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Kentenich H, Dorn C, Buchholz T, Hilland U, Diedrich K. Umsetzung der PID-Verordnung in Deutschland. Gynäkologische Endokrinologie 2015. [DOI: 10.1007/s10304-015-0695-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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De Wert G, Dondorp W, Shenfield F, Barri P, Devroey P, Diedrich K, Tarlatzis B, Provoost V, Pennings G. ESHRE Task Force on Ethics and Law 23: medically assisted reproduction in singles, lesbian and gay couples, and transsexual people†. Hum Reprod 2014; 29:1859-65. [PMID: 25052011 DOI: 10.1093/humrep/deu183] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
This Task Force document discusses ethical issues arising with requests for medically assisted reproduction from people in what may be called 'non-standard' situations and relationships. The document stresses that categorically denying access to any of these groups cannot be reconciled with a human rights perspective. If there are concerns about the implications of assisted reproduction on the wellbeing of any of the persons involved, including the future child, a surrogate mother or the applicants themselves, these concerns have to be considered in the light of the available scientific evidence. When doing so it is important to avoid the use of double standards. More research is needed into the psychosocial implications of raising children in non-standard situations, especially with regard to single women, male homosexual couples and transsexual people.
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Affiliation(s)
- G De Wert
- Department of Health, Ethics & Society, Research Institutes CAPHRI and GROW, Maastricht University, PO Box 616, MD 6200 Maastricht, The Netherlands
| | - W Dondorp
- Department of Health, Ethics & Society, Research Institutes CAPHRI and GROW, Maastricht University, PO Box 616, MD 6200 Maastricht, The Netherlands
| | - F Shenfield
- Reproductive Medicine Unit, Obstetric Hospital, University College Hospital, Huntley Street, London WC1 6AU, UK
| | - P Barri
- Servei de Medicina de la Reproducció, Departament d'Obstetricia, Universitari Dexeus, Ginecologia i Reproducció, Barcelona, Spain
| | - P Devroey
- Centre for Reproductive Medicine, UZ Brussel, Brussels, Belgium
| | - K Diedrich
- Department of Obstetrics and Gynaecology, University of Luebeck, Ratzeburger Allee 160, D-23538 Luebeck, Germany
| | - B Tarlatzis
- Infertility and IVF Center, Department of OB/Gyn, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - V Provoost
- Department of Philosophy, University of Ghent, Blandijnberg 2, Gent 9000, Belgium
| | - G Pennings
- Department of Philosophy, University of Ghent, Blandijnberg 2, Gent 9000, Belgium
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De Wert G, Dondorp W, Shenfield F, Devroey P, Tarlatzis B, Barri P, Diedrich K, Provoost V, Pennings G. ESHRE task force on ethics and Law22: preimplantation genetic diagnosis. Hum Reprod 2014; 29:1610-7. [PMID: 24927929 DOI: 10.1093/humrep/deu132] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This Task Force document discusses some relatively unexplored ethical issues involved in preimplantation genetic diagnosis (PGD). The document starts from the wide consensus that PGD is ethically acceptable if aimed at helping at-risk couples to avoid having a child with a serious disorder. However, if understood as a limit to acceptable indications for PGD, this 'medical model' may turn out too restrictive. The document discusses a range of possible requests for PGD that for different reasons fall outwith the accepted model and argues that instead of rejecting those requests out of hand, they need to be independently assessed in the light of ethical criteria. Whereas, for instance, there is no good reason for rejecting PGD in order to avoid health problems in a third generation (where the second generation would be healthy but faced with burdensome reproductive choices if wanting to have children), using PGD to make sure that one's child will have the same disorder or handicap as its parents, is ethically unacceptable.
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Affiliation(s)
- G De Wert
- Department of Health, Ethics & Society, Research Institutes CAPHRI and GROW, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands
| | - W Dondorp
- Department of Health, Ethics & Society, Research Institutes CAPHRI and GROW, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands
| | - F Shenfield
- Reproductive Medicine Unit, Obstetric Hospital, 2nd Floor, University College Hospital Huntley Street, London WC1 6AU, UK
| | - P Devroey
- Centre for Reproductive Medicine, UZ Brussel, Brussels, Belgium
| | - B Tarlatzis
- Infertility and IVF Center, Department of OB/GYN Medical School, Aristotle University of Thessaloniki, Greece
| | - P Barri
- Servei de Medicina de la Reproducció, Departament d'Obstetricia, Universitari Dexeus, Ginecologia i Reproducció, Barcelona, Spain
| | - K Diedrich
- Department of Obstetrics and Gynaecology, University of Luebeck, Ratzeburger Allee 160, D-23538 Luebeck, Germany
| | - V Provoost
- Department of Philosophy, University of Ghent, Blandijnberg 2, Gent 9000, Belgium
| | - G Pennings
- Department of Philosophy, University of Ghent, Blandijnberg 2, Gent 9000, Belgium
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Dondorp W, De Wert G, Pennings G, Shenfield F, Devroey P, Tarlatzis B, Barri P, Diedrich K, Eichenlaub-Ritter U, Tuttelmann F, Provoost V. ESHRE Task Force on Ethics and Law 21: genetic screening of gamete donors: ethical issues. Hum Reprod 2014; 29:1353-9. [DOI: 10.1093/humrep/deu111] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
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Fauser BCJM, Devroey P, Diedrich K, Balaban B, Bonduelle M, Delemarre-van de Waal HA, Estella C, Ezcurra D, Geraedts JPM, Howles CM, Lerner-Geva L, Serna J, Wells D. Health outcomes of children born after IVF/ICSI: a review of current expert opinion and literature. Reprod Biomed Online 2013; 28:162-82. [PMID: 24365026 DOI: 10.1016/j.rbmo.2013.10.013] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Revised: 10/03/2013] [Accepted: 10/08/2013] [Indexed: 01/28/2023]
Abstract
The Sixth Evian Annual Reproduction (EVAR) Workshop Group Meeting was held to evaluate the impact of IVF/intracytoplasmic sperm injection on the health of assisted-conception children. Epidemiologists, reproductive endocrinologists, embryologists and geneticists presented data from published literature and ongoing research on the incidence of genetic and epigenetic abnormalities and congenital malformations in assisted-conception versus naturally conceived children to reach a consensus on the reasons for potential differences in outcomes between these two groups. IVF-conceived children have lower birthweights and higher peripheral fat, blood pressure and fasting glucose concentrations than controls. Growth, development and cognitive function in assisted-conception children are similar to controls. The absolute risk of imprinting disorders after assisted reproduction is less than 1%. A direct link between assisted reproduction and health-related outcomes in assisted-conception children could not be established. Women undergoing assisted reproduction are often older, increasing the chances of obtaining abnormal gametes that may cause deviations in outcomes between assisted-conception and naturally conceived children. However, after taking into account these factors, it is not clear to what extent poorer outcomes are due to the assisted reproduction procedures themselves. Large-scale, multicentre, prospective epidemiological studies are needed to investigate this further and to confirm long-term health consequences in assisted-conception children. Assisted reproduction treatment is a general term used to describe methods of achieving pregnancy by artificial means and includes IVF and sperm implantation. The effect of assisted reproduction treatment on the health of children born using these artificial methods is not fully understood. In April 2011, fertility research experts met to give presentations based on research in this area and to look carefully at the evidence for the effects of assisted reproduction treatment on children's health. The purpose of this review was to reach an agreement on whether there are differences in the health of assisted-conception children with naturally conceived children. The researchers discovered no increased risk in birth defects in assisted-conception children compared with naturally conceived children. They found that IVF-conceived children have lower birth weights and higher fat under the skin, higher blood pressure and higher fasting glucose concentrations than naturally conceived children; however, growth, development and cognitive function are similar between groups. A very low risk of disorders of genetic control was observed in assisted-conception children. Overall, there did not appear to be a direct link between assisted reproduction treatment and children's health. The researchers concluded that the cause of some differences in the health of children conceived using assisted reproduction treatment may be due to the age of the woman receiving treatment. Large-scale, research studies are needed to study the long-term health of children conceived using assisted reproduction treatment.
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Affiliation(s)
- B C J M Fauser
- Department of Reproductive Medicine and Gynaecology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
| | - P Devroey
- Center for Reproductive Medicine, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - K Diedrich
- Department of Obstetrics and Gynecology, University Clinic of Schleswig-Holstein, Campus Luebeck, 23538 Luebeck, Germany
| | - B Balaban
- Assisted Reproduction Unit, American Hospital of Istanbul, Guzelbahce Sokak No 20, Nisantasi, Istanbul 34365, Turkey
| | - M Bonduelle
- Centre for Medical Genetics, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | | | - C Estella
- Fundación Instituto Valenciano de Infertilidad (FIVI), Valencia University, and Instituto Universitario IVI/INCLIVA, Parc Científic Universitat de València C/Catedrático Agustín Escardino n(o) 9, Edificio 3, 46980 Paterna, Spain; Departamento de Biología Molecular and Centro de Biología Molecular 'Severo Ochoa' (CSIC-UAM), Universidad Autónoma de Madrid, Madrid, Spain
| | - D Ezcurra
- Global Development and Medical Unit, Merck Serono SA Geneva, Chemin des Mines 9, 1202 Geneva, Switzerland
| | - J P M Geraedts
- Department of Genetics and Cell Biology, Research Institute GROW, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - C M Howles
- Global Development and Medical Unit, Merck Serono SA Geneva, Chemin des Mines 9, 1202 Geneva, Switzerland
| | - L Lerner-Geva
- Woman and Child Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research, Tel Hashomer 52621, Israel
| | - J Serna
- Instituto Valenciano de Infertilidad (IVI) Zaragoza, C/María Zambrano, 31, 50018 Zaragoza, Spain
| | - D Wells
- University of Oxford, Nuffield Department of Obstetrics and Gynaecology, Women's Centre, John Radcliffe Hospital, Oxford OX3 9DU, UK
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Ruhnke H, Eckey T, Bohlmann MK, Beldoch MP, Neumann A, Agic A, Hägele J, Diedrich K, Barkhausen J, Hunold P. MR-guided HIFU treatment of symptomatic uterine fibroids using novel feedback-regulated volumetric ablation: effectiveness and clinical practice. ROFO-FORTSCHR RONTG 2013; 185:983-991. [PMID: 24490234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE To evaluate a novel feedback-regulated volumetric sonication method in MRguided HIFU treatment of symptomatic uterine fibroids. MATERIALS AND METHODS 27 fibroids with an average volume of 124.9 ± 139.8 cc in 18 women with symptomatic uterine fibroids were ablated using the new HIFU system Sonalleve (1.5 TMR system Achieva, Philips). 21 myomas in 13 women were reevaluated 6 months later. Standard (treatment) cells (TC) and feedback-regulated (feedback) cells (FC) with a diameter of 4, 8, 12, and 16 mm were used and compared concerning sonication success, diameter of induced necrosis, and maximum achieved temperature. The non-perfused volume ratio (NPV related to myoma volume) was quantified. The fibroid volume was measured before, 1 month, and 6 months after therapy. Symptoms were quantified using a specific questionnaire (UFS-QoL). RESULTS In total, 205 TC and 227 FC were applied. The NPV ratio was 23 ± 15 % (2 – 55). The TC were slightly smaller than intended (-3.9 ± 52 %; range, -100 – 81), while the FC were 20.1 ± 25.3 % bigger (p = 0.02). Feedback mechanism is less diversifying in diameter (p < 0.001). Overall, the FC correlate well with the planned treatment diameter (r = 0.79), other than the TC (r = 0.38). Six months after therapy, the fibroid volume was reduced by 45 ± 21 % (5 – 100) (p = 0.001). The symptoms decreased significantly (p = 0.001). No serious adverse events were recorded. CONCLUSION Use of volumetric sonication leads to homogenous heating and sufficient necrosis. It is a safe and effective therapy for treating symptomatic uterine fibroids. Successful sonication of feedback cells leads to more contiguous necrosis in diameter
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Ruhnke H, Eckey T, Bohlmann MK, Beldoch MP, Neumann A, Agic A, Hägele J, Diedrich K, Barkhausen J, Hunold P. MR-guided HIFU treatment of symptomatic uterine fibroids using novel feedback-regulated volumetric ablation: effectiveness and clinical practice. ROFO-FORTSCHR RONTG 2013; 184:983-91. [PMID: 23884908 DOI: 10.1055/s-0033-1335289] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE To evaluate a novel feedback-regulated volumetric sonication method in MR-guided HIFU treatment of symptomatic uterine fibroids. MATERIALS AND METHODS 27 fibroids with an average volume of 124.9 ± 139.8 cc in 18 women with symptomatic uterine fibroids were ablated using the new HIFU system Sonalleve (1.5 T MR system Achieva, Philips). 21 myomas in 13 women were reevaluated 6 months later. Standard (treatment) cells (TC) and feedback-regulated (feedback) cells (FC) with a diameter of 4, 8, 12, and 16 mm were used and compared concerning sonication success, diameter of induced necrosis, and maximum achieved temperature. The non-perfused volume ratio (NPV related to myoma volume) was quantified. The fibroid volume was measured before, 1 month, and 6 months after therapy. Symptoms were quantified using a specific questionnaire (UFS-QoL). RESULTS In total, 205 TC and 227 FC were applied. The NPV ratio was 23 ± 15 % (2 - 55). The TC were slightly smaller than intended (-3.9 ± 52 %; range, -100 - 81), while the FC were 20.1 ± 25.3 % bigger (p = 0.02). Feedback mechanism is less diversifying in diameter (p < 0.001). Overall, the FC correlate well with the planned treatment diameter (r = 0.79), other than the TC (r = 0.38). Six months after therapy, the fibroid volume was reduced by 45 ± 21 % (5 - 100) (p = 0.001). The symptoms decreased significantly (p = 0.001). No serious adverse events were recorded. CONCLUSION Use of volumetric sonication leads to homogenous heating and sufficient necrosis. It is a safe and effective therapy for treating symptomatic uterine fibroids. Successful sonication of feedback cells leads to more contiguous necrosis in diameter and a less diversifying temperature. KEY POINTS ▶ MR-guided HIFU ablation of symptomatic uterine fibroids is a valuable treatment option. ▶ By non-invasive HIFU fibroid volumes can be reduced and symptoms improved. ▶ The novel feedback-regulated treatment cells offer advantages over standard treatment cells.
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Affiliation(s)
- H Ruhnke
- Clinic for Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck/Germany
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Ludwig M, Katalinic A, Felberbaum RE, Diedrich K. Safety aspects of gonadotrophin-releasing hormone antagonists in ovarian stimulation procedures: ovarian hyperstimulation syndrome and health of children born. Reprod Biomed Online 2013; 5 Suppl 1:61-7. [PMID: 12537784 DOI: 10.1016/s1472-6483(11)60219-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The safety of ovarian stimulation procedures or the procedure of assisted reproduction in general can be estimated by various parameters. Two of the most important are the health of children born after the procedure and the incidence of ovarian hyperstimulation syndrome (OHSS). The latter is important because it is the most severe, potentially life-threatening complication of any stimulation procedure. The use of gonadotrophin-releasing hormone (GnRH) antagonists in ovarian stimulation protocols has had no impact on the health of children born. This was proven in 227 children born after the use of cetrorelix and in 73 children born after the use of ganirelix. To analyse the incidence of OHSS and the impact of GnRH antagonists on clinical pregnancy rates compared with the long protocol, a meta-analysis was done. This showed a reduction of OHSS with the use of cetrorelix. Furthermore, when compared with the long protocol, clinical and ongoing pregnancy rates were not significantly reduced with the use of cetrorelix. Taken together, the use of GnRH antagonists are safe with regard to children's health. The incidence of OHSS does not increase with ganirelix, and a reduction can be expected with cetrorelix.
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Affiliation(s)
- M Ludwig
- Division of Reproductive Medicine and Gynecologic Endocrinology, Department of Gynecology and Obstetrics, University Clinic, Ratzeburger Allee 160, 23538 Lübeck, Germany.
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Abstract
The hypothalamic decapeptide gonadotrophin-releasing hormone (GnRH) binds to specific receptors on pituitary gonadotrophs. These receptors belong to the family of G protein-coupled receptors. Their activation leads to phosphoinositide breakdown with generation of inositol 1,4,5-trisphosphate (Ins(1,4,5)P3) and diacylglycerol. These second messengers initiate Ca2+ release from intracellular stores and activation of protein kinase C, both of which are important for gonadotrophin secretion and synthesis. Prolonged activation of GnRH receptors by GnRH leads to desensitization and consequently to suppressed gonadotrophin secretion. This is the primary mechanism of action of agonistic GnRH analogues. By contrast, GnRH antagonists compete with GnRH for receptors on gonadotroph cell membranes, inhibit GnRH-induced signal transduction and consequently gonadotrophin secretion. These compounds are free of agonistic actions, which might be beneficial in certain clinical applications.
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Affiliation(s)
- O Ortmann
- Department of Obstetrics and Gynecology, Medical University of Lübeck, 23538 Lübeck, Germany.
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Diedrich K. DGGG-Kommissionen. Kommission PID. Geburtshilfe Frauenheilkd 2013. [DOI: 10.1055/s-0032-1328756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Dondorp W, De Wert G, Pennings G, Shenfield F, Devroey P, Tarlatzis B, Barri P, Diedrich K. ESHRE Task Force on ethics and Law 20: sex selection for non-medical reasons. Hum Reprod 2013; 28:1448-54. [PMID: 23578946 DOI: 10.1093/humrep/det109] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This Task Force document revisits the debate about the ethics of sex selection for non-medical reasons in the light of relevant new technological developments. First, as a result of improvement of the Microsort® flow cytometry method, there is now a proven technique for preconception sex selection that can be combined both with IVF and IUI. Secondly, the scenario where new approaches that are currently being developed for preimplantation genetic screening (PGS) may lead to such screening becoming a routine part of all IVF treatment. In that scenario professionals will more often be confronted with parental requests for transfer of an embryo of a specific sex. Thirdly, the recent development of non-invasive prenatal testing based on cell-free fetal DNA in maternal plasma allows for easy and safe sex determination in the early stages of pregnancy. While stressing the new urgency that these developments give to the debate, the Task Force did not come to a unanimous position with regard to the acceptability of sex selection for non-medical reasons in the context of assisted reproduction. Whereas some think maintaining the current ban is the best approach, others are in favour of allowing sex selection for non-medical reasons under conditions that take account of societal concerns about the possible impact of the practice. By presenting these positions, the document reflects the different views about this issue that also exist in the field. Specific recommendations include the need for a wider delineation of accepted 'medical reasons' than in terms of avoiding a serious sex-linked disorder, and for a clarification of the legal position with regard to answering parental requests for 'additional sex selection' in the context of medically indicated preimplantation genetic diagnosis, or routine PGS.
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Affiliation(s)
- W Dondorp
- Department of Health, Ethics & Society, Research Institutes CAPHRI and GROW, Maastricht University, Maastricht, The Netherlands.
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Baird D, Bhattacharya S, Devroey P, Diedrich K, Evers J, Fauser B, Jouannet P, Pellicer A, Walters E, Crosignani P, Fraser L, Geraedts J, Gianaroli L, Glasier A, Liebaers I, Sunde A, Tapanainen J, Tarlatzis B, Van Steirteghem A, Veiga A. Failures (with some successes) of assisted reproduction and gamete donation programs. Hum Reprod Update 2013; 19:354-65. [DOI: 10.1093/humupd/dmt007] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Nause SL, Schröer A, Diedrich K, Weichert J. [Atypical myometric fluid accumulation in graviditate--intramural pregnancy or degenerated fibroid?]. Z Geburtshilfe Neonatol 2012; 216:226-9. [PMID: 23108967 DOI: 10.1055/s-0032-1323792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We wish to discuss a case of suspected fluid accumulation within the anterior uterine wall in graviditate. The initial diagnosis of a rare intramural pregnancy could not be confirmed by 4+5 gestational weeks. Following removal of the fluid and establishing the diagnosis of degenerated fibroid(s), the advancing pregnancy was somewhat uneventful, whereas the uterine wall lesion showed continuing growth. Both during delivery (via Caesarean section) and on repeated sonographic scans post partum the clinical diagnosis of uterine wall fibroids could be confirmed. The present case illustrates the feasibility of expectant monitoring of atypical fybroids in pregnancy. Nevertheless, a thorough sonographic monitoring as well as comprehensive counselling of the gravida is mandatory. Potentially more serious differential diagnoses (intramural pregnancy, uterine sarcoma) should be born in mind.
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Affiliation(s)
- S L Nause
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
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Baird DT, Balen A, Escobar-Morreale HF, Evers JLH, Fauser BCJM, Franks S, Glasier A, Homburg R, La Vecchia C, Devroey P, Diedrich K, Fraser L, Gianaroli L, Liebaers I, Sunde A, Tapanainen JS, Tarlatzis B, Van Steirteghem A, Veiga A, Crosignani PG, Evers JLH. Health and fertility in World Health Organization group 2 anovulatory women. Hum Reprod Update 2012; 18:586-99. [DOI: 10.1093/humupd/dms019] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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Abstract
In the 1960s and 70s, Germany played a leading role in the field of gynaecological endocrinology, which was reflected by the scientific activity of German universities during this period. More recently, however, a dramatic change occurred, resulting in a decreasing number of publications in this field. This has undoubtedly contributed to the marginal scientific position of Germany in gynaecological endocrinology today. This change is reflected by the decreasing number of university centres carrying out active scientific research in the fields of gynaecological endocrinology, reproductive medicine and andrology. Universities now lack mid- and upper-level faculty staff, as interesting and senior positions in the field of reproductive medicine, andrology and reproductive medicine no longer exist. Moreover, in 1991 the German embryo protection law came into force, which severely curtailed scientific research and blocked scientific efforts in this area. German scientists and, of course, childless couples were cut off from scientific advances, e.g. the possibility of single embryo transfer. Germany's scientific position in the fields of gynaecological endocrinology, reproductive medicine and andrology needs to be strengthened. The creation of appropriate structures in German universities is therefore necessary. These would include important cooperations with private medical practices, which currently account for about 75 % of patient care. The lines of communication between the groups representing reproductive medicine in Germany need to be greatly improved. Moreover, we suggest that an important step would be the development of a general human embryology and fertilisation act which would allow German couples to benefit from the global advances in the field of reproductive technology. Germany must stop its policy of scientific obstruction and permit scientific progress in this field in German universities.
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Affiliation(s)
- K Diedrich
- Clinic for Gynaecology and Obstetrics, Lübeck
| | | | - H Kentenich
- Clinic for Gynaecology and Obstetrics, Lübeck
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Fauser B, Diedrich K, Bouchard P, Domínguez F, Matzuk M, Franks S, Hamamah S, Simón C, Devroey P, Ezcurra D, Howles C. Contemporary genetic technologies and female reproduction. Hum Reprod Update 2012. [DOI: 10.1093/humupd/dmr054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Thill M, Blohmer J, Friedrichs K, Röder K, Diedrich K, Dittmer C. 506 Intraoperative Assessment of Surgical Margins During Breast Conserving Surgery of Ductal Carcinoma in Situ by use of Radiofrequency Spectroscopy. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)70571-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Friedrich A, Ludwig AK, Jauch-Chara K, Loebig M, Rudolf S, Tauchert S, Diedrich K, Schweiger U, Oltmanns KM. Oral contraception enhances growth hormone responsiveness to hyper- and hypoglycaemia. Diabet Med 2012; 29:345-50. [PMID: 21883439 DOI: 10.1111/j.1464-5491.2011.03430.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS Plasma glucose levels influence growth hormone concentrations. Oral contraceptives are known to affect circulating growth hormone levels and glucose metabolism. While growth hormone plays an important role in hypoglycaemia counter-regulation, it has been shown that oral contraceptives increase growth hormone concentrations. In this context, we tested if serum growth hormone concentrations display a differential response on glycaemic variations in healthy women using oral contraceptives and those not using contraceptives. METHODS Fifteen healthy women with oral contraceptive treatment and 10 without participated in a stepwise hyper- and hypoglycaemic glucose clamp procedure. Serum growth hormone concentrations were measured at euglycaemic baseline and subsequently at plasma glucose plateaus of 8.8, 6.8, 4.8 and 2.8 mmol/l. RESULTS Growth hormone values were significantly higher in women using oral contraceptives throughout the experiments (P = 0.001). Hyperglycaemia decreased growth hormone concentrations in women using oral contraceptives (P = 0.009), but not in those who were not using oral contraceptives (P = 0.241). Hypoglycaemia significantly elevated growth hormone concentrations in women using oral contraceptives (P = 0.009), but not in those not using oral contraceptives (P = 0.094). Maximum growth hormone values were reached at the end of the hypoglycaemic plateau, with significantly higher concentrations in the group using oral contraceptives than in the group not using oral contraceptives (P = 0.016). CONCLUSION Healthy women on oral contraceptive treatment display an increased responsiveness of growth hormone to hypoglycaemic, as well as hyperglycaemic conditions and generally higher serum growth hormone concentrations than women without oral contraceptives. Given the known boosting effects of growth hormone on hypoglycaemic hormonal counter-regulation, oral contraceptives may thus be a pharmacological candidate contributing to combat hypoglycaemia unawareness in women with diabetes in the future.
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Affiliation(s)
- A Friedrich
- Department of Psychiatry and Psychotherapy, University of Luebeck, Germany.
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Dondorp W, de Wert G, Pennings G, Shenfield F, Devroey P, Tarlatzis B, Barri P, Diedrich K. Oocyte cryopreservation for age-related fertility loss. Hum Reprod 2012; 27:1231-7. [DOI: 10.1093/humrep/des029] [Citation(s) in RCA: 159] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Hu JCY, Seo BK, Neri QV, Rozenwaks Z, Palermo GD, Fields T, Neri QV, Monahan D, Rosenwaks Z, Palermo GD, Szkodziak P, Plewka K, Wozniak S, Czuczwar P, Mroczkowski A, Lorenzo Leon C, Hernandez J, Chinea Mendez E, Concepcion Lorenzo C, Sanabria Perez V, Puopolo M, Palumbo A, Toth B, Franz C, Montag M, Boing A, Strowitzki T, Nieuwland R, Griesinger G, Schultze-Mosgau A, Cordes T, Depenbusch M, Diedrich K, Vloeberghs V, Verheyen G, Camus M, Van de Velde H, Goossens A, Tournaye H, Coppola G, Di Caprio G, Wilding M, Ferraro P, Esposito G, Di Matteo L, Dale R, Coppola G, Dale B, Daoud S, Auger J, Wolf JP, Dulioust E, Lafuente R, Lopez G, Brassesco M, Hamad M, Montenarh M, Hammadeh M, Robles F, Magli MC, Crippa A, Pescatori E, Ferraretti AP, Gianaroli L, Zahiri M, Movahedin M, Mowla SJ, Noruzinia M, Crippa A, Ferraretti AP, Magli MC, Crivello AM, Robles F, Gianaroli L, Sermondade N, Dupont C, Hafhouf E, Cedrin-Durnerin I, Poncelet C, Benzacken B, Levy R, Sifer C, Ferfouri F, Boitrelle F, Clement P, Molina Gomes D, Bailly M, Selva J, Vialard F, Yaprak E, Basar M, Guzel E, Arda O, Irez T, Norambuena P, Krenkova P, Tuettelmann F, Kliesch S, Paulasova P, Stambergova A, Macek M, Macek M, Rivera R, Garrido-Gomez T, Galletero S, Meseguer M, Dominguez F, Garrido N, Mallidis C, Sanchez V, Weigeng L, Redmann K, Wistuba J, Gross P, Wuebbelling F, Fallnich C, Burger M, Kliesch S, Schlatt S, San Celestino Carchenilla M, Pacheco Castro A, Simon Sanjurjo P, Molinero Ballesteros A, Rubio Garcia S, Garcia Velasco JA, Macanovic B, Otasevic V, Korac A, Vucetic M, Garalejic E, Ivanovic Burmazovic I, Filipovic MR, Buzadzic B, Stancic A, Jankovic A, Velickovic K, Golic I, Markelic M, Korac B, Gosalvez J, Ruiz-Jorro M, Garcia-Ochoa C, Sachez-Martin P, Martinez-Moya M, Caballero P, Hasegawa N, Fukunaga N, Nagai R, Kitasaka H, Yoshimura T, Tamura F, Kato M, Nakayama K, Oono H, Kojima E, Yasue K, Watanabe H, Asano E, Hashiba Y, Asada Y, Das M, Al-Hathal N, San-Gabriel M, Phillips S, Kadoch IJ, Bissonnette F, Holzer H, Zini A, Zebitay AG, Irez T, Ocal P, Sahmay S, Karahuseyinoglu S, Usta T, Repping S, Silber S, Van Wely M, Datta A, Nayini K, Eapen A, Barlow S, Lockwood G, Tavares R, Baptista M, Publicover SJ, Ramalho-Santos J, Vaamonde D, Rodriguez I, Diaz A, Darr C, Chow V, Ma S, Smith R, Jeria F, Rivera J, Gabler F, Nicolai H, Cunha M, Viana P, Goncalves A, Silva J, Oliveira C, Teixeira da Silva J, Ferraz L, Madureira C, Doria S, Sousa M, Barros A, Herrero MB, Delbes G, Troueng E, Holzer H, Chan PTK, Vingris L, Setti AS, Braga DPAF, Figueira RCS, Iaconelli A, Borges E, Sargin Oruc A, Gulerman C, Zeyrek T, Yilmaz N, Tuzcuoglu D, Cicek N, Scarselli F, Terribile M, Franco G, Zavaglia D, Dente D, Zazzaro V, Riccio T, Minasi MG, Greco E, Cejudo-Roman A, Ravina CG, Candenas L, Gallardo-Castro M, Martin-Lozano D, Fernandez-Sanchez M, Pinto FM, Balasuriya A, Serhal P, Doshi A, Harper J, Romany L, Garrido N, Fernandez JL, Pellicer A, Meseguer M, Ribas-Maynou J, Garcia-Peiro A, Fernandez-Encinas A, Prada E, Jorda I, Cortes P, Llagostera M, Navarro J, Benet J, Kesici H, Cayli S, Erdemir F, Karaca Z, Aslan H, Karaca Z, Cayli S, Ocakli S, Kesici H, Erdemir F, Aslan H, Tas U, Ozdemir AA, Aktas RG, Tok OE, Ocakli S, Cayli S, Karaca Z, Erdemir F, Aslan H, Li S, Lu C, Hwu Y, Lee RK, Landaburu I, Gonzalvo MC, Clavero A, Ramirez JP, Pedrinaci S, Serrano M, Montero L, Carrillo S, Weiss J, Ortiz AP, Castilla JA, Sahin O, Bakircioglu E, Serdarogullari M, Bayram A, Yayla S, Ulug U, Tosun SB, Bahceci M, Aktas RG, Ozdemir AA, Tok OE, Yoon SY, Shin DH, Shin TE, Park EA, Won HJ, Kim YS, Lee WS, Yoon TK, Lee DR, Hattori H, Nakajo Y, Kyoya T, Kuchiki M, Kanto S, Kyono K, Park M, Park MR, Lim EJ, Lee WS, Yoon TK, Lee DR, Choi Y, Mitra A, Bhattacharya J, Kundu A, Mukhopadhaya D, Pal M, Enciso M, Alfarawati S, Wells D, Fernandez-Encinas A, Garcia-Peiro A, Ribas-Maynou J, Abad C, Amengual MJ, Navarro J, Benet J, Esmaeili V, Safiri M, Shahverdi AH, Alizadeh AR, Ebrahimi B, Brucculeri AM, Ruvolo G, Giovannelli L, Schillaci R, Cittadini E, Scaravelli G, Perino A, Cortes Gallego S, Gabriel Segovia A, Nunez Calonge R, Guijarro Ponce A, Ortega Lopez L, Caballero Peregrin P, Heindryckx B, Kashir J, Jones C, Mounce G, Ramadan WM, Lemmon B, De Sutter P, Parrington J, Turner K, Child T, McVeigh E, Coward K, Bakircioglu E, Ulug U, Tosun S, Serdarogullari M, Bayram A, Ciray N, Bahceci M, Saeidi S, Shapouri F, Hoseinifar H, Sabbaghian M, Pacey A, Aflatoonian R, Bosco L, Ruvolo G, Carrillo L, Pane A, Manno M, Roccheri MC, Cittadini E, Selles E, Garcia-Herrero S, Martinez JA, Munoz M, Meseguer M, Garrido N, Durmaz A, Dikmen N, Gunduz C, Tavmergen Goker E, Tavmergen E, Gozuacik D, Vatansever HS, Kara B, Calimlioglu N, Yasar P, Tavmergen E, Tavmergen Goker E, Semerci B, Baka M, Ozbilgin K, Karabulut A, Tekin A, Sabah B, Cottin V, Kottelat D, Fellmann M, Halm S, Rosenthaler E, Kisida T, Kojima F, Sakamoto T, Makutina VA, Balezin SL, Rosly OF, Slishkina TV, Hatzi E, Lazaros L, Xita N, Makrydimas G, Sofikitis N, Kaponis A, Stefos T, Zikopoulos K, Georgiou I, Zikopoulos K, Lazaros L, Xita N, Makrydimas G, Sofikitis N, Kaponis A, Stefos T, Hatzi E, Georgiou I, Georgiou I, Lazaros L, Xita N, Makrydimas G, Sofikitis N, Kaponis A, Stefos T, Hatzi E, Zikopoulos K, Hibi H, Ohori T, Sumitomo M, Asada Y, Anarte C, Calvo I, Domingo A, Presilla N, Aleman M, Bou R, Guardiola F, Agirregoikoa JA, De Pablo JL, Barrenetxea G, Zhylkova I, Feskov O, Feskova I, Zozulina O, Somova O, Nabi A, Khalili MA, Roudbari F, Parmegiani L, Cognigni GE, Bernardi S, Taraborrelli S, Troilo E, Ciampaglia W, Pocognoli P, Infante FE, Tabarelli de fatis C, Arnone A, Maccarini AM, Filicori M, Silva L, Oliveira JBA, Petersen CG, Mauri AL, Massaro FC, Cavagna M, Baruffi RLR, Franco JG, Fujii Y, Endou Y, Mtoyama H, Shokri S, Aitken RJ. ANDROLOGY. Hum Reprod 2012. [DOI: 10.1093/humrep/27.s2.73] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Cordes T, Hoellen F, Dittmer C, Salehin D, Kümmel S, Friedrich M, Köster F, Becker S, Diedrich K, Thill M. Correlation of prostaglandin metabolizing enzymes and serum PGE2 levels with vitamin D receptor and serum 25(OH)2D3 levels in breast and ovarian cancer. Anticancer Res 2012; 32:351-357. [PMID: 22213326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Vitamin D and its active form calcitriol have multiple effects in cancer cells, such as anti-proliferative effects, induction of apoptosis and cell cycle arrest. There is a link between vitamin D metabolism and inflammatory processes, which should be considered in cancer therapy. An association between these two types of metabolism is also observed in breast and ovarian cancer. These inflammatory processes are based on an increase of cyclooxygenase-2 (COX-2) activity. The current study aimed to evaluate the expression of prostaglandin-metabolising enzymes COX-2 and 15-hydroxyprostaglandin-dehydrogenase (15-PGDH) along with the vitamin D receptor (VDR) in benign and malignant breast and ovarian tissues. PATIENTS AND METHODS VDR, COX-2, 15-PGDH and prostanoid receptor E2/E4 expression were measured in tissues by western blot analysis. Additionally, plasma 25(OH)(2)D(3) and PGE(2) levels were measured in healthy patients and cancer patients. RESULTS We detected an elevated COX-2 and inversely a lowered VDR expression in cancer patients compared to healthy women. Breast cancer patients diagnosed during wintertime had a significantly lower serum level of 25(OH)(2)D(3); PGE(2) serum levels were higher in both types of cancer. CONCLUSION These results support the idea of a link between prostaglandin and vitamin D metabolism in regards to their influences on breast and ovarian cancer.
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Affiliation(s)
- T Cordes
- Department of Gynecology and Obstetrics, University Medical Center Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany.
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Salehin D, Haugk C, William M, Hemmerlein B, Thill M, Diedrich K, Friedrich M. Leiomyosarcoma of the vulva. EUR J GYNAECOL ONCOL 2012; 33:306-308. [PMID: 22873106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Malignant tumors of the vulva soft tissue are uncommon. About 1-3% are sarcomas. They can be mistaken as benign lesions, leading to misdiagnosis and mistreatment. A case of a 71-year-old woman with a leiomyosarcoma of the vulva is presented. The surgical excision of the lesion is described and there were no additional malignancies or lesions found. There was no need for adjuvant therapy.
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Affiliation(s)
- D Salehin
- Department of Gynecology and Obstetrics, Helios Hospital Krefeld, Krefeld, Germany.
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Altgassen C, Bends R, Kelling K, Hornung D, Friedrich M, Salehin D, Diedrich K, Kavallaris A. Retromesenteric para-aortic lymphadenectomy in gynecologic malignancy. EUR J GYNAECOL ONCOL 2012; 33:574-578. [PMID: 23327048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
UNLABELLED In gynecologic oncology lymphadenectomy is of prognostic and therapeutic importance because recurrence-free time and survival depend on the metastatic involvement of lymph nodes. Lymphadenectomies are not performed to such an extent as they are indicated. This might be due to a laborious or problematic preparation. The authors therefore report their experience in a seldom taught preparation of the left para-aortic compartment in the form of a learning curve. MATERIALS AND METHODS To access the left para-aortic area, the descending colon is lifted to open the retroperitoneum along the line of Toldt. The mesentery of the descending colon was separated from the kidney along the fascia of Gerota by blunt preparation. Time was measured from the incision of the peritoneum until the renal vein was clearly visible. RESULTS The authors collected the data from the first 25 preparations. Mean duration for the left para-aortic preparation was 7.8 minutes compared to 5.9 minutes for the right side. Duration of preparation of the left area dropped from 11.0 minutes within the first patients (#1 to #5) to 3.8 minutes in the last patients (#20 to #25). No complications were observed in the study group linked to the retromesenteric approach described. CONCLUSION Retromesenteric para-aortic lymphadenectomy is quick to learn. The authors needed 20 preparations to observe a significant drop in the time needed for preparation. Retromesenteric para-aortic lymphadenectomy offers an excellent overview that lightens lymphadenectomy and therefore reduces the risks for patients.
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Affiliation(s)
- C Altgassen
- Department of Obstetrics and Gynecology, UK-SH, Campus Luebeck, Germany.
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Thill M, Cordes T, Fischer D, Hoellen F, Friedrich M, Diedrich K, Dittmer C. P5-07-02: Could the Combination of COX-2 Inhibitor and Calcitriol Be a New Chemopreventive Approach To Decrease the Incidence of Breast Cancer? Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-p5-07-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
COX-2 is a potential molecular prognostic factor for breast cancer and 15-hydroxyprostaglandin dehydrogenase (15-PGDH) is described as a tumour suppressor in cancer. The antiproliferative effects of calcitriol (1,25(OH)2D3) mediated via the vitamin D receptor (VDR) render vitamin D a promising target in breast cancer therapy.
Material and Methods: The expression of the prostaglandin (PG) metabolising enzymes (COX-2, 15-PGDH), the PG receptors, the vitamin D metabolising enzymes (1-alpha-hydroxylase, 24-hydroxylase) and the VDR were determined in benign and malignant breast cell lines as well as in normal and malignant breast tissue. Measurement of PGE2 and 25(OH)2D3 serum level in healthy women and breast cancer patients was performed in winter and summertime. Additionally, the influence of calcitriol on cell proliferation was determined. In addition we examined the effect of calcitriol on the enzyme expression.
Results: We found an inverse correlation between the expression of the PG metabolising enzymes with the VDR as well as with the vitamin D metabolising enzymes by investigating the tissue samples. Moreover, we detected an inverse correlation between the PGE2 and 25(OH)2D3 serum level in breast cancer patients during wintertime. Furthermore the PG receptors were associated with an increased carcinogenesis. The breast cell experiments presented a dysregulated vitamin D metabolism, especially in the invasive breast cell line. Calcitriol showed an antiproliferative effect only in the benign but not in the malignant cell lines, and the expression of COX-2 and 15-hydroxyprostaglandindehydrogenase was influenced by calcitriol only in the benign breast cell line.
Conclusions: These results suggest a link between vitamin D and PG metabolism and therefore a possible synergism between COX-2 inhibition and calcitriol in breast cancer cells. For the first time, we could show an inverse correlation between the two metabolisms in breast cancer on different levels. Thus, the chemopreventive combination of calcitriol and/or vitamin D analogue with a COX-2 inhibitor might decrease the incidence of breast cancer.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P5-07-02.
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Affiliation(s)
- M Thill
- 1University Hospital Schleswig-Holstein, Campus Luebeck, Luebeck, Germany; Helios Klinikum Krefeld, Krefeld, Germany
| | - T Cordes
- 1University Hospital Schleswig-Holstein, Campus Luebeck, Luebeck, Germany; Helios Klinikum Krefeld, Krefeld, Germany
| | - D Fischer
- 1University Hospital Schleswig-Holstein, Campus Luebeck, Luebeck, Germany; Helios Klinikum Krefeld, Krefeld, Germany
| | - F Hoellen
- 1University Hospital Schleswig-Holstein, Campus Luebeck, Luebeck, Germany; Helios Klinikum Krefeld, Krefeld, Germany
| | - M Friedrich
- 1University Hospital Schleswig-Holstein, Campus Luebeck, Luebeck, Germany; Helios Klinikum Krefeld, Krefeld, Germany
| | - K Diedrich
- 1University Hospital Schleswig-Holstein, Campus Luebeck, Luebeck, Germany; Helios Klinikum Krefeld, Krefeld, Germany
| | - C Dittmer
- 1University Hospital Schleswig-Holstein, Campus Luebeck, Luebeck, Germany; Helios Klinikum Krefeld, Krefeld, Germany
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Silveira CGT, Krampe J, Ruhland B, Diedrich K, Hornung D, Agic A. Cold-shock domain family member YB-1 expression in endometrium and endometriosis. Hum Reprod 2011; 27:173-82. [PMID: 22095791 DOI: 10.1093/humrep/der368] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND The Y-box-binding protein (YB-1) is described as a potential oncogene highly expressed in tumors and associated with increased cell survival, proliferation, migration and anti-apoptotic signaling. The aim of our study was to examine the expression and role of YB-1 in human endometriosis (Eo) and its association with cell survival, proliferation and invasion. METHODS We analyzed the gene and protein expression levels of YB-1 by quantitative real-time RT-PCR and immunoassays, respectively, in peritoneal macrophages, ovarian endometrioma and eutopic endometrial tissues/cells derived from women with (n= 120) and without (n= 91) Eo. We also evaluated the functional consequences of YB-1 knockdown in the Z12 Eo cell line by measuring cell proliferation [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazoliumbromid cell proliferation assay], invasion (Matrigel invasion assay) and spontaneous and tumour necrosis factor (TNFα)-induced RANTES (regulated upon activation, normal T-cell expressed and secreted chemokine) expression and apoptosis (ELISA-based assay). RESULTS YB-1 gene and protein expression was statistically significantly higher in ovarian lesions, eutopic endometrium and peritoneal macrophages of patients with Eo in comparison with the control group. Interestingly, the strongest YB-1 expression was observed in the epithelial compartment of endometrial tissues. In the Z12 cell line, YB-1 knockdown resulted in significant cell growth inhibitory effects including reduced cell proliferation and increased rates of spontaneous and TNFα-induced apoptosis. Significantly, higher RANTES expression and decreased cell invasion in vitro were also associated with YB-1 inactivation. CONCLUSION High YB-1 expression could have an impact on the development and progression of Eo. This study suggests the role of YB-1 as a potential therapeutic target for Eo patients.
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Affiliation(s)
- C G T Silveira
- Department of Obstetrics and Gynecology, University of Schleswig-Holstein, Campus Luebeck, Ratzeburgerallee 160, 23538 Luebeck, Germany
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Rogenhofer N, Mittenzwei S, Thaler C, Diedrich K, Baumann K, Bohlmann M. Stellenwert der aktiven Immuntherapie bei Kinderwunschpatientinnen. Gynäkologische Endokrinologie 2011. [DOI: 10.1007/s10304-011-0429-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Bohlmann MK, Goettsching H, Jatzko B, Härtel C, Diedrich K, Husslein P. Schwangerschaftsoutcome nach einer länger als 48h durchgeführten Tokolyse–ein retrospektiver Vergleich zwischen Fenoterol und Atosiban. Z Geburtshilfe Neonatol 2011. [DOI: 10.1055/s-0031-1293384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Von Minckwitz G, Darb-Esfahani S, Loibl S, Huober JB, Tesch H, Solbach C, Holms F, Eidtmann H, Diedrich K, Just M, Clemens M, Hanusch C, Schrader I, Henschen S, Hoffmann G, Tiemann K, Diebold K, Untch M, Denkert C. Responsiveness of adjacent ductal carcinoma in situ and changes in HER2 status after neoadjuvant chemotherapy/trastuzumab treatment in early breast cancer: Results from the GeparQuattro study (GBG 40). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.27_suppl.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
6 Background: Adjacent ductal carcinoma in situ (DCIS) is in found in approximately 45% of invasive ductal carcinomas (IDC) of the breast. Pure DCIS overexpresses HER2 in approximately 45%. There is uncertainty whether adjacent DCIS impacts on the response to neoadjuvant chemotherapy and trastuzumab as well as whether HER2 expression in IDC component or adjacent DCIS changes throughout treatment. Methods: Core biopsies and surgical tissue from participants of the GeparQuattro study with HER2-positive IDC were centrally examined for the area of invasive ductal component and adjacent DCIS before and after receiving neoadjuvant anthracycline-taxane-trastuzumab containing chemotherapy. HER2 overexpression in IDC and adjacent DCIS was quantified separately by immunohistochemistry using the Ventana automated staining system. Pathological complete response (pCR) was defined as no residual invasive or non-invasive tumor tissue. Results: Fifty nine (37.3%) of 158 IDCs presented with adjacent DCIS at diagnosis. These tumors showed lower regression grades than pure IDC (p=0.033). Presence of adjacent DCIS was an independent negative predictor of pCR (odds ratio 0.42 [95% CI 0.2-0.9], p=0.027). Adjacent DCIS area decreased from pre-treatment to surgery (r=0.205) with 30 (50.8%) IDCs with adjacent DCIS showing complete eradication of adjacent DCIS. HER2 status of adjacent DCIS was highly correlated with HER2 status of IDC component before (r=0.892) and after treatment (r=0.676). Degree of HER2 overexpression of the IDC component decreased in 16 (33.3%) out of 49 patients without a pCR. These 16 IDCs showed lower RGs compared to the 33 IDCs with unchanged HER2 expression (p=0.055). Conclusions: HER2-positive IDCs with adjacent DCIS is less responsive to neoadjuvant chemotherapy and trastuzumab compared to pure IDC. However, complete eradication of adjacent DCIS is frequently observed. HER2-overexpression of the invasive ductal component decreases in a subset of tumors, which showed less tumor regression.
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Affiliation(s)
- G. Von Minckwitz
- German Breast Group, Neu-Isenburg, Germany; Charite Universitätsmedizin, Berlin, Germany; University of Tuebingen and Kantonsspital St. Gallen, St. Gallen, Switzerland; Fachpraxis, Frankfurt, Germany; UFK Frankfurt/Main, Frankfurt/Main, Germany; Barbaraklinik, Hamm, Germany; University of Schleswig-Holstein, Kiel, Germany; Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Luebeck, Germany; Onkologische Schwerpunktpraxis, Bielefeld, Germany; Mutterhaus der Boromaerinnen,
| | - S. Darb-Esfahani
- German Breast Group, Neu-Isenburg, Germany; Charite Universitätsmedizin, Berlin, Germany; University of Tuebingen and Kantonsspital St. Gallen, St. Gallen, Switzerland; Fachpraxis, Frankfurt, Germany; UFK Frankfurt/Main, Frankfurt/Main, Germany; Barbaraklinik, Hamm, Germany; University of Schleswig-Holstein, Kiel, Germany; Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Luebeck, Germany; Onkologische Schwerpunktpraxis, Bielefeld, Germany; Mutterhaus der Boromaerinnen,
| | - S. Loibl
- German Breast Group, Neu-Isenburg, Germany; Charite Universitätsmedizin, Berlin, Germany; University of Tuebingen and Kantonsspital St. Gallen, St. Gallen, Switzerland; Fachpraxis, Frankfurt, Germany; UFK Frankfurt/Main, Frankfurt/Main, Germany; Barbaraklinik, Hamm, Germany; University of Schleswig-Holstein, Kiel, Germany; Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Luebeck, Germany; Onkologische Schwerpunktpraxis, Bielefeld, Germany; Mutterhaus der Boromaerinnen,
| | - J. B. Huober
- German Breast Group, Neu-Isenburg, Germany; Charite Universitätsmedizin, Berlin, Germany; University of Tuebingen and Kantonsspital St. Gallen, St. Gallen, Switzerland; Fachpraxis, Frankfurt, Germany; UFK Frankfurt/Main, Frankfurt/Main, Germany; Barbaraklinik, Hamm, Germany; University of Schleswig-Holstein, Kiel, Germany; Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Luebeck, Germany; Onkologische Schwerpunktpraxis, Bielefeld, Germany; Mutterhaus der Boromaerinnen,
| | - H. Tesch
- German Breast Group, Neu-Isenburg, Germany; Charite Universitätsmedizin, Berlin, Germany; University of Tuebingen and Kantonsspital St. Gallen, St. Gallen, Switzerland; Fachpraxis, Frankfurt, Germany; UFK Frankfurt/Main, Frankfurt/Main, Germany; Barbaraklinik, Hamm, Germany; University of Schleswig-Holstein, Kiel, Germany; Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Luebeck, Germany; Onkologische Schwerpunktpraxis, Bielefeld, Germany; Mutterhaus der Boromaerinnen,
| | - C. Solbach
- German Breast Group, Neu-Isenburg, Germany; Charite Universitätsmedizin, Berlin, Germany; University of Tuebingen and Kantonsspital St. Gallen, St. Gallen, Switzerland; Fachpraxis, Frankfurt, Germany; UFK Frankfurt/Main, Frankfurt/Main, Germany; Barbaraklinik, Hamm, Germany; University of Schleswig-Holstein, Kiel, Germany; Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Luebeck, Germany; Onkologische Schwerpunktpraxis, Bielefeld, Germany; Mutterhaus der Boromaerinnen,
| | - F. Holms
- German Breast Group, Neu-Isenburg, Germany; Charite Universitätsmedizin, Berlin, Germany; University of Tuebingen and Kantonsspital St. Gallen, St. Gallen, Switzerland; Fachpraxis, Frankfurt, Germany; UFK Frankfurt/Main, Frankfurt/Main, Germany; Barbaraklinik, Hamm, Germany; University of Schleswig-Holstein, Kiel, Germany; Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Luebeck, Germany; Onkologische Schwerpunktpraxis, Bielefeld, Germany; Mutterhaus der Boromaerinnen,
| | - H. Eidtmann
- German Breast Group, Neu-Isenburg, Germany; Charite Universitätsmedizin, Berlin, Germany; University of Tuebingen and Kantonsspital St. Gallen, St. Gallen, Switzerland; Fachpraxis, Frankfurt, Germany; UFK Frankfurt/Main, Frankfurt/Main, Germany; Barbaraklinik, Hamm, Germany; University of Schleswig-Holstein, Kiel, Germany; Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Luebeck, Germany; Onkologische Schwerpunktpraxis, Bielefeld, Germany; Mutterhaus der Boromaerinnen,
| | - K. Diedrich
- German Breast Group, Neu-Isenburg, Germany; Charite Universitätsmedizin, Berlin, Germany; University of Tuebingen and Kantonsspital St. Gallen, St. Gallen, Switzerland; Fachpraxis, Frankfurt, Germany; UFK Frankfurt/Main, Frankfurt/Main, Germany; Barbaraklinik, Hamm, Germany; University of Schleswig-Holstein, Kiel, Germany; Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Luebeck, Germany; Onkologische Schwerpunktpraxis, Bielefeld, Germany; Mutterhaus der Boromaerinnen,
| | - M. Just
- German Breast Group, Neu-Isenburg, Germany; Charite Universitätsmedizin, Berlin, Germany; University of Tuebingen and Kantonsspital St. Gallen, St. Gallen, Switzerland; Fachpraxis, Frankfurt, Germany; UFK Frankfurt/Main, Frankfurt/Main, Germany; Barbaraklinik, Hamm, Germany; University of Schleswig-Holstein, Kiel, Germany; Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Luebeck, Germany; Onkologische Schwerpunktpraxis, Bielefeld, Germany; Mutterhaus der Boromaerinnen,
| | - M. Clemens
- German Breast Group, Neu-Isenburg, Germany; Charite Universitätsmedizin, Berlin, Germany; University of Tuebingen and Kantonsspital St. Gallen, St. Gallen, Switzerland; Fachpraxis, Frankfurt, Germany; UFK Frankfurt/Main, Frankfurt/Main, Germany; Barbaraklinik, Hamm, Germany; University of Schleswig-Holstein, Kiel, Germany; Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Luebeck, Germany; Onkologische Schwerpunktpraxis, Bielefeld, Germany; Mutterhaus der Boromaerinnen,
| | - C. Hanusch
- German Breast Group, Neu-Isenburg, Germany; Charite Universitätsmedizin, Berlin, Germany; University of Tuebingen and Kantonsspital St. Gallen, St. Gallen, Switzerland; Fachpraxis, Frankfurt, Germany; UFK Frankfurt/Main, Frankfurt/Main, Germany; Barbaraklinik, Hamm, Germany; University of Schleswig-Holstein, Kiel, Germany; Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Luebeck, Germany; Onkologische Schwerpunktpraxis, Bielefeld, Germany; Mutterhaus der Boromaerinnen,
| | - I. Schrader
- German Breast Group, Neu-Isenburg, Germany; Charite Universitätsmedizin, Berlin, Germany; University of Tuebingen and Kantonsspital St. Gallen, St. Gallen, Switzerland; Fachpraxis, Frankfurt, Germany; UFK Frankfurt/Main, Frankfurt/Main, Germany; Barbaraklinik, Hamm, Germany; University of Schleswig-Holstein, Kiel, Germany; Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Luebeck, Germany; Onkologische Schwerpunktpraxis, Bielefeld, Germany; Mutterhaus der Boromaerinnen,
| | - S. Henschen
- German Breast Group, Neu-Isenburg, Germany; Charite Universitätsmedizin, Berlin, Germany; University of Tuebingen and Kantonsspital St. Gallen, St. Gallen, Switzerland; Fachpraxis, Frankfurt, Germany; UFK Frankfurt/Main, Frankfurt/Main, Germany; Barbaraklinik, Hamm, Germany; University of Schleswig-Holstein, Kiel, Germany; Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Luebeck, Germany; Onkologische Schwerpunktpraxis, Bielefeld, Germany; Mutterhaus der Boromaerinnen,
| | - G. Hoffmann
- German Breast Group, Neu-Isenburg, Germany; Charite Universitätsmedizin, Berlin, Germany; University of Tuebingen and Kantonsspital St. Gallen, St. Gallen, Switzerland; Fachpraxis, Frankfurt, Germany; UFK Frankfurt/Main, Frankfurt/Main, Germany; Barbaraklinik, Hamm, Germany; University of Schleswig-Holstein, Kiel, Germany; Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Luebeck, Germany; Onkologische Schwerpunktpraxis, Bielefeld, Germany; Mutterhaus der Boromaerinnen,
| | - K. Tiemann
- German Breast Group, Neu-Isenburg, Germany; Charite Universitätsmedizin, Berlin, Germany; University of Tuebingen and Kantonsspital St. Gallen, St. Gallen, Switzerland; Fachpraxis, Frankfurt, Germany; UFK Frankfurt/Main, Frankfurt/Main, Germany; Barbaraklinik, Hamm, Germany; University of Schleswig-Holstein, Kiel, Germany; Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Luebeck, Germany; Onkologische Schwerpunktpraxis, Bielefeld, Germany; Mutterhaus der Boromaerinnen,
| | - K. Diebold
- German Breast Group, Neu-Isenburg, Germany; Charite Universitätsmedizin, Berlin, Germany; University of Tuebingen and Kantonsspital St. Gallen, St. Gallen, Switzerland; Fachpraxis, Frankfurt, Germany; UFK Frankfurt/Main, Frankfurt/Main, Germany; Barbaraklinik, Hamm, Germany; University of Schleswig-Holstein, Kiel, Germany; Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Luebeck, Germany; Onkologische Schwerpunktpraxis, Bielefeld, Germany; Mutterhaus der Boromaerinnen,
| | - M. Untch
- German Breast Group, Neu-Isenburg, Germany; Charite Universitätsmedizin, Berlin, Germany; University of Tuebingen and Kantonsspital St. Gallen, St. Gallen, Switzerland; Fachpraxis, Frankfurt, Germany; UFK Frankfurt/Main, Frankfurt/Main, Germany; Barbaraklinik, Hamm, Germany; University of Schleswig-Holstein, Kiel, Germany; Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Luebeck, Germany; Onkologische Schwerpunktpraxis, Bielefeld, Germany; Mutterhaus der Boromaerinnen,
| | - C. Denkert
- German Breast Group, Neu-Isenburg, Germany; Charite Universitätsmedizin, Berlin, Germany; University of Tuebingen and Kantonsspital St. Gallen, St. Gallen, Switzerland; Fachpraxis, Frankfurt, Germany; UFK Frankfurt/Main, Frankfurt/Main, Germany; Barbaraklinik, Hamm, Germany; University of Schleswig-Holstein, Kiel, Germany; Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Luebeck, Germany; Onkologische Schwerpunktpraxis, Bielefeld, Germany; Mutterhaus der Boromaerinnen,
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Dittmer C, Fischer D, Diedrich K, Thill M. Diagnosis and treatment options of vulvar cancer: a review. Arch Gynecol Obstet 2011; 285:183-93. [PMID: 21909752 DOI: 10.1007/s00404-011-2057-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2011] [Accepted: 08/02/2011] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Vulvar cancer is a rare malignancy in women. However, within the past decade, a distinct increase in the incidence of vulvar intraepithelial neoplasia (VIN) as a precursor lesion, and an increase of vulvar cancer have been reported within Europe and the USA. Surgery is the first choice in treating patients with vulvar cancer, especially in its early stages. In an attempt to decrease the incidence of complications, research was made into modifications of the surgical procedure without compromising the prognosis. The replacement of radical vulvectomy by less wide local excision is one of these modifications. As vulvar cancer is relatively rare, it is possible to give evidence-based treatment recommendations, but usually on a low evidence level. Aim of this paper is to elucidate diagnostics and surgical treatment options in the management of vulvar cancer. MATERIALS AND METHODS We searched major databases (i.e. pubmed) with the following selection criteria: vulvar cancer, en bloc resection, triple incision, and sentinel node biopsy. CONCLUSIONS Today, the operative therapy is much less radical and more emphasized on individualized therapeutic concepts. The tendency is to leave the ultraradical surgical options which suffer from high morbidity towards less radical, minimal invasive techniques. Due to the rarity of the disease further studies will have to be performed by international collaborative groups.
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Affiliation(s)
- C Dittmer
- Department of Obstetrics and Gynaecology, University Hospital of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany.
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Fauser BCJM, Diedrich K, Bouchard P, Domínguez F, Matzuk M, Franks S, Hamamah S, Simón C, Devroey P, Ezcurra D, Howles CM. Contemporary genetic technologies and female reproduction. Hum Reprod Update 2011; 17:829-47. [PMID: 21896560 PMCID: PMC3191938 DOI: 10.1093/humupd/dmr033] [Citation(s) in RCA: 307] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The Fifth Evian Annual Reproduction (EVAR) Workshop Meeting discussed knowledge regarding contemporary genetics in female reproduction. METHODS Specialist reproductive medicine clinicians and geneticists delivered presentations based on published literature and current research. The content of this report is based on the expert presentations and subsequent group discussions that took place during this Workshop. RESULTS Numerous ovarian genes with a role in infertility have been identified. Future challenges for genetic screening of patients, such as those with polycystic ovary syndrome, primary ovarian insufficiency or endometriosis, include the identification of high-throughput strategies and how to apply these findings to infertile patients. The identification of high-quality embryos in IVF using objective technologies remains a high priority in order to facilitate single-embryo transfer. Gene expression profiling of cumulus cells surrounding the oocyte, and proteomic and metabolomic approaches in embryo culture media may significantly improve non-invasive embryo quality assessment. CONCLUSIONS The way forward in advancing the knowledge of genes involved in reproduction was considered to be through genome-wide association studies involving large numbers of patients. Establishing international collaboration is required to enable the application of such technologies in sufficient numbers of patients.
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Diedrich K. Zulässigkeit der Präimplantationsdiagnostik in Deutschland. Gynäkologische Endokrinologie 2011. [DOI: 10.1007/s10304-011-0436-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Griesinger G, Diedrich K. Progesteronsubstitution in der Frühschwangerschaft. Gynäkologische Endokrinologie 2011. [DOI: 10.1007/s10304-011-0438-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Colakoglu M, Toy H, Icen MS, Vural M, Mahmoud AS, Yazici F, Buendgen N, Cordes T, Schultze-Mosgau A, Diedrich K, Beyer D, Griesinger G, Oude Loohuis EJ, Nahuis MJ, Bayram N, Hompes PGA, Oosterhuis GJE, Bossuyt PM, van der Veen F, Mol BWJ, van Wely M, Nahuis MJ, Oude Loohuis EJ, Kose N, Bayram N, Hompes PGA, Oosterhuis GJE, Bossuyt PM, van der Veen F, Mol BWJ, van Wely M, Yaba A, Demir N, Allegra A, Pane A, Marino A, Scaglione P, Ruvolo G, Manno M, Volpes A, Lunger F, Wildt L, Seeber B, Kolibianakis EM, Venetis CA, Bosdou J, Toulis K, Goulis DG, Tarlatzi TB, Tarlatzis BC, Franz M, Keck C, Daube S, Pietrowski D, Demir N, Yaba A, Iannetta R, Santos RDS, Lima TP, Giolo F, Iannetta O, Martins WP, Paula FJ, Ferriani RA, Rosa e Silva ACJS, Martinelli CE, Reis RM, Devesa M, Rodriguez I, Coroleu B, Tur R, Gonzalez C, Barri PN, Nardo LG, Mohiyiddeen L, Mulugeta B, McBurney H, Roberts SA, Newman WG, Grynberg M, Lamazou F, Even M, Gallot V, Frydman R, Fanchin R, Abdalla H, Nicopoullos J, Leader A, Pang S, Witjes H, Gordon K, Devroey P, Arrivi C, Ferraretti AP, Magli MC, Tartaglia ML, Fasolino MC, Gianaroli L, Macek sr. M, Feldmar P, Kluckova H, Hrehorcak M, Diblik J, Cernikova J, Paulasova P, Turnovec M, Macek jr. M, Hillensjo T, Yeko T, Witjes H, Elbers J, Devroey P, Mardesic T, Abuzeid M, Witjes H, Mannaerts B, Okubo T, Matsuo R, Kuwayama M, Teramoto S, Chakraborty P, Goswami SK, Chakravarty BN, Nandi SS, Kabir SN, Ramos Vidal J, Prados N, Caligara C, Garcia J, Carranza FJ, Gonzalez-Ravina A, Salazar A, Tocino A, Rodriguez I, Fernandez-Sanchez M, Ito H, Iwasa T, Hasegawa E, Hatano K, Nakayama D, Kazuka M, Usuda S, Isaka K, Ventura V, Doria S, Fernandes S, Barros A, Valkenburg O, Lao O, Schipper I, Louwers YV, Uitterlinden AG, Kayser M, Laven JSE, Sharma S, Goswami S, Goswami SK, Ghosh S, Chattopadhyay R, Sarkar A, Chakravarty BN, Louwers YV, Valkenburg O, Lie Fong S, van Dorp W, de Jong FH, Laven JSE, Ghosh S, Chattopadhyay R, Goswami SK, Radhika KL, Chakravarty BN, Benkhalifa M, Demirol A, Montjeant D, Delagrange P, Gentien D, Giakoumakis G, Menezo Y, Dattilo M, Gurgan T, Engels S, Blockeel C, Haentjens P, De Vos M, Camus M, Devroey P, Dimitraki M, Koutlaki N, Gioka T, Messini CI, Dafopoulos K, Messinis IE, Gurlek B, Batioglu S, Ozyer S, Nafiye Y, Kale I, Karayalcin R, Uncu G, Kasapoglu I, Uncu Y, Celik N, Ozerkan K, Ata B, Ferrero H, Gomez R, Delgado F, Simon C, Gaytan F, Pellicer A, Osborn JC, Fien L, Wolyncevic J, Esler JH, Choi D, Kim N, Choi J, Jo M, Lee E, Lee D, Fujii R, Neyatani N, Waseda T, Oka Y, Takagi H, Tomizawa H, Sasagawa T, Makinoda S, Ajina M, Zorgati H, Ben Salem A, Ben Ali H, Mehri S, Touhami M, Saad A, Piouka A, Karkanaki A, Katsikis I, Delkos D, Mousatat T, Daskalopoulos G, Panidis D, Pantos K, Stavrou D, Sfakianoudis K, Angeli E, Chronopoulou M, Vaxevanoglou T, Jones R GMJ, Lee WD, Kim SD, Jee BC, Kim KC, Kim KH, Kim SH, Kim YJ, Park KA, Chae SJ, Lim KS, Hur CY, Kang YJ, Lee WD, Lim JH, Tomizawa H, Makinoda S, Fujita S, Waseda T, Fujii R, Utsunomiya R T, Vieira C, Martins WP, Fernandes JBF, Soares GM, Reis RM, Silva de Sa MF, Ferriani R RA, Yoo JH, Kim HO, Cha SH, Koong MK, Song IO, Kang IS, Hatakeyama N, Jinno M, Watanabe A, Hirohama J, Hiura R, Konig TE, Beemsterboer SN, Overbeek A, Hendriks ML, Heymans MW, Hompes P, Homburg R, Schats R, Lambalk CB, van der Houwen L, Konig TE, Overbeek A, Hendriks ML, Beemsterboer SN, Kuchenbecker WK, Renckens CNM, Bernardus RE, Schats R, Homburg R, Hompes P, Lambalk CB, Potdar N, Gelbaya TA, Nardo LG, de Groot PCM, Dekkers OM, Romijn JA, Dieben SWM, Helmerhorst FM, Guivarch Leveque A, Homer L, Broux PL, Moy L, Priou G, Vialard J, Colleu D, Arvis P, Dewailly D, Aghahosseini M, Aleyasin A, Sarvi F, Safdarian L, Rahmanpour H, Akhtar MA, Navaratnam K, Ankers D, Sharma SD, Son WY, Chung JT, Reinblatt S, Dahan M, Demirtas M, Holzer H, Aspichueta F, Exposito A, Crisol L, Prieto B, Mendoza R, Matorras R, Kim K, Lee J, Jee B, Lee W, Suh C, Moon J, Kim S, Sarapik A, Velthut A, Haller-Kikkatalo K, Faure GC, Bene MC, de Carvalho M, Massin F, Uibo R, Salumets A, Alhalabi M, Samawi S, Taha A, Kafri N, Modi S, Khatib A, Sharif J, Othman A, Hamamah S, Assou S, Anahory T, Loup V, Dechaud H, Dewailly D, Mousavi Fatemi H, Doody K, Witjes H, Mannaerts B, Basconi V, Jungblut L, Young E, Van Thillo G, Paz D, Pustovrh MC, Fabbri R, Pasquinelli G, Magnani V, Macciocca M, Parazza I, Battaglia C, Paradisi R, Venturoli S, Ono M, Teranisi A, Fumino T, Ohama N, Hamai H, Chikawa A, Takata R, Teramura S, Iwahasi K, Shigeta M, Heidari M, Farahpour M, Talebi S, Edalatkhah H, Zarnani AH, Ardekani AM, Pietrowski D, Szabo L, Sator M, Just A, Franz M, Egarter C, Hope N, Motteram C, Rombauts LJ, Lee W, Chang E, Han J, Won H, Yoon T, Seok H, Diao FY, Mao YD, Wang W, Ding W, Liu JY, Chang E, Yoon T, Lee W, Cho J, Kwak I, Kim Y, Afshan I, Cartwright R, Trew G, Lavery S, Lockwood G, Niyani K, Banerjee S, Chambers A, Pados G, Tsolakidis D, Billi H, Athanatos D, Tarlatzis B, Salumets A, Laanpere M, Altmae S, Kaart T, Stavreus-Evers A, Nilsson TK, van Dulmen-den Broeder E, van der Stroom E, Konig TE, van Montfrans J, Overbeek A, van den Berg MH, van Leeuwen FE, Lambalk CB, Taketani T, Tamura H, Tamura I, Asada H, Sugino N, Al - Azemi M, Kyrou D, Papanikolaou EG, Polyzos NP, Devroey P, Fatemi HM, Qiu Z, Yang L, Yan G, Sun H, Hu Y, Mohiyiddeen L, Higgs J, Roberts S, Newman W, Nardo LG, Ho C, Guijarro JA, Nunez R, Alonso J, Garcia A, Cordeo C, Cortes S, Caballero P, Soliman S, Baydoun R, Wang B, Shreeve N, Cagampang F, Sadek K, Hill CM, Brook N, Macklon N, Cheong Y, Santana R, Setti AS, Maldonado LG, Valente FM, Iaconelli C, Braga DPAF, Iaconelli Jr. A, Borges Jr. E, Yoon JS, Won MY, Kim SD, Jung JH, Yang SH, Lim JH, Kavrut M, Kahraman S, Sadek KH, Bruce KB, Macklon N, Cagampang FR, Cheong YC, Cota AMM, Oliveira JBA, Petersen CG, Mauri AL, Massaro FC, Silva LFI, Vagnini LD, Nicoletti A, Pontes A, Cavagna M, Baruffi RLR, Franco Jr. JG, Won MY, Kim SD, Yoon JS, Jung JH, Yang SH, Lim JH, Kim SD, Kim JW, Yoon TK, Lee WS, Han JE, Lyu SW, Shim SH, Kuwabara Y, Katayama A, Tomiyama R, Piao H, Ono S, Shibui Y, Abe T, Ichikawa T, Mine K, Akira S, Takeshita T, Hatzi E, Lazaros L, Xita N, Kaponis A, Makrydimas G, Sofikitis N, Stefos T, Zikopoulos K, Georgiou I, Guimera M, Casals G, Fabregues F, Estanyol JM, Balasch J, Mochtar MH, Van den Wijngaard L, Van Voorst S, Koks CAM, Van Mello NM, Mol BWJ, Van der Veen F, Van Wely M, Fabregues F, Iraola A, Casals G, Creus M, Carmona F, Balasch J, Villarroel C, Lopez P, Merino P, Iniguez G, Codner E, Xu B, Cui Y, Gao L, Xue KAI, Li MEI, Zhang YUAN, Diao F, Ma X, Liu J, Leonhardt H, Gull B, Kishimoto K, Kataoka M, Stener-Victorin E, Hellstrom M, Cui Y, Wang X, Zhang Z, Ding G, HU X, Sha J, Zhou Z, Liu J, Liu J, Kyrou D, Kolibianakis EM, Fatemi HM, Camus M, Tournaye H, Tarlatzis BC, Devroey P, Davari F, Rashidi B, Rahmanpour Zanjani H, Al-Inany H, Youssef M, Aboulghar M, Broekmans F, Sterrenburg M, Smit J, Abousetta A, Van Dessel H, Van Leeuwen J, McGee EA, Bodri D, Guillen JJ, Rodriguez A, Trullenque M, Coll O, Vernaeve V, Snajderova M, Keslova P, Sedlacek P, Formankova R, Kotaska K, Stary J, Weghofer A, Dietrich W, Barad DH, Gleicher N, Rustamov O, Pemberton P, Roberts S, Smith A, Yates A, Patchava S, Nardo L, Toulis KA, Mintziori G, Goulis DG, Kintiraki E, Eukarpidis E, Mouratoglou SA, Pavlaki A, Stergianos S, Poulasouhidou M, Tzellos TG, Tarlatzis BC, Nasiri R, Ramezanzadeh F, Sarafraz Yazdi M, Baghrei M, Lee RKK, Wu FS, Lin S, Lin MH, Hwu YM. POSTER VIEWING SESSION - REPRODUCTIVE ENDOCRINOLOGY. Hum Reprod 2011. [DOI: 10.1093/humrep/26.s1.90] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Banz-Jansen C, Diedrich K, Mebes I. Totale laparoskopische Hysterektomie ohne uterinen Manipulator an großen Uteri (>280g): Technik und Outcome. Geburtshilfe Frauenheilkd 2011. [DOI: 10.1055/s-0031-1286400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Untch M, Gerber B, Möbus V, Schneeweiss A, Thomssen C, Minckwitz GV, Beckmann M, Blohmer JU, Costa SD, Diedrich K, Diel I, Eiermann W, Friese K, Harbeck N, Hilfrich J, Jackisch C, Janni W, Jänicke F, Jonat W, Kaufmann M, Kiechle M, Köhler U, Kreienberg R, Maass N, Marschner N, Nitz U, Scharl A, Wallwiener D. St.-Gallen-Konferenz 2011 zum primären Mammakarzinom. Geburtshilfe Frauenheilkd 2011. [DOI: 10.1055/s-0030-1271133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Ruhland B, Agic A, Krampe J, Diedrich K, Hornung D. Innovations in conservative endometriosis treatment: an updated review. Minerva Ginecol 2011; 63:247-259. [PMID: 21654610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Endometriosis is a common, benign and chronic gynecological disorder. It is also an estrogen-dependent disorder that can result in intractable dysmenorrhea, heavy and/or irregular periods, painful bowel movements and urination during menstruation and infertility and ultimatively in repeated surgeries. Although surgery to remove endometriotic lesions is effective in relieving endometriosis-associated pain, recurrence rates are high and many women require continuous medical therapy to control symptoms. Symptom relief with palliation of pain and optimization of the quality of life should be the main aim of the medical therapy. Different pharmacologic treatment options are currently available. The most widely exerted medical therapy for endometriosis involves gonadotropin-releasing hormone (GnRH) agonists and oral contraceptives. Also progestogens and androgen derivates are used. New treatment options that are currently under investigation are selective progestogen receptor modulators (SPRMs), aromatase inhibitors (AI), GnRH- antagonists, cyclooxygenase (COX)-2 inhibitors, angiogenesis disruptor's und immune modulators. Although these new agents are promising, further confirmation in randomized clinical trials is required.
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Affiliation(s)
- B Ruhland
- University of Schleswig-Holstein, Campus Luebeck, Luebeck, Germany
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Thill M, Becker S, Fischer D, Cordes T, Hoellen F, Friedrich M, Diedrich K, Dittmer C. Is the combination of COX-2 inhibitor and calcitriol a new chemopreventive approach to decrease the incidence of breast cancer? J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e11103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Friese K, Diedrich K. Reproduktionsmedizin. Fragen an die Reproduktionsmedizin. Geburtshilfe Frauenheilkd 2011. [DOI: 10.1055/s-0031-1280000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Agic A, Diedrich K, Hornung D. Die Expression von YB-1 (Mitglied der Cold Shock Domain Familie) in Endometrium und Endometriose. Geburtshilfe Frauenheilkd 2011. [DOI: 10.1055/s-0031-1280503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Deckwart V, Diedrich K, Bündgen N, Beyer D. Bedeutung der Late-onset-Form des adrenogenitalen Syndroms in der Kinderwunschbehandlung. Gynäkologische Endokrinologie 2011. [DOI: 10.1007/s10304-010-0400-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Diedrich K, Fauser B, Devroey P. Cancer and fertility: strategies to preserve fertility. Reprod Biomed Online 2011; 22:232-48. [DOI: 10.1016/j.rbmo.2010.11.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2010] [Revised: 09/07/2010] [Accepted: 11/02/2010] [Indexed: 11/26/2022]
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Beyer D, Diedrich K, Griesinger G. Reproduktionsmedizin. Imprinting-Defekte nach In-vitro-Maturation? Stand der Dinge. Geburtshilfe Frauenheilkd 2011. [DOI: 10.1055/s-0030-1271003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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de Wert G, Dondorp W, Pennings G, Shenfield F, Devroey P, Tarlatzis B, Barri P, Diedrich K. Intrafamilial medically assisted reproduction. Hum Reprod 2011; 26:504-9. [DOI: 10.1093/humrep/deq383] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Dul EC, van Ravenswaaij-Arts CMA, Groen H, van Echten-Arends J, Land JA, Tyulenev Y, Naumenko V, Kurilo L, Shileiko L, Segal A, Klimova R, Kushch A, Ribas-Maynou J, Garcia-Peiro A, Abad C, Amengual MJ, Benet J, Navarro J, Colasante A, Lobascio AM, Scarselli F, Minasi MG, Alviggi E, Rubino P, Casciani V, Pena R, Varricchio MT, Litwicka K, Ferrero S, Zavaglia D, Franco G, Nagy ZP, Greco E, Romany L, Meseguer M, Garcia-Herrero S, Pellicer A, Garrido N, Dam A, Pijnenburg A, Hendriks JC, Westphal JR, Ramos L, Kremer JAM, Eertmans F, Bogaert V, Puype B, Geisler W, Clusmann C, Klopsch I, Strowitzki T, Eggert-Kruse W, Maettner R, Isachenko E, Isachenko V, Strehler E, Sterzik K, Band G, Madgar I, Brietbart H, Naor Z, Cunha-Filho JS, Souza CA, Krebs VG, Santos KD, Koff WJ, Stein A, Hammoud I, Albert M, Bergere M, Bailly M, Boitrelle F, Vialard F, Wainer R, Izard V, Selva J, Cohen - Bacrie P, Belloc S, de mouzon J, Cohen-Bacrie M, Alvarez S, Junca AM, Dumont M, Douard S, Prisant N, Tomita K, Hashimoto S, Akamatsu Y, Satoh M, Mori R, Inoue T, Ohnishi Y, Ito K, Nakaoka Y, Morimoto Y, Smith VJH, Ahuja KK, Atig F, Raffa M, Sfar MT, Saad A, Ajina M, Braga DPAF, Halpern G, Figueira RCS, Setti AS, Iaconelli Jr. A, Borges Jr. E, Medeiros GS, Borges Jr. E, Pasqualotto EB, Pasqualotto FF, Nadalini M, Tarozzi N, Di Santo M, Borini A, Lopez-Fernandez C, Arroyo F, Caballero P, Nunez-Calonge R, Fernandez JL, Gosalvez J, Gosalvez J, Lopez-Fernandez C, Gosalbez A, Cortes S, Caballero P, Nunez-Calonge R, Zikopoulos K, Lazaros L, Vartholomatos G, Kaponis A, Makrydimas G, Plachouras N, Sofikitis N, Kalantaridou S, Hatzi E, Georgiou I, Belloc S, de Mouzon J, Cohen-Bacrie M, Junca AM, Dumont M, Amar E, Cohen-Bacrie P, Vuillaume ML, Brugnon F, Artonne C, Janny L, Pons-Rejraji H, Fedder J, Bosco L, Ruvolo G, Bruccoleri AM, Manno M, Roccheri MC, Cittadini E, Bochev I, Gavrilov P, Kyurkchiev S, Shterev A, Carlomagno G, Colone M, Condorelli RA, Stringaro A, Calogero AE, Zakova J, Kralikova M, Crha I, Ventruba P, Melounova J, Matejovicova M, Vodova M, Lousova E, Sanchez Toledo M, Alvarez LLeo C, Garcia Garrido C, Resta Serra M, Belmonte Andujar LL, Gonzalez de Merlo G, Crha I, Zakova J, Ventruba P, Lousova E, Pohanka M, Huser M, Amiri I, Karimi J, Goodarzi MT, Tavilani H, Filannino A, Magli MC, Boudjema E, Crippa A, Ferraretti AP, Gianaroli L, Robles F, Magli MC, Crippa A, Filannino A, Ferraretti AP, Gianaroli L, Huang H, Yao DJ, Huang HJ, Li JR, Fan SK, Wang ML, Yung-Kuei S, Amer S, Mahran A, Darne J, Shaw R, Boudjema E, Magli MC, Borghi E, Cetera C, Ferraretti AP, Gianaroli L, Shukla U, Ogutu D, Deval B, Jansa M, Savvas M, Narvekar N, Houska P, Dackland AL, Bjorndahl L, Kvist U, Crippa A, Magli MC, Muzii L, Barboni B, Ferraretti AP, Gianaroli L, Samanta L, Kar S, Yakovenko SA, Troshina MN, Rutman BK, Dyakonov SA, Holmes E, Bjorndahl L, Kvist U, Feijo C, Verza Junior S, Esteves SC, Berta CL, Caille AM, Ghersevich SA, Zumoffen C, Munuce MJ, San Celestino M, Agudo D, Alonso M, Sanjurjo P, Becerra D, Bronet F, Garcia-Velasco JA, Pacheco A, Lafuente R, Lopez G, Checa MA, Carreras R, Brassesco M, Oneta M, Savasi V, Parrilla B, Guarneri D, Laureti A, Pagano F, Cetin I, Ekwurtzel E, Bjorndahl L, Kvist U, Morgante G, Piomboni P, Stendardi A, Serafini F, De Leo V, Focarelli R, Dumont M, Belloc S, Junca AM, Benkhalifa M, Cohen-Bacrie M, De Mouzon J, Entezami F, Cohen-Bacrie P, Junca A, Belloc S, Dumont M, Cohen-Bacrie M, Benkhalifa M, De Mouzon JJ, Entezami F, Cohen-Bacrie P, Mangiarini A, Capitanio E, Paffoni A, Restelli L, Guarneri C, Scarduelli C, Ragni G, Harrison K, Irving J, Martin N, Sherrin D, Yazdani A, Almeida C, Correia S, Rocha E, Alves A, Cunha M, Ferraz L, Silva S, Sousa M, Barros A, Perdrix A, Travers A, Milazzo JP, Clatot F, Mousset-Simeon N, Mace B, Rives N, Clarke HS, Callow A, Saxton D, Pacey AA, Sapir O, Oron G, Ben-Haroush A, Garor R, Feldberg D, Pinkas H, Stein A, Wertheimer A, Fisch B, Palacios E, Gonzalvo MC, Clavero A, Ramirez JP, Rosales A, Mozas J, Bjorndahl L, Castilla JA, Mugica J, Ramon O, Valdivia A, Exposito A, Casis L, Matorras R, Bongers R, Gottardo F, Zitzmann M, Kliesch S, Cordes T, Kamischke A, Schultze-Mosgau A, Buendgen N, Diedrich K, Griesinger G, Crisol L, Aspichueta F, Exposito A, Hernandez ML, Ruiz-Sanz JI, Mendoza R, Matorras R, Sanchez-Tusie AA, Bermudez A, Lopez P, Churchill GC, Trevino CL, Maldonado I, Dabbah J. POSTER VIEWING SESSION - ANDROLOGY. Hum Reprod 2011. [DOI: 10.1093/humrep/26.s1.75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kallio S, Kuiri-Hanninen T, Tyrvainen E, Seuri R, Liakka A, Sankilampi U, Dunkel L, Tapanainen JS, Bentzen JG, Pinborg A, Larsen EC, Andersen EW, Johannsen TH, Friis-Hansen L, Nyboe Andersen A, Griesinger G, Dafopoulos K, Buendgen N, Cascorbi I, Georgoulias P, Zavos A, Messinis C, Diedrich K, Messinis I, Kanta Goswami S, Chakravarty BN, Banerjee S, Kabir SN, Souter I, Dimitriadis I, Smith K, Ehrlich S, Berry K, Hauser R, Dewailly D, Gronier H, Poncelet E, Robin G, Leroy M, Pigny P, Duhamel A, Catteau-Jonard S. SELECTED ORAL COMMUNICATION SESSION, SESSION 03: REPRODUCTIVE AGEING AND AMH, Monday 4 July 2011 10:00 - 11:30. Hum Reprod 2011. [DOI: 10.1093/humrep/26.s1.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Rahim A, Devroey P, Diedrich K, Al-Hasani S. Cancellation of fresh embryo transfer: A future perspective. Middle East Fertility Society Journal 2010. [DOI: 10.1016/j.mefs.2010.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Weichert J, Kahl FO, Schröer A, Bohlmann MK, Diedrich K, Hartge DR. [Congenital gastroschisis--prenatal diagnosis and perinatal management]. Z Geburtshilfe Neonatol 2010; 214:135-44. [PMID: 20806148 DOI: 10.1055/s-0030-1255101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The birth prevalence of gastroschisis is increasing world-wide. This situation applies particularly to young, slim women who smoke. At a first glance this is a paradox in light of the ever-increasing age of pregnant women among whom there are fewer and fewer smokers. In numerous studies it has been clearly demonstrated that not only (nutritional) teratogenic substances and environmental factors but also epidemiological causes can be held responsible for this phenomenon. Nowadays gastroschisis is detected prenatally in up to 90% of all foetuses. Advantages of a prenatal diagnosis include the identification of associated disorders and the determination of a high-risk constellation (IUGR, intraabdominal bowel dilatation or vanishing gut). This is essential for an adequate interdisciplinary counseling for the afflicted parents together with obstetricians, paediatric surgeons and neonatalogists. The efficacy of serial amnioexchanges with regard to a better neonatal outcome has as yet not been unambiguously clarified. The possibilities for surgical procedures on the foetus are limited and can at present only be considered as experimental attempts in animal models. From an obstetrical perspective the in utero transport and elective Caesarean section before completion of the 36 (th) week of gestation in a tertiary centre with appropriate facilities (paediatric surgery, neonatalogy) seem to be the course recommended by most authors in spite of inconclusive data. The survival rates for babies with gastroschisis after operative treatment (primary defect closure, silotechnique) are considerably high (>90%).
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Affiliation(s)
- J Weichert
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Campus Lübeck.
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