Yumiko Iba

Gonadotropin-releasing hormone agonist treatment reduced serum interleukin-6 concentrations in patients with ovarian endometriomas

OBJECTIVE To determine whether serum interleukin (IL)-6 can be measured in patients with ovarian endometriomas and whether these measurements are useful in managing this disease. DESIGN A controlled clinical study and an in vitro study. SETTING Department of Obstetrics and Gynecology, Tottori University, Japan.Twenty-two patients with ovarian endometriomas. INTERVENTION(S) Laparoscopic cystectomy for ovarian endometriomas was performed. Gonadotropin-releasing hormone (GnRH) agonist was administered for 3 months in nine patients before laparoscopic surgery. Endometriotic stromal cells obtained from patients with endometriomas with or without GnRH agonist treatment were cultured. MAIN OUTCOME MEASURES(S) IL-6 concentrations in serum or supernatant of the cell culture were measured using ELISA. RESULTS The serum concentration of IL-6 in patients with endometriomas was higher at the time of diagnosis than in those without endometriomas. Laparoscopic surgery significantly reduced serum levels of IL-6. Serum IL-6 concentrations also decreased after treatment with GnRH agonist. IL-6 production was attenuated in the endometriotic stromal cells obtained from patients with GnRH agonist treatment compared with patients without such treatment. CONCLUSION(S) GnRH agonist treatment may decrease IL-6 production in endometriotic cells. Measurement of serum IL-6 concentrations may be of value in managing patients with endometriomas.

The efficacy and safety of dydrogesterone for treatment of dysmenorrhea: An open-label multicenter clinical study: Dydrogesterone for dysmenorrhea

Dydrogesterone is a retro‐progesterone preparation widely used for over a half century. We sought to evaluate the efficacy and safety of dydrogesterone in Japanese women with dysmenorrhea.

Concordant Body Stalk Anomalies in Dichorionic Twins.

A body stalk anomaly is a sporadic and rare condition characterized by serious defects of the abdominal wall and spine.1 It is often diagnosed on the basis of sonographic findings, such as substantial disruption of the anterior abdominal wall, severe kyphoscoliosis, and an obviously short umbilical cord; however, the mechanism of its development has not yet been elucidated. The estimated incidence of body stalk anomalies is 1 per 7500 women undergoing sonography during the first trimester of pregnancy.2 Body stalk anomalies in twins are extremely rare,3 and to date, there are no reported cases of body stalk anomalies in both fetuses in a dichorionic twin pregnancy. Here we report an extremely rare case of body stalk anomalies in both fetuses of a dichorionic twin pregnancy. The patient, a 31-year-old woman, gravida 1, visited our infertility clinic in January 2014. She had no notable personal and family histories. She conceived after treatment with clomiphene citrate, human menopausal gonadotropin, and human chorionic gonadotropin. At 6 weeks’ gestation, 2 gestational sacs were seen in the uterus, and an embryo and embryonic heartbeats were confirmed in each gestational sac. Determination of chorionicity by sonography revealed a dichorionic twin pregnancy. At 8 weeks’ gestation, the crown-rump lengths were 18.6 and 18.5 mm, and no abnormalities were detected. At 9 weeks’ gestation, the crown-rump lengths were 25 and 22 mm. At this time, the expected date of delivery was calculated on the basis of a crown-rump length of 22 mm. At 11 weeks’ gestation, one fetus showed nuchal translucency of 6.2 mm. In addition, the fetus also had a deformity of the ventral wall, and the clinical course was carefully followed, considering the possibility of physiologic omphalocele. At 12 weeks’ gestation, both fetuses showed prominent nuchal translucency and a deformity of the ventral wall, and the patient was referred to the university hospital for a further detailed examination. At the first visit to the university hospital, at 13 weeks’ gestation, marked nuchal translucency was detected in both fetuses. In addition, the examination raised the suspicion of omphalocele. At 15 weeks’ gestation, sonography revealed organs protruding from the abdomen, kyphoscoliosis and flexure of the lower extremities, and a short umbilical cord, based on which the diagnosis of a body stalk anomaly was made (Figure 1, A and B). Because of the extremely poor prognosis of the body stalk anomaly, an abortion was performed at 16 weeks’ gestation. In the first fetus, the amnion was attached to the fetus, and the organs prolapsed outside the abdominal cavity, Clinical Letters