Gynecology Oncology
Soheila Aminimoghaddam; Nima Azh; Somayyeh Noei Teymoordash; Firouzeh Ghaffari
Volume 7, Issue 5 , July and August 2022, , Pages 362-373
Abstract
Uterine cancer affects more than 1.28 million people worldwide; considering current world trends in obesity and aging, a +52.7% growth by 2040 is foreseen. Around 5% of endometrial cancer patients are less than 40 years old, meaning that conventional oncologic approaches would result in fertility loss; ...
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Uterine cancer affects more than 1.28 million people worldwide; considering current world trends in obesity and aging, a +52.7% growth by 2040 is foreseen. Around 5% of endometrial cancer patients are less than 40 years old, meaning that conventional oncologic approaches would result in fertility loss; thus, it is essential to consult patients regarding their fertility and family planning.Owing to developments of oncofertility, patients are now able to preserve their fertility and complete their childbearing, drafting from the standard of care in endometrial cancer. Strict criteria should be applied to make sure of selecting patients who benefit most from the fertility preservation approach. Furthermore, careful selection of patients increases the possibility of successful treatment.Most candidates for fertility preservation have risk factors in common with infertility, including polycystic ovarian syndrome, obesity, increasing of age and irregular menses; therefore, Advanced Reproductive Technology (ART) can improve their chances for pregnancy.Current applied knowledge towards the fertility preservation approach in patients with endometrial cancer is reviewed in this article.
Gynecology Oncology
Mohammad Pouryasin; Azam-Sadat Mousavi; Jalil Pakravesh; Delaram Zare Kamel; Shahla Nooriardabili; Shakiba Khodadad; Soheila Aminimoghaddam; Mehran Ghazimoghadam; Yasaman Farbod; Ali Pouryasin
Volume 7, Issue 5 , July and August 2022, , Pages 405-413
Abstract
Background & Objective: Persistent infection with some types of Human papillomavirus (HPV), which are high-risk genotypes, can lead the patients toward cervical cancer and, finally, death. Recent studies showed HPV co-infection with non-HPV sexually transmitted infections (non-HPV STIs) could increase ...
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Background & Objective: Persistent infection with some types of Human papillomavirus (HPV), which are high-risk genotypes, can lead the patients toward cervical cancer and, finally, death. Recent studies showed HPV co-infection with non-HPV sexually transmitted infections (non-HPV STIs) could increase the persistency rate of HPV infections. This study aimed to estimate the prevalence of STIs and assess the association of HPV/non-HPV STIs co-infection on cervical cell changes based on cytological findings.Materials & Methods: In this cross-sectional study, in addition to the routine cervical screening, including HPV testing and cytological assessment, non-HPV STI testing was performed on 1065 Iranian women. To assess the HPV and non-HPV STIs, commercial kits were used.Results: 964 (90.5%) women had normal cytology (NILM) results. The overall prevalence of HPV and non-HPV STIs were 39.1% and 68.5%, respectively. HPV-53 (6.5%), -16 (6.1%) and -31 (5.5%) were found as the most prevalent genotypes. Ureaplasma Parvum (UP) (42.7%), Group B Streptococcus (GBS) (23.7%), Candida Species (CS) (23.6%), Ureaplasma Urealyticum (UU) (9.6%), and Mycoplasma Hominis (MH) (7.1%) were found as the most prevalent non-HPV STIs. The co-infection of HPV with GBS played an important role in developing the cervical lesion (P < /i><0.05). Conclusion: In the present study, the STIs, including HPV, UP, GBS, CS, UU, and MH, were prevalent among the study participant, and it was found that the HPV/GBS co-infection played a significant role in the development of LSIL or worse cytological grades. To clarify this issue, further studies will be conducted.
Obstetrics and Gynecology
Soheila Aminimoghaddam
Volume 7, Issue 4 , March and April 2022, , Pages 358-360
Abstract
Response to the editor letter Dear Professor Behtash,I am writing this letter to respond to the letter written by Professor Reda Hemida from Mansoura University, Egypt, regarding a publication of mine titled “The Association of Gestational Trophoblastic Neoplasia and Misoprostol Administered ...
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Response to the editor letter Dear Professor Behtash,I am writing this letter to respond to the letter written by Professor Reda Hemida from Mansoura University, Egypt, regarding a publication of mine titled “The Association of Gestational Trophoblastic Neoplasia and Misoprostol Administered Before Suction Curettage of Molar Pregnancy,” published in 2019 in your journal.I want to first thank Professor Hemida for reading my paper carefully and sharing his comments. I highly believe that sharing comments and raising scientific questions could benefit our society. I hope that the responses that the co-authors have provided be helpful and to the point. As he suggested, I am willing to let the journal publish the responses in the next issue.
Obstetrics and Gynecology
Tahereh Ashrafganjoei; Atyeh Bahman; Somayyeh Noei Teymoordash; Soheila Aminimoghaddam; Abdolali Ebrahimi; Maryam Talayeh
Volume 6, Issue 3 , June 2021, , Pages 105-109
Abstract
Background & Objective: Endometrial carcinoma is the most common malignancy of the female genital tract, which most often affects postmenopausal women. The ovaries may be active when a patient has endometrial cancer, so removing an ovary can worsen a patient's quality of life. On the other hand, ...
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Background & Objective: Endometrial carcinoma is the most common malignancy of the female genital tract, which most often affects postmenopausal women. The ovaries may be active when a patient has endometrial cancer, so removing an ovary can worsen a patient's quality of life. On the other hand, a complete surgical staging in endometrial cancer includes oophorectomy since 1988. There has been some research to assess whether an oophorectomy should be performed and in which cases, ovaries can be preserved.Materials & Methods: Aim of this study was to evaluate the coexistence of ovarian involvement in endometrioid endometrial carcinoma. In this study, we evaluated 180 patients with endometrioid endometrial cancer patients who were surgically staged at Imam Hossein Hospital between 2004 and 2017.Results: Mean age of subjects of the study was 56.78 ±10.59. Forty-six of patients (25.6 %) were less than 50 years old and 74.4 % (134) were older than 50. Twenty out of 180 (11.1 %) of them had ovarian involvement (one of them had simultaneous ovarian tumor) and 11 (55%) of these cases were less than 50 years old. In 55 % (11) patients, the involved ovaries were less than 5 cm with grossly normal appearance, lymph nodes metastases were detected in 3 out of 20 (15 %) of them although their ovarian size were 4, 4.5 and 6.5 cm. In 10 (50 %) of them, deep myometrial invasion was detected.Conclusion: In endometrial cancer staging, ovarian preservation could be a challenging decision and a real controversy which needs more researches.
Soheila Aminimoghaddam; Afsar Ahmad; Setare Nassiri
Volume 4, Issue 3 , September and October 2019, , Pages 111-116
Abstract
Background & Objective: Gestational trophoblastic neoplasia contains a group of abnormal trophoblastic tumors including hydatidiform moles (partial and complete) and non-molar trophoblastic neoplasms (invasive mole, choriocarcinoma, placental site trophoblastic tumor). The incidence is 1-2 per 1000 ...
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Background & Objective: Gestational trophoblastic neoplasia contains a group of abnormal trophoblastic tumors including hydatidiform moles (partial and complete) and non-molar trophoblastic neoplasms (invasive mole, choriocarcinoma, placental site trophoblastic tumor). The incidence is 1-2 per 1000 deliveries both in the United States and Europe. The aim of this study was to prove the noninferiuority and safety of misoprostol use in cervical ripening in patient with molar pregnancy.
Materials & Methods: This retrospective cohort study was performed on 150 women with molar pregnancy referred to Firuzgar and Mirza-koochack-khan hospitals in Tehran, between 2006 and 2013. We defined group 1 as 100 patients without Misoprostol pretreatment and group 2 as 50 patients with Misoprostol pretreatment. There was no significant difference in the number of complete or partial mole between the two groups. They were followed by serum ß-hCG level and if it became plateaued in 4 measurements or rose more than 10% in 3 measurements in a period of three weeks, would be defined as persistent.
Results: We found no significant difference of maternal age, fundal height, gestational age, gravity, parity, number of previous abortions and prevalence of complete and partial moles between the two groups. A total of 27 (27%) patients in non-Misoprostol group and 5 (10%) patients in Misoprostol group developed Persistent GTN (P < /em><0.05). We observed no case of trophoblastic embolism in the misoprostol group.
Conclusion: Misoprostol cervical ripening resulted in lower Persistent GTN incidence. Also, trophoblastic embolism following misoprostol administration is so rare that we observed no case.
Soheila Aminimoghaddam; Nastaran Abolghasem
Volume 4, Issue 1 , March and April 2019, , Pages 5-11
Abstract
Vasomotor symptoms, also known as hot flashes, can be defined as a sensation of heat, intense sweating, and flushing, which are experienced episodically by many perimenopausal women. This sensation usually affects the face, neck, and chest. It is estimated that about 75% to 80% of women would suffer ...
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Vasomotor symptoms, also known as hot flashes, can be defined as a sensation of heat, intense sweating, and flushing, which are experienced episodically by many perimenopausal women. This sensation usually affects the face, neck, and chest. It is estimated that about 75% to 80% of women would suffer from hot flashes at some point during their perimenopausal years. A decline in oestrogen levels during menopause seems to be responsible for the appearance of hot flashes. This decline increases norepinephrine levels, leading to an up-regulation of serotonin receptors in the hypothalamus, which are involved in temperature regulation. The outcome of the activation of this norepinephrine serotonin pathway is believed to be the narrower thermoregulation zone, which in turn results in a greater risk of crossing the upper and lower thresholds of the thermoregulatory zone. Thus, it causes sweats and chills in this group of women. The most known effective treatment of hot flashes is hormone replacement therapy (HRT); however, in recent years, other non-hormonal options have become available for those women who cannot or do not want to take HRT.
Soheila Aminimoghaddam; Nastaran Abolghasem; Tahereh Ashraf- Ganjooie
Volume 3, Issue 3 , September and October 2018, , Pages 123-128
Abstract
Introduction: Gestational trophoblastic diseases (GTD) is the only group of female reproductive neoplasms derived from paternal genetic material (Androgenic origin). GTD is a continuum from benign to malignant; molar pregnancy is benign, but choriocarcinoma is malignant. Approximately 45% of patients ...
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Introduction: Gestational trophoblastic diseases (GTD) is the only group of female reproductive neoplasms derived from paternal genetic material (Androgenic origin). GTD is a continuum from benign to malignant; molar pregnancy is benign, but choriocarcinoma is malignant. Approximately 45% of patients have metastatic disease when Gestational trophoblastic neoplasia (GTN) is diagnosed. GTN is unique in women malignancies because it arises from trophoblast but not from genital organs. It is curable with chemotherapy, low-risk GTN completely response to single-agent chemotherapy and does not require histological confirmation. In persistent GTN, clinical staging and workup of metastasis should be performed. The aim of the present study was to review the new management of GTD.
Conclusion In the case of brain, liver, or renal metastases, any woman of reproductive age who presents with an apparent metastatic malignancy of unknown primary site should be screened for the possibility of GTN with a serum HCG level. Excisional biopsy is not indicated to histologically confirm the diagnosis of malignant GTN if the patient is not pregnant and has a high HCG value. Given the vascular nature of these lesions, a biopsy can have significant morbidity. In every woman with abnormal bleeding or neurologic symptom without documented reason, the probability of malignant GTN should be in mind and determination of HCG titer is recommended. In selected cases with low-risk GTN, repeat curettage is done to reduce the need for chemotherapy courses. In recent years personalized medicine is encouraged for treatment of GTN.
Soheila Aminimoghaddam; Ghazal Kamyabi; Fariba Yarandi; Soghra Zarei
Volume 2, Issue 2 , May and June 2017
Abstract
Background: Endometrial carcinoma is the most common cancer of the female genitalia and its prevalence is 2% to 3% along the females’ lifetime. This adenocarcinoma is diagnosed in the early stages because the patients become symptomatic early in the course of disease. The correlation of the lower ...
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Background: Endometrial carcinoma is the most common cancer of the female genitalia and its prevalence is 2% to 3% along the females’ lifetime. This adenocarcinoma is diagnosed in the early stages because the patients become symptomatic early in the course of disease. The correlation of the lower uterine segment involvement (LUSI) with the recurrence, and the survival rates in patients with endometrial adenocarcinoma are always questionable. Confirming the prognostic significance of LUSI can fundamentally improve the current state of patients’ surveillance. The current study aimed at investigating the association of lower uterine segment involvement with deep myometrial invasion in endometrial adenocarcinoma.
Methods: In the current retrospective cohort study, 54 patients with stage I endometrial endometrioid adenocarcinoma who underwent surgery in Mirza-Koochak-Khan Hospital, Tehran, Iran, from 2004 to 2014 were divided into 2 groups according to the presence of LUSI. In the current cohort study, the data from the patients exposed to LUSI were obtained by questionnaires to measure deep myometrial invasion besides post-operative adjuvant radiotherapy. The median of follow-up period was 48 months for all of the patients, which started after their surgery, and the measurement period for variables were similar to those of the follow-up period, which was 48 months. They were compared regarding to age, tumor grade, depth of myometrial invasion, lymphovascular involvement, extra uterine diseases, the extent of lymphadenectomy, adjuvant therapy, recurrence rate, time, and location. The data analysis was conducted by the SPSS v.16 statistical software (Chicago, IL, USA) at the significance level of 5%. In the investigation, Chi-square, the Kolmogorov-Smirnov, t test, and the Mann-Whitney U tests were used.
Results: Group 1 consisted of 13 patients with LUSI and group 2 had 41 patients without LUSI divided by a non-random sampling method. According to the results of the Mann-Whitney U test, there was a significant difference between the mean age of patients with LUSI and that of the ones without LUSI (P = 0.03). It showed that the mean age in the former group was significantly higher than that of the latter. A Chi-square test showed no significant association between the lymphovascular involvement and the presence of LUSI (P = 0.1). The Fisher exact test showed that patients with LUSI had significantly higher rate of radiotherapy after surgery rather than the ones without LUSI (P < 0.001).
Conclusions: In conclusion, there was a significant association between the lower uterine segment involvements with deep my ometrial invasion in the endometrial endometrioid adenocarcinoma. In other words, there was a significant difference in the depth of myometrial invasion between the groups, and the patients with LUSI had deeper myometrial invasion (the Mann-Whitney U test, P < 0.001).
Maryam Kashanian; Sara Norouzi; Nooshin Eshraghi; Mohammadreza Babai; Soheila Aminimoghaddam
Volume 1, Issue 3 , November and December 2016
Abstract
Introduction: Pseudoaneurysm of the uterine arteries is a rare cause of late postpartum hemorrhage (PPH) but could potentially be a life threatening complication.
Case Presentation: We report a case of a patient with pseudoaneurysm of the uterine arteries following a cesarean section, who presented ...
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Introduction: Pseudoaneurysm of the uterine arteries is a rare cause of late postpartum hemorrhage (PPH) but could potentially be a life threatening complication.
Case Presentation: We report a case of a patient with pseudoaneurysm of the uterine arteries following a cesarean section, who presented with late PPH. Bilateral uterine artery ligation was done to conserve the uterus, however, the hemorrhage did not cease. In order to control the bleeding, embolization was suggested. During angiography, a pseudoaneurysm of the feeding femoral artery was noticed and embolization was performed to save the patient.
Discussion: Uterine artery pseudoaneurysm is one of the uncommon causes of secondary postpartum hemorrhage and could lead to a life-threatening situation. Management should be multidisciplinary and the gold standard for treatment and diagnosis is through interventional radiology.
Fatemeh Sharifzadeh; Sara Norouzi; Mahnaz Ashrafi; Soheila Aminimoghaddam; Jalil Koohpayezadeh
Volume 1, Issue 2 , September and October 2016
Abstract
Background: Different studies found that zinc is necessary for sexual maturity, growth and fertility. But there are no distinct studies that clarify the role of zinc supplements on semen parameters.
Objectives: The current study aimed to evaluate the zinc supplement therapeutic effects on semen samples ...
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Background: Different studies found that zinc is necessary for sexual maturity, growth and fertility. But there are no distinct studies that clarify the role of zinc supplements on semen parameters.
Objectives: The current study aimed to evaluate the zinc supplement therapeutic effects on semen samples of infertile males. Patients and Methods: The study comprised one-hundred-twenty sub fertile males. The study was a double-blinded placebo controlled clinical trial. The subjects were randomly allocated to treatment with zinc supplement (n = 60) or placebo (n = 60) groups. Subjects in both groups were given 10 mL, three times daily. In order to determine the sperm concentration, Motility and morphology, standardized semen and blood samples were obtained before and after treatment, according to the World Health Organization (WHO) guidelines; semen morphology according to strict criteria, and blood and semen zinc concentration also were measured. Effects of the two interventions were evaluated in sub fertile males.
Results: Sub fertile males demonstrated a significant increase (8.8 ± 7.4 × 106 cells/mL to 17.2 ± 13.5 × 106 cells/mL) in concentration and normal sperm in zinc group versus the placebo group. Blood serum zinc concentration increased in the interventional group significantly (P = 0.000), and also semen plasma zinc concentration increased significantly (P = 0.000).
Conclusions: Normal sperm percentage and total sperm concentration increased after zinc sulfate treatment. The beneficial effect of zinc and all results of the current study opened new way to medical purposes and public health researches.
