Menstrual bleeding and spotting with the Levonorgestrel Intrauterine System (52 mg) during the first-year post-insertion: a systematic review and meta-analysis.

Abstract: Changes in menstrual bleeding concern many users of the 52 mg Levonorgestrel Intrauterine System (LNG-IUS). Prescribing information for LNG-IUS devices describe an overall decrease in bleeding and spotting days […]

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Association of the Eukaryotic Vaginal Virome with Prophylactic Antibiotic Exposure and Reproductive Outcomes in a Subfertile Population Undergoing In Vitro Fertilization: A Prospective Exploratory Study.

Abstract: The objective of this study was to use high-throughput sequencing to describe the vaginal eukaryotic DNA virome in patients undergoing in vitro fertilization (IVF) to examine associations between the […]

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Undetectable Equals Untransmittable (U=U): Implications for Preconception Counseling for Human Immunodeficiency Virus Serodiscordant Couples.

Abstract: Although limited by society guidelines from the American Society for Reproductive Medicine and the Centers for Disease Control in the past, many human immunodeficiency virus serodiscordant American couples who […]

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Early life famine exposure to the Great Chinese Famine in 1959-1961 and subsequent pregnancy loss: a population-based study.

Abstract: To explore the relationship between famine exposure in early life and subsequent pregnancy loss, including stillbirth and spontaneous abortion, in adulthood.A population-based partially ecological study.Individual data of 58,601 females […]

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Gynecologic cancers in pregnancy: guidelines based on a third international consensus meeting.

Abstract: We aimed to provide comprehensive protocols and promote effective management of pregnant women with gynecological cancers. New insights and more experience have been gained since the previous guidelines were […]

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Preserving fertility in female patients with hematological malignancies: A multidisciplinary oncofertility approach.

Abstract: Oncofertility is a new interdisciplinary field at the intersection of oncology and reproductive medicine that expands fertility options for young cancer patients. The most common forms of hematological malignancies […]

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Adnexal Torsion in Adolescents: ACOG Committee Opinion No, 783.

Adnexal torsion is the fifth most common gynecologic emergency. The most common ovarian pathologies found in adolescents with adnexal torsion are benign functional ovarian cysts and benign teratomas. Torsion of malignant ovarian masses in this population is rare. In contrast to adnexal torsion in adults, adnexal torsion in pediatric and adolescent females involves an ovary without an associated mass or cyst in as many as 46% of cases. The most common clinical symptom of torsion is sudden-onset abdominal pain that is intermittent, nonradiating, and associated with nausea and vomiting. If ovarian torsion is suspected, timely intervention with diagnostic laparoscopy is indicated to preserve ovarian function and future fertility. When evaluating adolescents with suspected adnexal torsion, an obstetrician-gynecologist or other health care provider should bear in mind that there are no clinical or imaging criteria sufficient to confirm the preoperative diagnosis of adnexal torsion, and Doppler flow alone should not guide clinical decision making. In 50% of cases, adnexal torsion is not found at laparoscopy; however, in most instances, alternative gynecologic pathology is identified and treated. Adnexal torsion is a surgical diagnosis. A minimally invasive surgical approach is recommended with detorsion and preservation of the adnexal structures regardless of the appearance of the ovary. A surgeon should not remove a torsed ovary unless oophorectomy is unavoidable, such as when a severely necrotic ovary falls apart. Although surgical steps may be similar to those taken when treating adult patients, there are technical adaptations and specific challenges when performing gynecologic surgery in adolescents. A conscientious appreciation of the physiologic, anatomic, and surgical characteristics unique to this population is required.

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