Reproductive plans and knowledge of assisted reproductive techniques among lesbian women: an international survey study.

OBJECTIVE: Lesbian couples must resort to adoption or donated semen to achieve parenthood, the latter usually involving assisted reproductive technology. The aim of this study is to assess homosexual women's knowledge about assisted reproductive techniques, the importance of perceived genetic and gestational relationships for their future mother-child bond, as well as their reproductive plans. METHODS: This is an observational study based on an anonymous survey disseminated online in several countries on different continents, addressed to homosexual women. RESULTS: From the 549 participants, most reported being well informed about reproductive options including assisted reproductive technology. The majority want to be a mother as part of a couple, mainly through assisted reproduction or step adoption of their partner's child. The importance of a genetic or gestational relationships with their future child varies greatly between women. Among the sampled women, pregnancy was believed to have a slightly greater impact on the future mother-child connection compared to genetics. CONCLUSIONS: Homosexual women are well informed about the assisted reproductive technology treatments. The majority considers it important to become a mother as a couple, mainly through assisted reproduction or step adoption of their partner's child. The importance given to gestation or genetic mother-child relationships varies greatly between women, and it seems they believe pregnancy may have a slightly greater impact on the future mother-child connection compared to genetics.

Ulipristal Acetate in Adenomyosis.

Adenomyosis is defined as the invasion of the basal endometrium (stroma and glands) into the underlying myometrium. It may lead to abnormal uterine bleeding (AUB), pelvic pain, and infertility. The definitive treatment is hysterectomy. Some conservative measures have been used in patients willing to procreate. Ulipristal acetate is a selective progesterone receptor modulator used to treat AUB caused by leiomyomas. This is a systematic review on the use of ulipristal to treat adenomyosis. Eight eligible articles were retrieved from PubMed, SCOPUS, and Cochrane Library. Only one randomized clinical trial was published until date concerning this matter. It seems that ulipristal acetate induces partial or complete remission of AUB caused by adenomyosis, but the evidence concerning its effect on pelvic pain and the radiologic findings of the disease is conflicting. Nevertheless, given the paucity of data, it is still preliminary to draw any conclusion about the subject.