Anatomic distribution of endometriosis: A reappraisal based on series of 1101 patients.

OBJECTIVE: To reappraise the anatomic distribution of endometriosis lesions in cases with Superficial Implants (SI), Ovarian Endometrioma (OMA) and Deep Infiltrating Endometriosis (DIE). MATERIALS AND METHODS: A prospective observational study was operated between January 1989 to June 2009. A total of 1333 consecutive patients with a laparoscopic diagnosis of endometriosis, were extracted from our database. Due to missing data or repeated operations, 232 patients were excluded from the study. Finally, 1101 patients who met the selected criteria were included in the present analysis.. Primary outcome of study was the anatomic location of endometriotic lesions. Secondary outcomes were laterality of lesions as well as location of adhesions. RESULTS: Mean age of patients was 33.06 years (range 15-63 years) while the mean BMI was 21.5. The ovary was the most frequent site of endometriotic lesions (737 patients, 66.94%) followed by the utero-sacral ligaments (USL) (45.51%), the ovarian fossa (32.15%), the pouch of Douglas (29.52%) and the bladder (21.25%). Deep Infiltrating Endometriosis (DIE) was diagnosed in 159 patients (14.4%) with an increasing rate starting from the mid-nineties. The left side was predominant for all locations except fromr ovarian SI and fallopian tube, but for this latter location the number of cases was limited. 600 (54.4%) patients had adhesions wjth the adnexa being the most frequent site of location (47.4%). CONCLUSIONS: Ovary was the main site of endometriotic lesions followed by the utero sacral ligaments. Left side was predominant for all locations except for ovarian SI and fallopian tube. The diagnosis of DIE has constantly being increased since mid-nineties. The large cohort of patients included in the study has strengthened previous reported data.

Fluorescence in situ hybridisation sperm examination is significantly impaired in all categories of male infertility.

To study the outcome of FISH sperm examination in cases with sperm pathology and outline the potential correlation with certain chromosomal defects. A retrospective study of prospectively collected data was performed in IAKENTRO, Infertility Treatment Center. Rates of abnormal FISH semen examination were compared between male infertility patients and fertile controls. Detection of abnormal FISH semen examination as well as each chromosomal abnormality detected was correlated with each sperm deficiency (asthenozoospermia, oligozoospermia and teratozoospermia) in a univariate regression model. There were 72 male partners included, of which 52 male infertility patients and 20 controls. The rate of abnormal sperm FISH examination was significantly higher in patients' group (55.8% vs. 15.0% for controls, p = .002). Asthenozoospermia, oligozoospermia and teratozoospermia were significantly correlated with detection of abnormal FISH examination (p = .004, p = .01 and p < .001 respectively). Teratospermia was significantly correlated with increased aneuploidy rate for chromosome 17 (p = .005), chromosome X (p = .05) and Y (p = .03). FISH examination reveals pathology in a significant proportion of patients with sperm defects and should be recommended to achieve early detection of chromosomal defects that may postpone favourable reproductive outcome.

Can high levels of D-chiro-inositol in follicular fluid exert detrimental effects on blastocyst quality?

OBJECTIVE: It was previously shown that higher concentrations of myo-inositol in human follicular fluid improve oocyte and embryo quality, whereas D-chiro-inositol seems to worsen oocyte quality and ovarian response in polycystic ovary syndrome patients. Our study was the first one aiming to test whether different myo-inositol and D-chiro-inositol concentration in follicular fluids correlate with blastocyst quality in healthy young women. PATIENTS AND METHODS: Eight egg donors and eleven couples undergoing in vitro fertilization, were involved in a prospective observational study. Myo-inositol/D-chiro-inositol ratio was calculated in the follicular fluids and associated with different blastocyst grades. Donors were homogeneous and followed the same standard stimulation protocol. RESULTS: The ratio between myo-inositol and D-chiro-inositol was significantly higher in the specimens rated as good quality blastocysts, compared to those rated as poor-quality blastocysts. In this study, almost all the transferred blastocysts were graded as good quality and were correlated to lower D-chiro-inositol content in the follicular fluid; the implantation rate and pregnancy rate were satisfying. Our data suggest that the reduction of such ratio in follicular fluid seems to play a negative role in follicular development. CONCLUSIONS: We found a correlation between myo-inositol/D-chiro-inositol ratio in follicular fluid and blastocyst quality. The value of this ratio may represent a new biomarker for estimating the good features of blastocysts, and a prognostic factor of embryo implantation and pregnancy success. Moreover, the pre-treatment with myo-inositol in women undergoing in vitro fertilization (IVF) may improve oocyte quality and ART outcome. CLINICAL TRIAL REGISTRATION NUMBER: NCT03055442 (ClinicalTrials.gov registry).

Effect of short-term tibolone treatment on risk markers for cardiovascular disease in healthy postmenopausal women: a randomized controlled study.

OBJECTIVE: The aim of this prospective randomized controlled cross sectional study was to evaluate the effect of a six month tibolone treatment in healthy postmenopausal women on biochemical CVD markers by calculating the changes of the blood serum levels of total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides (Tg), high-sensitivity C-reactive protein (hsCRP), homocysteine (Hcy), and endothelin-1 (ET-1) at the beginning of the treatment and after six months. MATERIALS AND METHODS: Fifty-two healthy postmenopausal women were enrolled in a prospective, randomized, case-controlled outpatient trial. Group 1 (n = 26) received 2,5 mg/d tibolone for six months, while Group 2 (n = 26) received no treatment. Serum levels ofTC, LDL, HDL, Tg, hsCRP, Hcy, and ET-1 were evaluated at baseline and after six months. RESULTS: The two groups did not statistically differ at baseline characteristics. In Group 1 tibolone treatment decreased significantly TC (p = 0.01), HDL (p < 0.001), and Tg (p < 0.001) serum levels while a significant increase ofhsCRP (p < 0.001) was observed. Finally no changes were noticed on LDL, Hcy, and ET-1 serum levels. Regarding Group 2, no changes were observed. CONCLUSION: Short-term tibolone treatment in healthy postmenopausal women exerts a mixed action, acting beneficially in some markers (TC, LDL, Tg, Hcy, and ET-1) where as detrimentally in others (HDL, hsCRP).