Transforming growth factor-beta 1 (TGF-beta 1) is a polypeptide involved in a variety of important physiological and pathophysiological processes such as the implantation of the embryo into the endometrium. Many factors seem to be related to this event. TGF-beta 1 is involved in many mechanisms both in endometrial and in embryonic tissues: it induces proliferation and differentiation, it regulates proteolytic activity and it modulates the maternal immune response. This study evaluated the presence of TGF-beta 1 in the endometrium during normal menstrual cycles and in the uterine fluids during induction of ovulation in the framework of an in vitro fertilization program. Immunohistochemistry was used to identify TGF-beta 1 in the endometrium and immunodot-blot to quantitate TGF-beta 1 in the uterine cavity fluid. The study shows that TGF-beta 1 is present in the endometrial tissue and its secretion is modulated during the menstrual cycle, as demonstrated immunohistochemically; its production seems to be controlled by ovarian steroids. In conclusion, TGF-beta 1 influences the growth and differentiation of the embryo, as well as the activation of embryonic proteolytic enzymes, and it modulates the maternal-embryonic immune response. Its variability in the uterine cavity is demonstrated in this study, and the underexpression of TGF-beta 1 in the uterine cavity might be responsible for failed implantation.
Background:The Manchester-Fothergill operation (MF) has largely been replaced by Vaginal Hysterectomy (VH) however the MF procedure may permit to preserve the fertility in many cases of genital prolapse.Objective: To obtain pregnancies after MF procedure. Materials and Method:Four women submitted to MF desiring pregnancy. Results:Every patient became pregnant with deliveries near term. Conclusion:The MF operation should be taken into account in fertile women even in view of the fact that the long-term outcome is similar to VH.
The aim of this multicentric, prospective study was to evaluate the effects of vaginal erbium laser (VEL-SMOOTH®) on sexual function in postmenopausal women suffering from the genitourinary syndrome of menopause (GSM). This study was performed on an outpatient basis without anesthesia or drug use before or after the intervention, using an erbium laser (XS Fotona Smooth®, Fotona, Ljubljana, Slovenia) in 1081 postmenopausal women (age 54.3 ± 3.9 years) treated with up to three laser applications every 30 days. Patients were assessed using the Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale-Revised (FSDS-R). No adverse events were recorded during the study. The FSDS-R scores (n = 554), from basal values of 25.5 ± 3.5, were 11.5 ± 3.0, 10.5 ± 3.5 and 11.5 ± 3.5 at the 4-, 12- and 24-week follow-ups, respectively (p < 0.01 vs. corresponding basal values). Individual FSFI domain scores (n = 569) significantly (p < 0.001) increased after VEL-SMOOTH® treatment and remained significantly higher up to the 24th week after the end of treatment. The total scores, from basal values of 15.5 ± 1.5, were 27.5 ± 2.5, 27.6 ± 2.7and 27.0 ± 3.5 at the 4-, 12- and 24-week follow-ups, respectively (p < 0.01 vs. corresponding basal values). Albeit not randomized, this large, prospective study shows that VEL-SMOOTH® treatment may improve sexual function in postmenopausal women suffering from GSM.
