Gynae

 

Recent Submissions

  • Stalling of the endometrial decidual reaction determines the recurrence risk of miscarriage
    Brosens, Jan; 1 Warwick Medical School, Division of Biomedical Sciences, University of Warwick; CV4 7AL Coventry, UK. 2 Tommy’s National Centre for Miscarriage Research, University Hospitals Coventry & Warwickshire National Health Service Trust; CV2 2DX Coventry, UK. 3 Research Group Genetics, Reproduction and Development, Vrije Universiteit Brussel; 1050 Brussels, Belgium. 4 Department of Clinical Immunology Service, University of Birmingham; B15 2TT Birmingham, UK. 5 Department of Cardiovascular Sciences, University of Leicester; LE1 7RH Leicester, UK. 6 Tommy's National Centre for Miscarriage Research, Imperial College London; W12 0HS. London, UK. *Corresponding author. Email: J.J.Brosens@warwick.ac.uk (J.J.B.) †These authors contributed equally to this work. ‡Present address: Lonza Pharma & Biotech; CB10 1XL Saffron Walden, UK. §Present address: Department of Obstetrics and Gynecology, Nagoya City University; 464- 8601 Nagoya, Japan. ¶Present address: School of Medicine and Population Health, University of Sheffield; S10 2RX, Sheffield, UK (Science Family of Journals, 2025)
    In every menstrual cycle, progesterone acting on estrogen-primed endometrium elicits an inflammatory decidual reaction, rendering it poised for embryo implantation and transformation into the decidua of pregnancy. Here, we show that the sequential functions of the decidual reaction - implantation and decidualization - pivot on the time-sensitive loss of progesterone-resistant DIO2+ stromal cells that form a specialized implantation niche and reciprocal expansion of progesterone-dependent PLA2G2A+ pre-decidual cells. Simultaneously, uterine natural killer (uNK) cell proliferation results in the accumulation of immunotolerant subsets. Examination of endometrial biopsies from 924 women revealed that the recurrence risk of miscarriage closely aligns with the incidence of a weakened or stalled decidual reaction, more so than poor uNK cell expansion. Analysis of paired biopsies obtained in different cycles and modeling in assembloids intimated that prior miscarriages disrupt intercycle endometrial homeostasis and calibration of the decidual reaction. Our findings show that erosion of the decidual reaction following a miscarriage drives the recurrence risk irrespective of maternal age.

  • Robotic and laparoscopic gynaecological surgery: a prospective multicentre observational cohort study and economic evaluation in England.
    McCarthy, Andrew; Samarakoon, Dilupa; Gray, Joanne; Mcmeekin, Peter; McCarthy, Stephen; Newton, Claire; Nobbenhuis, Marielle; Lippiatt, Jonathan; Twigg, Jeremy; twigg, jeremy; et al. (BMJ Publishing Group, 2023-09-28)
    Objective: To compare the health-related quality of life and cost-effectiveness of robot-assisted laparoscopic surgery (RALS) versus conventional 'straight stick' laparoscopic surgery (CLS) in women undergoing hysterectomy as part of their treatment for either suspected or proven gynaecological malignancy.

  • Low-grade Serous Carcinoma Arising in Inguinal Nodal Endosalpingiosis: Report of 2 Cases and Literature Review.
    Sah, Shatrughan; Fulmali, Rahul; McCluggage, W Glenn; Sah, Shatrughan; Clinical Diagnostic Services; Medical and Dental (Wolters Kluwer, 2020-05)
    We report 2 cases of low-grade serous carcinoma probably arising from endosalpingiosis within inguinal lymph nodes. The neoplasms occurred in 51- and 58-yr old women in the absence of tumor within the adnexa, peritoneum or elsewhere. These represent the first reported examples of low-grade serous carcinoma arising within and confined to inguinal nodes. We review the pertinent literature regarding primary nodal low-grade serous carcinoma.