The Australian New Zealand Consortium in Children, Adolescents, and Young Adults Oncofertility action plan.

International and national oncofertility networks, including the US-led Oncofertility Consortium, FertiProtekt, and the Danish Network, have played pivotal roles in advancing the discipline of oncofertility over the last decade. Many other countries lack a shared approach to pediatric oncofertility health service delivery. This study aims to describe baseline oncofertility practices at Australian New Zealand Children's Haematology/Oncology Group centers in 2019-2021, describe binational priorities for care, and propose a 5-year action plan for best practice to be implemented by the newly formed Australian New Zealand Consortium in Children, Adolescents, and Young Adults (CAYA) Oncofertility (ANZCO).

Management of Adnexal Torsion in the Pediatric and Adolescent Population at Western Australia's Single Tertiary Children's Hospital over the Last 10 Years: Retrospective Study.

OBJECTIVE: To review our institutional data regarding the management of adnexal torsion (AT) and assess the ovarian conservation rates. DESIGN: Retrospective study. SETTING: Tertiary children's hospital. PATIENTS: Pediatric and adolescent patients with surgically diagnosed AT. Participants (n = 54, mean age 9.80 ± 3.95 years) were identified between June 2010 and May 2019. INTERVENTIONS: Surgical management of AT. MEASUREMENTS AND MAIN RESULTS: The primary outcome was to determine the ovarian conservation rates in AT cases. The secondary outcomes were to determine the incidence of AT to total emergency department (ED) presentations, decision to operation theater (OT) time in AT cases, return to OT, histopathology, and follow-up with ultrasound to determine ovarian function. Data were collected on demographic and clinical characteristics. Continuous data were compared with t tests or Kruskal-Wallis tests; categoric data were compared with chi-square tests. A total of 52 (96.29%) patients had ovarian conservation, and 53 (98.14%) had laparoscopic management. The incidence rate for AT cases to total ED presentations for the last 10 years was 9.9 per 100 000, which was based on a Poisson distribution. Presentations to an ED for AT cases have trended upward since 2010. Decision to OT time was statistically significantly shorter in cases with preoperative suspicion of AT than those with intraoperative diagnosis of AT (p = .000). A total of 7 (12.96%) patients returned to OT for suspicion of recurrent torsion. Of these, 5 (9.26%) had confirmed repeat AT. The presence of fever, pain duration, severity of pain, and severity of torsion did not correlate with the follow-up ultrasound findings of ovarian activity. CONCLUSION: The findings from our study suggest that high ovarian conservation rates are achievable in AT cases. A high index of suspicion is required to prevent a delay in surgery.

The Place of In Vitro Maturation in PCO/PCOS.

In vitro maturation (IVM) of human oocytes is an emerging treatment option for women with polycystic ovary/polycystic ovary syndrome (PCO/PCOS) in addition to the standard in vitro fertilization (IVF) treatment. There has been significant improvements in pregnancy rates with IVM over the last two decades. This article reviews the place of IVM for women with PCO/PCOS, placing an emphasis on the predictors of successful pregnancy, optimization of culture media, IVM protocols, pregnancy rates, and neonatal outcomes following IVM treatment.

Heterotopic simultaneous splenic and intrauterine pregnancy after spontaneous conception and review of literature.

A 31-year-old woman presented to the emergency department with sudden onset left upper quadrant pain radiating to the left shoulder. Urine ß-hCG test was positive. Transvaginal sonography was suggestive of ruptured ectopic pregnancy with a large amount of free fluid in the pouch of Douglas. The patient was then taken for emergency laparoscopy. On laparoscopy, hemoperitoneum was noted but both the fallopian tubes and ovaries were normal. On further exploration, bleeding was noted from the spleen so laparotomy was performed and emergency splenectomy was carried out by a surgeon. The histopathology report of the spleen confirmed a splenic ectopic pregnancy. On postoperative follow-up, the patient's quantitative serum ß-hCG started rising again, which raised suspicion of another pregnancy. After serial ß-hCG and ultrasound, a failed intrauterine pregnancy was diagnosed. Suction evacuation was performed, with histopathology confirming products of conception.

Antenatal dietary interventions in obese pregnant women to restrict gestational weight gain to Institute of Medicine recommendations: a meta-analysis.

OBJECTIVE: To estimate whether antenatal dietary interventions restrict maternal weight gain in obese pregnant women without compromising newborn birth weight. DATA SOURCES: PubMed and Cochrane Controlled Trials Register were searched using free-text search terms: pregnancy, obesity, overweight, dietary intervention, lifestyle, and randomis(z)ed controlled trial through March 2011 in a similar search strategy to that used in a previous systematic review. METHODS OF STUDY SELECTION: We included randomized controlled trials in which antenatal dietary intervention was provided to pregnant women who were overweight or obese at booking. We extracted 263 abstracts or reports, from which 39 full-text articles were reviewed. TABULATION, INTEGRATION, AND RESULTS: Four randomized controlled trials were identified involving 537 women. The results suggested that there was a significant pool treatment effect (z=11.58, P<.001), because antenatal dietary intervention programs were effective in reducing the total gestational weight gain by 6.5 kg. Despite this, antenatal dietary interventions did not alter newborn birth weight (z=0.18, P=.859). CONCLUSION: Antenatal dietary interventions in obese pregnant women can reduce maternal weight gain in pregnancy without an effect on newborn birth weight.