Fertility Sparing in Endometrial Cancer: Where Are We Now?

Endometrial cancer is the most common gynecological neoplasm with an increased incidence in the premenopausal population in recent decades. This raises the problem of managing endometrial cancer in fertile women who have not yet achieved pregnancy. In these women, after careful selection, hysterectomy may be postponed in favor of conservative management if specific requirements are met.

Combine Surgery and In Vitro Fertilization (IVF) in Endometriosis-Related Infertility: When and Why.

Endometriosis is a chronic, estrogen-dependent inflammatory disease characterized by the presence of endometrial tissue outside the uterus, causing pelvic pain and infertility. Infertility arises mainly due to inflammatory mediators in the peritoneal fluid, contributing to local hypoestrogenism, which appears to exacerbate chronic inflammation and sensitize pelvic nerves. Local hypoestrogenism within endometriotic lesions contrasts with the systemic estrogen-dependent nature of the disease.

Ultrasonographic Features of the Fallopian Tubes: An Overview on Main Tubal Pathologies.

Fallopian tubes are not usually visible on a transvaginal pelvic scan unless pelvic fluid or pathological processes are present. Depending on the underlying pathological process, they may exhibit different wall thicknesses, grades of vascularization, and variable echogenicity. Recognizing the affected tube and assessing the possible underlying process is of primary importance in clinical practice, as pathological tubes may represent benign pathologies, oncological state, or life-threatening conditions requiring different treatment to preserve fertility.

Adenomyosis and Adolescence: A Challenging Diagnosis and Complex Management.

Adenomyosis is a chronic, hormone-related disease characterized by the presence of the endometrial glands and stroma within the myometrium. This condition can manifest in various features, focal or diffuse adenomyosis or as an adenomyoma, and it may involve different uterine walls (posterior, anterior, and/or lateral walls). The disease can also be classified into different degrees, as mild, moderate and severe, which can be associated with more intense symptoms, although this correlation is not always directly proportional.

Tailoring the Diagnostic Pathway for Medical and Surgical Treatment of Uterine Fibroids: A Narrative Review.

Uterine leiomyomas are the most common benign uterine tumors in women and are often asymptomatic, with clinical manifestation occurring in 20-25% of cases. The diagnostic pathway begins with clinical suspicion and includes an ultrasound examination, diagnostic hysteroscopy, and, when deemed necessary, magnetic resonance imaging. The decision-making process should consider the impairment of quality of life due to symptoms, reproductive desire, suspicion of malignancy, and, of course, the woman's preferences.