What is good practice in ultrasound (US), and more specifically during the different stages of transvaginal oocyte retrieval, based on evidence in the literature and expert opinion on US practice in ART? This document provides good practice recommendations covering technical aspects of US-guided transvaginal oocyte retrieval (oocyte pick up: OPU) formulated by a group of experts after considering the published data, and including the preparatory stage of OPU, the actual procedure and post-procedure care. US-guided transvaginal OPU is a widely performed procedure, but standards for best practice are not available. A working group (WG) collaborated on writing recommendations on the practical aspects of transvaginal OPU. A literature search for evidence of the key aspects of the procedure was carried out. Selected papers (n = 190) relevant to the topic were analyzed by the WG. The WG members considered the following key points in the papers: whether US practice standards were explained; to what extent the OPU technique was described and whether complications or incidents and how to prevent such events were reported. In the end, only 108 papers could be used to support the recommendations in this document, which focused on transvaginal OPU. Laparoscopic OPU, transabdominal OPU and OPU for IVM were outside the scope of the study. There was a scarcity of studies on the actual procedural OPU technique. The document presents general recommendations for transvaginal OPU, and specific recommendations for its different stages, including prior to, during and after the procedure. Most evidence focussed on comparing different equipment (needles) and on complications and risks, including the risk of infection. For these topics, the recommendations were largely based on the results of the studies. Recommendations are provided on equipment and materials, possible risks and complications, audit and training. One of the major research gaps was training and competence. This paper has also outlined a list of research priorities (including clarification on the value or full blood count, antibiotic prophylaxis and flushing, and the need for training and proficiency). The recommendations of this paper were mostly based on clinical expertise, as at present, only a few clinical trials have focused on the oocyte retrieval techniques, and almost all available data are observational. In addition, studies focusing on OPU were heterogeneous with significant difference in techniques used, which made drafting conclusions and recommendations based on these studies even more challenging. These recommendations complement previous guidelines on the management of good laboratory practice in ART. Some useful troubleshooting/checklist recommendations are given for easy implementation in clinical practice. These recommendations aim to contribute to the standardization of a rather common procedure that is still performed with great heterogeneity. The meetings of the WG were funded by ESHRE. The other authors declare that they have no conflict of interest. NA. ESHRE Pages content is not externally peer reviewed. The manuscript has been approved by the Executive Committee of ESHRE.

Background and Objectives. Uterine fibroids are relatively common in reproductive-age women and are directly linked to pregnancy. There are many debates about performing a myomectomy at the same time as a caesarian section (CS) in such cases due to the risk of a hemorrhage. Our study aims to investigate fibroid features and their evolution in pregnancy, complications of a myomectomy during CS and maternal and fetal obstetric outcomes of pregnancies with fibroids. Materials and methods. We realize a prospective study that includes 57 patients with fibroids in pregnancy diagnosed in January 2017–June 2019. We analyze the number, the location and the growth of fibroids during pregnancy and the maternal and fetal outcome. We appreciate the bleeding in patients with a myomectomy and without a myomectomy during CS, using hemoglobin values before and after birth. Results. Most of the patients present single fibroids that are 30–160 mm in size, located on the anterior uterine wall. Vaginal delivery is used in 7% of women, whereas 85.96% deliver by CS. In addition, 68% of fibroids are diagnosed in the first trimester. In most cases, the fibroid has maximum growth in the second trimester of pregnancy. The myomectomy rate for fibroids during CS is 24.48. Hemoglobin values showed no statistically significant difference between the two groups with and without myomectomy. The operating time is double for the group with a myomectomy associated with a CS. The results of the obstetric outcomes are abortion in 7% of all patients, whereas premature delivery and births at term are 9.43% and 90.57%, respectively. Conclusions. The decision of performing a myomectomy during pregnancy can be a challenge and must be performed for selected cases. This procedure may have several benefits, such as avoiding another operation to remove fibroids.

Cervical cancer is a major public health problem worldwide. While Romania has the highest incidence of cervical cancer in Europe, the prevalence of HPV has not been evaluated. We report the first data on HPV prevalence and type distribution in Northeast Romania.

This research illustrates a complex, observational, longitudinal, comparative and noninterventional biometric study on the evaluation, in dynamics, of stature-weight development, in children with Down syndrome (DS), compared to children with varying degrees of mental retardation (MR), by repeatedly determining their height and weight, as well as by correlating these two parameters, in order to highlight the harmonious or disharmonious aspect of their stature-weight development. For this purpose, from patients’ medical files, we extracted the data regarding the periodic, annual, height and weight determinations of 50 preschoolers and schoolchildren, institutionalized in two Special Schools in Bucharest, which we compared with the standard tables used for Romanian population. The results showed that all children with DS show a disharmonious stature-weight development, with excess weight, as a consequence of both chromosomal trisomy and associated congenital malformations, especially heart malformations. In children with MR, the results showed a great phenotypic variability in terms of their stature-weight development. Thus, there were several cases in which the stature-weight development was harmonious, but, in the vast majority of cases, the results showed the presence of harmonious stature-weight development periods, which alternate with disharmonious stature-weight development periods, with weight surplus or weight deficit, alternation, which can be explained both by the involvement of genetic factors, and especially by the involvement of environmental, exogenous or endogenous factors.

Human immunodeficiency virus (HIV) infection cannot be completely eliminated from the body because the virus integrates its genetic code into that of the host cell. The prevalence of pregnancy in women with HIV infection has increased due to the efficacy of antiretroviral therapy (ART). Placental insufficiency is associated with a reduction in blood flow and circulatory redistribution, resulting in fetal hypoxia and nutrient deprivation as a consequence of an altered placental function, and it can result in a lower birthweight. The aim of the study was to determine the combined effect of HIV infection and ART on the anthropometric parameters of infants born to HIV-positive pregnant women under ART compared to the values of these parameters in a control group of infants born to healthy mothers. There are no significant differences between the two groups in terms of gestational age at birth. We found a statistically significant lower birth weight in infants born from HIV-positive mothers under ART, with 3041 g in the control group compared to 2758 g in the group of HIV positive pregnant women (p < 0.01). There were statistically significant differences in all anthropometric parameters, these showing higher values in the control group (seronegative pregnant women).

Background and Objectives: Endometriosis, a complex and often underdiagnosed gynecological condition, frequently manifests with ovarian involvement, posing significant clinical challenges. Current diagnostic protocols primarily rely on invasive techniques, thus highlighting the critical need for reliable, non-invasive biomarkers. This study aimed to evaluate the diagnostic performance and clinical relevance of Urocortin and Histone H4, assessed in both serum and urine, as potential biomarkers for ovarian endometriosis. Materials and Methods: We implemented an exploratory study design to investigate potential biomarkers for ovarian endometriosis. The study cohort consisted of 40 women, divided into three groups: Those with histologically confirmed ovarian endometriosis are 30, those with parietal endometriosis are 5, and 5 healthy controls. Standardized ELISA protocols were employed for the quantification of Urocortin and Histone H4 in both serum and urine samples. To ensure consistency, all participants were assessed during the proliferative phase of their menstrual cycle. Finally, comparative and multivariate statistical analyses were conducted to evaluate biomarker variability in the context of relevant clinical parameters. Results: Serum Urocortin levels were comparable across the three groups (mean ± SD: 3.63 ± 0.41 µg/mL in ovarian endometriosis vs. 3.59 ± 0.31 µg/mL in parietal endometriosis and 3.70 ± 0.38 µg/mL in controls; p > 0.05). In contrast, urinary Urocortin levels were significantly elevated in patients with ovarian endometriosis (2.51 ± 1.36 µg/mL), compared to both parietal endometriosis (0.13 ± 0.04 µg/mL) and controls (0.33 ± 0.18 µg/mL; p = 0.001). Multivariate linear regression revealed that age, age at menarche, and disease duration accounted for 28.3% of the variance in urinary Urocortin levels (adjusted R² = 0.283; p = 0.002). Serum Histone H4 concentrations were modestly elevated in the ovarian endometriosis group (0.49 ± 0.18 ng/mL), although no statistically significant intergroup differences were observed. Urinary Histone H4 levels showed subtle variation but lacked discriminatory value. Conclusions: Urinary Urocortin showed a preliminary diagnostic signal in this small exploratory cohort, whereas Histone H4 did not perform significantly. Our findings require replication in larger, multicenter, and rigorously controlled studies with validated urine normalization methods. Nonetheless, our study opens further perspectives for complementing the biomarker panel with potential non-invasive diagnostic value with new candidates.