Background: Endometriosis (EM) is an inflammatory condition in which the endometrium is observed to develop outside the uterine cavity. Endometrium has conventionally been recognized as a rich source of endometrial mesenchymal stem cells (E-MSCs). The influence of dienogest, a medication frequently prescribed for EM, on E-MSCs has not been extensively investigated. Aims: To explore effects of dienogest on the E-MSCs derived from healthy (E-MSCs-control) and diseased (E-MSCs-endometriosis) endometrial tissue samples in vitro. Methods: We collected samples from healthy and diseased endometrial tissues. E-MSCs were derived from both healthy and EM tissues. The effect of dienogest (VISANNE) on E-MSCs was assessed by examining cell proliferation, telomerase activity, cell migration, and estrogen secretion levels after the isolation and characterization of E-MSCs. Results: We discovered that cellular proliferation rate was higher in the E-MSCs derived from EM tissues compared to those derived from healthy tissue. The proliferation rate , telomerase activity were both suppressed by dienogest treatment, particularly in E-MSCs-endometriosis. The drug treatment also resulted in a decrease in the migration capacity of E-MSCs-endometriosis, from 60.4% to 59.2%. The expression of CXCL12, Ki67 , beta-catenin was analyzed in both E-MSCs-endometriosis and E-MSCs-control. The CXCL12 and Ki67 expressions were quite elevated in the E-MSCs-endometriosis without drug treatment compared to the E-MSCs-control. Following the treatment, these levels declined drastically to the levels close to E-MSCs-control. Similarly, this decrease in gene expression was accompanied by a decrease in estrogen secretion into the medium. Conclusion: This research demonstrates that dienogest exerts a substantial impact on both stromal and stem cells, as it effectively controls the disease by reversing EM markers, despite the absence of progesterone receptors on endometrial stem cells.

Purpose: Obesity is a systemic condition that is increasingly common. Obesity negatively affects sexual function and menstrual regularity. Therefore, losing excess weight is important for women's sexual and menstrual health. Methods: The change in body mass index (BMI) and and excess weight loss (EWL) of sexually active female patients who underwent laparoscopic sleeve gastrectomy (LSG) were evaluated by a general surgeon. The preoperative and postoperative periods were compared by a gynecologist using the survey method menstrual patterns, dysmenorrhea complaints, if any, and sexual function with the Female Sexual Function Scale (FSFI). Results: The study included 55 patients with a mean ± standard deviation BMI on the day of the operation of 45.32 ± 5.82 kg/m2. In the first postoperative year, the mean BMI significantly reduced to 27.88 ± 1.99 (p < 0.001). The mean percentage of EWL at the end of 1 year was 73.09 ± 19.74 after LSG. The median (range) preoperative FSFI score of the patients was 26.30 (22.70–27.70). One year after LSG, the median FSFI score significantly improved to 34.50 (30.20–35.30) (p < 0.001). Compared to the period before surgery, the frequency of sexual intercourse increased from two-to-three times a week (p < 0.001). Conclusion: Women's sexual desires are a fundamental human right and contribute to female well-being. Thus, it is important to treat sexual dysfunction. The results of the present study demonstrate a significant improvement in sexual dysfunctions after LSG. LSG was an effective procedure that may be recommended to obese women with sexual dysfunction and menstrual problems. Graphical

Introduction: The success of emergency cerclage in the presence of incompetent cervix and protruding fetal membrane is a matter of debate. Theories suggest that the microbiome may play an important role in influencing the structural integrity of the cervix. Hence, understanding the microbiome status before cerclage operation may have value in predicting the success rate of the procedure. This study aimed to examine the existence of microbial organisms in amniotic fluid through polymerase chain reaction (PCR) detection of 16S rRNA species and assess its correlation with perinatal outcomes in mid-trimester emergency cerclage cases. Methods: Nineteen patients were scheduled for amniodrainage and emergency cerclage due to cervical insufficiency and they formed the cerclage group. The control group was formed by 56 patients who were seeking consultation for routine control and underwent karyotyping and physical examination at our clinic. Results: In the cerclage group, PCR results were negative in all control group patients, whereas nine patients tested positive for PCR (p<0.001). Chorioamnionitis was observed in five PCR-positive patients but not in PCR-negative patients (p<0.001), and three newborns had sepsis in PCR-positive patients, while none were observed in PCR-negative patients (p=0.01). Neonatal mortality was significantly higher in PCR-positive patients compared to PCR-negative patients (p=0.011), with all infants born to PCR-positive patients succumbing. Conversely, 60% of the infants of PCR-negative patients in the cerclage group were discharged in good health. Conclusions: In this study, the presence of a potential link between the microbiome status and the success of emergency cerclage procedures was underlined.