Gestational diabetes mellitus (GDM) is a very common condition among pregnant women worldwide with important metabolic implications on the mother and the offspring. Vitamin D status has been suggested to potentially play a role in GDM risk with no documented consequences for the offspring. The purpose of this article was to review currently available evidence on the relationship between vitamin D and GDM. Current evidence shows an association between vitamin D blood levels and risk of GDM, despite heterogeneity of results across studies limit the conclusions. Moreover, data from randomized controlled trials is scarce and resulting in null findings. Among the limitations to be noted, improving the standardization of dosages, the characteristics of individuals in the sample, and the appropriate outcome measurement could provide a more effective approach in understanding the relationship between vitamin D and GDM. In conclusions, despite observational studies may suggest that adequate vitamin D levels may decrease the risk of GDM compared to deficiency status, evidence from clinical trials is inadequate to draft any definitive conclusion regarding its supplementation. Future better designed randomized clinical trials taking into account a more integrated approach could provide clearer and definitive data on the outcomes of such a multifactorial condition.

The aim of this study is to summarize evidence on the effectiveness of virtual reality simulators for experienced and novice surgeons in improving their hysteroscopic skills. Three types of hysteroscopic simulators were evaluated: Hyst Sim VR, Virtual Reality Uterine Resectoscopic Simulator, Essure Sim TM. Virtual reality simulators have been assessed to be highly relevant to reality and all surgeons attained significant improvements between their pre-test and post-test phases, independent of their previous level of experience, demonstrating more improvement among novices than experts. Available evidence supports the effectiveness of virtual simulators in increasing the diagnostic and surgical skills of gynaecologists, independent from their starting level of expertise.

Expression of kisspeptin (protein) and Kiss1r (mRNA) was recently documented in the mouse uterus on D4 of pregnancy (the day of embryo implantation) suggesting that the uterine-based kisspeptin (KP)/kisspeptin receptor (KISS1R) signaling system regulates embryo implantation. Despite this important suggestion, it was never demonstrated that the uterus actually exhibits a functional KP/KISS1R signaling system on D4 of pregnancy. Thus, the goal of this study was to determine whether a functional KP/KISS1R signaling system exists in the mouse uterus on D4 of pregnancy. Since kisspeptin/KISS1R signaling triggers the phosphorylation of the mitogen-activated protein kinases p38 and ERK1/2, through immunohistochemical analyses, we determined whether exogenously administered kisspeptin could trigger p38 and ERK1/2 phosphorylation in the uterus on D4 of pregnancy. The results clearly demonstrated that kisspeptin could and that its effects were mediated via KISS1R. Additionally, the robust kisspeptin-triggered response was observed in the pregnant uterus only. Finally, it was demonstrated that on D4 of pregnancy the Kiss1 null uterus expresses functional KISS1R molecules capable of mediating the effects of kisspeptin. These results lead us to conclude that on D4 of pregnancy, the mouse uterus expresses a functional KP/KISS1R signaling system strengthening the possibility that this signaling system regulates embryo implantation. These findings strengthen the rationale for determining whether such a functional system exists in the uterus of the human female and if so, what role it might play in human pregnancy.

Background: Vilaprisan (VPR) is a new orally available selective progesterone receptor modulator (SPRM), with anti-proliferative activity against uterine fibroids (UFs). It definitively causes suppression of ovulation and inhibition of proliferation of endometrial, myometrial and UF cells. Purpose: This review aims to summarize current knowledge on VPR from all studies, including clinical trials, conducted to date and to contextualize the potential role of VPR in future medical regimens for the treatment of UFs. Methods: We performed a literature search in PubMed US National Library of Medicine and Google Scholar databases. Both databases were extensively searched for all original and review articles/book chapters as well as congress abstracts published in English until July 2019. The use of VPR for UF therapy was identified by using the keywords: “uterine fibroids” and “vilaprisan”. Results: In phase I and II clinical trials, VPR was shown to be effective in ameliorating UF-related clinical symptoms, especially abnormal or excessive uterine bleeding and in shrinking UFs. The tolerability of VPR is roughly similar to that of ulipristal acetate (UPA) and it tends to be more favorable than that of GnRH-agonists. Conclusion: Presently, all trials examining the utility of VPR for the treatment of UF are halted; likely, due to the recently reported cases of hepato-toxicity with UPA, in addition to non reassuring toxicology results from preclinical long-term testing on rodents, carried out in parallel with late stage testing on humans. An accurate summary of robust data related to the safety of VPR is urgently needed to draw definitive conclusions on the future clinical development of this drug for UF therapy.