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Adenomyosis

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7501. GnRH agonist and antagonist protocols for stage I-II endometriosis and endometrioma in in vitro fertilization/intracytoplasmic sperm injection cycles. (Abstract)

GnRH agonist and antagonist protocols for stage I-II endometriosis and endometrioma in in vitro fertilization/intracytoplasmic sperm injection cycles. To investigate the outcomes of intracytoplasmic sperm injection (ICSI) cycles after controlled ovarian hyperstimulation (COH) with GnRH antagonist or GnRH agonist (GnRH-a) in mild-to-moderate endometriosis and endometrioma.Prospective randomize trial.A private IVF center.A total of 246 ICSI cycles in 246 patients were divided into three groups (...) : women with mild-to-moderate endometriosis (n = 98); women who had ovarian surgery for endometrioma (n = 81); women with endometrioma and no history of previous surgery (n = 67).Patients in each group were randomized to COH with either triptrolein or cetrorelix.Clinical parameters, characteristics of COH, and ICSI results were analyzed.Outcomes of COH with both GnRH antagonist and GnRH-a were similar in patients with mild-to-moderate endometriosis. Implantation rates were 15.9% vs. 22.6% and clinical

2007 Fertility and sterility Controlled trial quality: uncertain

7502. Pain and ovarian endometrioma recurrence after laparoscopic treatment of endometriosis: a long-term prospective study. Full Text available with Trip Pro

Pain and ovarian endometrioma recurrence after laparoscopic treatment of endometriosis: a long-term prospective study. To identify prognostic factors for pain and endometrioma recurrence after complete laparoscopic excision of endometrioma(s).Prospective observational study.Tertiary care university hospital.One-hundred sixty-six consecutive women affected by uni- or bilateral ovarian endometrioma(s).Laparoscopic conservative treatment of endometriosis.Patient demographic characteristics (...) , surgical findings, and surgical results were prospectively recorded. Postoperative follow-ups were carried out every 3 months to identify pain and/or endometrioma recurrence for a minimum of 3 years.Dysmenorrheal, dyspareunia, and chronic pelvic pain recurred in 14.5%, 6%, and 5.4% of women, respectively. Prior surgery for endometriosis, adhesion extension, and use of ovarian stimulation drugs (OSD) were unfavorable prognostic factors for pain symptoms. Ovarian endometrioma recurred in 9.6% of cases

2008 Fertility and Sterility

7503. Does the diameter of an endometrioma predict the extent of pelvic adhesions associated with endometriosis? (Abstract)

Does the diameter of an endometrioma predict the extent of pelvic adhesions associated with endometriosis? To correlate ovarian endometrioma diameter with the extent of pelvic adhesions.Forty women with unilateral ovarian cysts thought to be endometriomas were prospectively recruited. The interventions were transvaginal ultrasound to measure the size of the ovarian endometrioma and a laparoscopic surgical procedure, including detailed pelvic assessment. Main outcome measures were pelvic (...) adhesion scores using the American Fertility Society revised classification of endometriosis.Thirty-two women met the inclusion criteria. Twelve had an endometrioma < 3 cm in diameter; 12, 3-5 cm; and 8, > 5 cm. Adhesion scores from various anatomic areas did not differ across these 3 groups. No correlation between the size of the endometrioma and associated pelvic adhesions was found using multiple regression analysis.The size of an endometrioma measured by transvaginal ultrasound does not correlate

2005 Journal of Reproductive Medicine

7504. Usefulness and limits of CA-125 in diagnosis of endometriosis without associated ovarian endometriomas. Full Text available with Trip Pro

Usefulness and limits of CA-125 in diagnosis of endometriosis without associated ovarian endometriomas. The aim of this study was to evaluate the diagnostic significance of CA-125 for endometriosis without ovarian endometriomas.Preoperative serum CA-125 levels were measured in 775 consecutive women diagnosed by laparoscopy or laparotomy with endometriosis, adenomyosis, leiomyomas, or normal pelvis.Receiver operating characteristic curve analysis revealed that the area under the curve (...) for endometriosis without endometriomas was 0.788, significantly smaller than that for endometriosis with endometriomas (0.935, P < 0.05). In diagnosis of endometriosis without endometriomas, both the maximal accuracy of 78.8% and the maximal diagnostic value of 61.2% were obtained at the cutoff value of 20 U/mL. Negative predictive value was 78.0% at the cutoff value of 20 U/mL, whereas positive predictive value was 92.9% at the cutoff value of 30 U/mL. This range is clearly superior to the empirical single

2005 Human Reproduction

7505. Associated ovarian endometriomas is a marker for greater severity of deeply infiltrating endometriosis. (Abstract)

Associated ovarian endometriomas is a marker for greater severity of deeply infiltrating endometriosis. To investigate whether an associated ovarian endometrioma is a marker for severity of deep infiltrating endometriosis (DIE).Observational study between June 1992 and December 2005.University tertiary referral center.Five hundred patients with histologically assessed DIE.Complete surgical exeresis of deep endometriotic lesions.Severity of the disease was quantified according to the mean number (...) of DIE lesions and the type of main lesion.In patients with associated ovarian endometrioma, the number of single isolated DIE lesions was statistically significantly lower (41.9% vs. 61.1%). The mean number of DIE lesions was statistically significantly higher in patients presenting with an associated ovarian endometrioma (2.51 +/- 1.72 vs. 1.64 +/- 1.0). For patients with associated ovarian endometrioma DIE lesions were more severe with an increased rate of vaginal, intestinal, and ureteral

2008 Fertility and Sterility

7506. Persistence of dysmenorrhea and nonmenstrual pain after optimal endometriosis surgery may indicate adenomyosis. (Abstract)

Persistence of dysmenorrhea and nonmenstrual pain after optimal endometriosis surgery may indicate adenomyosis. To evaluate whether persistence of pelvic pain after excision of endometriosis was associated with adenomyosis as defined by a thickened uterine junctional zone (JZ) on magnetic resonance (MR) imaging.Prospective clinical trial.Government research hospital.Fifty-three women with chronic pelvic pain.Preoperative MR imaging to measure uterine JZ thickness, surgical excision (...) <8 mm (VAS decreased 4.0 +/- 0.7, P<.0001). The association between dysmenorrhea and nonmenstrual pain reduction and thinner JZ remained after controlling for medical treatment.Following surgical excision of endometriosis, chronic pelvic pain was significantly more likely to persist with JZ thickness >11mm on preoperative MR imaging. This suggests that myometrial JZ abnormalities or adenomyosis may contribute to chronic pelvic pain in women with endometriosis.

2006 Fertility and sterility Controlled trial quality: uncertain

7507. Uterotubal transport disorder in adenomyosis and endometriosis--a cause for infertility. Full Text available with Trip Pro

Uterotubal transport disorder in adenomyosis and endometriosis--a cause for infertility. Uterine hyperperistalsis and dysperistalsis are common phenomena in endometriosis and may be responsible for reduced fertility in cases of minimal or mild extent of disease. Since a high prevalence of adenomyosis uteri has been well documented in association with endometriosis, we designed a study to examine whether hyperperistalsis and dysperistalsis are caused by the endometriosis itself (...) underwent T2-weighed magnetic resonance imaging (MRI) and hysterosalpingoscintigraphy (HSSG) during the subsequent menstrual cycle. MRI revealed the extent of the adenomyotic component of the disease and the integrity of uterotubal transport capacity was evaluated by HSSG.Influence of adenomyosis on uterotubal transport capacity in endometriosis.In 35 of the 41 subjects (85%) with endometriosis, signs of adenomyosis were detected using T2-weighed MRI. Two of six (33%) subjects with no adenomyosis (group

2006 BJOG

7508. Adenomyosis and endometriosis in the California Teachers Study. Full Text available with Trip Pro

Adenomyosis and endometriosis in the California Teachers Study. To evaluate the reproductive and lifestyle correlates of a surgically confirmed diagnosis of endometriosis or adenomyosis in a large prospective cohort.Collection of surgical diagnoses of endometriosis and adenomyosis during follow-up of women with no prior history of endometriosis and no prior surgery for adenomyosis.The California Teachers Study (CTS), an ongoing prospective study of female teachers and school administrators (...) established from the rolls of the California State Teachers Retirement System.Women with surgical diagnoses of endometriosis and adenomyosis were identified from California statewide hospital patient discharge records for CTS cohort members with an intact uterus and no prior history of endometriosis. Women with an incident surgical diagnosis of endometriosis (n = 229) or adenomyosis (n = 961) were compared with disease-free women in the same age range (for endometriosis, n = 43,493; for adenomyosis, n

2007 Fertility and Sterility

7509. Adenomyosis in endometriosis--prevalence and impact on fertility. Evidence from magnetic resonance imaging. Full Text available with Trip Pro

Adenomyosis in endometriosis--prevalence and impact on fertility. Evidence from magnetic resonance imaging. The hypothesis is tested that there is a strong association between endometriosis and adenomyosis and that adenomyosis plays a role in causing infertility in women with endometriosis. METHODS. Magnetic resonance imaging of the uteri was performed in 160 women with and 67 women without endometriosis. The findings were correlated with the stage of the disease, the age of the women (...) with endometriosis below an age of 36 years and fertile partners, the prevalence of adenomyosis was 90% (P<0.01)With a prevalence of up to 90%, uterine adenomyosis is significantly associated with pelvic endometriosis and constitutes an important factor of sterility in endometriosis presumably by impairing uterine sperm transport.

2005 Human Reproduction

7510. Association of two polymorphisms in the peroxisome proliferator-activated receptor-gamma gene with adenomyosis, endometriosis, and leiomyomata in Japanese women. (Abstract)

Association of two polymorphisms in the peroxisome proliferator-activated receptor-gamma gene with adenomyosis, endometriosis, and leiomyomata in Japanese women. The peroxisome proliferator-activated receptor-gamma (PPAR-gamma) is a nuclear hormone receptor that plays an important role in many diseases. This study investigated whether two polymorphisms (Pro12Ala in exon B and C161T in exon 6) of the PPAR-gamma2 gene are related to adenomyosis, endometriosis, or leiomyomata.A total of 390 (...) patients with adenomyosis, endometriosis, and/or leiomyomata were classified into four groups: 103 patients with adenomyosis (21 adenomyosis only and 82 adenomyosis with endometriosis and/or leiomyomata), 95 patients with endometriosis only, 100 patients with leiomyomata only, and 92 patients with endometriosis and leiomyomata.There was no association between distribution of genotype or allele frequencies for the PPAR-gamma Pro12Ala polymorphism and the presence of adenomyosis, endometriosis

2006 Journal of the Society for Gynecologic Investigation

7511. CYP17, CYP1A1 and COMT polymorphisms and the risk of adenomyosis and endometriosis in Taiwanese women. Full Text available with Trip Pro

CYP17, CYP1A1 and COMT polymorphisms and the risk of adenomyosis and endometriosis in Taiwanese women. The aim of the study was to test whether the COMT, CYP1A1 and CYP17 genes influence the risk of developing adenomyosis and endometriosis.We conducted two case-control studies, where the cases (n = 198) had either of the two diseases, and controls (n = 312) were disease-free women. For the COMT gene, we selected the G/A nonsynonymous single-nucleotide polymorphism (SNP) that leads to valine (...) -adjusted odds ratio of 3.2 (95% confidence interval 1.3-7.8; P = 0.006). The COMT gene, however, was not associated with endometriosis. Neither the CYP1A1 nor CYP17 genes had any significant association with either of the two diseases.The COMT gene significantly influences the risk of adenomyosis but not endometriosis. The present study does not provide evidence to support any of the three genes exerting pleiotropic effects on both diseases.

2006 Human Reproduction

7512. The migrating adenomyoma: past views on the etiology of adenomyosis and endometriosis. (Abstract)

The migrating adenomyoma: past views on the etiology of adenomyosis and endometriosis. This article discusses the history surrounding the debate on the etiopathology of endometriosis, specifically deep infiltrating endometriosis, and traces the controversies in its management that are as pertinent today as they were when the disease was first described in the late 19th and early 20th centuries.

2008 Fertility and Sterility

7513. Immunohistochemical expression of p53, MDM2, and p21Waf1 oncoproteins in endometriomas but not adenomyosis. (Abstract)

Immunohistochemical expression of p53, MDM2, and p21Waf1 oncoproteins in endometriomas but not adenomyosis. p53, MDM2, and p21Waf1 are oncoproteins that regulate the cell cycle. The purpose of this study was to examine the distribution of p53, MDM2, and p21Waf1 oncoprotein expression in endometriomas and in adenomyosis.Tissue samples from 25 women with pathologically confirmed endometriomas and 31 women with pathologically confirmed adenomyosis were analyzed. Expression of p53, MDM2 (...) , and p21Waf1 oncoproteins was assessed by immunohistochemical nuclear staining.p53, MDM2, and p21Waf1 expression were detected in 20%, 60%, and 80% of endometrioma tissue samples, respectively. All endometrioma tissue samples expressing p53 also tested positive for both MDM2 and p21Waf1. MDM2 expression was significantly higher in the proliferative than in the secretory phase of the cycle. In contrast, all 31 adenomyosis tissue samples were negative for p53, MDM2, and p21Waf1 expression.The expression

2005 Journal of the Society for Gynecologic Investigation

7514. Left lateral predisposition of endometriosis and endometrioma. (Abstract)

Left lateral predisposition of endometriosis and endometrioma. To evaluate lateral distribution of endometriosis and ovarian endometrioma in women with endometriosis. We evaluated operative reports of women who underwent laparoscopic treatment of endometriosis (n = 330) and ovarian endometrioma (n = 185) from January 1996 to January 2002. Data on all operative findings consisted of a written report, a diagram, the revised American Fertility Society classification of endometriosis (...) , and a printout of the dictated report. Endometriotic implants were confined to one side of the pelvis in 143 women and bilaterally in 187 others. Endometriosis was significantly more frequent in the left (64.3%) than in the right hemipelvis (P <.001, odds ratio 3.3, 95% confidence interval 2.0, 5.3). Of those with bilateral lesions, adhesions were also more frequently found on the left than on the right hemipelvis (16.6% versus 6.9%, P <.01, odds ratio 2.6, 95% confidence interval 1.3, 5.2). Endometrioma

2003 Obstetrics and Gynecology

7515. Laparoscopic Surgical Techniques for Endometriosis and Adenomyosis Full Text available with Trip Pro

Laparoscopic Surgical Techniques for Endometriosis and Adenomyosis The details of surgical techniques for laparoscopic removal of endometriosis and adenomyosis are described briefly in textbooks and gynaecological journal articles. We have described a wide variety of techniques for the various procedures required in the treatment of endometriosis and adenomyosis, excluding hysterectomy. The principles are based upon those used in removal of primary cancer lesions. The limitations of thermal

2000 Diagnostic and therapeutic endoscopy

7516. [Hormone replacement therapy in women with surgical treatment of endometriosis and adenomyosis: prospective and follow-up study. Part I]. (Abstract)

[Hormone replacement therapy in women with surgical treatment of endometriosis and adenomyosis: prospective and follow-up study. Part I]. To determine whether the initiation of estrogen replacement therapy (ERT) in the postoperative period increases the incidence of symptom recurrence following laparoscopic hysterectomy (LH) and/without bilateral salpingo-oophorectomy (BSO) for the treatment of endometriosis and adenomyosis.Prospective partially randomized patient preference follow up trial (...) (PRPPT).Department of Gynaecology, Endoscopic Training Centre, Kladno Hospital.Chart review of 286 consecutive patients who underwent LH and/or without BSO for endometriosis or adenomyosis between April 1994 and June 1999 and who subsequently received ERT. The methods of second phase of trial was prepared. The symptoms of recurrence in patients who started ERT after surgery and in those who did not start ERT (control group) will be compared and adjusted.Seventy-three percent had preoperative pelvic

2000 Ceská gynekologie / Ceská lékarská spolecnost J. Ev. Purkyne Controlled trial quality: uncertain

7517. Uterus didelphys with cervical agenesis associated with adenomyosis, a leiomyoma and ovarian endometriosis. A case report. (Abstract)

Uterus didelphys with cervical agenesis associated with adenomyosis, a leiomyoma and ovarian endometriosis. A case report. Elevated level of serum CA-125 was detected in a 48-year-old woman who was diagnosed with a lateral fusion defect in association with congenital agenesis of the uterine cervix. This unusual case combined two developmental anomalies of the müllerian duct.A 48-year-old woman consulted our outpatient department due to persistent abdominal pain for six months. Bimanual pelvic (...) examination showed absence of the cervix, an anteverted uterus and a 6-cm, left adnexal mass. Ultrasound and computed tomography revealed a uterus didelphys with a 3-cm cystic mass over the right ovary. Serum level of CA-125 was 641.4 U/mL. The patient underwent exploratory laparotomy, and total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. Pathology confirmed adenomyosis and a leiomyoma of the uterus with functional endometrium in conjunction with endometriosis of the right

2002 Journal of Reproductive Medicine

7518. Involvement of catalase in the endometrium of patients with endometriosis and adenomyosis. (Abstract)

Involvement of catalase in the endometrium of patients with endometriosis and adenomyosis. To determine the distribution of catalase in eutopic and ectopic endometria in patients with endometriosis or adenomyosis.Retrospective randomized study.Department of obstetrics and gynecology in a university hospital.Thirty-three patients with endometriosis, 36 with adenomyosis, and 47 fertile controls (total, 116 women).Semiquantitative immunostaining of endometrial cells obtained by biopsy sampling (...) , followed by calculation of an evaluation nomogram score.The score of catalase in the glandular epithelium of controls group fluctuated during the menstrual cycle; it was lowest in the early proliferative phase and peaked in the late secretory phase. In patients with endometriosis, catalase scores did not fluctuate during the cycle, and scores were high compared with controls throughout the menstrual cycle. Catalase scores did not vary in patients with adenomyosis, and scores in this group were

2002 Fertility and Sterility

7519. Gonadotropin-releasing hormone agonist and danazol normalize aromatase cytochrome P450 expression in eutopic endometrium from women with endometriosis, adenomyosis, or leiomyomas. (Abstract)

Gonadotropin-releasing hormone agonist and danazol normalize aromatase cytochrome P450 expression in eutopic endometrium from women with endometriosis, adenomyosis, or leiomyomas. To investigate whether GnRH agonists or danazol therapy normalizes estrogen metabolism in the eutopic endometrium of women with endometriosis, adenomyosis, or leiomyomas.Prospective clinical study.University hospital.Fifty-three women with endometriosis, adenomyosis, or leiomyomas.Patients received GnRH agonist (...) or danazol. Biopsy samples of the endometrium were obtained before and after endocrine therapy. Nontreated endometrial explants were cultured in the presence of either drug.Reverse transcription polymerase chain reaction-Southern blot and immunohistochemical analyses of the endometrial expression of aromatase cytochrome P450, estrogen receptor, progesterone receptor, and Ki-67. Nontreated endometrial explants were cultured in the presence of either drug.Messenger RNA and protein of aromatase cytochrome

2003 Fertility and Sterility

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