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Gynaecology, infertility and cancers

This section includes RHL summaries of published systematic reviews on menopause, gynaecological problems, gynaecological cancers, and infertility.

Assisted reproduction

In vitro fertilization for unexplained subfertility

RHL Summary Key findings This updated review compared the effectiveness and safety of IVF with other interventions for the management of unexplained subfertility.Key findings were: Live birth rate per woman/couple was significantly higher with IVF than expectant management or unstimulated...

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Menopause

Relaxation for perimenopausal and postmenopausal symptoms

RHL summary Findings of the review : This review aimed to determine the effectiveness of relaxation techniques as treatment for vasomotor symptoms and associated sleep disturbances in perimenopausal and postmenopausal women. Four studies with 281 participants were included. The overall quality of...

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Gynaecological cancers and disorders

Interventions for treating chronic pelvic pain in women

The progestogen medroxyprogesterone acetate is associated with a reduction of pain at the end of treatment, but the benefit is not sustained nine months post treatment. Counseling supported by ultrasound scanning is associated with reduced pain and improvement in mood.

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Surgical approach to hysterectomy for benign gynecological disease

RHL Summary Key findings No statistically significant differences between abdominal hysterectomy (AH), vaginal hysterectomy (VH) and laparoscopic hysterectomy (LH) in women’s satisfaction and quality of life No data on perioperative mortality and in most of the major long-term complications (pelvic...

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Long-term hormone therapy for perimenopausal and postmenopausal women

Long-term HRT is not indicated for routine prevention and management of chronic conditions in women. Since HRT is not common in many developing countries, this Cochrane review concerns very few women and health-care providers in selected urban settings in the developing world.

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Aromatase inhibitors for subfertile women with polycystic ovary syndrome

Citation: Franik S, Kremer JAM, Nelen WLDM, Farquhar C. Aromatase inhibitors for subfertile women with polycystic ovarysyndrome. Cochrane Database of Systematic Reviews2014, Issue 2. Art. No.: CD010287. DOI: 10.1002/14651858.CD010287.pub2.

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Early versus delayed oral fluids and food for reducing complications after major abdominal gynaecologic surgery

RHL summary Key findings Early postoperative feeding was associated with faster recovery of bowel function, lower rates of infectious complications, shorter hospital stay, and higher women satisfaction. No difference in postoperative GIT complication such as nausea, vomiting, ileus and abdominal...

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Laparoscopy for diagnosing resectability of disease in patients with advanced ovarian cancer

Citation:Rutten MJ, Leeflang MMG, Kenter GG, Mol BWJ, Buist M. Laparoscopy for diagnosing resectability of diseasein patients with advanced ovarian cancer.Cochrane Database of Systematic Reviews 2014, Issue 2. Art. No.: CD009786. DOI:10.1002/14651858.CD009786.pub2.

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Interventions for tubal ectopic pregnancy

Laparoscopic surgery and systemic methotrexate are the two best options for the treatment of a non-complicated tubal pregnancy. For the treatment of very early stages of ectopic pregnancy, systemic methotrexate is preferred over laparoscopic surgery for its simplicity and low cost.

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Vitrification versus slow freezing for women undergoing oocyte cryopreservation

RHL Summary Key findings Vitrification is a cryopreservation method that can be used to preserve human oocytes. This updated review found that vitrification was associated with: Statistically significant increase in clinical pregnancy rates Oocyte survival rate, fertilization rate and embryo...

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Endometriosis: an overview of Cochrane Reviews

Citation: Brown J, Farquhar C. Endometriosis: an overview of Cochrane Reviews.Cochrane Database of Systematic Reviews 2014, Issue3. Art. No.: CD009590. DOI: 10.1002/14651858.CD009590.pub2.

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Minimally invasive surgical techniques versus open myomectomy for uterine fibroids

RHL summary Key findings Subjective pain scores were reduced by 1-3 points on a 0-10 point pain scale at 6 and 48 hours in women undergoing laparoscopic myomectomy versus open myomectomy. A lower risk of postoperative fever was found with laparoscopic myomectomy versus open myomectomy. No...

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Accuracy of urinary human papillomavirus testing for presence of cervical HPV

RHL summary Key findings Compared to testing for cervical HPV DNA, urinary HPV detection has a sensitivity of 87% and specificity of 94% overall Testing for detection of high-risk HPV has a sensitivity of 77% and specificity of 88% Testing for detection of HPV 16 or 18 has a sensitivity of 73% and...

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Interventions to reduce haemorrhage during myomectomy for fibroids

RHL summary Key findings Blood loss and blood transfusion were reduced by: Peri-cervical tourniquet Intramyometrial vasopressin* Gelatin-thrombin matrix Vaginal dinoprostone Blood loss was reduced by: Vaginal misoprostol* Intramyometrial bupivacaine plus epinephrine Intravenous tranexamic acid...

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Levonorgestrel-releasing intrauterine device (LNG-IUD) for symptomatic endometriosis following surgery

Citation: Abou-Setta AM, Houston B, Al-Inany HG, Farquhar C. Levonorgestrel-releasing intrauterine device (LNG-IUD) forsymptomatic endometriosis following surgery.Cochrane Database of Systematic Reviews 2013, Issue 1. Art. No.: CD005072. DOI:10.1002/14651858.CD005072.pub3.

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Infertility

In vitro fertilization for unexplained subfertility

RHL Summary Key findings This updated review compared the effectiveness and safety of IVF with other interventions for the management of unexplained subfertility.Key findings were: Live birth rate per woman/couple was significantly higher with IVF than expectant management or unstimulated...

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