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Cochrane Gynecology and Fertility

Jan Bosteels, Steven Weyers, Thomas M D'Hooghe, Helen Torrance, Frank J Broekmans, Su Jen Chua, Ben Willem J Mol
BACKGROUND: Observational evidence suggests a potential benefit with several anti-adhesion therapies in women undergoing operative hysteroscopy (e.g. insertion of an intrauterine device or balloon, hormonal treatment, barrier gels or human amniotic membrane grafting) for decreasing intrauterine adhesions (IUAs). OBJECTIVES: To assess the effectiveness of anti-adhesion therapies versus placebo, no treatment or any other anti-adhesion therapy, following operative hysteroscopy for treatment of female subfertility...
November 27, 2017: Cochrane Database of Systematic Reviews
Alexander Kotlyar, Julian Gingold, Shirley Shue, Tommaso Falcone
Tubal surgery is performed for a variety of indications in gynecology. Salpingectomy is the most aggressive form of tubal surgery and may be performed for potential risk reduction for epithelial ovarian cancer, sterilization, and ectopic pregnancy and as a method to enhance fertility in the setting of hydrosalpinx. Depending on the indication, alternatives include conservative therapy alone, tubal occlusion, and salpingostomy. However, aggressive tubal surgery may impact fertility and ovarian reserve because of its effects on adjacent ovarian tissue...
May 2017: Journal of Minimally Invasive Gynecology
Julie Brown, Karen Buckingham, William Buckett, Ahmed M Abou-Setta
BACKGROUND: Many women undergoing an assisted reproductive technology (ART) cycle will not achieve a live birth. Failure at the embryo transfer stage may be due to lack of good-quality embryo/s, lack of uterine receptivity, or the transfer technique itself. Numerous methods, including the use of ultrasound guidance for proper catheter placement in the endometrial cavity, have been suggested as more effective techniques of embryo transfer. This review evaluates the efficacy of ultrasound-guided embryo transfer (UGET) compared with 'clinical touch' (CTET), which is the traditional method of embryo transfer and relies on the clinician's tactile senses to judge when the transfer catheter is in the correct position...
2016: Cochrane Database of Systematic Reviews
Stephanie S Faubion, Kathy L MacLaughlin, Margaret E Long, Sandhya Pruthi, Petra M Casey
BACKGROUND: Care of the gynecologic cancer survivor extends beyond cancer treatment to encompass promotion of sexual, cardiovascular, bone, and brain health; management of fertility, contraception, and vasomotor symptoms; and genetic counseling. METHODS: This is a narrative review of the data and guidelines regarding care and surveillance of the gynecologic cancer survivor. We searched databases including PubMed, Cochrane, and Scopus using the search terms gynecologic cancer, cancer surveillance, and cancer survivor and reached a consensus for articles chosen for inclusion in the review based on availability in the English language and publication since 2001, as well as key older articles, consensus statements, and practice guidelines from professional societies...
November 2015: Journal of Women's Health
A Di Spiezio Sardo, R Campo, S Gordts, M Spinelli, C Cosimato, V Tanos, S Brucker, T C Li, M Gergolet, C De Angelis, L Gianaroli, G Grimbizis
STUDY QUESTION: How comprehensive is the recently published European Society of Human Reproduction and Embryology (ESHRE)/European Society for Gynaecological Endoscopy (ESGE) classification system of female genital anomalies? SUMMARY ANSWER: The ESHRE/ESGE classification provides a comprehensive description and categorization of almost all of the currently known anomalies that could not be classified properly with the American Fertility Society (AFS) system. WHAT IS KNOWN ALREADY: Until now, the more accepted classification system, namely that of the AFS, is associated with serious limitations in effective categorization of female genital anomalies...
May 2015: Human Reproduction
George A Vilos, Catherine Allaire, Philippe-Yves Laberge, Nicholas Leyland
OBJECTIVES: The aim of this guideline is to provide clinicians with an understanding of the pathophysiology, prevalence, and clinical significance of myomata and the best evidence available on treatment modalities. OPTIONS: The areas of clinical practice considered in formulating this guideline were assessment, medical treatments, conservative treatments of myolysis, selective uterine artery occlusion, and surgical alternatives including myomectomy and hysterectomy...
February 2015: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Trine E W Hyttel, Geske S Bak, Solveig B Larsen, Ellen C L Løkkegaard
The increasing use of de-torsion of the ovaries may result in re-torsion. This review addresses risk of re-torsion and describes preventive strategies to avoid re-torsion in pre-menarcheal girls, and fertile and pregnant women. We clinically reviewed PubMed, Embase, Trip and Cochrane databases. The main outcome measures were re-torsion and viability of ovary with fixation measures. A total of 38 publications including 71 girls, 363 fertile women, and 69 pregnant women were found to be relevant. All studies were case reports or case series, sometimes with non-randomized controls...
March 2015: Acta Obstetricia et Gynecologica Scandinavica
Sukhbir Sony Singh, Liane Belland
OBJECTIVE: This review provides an overview of therapeutic options, with a specific focus on the emerging role of medical options for UF management. RESEARCH DESIGN AND METHODS: PubMed, Google Scholar, and Cochrane Systematic Reviews were searched for articles published between 1980 and 2013. Relevant articles were identified using the following terms: 'uterine fibroids', 'leiomyoma', 'heavy menstrual bleeding', and 'menorrhagia'. The reference lists of articles identified were also searched for other relevant publications...
January 2015: Current Medical Research and Opinion
Gaity Ahmad, Fiona L Mackie, David A Iles, Helena O'Flynn, Sofia Dias, Mostafa Metwally, Andrew Watson
BACKGROUND: Adhesions are fibrin bands that are a common consequence of gynaecological surgery. They are caused by various conditions including pelvic inflammatory disease and endometriosis. Adhesions are associated with considerable co-morbidity, including pelvic pain, subfertility and small bowel obstruction. Patients may require further surgery-a fact that has financial implications. OBJECTIVES: To evaluate the role of fluid and pharmacological agents used as adjuvants in preventing formation of adhesions after gynaecological surgery...
July 9, 2014: Cochrane Database of Systematic Reviews
Jan Bosteels, Steven Weyers, Ben W J Mol, Thomas D'Hooghe
The aim of this study was to assess the effects of any anti-adhesion barrier gel used after operative hysteroscopy for treating infertility associated with uterine cavity abnormalities. Gynecologists might use any barrier gel following operative hysteroscopy in infertile women for decreasing de novo adhesion formation; the use of any barrier gel is associated with less severe de novo adhesions and lower mean adhesion scores. Nevertheless, infertile women should be counseled that there is at the present no evidence for higher live birth or pregnancy rates...
2014: Gynecological Surgery
Lixia Wu, Qianyu Wu, Lan Liu
To assess the effects of oral contraceptive pills (OCPs) for endometriosis in women after conservative surgery, we performed a search of PubMed, Embase, ISI Web of Science, Cochrane Library, Scidirect, Chinese VIP, CNKI and WANGFANG database. Randomized controlled trials (RCTs) of OCPs in postoperative medical therapy for endometriosis were collected. Articles published as of January 2013 with no language restriction were identified using defined keywords, and 15 studies comprising 1850 patients were included...
October 2013: Gynecological Endocrinology
Alison W Loren, Pamela B Mangu, Lindsay Nohr Beck, Lawrence Brennan, Anthony J Magdalinski, Ann H Partridge, Gwendolyn Quinn, W Hamish Wallace, Kutluk Oktay
PURPOSE: To update guidance for health care providers about fertility preservation for adults and children with cancer. METHODS: A systematic review of the literature published from March 2006 through January 2013 was completed using MEDLINE and the Cochrane Collaboration Library. An Update Panel reviewed the evidence and updated the recommendation language. RESULTS: There were 222 new publications that met inclusion criteria. A majority were observational studies, cohort studies, and case series or reports, with few randomized clinical trials...
July 1, 2013: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Salvatore Gizzo, Carlo Saccardi, Tito Silvio Patrelli, Stefania Di Gangi, Elisa Breda, Simone Fagherazzi, Marco Noventa, Donato D'Antona, Giovanni Battista Nardelli
OBJECTIVE: To investigate the most appropriate surgical technique for optimizing hemostasis and preservation of subsequent fertility after postpartum hemorrhage (PPH). DESIGN: Systematic review of the literature. SETTING: Not applicable. PATIENT(S): None. INTERVENTION(S): Review of MEDLINE, EMBASE, ScienceDirect, and the Cochrane Library. MAIN OUTCOME MEASURE(S): Comparison of the effectiveness of conservative surgical techniques, separately or together, with respect to success rate (ability to stop bleeding and preserve the uterus), fertility rate (subsequent pregnancies or the return of regular menstrual cycles), complication rate of the procedure, and the outcomes of subsequent pregnancies in terms of type of delivery and eventual delivery complications...
June 2013: Fertility and Sterility
Hervé Fernandez, Perrine Capmas, Jean Philippe Lucot, Benoit Resch, Pierre Panel, Jean Bouyer
STUDY QUESTION: Does treatment for the resolution of ectopic pregnancy (EP) affect subsequent spontaneous fertility [occurrence of an intrauterine pregnancy (IUP)]? SUMMARY ANSWER: There is no significant difference in 2 years subsequent fertility neither between methotrexate and conservative surgery for less active EP nor between conservative and radical surgery for the most active EP. WHAT IS KNOWN ALREADY: No randomized trial has compared radical and conservative surgery treatments...
May 2013: Human Reproduction
G Legendre, J-L Brun, H Fernandez
OBJECTIVE: To define the involvement of myomas and myomectomy in all stages from conception to post-partum in women of reproductive age. MATERIALS AND METHODS: A literature review was conducted using the Medline and Cochrane databases to March 2011 by matching the keywords "fertility, infertility, miscarriage, pregnancy, delivery" with "myomas, fibroids, myomectomy". RESULTS: An association between myomas and fertility has been observed but the responsibility fibroids in infertility remains unclear...
December 2011: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
Ling Han, Xiao-Yun Yang, Ai Zheng, Li Wang, Yan-Xia Chu, Yu Wang
OBJECTIVE: To review the effects of radical vaginal trachelectomy (RVT) and radical hysterectomy (RH) on overall progression-free survival rate, and intraoperative and postoperative complications in patients with cervical cancer (FIGO stage IA-IB1). METHODS: Electronic searches for studies of RVT and RH in the treatment of cervical cancer between 1994 and January 2010 were made on MEDLINE, the Cochrane Library, the China National Knowledge Infrastructure, and the Wan Fang dissertation database...
February 2011: International Journal of Gynaecology and Obstetrics
Deborah Robertson, Guylaine Lefebvre
OBJECTIVES: To review the etiology and incidence of and associative factors in the formation of adhesions following gynaecological surgery. To review evidence for the use of available means of adhesion prevention following gynaecological surgery. OPTIONS: Women undergoing pelvic surgery are at risk of developing abdominal and/or pelvic adhesive disease postoperatively. Surgical technique and commercial adhesion prevention systems may decrease the risk of postoperative adhesion formation...
June 2010: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
James M N Duffy, Neil Johnson, Gaity Ahmad, Andrew Watson
BACKGROUND: Hydrotubation with oil-soluble contrast media for unexplained infertility and adhesiolysis for infertility due to peritubal adhesions are primary procedures that are of recognised benefit. It is less clear whether postoperative procedures such as hydrotubation or second-look laparoscopy with adhesiolysis are beneficial following pelvic reproductive surgery. OBJECTIVES: To assess the value of postoperative hydrotubation and second-look laparoscopy with adhesiolysis following female pelvic reproductive surgery...
2009: Cochrane Database of Systematic Reviews
Sajal Gupta, Jeffrey M Goldberg, Nabil Aziz, Eric Goldberg, Natalie Krajcir, Ashok Agarwal
OBJECTIVE: To review the mechanisms by which endometriosis may affect reproductive function. DESIGN: Review of the English literature from 1986 to 2007 after searching Medline, EMBASE, Cochrane, and BIOSIS, as well as relevant meeting abstracts. SETTING: Fertility research center and obstetrics and gynecology department in a tertiary care hospital. RESULT(S): There is compelling evidence in the literature that endometriosis has detrimental effects on ovarian and tubal function and uterine receptivity, resulting in female infertility...
August 2008: Fertility and Sterility
Mostafa Metwally, Dylan Gorvy, Andrew Watson, Tin Chiu Li
OBJECTIVE: To investigate the role of hyaluronic acid-based fluid agents in the prevention of adhesions after fertility-preserving gynecological surgery. DESIGN: Meta-analysis. SETTING: The authors searched the Cochrane Menstrual Disorders and Subfertility Group Specialized Register of Controlled Trials, The Cochrane Central Register of Controlled Trials, MEDLINE, and EMBASE for randomized controlled trials of hyaluronic acid fluid agents compared with no treatment or placebo...
May 2007: Fertility and Sterility
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