Combination of noninvasive methods in diagnosis of infertile women with minimal or mild endometriosis, a retrospective study in China

Abstract

This study means to investigate a combination of noninvasive methods in diagnosis of minimal or mild endometriosis expecting to narrow down the range of laparoscopic exploration for female infertility. It is a retrospective case control study of totally 447 patients suspected unexplained infertility before surgery were eligible from May 2012 to February 2017. Of these, 299 patients were laparoscopy-proved minimal or mild endometriosis group, the remaining 148 patients served as control group (normal pelvis). Preoperative age, duration of infertility, type of infertility, body mass index, baseline follicle-stimulating hormone, anti- Müllerian hormone, serum CA 125 , clinical symptoms, findings on vagino-recto-abdominal examinations and pregnancy prognosis had been recorded. Every variable and their combinations were evaluated. Any single factor had limited diagnostic value. The cut-off value for CA 125 was 19.25 IU/L. Parallel testing had a higher sensitivity at 81.3%. Serial tests of vagino-recto-abdominal examination combined with dysmenorrhea or positive CA 125 got reasonable sensitivity (51.4% and 49%), remarkable high specificities (95.7% and100%) and Positive Predictive Value (96.4% and 100%). Multivariate logistic regression identified the following factors in decreasing order of importance: (1) vagino-recto-abdominal examinations, (2) CA 125 , (3) dysmenorrhea, their ORs being 16.148, 3.796, and 2.809, respectively. The spontaneous pregnancy rate (50.8%) in minimal or mild endometriosis was higher than control (35.6%, P = .043). A combination of noninvasive diagnostic methods had certain preoperative diagnostic value of minimal or mild endometriosis, which might benefit some patients from avoiding laparoscopic surgery.

Occult vaginal cancer recurrence after hysterectomy: a case report and literature review

“…Vagino-recto-abdominal examination is currently highlighted as the most valuable single noninvasive diagnostic method for assessing women with suspected endometriosis. 7 However, clinicians should also remain aware of the significance of careful physical examination in patients with cervical disease. In the current case, it was difficult to detect the invisible vaginal cancer, and physical examination played a key role in its diagnosis.…”

Role of prolidase activity and oxidative stress biomarkers in unexplained infertility

“…We used transvaginal ultrasound and hysterosalphingography for all patients. In other cases ( n = 32), to distinguish endometriosis, we performed laparoscopy and hysteroscopy 15 . Women with polycystic ovary syndrome, endometriosis, cancer, hypertension, diabetes mellitus, multiple sclerosis, autoimmune disorders, or a history of coronary, hepatic, or renal diseases were not included in the study.…”

Circulating exosomal microRNAs as novel potential detection biomarkers in pancreatic cancer

“…Thus, there is an urgent need to investigate the underlying molecular mechanisms of PC and identify novel diagnostic biomarkers for the disease. Identifying a minimally invasive/non-invasive and sensitive diagnostic method has recently become a popular topic of research and there has been some progression in the study of serum markers (5,6). Further elucidation of the associated biological processes involved is crucial as it may uncover novel potential biomarkers for early diagnosis of PC.…”