Shieldshenson7642

The number of mature oocytes was similar between patients with localized (n = 75) and advanced (n = 66) lymphomas. Women with unfavorable combination of stage and biochemical factors had lower number of mature oocytes compared to patients with favorable combination 8 (5-10) versus 11 (7-16), respectively. Multivariate logistic regression showed that favorable levels of biochemical markers as well as a combination of extent and biochemical parameters were statistically significantly associated with the result of over 10 mature oocytes. CONCLUSION(S) Highly-aggressive lymphoid neoplasms have a negative impact on ovarian function and response during fertility preservation treatment. OBJECTIVE To examine the association between prior cancer treatments, medical comorbidities, and voluntary childlessness in reproductive-age women who are survivors of cancers diagnosed as adolescents and young adults (AYA survivors). DESIGN Cross-sectional analysis. UNC0379 price SETTING Participants were recruited from California and Texas cancer registries, fertility preservation programs, and cancer advocacy groups. PATIENT(S) Women (n = 413) ages 18-40 who were diagnosed with cancer between ages 15 and 35, completed primary cancer treatments, had at least one ovary, and were nulliparous. INTERVENTION(S) Cancer treatment gonadotoxicity and medical comorbidities. MAIN OUTCOME MEASURE(S) Voluntary childlessness. RESULT(S) The mean age of survivors was 31.8 years (SD, 4.9) with a mean of 6.5 years (SD, 4.4) since cancer diagnosis. Breast (26%), thyroid (19%), and Hodgkin lymphoma (18%) were the most common cancers. Twenty-two percent of the cohort was voluntarily childless. Medical comorbidities, cancer diagnosis, prior surgery, prior chemotherapy, and prior gonadotoxic treatments were not significantly associated with voluntary childlessness. In adjusted analysis, survivors of older reproductive age (adjusted odds ratio = 2.97 [1.71-5.18]) and nonheterosexual participants (adjusted odds ratio = 4.71 [2.15-10.32]) were more likely to report voluntary childlessness. CONCLUSION(S) A moderate proportion of AYA cancer survivors are voluntarily childless, but reproductive intentions were not related to cancer type or cancer treatments. AYA survivors of older age and nonheterosexual identification were more likely to be voluntarily childless. These data support assessing reproductive intentions and tailoring reproductive care such as fertility and contraception counseling that is appropriate for a survivor's intentions. OBJECTIVE To compare the effectiveness of different treatments for women with endometriosis-related infertility. DESIGN A systematic review and network meta-analysis of randomized controlled trials (RCTs). SETTING Not applicable. PATIENT(S) Women with endometriosis confirmed by laparoscopy with associated infertility. INTERVENTION(S) An extensive electronic search of the following databases Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, ClinicalTrials.gov, and Embase. MAIN OUTCOME MEASURE(S) Clinical pregnancy, live birth rate, miscarriage, and adverse events. RESULT(S) A total of 4,252 trials/abstracts were identified through the literature search, of which we included 36 trials in the systematic review and 26 trials reporting on 2,245 women with endometriosis-related infertility in the network meta-analysis. Network meta-analysis showed that compared with placebo, surgical laparoscopy alone (odds ratio = 1.63; 95% confidence interval, 1.13-2.35) or GnRH agonist alone (odds ratio = 1.68; 95% confidence interval, 1.07-2.46) results in higher odds of pregnancy. The evidence on the other interventions versus placebo or on the secondary outcomes including live birth, miscarriage, and adverse events is insufficient. CONCLUSION(S) The most important conclusion is that more RCTs are needed to clarify the relative effectiveness of treatments for endometriosis-related infertility, ideally comparing interventions to existing recommended interventions such as surgical laparoscopy. In addition, further RCTs comparing IVF and IUI to other treatments are essential. REGISTRATION NUMBER PROSPERO registration number, CRD42018087572. OBJECTIVE To demonstrate the feasibility of studying exosomes directly from peritoneal fluid, we isolated exosomes from endometriosis patient samples and from controls, and characterized their cargo. DESIGN Case-control experimental study. SETTING Academic clinical center. PATIENT (S) Women with and without endometriosis who underwent laparoscopic surgery (n = 28 in total). INTERVENTION (S) None. MAIN OUTCOME MEASURE (S) Concentration of exosomes within peritoneal fluid and protein content of the isolated exosomes. RESULT (S) Peritoneal fluid samples were pooled according to the cycle phase and disease stage to form six experimental groups, from which the exosomes were isolated. Exosomes were successfully isolated from peritoneal fluid in all the study groups. The concentration varied with cycle phase and disease stage. Proteomic analysis showed specific proteins in the exosomes derived from endometriosis patients that were absent in the controls. Five proteins were found exclusively in the endometriosis groups PRDX1, H2A type 2-C, ANXA2, ITIH4, and the tubulin α-chain. CONCLUSION (S) Exosomes are present in peritoneal fluid. The characterization of endometriosis-specific exosomes opens up new avenues for the diagnosis and investigation of endometriosis. OBJECTIVE To evaluate the effectiveness of intracytoplasmic sperm injection (ICSI) in improving fertilization rates compared to conventional in vitro fertilization rates (IVF) among women aged ≥38 years with a non-male factor diagnosis. DESIGN Systematic review and meta-analysis. SETTING Not applicable. PATIENT(S) Women aged ≥38 years with a non-male factor diagnosis receiving IVF or ICSI. INTERVENTION(S) A systematic review of databases including PubMed and Embase was performed. Study protocol was registered at the International Prospective Register of Systematic Reviews. Studies were selected if they compared fertilization rates from ICSI with those from conventional IVF among women aged ≥38 years with a non-male factor infertility diagnosis. A random effects model was used. Meta-analysis of Observational Studies in Epidemiology guidelines were applied. MAIN OUTCOME MEASURE(S) Fertilization rate. RESULTS Seven studies including 8796 retrieved oocytes (ICSI 4,369; IVF 4,427) with mean female age ≥38 years met the inclusion criteria.