Obstetrics & Gynecology

Zishen Yutai Pill modestly improves live-birth rates in advanced maternal age IVF

In this multicenter double-blind RCT, 1,467 women aged 35–42 undergoing IVF were randomized to Zishen Yutai Pill (ZYP) or placebo. Fresh-cycle live birth occurred in 23.3% with ZYP versus 19.0% with placebo (relative ratio 1.23, 95% CI 1.01–1.50; absolute difference 4.3%). ZYP was started in the late luteal phase of the preceding cycle and continued until 2–5 weeks after embryo transfer. Maternal and neonatal adverse events did not increase with ZYP, suggesting acceptable short-term safety in this population. 1

Ovarian cystectomy shows survival comparable to USO in stage I malignant ovarian germ cell tumors

This National Cancer Database analysis included 1,345 women aged 18–49 with stage I malignant ovarian germ cell tumors undergoing cystectomy or unilateral salpingo-oophorectomy (USO). Cystectomy accounted for 11.2% of cases and declined over time from 18.4% to 9.4%, remaining more common in mixed germ cell tumors and community programs. After inverse probability weighting, 2- and 5-year overall survival were essentially equivalent for cystectomy and USO, with an adjusted mortality hazard ratio of 0.70 (95% CI 0.21–2.33). Lymphadenectomy was less frequent with cystectomy, whereas adjuvant chemotherapy use was similar between groups. 2

Perioperative ctDNA strongly predicts progression in endometrial cancer

This systematic review and meta-analysis pooled 11 studies including 1,298 endometrial cancer patients with perioperative ctDNA assessment. Preoperative ctDNA positivity was associated with substantially worse progression-free survival (HR 3.69, 95% CI 2.58–5.26). Postoperative ctDNA positivity conferred even higher progression risk (HR 12.61, 95% CI 8.78–18.13), with no significant heterogeneity across studies. Findings indicate ctDNA is a powerful prognostic marker that could refine risk stratification and adjuvant therapy decisions. 3