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STUDY QUESTION What is the estimated prevalence and incidence of uterine fibroids diagnosed in Australian women of reproductive age? SUMMARY ANSWER An estimated 7.3% of Australian women had a diagnosis of uterine fibroids by the age of 45–49 years, with age-specific incidence highest in women aged 40–44 years (5.0 cases per 1000 person-years). WHAT IS KNOWN ALREADY Uterine fibroids are associated with a high symptom burden and may affect overall health and quality of life. Studies in different countries show a wide variation in both the prevalence (4.5–68%) and incidence (2.2–37.5 per 1000 person-years) of uterine fibroids, which may be partly explained by the type of investigation, method of case ascertainment, or the age range of the study population, necessitating the reporting of country-specific estimates. STUDY DESIGN, SIZE, DURATION This observational prospective cohort study using self-report survey and linked administrative data (2000–2022) included 8066 women, born between 1973 and 1978, in the Australian Longitudinal Study on Women's Health. PARTICIPANTS/MATERIALS, SETTING, METHODS A combination of self-report survey and linked administrative health data (hospital, emergency department, the Medicare Benefits Schedule, and the Pharmaceutical Benefits Scheme) were used to identify women with a report of a diagnosis of uterine fibroids between 2000 and 2022. MAIN RESULTS AND THE ROLE OF CHANCE Of the 8066 Australian women followed for 22 years, an estimated 7.3% of women (95% CI 6.9, 7.6) had a diagnosis of uterine fibroids by the age of 45–49 years. The incidence increased with age and was highest in women aged 40–44 years (5.0 cases per 1000 person-years, 95% CI 4.3, 5.7 cases per 1000 person-years). Women with uterine fibroids were more likely to experience heavy or painful periods. They were also more likely to report low iron levels, endometriosis, and poor self-rated health and to have two or more annual visits to their general practitioner. LIMITATIONS, REASONS FOR CAUTION Our estimates are based on self-report of doctor diagnosis or treatment for fibroids and/or data linked to treatment and procedure administrative records. This predominantly captures women with symptomatic fibroids, but has the potential for misclassification of asymptomatic women and an underestimate of overall prevalence and incidence. In addition, questions on fibroids were only asked in surveys when women were 37–42 years of age to 43–48 years of age, so cases at younger ages may have been underestimated (particularly in women with less severe symptoms) as these were only ascertained through data linkage. WIDER IMPLICATIONS OF THE FINDINGS These are the first population-based estimates of the prevalence and incidence of uterine fibroids in women of reproductive age in Australia. Establishing these first estimates will help inform health policy and health care provision in the Australian context. STUDY FUNDING/COMPETING INTEREST(S) The ALSWH is funded by the Australian Government Department of Health and Aged Care. L.FW. was supported by an Australian National Health and Medical Research Council (NHMRC) Centres for Research Excellence grant (APP1153420) and G.D.M. was supported by an NHMRC Leadership Fellowship (APP2009577). The funding bodies played no role in the design, the collection, analysis or interpretation of data, the writing of the manuscript, or the decision to submit the manuscript for publication. There are no competing interests. TRIAL REGISTRATION NUMBER N/A. [ABSTRACT FROM AUTHOR]

Background: Developing a shared agenda is an important step in ensuring future research has the necessary relevance.Objective: To characterise research priority setting partnerships (PSPs) relevant to women's health.Search Strategy: Included studies were identified by searching MEDLINE and the James Lind Alliance (JLA) database.Selection Criteria: Priority setting partnerships using formal consensus methods.Data Collection and Analysis: Descriptive narrative to describe the study characteristics, methods, and results.Main Results: Ten national and two international PSPs were identified. All PSPs used the JLA method to identify research priorities. Nine PSPs had published a protocol. Potential research uncertainties were gathered from guidelines (two studies), Cochrane reviews (five studies), and surveys (12 studies). The number of healthcare professionals (31-287), patients (44-932), and others (33-139) who responded to the survey, and the number of uncertainties submitted (52-4767) varied. All PSPs entered confirmed research uncertainties (39-104) into interim priority setting surveys and healthcare professionals (31-287), patients (44-932), and others (33-139) responded. All PSPs entered a short list of research uncertainties into a consensus development meeting, which enabled healthcare professionals (six to 21), patients (eight to 14), and others (two to 13) to identify research priorities (ten to 15). Four PSPs have published their results.Conclusion: Future research priority setting studies should publish a protocol, use formal consensus development methods, and ensure their methods and results are comprehensively reported.Tweetable Abstract: Research published in @BJOGtweets highlights future research priorities across women's health, including @FertilityTop10, @jamesmnduffy. [ABSTRACT FROM AUTHOR]

The article presents a comment to the gold standard in reproductive medicine and advances in assisted reproductive technology (ART). It discusses the expensive cost for fertility treatments, the gap between clinical practice and evidence, and the challenges for evidence-based ART. It also examines the risk of informed patient choice.

BACKGROUND: Ovulation induction treatment with metformin, either alone or in combination with clomiphene citrate (CC), remains controversial even though previous randomized trials have examined this. METHODS: A double blinded multi-centre randomized trial was undertaken including 171 women with anovulatory or oligo-ovulatory polycystic ovary syndrome. Women with high body mass index (BMI) > 32 kg/m² received placebo ('standard care') or metformin; women with BMI ⩽ 32 kg/m² received CC ('standard care'), metformin or both. Treatment continued for 6 months or until pregnancy was confirmed. Primary outcomes were clinical pregnancy and live birth. RESULTS: For women with BMI > 32 kg/m², clinical pregnancy and live birth rates were 22% (7/32) and 16% (5/32) with metformin, 15% (5/33) and 6% (2/33) with placebo. For women with BMI = 32 kg/m², clinical pregnancy and live birth rates were 40% (14/35) and 29% (10/35) with metformin, 39% (14/36) and 36% (13/36) with CC, 54% (19/35) and 43% (15/35) with combination metformin plus CC. CONCLUSIONS: There is no evidence that adding metformin to 'standard care' is beneficial. Pregnancy and live birth rates are low in women with BMI > 32 kg/m² whatever treatment is used, with no evidence of benefit of metformin over placebo. For women with BMI ⩽ 32 kg/m² there is no evidence of significant differences in outcomes whether treated with metformin, CC or both. ClinicalTrials.gov number NCT00795808; trial protocol accepted for publication November 2005: Johnson, Aust N Z Journal Obstet Gynaecol 2006;46:141-145. [ABSTRACT FROM AUTHOR]

BACKGROUND: It has been suggested that body mass index (BMI), especially obesity, is associated with subfertility in men. Semen parameters are central to male fertility and reproductive hormones also play a role in spermatogenesis. This review aimed to investigate the association of BMI with semen parameters and reproductive hormones in men of reproductive age. [ABSTRACT FROM PUBLISHER]

The effect of clinical priority access criteria for access to infertility treatment was examined for women outside the body mass index (BMI) range of 18–32 kg/m2. Treatments and outcomes were analysed from 1280 cases referred from 1998 to May 2005. Sixteen percent of women had a BMI of >32 kg/m2. Overall, 38% of these women had a birth from conceiving a treatment-related pregnancy or spontaneous pregnancy, compared with 52% of women with BMI < 32 kg/m2. Weight loss allowed women in the BMI group >32<35 kg/m2 to access treatment, but women in higher BMI groups were less successful. [ABSTRACT FROM AUTHOR]

This article analyzes several therapies related to women's diseases. While analyzing these therapies, the article at the out set focuses on hormone replacement therapy in postmenopausal women, and discusses endometrial hyperplasia and irregular bleeding. The objective of this analysis is to assess which hormone replacement therapy regimens provide effective protection against the development of endometrial hyperplasia and/or carcinoma with a low rate of abnormal vaginal bleeding. The article further discusses various issues related to local oestrogen for vaginal atrophy in postmenopausal women.

Unlabelled: This paper is based on a Cochrane review of the same title by the same authors published in The Cochrane Library, issue 3, 2003 (see www.CochraneLibrary.net for information) with permission from the Cochrane Collaboration-John Wiley and Sons. Cochrane reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and The Cochrane Library should be consulted for the most recent version of the review.Background: The objective of this review was to investigate whether ICSI improves live-birth rate in comparison with IVF in couples with non-male factor subfertility.Methods: We searched the Cochrane Menstrual Disorders and Subfertility Group trials register (searched 30 May 2002), the Cochrane Controlled Trials Register (Cochrane Library Issue 2, 2002), PubMed (January 1992 to September 2003) and reference lists of articles. Trials were included if they compared the effects of ICSI and IVF on live births, pregnancy and fertilization outcomes. Only randomized studies were included in this review. Two reviewers extracted data independently.Results: There were no randomized data comparing live-birth rates. The single identified study did not find a difference in pregnancy rates (OR 1.4, 95% CI 0.95-2.2). There were no randomized data on miscarriage rates, or on other adverse events such as congenital malformations that may be of concern (415 couples randomized). Two studies used alternation to assign their couples and did have live birth as an outcome. These studies showed a significantly higher fertilization rate in the IVF group, but no difference in pregnancy, miscarriage or live-birth rate.Conclusions: Whether ICSI should be preferred to IVF for cases of non-male factor subfertility remains an open question. Further research should focus on live-birth rates and adverse events. [ABSTRACT FROM AUTHOR]

Premature ovarian failure (POF) occurs in 1% of all women, and in 0.1% of women under the age of 30 years. The mechanisms that give rise to POF are largely unknown. Inhibin has a role in regulating the pituitary secretion of FSH, and is therefore a potential candidate gene for ovarian failure. Using single-stranded conformation polymorphism (SSCP) and DNA sequencing, DNA samples were screened from 43 women with POF for mutations in the three inhibin genes. Two variants were found: a 1032C-->T transition in the INHssA gene in one patient, and a 769G-->A transition in the INHalpha gene in three patients. The INHssA variant appears to be a polymorphism, as there was no change in the amino acid sequence of the gene product. The INHalpha variant resulted in a non-conservative amino acid change, with a substitution from alanine to threonine. This alanine is highly conserved across species, and has the potential to affect receptor binding. The INHalpha variant is significantly associated with POF (3/43 patients; 7%) compared with control samples (1/150 normal controls; 0.7%) (Fisher's exact test, P < 0.035). Further analysis of the inhibin gene in POF patients and matched controls will determine its role in the aetiology of POF. [ABSTRACT FROM AUTHOR]

Linked article: This Correspondence comments on Del Forno et al. Click here to view the article. [ABSTRACT FROM AUTHOR]

The last two decades have seen a rapid explosion in research surrounding subfertility treatments. This ever-increasing volume of research has made it a difficult task for health professionals involved in the management of the subfertility to be able to assimilate the information easily. There is an urgent need for the findings from research to be synthesized into simple easy to read reviews that are both of a high quality and are based on the best evidence available. The Menstrual Disorders and Subfertility Group of the Cochrane Collaboration is attempting to address these issues by collecting a register of all the randomized controlled trials in the field of reproductive medicine and preparing systematic reviews on topics that will be of interest to healthcare workers and consumers. Readers are invited to participate in this process by identifying published and unpublished data and by helping in the process of preparing protocols and systematic reviews for inclusion in the Cochrane Library. [ABSTRACT FROM AUTHOR]

The article reports on a study which reviews various research to determine whether long-term hormone therapy (HT) can affect the risk of death, vascular disease, cancer, dementia and other chronic diseases in perimenopausal and postmenopausal women. Findings indicated that HT offer protection against colorectal cancer and fractures but increases the risk of coronary events, venous thromboembolism, stroke, breast cancer, dementia and gallbladder disease.

Study Question: Can a core outcome set to standardize outcome selection, collection, and reporting across future infertility research be developed?, Summary Answer: A minimum data set, known as a core outcome set, has been developed for randomized controlled trials (RCT) and systematic reviews evaluating potential treatments for infertility., What Is Known Already: Complex issues, including a failure to consider the perspectives of people with fertility problems when selecting outcomes, variations in outcome definitions, and the selective reporting of outcomes on the basis of statistical analysis, make the results of infertility research difficult to interpret., Study Design, Size, Duration: A three-round Delphi survey (372 participants from 41 countries) and consensus development workshop (30 participants from 27 countries)., Participants/materials, Setting, Methods: Healthcare professionals, researchers, and people with fertility problems were brought together in an open and transparent process using formal consensus science methods., Main Results and the Role of Chance: The core outcome set consists of: viable intrauterine pregnancy confirmed by ultrasound (accounting for singleton, twin, and higher multiple pregnancy); pregnancy loss (accounting for ectopic pregnancy, miscarriage, stillbirth, and termination of pregnancy); live birth; gestational age at delivery; birthweight; neonatal mortality; and major congenital anomaly. Time to pregnancy leading to live birth should be reported when applicable., Limitations, Reasons for Caution: We used consensus development methods which have inherent limitations, including the representativeness of the participant sample, Delphi survey attrition, and an arbitrary consensus threshold., Wider Implications of the Findings: Embedding the core outcome set within RCTs and systematic reviews should ensure the comprehensive selection, collection, and reporting of core outcomes. Research funding bodies, the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) statement, and over 80 specialty journals, including the Cochrane Gynaecology and Fertility Group, Ferility and Sterility, and Human Reproduction, have committed to implementing this core outcome set., Study Funding/competing Interest(s): This research was funded by the Catalyst Fund, Royal Society of New Zealand, Auckland Medical Research Fund, and Maurice and Phyllis Paykel Trust. Siladitya Bhattacharya reports being the Editor-in-Chief of Human Reproduction Open and an editor of the Cochrane Gynaecology and Fertility group. Hans Evers reports being the Editor Emeritus of Human Reproduction. José Knijnenburg reports research sponsorship from Ferring and Theramex. Richard Legro reports consultancy fees from Abbvie, Bayer, Ferring, Fractyl, Insud Pharma and Kindex and research sponsorship from Guerbet and Hass Avocado Board. Ben Mol reports consultancy fees from Guerbet, iGenomix, Merck, Merck KGaA and ObsEva. Craig Niederberger reports being the Co Editor-in-Chief of Fertility and Sterility and Section Editor of the Journal of Urology, research sponsorship from Ferring, and retains a financial interest in NexHand. Annika Strandell reports consultancy fees from Guerbet. Ernest Ng reports research sponsorship from Merck. Lan Vuong reports consultancy and conference fees from Ferring, Merck and Merck Sharp and Dohme. The remaining authors declare no competing interests in relation to the work presented. All authors have completed the disclosure form., Trial Registration Number: Core Outcome Measures in Effectiveness Trials Initiative: 1023., (Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.)