Saline Hysteroscopy for Removal of Retained Intrauterine Contraceptive Devices in Early Pregnancy.

Objective: Pregnancies complicated by a retained intrauterine device (IUD) are at increased risk for adverse outcomes such as miscarriage and preterm labour. There is limited evidence to guide the management of retained IUDs in pregnancy when the strings are not visible at the external cervical os. We describe a method for IUD retrieval in such cases.

Intrauterine Adhesions Following Miscarriage: Look and Learn.

Objective: To examine the incidence of intrauterine adhesions (IUA) following the management of miscarriage in women with previously documented normal uterine cavities.

Methods: We conducted a retrospective cohort study from two fertility clinics with standard practice protocols for evaluating the uterine cavity prior to infertility treatment and following clinical pregnancy loss. A database query and manual chart review identified 144 women with normal uterine cavities who experienced a miscarriage between January 2010 and November 2012 and returned to the clinic for follow-up hysteroscopy.

Curettage and Asherman's syndrome-lessons to (re-) learn?

Objective: To investigate the noted cluster of cases of Asherman's syndrome in an 18-month period at an Early Pregnancy Assessment Centre at a tertiary care institution.

Methods: A practice audit was performed involving (a) a detailed chart review of the six index cases; and (b) compilation of treatment choices for all new patient referrals in the same 18-month time frame from July 2011 to December 2012. Diagnosis of Asherman's syndrome was made with a combination of clinical menstrual symptoms and hysteroscopic diagnosis of intrauterine adhesions.

Telomere length and reproductive aging.

Background: Rate of reproductive aging may be related to rate of biological aging. Thus, indicators of aging, such as short telomere length, may be more frequent in women with a history suggestive of premature reproductive senescence.

Methods: Telomere-specific quantitative PCR was used to assess telomere length in two groups of women with evidence of reproductive aging: (i) patients with idiopathic premature ovarian failure (POF, N = 34) and (ii) women with a history of recurrent miscarriage (RM, N = 95); and two control groups: (1) women from the general population (C1, N = 108) and (2) women who had a healthy pregnancy after 37 years of age (C2, N = 46).

Estrogen receptor alpha gene polymorphisms are associated with idiopathic premature ovarian failure.

Objective: To assess the role of hormone receptor/binding protein variants in genetic predisposition to premature ovarian failure (POF).

Design: Case-control study.

Setting: Academic.

Skewed X-chromosome inactivation is associated with primary but not secondary ovarian failure.

Premature ovarian failure (POF) is the occurrence of menopause before the age of 40, and may present with either primary or secondary amenorrhea. Numerous cases of POF in women with X-chromosome deletions or translocations have been reported; thus, it is possible that smaller rearrangements undetectable by conventional cytogenetics may contribute to POF in some patients. In females with an abnormal X chromosome, cells with inactivation of the normal X may be selected against, causing skewed X-chromosome inactivation (XCI).

FMR1 repeat sizes in the gray zone and high end of the normal range are associated with premature ovarian failure.

Premature ovarian failure (POF) is the occurrence of menopause before the age of 40 and affects 1% of the female population. Whereas the etiology of POF is largely unexplained, FMR1 premutation carriers are known to be at increased risk of POF compared with the general population. The FMR1 premutation alleles have 55-200 copies of a CGG repeat in the 5' untranslated region of the FMR1 gene.

A randomized, double-blind, multicenter study comparing a starting dose of 100 IU or 200 IU of recombinant follicle stimulating hormone (Puregon) in women undergoing controlled ovarian hyperstimulation for IVF treatment.

Purpose: To compare the efficiency and efficacy of two starting doses of recombinant FSH (follitropin-beta, Puregon) in women undergoing IVF treatment.

Methods: This prospective, randomized, double-blind, multicentric (N = 6) study included 192 women undergoing IVF using the long protocol of GnRH agonist who received either 100 IU or 200 IU of r-FSH per day. Gonadotropin dose adjustment was allowed after day 4 of stimulation.