Karolina Frankowska

Background: Benign ovarian cysts encompass various lesions, including functional cysts and endometriomas. Given the complex pathogenesis of endometriosis, this study aimed to perform the first exploratory, high-throughput microarray profiling of microRNAs (miRNAs) directly from endometrioma fluid, comparing it with functional ovarian cyst fluid to establish a novel molecular baseline and map putative regulatory networks. Methods: Total RNA was isolated from uncentrifuged cyst fluid (n = 7). Profiling was performed using Affymetrix GeneChip miRNA 4.0 Arrays. Following differential expression analysis (FDR < 0.05, FC > 2.0), candidate target genes for the directly measured mature miRNAs were retrieved from miRTarBase. Standardized HGNC targets regulated by ≥4 distinct miRNAs were analyzed using Cytoscape v3.10.4 for network topology, g:Profiler (version e114_eg62_p19_27110d83) for Gene Ontology (GO) enrichment, and Metascape v3.5.20260701 for protein–protein interaction (PPI) modules. Results: Principal Component Analysis demonstrated robust separation between cohorts (PC1: 93.5% variance). We identified 37 FDR-significant microarray features, including 35 mature miRNAs. The primary mature miRNA network comprised 234 unique target genes and 1072 interactions. Functional enrichment highlighted the regulation of primary metabolic processes (p_adj = 1.43 × 10⁻¹⁶), cell division (p_adj = 9.97 × 10⁻⁴), and nucleocytoplasmic transport. PPI clustering identified densely connected modules driving cellular stress responses, cell cycle progression, and AGE-RAGE signaling. Conclusions: The identified whole-fluid miRNA profile predominantly reflects the distinct cellular, inflammatory, and hemorrhagic composition of the endometriotic microenvironment. These highly filtered, database-curated networks provide a robust in silico reference framework for future targeted functional validation and biomarker discovery in endometriosis.

Ultrasound-guided transvaginal ethanol sclerotherapy belongs to one of the minimally invasive methods for endometrioma management. Nevertheless, some reports suggested a possible link between the method and the presence of pelvic adhesions. Therefore, our study aimed to describe ultrasound-guided transvaginal sclerotherapy with high-percentage ethanol, which resulted in the preservation of normal anatomy of the minor pelvis and the normal appearance of affected ovaries in the laparoscopic images obtained during postsclerotherapy surgeries. We present four cases of patients who underwent laparoscopic surgeries several months after ethanol sclerotherapies for ovarian endometriomas. During sclerotherapies, cyst fluid was aspirated under ultrasound guidance, cyst cavities were flushed with saline, and then filled with 96% ethanol to 60% of their initial volume for 10 min. The reported cases demonstrate that ultrasound-guided transvaginal ethanol sclerotherapy did not cause excessive adhesion formation or affect ovarian morphology. Therefore, it seems that this treatment method does not adversely affect fertility.

Eutopic Endometrium Immune Changes Involved in Development and Progression of Endometriosis: A Review - Article abstract #949643

Ultrasound-guided transvaginal ethanol sclerotherapy is one of the therapeutic approaches for endometrioma treatment. Similarly, as other treatment options, this method for endometrioma management is associated with risk of endometrioma recurrence. Although some researchers mention reapplication of sclerotherapy in case of the first procedure failure, there are negligible reports on the effects of repeated sclerotherapy. Hence, the purpose of this clinical report is to present a case of a 48-year-old female patient suffering from recurrent ovarian endometrioma who twice underwent this procedure. The patient had a history of ovarian cystectomy, which resulted in a left-sided oophorectomy. Despite hormonal treatment, she still had pain symptoms. The patient underwent ethanol sclerotherapy for endometrioma; however, several weeks after the procedure, recurrence was noticed. Thus, she was qualified for repeated sclerotherapy. During the 5-month follow-up after the second procedure, the patient reported a reduction in pain symptoms, with no evidence of recurrence. Since this case is limited by the short follow-up period, further monitoring of the patient is necessary. Ultrasound-guided ethanol sclerotherapy is, in some cases, associated with endometrioma recurrences. Nevertheless, repeated use of this treatment method can also lead to the achievement of therapeutic goals.

Objectives: Endometriosis is a prevalent chronic gynecological condition resulting in infertility, and severe pain that strongly deteriorates patients’ quality of life. In addition to surgery and pharmacotherapy, there are also other methods of endometriosis management, such as sclerotherapy, which is used in patients with endometrial cysts. So far, there is a shortage of knowledge regarding sclerotherapy's influence on pain symptoms and quality of life. Therefore, the main objective of our study was to assess the effects of sclerotherapy on pain relief and quality of life. Material and methods: Study participants consisted of patients with ovarian endometriomas who have undergone ultrasound-guided transvaginal sclerotherapy with the use of high-percentage ethanol. Patients had no history of chronic diseases, besides endometriosis. They completed self-constructed both pre-procedural and post-procedural questionnaires between 3 and 6 months after sclerotherapy. Results: Our study included 59 patients. Sclerotherapy resulted in a significant alleviation of pain regardless of primary cyst volume, history of endometriosis surgery, post-procedural hormonal treatment, and elapsed time between two questionnaires collection. There was a significant decreasing in Visual Analog Scale (VAS) scores measured for pain during menstruation, sexual intercourse, and chronic pelvic pain after sclerotherapy. Moreover, this procedure resulted in significant improvement in life quality. Most patients reported that they would recommend this treatment method to other patients. Conclusions: Sclerotherapy is characterized by a great ability to alleviate pain and improve quality of life. Keywords: endometriosis ethanol sclerotherapy pain quality of life

Not available Keywords: infertility Hysterosalpingo Contrast Sonography complications

Ultrasound-guided transvaginal ethanol sclerotherapy is one of the methods for ovarian endometrioma treatment. It involves aspiration of the cyst content and subsequent administration of some fibrosis agent. This minimally invasive procedure does not reduce ovarian reserve hence, it is addressed to patients with fertility plans. To date, there have been no reports of this method being used in patients with advanced disease stages. Therefore, we present a case of a patient with advanced deep infiltrating endometriosis who underwent this treatment procedure for endometrioma. Our patient had a history of two extensive laparotomies for deep infiltrating endometriosis. A follow-up MRI examination revealed the presence of ovarian endometrioma and disturbed anatomy of the pelvis. The patient was referred to our center and deemed a suitable candidate for ultrasound-guided transvaginal ethanol sclerotherapy for endometrioma. The procedure was successfully performed. After 8 months of follow-up, no recurrences were observed, and the patient reported significant alleviation of pain symptoms. The high efficacy of sclerotherapy in managing advanced endometriosis phenotypes is encouraging. However, further research is needed.

MicroRNAs as Biomarkers for Metabolic Disorders in Polycystic Ovary Syndrome (PCOS): A Review - Article abstract #946480

Endometriosis in half of affected women is closely related to problems with fertility. Endometriosis-associated infertility is caused by a wide range of abnormalities affecting the female reproductive tract, from oocyte quality impairment to disturbances in the eutopic endometrium or mechanical abnormalities resulting from disease progression. Since supportive antioxidant therapies, in addition to surgical treatment or assisted reproductive techniques (ARTs), have overall been proven to be effective tools in endometriosis management, the objective of our review was to analyze the role of antioxidant substances, including vitamins, micronutrients, N-acetylcysteine (NAC), curcumin, melatonin, and resveratrol, in endometriosis-related infertility. Most of these substances have been proven to alleviate the systemic oxidant predominance, which has been expressed through decreased oxidative stress (OS) markers and enhanced antioxidative defense. In addition, we demonstrated that the predominant effect of the aforementioned substances is the inhibition of the development of endometriotic lesions as well as the suppression of pro-inflammatory molecules. Although we can undoubtedly conclude that antioxidants are beneficial in fertility support, further studies explaining the detailed pathways of their action are needed.

(1) Background: There is a lack of direct evidence on whether SARS-CoV-2 affects women’s sexual function through a biological-organic mechanism. Existing studies on the topic are few and have produced contradictory results. This study aims to explore the possible relationship between sex hormones and sexual function in patients who have been infected with SARS-CoV-2. Moreover, we aimed to determine whether these changes are related to the clinical course of COVID-19 and whether they are temporary or long-lasting. (2) Methods: A study was conducted on 104 women, including 64 women infected with COVID-19 and a control group of 40 healthy women, between January 2021 and August 2022. Blood samples were collected to measure prolactin and oxytocin levels, and a clinical assessment was performed 3 and 6 months later. Sexual function self-assessment was captured based on the FSFI scale. (3) Results: Our study found that patients with severe COVID-19 had better sexual satisfaction scores one month after recovery but no discernible difference after six months. High levels of serum prolactin were observed in patients with active COVID-19 but became similar to a control group after one month and remained stable over time. Higher prolactin levels were significantly associated with increased arousal and hydration. Individuals with severe COVID-19 had notably low levels of plasma oxytocin, but there was no correlation between oxytocin levels and sexual satisfaction. (4) Conclusions: The gynecologic symptoms, as well as disturbances in oxytocin and prolactin levels, might be observed in a short time after infection. However, SARS-CoV-2 infection has no lasting effect on sexual function, oxytocin, and prolactin levels among women.