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Introduction: Thrombosis occurs frequently in COVID-19. While the exact mechanism is unclear, 3 processes seem to play important roles in sepsis-related thrombosis and mortality: tissue factor expression on circulating monocytes and microparticles, hypercoagulability (increased clot firmness), and hypofibrinolysis. Rotational thromboelastometry is a point-of-care viscoelastic technique that uses the viscoelastic properties of blood to monitor coagulation. Using various assays, viscoelastometry could monitor this triad of changes in severely ill, COVID-19-positive patients. Similarly, with the increased incidence of coagulopathy, many patients are placed on anticoagulants, making management more difficult depending on the agents utilized. Viscoelastometry might also be used in these settings to monitor anticoagulation status and guide therapy, as it has in other areas. Case Presentation: We present a case series of 6 patients with different stages of disease and different management plans. These cases occurred at the height of the pandemic in New York City, which limited testing abilities. We first discuss the idea of using the NaHEPTEM test as a marker of tissue factor expression in COVID-19. We then present cases where patients are on different anticoagulants and review how viscoelastometry might be used in a patient on anticoagulation with COVID-19. Conclusion: In a disease such as COVID-19, which has profound effects on hemostasis and coagulation, viscoelastometry may aid in patient triage, disease course monitoring, and anticoagulation management.

The utilization of assisted reproductive technology (ART), particularly by same-sex female couples (SSFCs), has increased over the past few decades. Alongside the increase in use by lesbian women, there has also been an increase in the number of available treatment options. The process by which SSFCs make the various decisions associated with conceiving and parenting, however, has been largely overlooked. This review provides an overview of the reproductive treatments available to lesbian women and specifically highlights the “biological” and “social” obstacles they must overcome on their journey to parenthood. This review also describes how a relatively novel treatment strategy, co-in vitro fertilization, can give couples greater flexibility and provide them with the unique opportunity of a shared biological motherhood.

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Myomectomy is associated with a short-term decline in serum anti-müllerian hormone levels; however, no long-term change in ovarian reserve, as measured by anti-müllerian hormone levels, is observed, regardless of route of surgery.

Objectives To determine if large‐for‐gestational age (LGA) diagnosed during second‐trimester ultrasound examination is associated with the development of gestational diabetes mellitus (GDM) and LGA at birth. Methods This was a retrospective cohort study of all pregnant women who underwent a second‐trimester anatomy ultrasound examination between 18 and 22 weeks at our institution from 2012 to 2017. Patients were included in the LGA group if estimated fetal weight and/or fetal abdominal circumference was ≥ 90th percentile for gestational age. Patients with a history of pre‐GDM, multiple gestation, preterm delivery, use of betamethasone or fetal anomaly were excluded. The control group consisted of appropriate‐for‐gestational‐age (AGA) pregnancies that were scanned at 18–22 weeks during the study period. AGA was defined as EFW > 10th percentile and ≤ 89th percentile. Prenatal and delivery records were reviewed and demographic and outcome variables were collected. Multivariable logistic regression models were applied to assess the impact of LGA diagnosed in the second trimester on the development of GDM and LGA at birth (birth weight ≥ 90th percentile). Results The study population included 756 patients with a LGA fetus and 756 with an AGA fetus on second‐trimester ultrasound examination. In patients with a LGA fetus diagnosed during the second‐trimester ultrasound examination, the incidence of GDM was 6.0% and the incidence of LGA at birth was 14.9%. Among patients with a LGA fetus in the second trimester, those who developed GDM or LGA at birth were significantly older and were more likely to be obese. Moreover, parity was associated with neonatal LGA (P = 0.0003) but not with GDM (P = 0.82). On multivariable logistic regression analysis with adjustment for age, parity, change in gestational body mass index, obesity, ethnicity and neonatal sex, LGA diagnosed during the second trimester was associated significantly with GDM (adjusted odds ratio (aOR), 2.54; 95% CI, 1.29–5.03; P = 0.007) and LGA at birth (aOR, 6.85; 95% CI, 3.60–13.05; P < 0.0001). Conclusions LGA diagnosed during second‐trimester ultrasound examination is associated with the development of GDM and LGA at birth, independent of known risk factors, and could be used to identify these women earlier for intervention. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.