| 1. |
- Brandell, K., et al.
(författare)
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Medical Abortion before Confirmed Intrauterine Pregnancy: A Systematic Review
- 2022
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Ingår i: Seminars in Reproductive Medicine. - : Georg Thieme Verlag KG. - 1526-8004 .- 1526-4564. ; 40:05/06, s. 258-263
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Tidskriftsartikel (refereegranskat)abstract
- "Very early medical abortion " (VEMA) refers to medical abortion (with mifepristone and misoprostol) before intrauterine pregnancy is visualized on ultrasound. Our aim is to present the current evidence on efficacy, safety (focused on ectopic pregnancies), and how to assess treatment success of VEMA. We conducted a systematic review of studies reporting outcomes of VEMA. The field is small and so our objective was to map all relevant literature, without conducting meta-analysis. We searched PubMed, Medline, and Embase on April 19, 2022. We conducted a narrative synthesis of the evidence. A total of 373 articles were identified. Six articles (representing four observational and one pilot trial) were included in the final review. Across all included studies, treatment efficacy ranged between 91 and 100%. Prevalence of ectopic pregnancy was low and very few cases ( n = 2) of ruptures were reported. Most studies used serial serum human chorionic gonadotrophin (s-hCG) levels to determine success of abortion; one study used low sensitivity urine hCG. From the available evidence, VEMA appears to be efficacious and does not appear to cause harm to ectopic pregnancies. Treatment can be assessed with pre- and postabortion s-hCG. Good quality, randomized controlled trial evidence is needed to best inform practice.
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| 2. |
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| 3. |
- Glazer, Clara Helene, et al.
(författare)
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Male Infertility and Risk of Nonmalignant Chronic Diseases : A Systematic Review of the Epidemiological Evidence
- 2017
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Ingår i: Seminars in Reproductive Medicine. - : Georg Thieme Verlag KG. - 1526-8004 .- 1526-4564. ; 35:3, s. 282-290
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Forskningsöversikt (refereegranskat)abstract
- The association between male infertility and increased risk of certain cancers is well studied. Less is known about the long-term risk of nonmalignant diseases in men with decreased fertility. A systemic literature review was performed on the epidemiologic evidence of male infertility as a precursor for increased risk of diabetes, cardiovascular diseases, and all-cause mortality. PubMed and Embase were searched from January 1, 1980, to September 1, 2016, to identify epidemiological studies reporting associations between male infertility and the outcomes of interest. Animal studies, case reports, reviews, studies not providing an accurate reference group, and studies including infertility due to vasectomy or malignancy were excluded. The literature search resulted in 2,485 references among which we identified seven articles fulfilling the eligibility criteria. Of these, four articles were prospective (three on risk of mortality, one on risk of chronic diseases) and three were cross-sectional relating male infertility to the Charlson Comorbidity Index. The current epidemiological evidence is compatible with an association between male infertility and risk of chronic disease and mortality, but the small number of prospective studies and insufficient adjustment of confounders preclude strong statements about male infertility as precursor of these outcomes.
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| 4. |
- Hirschberg, AL
(författare)
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Female Hyperandrogenism in Elite Sports and the Athletic Triad
- 2022
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Ingår i: Seminars in reproductive medicine. - : Georg Thieme Verlag KG. - 1526-4564 .- 1526-8004. ; 40:01/021-02, s. 32-41
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Tidskriftsartikel (refereegranskat)abstract
- Essential hyperandrogenism seems to be overrepresented in female elite athletes. This applies to mild forms such as polycystic ovary syndrome, as well as rare differences/disorders of sex development (DSD). The reason is likely a selection bias since there is increasing evidence that androgens are beneficial for athletic performance by potent anabolic effects on muscle mass and bone mass, and stimulation of erythropoiesis. XY DSD may cause a greatly increased production of testosterone in the male range, that is, 10 to 20 times higher than the normal female range. The established regulations concerning the eligibility of female athletes with severe hyperandrogenism to compete in the female classification remain controversial. The most common cause of menstrual disorders in female athletes, however, is probably an acquired functional hypothalamic disturbance due to energy deficiency in relation to energy expenditure, which could lead to low bone mineral density and increased risk of injury. This condition is particularly common in endurance and esthetic sports, where a lean body composition is considered an advantage for physical performance. It is important to carefully evaluate endocrine disturbances and menstrual disorders in athletes since the management should be specific according to the underlying cause.
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| 5. |
- Maliqueo, Manuel, et al.
(författare)
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Rodent Models of Polycystic Ovary Syndrome: Phenotypic Presentation, Pathophysiology, and the Effects of Different Interventions
- 2014
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Ingår i: Seminars in Reproductive Medicine. - : Georg Thieme Verlag KG. - 1526-8004 .- 1526-4564. ; 32:3, s. 183-193
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Tidskriftsartikel (refereegranskat)abstract
- This review focuses on rodent models exposed to sex steroids prepubertally and describes their phenotypes and pathophysiology with specific focus on the estradiol valerate-, dihydrotestosterone-, and letrozole-induced rat polycystic ovary syndrome (PCOS) models. Phenotypic presentations are compared among models as a function of the timing and dose of the exposure. Furthermore, the use of these models to study the possible effects and mechanisms of different treatment modalities relevant for women with PCOS will be discussed. Importantly, we do not claim to review all available rodent models of PCOS. Despite the variety of rodent PCOS models currently available, there is no "gold standard" that mimics the complete range of abnormalities observed in women with PCOS. In this regard, it is important to select the most suitable model for the pathophysiological experiment to be performed or the treatment strategy to be tested. Important variables to take into consideration are dose, route of administration, timing and duration of exposure, and the relevance of the abnormalities of the reproductive and metabolic axes in the rodent model to those observed in human PCOS.
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| 7. |
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| 8. |
- Stener-Victorin, E
(författare)
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Acupuncture for Infertility in Women with Polycystic Ovary Syndrome: What Does It Add?
- 2017
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Ingår i: Seminars in reproductive medicine. - : Georg Thieme Verlag KG. - 1526-4564 .- 1526-8004. ; 35:4, s. 353-358
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Tidskriftsartikel (refereegranskat)abstract
- Acupuncture is a nonpharmacological therapy to induce ovulation in women with polycystic ovary syndrome (PCOS), but not until recently there has been a study reporting the live birth rate following ovulation induction by acupuncture or its potential as an adjuvant to pharmacological ovulation induction. Clomiphene citrate, the first-line treatment for ovulation induction in women with PCOS, was twice as effective at achieving live birth, with no effect of acupuncture alone or in combination with clomiphene. Thus, the findings from the recent randomized control trial do not support acupuncture as an infertility treatment, alone or in combination, in women with PCOS. The recent trial has important clinical implications not only for women with PCOS with an active wish for pregnancy but also for those with no active wish of pregnancy, as acupuncture induces ovulation to a higher degree than no treatment and also relieves other PCOS-related symptoms. This narrative review dissects possible mechanism of action of acupuncture on reproductive function, it discusses stimulation parameters, it discusses the recent findings on live birth, and it also discusses the control situation in potential future acupuncture trials.
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| 9. |
- Westgren, M
(författare)
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In utero stem cell transplantation
- 2006
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Ingår i: Seminars in reproductive medicine. - : Georg Thieme Verlag KG. - 1526-8004 .- 1526-4564. ; 24:5, s. 348-357
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Tidskriftsartikel (refereegranskat)
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| 10. |
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