Changes in Endometriosis-Associated Symptoms Following Immunization against SARS-CoV-2: A Cross-Sectional Study

Background: There are many reports about variations in the menstrual cycle after infection with SARS-CoV-2 or vaccination against it. However, data on SARS-CoV-2 infection or vaccination-related changes in menstruation-associated endometriosis-typical symptoms such as dysmenorrhea, dyspareunia, dyschezia, dysuria, and bloating are rare or missing. Methods: This retrospective study was performed as an online survey among employees and students at the University Hospital Ulm, Germany. Changes regarding the presence of mentioned symptoms and after immunization (vaccination and/or infection) were evaluated with the McNemar Test. Additionally, the risk factors associated with these changes and associations between a subjectively perceived general change in menstruation and changes in the symptoms were evaluated. Results: A total of 1589 respondents were included in the final analysis. Less than 4% of respondents reported the occurrence of new symptoms that they had not experienced before immunization. Overall, there was a significant reduction in the presence of dysmenorrhea, back pain, dyschezia, bloating, and dyspareunia after immunization against coronavirus (p Conclusions: Our results provide unique data about a reduction in the incidence of endometriosis-associated symptoms as dysmenorrhea, dyschezia, and dyspareunia after immunization against COVID-19

Fishing for (in)continence: long-term follow-up of women with OASIS–still a taboo

Purpose!#!Obstetric anal sphincter injuries (OASIS) increase the risk for pelvic floor dysfunctions. The goal of this study was to examine the long-term outcomes after OASIS on pelvic floor functions and quality of life.!##!Material and methods!#!Between 2005 and 2013, 424 women had an OASIS at the Women University Hospital Ulm. Out of these 71 women completed the German pelvic floor questionnaire, which includes questions regarding prolapse symptoms as well as bladder, bowel and sexual function. In addition, 64 women were physically examined, including a speculum examination to evaluate the degree of prolapse, a cough test to evaluate urinary stress incontinence (SI) and an evaluation of both pelvic floor sphincter (modified Oxford score) and anal sphincter contraction.!##!Results!#!A high rate of pelvic floor disorders after OASIS was found, as 74.6% of women reported SI, 64.8% flatus incontinence and 18.3% stool incontinence, respectively. However, only few women stated a substantial negative impact on quality of life. The clinical examination showed that a positive cough test, a weak anal sphincter tone and a diagnosed prolapse correlated with the results of the self-reported questionnaire.!##!Conclusion!#!On one hand, OASIS has an influence on pelvic floor function going along with lots of complaints, while on the other hand, it still seems to be a taboo topic, as none of the participants spoke about the complaints after OASIS with a doctor. Therefore, the gynecologist should actively address these issues and offer therapy options for the women with persisting problems

Comparison of in vitro- and chorioallantoic membrane (CAM)-culture systems for cryopreserved medulla-contained human ovarian tissue.

At present, there are three ways to determine effectively the quality of the cryopreservation procedure using ovarian tissue before the re-implantation treatment: evaluation of follicles after post-thawing xenotransplantation to SCID mouse, in-vitro culture in a large volume of culture medium under constant agitation and culture on embryonic chorio-allantoic membrane within a hen's eggs. The aim of this study was to compare the two methods, culture in vitro and culture on embryonic chorioallantoic membrane (CAM) of cryopreserved human ovarian medulla-contained and medulla-free cortex. Ovarian fragments were divided into small pieces (1.5-2.0×1.0-1.2×0.8-1.5) of two types, cortex with medulla and medulla-free cortex, frozen, thawed and randomly divided into the following four groups. Group 1: medulla-free cortex cultured in vitro for 8 days in large volume of medium with mechanical agitation, Group 2: medulla-containing cortex cultured in vitro, Group 3: medulla-free cortex cultured in CAM-system for 5 days, Group 4: medulla-containing cortex cultured in CAM-system. The efficacy of the tissue culture was evaluated by the development of follicles and by intensiveness of angiogenesis in the tissue (von Willebrand factor and Desmin). For Group 1, 2, 3 and 4, respectively 85%, 85%, 87% and 84% of the follicles were morphologically normal (P>0.1). The immunohistochemical analysis showed that angiogenesis detected by von Willebrand factor was lower in groups 1 and 3 (medulla-free cortex). Neo-vascularisation (by Desmin) was observed only in ovarian tissue of Group 4 (medulla-contained cortex after CAM-culture). It appears that the presence of medulla in ovarian pieces is beneficial for post-thaw development of cryopreserved human ovarian tissue. For medical practice it is recommended for evaluation of post-warming ovarian tissue to use the CAM-system as a valuable alternative to xenotransplantation and for cryopreservation of these tissues to prepare ovarian medulla-contained strips

Recurrent Miscarriage: Diagnostic and Therapeutic Procedures. Guideline of the DGGG, OEGGG and SGGG (S2k-Level, AWMF Registry Number 015/050).

Purpose Official guideline of the German Society of Gynecology and Obstetrics (DGGG), the Austrian Society of Gynecology and Obstetrics (ÖGGG) and the Swiss Society of Gynecology and Obstetrics (SGGG). The aim of this guideline was to standardize the diagnosis and treatment of couples with recurrent miscarriage (RM). Recommendations were based on the current literature and the views of the involved committee members. Methods Based on the current literature, the committee members developed the statements and recommendations of this guideline in a formalized process which included DELPHI rounds and a formal consensus meeting. Recommendations Recommendations for the diagnosis and treatment of patients with RM were compiled based on the international literature. Specific established risk factors such as chromosomal, anatomical, endocrine, hemostatic, psychological, infectious and immunological disorders were taken into consideration

Diagnostik und Therapie von Frauen mit wiederholten Spontanaborten. Leitlinie der DGGG, OEGGG und SGGG (S2k-Level, AWMF-Registernummer 015/050, Mai 2022)

Purpose The aim of this guideline is to standardize the diagnosis and therapy of recurrent miscarriage (RM) using evidence from the recent literature. This is done by using consistent definitions, objective evaluations and standardized treatment protocols. Methods When this guideline was compiled, special consideration was given to previous recommendations in prior versions of this guideline and the recommendations of the European Society of Human Reproduction and Embryology, the Royal College of Obstetricians and Gynecologists, the American College of Obstetricians and Gynecologists and the American Society for Reproductive Medicine, and a detailed individual search of the literature about the different topics was carried out. Recommendations Recommendations about the diagnostic and therapeutic procedures offered to couples with RM were developed based on the international literature. Special attention was paid to known risk factors such as chromosomal, anatomical, endocrinological, physiological coagulation, psychological, infectious and immune disorders. Recommendations were also developed for those cases where investigations are unable to find any abnormality (idiopathic RM).Ziel Ziel der vorliegenden Leitlinie ist es, die Diagnostik und Therapie von wiederholten Spontanaborten (WSA) anhand der aktuellen Literatur evidenzbasiert zu standardisieren. Dies erfolgt unter Verwendung einheitlicher Definitionen, objektivierter Bewertungsmöglichkeiten und standardisierter Therapieprotokolle. Methoden Die Erstellung dieser Leitlinie erfolgte unter besonderer Berücksichtigung der bisherigen Empfehlungen der Vorversionen dieser Leitlinie, den Empfehlungen der European Society of Human Reproduction and Embryology, des Royal College of Obstetricians and Gynecologists, des American College of Obstetricians and Gynecologists und der American Society for Reproductive Medicine sowie einer ausführlichen individuellen Literaturrecherche zu den jeweiligen Themen. Empfehlungen Es wurden Empfehlungen zur Diagnostik und Therapie von Paaren mit WSA anhand der internationalen Literatur erarbeitet. Insbesondere wurde auf die bekannten Risikofaktoren wie chromosomale, anatomische, endokrinologische, gerinnungsphysiologische, psychologische, infektiologische und immunologische Störungen eingegangen. Aber auch für die Fälle einer unauffälligen Abklärung (idiopathische WSA) wurden Empfehlungen erarbeitet

Vascularisation (von Willebrand factor expression) in cryopreserved medulla-containing ovarian tissue after in vitro and CAM-culture.

<p>Immonostained after in vitro (a, A) and CAM (b, B) culture. Bar = 0.25 mm.</p

Cryopreserved ovarian medulla-free and medulla-containing ovarian pieces after thawing and 8 days in vitro culture.

<p>(a, b) medulla-free piece, (a) just after thawing, (b) the same piece after culture, (c, d) medulla-containing piece, (c) just after thawing, (d) the same piece after culture. Bar = 1 mm.</p

Cryopreserved ovarian medulla-free and medulla-containing pieces before and after 5 days culture with chorioallantoic membrane (CAM) system.

<p>(a, b, c, d, e) medulla-free piece, (a, b) just after thawing and seeding on CAM marked by silicone ring, (c, d, e) the same piece after culture, (c) piece on CAM, (d, e) piece in Petri dish; (f, g, h, i, j) medulla-containing piece, (f, g) just after thawing and seeding on CAM marked by silicone ring, (h, i, j) the same piece after culture, (c) piece on CAM, (d, e) piece in Petri dish; (e) outer CAM-layer with medulla-free piece, (j) inner CAM-layer with medulla-containing piece. Different intensiveness of the avian vascularisation in the place of the seeding of pieces was noted: (e) versus (j). Bar = 1 mm.</p

Quality of follicles (expressed as quantity and percentage of normal follicles) after in vitro and CAM-culture of cryopreserved ovarian pieces.

<p>Respective rates are not statistical different (P>0.1).</p