AI Article Synopsis
Article Abstract
Background: Although hysteroscopy is frequently used in the management of subfertile women, a systematic review of the evidence on this subject is lacking.
Methods: We summarized and appraised the evidence for the benefit yielded by this procedure. Our systematic search was limited to randomized and controlled studies. The QUOROM and MOOSE guidelines were followed. Language restrictions were not applied.
Results: We identified 30 relevant publications. Hysteroscopic removal of endometrial polyps with a mean diameter of 16 mm detected by ultrasound doubles the pregnancy rate when compared with diagnostic hysteroscopy and polyp biopsy in patients undergoing intrauterine insemination, starting 3 months after the surgical intervention [relative risk (RR) = 2.3; 95% confidence interval (CI): 1.6-3.2]. In patients with one fibroid structure smaller than 4 cm, there was a marginally significant benefit from myomectomy when compared with expectant management (RR = 1.9; 95% CI: 1.0-3.7). Hysteroscopic metroplasty for septate uterus resulted in fewer pregnancies in patients with subfertility when compared with those with recurrent pregnancy loss (RR = 0.7; 95% CI: 0.5-0.9). Randomized controlled studies on hysteroscopic treatment of intrauterine adhesions are lacking. Hysteroscopy in the cycle preceding a subsequent IVF attempt nearly doubles the pregnancy rate in patients with at least two failed IVF attempts compared with starting IVF immediately (RR = 1.7; 95% CI: 1.5-2.0).
Conclusions: Scarce evidence on the effectiveness of hysteroscopic surgery in subfertile women with polyps, fibroids, septate uterus or intrauterine adhesions indicates a potential benefit. More randomized controlled trials are needed before widespread use of hysteroscopic surgery in the general subfertile population can be justified.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1093/humupd/dmp033 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Oxidative stress and energy metabolism abnormalities in polycystic ovary syndrome: from mechanisms to therapeutic strategies.
Reprod Biol Endocrinol
December 2024
Key Laboratory of Reproductive Medicine, Sichuan Provincial Woman's and Children's Hospital, The Affiliated Women's and Children's Hospital of Chengdu Medical College, Chengdu, Sichuan, 610045, China.
Polycystic ovary syndrome (PCOS), as a common endocrine and metabolic disorder, is often regarded as a primary cause of anovulatory infertility in women. The pathogenesis of PCOS is complex and influenced by multiple factors. Emerging evidence highlights that energy metabolism dysfunction and oxidative stress in granulosa cells (GCs) are pivotal contributors to aberrant follicular development and impaired fertility in PCOS patients.
View Article and Find Full Text PDFA Systematic Review of the Molecular Mechanisms Involved in the Association Between PCOS and Endometrial and Ovarian Cancers.
J Cell Mol Med
December 2024
Biosciences Institute, Newcastle University Cancer Centre, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK.
Polycystic ovary syndrome (PCOS), a major cause of female infertility, affects 4%-20% of reproductive-age women. Metabolic and hormonal alterations are key features of PCOS, potentially raising the risk of endometrial (EC) and ovarian (OVCA) cancers. This systematic review aims to summarise the proposed molecular mechanisms involved in the association between PCOS and EC or OVCA.
View Article and Find Full Text PDFSubclinical/overt hypothyroidism may be associated with diminished ovarian reserve in infertile women independent of thyroid autoimmunity.
Front Endocrinol (Lausanne)
December 2024
Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproductive Medicine and Genetics, Shenzhen, China.
Objective: To investigate the association between thyroid dysfunction or thyroid autoimmunity (TAI) and diminished ovarian reserve (DOR).
Methods: A total of 2,867 women undergoing their first fertilization (IVF) cycle at Shenzhen Zhongshan Obstetrics & Gynecology Hospital between January 1, 2013 and June 30, 2021, were enrolled in this study. The participants had documented thyroid and ovarian reserve metrics.
Probiotic supplement for the treatment of polycystic ovarian syndrome.
Pharmacol Ther
December 2024
Institute of Microbiology and Molecular Genetics, University of the Punjab, New Campus, Lahore 54590, Pakistan. Electronic address:
Polycystic Ovarian Syndrome is one of the major prevalent causes of infertility reported worldwide nearly 6-26 %, especially in girls hitting puberty and women at their childbearing age. The main clinical manifestations include irregular menstrual cycle, small cysts on one or both ovaries, chronic oligo-anovulation, and hirsutism. The etiological criteria are very complex and related to many factors like obesity, insulin sensitivity, inflammation, hyperandrogenism, diabetes mellitus type II, cardiovascular diseases, and dysbiosis of gut microbiota.
View Article and Find Full Text PDFSimple prediction model for vitamin D deficiency in women with osteoporosis or risk factors for osteoporosis in Thailand.
J Clin Transl Endocrinol
December 2024
Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama 6 Road, Ratchathewi, Bangkok 10400, Thailand.
Introduction: In Thailand, the assessment of vitamin D status by measuring 25-hydroxyvitamin D[25(OH)D] levels in individuals at risk for osteoporosis is constrained by limited facilities and high costs. This study aimed to create a clinical model for predicting vitamin D deficiency in women with osteoporosis or risk factors for osteoporosis.
Materials And Methods: This was a cross-sectional study of 490 women.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!