RESUMO
<p><b>BACKGROUND</b>The relationship between intramural myomas and fertility remains unclear. The main debate rests on whether cavity-distorting intramural myomas (CDMs) adversely affect fertility more than non-CDMs. We aimed to compare the effects of enucleating non-CDMs and CDMs on fertility improvement in females with unexplained infertility.</p><p><b>METHODS</b>We prospectively recruited 83 women undergoing myomectomy for unexplained infertility with intramural myomas between June 2008 and November 2012 and classified them into non-CDMs group (n = 45) and CDMs group (n = 38). We then compared postoperative infertility rates, spontaneous pregnancy rates, pregnancy outcomes, live birth rates, and obstetric complications. For continuous variables, we calculated the mean ± standard deviation, median and interquartile range, and analyzed the data using Student's t-test and the Mann-Whitney U-test. For categorical variables, the Pearson's Chi-square test, the continuity correction test, and Fisher's exact test were used.</p><p><b>RESULTS</b>Patients' demographics and myoma characteristics were comparable between the two groups. The overall spontaneous pregnancy rate increased from 0% to 68.42% following myomectomy. The postoperative infertility rate was significantly higher in the non-CDMs group than that in the CDMs group (50.00% vs. 23.53%, t = 5.579, P = 0.018), whereas the postoperative spontaneous pregnancy rate was significantly lower in the non-CDMs group than that in the CDMs group (47.62% vs. 70.59%, t = 4.067, P = 0.044). Compared with the enucleation of non-CDM, the enucleation of CDM patients was a protective factor for the fertility restoration (risk ratio [RR] = 3.717, 95% confidence interval [CI]: 1.284-10.753, P = 0.015), although postoperative fertility restoration declined with age (RR = 1.141, 95% CI: 1.005-1.295, P = 0.041).</p><p><b>CONCLUSIONS</b>Intramural myomas are associated with impaired fertility. Women experiencing unexplained infertility, and possessing intramural myomas, have a better chance of conception following myomectomy, and these benefits are more obvious for younger patients and patients with CDM.</p>
RESUMO
Objective To investigate the prevalence and relationship between high risk human papillomavirus(HR-HPV)and cervical intraepithelial neoplasia(CIN)in married women from Beijing.Methods From March 2007 to September 2008,a total of 6185 married women were sampled,covering 137 communities in 12 districts.The samples were screened by high-risk HPV DNA test(HC2)and cytological test.For those participants with cytological test results≥ASCUS,pathological tests were performed.An interview was also carried out with the same questionnaire.Results from the tests were inputted into the database twice using EpiData 3.0,reviewed,analyzed,using SPSS 15.0.Results(1)The prevalence rates of HR-HPV and CIN were 9.9% and 6.0%,respectively for the age group 25 to 54.(2)The peak age groups for HR-HPV and CIN prevalence rates were 30 to 34 years old.(3)The prevalence rates of positive cytology(40.3%)and CIN (30.4%)in HR-HPV positive female population were significantly higher than that in HR-HPV negative group.(4)Data from unconditional logistic regression analysis showed that,when comparing with the normal subjects,the risk odds ratios of HR-HPV with low grade CIN and cervical cancer/high grade CIN were 8.385 and 97.416 and the attributable risk proportions with these groups were 88.1% and 99.0%,respectively.Conclusion HR-HPV infection seemed to be the main risk factor for CIN.Married women,from age group 30-34,were under the high risk group in both HR-HPV infection and CIN incidence.