Endometriosis seems to have a strong negative effect on female fertility. The aim of this study was to assess the rate of tubal occlusion diagnosed via laparoscopic chromopertubation in infertile women with endometriosis and compare the results to infertile women without endometriosis. In this retrospective cohort study, 275 infertile women with endometriosis and 49 infertile women without endometriosis undergoing diagnostic laparoscopy for primary or secondary infertility with chromopertubation at the Medical University of Vienna between January 2012 and December 2020 have been investigated. During the laparoscopic assessment of tubal patency, significantly more fallopian tubes were occluded in the endometriosis group compared to the control group (25.8 versus 15.3%; p = 0.029). Unilateral and bilateral occlusion was found significantly more often in patients with endometriosis (p = 0.021). In the multivariate analysis, only the rASRM stage (the revised classification of endometriosis by the American Society for Reproductive Medicine) showed a significant association with bilateral occlusion (OR 1.400, 95%CI: 1.018–1.926; p = 0.038). Both a higher rASRM stage (OR 2.181, 95%CI: 1.191–3.995; p = 0.012) and secondary infertility (OR 1.514, 95%CI: 1.156–1.983; p = 0.003) were associated with an increased risk for any kind of fallopian tube occlusion. Endometriosis seems to be associated with an increased risk for fallopian tube occlusion. The rate of tubal occlusion increased significantly with the rASRM stage.

For women with polycystic ovarian syndrome (PCOS) and infertility, stimulation with the aromatase-inhibitor letrozole has been recommended as a first-line for ovulation induction. Calcium-associated signaling has also been a component for other ovulation induction and superovulation medications. This study’s aim was to evaluate parameters of calcium metabolism in PCOS women. In a prospective cohort study, 61 anovulatory, infertile PCOS patients who underwent letrozole stimulation were included. Outcome measures were: follicular maturation after letrozole stimulation; parathyroid hormone (PTH); 25-hydroxyvitamin D3 (25OHD3); serum levels of calcium, phosphorus, magnesium, albumin, and total protein. Successful recruitment of a dominant follicle was achieved in 35 patients (57.4%). Women with and without successful follicular development did not differ in serum levels of PTH (38.4 ± 19.7 vs. 39.6 ± 16.2 pg/mL), 25OHD3 (62.5 ± 32.1 vs. 65.4 ± 30.9 nmol/L), calcium (2.36 ± 0.08 vs. 2.37 ± 0.12 mmol/L), or protein (70.2 ± 13.3 vs. 74.0 ± 3.7 g/L), respectively (p > 0.05). However, women who were not responsive to letrozole for ovulation induction demonstrated higher anti-Müllerian hormone (AMH) levels (9.7 ± 4.7 vs. 5.0 ± 3.2 ng/mL, p = 0.005). In conclusion, the success of letrozole stimulation in women with PCOS is independent from calcium metabolism parameters. However, AMH levels seem predictive of medication resistance.

Objective: Polycystic ovary syndrome is frequently associated with hyperandrogenemia-related hirsutism, which creates notable cosmetic concerns for many affected women. Although multiple antiandrogenic treatments exist, many patients remain dissatisfied, and combined oral contraceptives are often contraindicated due to metabolic and cardiovascular risk factors. This study evaluates whether a drospirenone-only pill improves hormonal profiles and hirsutism in PMOS compared to cyclic dydrogesterone. Methods: This retrospective cohort study assessed hyperandrogenemia and hirsutism using the modified Ferriman–Gallwey score in 60 overweight or obese women with PMOS who were treated at the Clinical Division of Gynecologic Endocrinology and Reproductive Medicine of the Medical University of Vienna, Austria. Patients underwent follow-up examinations after three and six months of treatment. Thirty women chose treatment with drospirenone-only and were age-matched with 30 women receiving cyclic dydrogesterone. Results: After 3 months, women in the drospirenone group showed significant improvements, including reductions in LH (p < 0.001), FSH (p < 0.001), testosterone (p = 0.001), FAI (p < 0.001) and AMH (p = 0.005). Ferriman–Gallwey scores were significantly lower after 3 months (p < 0.001) and 6 months (p = 0.001). At follow-up, the drospirenone group exhibited lower LH (5.4 vs. 8.8 mIU/mL; p = 0.004) and lower FAI (2.9 vs. 4.0; p = 0.045) compared with controls. Among women with baseline hirsutism (FGS ≥ 8), scores decreased from 14 to 12 (p < 0.001) after 3 months and to 10 (p = 0.002) after 6 months in the drospirenone group. Conclusions: Drospirenone-only treatment resulted in a modest reduction in Ferriman–Gallwey score, with more pronounced improvements observed in women with baseline hirsutism. This was accompanied by hormonal changes, suggesting a potentially beneficial option for women with hyperandrogenic PMOS for whom combined oral contraceptives are not suitable.