaria. Se compararon las tasas de implantación entre los distintos grupos y efectuó estadística descriptiva con c2. Resultados: Se analizaron 255 pacientes con diagnóstico de infertilidad. El estudio histerosópico previo a la transferencia de embriones reportó que 122 (47%) tenían pólipos endometriales, 70 (28%) cavidad uterina normal, 27 (11%) sinequias uterinas, 24 (9%) miomatosis submucosa y 12 (5%) malformación mülleriana de tipo útero septado. 185 pacientes con alteración en la cavidad uterina se intervinieron por vía histeroscópica para corrección, antes de la transferencia embrionaria; de éstas, 44 (24%) quedaron embarazadas. A las que tenían malformación mulleriana se les resecó el tabique uterino y en 9 pacientes se logró el embarazo (75%). A las pacientes del grupo 4 se les practicó adherenciolisis y 6 lograron el embarazo (22%). En el grupo 2, posterior a la polipectomia, 26 pacientes quedaron embarazadas (21%) y en el grupo 3, posoperadas de miomectomia submucosa, 3 (12%) lograron el embarazo. De las pacientes del grupo 1 con cavidad uterina normal (n = 70), a quienes se efectuó transferencia embrionaria, 37 (53%) consiguieron quedar embarazadas. Conclusiones: En las pacientes con subfertilidad y poliposis endometrial, la histeroscopia es un recurso útil para detectar anormalidades susceptibles de corrección antes de la transferencia embrionaria.

Abstract Objective: To determine if operative hysteroscopy improves reproductive outcomes in patients who undergo embryo tansfer and report the most frequent hysteroscopic findings prior to embryo transfer. Materials and methods: Retrospective, observational and longitudinal study performed in patients with diagnosis of infertility of the Clínica de Reproducción Asistida Hisparep, Mexico, who received IVF-ICSI cycles with hysteroscopy prior to embryo transfer. The implantation rates between the different groups were compared and descriptive statistics were performed with c2. Results: 255 patients with a diagnosis of infertility were analyzed. The hysteroscopic study prior to embryo transfer reported that 122 (47%) had endometrial polyps, 70 (28%) normal uterine cavity, 27 (11%) uterine synechiae, 24 (9%) submucosal myomatosis and 12 (5%) Mullerian malformation of septate uterus type. 185 patients with alteration in the uterine cavity were intervened hysteroscopically for correction, before the embryo transfer; of these, 44 (24%) became pregnant. Those who had Müllerian malformation resected the uterine septum and in 9 patients pregnancy was achieved (75%). The patients in group 4 underwent adherenciolisis and 6 achieved pregnancy (22%). In group 2, after polypectomy, 26 patients became pregnant (21%) and in group 3, postoperated by submucosal myomectomy, 3 (12%) achieved pregnancy. Of the patients in group 1 with normal uterine cavity (n = 70), to whom embryo transfer was made, 37 (53%) were able to get pregnant. Conclusions: In patients with subfertility and endometrial polyposis, hysteroscopy is a useful resource to detect abnormalities susceptible to correction before embryo transfer.

[Tubal obstruction with an implant inserted by hysteroscopy: a report of 50 cases]. / Obstrucción tubaria con un implante insertado mediante histeroscopia: reporte de 50 casos.

BACKGROUND: The Essure contraceptive device consists of a titanium and nickel coiled spring containing Dacron fibers. It is placed under hysteroscopic visualizaron in the proximal section of the Fallopian tube. The microinsert acts by inducing a tissue reaction that permanently blocks the tube within three months. OBJECTIVE: Show our experience in the use and insertion of the Essure device, in a private office. METHODS: We reviewed insertion procedure, complications, degree of tolerance and acceptance by user. Between June 2008 and May 2013 fifty cases with Essure placement were made in our office. RESULTS: The average age was 36 years, as for the average number of pregnancies was two. The procedure time average was 6 minutes 25 seconds, no intraoperative complication was reported. All patients expressed very good tolerance and high degree of satisfaction with the procedure. A simple abdominal radiography was performed three months after the hysteroscopy to dem6nstrate the correct placement and position of the device, in all patients. CONCLUSION: [corrected] The number of patients is enough to show the advantages of the method and the possibility of performing it in an ambulatory environment, as it can be a private office with the correct equipment to do it.

[Clinical practice guideline for the diagnosis and treatment of hyperprolactinemia]. / Guía de práctica clínica para el diagnóstico y tratamiento de la hiperprolactinemia.

BACKGROUND: Hyperprolactinemia is a common finding within clinical practice in both endocrinology and general practice fields, amongst other specialties. The general practitioner and other specialists must know the indications and serum prolactin determination parameters in order to, once detected, derive the patient for a correct assessment and begin treatment. OBJECTIVE: Formulate a clinical practice guideline evidence-based for the diagnosis and treatment of hyperprolactinemia. METHOD: It took the participation of eight gynecologists, two pathologists and a pharmacologist in the elaboration of this guideline due their experience and clinical judgement. These recommendations were based upon diagnostic criteria and levels of evidence from treatment guidelines previously established, controlled clinical trials and standardized guides for adolescent and adult population with hyperprolactinemia. RESULTS: During the conformation of this guideline each specialist reviewed and updated a specific topic and established the evidence existent over different topics according their field of best clinical expertise, being enriched by the opinion of other experts. At the end, all the evidence and decisions taken were unified in the document presented here. CONCLUSIONS: It is presented the recommendations established by the panel of experts for diagnosis and treatment of patients with high levels of prolactin; also the level of evidence for the diagnosis of hyperprolactinemia, handling drug-induced hyperprolactinemia and prolactinomas in pregnant and non-pregnant patients.

[Mexican National Consensus on Assisted Reproduction Treatment]. / Consenso Nacional Mexicano de Reproducción Asistida.

BACKGROUND: It is estimated that 15% of couples living in industrialized countries are infertile, ie have failed to conceive, reproductive age, after 12 months ormore of regular intercourse without contraception. During the past decade has increased the demand for fertility treatments because they believe are moreeffective now. OBJECTIVE: To unify the therapeutic approach and service to patients and set a precedent for a Mexican Official Standard respect and support for the legislation of these procedures. METHOD: Consensus by technical experts group panel with the participation of 34 national centers accredited for use in assisted reproduction. He organized seven workshops with the following themes: 1) selection of patients for assisted reproduction treatment, 2) schemes controlled ovarian stimulation for assisted reproduction techniques of high complexity, 3) preparation and egg retrieval technique, 4) transferembryo; 5) luteal phase supplementation; 6) indications and techniques of cryopreservation and 7) informed consent. Each table had a coordinator who wrote and presented the findings to the full, it made a number of observations until they reached unanimity of criteria, which are reflected in this document. RESULTS: Patient selection for assisted reproduction techniques is the first step of the process. Proper selection lead to success, in the same way that a bad pick up for failure. In the case of egg donation the most important recommendation is that only one to two embryos transferred in order to reduce multiple pregnancy rates and maintaining high pregnancy rates.

[MURCS association: case report]. / Asociación MURCS: reporte de un caso.

Clinical term of association refers to a not randomized congenital malformations which are present in one single subject. The term MURCS is an acronym for (MU) Mullerian, (R) Renal, (C) Cervicothoracic, (S) Somite abnormalities. We communicate a case of a phenotipically normal 16 years old female patient with primary amenorrhea due to müllerian malformations and cervicothoracic dysplasia integrating the MURCS association diagnosis.

[Usefulness of office hysteroscopy]. / Utilidad de la histeroscopia de consultorio.

OBJECTIVE: To demonstrate the efficacy and feasibility of the office hysteroscopy in the treatment of the endouterine pathologies. DESIGN: retrospective, descriptive and observational. PATIENTS AND METHOD: We included all the office hysteroscopies performed since February-2000 to August-2004 (n=84) in a private medical office. We performed 32 diagnostic procedures without anesthesia and 52 operative procedures with anesthesia (I.V. sedation). We used a Karl Storz diagnostic telescope and a Bettocchi operative telescope. RESULTS: Postoperative care was in the office since 90 minutes and all patients went home without complications, Mean age of the patients was 38+/-10 years. The indications to perform the procedure were infertility and abnormal transvaginal bleeding. There were not complications. All of the diagnostic procedures were done without anesthesia and we verified patient satisfaction with a pain store since 1 to 10 points. Twenty patients could get pregnant after the procedure and in two patients we detected endometrial carcinoma. CONCLUSION: With these results, we can assume that office hysteroscopy is a procedure with minimal complications when is performed by expert hands and with excellent patients' satisfaction and benefit.

Frecuencia de embarazos después de tratamiento microquirúrgico en pacientes estériles por enfermedad adherencial tuboovárica / Frequency of pregnancy after microsurgical treatment in sterile patients by tuboovarian adherencial disease

En los últimos años la enfermedad adherencial de los anexos se ha incrementado debido principalmente al aumento en la frecuencia de infecciones pélvicas lo que origina, de acuerdo con la localización, naturaleza y extensión de las lesiones, problemas de esterilidad. En este trabajo se informan los resultados obtenidos en 70 pacientes con esta enfermedad en las que se realizó salpingo-ovariolisis microquirúrgica con el propósito de corregir su esterilidad. Todas las pacientes recibieron rutinariamente medidas adyuvantes en el pre, trans y posoperatorio inmediato (heparina, corticoides y antimicrobianos). El tiempo mínimo de observación posoperatoria fue de seis meses. En 27 de las 70 enfermas (38.6 por ciento) las adherencias eran laxas (IA y IIA de Hulka), en tanto que en 43 (61.4 por ciento) estas adherencias eran densas y vascularizadas (IB y IIB de Hulka). En el primer grupo se obtuvieron 15 embarazos (20.9 por ciento), cinco de término y cuatro abortos

Factor tubo peritoneal. Reversión de la oclusión tubaria / Tubo-peritoneal factor. Tabal occlusion reversion

Se analizan las técnicas de oclusión tubaria bilateral más empleadas y cuáles son las que tienen mayor potencialidad de reversión. Revisando 200 casos de pacientes con factor tuboperitoneal de esterilidad se encontró que 24 solicitaban recanalización tubaria por tener antecedente de salpingoclasia. En el perfil de estas pacientes, se obtuvo un promedio de 29.4 años, con un periodo de latencia entre la oclusión tubaria y la solicitud de reversión de 4.1 años teniendo un promedio de 2 hijos vivos. Los motivos de solicitud fueron las segundas nupcias 54%, hijos fallecidos 12.5%, OTB involuntaria 12.5% alteraciones psicológicas 12.5% e inestabilidad matrimonial 8.5%. La técnica OTB más empleada fué Pomeroy 70.8%. De las 24 pacientes estudiadas, cuatro se descartaron por no reunir los requisitos necesarios, de las 20 restantes dos desertaron en el periodo preoperatorio y dos están pendientes de efectuar la renalización. De las 16 operadas, tres desertaron y siete se embarazoron; lo que dá un cuadro de 53.8% de embarazos. Resultado que está dentro de los límites de éxito reportados por otros investigadores.

Correlación de la histerosalpingografía, pruebas de Rubin y celiotomía con los diagnósticos laparoscópicos en la permeabilidad tubárica / Correlation of hysterosalpingography, Rubins test and celiotomy with laparoscopic diagnosis in tubal permeability

No se cuenta con un método único para el estudio integral de la trompa de falopio. Los métodos más utilizados: HSG, PR y cromotubación por Laparoscopia por ser ascendentes no son fisiológicos y no evalúan la función del endosalpinx. La PR debe seguirse utilizando por evaluar la contractibilidad del miosalpinx u ostium tubario; es barato, prácticamente inócuo y coincide más frecuentemente con la laparoscopia que con la HSG. La coincidencia de permeabilidad y obstrucción tubaria por HSG y Laparoscopia se obtuvo en 70.5% y en 29.5% no hubo correlación. Las obstrucciones tubarias evidenciadas por HSG pueden ser permables a la laparoscopia por quitarse el componente espasmo-dolor en esta última prueba. Las funciones de permeabilidad en la HSG que muestran oclusión en la laparoscopia pueden deberse a defecto de técnica, hidrocromotubación preferencial, proceso inflamatório evolutivo reactivo o inducido por el estudio radiográfico. Durante la HSG no sólo se debe analizar las imáges de permeabilidad y de oclusión tubaria, sino que es obligado analizar la distribución del material radiopaco en el Douglas y tratar de evidenciar la calidad de la relación fibrio-ovárica. La laparoscopia tiene mayor grado de confiabilidad y sólo 6.7% de error. Es un estudio parorámico y evaluativo de las condiciones del aparato genital interno, pero no evidencia la contractilidad ni la imagen de las cavidades uterotubaria. Los tres métodos deben utilizarse en el protocolo de estudio de la pareja estéril y complementarse entre sí, por la falta de correlación observada y para tener un diagnóstico integral de la patología existente