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Jännebring J, Liv P, Knuts M, Idahl A. Impact of patient-reported salpingitis on the outcome of hysterectomy and adnexal surgery: A national register-based cohort study in Sweden. Acta Obstet Gynecol Scand 2024; 103:1153-1164. [PMID: 38358021 PMCID: PMC11103142 DOI: 10.1111/aogs.14797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 01/18/2024] [Accepted: 01/21/2024] [Indexed: 02/16/2024]
Abstract
INTRODUCTION Salpingitis is caused by ascending microbes from the lower reproductive tract and contributes to tubal factor infertility, ectopic pregnancy, and chronic pelvic pain. The aim of this study was to analyze if the risk for complications and dissatisfaction after hysterectomy and adnexal surgery was increased in women reporting previous salpingitis. MATERIAL AND METHODS This is an observational cohort study including women undergoing gynecologic surgery from 1997 to 2020, registered in the Swedish National Quality Register of Gynecologic Surgery (GynOp). Patient-reported previous salpingitis was the exposure. Complications up to 8 weeks and satisfaction at 1 year postoperatively were the outcomes. Multivariable logistic regression and ordinal regression were performed. Results were adjusted for potential confounders including age, body mass index, smoking and year of procedure as well as endometriosis and previous abdominal surgery. Multiple imputation was used to handle missing data. RESULTS In this study, 61 222 women were included, of whom 5636 (9.2%) women reported a previous salpingitis. There was an increased risk for women reporting previous salpingitis in both the unadjusted and fully adjusted models to have complications within 8 weeks of surgery (adjusted odds ratio [aOR] 1.22, 95% confidence interval [CI] 1.14-1.32). The highest odds ratios were found for bowel injury (aOR 1.62, 95% CI 1.29-2.03), bladder injury (aOR 1.52, 95% CI 1.23-1.58), and postoperative pain (aOR 1.37, 95% CI 1.22-1.54). Women exposed to salpingitis were also more likely to report a lower level of satisfaction 1 year after surgery compared with unexposed women (aOR 0.87, 95% CI 0.81-0.92). CONCLUSIONS Self-reported salpingitis appears to be a risk factor for complications and dissatisfaction after gynecologic surgery. This implies that known previous salpingitis should be included in the risk assessment before gynecologic procedures.
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Affiliation(s)
- Josefin Jännebring
- Department of Clinical SciencesObstetrics and Gynecology, Umeå UniversityUmeåSweden
| | - Per Liv
- Department of Public Health and Clinical MedicineUmeå UniversityUmeåSweden
| | - Malin Knuts
- Department of Clinical SciencesObstetrics and Gynecology, Umeå UniversityUmeåSweden
| | - Annika Idahl
- Department of Clinical SciencesObstetrics and Gynecology, Umeå UniversityUmeåSweden
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Miao L, Xu L, Wang M, Xiong F, Zou L, Zhang Y, Weng M, Zeng H. Study on the influence of syphilis on the outcome of frozen-thawed embryo transfer in infertility patients. Heliyon 2024; 10:e29342. [PMID: 38628734 PMCID: PMC11019224 DOI: 10.1016/j.heliyon.2024.e29342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 04/04/2024] [Accepted: 04/05/2024] [Indexed: 04/19/2024] Open
Abstract
Objective In this study, the effect of in vitro Fertilization-Embryo Transfer (IVF-ET) on the clinical outcome of patients with syphilis infertility during resuscitation cycle. Methods A retrospective single-center method was adopted. This study included 4430 pairs of infertile patients who underwent syphilis detection. The influence of the syphilis freeze-thaw embryos transplantation outcome was studied in the patients with infertility by comparing the general clinical characteristics of patients (age, years of infertility, body mass index (BMI), basal follicle stimulating hormone (FSH), serum basal estradiol (Estradiol, E2), transplanted intimal thickness, the number of embryos transferred) and the clinical pregnancy (biochemical pregnancy rate, clinical pregnancy rate, implantation rate, live birth rate and abortion rate). Results Firstly, in the clinical outcome of one frozen-thawed embryos transfer, the live birth rate of the woman's syphilis-infected group was lower than that of the uninfected group (71.3 % vs. 50.0 %), while the abortion rate was higher than that of the uninfected group (7.8 % vs. 26.7 %), and there was a statistical difference (P < 0.05), and there was no statistical difference in other indicators between other groups (P > 0.05). Secondly, in the clinical outcome of two frozen-thawed embryos transfers, the biochemical pregnancy rate (61.3 % vs. 28.6 %) and clinical pregnancy rate (42.9 % vs. 14.3 %) of the group which was infected with syphilis alone were lower than those of the uninfected group (P < 0.05), and other indicators among the other groups showed no statistical difference (P > 0.05). Thirdly, in the clinical outcomes of frozen-thawed embryos transfer three times or more, there was no significant difference in the clinical indicators between the syphilis infertility patients and the non-infected infertility patients (P > 0.05). Conclusion When the syphilis infertility patients and the non-infected infertile patients underwent IVF-ET treatment for the first time, the live birth rate and abortion rate of the syphilis group were significantly different (P < 0.05). In the outcome of two transplants, the biochemical pregnancy rate and clinical Pregnancy rates were significantly reduced so patients with syphilis infertility who undergo IVF-ET should be informed about the risk of adverse clinical outcomes.
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Affiliation(s)
- Lixia Miao
- Wuxi Maternity and Child Health Care Hospital, Affiliated Women’s Hospital of Jiangnan University, Wuxi, 214002, Jiangsu, China
| | - Lishuang Xu
- Wuxi Maternity and Child Health Care Hospital, Affiliated Women’s Hospital of Jiangnan University, Wuxi, 214002, Jiangsu, China
| | - Min Wang
- Wuxi Maternity and Child Health Care Hospital, Affiliated Women’s Hospital of Jiangnan University, Wuxi, 214002, Jiangsu, China
| | - Fang Xiong
- Wuxi Maternity and Child Health Care Hospital, Affiliated Women’s Hospital of Jiangnan University, Wuxi, 214002, Jiangsu, China
| | - Lian Zou
- Wuxi Maternity and Child Health Care Hospital, Affiliated Women’s Hospital of Jiangnan University, Wuxi, 214002, Jiangsu, China
| | - Yun Zhang
- Wuxi Maternity and Child Health Care Hospital, Affiliated Women’s Hospital of Jiangnan University, Wuxi, 214002, Jiangsu, China
| | - Meiling Weng
- Wuxi Maternity and Child Health Care Hospital, Affiliated Women’s Hospital of Jiangnan University, Wuxi, 214002, Jiangsu, China
| | - Huiming Zeng
- Wuxi Maternity and Child Health Care Hospital, Affiliated Women’s Hospital of Jiangnan University, Wuxi, 214002, Jiangsu, China
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Shibuki S, Saida T, Hoshiai S, Ishiguro T, Sakai M, Amano T, Abe T, Yoshida M, Mori K, Nakajima T. Imaging findings in inflammatory disease of the genital organs. Jpn J Radiol 2024; 42:331-346. [PMID: 38165529 PMCID: PMC10980613 DOI: 10.1007/s11604-023-01518-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 11/20/2023] [Indexed: 01/03/2024]
Abstract
This review focuses on inflammatory diseases of female and male genital organs and discusses their epidemiology, pathogenesis, clinical presentation, and imaging findings. The female section covers pelvic inflammatory disease (PID) primarily caused by sexually transmitted infections (STIs) that affect the uterus, fallopian tubes, and ovaries. Unusual causes such as actinomycosis and tuberculosis have also been explored. The male section delves into infections affecting the vas deferens, epididymis, testes, prostate, and seminal vesicles. Uncommon causes such as tuberculosis, and Zinner syndrome have also been discussed. In addition, this review highlights other conditions that mimic male genital tract infections such as vasculitis, IgG4-related diseases, and sarcoidosis. Accurate diagnosis and appropriate management of these inflammatory diseases are essential for preventing serious complications and infertility. Imaging modalities such as ultrasound, magnetic resonance imaging, and computed tomography play a crucial role in diagnosis. Understanding the diverse etiologies and imaging findings is vital for the effective management of inflammatory diseases of the genital organs.
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Affiliation(s)
- Saki Shibuki
- Department of Radiology, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan
| | - Tsukasa Saida
- Department of Radiology, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Sodai Hoshiai
- Department of Radiology, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
| | - Toshitaka Ishiguro
- Department of Radiology, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Masafumi Sakai
- Department of Radiology, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Taishi Amano
- Department of Radiology, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan
| | - Tetsuya Abe
- Department of Radiology, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan
| | - Miki Yoshida
- Department of Radiology, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan
| | - Kensaku Mori
- Department of Radiology, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Takahito Nakajima
- Department of Radiology, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
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Kanthawang T, Pattamapaspong N, Peh WCG, Hammami N, Bouaziz MC, Ladeb MF. Imaging of infra-thoracic tuberculosis. Br J Radiol 2024; 97:492-504. [PMID: 38288505 DOI: 10.1093/bjr/tqad051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 11/16/2023] [Accepted: 11/29/2023] [Indexed: 03/01/2024] Open
Abstract
Tuberculosis (TB) is a potentially curable disease that is a leading cause of death globally. While it typically affects the lungs, this disease may involve many extra-pulmonary sites, particularly in patients with risk factors. Extra-pulmonary TB often mimics a variety of different diseases, posing a diagnostic dilemma. Imaging aids in early diagnosis of TB, especially in patients with non-specific or atypical symptoms found at extra-pulmonary infra-thoracic locations. Imaging also helps guide appropriate laboratory investigation, monitor disease progress, and response to treatment. This review aims to highlight the imaging spectrum of TB affecting the infra-thoracic region, that is, gastrointestinal tract, abdominal lymph nodes, peritoneal cavity, intra-abdominal solid organs, and urogenital system.
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Affiliation(s)
- Thanat Kanthawang
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Nuttaya Pattamapaspong
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Wilfred C G Peh
- Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Singapore 768828
| | - Nadia Hammami
- Department of Neuroradiology, National Institute of Neurology Mongi Ben Hamida, Tunis 1007, Tunisia
| | - Mouna Chelli Bouaziz
- Department of Radiology, Faculty of Medicine of Tunis, MT Kassab Institute of Orthopaedics, Tunis-El Manar University, Ksar Said, Tunis 2010, Tunisia
| | - Mohamed Fethi Ladeb
- Department of Radiology, Faculty of Medicine of Tunis, MT Kassab Institute of Orthopaedics, Tunis-El Manar University, Ksar Said, Tunis 2010, Tunisia
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Ribak R, Schonman R, Sharvit M, Schreiber H, Raviv O, Klein Z. Can the Need for Invasive Intervention in Tubo-ovarian Abscess Be Predicted? The Implication of C-reactive Protein Measurements. J Minim Invasive Gynecol 2020; 27:541-547. [DOI: 10.1016/j.jmig.2019.04.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 03/24/2019] [Accepted: 04/09/2019] [Indexed: 10/26/2022]
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Tang B, Wu K, Meng Q, Wang F. Comparison of the Analgesic and Anti-Inflammatory Effects of Xiaoyuningkun Decoction with Cynanchum Paniculatum and Fukeqianjin in a Mouse Model of Pelvic Inflammatory Disease. Med Sci Monit 2019; 25:9094-9102. [PMID: 31784502 PMCID: PMC6900919 DOI: 10.12659/msm.916070] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Preclinical and clinical studies have shown that the extract of Cynanchum paniculatum (bunge) kitag and the fukeqianjin formulation have beneficial effects in pelvic inflammatory disease (PID). This study aimed to compare the effects of Cynanchum paniculatum and fukeqianjin with a new decoction, xiaoyuningkun, consisting of Melia toosendan, Angelica biserrata, and Cynanchum paniculatum, in a mouse model of PID. MATERIAL AND METHODS The mouse model of PID included injection of the upper genital tract with hydrochloric acid (HCl) and lipopolysaccharide (LPS). The control group underwent sham treatment with 0.9% physiological saline. Cynanchum paniculatum, fukeqianjin, and xiaoyuningkun decoction were administered orally for 15 days. Acetic acid-induced writhing and thermal nociception hot plate tests evaluated the analgesic effects of treatment. Mouse uterus and Fallopian tubes were examined histologically to evaluate the degree of inflammation. Immunohistochemistry was used to measure the protein expression of intercellular adhesion molecule-1 (ICAM-1) and vascular endothelial growth factor (VEGF). Enzyme-linked immunosorbent assay (ELISA) measured serum levels of inflammatory cytokines. RESULTS Treatment with xiaoyuningkun decoction significantly reduced the pain threshold in the mouse model of PID and the degree of inflammation in the uterus and Fallopian tubes compared with Cynanchum paniculatum and fukeqianjin. Cynanchum paniculatum decoction significantly reduced the serum levels of interleukin-1ß (IL-1ß), tumor necrosis factor-alpha (TNF-alpha), ICAM-1, and VEGF, and the expression of ICAM-1 and VEGF in the mouse uterus and Fallopian tubes. CONCLUSIONS The new xiaoyuningkun decoction had analgesic and anti-inflammatory effects in the mouse model of PID, possibly by inhibiting ICAM-1, VEGF, and inflammatory cytokines.
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Affiliation(s)
- Bixin Tang
- Department of Traditional Chinese Medicine Gynecology, Shanghai Pudong New District Gongli Hospital, Second Military Medical University, Shanghai, China (mainland)
| | - Kunlun Wu
- Department of Traditional Chinese Medicine Gynecology, Shanghai Pudong New District Gongli Hospital, Second Military Medical University, Shanghai, China (mainland)
| | - Qingyi Meng
- Department of Traditional Chinese Medicine Gynecology, Shanghai Pudong New District Gongli Hospital, Second Military Medical University, Shanghai, China (mainland)
| | - Fang Wang
- Department of Traditional Chinese Medicine Gynecology, Shanghai Pudong New District Gongli Hospital, Second Military Medical University, Shanghai, China (mainland)
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Sun Y, Zhang J, Bai W. Higher Prevalence of Endometrial Polyps in Patients with Fallopian Tube Obstruction: A Case-control Study. J Minim Invasive Gynecol 2018; 26:935-940. [PMID: 30273685 DOI: 10.1016/j.jmig.2018.07.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 07/01/2018] [Accepted: 07/06/2018] [Indexed: 10/28/2022]
Abstract
STUDY OBJECTIVE To study the association between endometrial polyps and fallopian tube patency diagnosed by hysteroscopy, conventional histology, and 4-dimensional (4D) hysterosalpingo-contrast sonography (HyCoSy). DESIGN A case-control study (Canadian Task Force classification II-2). SETTING A university hospital. PATIENTS A total of 323 women of reproductive age underwent 4D HyCoSy and hysteroscopy between January 2015 and December 2017. INTERVENTION A retrospective analysis of the association of endometrial polyps and fallopian tube obstruction (n = 154) or patency (n = 169) in patients who underwent 4D HyCoSy. MEASUREMENTS AND MAIN RESULTS The prevalence of endometrial polyps was significantly higher in patients with bilateral fallopian tube obstruction than in patients with bilateral fallopian tube patency (42.9% [66/154] vs 20.1% [34/169], p <.0001). In univariate and multivariate analyses, the presence of endometrial polyps was found to be a risk factor for tubal obstruction with an odds ratio of 3.16 and 2.59, respectively. CONCLUSION The prevalence of endometrial polyps is higher in infertile patients with fallopian tube obstruction than in patients with fallopian tube patency. History of endometrial polyps, ectopic pregnancy, and pelvic inflammatory disease are risk factors for tubal obstruction.
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Affiliation(s)
- Yu Sun
- Department of Obstetrics and Gynecology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China (Drs. Sun and Bai)
| | - Jing Zhang
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China (Dr. Zhang)
| | - Wenpei Bai
- Department of Obstetrics and Gynecology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China (Drs. Sun and Bai).
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Song L, Tian L, Ma Y, Xie Y, Feng H, Qin F, Mo L, Lin S, Hou L, Wang C. Protection of flavonoids from Smilax china L. rhizome on phenol mucilage-induced pelvic inflammation in rats by attenuating inflammation and fibrosis. J Funct Foods 2017. [DOI: 10.1016/j.jff.2016.11.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
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Liu X, Bian S, Cheng X, Wang W, Tian Q, Zhang L, Zhang Y, Shi X, Zhang Y, Liang Z. Utility of T-cell interferon-γ release assays for the diagnosis of female genital tuberculosis in a tertiary referral hospital in Beijing, China. Medicine (Baltimore) 2016; 95:e5200. [PMID: 27858862 PMCID: PMC5591110 DOI: 10.1097/md.0000000000005200] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Diagnosis of female genital tuberculosis (FGTB) remains a challenge. The aim of this study was to evaluate the diagnostic value of T-SPOT.TB on peripheral blood mononuclear cells (PBMCs) for diagnosing FGTB in an area with high TB burden.Patients with suspected FGTB were enrolled consecutively between August 2010 and August 2015. T-SPOT.TB on PBMCs and histopathology were performed in all patients. T-SPOT.TB results were evaluated against patients' final diagnosis of FGTB which was made based on clinical manifestations, radiology, microbiological and histopathological evaluation, and response to anti-TB treatment. The sensitivity, specificity, predictive value, and likelihood ratio of T-SPOT.TB were analyzed.Among the 66 patients enrolled, 32 were diagnosed with confirmed FGTB, 33 with non-TB including ovarian tumor in 10 patients (30%), pelvic inflammatory diseases in 8 patients (24%), endometriosis in 7 patients (21%), endometrial polyps in 3 patients (9%), abscess of fallopian tube in 2 patients (6%), cyst of fallopian tube in 2 patients (6%), and endometrial carcinoma in 1 patient (3%). One patient with clinically indeterminate diagnosis was not included in the final analysis. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio, and negative likelihood ratio of T-SPOT.TB on PBMCs for diagnosis of FGTB were 94%, 70%, 75%, 92%, 3.09, and 0.09, respectively. Frequencies of spot forming cells (SFCs) of T-SPOT.TB were 430 (interquartile range [IQR] 155-706) SFCs/10 PBMCs and 124 (IQR 61-313) SFCs/10 PBMCs in FGTB and non-TB patients, respectively, and the difference was statistically significant (P = 2.14 × 10). By receiver operating characteristic curve analysis, a cutoff value of 40 SFCs/10 PBMCs of T-SPOT.TB had a sensitivity of 94% and specificity of 76% for the diagnosis of FGTB.T-SPOT.TB on PBMCs appeared to be a valuable and rapid diagnostic method for FGTB in TB endemic settings with high sensitivity and NPV.
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Affiliation(s)
- Xiaoqing Liu
- Department of Infectious Diseases, Peking Union Medical College Hospital
- Clinical Epidemiology Unit, International Epidemiology Network, Peking Union Medical College
- Correspondence: Xiaoqing Liu, Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China (e-mail: ; )
| | - Sainan Bian
- Department of Infectious Diseases, Peking Union Medical College Hospital
| | - Xinhe Cheng
- Department of Infectious Diseases, Peking Union Medical College Hospital
| | | | - Qinjie Tian
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Lifan Zhang
- Department of Infectious Diseases, Peking Union Medical College Hospital
- Clinical Epidemiology Unit, International Epidemiology Network, Peking Union Medical College
| | - Yueqiu Zhang
- Department of Infectious Diseases, Peking Union Medical College Hospital
| | - Xiaochun Shi
- Department of Infectious Diseases, Peking Union Medical College Hospital
| | - Yao Zhang
- Clinical Epidemiology Unit, International Epidemiology Network, Peking Union Medical College
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Chronic Pelvic Inflammation Diminished Ovarian Reserve as Indicated by Serum Anti Mülerrian Hormone. PLoS One 2016; 11:e0156130. [PMID: 27272680 PMCID: PMC4894572 DOI: 10.1371/journal.pone.0156130] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2016] [Accepted: 05/10/2016] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE To explore the potential damaging effect of chronic pelvic inflammation on ovarian reserve. DESIGN Case-control study. PATIENTS A total of 122 women with bilateral tubal occlusion, diagnosed by hysterosalipingography (HSG) and 217 women with normal fallopians were recruited. MEASUREMENTS Serum anti-Mullerian hormone (AMH), basic follicle-stimulating hormone (FSH), luteining hormone (LH), estradiol (E2), and testosterone (T) were measured; and antral follicle counts (AFCs) were recorded. RESULTS Significantly lower level of AMH was observed in women with bilateral tubal occlusion compared to control group [2.62 (2.95) ng/ml vs. 3.37 (3.11) ng/ml, P = 0.03], and the difference remained after adjustment of BMI (Padjust = 0.04). However, no statistical difference was found in the levels of FSH [7.00 (2.16) IU/L vs. 6.74 (2.30) IU/L], LH [4.18 (1.52) IU/L vs. 4.63 (2.52) IU/L], E2 [35.95 (20.40) pg/ml vs. 34.90 (17.85) pg/ml], T [25.07±11.46 ng/dl vs. 24.84±12.75 ng/dl], and AFC [6.00 (4.00) vs. 7.00 (4.00)] between two groups (p>0.05). CONCLUSIONS Women with bilateral tubal occlusion showed decreased AMH level, suggesting that chronic pelvic inflammation may diminish ovarian reserve. More caution should be paid when evaluating the detriment of PID on female fertility.
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Diagnosis and microecological characteristics of aerobic vaginitis in outpatients based on preformed enzymes. Taiwan J Obstet Gynecol 2016; 55:40-4. [DOI: 10.1016/j.tjog.2015.06.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2015] [Indexed: 11/23/2022] Open
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Wang J, Zhao X, Yuan P, Fang T, Ouyang N, Li R, Ou S, Wang W. Clinical Outcomes of In Vitro Fertilization among Chinese Infertile Couples Treated for Syphilis Infection. PLoS One 2015. [PMID: 26208116 PMCID: PMC4514756 DOI: 10.1371/journal.pone.0133726] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
To compare the clinical outcomes of infertile patients with and without syphilis after in vitro fertilization and embryo transfer (IVF-ET), in this case-control study, 320 infertile couples were enrolled and divided into syphilis (n = 160) and control groups (n = 160). The primary IVF outcomes were the clinical pregnancy rate and the birth of a healthy baby. All syphilis patients received the standard anti-syphilis treatment before undergoing IVF/ICSI. Our results showed that the endometrial thickness of the syphilis group was greater than that of the control group following hCG injection (16.9±5.4 vs. 13.0±4.7 mm, P<0.001). The numbers of normally fertilized eggs and normally cleaved fertilized eggs and the implantation rate were 6.8±4.8, 6.3±4.7 and 24.2%, respectively, for the syphilis group and 8.3±4.6, 8.1±4.6 and 34.4%, respectively, for the control group, and these values were significantly different between the groups. The clinical pregnancy rate was lower in the syphilis group compared with that in the control group (43.8% vs. 55.6%, P = 0.03). Lower offspring birth weight was observed in the infected male group compared with those in the infected female (2.7±0.4 vs. 3.0±0.4 kg, P = 0.01) and infected couple groups (2.7±0.4 vs. 3.1±0.5 kg, P = 0.007). Therefore, syphilis infection reduces the clinical pregnancy rate after IVF/ICSI.
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Affiliation(s)
- Jing Wang
- Reproductive Medicine Center, Department of Obstetrics & Gynecology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Xi Road, Guangzhou 510120, P. R. China
| | - Xiaomiao Zhao
- Reproductive Medicine Center, Department of Obstetrics & Gynecology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Xi Road, Guangzhou 510120, P. R. China
| | - Ping Yuan
- Reproductive Medicine Center, Department of Obstetrics & Gynecology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Xi Road, Guangzhou 510120, P. R. China
| | - Tingfeng Fang
- Reproductive Medicine Center, Department of Obstetrics & Gynecology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Xi Road, Guangzhou 510120, P. R. China
| | - Nengyong Ouyang
- Reproductive Medicine Center, Department of Obstetrics & Gynecology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Xi Road, Guangzhou 510120, P. R. China
| | - Ruiqi Li
- Reproductive Medicine Center, Department of Obstetrics & Gynecology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Xi Road, Guangzhou 510120, P. R. China
| | - Songbang Ou
- Reproductive Medicine Center, Department of Obstetrics & Gynecology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Xi Road, Guangzhou 510120, P. R. China
| | - Wenjun Wang
- Reproductive Medicine Center, Department of Obstetrics & Gynecology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Xi Road, Guangzhou 510120, P. R. China
- * E-mail:
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Lee SW, Rhim CC, Kim JH, Lee SJ, Yoo SH, Kim SY, Hwang YB, Shin SY, Yoon JH. Predictive Markers of Tubo-Ovarian Abscess in Pelvic Inflammatory Disease. Gynecol Obstet Invest 2015; 81:000381772. [PMID: 25926103 DOI: 10.1159/000381772] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Accepted: 03/18/2015] [Indexed: 02/28/2024]
Abstract
BACKGROUND/AIMS The purpose of this study was to identify predictive markers for tubo-ovarian abscess (TOA) through a comparison of clinical and laboratory data in patients diagnosed with pelvic inflammatory disease (PID). METHODS We reviewed the medical charts of 499 females who were admitted to hospital with clinical, surgical, imaging-based diagnoses of PID between 2001 and 2011. The patients were divided into the following two groups: (1) PID with TOA and (2) PID without TOA. RESULTS The TOA and non-TOA groups were comprised of 69 and 430 females, respectively. Mean age, history of intrauterine device (IUD) insertion and inflammatory markers, including erythrocyte sedimentation rate, C-reactive protein (CRP) and CA-125 levels, were higher in the TOA group than the non-TOA group. Independent factors that predicted TOA were older age, IUD insertion, increased CRP and CA-125, and chlamydia infection. CA-125 was found to have the highest predictive value for TOA. TOA size was associated with increased surgical therapy compared to patients with smaller abscesses. CONCLUSIONS Increased age, IUD insertion, chlamydia infection, and increased CRP and CA-125 level were the independent factors predictive of TOA in acute PID. These predictive values will be expected to help decrease gynecological morbidity by early diagnosis and appropriate treatment of TOA. © 2015 S. Karger AG, Basel.
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Affiliation(s)
- Suk Woo Lee
- Department of Obstetrics and Gynecology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
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Yildirim M, Turkyilmaz E, Avsar AF. Preoperative Neutrophil-to-Lymphocyte Ratio Has a Better Predictive Capacity in Diagnosing Tubo-Ovarian Abscess. Gynecol Obstet Invest 2015; 80:234-9. [DOI: 10.1159/000371762] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 12/26/2014] [Indexed: 11/19/2022]
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Joob B, Wiwanitkit V. Pelvic inflammatory disease in China. Gynecol Obstet Invest 2014; 77:272. [PMID: 24851818 DOI: 10.1159/000362232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 03/14/2014] [Indexed: 11/19/2022]
Affiliation(s)
- Beuy Joob
- Sanitation 1 Medical Academic Center, Bangkok, Thailand
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