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Revista Medica Del Instituto Mexicano... Aug 2022During folliculogenesis, different proinflammatory cytokines have a physiological role in the weakening of the follicle wall and an eventual rupture at ovulation.... (Review)
Review
During folliculogenesis, different proinflammatory cytokines have a physiological role in the weakening of the follicle wall and an eventual rupture at ovulation. Chronic inflammation is closely related to endothelial dysfunction, cardiovascular disease, coronary artery disease, and polycystic ovary syndrome. Polycystic ovary syndrome is characterized by androgen excess and ovarian dysfunction. Emerging evidence suggests that the long-term metabolic effects and cardiovascular complications observed in this syndrome may be related to the presence of a mild chronic inflammatory state. It is unclear whether androgen excess promotes an inflammatory state or, conversely, whether inflammatory molecules stimulate androgen production. Early detection of risk factors will help in the prevention and control of cardiovascular diseases, since the metabolic alterations associated with this syndrome can predispose to worse cardiovascular health outcomes.
Topics: Androgens; Cardiovascular Diseases; Cytokines; Female; Humans; Inflammation; Ovarian Follicle; Polycystic Ovary Syndrome
PubMed: 36049035
DOI: No ID Found -
Fertility and Sterility Apr 2022This month's Views and Reviews provides insights into one of the most difficult clinical care populations: individuals with low ovarian reserve and limited response to... (Review)
Review
This month's Views and Reviews provides insights into one of the most difficult clinical care populations: individuals with low ovarian reserve and limited response to stimulation. After a discussion of available definitions of "poor ovarian response" and how new definitions are improving the characterization of the individual patient and our ability to offer prognosis, we review alternative strategies for management. The first chapter presents options for pretreatment, including hormonal manipulation and nutriceuticals. The second chapter discusses the potential benefit of more gentle stimulation in this population. Subsequent chapters address adjuvants during stimulation, alterations of final oocyte maturation and processes in the laboratory, and finally when and how to stop treatment.
Topics: Female; Humans; Infertility, Female; Ovarian Diseases; Ovarian Reserve; Ovulation Induction
PubMed: 35367010
DOI: 10.1016/j.fertnstert.2022.02.026 -
American Family Physician Apr 2016Adnexal masses can have gynecologic or nongynecologic etiologies, ranging from normal luteal cysts to ovarian cancer to bowel abscesses. Women who report abdominal or... (Review)
Review
Adnexal masses can have gynecologic or nongynecologic etiologies, ranging from normal luteal cysts to ovarian cancer to bowel abscesses. Women who report abdominal or pelvic pain, increased abdominal size or bloating, difficulty eating, or rapid satiety that occurs more than 12 times per month in less than a year should be evaluated for ovarian cancer. Pelvic examination has low sensitivity for detecting an adnexal mass; negative pelvic examination findings in a symptomatic woman should not deter further workup. Ectopic pregnancy must be ruled out in women of reproductive age. A cancer antigen 125 (CA 125) test may assist in the evaluation of an adnexal mass in appropriate patients. CA 125 levels are elevated in conditions other than ovarian cancer. Because substantial overlap in CA 125 levels between pre- and postmenopausal women may occur, this level alone is not recommended for differentiating between a benign and a malignant adnexal mass. Transvaginal ultrasonography is the first choice for imaging of an adnexal mass. Large mass size, complexity, projections, septation, irregularity, or bilaterality may indicate cancer. If disease is suspected outside of the ovary, computed tomography may be indicated; magnetic resonance imaging may better show malignant characteristics in the ovary. Serial ultrasonography and periodic measurement of CA 125 levels may help in differentiating between benign or potentially malignant adnexal masses. If an adnexal mass larger than 6 cm is found on ultrasonography, or if findings persist longer than 12 weeks, referral to a gynecologist or gynecologic oncologist is indicated.
Topics: Adnexal Diseases; CA-125 Antigen; Chorionic Gonadotropin, beta Subunit, Human; Diagnosis, Differential; Endometriosis; Female; Gynecological Examination; Humans; Leiomyoma; Magnetic Resonance Imaging; Ovarian Cysts; Ovarian Diseases; Ovarian Neoplasms; Pelvic Inflammatory Disease; Practice Guidelines as Topic; Pregnancy; Pregnancy, Ectopic; Tomography, X-Ray Computed; Torsion Abnormality; Ultrasonography; Uterine Neoplasms
PubMed: 27175840
DOI: No ID Found -
Ultrasound in Obstetrics & Gynecology :... Oct 2000
Review
Terms, definitions and measurements to describe the sonographic features of adnexal tumors: a consensus opinion from the International Ovarian Tumor Analysis (IOTA) Group.
Topics: Diagnosis, Differential; Female; Guidelines as Topic; Humans; International Cooperation; Ovarian Cysts; Ovarian Diseases; Ovarian Neoplasms; Sensitivity and Specificity; Societies, Medical; Ultrasonography, Doppler, Color
PubMed: 11169340
DOI: 10.1046/j.1469-0705.2000.00287.x -
Journal of Assisted Reproduction and... Jan 2018There are large variations in the number of oocytes within each woman, and biologically, the total quantity is at its maximum before the woman is born. Scientific... (Review)
Review
There are large variations in the number of oocytes within each woman, and biologically, the total quantity is at its maximum before the woman is born. Scientific knowledge is limited about factors controlling the oocyte pool and how to measure it. Within fertility clinics, there is no uniform agreement on the diagnostic criteria for each common measure of ovarian reserve in women, and thus, studies often conflict. While declining oocyte quantity/quality is a normal physiologic occurrence as women age, some women experience diminished ovarian reserve (DOR) much earlier than usual and become prematurely infertile. Key clinical features of DOR are the presence of regular menstrual periods and abnormal-but-not-postmenopausal ovarian reserve test results. A common clinical challenge is counseling patients with conflicting ovarian reserve test results. The clinical diagnosis of DOR and the interpretation of ovarian reserve testing are complicated by changing lab testing options and processing for anti-mullerian hormone since 2010. Further, complicating the diagnostic and research scenario is the existence of other distinct yet related clinical terms, specifically premature ovarian failure, primary ovarian insufficiency, poor ovarian response, and functional ovarian reserve. The similarities and differences between the definitions of DOR with each of these four terms are reviewed. We recommend greater medical community involvement in terminology decisions, and the addition of DOR-specific medical subject-heading search terms.
Topics: Diagnostic Techniques, Endocrine; Diagnostic Techniques, Obstetrical and Gynecological; Female; Humans; Infertility, Female; Ovarian Diseases; Ovarian Reserve; Primary Ovarian Insufficiency; Reproduction; Terminology as Topic
PubMed: 28971280
DOI: 10.1007/s10815-017-1058-4 -
Cold Spring Harbor Perspectives in... May 2015MicroRNAs (miRNAs) are posttranscriptional gene regulatory molecules that show regulated expression within ovarian tissue. Most research investigating miRNAs in the... (Review)
Review
MicroRNAs (miRNAs) are posttranscriptional gene regulatory molecules that show regulated expression within ovarian tissue. Most research investigating miRNAs in the ovary has relied exclusively on in vitro analyses. In this review, we highlight those few studies in which investigators have illustrated an in vivo effect of miRNAs on ovarian function. We also provide a synopsis of how these small noncoding RNAs can impact ovarian disease. miRNAs have great potential as novel diagnostic biomarkers for the detection of ovarian disease and in the assisted reproductive technologies (ART) for selection of healthy viable oocytes and embryos.
Topics: Animals; Biomarkers; Corpus Luteum; Disease Models, Animal; Female; Fertility; Humans; Mice; MicroRNAs; Oocytes; Ovarian Diseases; Ovarian Follicle; Ovary; Reproductive Techniques, Assisted; Terminology as Topic
PubMed: 25986593
DOI: 10.1101/cshperspect.a022962 -
Annals of the Royal College of Surgeons... Feb 2020Gynaecological structures such as the ovaries, fallopian tubes, ligaments and uterus are rarely encountered inside a hernial sac. The prevalence of groin hernias...
INTRODUCTION
Gynaecological structures such as the ovaries, fallopian tubes, ligaments and uterus are rarely encountered inside a hernial sac. The prevalence of groin hernias containing parts of female genitalia remains unknown. The aim of this review was to summarise the existing evidence on inguinal hernias containing ovaries with or without the other female adnexa.
METHODS
A systematic search was conducted for literature published up to February 2018 using the MEDLINE, Scopus and Google Scholar™ databases along with the references of the full-text articles retrieved. Papers on observational studies and case reports concerning women who were diagnosed with an ovarian inguinal hernia (pre or intraoperatively) were considered eligible for inclusion in the review.
RESULTS
Fifteen papers (13 case reports, 2 case series) comprising seventeen patients (mean age 47.9 years) were evaluated. A left-sided hernia was noted in 13 cases (77%) whereas 4 patients had a right-sided hernia. Eight patients underwent preoperative imaging with computed tomography, ultrasonography or both. This was diagnostic in five cases. In 11 patients, hernia contents were repositioned, 2 had a salpingo-oophorectomy and 2 an oophorectomy. Eight patients underwent hernia repair with mesh placement while three had a herniorrhaphy.
CONCLUSIONS
Ovarian inguinal hernias should be considered among the differential diagnoses of a groin mass or swelling. In women of reproductive age, repair of the hernia with the intent to preserve fertility is of critical importance.
Topics: Female; Hernia, Inguinal; Herniorrhaphy; Humans; Inguinal Canal; Ovarian Diseases; Ovariectomy; Ovary; Prevalence; Salpingo-oophorectomy; Surgical Mesh; Tomography, X-Ray Computed; Ultrasonography
PubMed: 31696731
DOI: 10.1308/rcsann.2019.0137 -
Turk Patoloji Dergisi 2021Immunoglobulin G4-related disease is characterized by dense fibrosis, obliterative phlebitis, and lymphoplasmacytic infiltration that contains abundant IgG4 positive...
Immunoglobulin G4-related disease is characterized by dense fibrosis, obliterative phlebitis, and lymphoplasmacytic infiltration that contains abundant IgG4 positive plasma cells. It causes tumefactive lesions in the involved organs and is most commonly seen in the salivary glands, pancreas, and retroperitoneum. Ovarian involvement has been reported in only two cases. In our case, a 58-year-old female patient presented with abdominal distention and pain. Pelvic computed tomography revealed a soft tissue lesion compatible with the omental cake, several intraabdominal implants, and bilateral adnexal fullness. A laparotomy was performed under suspicion of peritoneal carcinomatosis secondary to bilateral adnexal mass. In the histopathologic examination, abundant lymphoplasmacytic infiltration and dense fibrosis were observed in both ovaries and the peritoneum. In the areas of greatest density, the density of IgG4-positive plasma cells was found to range from 40 to 50 per high-power field. The patient was accepted as suffering from probable IgG4-related disease because of the bilateral involvement of the ovaries and the histopathological findings. In conclusion, we present this case to draw attention to the fact that IgG4-related disease can also be seen in the ovary.
Topics: Diagnosis, Differential; Female; Fibrosis; Humans; Immunoglobulin G; Immunoglobulin G4-Related Disease; Middle Aged; Ovarian Diseases; Ovarian Neoplasms; Ovary; Plasma Cells
PubMed: 32779156
DOI: 10.5146/tjpath.2020.01500 -
Journal of Minimally Invasive Gynecology 2020Prior research has collectively shown that endometriosis is inversely related to women's adiposity. The aim of this study was to assess whether this inverse relationship... (Observational Study)
Observational Study
STUDY OBJECTIVE
Prior research has collectively shown that endometriosis is inversely related to women's adiposity. The aim of this study was to assess whether this inverse relationship holds true by disease severity and typology.
DESIGN
Cross-sectional study among women with no prior diagnosis of endometriosis.
SETTING
Fourteen clinical centers in Salt Lake City, UT, and San Francisco, CA.
PATIENTS
A total of 495 women (of which 473 were analyzed), aged 18-44 years, were enrolled in the operative cohort of the Endometriosis, Natural History, Diagnosis, and Outcomes (ENDO) Study.
INTERVENTIONS
Gynecologic laparoscopy/laparotomy regardless of clinical indication.
MEASUREMENTS AND MAIN RESULTS
Participants underwent anthropometric assessments, body composition measurements, and evaluations of body fat distribution ratios before surgery. Surgeons completed a standardized operative report immediately after surgery to capture revised American Society for Reproductive Medicine staging (I-IV) and typology of disease (superficial endometriosis [SE], ovarian endometrioma [OE], and deep infiltrating endometriosis [DIE]). Linear mixed models, taking into account within-clinical-center correlation, were used to generate least square means (95% confidence intervals) to assess differences in adiposity measures by endometriosis stage (no endometriosis, I-IV) and typology (no endometriosis, SE, DIE, OE, OE + DIE) adjusting for age, race/ethnicity, and parity. Although most confidence intervals were wide and overlapping, 3 general impressions emerged: (1) women with incident endometriosis had the lowest anthropometric/body composition indicators compared with those without incident endometriosis, (2) women with stage I or IV endometriosis had lower indicators compared with women with stage II or III, and (3) women with OE and/or DIE tended to have the lowest indicators, whereas women with SE had the highest indicators.
CONCLUSION
Our research highlights that the relationship between women's adiposity and endometriosis severity and typology may be more complicated than prior research indicates.
Topics: Adiposity; Adolescent; Adult; Body Mass Index; Cohort Studies; Cross-Sectional Studies; Diagnostic Techniques, Obstetrical and Gynecological; Endometriosis; Female; Gynecologic Surgical Procedures; Humans; Ovarian Diseases; Peritoneal Diseases; Pregnancy; Prognosis; Severity of Illness Index; Young Adult
PubMed: 31927045
DOI: 10.1016/j.jmig.2020.01.002 -
Cellular & Molecular Immunology Nov 2014The ovary is not an immunologically privileged organ, but a breakdown in tolerogenic mechanisms for ovary-specific antigens has disastrous consequences on fertility in... (Review)
Review
The ovary is not an immunologically privileged organ, but a breakdown in tolerogenic mechanisms for ovary-specific antigens has disastrous consequences on fertility in women, and this is replicated in murine models of autoimmune disease. Isolated ovarian autoimmune disease is rare in women, likely due to the severity of the disease and the inability to transmit genetic information conferring the ovarian disease across generations. Nonetheless, autoimmune oophoritis is often observed in association with other autoimmune diseases, particularly autoimmune adrenal disease, and takes a toll on both society and individual health. Studies in mice have revealed at least two mechanisms that protect the ovary from autoimmune attack. These mechanisms include control of autoreactive T cells by thymus-derived regulatory T cells, as well as a role for the autoimmune regulator (AIRE), a transcriptional regulator that induces expression of tissue-restricted antigens in medullary thymic epithelial cells during development of T cells. Although the latter mechanism is incompletely defined, it is well established that failure of either results in autoimmune-mediated targeting and depletion of ovarian follicles. In this review, we will address the clinical features and consequences of autoimmune-mediated ovarian infertility in women, as well as the possible mechanisms of disease as revealed by animal models.
Topics: Adrenal Gland Diseases; Animals; Autoimmune Diseases; Disease Models, Animal; Female; Humans; Infertility, Female; Mice; Ovarian Diseases; T-Lymphocytes, Regulatory; Transcription Factors; AIRE Protein
PubMed: 25327908
DOI: 10.1038/cmi.2014.97