Introduction:
Several independent risk factors of Ectopic Pregnancy (EP) have been described to date. Nevertheless, estradiol and progesterone have not been related to ectopic pregnancy, although there is biological rationale to think about them as possible candidates. Our aim was to correlate the incidence of EP with levels of estradiol (E2) and progesterone (P4), measured on two days (hCG day, and seven days later (hCG+7)), including the differences and ratios of these concentrations, between the two time-points.

Material and methods:
Retrospective cohort study of 578 patients undergoing fresh embryo transfer after IVF (100 cycles), ICSI (508 cycles) and IVF/ICSI (64 cycles) without risk of EP, between January 2005 and December 2015. We evaluated EP incidence (10 ectopic pregnancies) in fresh embryo transfers according to estradiol and progesterone levels on hCG day (hCGd) and seven days later (hCG+7) and their variation between both. The proportions were compared using the chi-square test or Fisher’s exact test and the means were compared using T-test or ANOVA. To determine the accuracy of each studied variable receiver-operating curves were built.

Results:
We identified a trend towards an increased risk of EP as progesterone levels rose on hCGd (p=0.020) and an association of progesterone values >1.89ng/ml on hCGd with EP (OR 6.8). An increased risk of EP when the difference of estradiol between hCGd and hCG+7 was either <39pg/mL, or >745pg/mL (p=0.001) was also found. ROC analysis only resulted significant for a moderate/good predictive ability for progesterone values on hCGd (AUC: 0.694).

Discussion:
We conclude that these measurements are sufficient to identify patients at a high risk of EP. These hormone levels on specific days, leading us to define proper strategies to prevent EP risks in IVF. Further studies should design to prove this hypothesis.

Permanent sterilization is a very common form of family planning. Hysteroscopic sterilization has been an ongoing target for litigation, complaints and adverse publicity. To establish a positive correlation between Essure® insertion and any given side effect, it must be demonstrated that the incidence of the specific symptom is higher in patients who underwent Essure® insertion than in the general population. There are many confounders that must be taken into consideration before concluding that a given symptom is related to an intervention. A review of different clinical conditions regarding Essure® is presented.

Conclusion: Evidence based support linking the use of Essure® to adverse events is lacking when placed in appropriate selected candidates. Adequate patient selection and thorough inform consent is strongly encouraged before inserting Essure®.

The Genitourinary Syndrome of Menopause (GSM) is the last terminology accepted that describes various menopausal symptoms and signs. It includes genital (burning, dryness or pain), sexual (lack of lubrication, discomfort), but also urinary symptoms (urgency, dysuria, and recurrent urinary tract infections).

In this review we explain this terminology and discuss the importance of this syndrome. Moreover, we comment the necessity of active treatment in postmenopausal women.

Objective:
To analyze the clinical effect of traditional Chinese herbs on acupoint shenque to manage postpartum urinary retention after vaginal delivery.

Methods:
47 women with postpartum urinary retentions following vaginal delivery from Haidian Maternal and Child Health Hospital (April 2011 to August 2011) were randomly divided into two sub-groups: Shenque acupoint group and intramuscular injection of neostigmine group, and then observed the effects of Shenque acupoint and neostigmine on urinary retention in the two groups.

Results:
61.89% patients in the neostigmine group had an immediate clinical response, while 100% response rate was observed in Shenque acupoint group (p<0.01). Patients in the Shenque acupoint group had a significantly shorter mean voiding time when compared to patients in the neostigmine group (p<0.01).

Conclusion:
Shenque application is an effective option for women with postpartum urinary following vaginal delivery.

Women with pre-existing medical conditions are at increased risk of complications during pregnancy that can affect the immediate and long-term health of themselves and their offspring. Evidence suggests that preparation in the peri-conception period, before and during very early pregnancy, is effective but not all women are aware of, or able to undertake, the advised condition-specific behaviour change prior to pregnancy. Improving outcomes for these women requires a greater understanding of what approaches work, for whom they work, in what context and how. This protocol outlines how realist review methods can be used to synthesize evidence on peri-conception care for women with pre-existing medical conditions. The review will be conducted in two phases using electronic database and supplementary searching to find relevant evidence to develop and test program theories about how peri-conception care works. Phase 1 will focus on initial theory development, specifically the context and mechanisms that may explain how it works. Phase 2 will then be undertaken to test and refine these program theories. Experts and women with relevant lived experience will be consulted at each phase of the review to ensure it is grounded in real-life. The findings will be disseminated locally, nationally and internationally to peri-conception care networks. This realist review will explore how and for whom peri-conception care works, in order to support decisions regarding how to implement effective peri-conception care for women with pre existing medical conditions and thus improve the lives of affected families. The findings will also inform a realist evaluation of peri-conception care, with the aim to further refine program theory and explore different methods of implementation of peri-conception care.