Reproductive Years Research Articles

Abortion and Women’s Future Socioeconomic Attainment

Abortion is a safe and common medical procedure. Roughly one in four women in the United States will have an abortion before the end of her reproductive years. Because of how common this experience is and how rapidly abortion policy is shifting, understanding the relationship between abortion and women’s socioeconomic futures is well worth exploring. Extant research has demonstrated that the transition to parenthood is a critical inflection point in women’s socioeconomic trajectories, often leading to poorer outcomes. In this article, we connect previous sociological work elucidating mechanisms of socioeconomic stratification and gender by considering the relationship between abortion use and access and future socioeconomic outcomes such as education, income, and financial stability—as measured by several measures, including evictions, debt, ability to pay bills, and a separate index of economic instability. We use national longitudinal survey data to assess socioeconomic outcomes associated with abortion using two statistical approaches. We find that women who lived in a location with fewer abortion restrictions in adolescence, and women who had an abortion, compared to a live birth, in adolescence, are more likely to have graduated from college, have higher incomes, and have greater financial stability at two time-points over an almost 25-year period. Our results provide evidence that policy environments allowing access to abortion, and teenagers having the option to use abortion to avoid early parenthood, are important axes along which women’s economic lives are shaped. Our research implies that the widespread abortion bans and restrictions in the United States are likely to lead to lower educational attainment and adult economic stability among women living under such restrictions, as compared to women in locations with better access to abortion.

A pooled analysis of the efficacy of sertraline in women, with a focus on those of childbearing age

IntroductionGender- and age-specific research on medications is essential for personalizing treatment plans, optimizing dosing, minimizing adverse effects and improving outcomes. Women are twice as likely to be diagnosed with major depressive disorder (MDD), and it is commonly reported during their reproductive years. This post-hoc pooled analysis evaluated the efficacy of sertraline (one of the most studied medications in women) in women of reproductive age (18–44 years).MethodsData was pooled from nine clinical trials of sertraline that included 1832 subjects with MDD. The analysis set included 1097 women, 651 of those were of reproductive age. Sertraline was compared with placebo for changes in total HAM-D17 and CGI scores measured over time through MMRM analysis. The change from baseline to the end of study (-week 8) was assessed using ANCOVA.ResultsThe changes from baseline in total HAM-D17 and CGI scores were significantly higher for sertraline than for placebo at the end of 8 weeks for all women (LS Mean difference, 95% CI: -1.81(-3.01,-0.62), P = 0.0029; -0.38(-0.55,-0.20), P < 0.0001, respectively). For women of reproductive age these changes (LS Mean difference, 95% CI: -2.08(-3.52,-0.64), P = 0.0047; -0.44(-0.66,-0.22), P < 0.0001, respectively), were significant from week 2 (HAM-D17) and week 1 (CGI) till the end of study.LimitationsOnly sertraline and placebo arms were included in the analysis. The dosing varied between studies, and the effect of dose was not addressed.ConclusionsSertraline is an effective option for treatment of MDD in women, including those in the childbearing age.

Using discrete choice modeling to understand the drivers of reproductive delay in the United Kingdom

The ideal family size in the UK is, on average, two children. However, there is a fertility gap, the difference between wanted and achieved family size, of around one in three children, which is largely caused by extended delays to reproduction. Standard quantitative methods used to identify what causes these delays have limitations, often relying on macro-level data which conveys little about individual needs, or applying longitudinal methods that produce outdated results because only once people have completed their reproductive years is it possible to infer which life-course factors led to later-age childbearing. This study is the first to overcome these challenges by applying a discrete choice experiment to reveal the barriers that people are facing right now. This innovative methodology allows the estimation of the relative importance of the barriers and the distance between them measured in months of reproductive delay. Among other things, the results show that for men and women, partner support was more important than finances or housing, although support means different things depending on the level of education with more educated women prioritizing hands-on fathers and household gender equality, whereas less-educated women strongly desired stable partnerships. Men favored partner readiness and neighborhood quality. These, and the other findings shown here, provide detailed insight into the contemporary causes of delayed fertility in the UK.

Western diet promotes endometriotic lesion growth in mice and induces depletion of Akkermansia muciniphila in intestinal microbiota.

Endometriosis, affecting 10% of women in their reproductive years, remains poorly understood. Both individual and environmental unexplained factors are implicated in this heterogenous condition. This study aims to examine the influence of a Western diet on endometriosis lesion development in mice and to uncover the mechanisms involved. Mice were fed either a control diet or a Western diet (high in fatty acids and low in fiber) for 4weeks. Endometriosis was then surgically induced, and lesion development was monitored by ultrasound. After 7weeks, the mice were sacrificed for analysis of lesion characteristics through RT-qPCR, immunohistochemistry, and flow cytometry. Additionally, the intestinal microbiota was assessed using 16S rRNA gene sequencing. Mice on the Western diet developed lesions that were significantly twice as large compared to those on the control diet. These lesions exhibited greater fibrosis and proliferation, alongside enhanced macrophage activity and leptin pathway expression. Changes in the intestinal microbiota were significantly noted after endometriosis induction, regardless of diet. Notably, mice on the Western diet with the most substantial lesions showed a loss of Akkermansia Muciniphila in their intestinal microbiota. A Western diet significantly exacerbates lesion size in a mouse model of endometriosis, accompanied by metabolic and immune alterations. The onset of endometriosis also leads to substantial shifts in intestinal microbiota, suggesting a potential link between diet, intestinal health, and endometriosis development.

Intrauterine Infections and Preterm Birth: Literature Review

Objective: Premature birth is involved in the worldwide health sector problem and an important part challenge. This incidence rate continues to increase and currently, premature births occur in developing countries at 12.5% of all births. Infections within the uterus are associated with at least 40% of births occurring prematurely. Genitourinary tract infections can affect around 41% of women in their reproductive years worldwide may be affected, with 60-80% of these pregnancy-related infections being symptom-free. This article attempts to review the link relating intrauterine infections to premature birth. Data source: This study was taken from six electronic bibliographic databases, namely PubMed, Science Direct. ProQuest, Scopus, EBSCO and DOAJ employing the terms "intrauterine infection", or "premature delivery". Data from all journal articles, summarized according to the categories of the framework of concepts. The following summarization involves the compilation, analysis, and understanding of study data. Results: 10- 12% of intrauterine infections were found in pregnant women, and 20% of premature births were caused by intrauterine infections. The risk factors for this infection are known to be nullipara, lifestyle, and generally women of reproductive age who frequently change partners. There are several types of intrauterine infections, including Bacterial vaginosis, Chlamydia, Asymptomatic bacteriuria, Trihcomonas, and Syphilis. Conclusion: preterm birth has several risk factors, one of which is intrauterine infection that occurs during pregnancy. A quick and accurate diagnosis will help the process of treating intrauterine events in pregnant women to prevent preterm birth.

Metabolomics for the identification of biomarkers in endometriosis.

Endometriosis affects the quality of life in women during their reproductive years, causing immense pain and can result in infertility. It is characterized by inflammation and the growth of the endometrium outside the uterine cavity. Metabolomics has the potential to resolve the major bottleneck of endometriosis which is delay in diagnosis due to the invasive diagnostic approach.In this review, the author has summarized the identified biomarkers of endometriosis from different bodily fluids. Metabolomics promises a non-invasive diagnostic approach for endometriosis that could aid in earlier diagnosis and prognosis. Patients with endometriosis keywords were searched in correspondence with the assigned keywords, including metabolomics from PubMed, from its inception to Dec 2023. The relevant studies from this search were extracted and included in the study. This article provides information regarding metabolomics studies in endometrisis. We demonstrated that metabolomics is about to change the world of endometriosis by analyzing and detecting the diagnosis, prognosis, mortality and treatment response biomarkers.

Determinants of fertility experience among reproductive women age (15-49) in Ethiopia: Application of count regression models.

Fertility refers to the average number of children born to a woman over her reproductive years. Due to cultural norms, economic development, education, access to healthcare, and government policies, fertility rates vary significantly across different countries and regions of the world. Ethiopia is one of the developing countries in Sub-Sahara Africa and its fertility rate has consistently been one of the highest in the world. Hence the main goal of this study was to identify the leading factors for the total number of children born per mother in Ethiopia. This study used the most recent secondary data obtained from the 2019 Ethiopia Mini Demographic and Health Survey. A total weighted sample of 8885 women aged 15 to 49 was included in the study. The primary outcome variable in this study was the number of children born per mother, and different socio-demographic and economic factors that could influence fertility experience were included. The analysis was performed using STATA version 17 software. Negative Binomial regression model was used to assess the association between outcome and predictor variables. A p-value <0.05 was considered to be statistically significant. From a total of 8885 women, on average approximately 2.73 children were born per mother. Age of mothers (IRR = 1.08, 95% CI: (1.077, 1.082)), religion for Muslim (IRR = 1.13, 95% CI: (1.08, 1.18)) and others (IRR = 1.16, 95% CI: (1.11, 1.22)), level of education secondary and above (IRR = .61, 95% CI: (.58, .65)) and primary (IRR = .84, 95% CI: (.81, .87)), household member of six to nine (IRR = 1.24, 95% CI: (1.20, 1.28)) and household members more than nine people (IRR = 1.14, 95% CI: (1.07, 1.21)), wealth index for rich (IRR = .94, 95%, CI: (.91, .98)), marital status for not married (IRR = .49, 95%, CI: (.48, .51)), pregnant mothers (IRR = 1.08, 95%, CI: (1.02, 1.13)) and contraceptive users (IRR = 1.12, 95%, CI: (1.09, 1.16)) were the signficant variables for number of children ever born per mother. In Ethiopia, the average number of children born per mother was approximately 2.73. Poisson and Negative Binomial regression models were compared, and we found the Negative Binomial regression model to be better to identify the determinants of fertility experience in Ethiopia. Age of mothers, religion, current pregnancy, use of contraceptive methods, mothers' education level, household members, wealth index, number of children aged five and under, region (Somali, Gambela, and Addis Ababa), and marital status were the determinants responsible for fertility experience among mothers in Ethiopia. These findings are helpful for policymakers and healthcare professionals for developing targeted interventions and programs aimed at improving the high fertility rate experience in Ethiopia.

Navigating Reproductive Care in Patients With Inflammatory Bowel Disease: A Comprehensive Review.

Inflammatory bowel disease [IBD] is often diagnosed in patients during their reproductive years. It is crucial that both healthcare providers and patients are adequately informed to avoid misguided decisions regarding family planning. One of the most important aspects during conception and pregnancy is to maintain disease remission, as disease activity is associated with adverse pregnancy outcomes. Apart from methotrexate, most conventional drugs used in IBD are considered low risk during conception and pregnancy. For newer agents, evidence is still limited. If needed, surgery must not be postponed and should ideally be performed in specialized centres. In most patients, delivery should be vaginal except for patients with complex perianal disease, with an ileoanal pouch anastomosis, or if there is an obstetric contraindication. In children exposed to biological treatments during pregnancy, the risk of infections appears to be low, and psychomotor development is probably not affected. Regarding immunizations, the standard vaccination schedule for inactivated vaccines should be followed for children exposed to biologics in utero. In the case of live vaccines, such as rotavirus, decisions should be individualized and take into consideration the risk-benefit ratio, particularly in developing countries. In this review, we provide a comprehensive and updated overview of aspects related to fertility, pregnancy, breastfeeding, and the impact on the care of children born to mothers with IBD. Both the available evidence and areas of uncertainty are discussed, with the goal of assisting healthcare professionals caring for IBD patients during this important stage of their lives.

Polycystic ovary syndrome: Fertility, prenatal care, pregnancy, and postpartum care.

Polycystic ovary syndrome (PCOS) is a complex, heterogeneous reproductive endocrinopathy affecting 8% to 13% of women in their reproductive years. PCOS has a vast array of clinical manifestations, including metabolic complications, biochemical and phenotypical hyperandrogenism, menstrual cycle dysfunction, and anovulation resulting in infertility. Understanding the relationship of the disorder's pathophysiologic and clinical manifestations is key to successfully managing patients with PCOS. Patients may have different prenatal, perinatal, and postnatal experiences than those who do not have PCOS, and may require a higher level of care or treatment plan adjustments.

Causality of immune cells and endometriosis: a bidirectional mendelian randomization study

BackgroundEndometriosis, a prevalent chronic condition, afflicts approximately 10% of women in their reproductive years. Emerging evidence implicates immune cells in the pathogenesis of endometriosis, particularly in angiogenesis, tissue proliferation, and lesion invasion. This investigation employs two-sample Mendelian Randomization (MR) to dissect the bidirectional causal relationships between immune cell profiles and endometriosis.MethodsWe leveraged publicly available genome-wide association study (GWAS) data to elucidate the causal interplay between immune cell traits and endometriosis. Utilizing GWAS summary statistics ranging from accession numbers GCST90001391 to GCST90002121 and endometriosis data from the FinnGen study GWAS (8,288 endometriosis cases and 68,969 controls), we adopted stringent criteria for instrumental variable selection. We applied MR-Egger, weighted median, inverse variance weighted (IVW), and weighted mode methods to derive causal estimates. To address potential heterogeneity and pleiotropy, Cochran’s Q test, MR-Egger intercept, and leave-one-out analyses were executed. Reverse-direction MR and bidirectional MR analyses evaluated potential reciprocal causation and the influence of endometriosis on immune cell composition.ResultsOur analysis identified five immune phenotypes inversely associated with endometriosis risk. These phenotypes comprise: a percentage of CD11c + HLA-DR + + monocytes, CD25 expression on CD39 + CD4 + T cells, elevated CD25 on CD45RA + CD4 + non-regulatory T cells, HLA-DR intensity on HLA-DR + CD8 bright (CD8br) T cells, and the proportion of naïve double-negative (CD4 − CD8− %DN) T cells. In contrast, eleven phenotypes were positively correlated with endometriosis risk, including: CD127 expression on T cells, the proportion of CD24 + CD27 + B cells within lymphocytes, CD25 expression on CD28 + CD4 + T cells, CD28 expression on CD39 + activated regulatory T cells (activated Tregs), the frequency of bright CD33 HLA-DR + CD14 − cells within the CD33br HLA-DR + compartment, CD45 expression on lymphocytes and natural killer (NK) cells, activation status of central memory CD8 bright (CM CD8br) T cells, CX3CR1 expression on monocytes, and the percentage of HLA-DR + NK cells within the NK cell subset. Sensitivity assessments that excluded significant heterogeneity and pleiotropy confirmed the stability of these associations, thereby reinforcing the validity of our findings.ConclusionThis study provides novel evidence of the potential causal impact of specific immune cells on the risk of developing endometriosis. These findings enhance our understanding of endometriosis pathophysiology and may inform innovative approaches for its diagnosis and management. While our findings provide novel insights, limitations such as potential horizontal pleiotropy and reliance on European ancestry data should be considered. Future research should expand to diverse populations and incorporate individual-level data to refine these findings.

The Potential Impact of Gestational Diabetes Mellitus on Long-Term Kidney Disease: A Narrative Review

Gestational diabetes mellitus (GDM) is a pervasive metabolic disorder associated with a spectrum of long-term adverse outcomes. Recent evidence indicates that women with GDM have a heightened subsequent risk of kidney disease. Persistent factors, both pre-gestational and postpartum, can contribute to these adverse outcomes years after a GDM pregnancy. Metabolic features such as insulin resistance, subclinical inflammation, and endothelial dysfunction can lead to enduring microvascular alterations, ultimately resulting in long-term renal complications. The insulin resistance and beta cell dysfunction that develop during GDM are chronic and progressive, increasing the risk of Type 2 diabetes mellitus, hypertension, and dyslipidaemia, all risk factors for chronic kidney disease (CKD). While few studies have specifically investigated the independent association between GDM and subsequent renal dysfunction, a recent study examining the adverse pregnancy outcomes and long-term risk of CKD identified GDM as one of the independent risk factors. The findings of this review strongly recommend that women who experience adverse pregnancy outcomes like GDM during their reproductive years should be well-informed about their long-term risk of kidney disease. This knowledge is essential for early preventive actions and follow-up care. In future, cardiometabolic surveillance and risk modification strategies in clinical practice are necessary to prevent maternal renal complications among women with a history of GDM.

Migraine and its Association with Stroke in Pregnancy: A National Examination.

Background: Migraine prevalence has been estimated to be as high as 25% during reproductive years. Despite this, and the known significantly lower odds of acute stroke being correctly diagnosed among women versus men, little is known about the migraine-stroke connection in this vulnerable population. Our study seeks to provide a consolidated examination of cerebrovascular and obstetric complications of migraines in pregnant women and to evaluate the role of concurrent comorbidities. Methods: We utilized the 2016-2020 Healthcare Cost and Utilization Project's National Inpatient Sample with the International Classification of Diseases, 10th Revision diagnostic codes to compare pregnant patients with migraines with those without migraines. Multivariable logistic regression was used to examine the incidence of subtypes of stroke while controlling for confounding variables. Results: Overall, 19,825,525 pregnant patients were evaluated; 219,175 (1.1%) had a concomitant diagnosis of migraine. Pregnant patients with migraines were more likely to suffer ischemic (0.1% versus 0.0%) or hemorrhagic stroke (0.3% versus 0.1%). On multivariate analysis, acute ischemic stroke was most strongly associated with migraine with aura (odds ratio [OR], 23.26; 95% confidence interval [CI], 18.46-29.31), followed by migraine without aura (OR, 8.15; 95% CI, 4.79-13.88). Conclusions: Pregnant women with migraine are at a significantly increased risk for both ischemic and hemorrhagic stroke. Pregnant women with migraines should be cautioned that they may be at an increased risk of stroke, particularly if they are experiencing an aura, and encouraged to contact their medical providers to rule out neurological complications.

Anti-Müllerian Hormone Serum Levels as Biomarker of Ovarian Reserve in Adult Women with Juvenile Idiopathic Arthritis Treated with csDMARDs and/or bDMARDs: A Pilot Study

Background/Objectives: Juvenile idiopathic arthritis (JIA) is a chronic childhood disease that often persists into the reproductive years. JIA may impact long-term fertility due to the prolonged exposure to immunosuppressive therapies. Methods: A total of 35 adult JIA female patients of childbearing age and 20 age-matched healthy controls were studied to test their anti-Müllerian hormone (AMH) serum levels as a biomarker of ovarian reserve. Demographic characteristics, disease duration, previous and current treatments, disease activity (DAS44), and a health assessment questionnaire (HAQ) were recorded. Results: JIA patients had a mean age of 22.3 ± 2.9 years, a disease duration of 12.3 ± 6.1 years, and a DAS44 of 1.24 ± 0.61. No differences were found in AMH serum levels between JIA and controls (5.78 ± 2.37 ng/mL vs. 6.60 ± 2.68 ng/mL, respectively; p = 0.17). Among the patients, 22 (62.9%) were receiving a stable dose of methotrexate (MTX) and 19 (54.3%) a dose of TNFα inhibitors. No difference in AMH serum levels was observed between JIA patients who were or were not exposed to MTX (p = 0.29) or to TNFα inhibitors (p = 0.50). Conclusions: Ovarian reserve as assessed by AMH serum levels appears to be comparable between those with JIA and age-matched controls and does not appear to be influenced by disease characteristics or prior/concomitant exposure to immunosuppressive drugs.

Sexuality in Older Adults: Comprehensive Strategies for Clinicians and Patient-Centered Care

Introduction: Healthcare providers play a crucial role in promoting sexual health among older adults, an important yet often neglected aspect of aging well. Although sexuality evolves beyond the reproductive years, it remains a meaningful part of life for many. Despite the natural decline in sexual activity with age, numerous older adults continue to value and engage in fulfilling sexual relationships. Unfortunately, targeted interventions to support later-life sexuality are lacking, creating gaps in care. Intervention: Sexuality in older adults is influenced by biological, psychological, and social factors. Clinicians should include comprehensive sexual health assessments, including STI screenings, as part of routine care. Providing age-appropriate sexual education and resources helps promote lifelong sexual wellness. Open communication between healthcare providers and patients is vital for addressing sexual concerns, often left unspoken due to stigma or discomfort. Additionally, adopting lifestyle medicine principles—such as balanced nutrition, regular exercise, stress management, and social connection—can enhance sexual health and overall well-being. Conclusion: Specialized training for healthcare professionals on the unique aspects of older adult sexuality is essential to bridge knowledge gaps. A holistic, evidence-based approach will empower providers to better support the evolving sexual health needs of older adults, improving their quality of life.

Enhancing endometriosis care with telehealth: Opportunities and challenges.

Endometriosis affects a significant portion of women during their reproductive years, causing substantial pain and impacting their quality of life. Telehealth services have emerged as a promising avenue for enhancing endometriosis care, especially in the post-COVID-19 era. For endometriosis patients, who often require frequent appointments and specialized care, telehealth offers a convenient and accessible solution, particularly for addressing pain management and interdisciplinary concerns. Despite the challenges posed by the lack of physical examinations in telehealth, studies show that it can be a viable option for endometriosis care. Integrating telehealth with in-person visits for initial assessments can build trust and ensure comprehensive care delivery. Moreover, telehealth facilitates collaboration among multidisciplinary teams, including gynecologists, psychologists, and physiotherapists, to provide holistic treatment plans addressing physical, psychological, and interpersonal aspects of endometriosis. Here, we explore the potential benefits of telehealth in managing endometriosis, highlighting its role in providing comprehensive, multidisciplinary care while overcoming barriers like diagnostic delays and limited access to specialists. Further research and integration of telehealth into routine practice are warranted to maximize its benefits and address the complex challenges associated with endometriosis management.

8417 Knowledge Of PCOS and Its Complications In A Population Of Hispanic Women

Abstract Disclosure: Y.G. Rivera-Rodriguez: None. B. Diaz Rios: None. C.M. Casas Loyola: None. B. Marin Rodriguez: None. P.A. Alicea Reyes: None. J. Romaguera: None. L.A. Gonzalez-Rodriguez: Research Investigator; Self; Eli Lilly &amp; Company. Purpose: Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder affecting women across their lifespan, with metabolic complications that are often overlooked. Studies have revealed an inadequate understanding of PCOS, its complications, and management. There is also limited information about this condition in Hispanic women. The purpose of this study is to assess the knowledge about PCOS and its complications among a sample of Hispanic women living in Puerto Rico. Methods: This is a descriptive cross-sectional study of Hispanic women aged 21-45 years recruited from the General Endocrinology and Gynecology Clinics at the UPR-RCM Clinics. A self-administered questionnaire assessing their knowledge about PCOS, and its complications was given. Patients were classified according to PCOS diagnosis. Results were compared between the groups. Results: A total of 47 women were included in this study. Approximately 45% of participants had a diagnosis of PCOS. Most participants agreed that PCOS involves a set of symptoms associated with hormonal imbalances (94%) and irregular menses (91%). Only 40% of participants considered PCOS a chronic condition without a cure and only 34% acknowledge weight loss as one of the treatments of this condition. Two-thirds of participants didn’t know that PCOS can be diagnosed with blood tests. When assessing their knowledge about complications related to PCOS, we found that only 36% associated PCOS with an increased risk of cardiovascular disease, 56% with obesity and 62% with abnormal blood glucose levels. When comparing the knowledge about their condition in patients with a diagnosis of PCOS, we found increased knowledge about signs and symptoms such as hirsutism, hair loss and weight gain when compared to controls. However, when assessing their knowledge about complications related to PCOS, neither group recognized PCOS as a chronic condition, or associated PCOS with cardiovascular, metabolic complications and/or increased risk of cancer. Conclusion: Our study suggests that there is a lack of general knowledge about PCOS and its long-term complications among a sample of Hispanic women in reproductive years. Most importantly, our data showed that even patients with a diagnosis of PCOS do not understand their condition or comprehend the associated complications. Our study emphasizes the need to develop educational tools and strategies to improve the general population knowledge about this condition and raise awareness about preventable complications and the importance of early treatment. Presentation: 6/3/2024

8417 Knowledge Of PCOS and Its Complications In A Population Of Hispanic Women

Abstract Disclosure: Y.G. Rivera-Rodriguez: None. B. Diaz Rios: None. C.M. Casas Loyola: None. B. Marin Rodriguez: None. P.A. Alicea Reyes: None. J. Romaguera: None. L.A. Gonzalez-Rodriguez: Research Investigator; Self; Eli Lilly &amp; Company. Purpose: Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder affecting women across their lifespan, with metabolic complications that are often overlooked. Studies have revealed an inadequate understanding of PCOS, its complications, and management. There is also limited information about this condition in Hispanic women. The purpose of this study is to assess the knowledge about PCOS and its complications among a sample of Hispanic women living in Puerto Rico. Methods: This is a descriptive cross-sectional study of Hispanic women aged 21-45 years recruited from the General Endocrinology and Gynecology Clinics at the UPR-RCM Clinics. A self-administered questionnaire assessing their knowledge about PCOS, and its complications was given. Patients were classified according to PCOS diagnosis. Results were compared between the groups. Results: A total of 47 women were included in this study. Approximately 45% of participants had a diagnosis of PCOS. Most participants agreed that PCOS involves a set of symptoms associated with hormonal imbalances (94%) and irregular menses (91%). Only 40% of participants considered PCOS a chronic condition without a cure and only 34% acknowledge weight loss as one of the treatments of this condition. Two-thirds of participants didn’t know that PCOS can be diagnosed with blood tests. When assessing their knowledge about complications related to PCOS, we found that only 36% associated PCOS with an increased risk of cardiovascular disease, 56% with obesity and 62% with abnormal blood glucose levels. When comparing the knowledge about their condition in patients with a diagnosis of PCOS, we found increased knowledge about signs and symptoms such as hirsutism, hair loss and weight gain when compared to controls. However, when assessing their knowledge about complications related to PCOS, neither group recognized PCOS as a chronic condition, or associated PCOS with cardiovascular, metabolic complications and/or increased risk of cancer. Conclusion: Our study suggests that there is a lack of general knowledge about PCOS and its long-term complications among a sample of Hispanic women in reproductive years. Most importantly, our data showed that even patients with a diagnosis of PCOS do not understand their condition or comprehend the associated complications. Our study emphasizes the need to develop educational tools and strategies to improve the general population knowledge about this condition and raise awareness about preventable complications and the importance of early treatment. Presentation: 6/3/2024

8162 A Unique Presentation of Ovarian Steroid Cell Tumor Causing Hyperandrogenism in a Postmenopausal Woman

Abstract Disclosure: A. Rehan: None. M. Pandey: None. I. Goyal: None. E. Punni: None. N. Shakir: None. Background:­­­ Steroid cell tumors of the ovary are a rare entity, constituting less than 0.1% of all ovarian tumors. These tumors can present with diverse endocrine and paraneoplastic effects, including androgen excess and polycythemia. Hyperandrogenism in females can lead to hirsutism, virilization, alopecia, menstrual irregularities, acne, and emotional changes, with complications including hyperlipidemia and insulin resistance. There are various causes of androgen excess in a female including polycystic ovary syndrome (PCOS), androgen-secreting tumors, Cushing’s syndrome, and congenital adrenal hyperplasia. In a postmenopausal woman displaying signs of androgen excess, one must consider androgen-secreting tumors, and even the rare ovarian steroid cell tumor as a possible cause. Clinical Case: A 62-year-old female with type 2 diabetes mellites, obstructive sleep apnea, anxiety and depression initially presented to her primary care provider with fatigue, light-headedness, and weight loss. Initial blood work done revealed a hemoglobin greater than 20 g/dL (NR 12-16) and hematocrit greater than 60% (NR 36-48), requiring several sessions of phlebotomy. Symptoms persisted and she was finally referred to a hematologist who noted physical exam findings of hirsutism and virilization, including temporal hair loss and excess facial/body hair growth. Other concerning signs included clitoromegaly, decrease in chest size, and deepening voice. Menopause had occurred at age 50, and the patient did not have any issues with fertility during her reproductive years. Biochemical evaluation revealed testosterone level of greater than 1500 ng/dL (NR 19-82) with normal sex hormone binding globulin level, DHEA-S 652 ug/dL (NR 29-220), appropriately suppressed FSH/ LH, and normal salivary cortisol levels. Tumor markers showed normal CEA, and alpha fetoprotein but elevated CA 125 to 80.5 U/ml (NR &amp;lt; 38.1). Pelvic ultrasound demonstrated a 12 cm heterogeneously echoic, vascular right adnexal mass concerning for ovarian malignancy. Pelvic MRI showed a 9.8 cm right sided cystic and solid adnexal mass. The patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy, peritoneal biopsies, and omentectomy. Pathology revealed a stage IA steroid cell tumor measuring 11.4 cm. After resection, the patient reported improvement in facial hair and fatigue. Labs showed normalization of hemoglobin, hematocrit, and testosterone levels. Conclusion: This rare case highlights the importance of considering steroid cell tumor as a cause of polycythemia with hyperandrogenism. Timely diagnosis and intervention play a critical role in preventing irreversible virilization, mitigating malignant risks, and, in certain instances, preserving fertility. Generally, the prognosis is favorable, and symptom and lab normalization is often achieved through surgical resection. Presentation: 6/2/2024

The Analysis Study of Cell Adhesion Molecules and Estrogen Receptor Expression In The Endometrium of Patients With Polycystic Ovary Syndrome: A Comprehensive Systematic Review

Introduction: Polycystic Ovary Syndrome (PCOS) is a multifaceted endocrine disorder affecting up to 7% of women in their reproductive years. Research on estrogen receptor expression and cell adhesion molecules in the endometrium is increasing, focusing on their roles in endometrial growth and embryo implantation. Despite insights, studies investigating these endometrial changes in PCOS are limited. Methods: This systematic review follows the PRISMA 2020 guidelines to analyze the relationship between cell adhesion molecules, estrogen receptor expression, and endometrial characteristics in patients with PCOS. Results: Eight relevant publications were identified after thorough screening from reputable sources. The included studies contribute to understanding the association between estrogen receptor gene variants and PCOS through various research approaches, highlighting significant findings related to estrogen receptor expression, cellular adhesion markers, and their implications on fertility. Conclusion: Variations in ESR1 and ESR2 gene SNPs are associated with altered protein structures that may contribute to PCOS pathogenesis. Genetic and molecular mechanisms identified in this review indicate how these variations can influence PCOS phenotypes and highlight the need for further research to develop targeted therapies.

A Review of Interleukin-23/Interleukin-17 Inhibitor Exposure during Pregnancy in Patients with Psoriasis

Psoriasis is an immune cell-mediated chronic relapsing inflammatory skin disease that often develops during the reproductive years of women. The treatment of psoriasis during pregnancy is challenging as remarkable changes occur in the maternal body, and it requires the selection of therapy which is safe for both mother and fetus. The use of interleukin-23 (IL-23)/IL-17 inhibitors has been growing in psoriasis disease management and so the risk of their exposure during pregnancy is increasing too. However, human safety data in pregnancy are limited. This article aims to review pregnancy outcomes associated with IL-23/IL-17 inhibitor exposure in psoriasis patients and to see possible therapeutic options for psoriasis treatment during pregnancy. A search of the PubMed database up to June 2023 for articles was performed. The search strategy included a combination of terms as (pregnancy) AND (psoriasis) AND (Ustekinumab)/(Secukinumab)/(ixekizumab)/(brodalumab)/(guselkumab)/(tildrakizumab)/(risankizumab)/IL-23 inhibitors/IL-17 inhibitors. Resulted articles were reviewed manually for case reports, exposures from registries, and clinical trials. Most of the exposures to IL-23/IL-17 inhibitors were inadvertent, and therapy was suspended upon the detection of pregnancy. No signals on miscarriages, spontaneous abortions, and adverse developmental outcomes have been reported with first-trimester exposures to IL-23/IL-17 inhibitors. However, benefit–risk profile cannot be extrapolated based on first-trimester exposure as the transfer of these biologics across the placenta occurs in the later stage of pregnancy. More safety data from large cohorts of full-term exposure are required for IL-23/IL-17 inhibitors to consider them safe therapeutic options during pregnancy.