BackgroundEndometriosis, a prevalent chronic gynecologic disorder, significantly impacts women’s health, with both genetic and environmental factors contributing to its heritability. Within the adaptive immune system, the NOD-like receptors (NLR) pathway plays pivotal roles in various autoinflammatory diseases, regulating interleukins, proinflammatory cytokines, and NF-κB activity. However, the potential association between single nucleotide polymorphisms (SNPs) of the NOD1, NOD2, PYDC1, and PYDC2 genes and the predisposition to endometriosis risk remains unexplored.MethodsIn this cross-sectional study, 54 patients diagnosed with ovarian endometriosis and 54 control subjects were included. The genetic SNPs of NOD1 (rs2075820 and rs2075818) and NOD2 (rs104895461) were assessed using the PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphism) method. Additionally, the polymorphisms of PYDC1 and PYDC2 were evaluated using Sanger sequencing. After conducting polymorphism analysis, the genetic profiles were assessed with the clinical manifestations and the size of ovarian endometriomas, categorized as either small (<4 cm) or large (≥4 cm).ResultsSignificant differences in the NOD1 rs2075820 (G: A) genotypes were found. The GG genotype was more prevalent in endometriosis patients (p = 0.04), while the GA genotype was less common (p = 0.029). The AA genotype was associated with higher rates of perimenstrual gastrointestinal symptoms (p = 0.005) and infertility (p = 0.037). The PYDC2 rs293833 variant was detected in 22.2% of patients. Carriers of this variant exhibited higher rates of perimenstrual gastrointestinal symptoms (p = 0.004), infertility (p = 0.001) and larger endometriomas (≥4 cm) (p < 0.001). No significant differences were found in NOD1 rs2075818 genotypes (p = 0.89) and no polymorphisms were detected in NOD2 or PYDC1 genes.ConclusionThese findings emphasize the influence of genetic polymorphisms on the clinical manifestations of endometriosis. Specifically, gene polymorphisms in NLRs have been found to significantly impact infertility and increase endometrioma size.

Background and Objectives: Osteoporosis is a common disease of the skeletal system that increases the risk of fracture. The prevalence of osteoporosis has been increasing as the aging population increases, affecting more than 200 million people worldwide. This study aimed to shed light on the clinical impact of osteoporosis on women’s health and quality of life by evaluating the prevalence and risk factors for this disease among postmenopausal women, using a 10-year dataset from a tertiary center. Materials and Methods: This retrospective cohort study was conducted at Dokuz Eylül University, Department of Obstetrics and Gynecology, between 2010 and 2022. A total of 3289 postmenopausal women aged 50–60 years who were undergoing routine gynecological checkups were included in the study. Patients with a prior diagnosis, a history of medical conditions, or who were taking medications affecting bone mineral density (BMD) were excluded. Data on demographics, smoking status, diabetes status, body mass index (BMI), parity, and fracture history were collected. BMD scores were classified as normal, osteopenia, or osteoporosis. Results: The prevalence of osteoporosis was 10.4%. The median age of the patients was 56.0 years. Smoking, diabetes, and a history of bone fractures were found to significantly increase the risk of osteoporosis. BMI was found to have a protective effect against osteoporosis. According to multivariate analysis, the risk of osteoporosis increased by 2.46 times in patients who smoke, 3.78 times in patients with diabetes, and 6.23 times in patients with a history of fractures. Conclusions: Awareness of modifiable risk factors such as smoking is crucial for preventing osteoporosis-related complications. Diabetes, even when it is not complicated, increases the risk of osteoporosis. Physical exercise, calcium, and vitamin D intake are important, especially during young adulthood, as they are the primary contributors to peak bone mass. Because neck fractures are more common in patients with osteopenia, early diagnosis and routine screening can mitigate future complications.

Cavernous hemangioma within the female genital tract is an extremely rare pathology, characterized by irregular vascular spaces containing blood or thrombus. We present a unique case of a 42-year-old primiparous woman who presented with typical endometriosis symptoms such as dysmenorrhea, dyspareunia, and heavy menstrual bleeding. The patient also experienced complex postpartum symptoms, which were misdiagnosed as cholecystitis and retained placental products. Imaging studies suggested deep infiltrative endometriosis with extraovarian endometriotic lesions. Surgical exploration revealed a hemangioma within the right anterior broad ligament alongside peritoneal endometriosis lesions. The hemangioma itself expresses estrogen and progesterone receptors in stromal cells. The presence of steroid hormone receptors strongly suggests symptom alleviation during the menstrual cycle and the postpartum period. The coexistence of cavernous hemangioma and endometriosis in the broad ligament, previously unreported, and symptomatic overlap between the two conditions complicates diagnosis and management, emphasizing the need for comprehensive evaluation integrating clinical symptoms and imaging findings.

OBJECTIVE:Endometriosis is a common gynecological disease among reproductive-age women. Numerous hypotheses exist regarding the pathogenesis of endometriosis. In Turkey, the consumption of Allium cepa (commonly known as the "onion cure") is a popular treatment employed to alleviate a variety of gynecological disorders.METHODS:In this study, our objective was to assess the therapeutic mechanisms of the onion bulb A. cepa using an autologous endometriosis model in Sprague-Dawley rats. Previous research has shown that A. cepa possesses anti-inflammatory, antioxidant, and antiapoptotic properties. We evaluated the pathological condition of endometriotic implants by employing hematoxylin-eosin staining and Ki67 immunohistochemistry analysis. Transforming growth factor-beta 1 (TGF-β1) and alpha-smooth muscle actin (α-SMA) have been identified as profibrotic markers that are highly overexpressed in endometriotic tissues relative to eutopic endometrial tissue. Furthermore, TGF-β1 influences the differentiation and progression of endometriosis. To quantify profibrotic activity, we measured TGF-β1 and α-SMA using the immunosorbent assay method.RESULTS:Lower histologic evaluation scores for endometriotic implants were observed in the group receiving high-dose A. cepa relative to the other groups. Ki67 expression was reduced following the high-dose A. cepa regimen, which consisted of 30% A. cepa and 70% normal feed. However, no statistically significant differences in TGF-β1 or α-SMA levels were observed among the groups (p=0.7 and p=0.778, respectively).CONCLUSION:The findings suggest that A. cepa could serve as a therapeutic agent in endometriosis treatment, as evidenced by the reduction in proliferative potential. Nevertheless, A. cepa was not associated with significantly lower levels of endometriosis-associated TGF-β1 or α-SMA.

Objective:Ischemia/reperfusion (I/R) damage following detorsion treatment, tissue fibrosis, and adhesions cause secondary tissue damage in the ovaries. Many studies have been evaluated to minimize antioxidant damage in ovarian reserve loss while minimizing I/R damage. However, no study observed long-term effects on the ovarian torsion model in rats. In this study, we evaluated the profibrotic effects of A. cepa on an ovarian torsion model on rats.Materials and Methods:Group I (n=7) rats were the sham group. Group II (n=7) rats were the torsion group and Group III (n=7) rats were the torsion + A. cepa group. To observe the long-term effects of allium cepa, rats were fed for 21 days. Cellular damage I/R is evaluated by histopathological damage score, and transforming growth factor-beta 1 (TGF-β1) and alpha-smooth muscle actin (α-SMA) is measured to analyze the profibrotic effect.Results:A. cepa altered cellular damage due to improvement in the histopathological damage score with A. cepa intake. However, the profibrotic mediators TGF-β1 and α-SMA are non- significantly changed by the A. cepa (p=0.477 and p=0.185 respectively).Conclusion:A. cepa is a potent protective on cellular tissue, minimizing I/R damage on ovarian tissue histologically. Our study implies that A. cepa does not affect fibrosis-related mediators in the rat ovary.

Transgender and nonbinary individuals are historically underserved by healthcare systems. A crucial area for improvement is fertility preservation counseling and service delivery, as gender-affirming hormone therapy and gender-affirming surgery may negatively affect future fertility. The methods available for fertility preservation depend on the patient’s pubertal status and utilization of gender-affirming therapies, and counseling and delivery of these services are complex and require a multidisciplinary approach. Further research is needed to identify pertinent stakeholders in managing the care of these patients, as well as to better understand the optimal frameworks for delivering integrated and comprehensive care to this patient population. Fertility preservation is an active and exciting area of scientific discovery and offers a wealth of opportunities to improve the care of transgender and nonbinary individuals.

Background: The pathogenesis of endometriosis is still debatable, and many studies reported a predisposition to infectious and immunological factors. In this study, we aimed to evaluate the human papillomavirus (HPV) positivity in endometriosis pain-related symptoms and infertility. Methods: In this cross-sectional study, 410 endometriosis patients were enrolled in this study. HPV-positive (n = 202) and HPV-negative (n = 208) patients compared with pain-related symptoms, infertility, and endometrioma presence. The term “Other HPV” was utilized to encompass all HPV types with the exception of HPV 16 and 18, which were specifically identified as HPV 16/18. Results: Dyspareunia in the “Other HPV”-positive group (12.8 %) was statistically higher than in the HPV-negative group (4.8%; p = 0.007). The infertility rate was significantly higher in the HPV 16/18 positive group (high-risk HPV) 35.8% than in the HPV-negative (7.6%), and “Other HPV” positive group (8%; p < 0.001). Endometriosis-related pain symptoms were significantly higher in high-risk HPV (49%) than in the HPV-negative (37%), and “Other HPV” positive group (46.3%; p = 0.046). The ovarian endometrioma rate was slightly higher in group HPV 16/18 positive population (16.9%) than in “Other HPV” types positive (11.4%), and HPV-negative groups (7.2%; p = 0.08). Conclusions: Our results could provide a potential predisposing role of HPV infection in pain in endometriosis clinics and infertility. Moreover, HPV subtypes may have a different impact on clinical conditions.

This paper reports the measures taken to manage the impact of the COVID-19 pandemic on O&G services in a tertiary referal centre and their outcomes. All the patients included in this study received inpatient treatment and underwent surgery between March 10 2020 and end of June 2020, including obstetric or gynaecologic cases combined. Data including age, diagnosis, operation, duration of preoperative and postoperative hospital stay, COVID-19 status were recorded. COVID-19 status of the patients was diagnosed with a nasopharyngeal swab test. Thirty-seven (20%) of 177 operations were performed because of gynaecologic reasons. The rest of them were caesarean sections (C/S). In gynaecologic cases, 22 (59%) of 37 were emergent operations, nine (24%) cases were oncologic and six (16%) cases were elective gynaecological surgeries. On the other hand, 43 (30%) of 140 patients, who underwent caesarean sections, were urgent surgeries. The rest were elective and planned caesarean sections. Only five patients (2.8%) who had undergone caesarean sections were tested positive for COVID-19. No COVID-19 transmission to staff was recorded in this period. Measures against the COVID-19 pandemic must be multidisciplinary and is crucial to prevent the spread of the disease to staff in close contact.Impact StatementWhat is already known on this subject? COVID-19 pandemic has been a crucial health problem worldwide. Healthcare workers work intensely to protect people from the pandemic. It is especially important to protect healthcare professionals and hospitalized patients from virus transmission. Therefore, utilization of personal protective equipment such as masks, gloves and goggles is obligatory, and hygiene rules such as sanitization of hands are strictly followed.What the results of this study add? This study adds the experience and success of a tertiary centre regarding the measure against COVID-19 to the literature. No viral transmission was detected to healthcare workers and other patients from COVID-19 patients. Hence, measures that mentioned in the present study should be an example to other centres for protection against pandemic.What the implications are of these findings for clinical practice and/or further research? As mentioned above, measures that are explained in the present study should be an example to other centres for protection against the pandemic. Further larger size clinical studies are needed to prove the beneficial effect of the measures that still used against pandemic.

OBJECTIVES:To determine the COVID-19 pandemic's effect on female sexual functions among Turkish women.MATERIAL AND METHODS:The present study was performed by using the previous study data that was conducted before the pandemic to detect female sexual function by using questionnaires. Comparison of Female Sexual Function Index (FSFI), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI) scores in women during and before the pandemic. Participants were asked to fill questionnaire forms again.RESULTS:FSFI scores of the participants were higher before the pandemic, however, this finding was not statistically significant (21.8 vs 21.0, p = 0.27). BAI and BDI scores with high scores accompanied by anxiety and depression were found statistically significantly higher in the study (11.2 vs 13.3, p < 0.01; 10.0 vs 13.7, p < 0.01; respectively). BAI scores had a negative correlation with FSFI scores, however, BDI scores had not a significant correlation with FSFI scores in the present study (p < 0.01, correlation coefficient = -0.302; p = 0.07; correlation coefficient = -0.183; respectively).CONCLUSIONS:Pandemic seems not to affect female sexual behavior. However, the pandemic is associated with anxiety and depression.