“Conceiving” the pill : the 45th birthday of the oral contraceptive pill in Europe

In 1961, the first combined oral contraceptive pill was introduced in Europe. This pill contained ethinylestradiol (0.05mg) and northisterone (4mg). Nowadays, monophasic pill preparations contain a low dose (20­35 g) of ethinylestradiol in combination with a progestogen. Progestogens include norethisterone and levonorgestrel (second generation); desogestrel and gestodene (third generation); and the newest progestogen, drospirenone (fourth generation). Risks of the combined oral contraceptive pill include venous thromboembolism and stroke. Benefits, such as protection from ovarian and endometrial cancer, apart from contraception, outweigh the risks if contraindications are observed, and low dose formulations used.peer-reviewe

Future fertility of women cancer survivors : the progress in fertility preservation

Diminished ovarian reserve (DOR) has devastating implications for the affected female in terms of quality of life, fertility, fecundity and overall well-being. DOR can be exacerbated by the use of chemotherapy and gynaecological surgeries. Analysis of the gonadotoxicity and efficacy of chemotherapeutic regimens currently available and the techniques for gynaecological surgeries, allows for the most appropriate regimen or technique to be selected following a risk-benefit ratio analysis. This should be done in conjunction with fertility preservation strategies including cryopreservation, ovarian transposition and suppression, and pharmacological agents. New approaches using fertoprotective agents need to be evaluated in order to keep up with the demand for oncofertility. This ensures the least possible damage to the ovarian environment and the utmost preservation of the follicular pool.peer-reviewe

Seminal fluid in infertility : more than just a vehicle

Infertility, which affects 15 % of couples worldwide, is defined as failure of conception despite unprotected sexual intercourse during a period of more than twelve months. Focus on infertility studies has been taking place for decades, however, such spotlight was mostly given towards the female counterpart. Nevertheless, the male contributes up to 50 % of infertility cases.peer-reviewe

Skin ageing

Cutaneous ageing manifests itself as a progressive reduction in maximum function and reserve capacity of skin tissue. It is not a unique and uniform biological event. Skin comprises three layers: epidermis, dermis and subcutaneous tissue. Collagen atrophy is a major factor in skin ageing. There is a strong correlation between skin collagen loss and estrogen deficiency due to the menopause. Skin ageing, especially in the face, is associated with a progressive increase in extensibility and a reduction in elasticity. With increasing age, the skin also becomes more fragile and susceptible to trauma, leading to more lacerations and bruising. Furthermore, wound healing is impaired in older women. Estrogen use after the menopause increases collagen content, dermal thickness and elasticity, and it decreases the likelihood of senile dry skin. Large-scale clinical trials are necessary to help make informed recommendations regarding postmenopausal estrogen use and its role in the prevention of skin ageing.peer-reviewe

Novel applications of COX-2 inhibitors, metformin, and statins for the primary chemoprevention of breast cancer

Recent evidence shows that commonly prescribed drugs, such as non-steroidal anti-inflammatory drugs (NSAIDs), metformin, and statins, may have beneficial roles in the primary chemoprevention of breast cancer. Therefore, these drugs could potentially be used in addition to the hormonal drugs currently used for this purpose (namely, selective estrogen receptor modulators and aromatase inhibitors) due to their alternative mechanisms of action.peer-reviewe

New insights in Foetal Alcohol Syndrome : a literature review

Foetal Alcohol Syndrome falls under the umbrella of Foetal Alcohol Spectrum Disorders which are caused by prenatal alcohol exposure. Foetal Alcohol Syndrome is characterised by craniofacial abnormalities, central nervous system abnormalities and growth deficiencies. Alcohol consumption during pregnancy is teratogenic causing issues in multiple aspects of neurological development in the foetus. It is a vital preventable cause of mental disability in the West. The main craniofacial abnormalities that are present in Foetal Alcohol Syndrome include a thin vermillion border, short palpebral fissures and a smooth philtrum. Alcohol exposure can also cause various epigenetic changes in the developing foetus. This alters gene expression resulting in various abnormalities in different organs and may also affect future behaviour. Prenatal alcohol exposure also affects brain morphology and biochemistry. Alcohol alters survival, migration and function of various cells in the brain. It also alters the Gamma-Aminobutyric Acid system, a vital neurotransmitter system in the brain. Brain neovascularisation is also altered with consequences on brain perfusion. This literature review shall highlight various effects of alcohol on craniofacial development, epigenetics, glia, the gamma-aminobutyric system, neovascularisation, and cell death in the developing foetus.peer-reviewe

Bridging the gap between research and cure in rare gynecological cancers : where do we stand? Report from the GYNOCARE Conference in Naples (17th-18th February 2023)

The European Network for Gynecological Rare Cancer Research: from Concept to Cure (GYNOCARE COST Action CA18117), organized a two-day hybrid conference entitled: “Bridging the gap between Research and Cure in Rare Gynecological Cancers: where do we stand?”. This conference was held in the historic Aula Botazzi at the Luigi Vanvitelli University of Campania in Naples, Italy. The aim of this conference was to showcase new approaches to improve the diagnosis and treatment of rare gynecological cancers. There were 24 invited talks by high-profile international speakers organized over 3 sessions, followed by a final roundtable. The current state of the art, and even beyond the state of the art, in the field of basic and translational research in rare gynecological cancers have been presented. Ongoing and future innovative clinical trials for rare gynecological cancers have been also discussed with the aim of designing personalized cure. The basis of and advances in pathological diagnosis of rare gynecological cancers have been outlined. The ultimate aim was to bridge the gap between the pharmaceutical industry and biotechnology companies and translational research in rare gynecological cancers, to overcome challenges in this area. The conference focused on the complex interplay of factors that contribute to susceptibility, prevention, and management of gynecological cancers, providing an excellent discussion forum on the key challenges and the latest advancements that mostly promise to propel this field forward.peer-reviewe

Pro- and anti-inflammatory cytokines in threatened miscarriages

OBJECTIVE: The purpose of this study was to evaluate circulating and intracellular levels of Th1 and Th2 cytokines in women with threatenedmiscarriage (TM) and subsequent outcome. STUDY DESIGN: Plasma levels of tumor necrosis factor (TNF)-receptors 1 and 2, TNF , interferon gamma (IFN ), and interleukins (IL) -6 and -10 were measured by flow cytometric bead assays in 80 women with TM: 53 women with normal outcome and 27 women who miscarried. Fluorescent antibody labeling was also performed on whole blood in a subgroup of 27 women of TM: 16 women with normal outcome and 11 women who miscarried. RESULTS: Monocyte expression of TNF and circulating levels of TNF , IFN , IL-10, IL-6, and TNF-R1 were significantly lower, whereas circulating levels of TNF /IL-10, IFN /IL-10, and TNF /IL-6 ratios were significantly higher, in women with TM who subsequently miscarried, compared with the women with normal outcome. CONCLUSION: An increased Th1 type of immune response, which was similar to that observed in preterm delivery, was found in TM cases that were complicated by a subsequent miscarriage.peer-reviewe

Inflammatory Cytokines in Maternal Circulation and Placenta of Chromosomally Abnormal First Trimester Miscarriages

The impact of abnormal placental karyotype on the inflammatory response within the villous tissue and peripheral circulation of women with miscarriage was evaluated. Villous (n = 38) and venous blood samples (n = 26) were obtained from women with missed miscarriage. Tissue chromosome analysis indicated 23 abnormal and 15 normal karyotypes. Concentration of tumour necrosis factor alpha (TNFα), TNF-R1 and TNF-R2, and interleukin (IL)-10 were measured using flowcytometric bead array in fresh villous homogenate, cultured villous extracts, culture medium, maternal whole blood, and plasma. Plasma TNFα/IL-10 ratios were significantly (P < 0.05) lower in miscarriages with abnormal karyotype. In the abnormal karyotype group, there were significantly higher levels of TNFα (P < 0.01), IL-10 (P < 0.01), TNF-R1 (P < 0.001), and TNF-R2 (P < 0.001) in the villous extracts and culture-conditioned medium compared to normal karyotype group. In miscarriage with abnormal karyotype, there is an exacerbated placental inflammatory response, in contrast to miscarriage of normal karyotype where maternal systemic response is increased

COX isozymes and non-uniform neoangiogenesis : what is their role in endometriosis?

This literature review compared the efficacy in of NSAIDs with a placebo in pain relief and disease regression of endometriosis. Despite the poor evidence found, the results showed that NSAIDs were more effective in pain relief with regressive effects on the endometriotic lesions compared to placebo. We postulate herein that COX-2 is chiefly responsible for pain whilst COX-1 is responsible mainly for the establishment of endometriotic lesions. Hence, there must be a temporal difference in the activation of the two isozymes. We differentiated between two pathways in the conversion of arachidonic acid to prostaglandins by the COX isozymes referred to as ‘direct’ and indirect’, supporting our initial theory. Finally, we postulate that there are two stages of neoangiogenesis in the formation of endometriotic lesions; ‘founding’ that first establishes blood supply and ‘maintenance’ that upkeeps it This is fertile ground for further research in a niche that needs more literature. Its aspects may be diversely explored. The theories we propose offer information for a more targeted treatment of endometriosis.peer-reviewe