Catecholamine-O-methyl transferase (COMT) catalyzes the O-methylation of catechol-structured compounds such as catecholamines and catecholestrogens. A genetic variation in the human COMT gene (rs4680 or Val158Met) significantly reduces three-to-four-fold catecholamine metabolism and influences neurotransmitter levels, thereby modulating preeclampsia (PE) susceptibility. The present meta-analysis was conducted to evaluate the link between the COMT Val158Met variant and PE risk. Case-control studies published until November 20, 2025 were systematically searched from PubMed, Google Scholar, and Web of Science databases. To assess the association between the COMT Val158Met variant and PE, Odds ratios and 95% confidence intervals were calculated under three genetic models. The results indicated no significant association between the COMT Val158Met variant and PE risk across three genetic models, including the allele (Met vs. Val: Overall OR 1.19, 95% CI 1.00-1.43, P = 0.052), recessive (Met/Met + Met/Val vs. Val/Val: Overall OR 1.16, 95% CI 0.95-1.40, P = 0.137), and dominant (Met/Met vs. Met/Val + Val/Val OR 1.39, 95% CI 0.97-2.00, P = 0.075) models. Furthermore, subgroup analyses based on ethnicity also indicated no association between the Val158Met variant and PE risk in Caucasian and Asian populations. Sensitivity analyses conducted using the leave-one-out method revealed that the results are robust. Asymmetry observed in Begg's funnel plot indicated a significant publication bias in the dominant model (P = 0.012). In summary, results showed that the COMT Val158Met variant is not associated with PE risk. As this meta-analysis contradicts the biological plausibility that COMT alleles influence catecholamine neurotransmitters and PE, the results warrant careful interpretation and further investigation.
OBJECTIVE:The aim of this pilot study was to evaluate and compare the diagnostic accuracy of digital vaginal examination versus intrapartum ultrasound (IUS) during the first and second stages of labor in women with cephalic presentation. MATERIALS AND METHODS:This prospective comparative study was conducted at the Department of Gynecology and Obstetrics, L. Pasteur University Hospital in Košice. The cohort included parturients (regardless of parity) with regular uterine contractions, cephalic presentation, and ruptured membranes. To ensure high data quality, all ultrasound examinations were performed by senior obstetricians with at least 8 years of clinical experience. Examining obstetricians were blinded to each other's findings. The assessment focused on fetal position, head position, head station, and progression during labor. IUS included a transabdominal approach (head position) and a transperineal approach, measuring head-perineum distance and angle of progression. In cases of discrepancy, the ultrasound finding was considered the reference standard. RESULTS:A total of 47 patients were included. Agreement between IUS and VE across all parameters was observed in 27 cases (57%). Discrepancies were noted in 20 patients (43%), with the most frequent errors occurring in the assessment of fetal head position. The statistical superiority of ultrasound over digital examination was highly significant (P < 0.0001). Presence of a caput succedaneum was a major confounding factor, which was present in 45% of non-correlated cases. The caesarean section rate in the cohort was 21% (N = 10). CONCLUSION:While vaginal examination remains the global gold standard in routine obstetrics, it is inherently subjective and prone to inter-observer variability. Our findings suggest that intrapartum ultrasound provides a more objective, accurate, and reproducible assessment. Incorporating IUS into labor management may reduce the need for frequent digital examinations, potentially lowering the risk of chorioamnionitis and enhancing patient comfort while optimizing clinical decision-making.
BACKGROUND:To investigate risk factors and clinical characteristics of recurrent ectopic pregnancies. The study specifically aims to compare demographic data, laboratory findings, and reproductive histories between patients with single and recurrent episodes to identify predictors for secondary prevention. METHODS:From December 2007 to December 2011, 199 women with single ectopic pregnancy and 51 women with recurrent ectopic pregnancy were identified from our hospital records. The information collected for each woman included age, smoking status, recurrent time, signs and symptoms, laboratory findings, and treatment parameters. RESULTS:The recurrence rate was 20.4%. Mean age was comparable between groups (30.2 ± 4.9 vs. 30.5 ± 5.7 years, P = 0.800). Gravidity was significantly higher in the recurrent group (3.4 ± 1.8 vs. 2.8 ± 1.5, P = 0.028), and gravida ≥ 4 was more frequent among recurrent cases (43.1 vs. 28.1%, P = 0.030). A history of abortion was significantly more common in the recurrent group (45.1 vs. 18.1%, P = 0.001), corresponding to an approximately fourfold increased risk (OR 3.9, 95% CI 1.7-7.9). Serum b-hCG levels were significantly higher in recurrent cases (5,135.8 ± 5,230 vs. 3,153.0 ± 5,643 mIU/mL, P = 0.040). b-hCG > 4,000 mIU/mL was more frequent in the recurrent group (33.3 vs. 18.1%, P = 0.017), whereas b-hCG levels between 2,001-4,000 mIU/mL were less frequent (7.8 vs. 23.1%, P = 0.015). Smoking status, intrauterine device use, prior cesarean section, ultrasonographic localization, rupture rates, treatment modalities, and complication rates did not significantly differ between groups (P > 0.05). In a multivariate analysis, only a history of abortion remained an independent predictor of recurrent ectopic pregnancy (OR 3.01, 95% CI 1.499-6.043, P = 0.002). CONCLUSION:When ectopic pregnancy is diagnosed early and appropriate treatment modality is selected, morbidity, mortality, radical intervention rate, and treatment costs are significantly reduced. Therefore, women of reproductive age should be informed about ectopic pregnancy symptoms by clinicians to increase community awareness. Moreover, for successful secondary prevention, identification of modifiable risk factors for recurrent ectopic pregnancy is important.
This article reviews current surgical options for treatment of stress urinary incontinence (SUI), focusing on Single Incision Sling (SIS) systems and the effect of infiltration anesthesia on implant fixation within the obturator complex. By analyzing the current literature, this study highlights the advantages of minimally invasive approaches - such as reduced surgical burden, shorter recovery time, and lower economic costs - while identifying their limitations in long-term efficacy. Anatomical and technical factors responsible for failure of different generations of SIS are discussed, particularly inadequate fixation and incompatibility with variable pelvic dimensions. Special attention is paid to infiltration anesthesia, which can alter tissue perfusion and cause local tissue loosening, thereby reducing anchor stability. Despite the procedural advantages of SIS, the retropubic approach remains the gold standard due to its higher long-term success rate and stability. The article emphasizes the importance of individualized surgical planning and calls for further studies aimed at optimizing both minimally invasive techniques and anesthetic protocols. It also emphasizes initial conservative therapy and the use of bulking agents to treat SUI.
OBJECTIVE:To evaluate whether intraovarian infusion of autologous adipose-derived mesenchymal stem cells (MSCs) improves ovarian reserve parameters and oocyte retrieval outcomes in women with poor ovarian response. MATERIALS AND METHODS:This retrospective pre-post cohort study included 29 women aged 25-40 years who met the European Society of Human Reproduction and Embryology (ESHRE) criteria for poor ovarian response and had experienced at least one previous Assisted Reproductive Technology (ART) cycle without oocyte retrieval. A total of 1 × 10⁶ autologous adipose-derived MSCs were laparoscopically infused into four cortical quadrants of each ovary. Serum anti-Müllerian hormone (AMH) levels were measured at baseline and 2 months after treatment. Controlled ovarian stimulation using a gonadotropin-releasing hormone (GnRH) antagonist protocol was initiated two months post-infusion, followed by oocyte retrieval. Paired comparisons were performed using the Wilcoxon signed-rank test. Multivariable linear regression evaluated factors associated with change in AMH (DAMH), and binomial logistic regression assessed predictors of successful oocyte retrieval. RESULTS:Serum AMH levels increased significantly following MSC therapy. Median AMH rose from 0.01 ng/mL (0.01-0.02) to 0.02 ng/mL (0.01-0.04) (P = 0.001). No baseline demographic or clinical variables were independently associated with DAMH (all P > 0.05). DAMH was the only variable significantly associated with successful oocyte retrieval (likelihood ratio c² = 6.54, P = 0.011). Higher DAMH values corresponded to progressively increased predicted probabilities of oocyte retrieval. CONCLUSION:Intraovarian administration of autologous adipose-derived MSCs was associated with modest but significant improvements in AMH levels and oocyte retrieval probability. These exploratory findings warrant confirmation in larger prospective controlled studies with definitive reproductive endpoints.
Ectopic adrenal tissue (EAT) is a rare developmental anomaly most frequently observed along the genitourinary tract, usually in pediatric males. Its persistence into adulthood, particularly within the fallopian tube, is exceedingly uncommon. We present the case of a 43-year--old woman who underwent total laparoscopic hysterectomy and bilateral salpingectomy for symptomatic uterine leiomyomas. Histopathologic examination incidentally revealed a well-circumscribed nodule in the right fallopian tube composed of polygonal cells with clear cytoplasm, morphologically resembling adrenal cortical tissue. Immunohistochemical staining demonstrated strong positivity for inhibin and calretinin, confirming the diagnosis of an ectopic adrenal cortical rest. No clinical or biochemical evidence of hormonal hyperfunction was noted. This rare finding expands the limited body of literature on fallopian tube EAT, emphasizing the importance of recognizing this entity to avoid misdiagnosis with metastatic clear cell lesions.
OBJECTIVE:The aim of this review study is to commemorate the 150-year history of Hlávka's Maternity Hospital in Prague, to analyze its historical development, and to highlight the contributions of key individuals who played a major role in the advancement of Czech obstetrics, gynecology, neonatology, and perinatology. STUDY DESIGN:A narrative review based on the analysis of published primary sources, memoirs of prominent physicians, and available secondary literature. METHODS AND RESULTS:Numerous studies have addressed various aspects of the history of the Apolinář Maternity Hospital, ranging from the early development of obstetric care in Prague through construction of the original Provincial Maternity Hospital and its subsequent evolution during the Habsburg Monarchy, the First Czechoslovak Republic, the Protectorate period, Communist Czechoslovakia, and the contemporary Czech Republic. However, apart from the extensive monograph authored by the present authors, a comprehensive synthetic study of this kind has been lacking. The present article summarizes the principal historical stages in the development of the institution and places them within a broader medical, academic, and social context. Particular attention is devoted to the physicians and scholars whose work significantly influenced the development of Czech obstetrics and gynecology. CONCLUSION:Hlávka's Maternity Hospital at Apolinář in Prague represents a unique healthcare, scientific, and educational institution. It ranks among the world's longest continuously operating maternity hospitals, and its significance extends far beyond the boundaries of Czech obstetrics and gynecology. For 150 years, it has maintained continuity in clinical care, medical education, and scientific advancement despite profound political and social changes, including the periods of Nazi occupation and Communist rule.
OBJECTIVE:To assess dynamic thiol-disulfide homeostasis as a biomarker of oxidative stress in patients with endometrial cancer and to evaluate its association with tumor grade and stage. METHODS:This prospective case-control study included 35 patients with histopathologically-confirmed endometrial cancer and 36 age-matched healthy controls. Venous blood samples were obtained after overnight fasting. Serum thiol-disulfide homeostasis parameters were measured using a fully-automated spectrophotometric method. Native thiol, total thiol, disulfide concentrations, and related ratios were analyzed. Tumor grade and International Federation of Gynecology and Obstetrics stage were recorded for all patients. RESULTS:Native thiol and total thiol levels were significantly lower in patients with endometrial cancer compared with healthy controls (both P < 0.001). Patients with grade 2 tumors exhibited significantly reduced native and total thiol levels compared with grade 1 patients and controls (P < 0.001). A significant inverse correlation was observed between tumor stage and thiol levels, with lower native and total thiol concentrations in stage IB compared with stage IA disease (R = -0.586, and R = -0.604, resp.; P < 0.001). Disulfide levels and thiol-disulfide ratios did not differ significantly between groups. CONCLUSION:Dynamic thiol-disulfide homeostasis is markedly impaired in endometrial cancer and is associated with tumor grade and stage. Reduced thiol levels reflect increased oxidative stress and diminished antioxidant capacity, suggesting that thiol-based redox parameters may serve as complementary biomarkers for disease severity and progression in endometrial cancer.
INTRODUCTION:Intrauterine administration of platelet-rich plasma (PRP) is a technique currently under intensive investigation. PRP therapy has the potential to play a complementary role in treatment protocols for women with a thin endometrium or a history of recurrent implantation failure (RIF). The principle of PRP is based on the release of multiple biologically active factors (e. g., cytokines, growth factors) following administration, which initiate reparative processes such as the synthesis of new connective tissue or revascularization. A major advantage of PRP therapy is its favorable safety profile, as no serious adverse effects have been reported to date. In the following study, we summarize our clinical experience with intrauterine PRP administration at our IVF center. The aim of this study was to evaluate the effect of PRP on the clinical pregnancy rate in women with recurrent implantation failure. MATERIALS AND METHODS:A retrospective data analysis was performed. Between January 2021 and December 2024, intrauterine PRP was administered to 45 women with a history of recurrent implantation failure. PRP was applied intrauterinely via a catheter with a volume of 0.5-1 mL using two different protocols. Protocol A consisted of a single intrauterine PRP administration performed 2-5 days prior to embryo transfer. Protocol B included two administrations: the first on days 21-23 of the preceding cycle and the second on days 7-10 of the preparation cycle. The control group comprised of patients with RIF who underwent treatment at our clinic between January 2015 and December 2018 using a standard frozen embryo transfer protocol without PRP administration. RESULTS:Among the 45 women with RIF treated with PRP, clinical pregnancy was confirmed by ultrasound in 23 patients (51.1%). In the control group of 35 women, 10 clinical pregnancies were achieved (28.6%). Statistical analysis using a Pearson's Chi-square test demonstrated a P-value of 0.042, indicating statistical significance. Our findings therefore suggest that intrauterine PRP administration in patients with RIF is associated with a significantly higher clinical pregnancy rate compared to the standard protocol without PRP. These results indicate a potential beneficial effect of this adjunctive therapy on endometrial receptivity.
BACKGROUND AND AIM:Abnormal uterine bleeding (AUB) is a common gynecological complaint with significant clinical and quality--of-life implications. Accurate diagnosis of the underlying pathology is critical to guide management. While three-dimensional transvaginal ultrasonography (3D TVUS) offers non-invasive evaluation of the uterine cavity and myometrium, hysteroscopy remains the gold standard for direct visualization. This study evaluated the diagnostic performance of 3D TVUS and hysteroscopy in women presenting with abnormal uterine bleeding, using histopathology as the reference standard. METHODS:This prospective observational cross-sectional study included 80 women presenting with AUB at Cairo University Hospital between June 2021 and April 2023. All participants underwent 3D TVUS, office hysteroscopy, and histopathological evaluation where applicable. Formal comparative analysis with hysteroscopy was restricted to intracavitary lesions, while myometrial lesions were evaluated primarily by TVUS. Diagnostic performance metrics (sensitivity, specificity, PPV - positive predictive value, NPV - negative predictive value, and accuracy) were calculated for individual lesions, overall pathology versus normal, and endometrial cavity lesions. RESULTS:The mean age of participants was 38.6 ± 9.8 years; menorrhagia (30%) was the most common presentation. Endometrial polyps (20%), adenomyosis (17.5%), and intramural fibroids (15%) were the leading pathologies. TVUS showed superior performance for myometrial lesions, with the highest accuracy for intramural fibroids (92.5%). Hysteroscopy was more accurate for intracavitary lesions, particularly hyperplasia (97.5%) and intrauterine adhesions (98.8%). For overall pathology versus normal, TVUS demonstrated higher sensitivity (97.1%) and accuracy (93.8%), while hysteroscopy offered greater specificity (80.0%) but lower NPV (40.0%). CONCLUSION:3D TVUS and office hysteroscopy are complementary diagnostic modalities in AUB. TVUS is superior for myometrial lesions, while hysteroscopy remains more accurate for intracavitary pathology. A combined approach offers the most comprehensive diagnostic strategy, optimizing accuracy and minimizing unnecessary invasive procedures.
OBJECTIVE:Dührssen-Schuchardt incision is an extended vaginoperineal, deep lateral incision of the vagina, paracolpium, levator ani, and perineum represented by the expansion of the operating field during vaginal hysterectomy. MATERIALS AND METHODS:In 21 extremely overweight patients with premalignant (11) and malignant endometrial disease FIGO IA (10) and policomorbidities, total vaginal hysterectomy with a unilateral Dührssen-Schuchardt incision was performed. It was impossible to perform a laparotomic or laparoscopic procedure in any of the patients due to the mentioned comorbidities and polycomorbidities. RESULTS:There were no postoperative complications related to the surgical procedure and the surgical wound; all wounds healed per primam, and no late postoperative complications related to the surgical technique were recorded. CONCLUSION:Therefore, this approach to total vaginal hysterectomy with the help of a Dührssen-Schuchardt incision is certainly a "minimally invasive procedure."
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in fertile women, with an estimated prevalence of 10-15%. It is a heterogeneous disease characterized by a complex pathogenesis. Genetic predisposition, neuroendocrine regulation disorders, and environmental influences play a key role. Dysregulation of the hypothalamic-pituitary-ovarian axis occurs with subsequent chronic anovulation, hyperandrogenemia, and metabolic abnormalities. Phenotypic variability reflects different pathophysiological mechanisms - based on genomic association studies, three subtypes of PCOS can be distinguished: reproductive, metabolic, and indeterminate. PCOS is one of the main causes of female infertility and a risk factor for the development of cardiometabolic diseases. Objective: The aim of the article is to summarize current recommendations of the European Society of Human Reproduction and Embryology (ESHRE 2023) regarding the diagnosis and treatment of polyendocrine metabolic ovarian syndrome (PMOS) in patients with fertility disorders and to demonstrate their practical application through a selected clinical case.
OBJECTIVE:To describe the current epidemiology of overweight and obesity among pregnant women in Czechia in the context of demographic trends and basic perinatal outcomes. MATERIALS AND METHODOLOGY:The analysis was based on data from the National Reproductive Health Registry (NRRZ) from April 1 to September 30, 2025, focusing on 1st trimester BMI. Since April 1, 2025, the new Registry Report systematically records women's height and weight at the beginning and the end of pregnancy. First-trimester BMI and its associations with selected demographic characteristics (particularly age, education, and parity) and selected clinical indicators of pregnancy and delivery outcomes were evaluated. For comparison, data from the European Union Statistics on Income and Living Conditions (EU-SILC) and European Health Interview Survey (EHIS) were also used. A total of 23,573 women with complete 1st trimester BMI data were included in the analysis. RESULTS AND CONCLUSION:Among the 23,573 pregnant women with available BMI data, 53.4% were normal weight, 24.3% were overweight, and 17.7% were obese. Overweight and obesity were more frequent among older women, had lower educational attainment, and higher parity. Higher BMI was associated with an increased risk of preterm birth, foetal macrosomia, caesarean section, gestational hypertension, preeclampsia, and gestational diabetes. Overweight and obesity affect more than 40% of pregnant women in Czechia representing a significant risk factor for adverse perinatal outcomes. Systematic data collection allows, for the first time, a detailed national analysis and provides a basis for preventive interventions.
The aim of this article is to summarize current knowledge on performing biopsies using a core needle, which have become a routine method in gynecologic oncology. The text is based on international guidelines focusing on the selection of imaging techniques for navigation, selection of approach, indications, and contraindications of this method. Additionally, the article addresses recommendations to minimize the risk of bleeding, proper management of anticoagulant or antiplatelet therapy, and provides an overview of the biopsy technique. Finally, it includes recommendations for the required expertise of physicians performing biopsies to ensure maximum safety.
Pregnancies resulting from assisted reproductive technologies are associated with an increased risk of developing preeclampsia. Available data indicate that one of the risk factors is frozen embryo transfer in an artificial cycle. Assessment of the pulsatility index of the uterine artery along with maternal factors and serum biomarkers form the basis for preeclampsia screening in the 1st trimester. Current evidence suggests that the method of endometrial preparation for embryo transfer may influence uterine artery pulsatility index values, thereby affecting the estimation of preeclampsia risk.
This article reviews the issue of persistent vulvar pain and vulvodynia, which are common conditions in women of reproductive age. Vulvodynia is defined as chronic vulvar pain lasting at least 3 months with no identified cause. It is characterized by increased sensitivity of the vulvar and vestibular tissues, neuroproliferation, increased vascularization, and structural changes of the mucosa. In contrast, persistent vulvar pain is usually associated with a specific, identifiable underlying condition. Both types of pain may coexist and overlap. This article comments on the current classification of vulvar pain according to the consensus of international societies dealing with this condition. It also summarizes the principles of differential diagnosis and therapeutic options for the management of vulvar pain. Treatment should be based on a comprehensive multidisciplinary approach including local and systemic pharmacotherapy, physiotherapy, psychotherapy, and in selected cases, surgical interventions. This article focuses on novel and promising therapeutic modalities in the treatment of vulvodynia, particularly various types of laser therapy. The review is supplemented by a case report of a patient with chronic provoked vestibulodynia treated by laser vaporization.
OBJECTIVE:This study aims to compare the outcomes of laparoscopic hysterectomy (LH) and vaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) hysterectomy (vNH) in obese patients undergoing the procedure for benign gynaecological indications, with results classified according to obesity class (class I, II, and III). MATERIALS AND METHODS:We retrospectively reviewed the data of patients with a body mass index (BMI) ≥ 30 kg/m² who underwent either LH or vNH for benign indications at a tertiary teaching and research hospital between January 2020 and December 2024. RESULTS:A total of 134 patients (70 LH, 64 vNH) were included in this single-centre study. The median operative time was significantly longer in the vNH group (205 min vs. 178 min; P < 0.01). Overall, major complication rates were similar between the two groups. The most striking finding of the study was that in patients with class III obesity (BMI ≥ 40 kg/m²), the vNOTES approach significantly reduced the conversion rate to laparotomy compared to laparoscopy (0 vs. 23.5%; P = 0.035). CONCLUSION:Our study demonstrates that the most significant advantage of vNOTES surgery in obese patients undergoing benign hysterectomy is the reduction in the conversion rate to laparotomy, particularly within the class III obesity group. vNOTES statistically eliminated the risk of conversion to laparotomy compared to laparoscopy in patients with class III obesity (OR 0.08; 95% CI 0.00-0.91; P = 0.035). These findings underscore the importance of risk stratification based on patient BMI when selecting a minimally invasive surgical approach for obese patients.
OBJECTIVE:To provide an overview of the most important histopathological characteristics and biomarkers of endometrial carcinoma that have clinical relevance for prognosis, prediction of treatment response, and decision-making regarding adjuvant therapy. METHODS AND RESULTS:Endometrial carcinoma represents the most common malignancy of the female reproductive tract in developed countries. Disease prognosis is determined not only by the anatomical extent, but also by a number of non-anatomical factors. The histological tumour type, presence of lymphovascular space invasion, and specific patterns of myometrial invasion (such as the MELF pattern) play major roles. Current molecular classification divides endometrial carcinomas into four groups (POLEmut, MMRd, NSMP, and TP53mut), which differ in prognosis as well as in therapeutic response. Additional clinically applicable biomarkers include oestrogen and progesterone receptors, L1CAM, HER2, CA125, and HE4. Emerging research focuses on novel biomarkers such as TROP2, circulating tumour DNA (ctDNA), circular RNA (circRNA), tumour- -infiltrating lymphocytes (TILs), and folate receptor alpha (FRa). These markers enable more precise risk stratification and identification of patients suitable for targeted therapies. Integration of multiple biomarkers with clinicopathological parameters further enhances the accuracy of risk assessment and prediction of treatment response. CONCLUSION:Incorporating histopathological features and biomarkers into routine clinical practice allows for a more accurate estimation of prognosis and a more rational selection of adjuvant therapy. An increasing number of non-anatomical biomarkers are becoming an integral part of the decision-making algorithm in endometrial carcinoma management.
OBJECTIVE:The aim of the study is to obtain information on the possibilities and success rate of cryopreservation of human oocytes. In the Czech Republic, this method is used to prolong women's reproductive health to a limited extent due to low awareness among women and also due to the high cost of this method. MATERIALS AND METHODS:Ninety-three oocyte retrievals were evaluated in women with oocyte retrievals intended for vitrification and long-term storage to extend reproductive age. Clients were divided according to age into two groups: under 35 years old and over 35 years old. At the same time, each age group was divided into two groups according to the number of vitrified oocytes: under 4 oocytes and over 4 oocytes. Furthermore, the success rate of the oocyte vitrification method was compared with the success rate of oocyte vitrification in healthy anonymous donors. RESULTS:In order to obtain information on the success rate of the oocyte vitrification method, we evaluated the survival rate (SR), fertilization rate (FR) and utilization rate (UR) in each group. SR was 61.5-89.3%, with the lowest value in older clients with a low oocyte count. FR was 50.0-80.0%, where the lowest value was again seen in older clients with a low oocyte count. UR was 34.9-75.0%, where the lowest value was seen in the group of older clients with a higher vitrified oocyte count compared to the other groups. CONCLUSION:In conclusion, the age at the time of oocyte freezing and the number of stored oocytes remain the two key factors that determine the success rate to secure the possibility of having a child in the future.
AIM:To analyze the relationship between the fibroblast growth factor soluble receptor 1 (sFlt-1/PlGF) ratio and adverse perinatal outcomes. MATERIALS AND METHODS:Patients admitted between 22+0 and 34+6 weeks of gestation from February 2024 to June 2025 were included. The sFlt-1/PlGF ratio was measured and its relationship to pregnancy outcome was evaluated. We assessed whether patients with increased sFlt-1/PlGF ratios developed conditions leading to preterm birth (spontaneous or iatrogenic). RESULTS:A total of 78 patients were included, of whom 47 delivered before 37 weeks of gestation and 31 after 37 weeks. The sFlt-1/PlGF ratio appeared significant in relation to the risk of preterm birth. Almost all women with an sFlt-1/PlGF ratio above 100 delivered before 37 weeks. Based on the collected data, we developed a model to estimate the probability of delivery within 3 or 7 days. The model showed low sensitivity (0.32 and 0.53), but high specificity (0.91 in both cases). It accurately identified patients who would not deliver within 3 or 7 days. CONCLUSION:The sFlt-1/PlGF ratio is a useful tool in assessing the further course of pregnancy.
