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  • Review Article

    Tribulus Terrestris for Female Sexual Dysfunction: A Systematic Review

    Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(7):427-435

    Summary

    Review Article

    Tribulus Terrestris for Female Sexual Dysfunction: A Systematic Review

    Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(7):427-435

    DOI 10.1055/s-0040-1712123

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    Abstract

    Objective

    We performed a systematic review to assess the effectiveness and safety of Tribulus terrestris to treat female sexual dysfunction (FSD).

    Data sources

    We performed unrestricted electronic searches in the MEDLINE, CENTRAL, EMBASE, LILACS, CINAHL, PsycINFO,WHO-ICTR, Clinicaltrials.gov and OpenGrey databases. Selection of studies We included any randomized controlled trials (RCTs) that compared T. terrestris versus inactive/active interventions. After the selection process, conducted by two reviewers, 5 RCTs (n = 279 participants) were included.

    Data collection

    Data extraction was performed by two reviewers with a preestablished data collection formulary.

    Data synthesis

    Due to lack of data and clinical heterogeneity, we could not perform meta-analyses. The risk of bias was assessed by the Cochrane Risk of Bias (RoB) tool, and the certainty of evidence was assessed with Grading of Recommendations, Assessment, Development and Evaluations (GRADE).

    Results

    After 1 to 3 months of treatment, premenopausal and postmenopausal women randomized to T. terrestris had a significant increase in sexual function scores. Three months of treatment with T. terrestris showed a significant increase in the serum testosterone levels of premenopausal women. There was no report of serious adverse events, and none of the studies assessed health-related quality of life. The certainty of the evidence was very low, whichmeans that we have very little confidence in the effect estimates, and future studies are likely to change these estimates.

    Conclusion

    MoreRCTs are needed to supportor refute the use of T. terrestris. The decision to use this intervention should be shared with the patients, and the uncertainties around its effects should be discussed in the clinical decision-making process. Number of Protocol registration in PROSPERO database: CRD42019121130

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    Tribulus Terrestris for Female Sexual Dysfunction: A Systematic Review
  • Artigos Originais

    Surgical scar endometriosis: a series of 42 patients

    Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(3):123-127

    Summary

    Artigos Originais

    Surgical scar endometriosis: a series of 42 patients

    Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(3):123-127

    DOI 10.1590/S0100-72032011000300004

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    PURPOSE: to evaluate the frequency and clinical picture of patients with incisional endometriosis. METHODS: retrospective descriptive study performed from the medical records of patients that underwent nodules resection in the surgical scar at Faculdade de Medicina do ABC, from November 1990 to September 2003. The age, parity, number of cesarean sections, symptoms, tumor location, initial diagnosis, treatment, and recurrences were surveyed and analyzed. The results were reported as percentage, mean, and standard deviation. RESULTS: we found 42 patients that were diagnosed with scar endometriosis. From these 42 cases, 37 were of endometriosis on cesarean section scar; 3 cases of episiotomies and 2 cases on bladder in scar of hysterography. The mean age of the patients was 32.4 years old, standard deviation of ±6.2 years. All of them had previous obstetric surgery, and the main complaint was nodulation with perimenstrual pain in 40% of the cases. In 57% of the patients, the clinical evaluation was confirmed by pelvic or transvaginal ultrasonography. Patients were treated with total resection, and recurrence occurred in only two cases. CONCLUSION: scar surgical endometriosis is uncommon; however, the clinical diagnosis is easy when the signs and symptoms are known. The effective treatment is surgical resection.

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  • Artigos Originais

    Analysis of VDR gene polymorphism Fok1 in infertile women with endometriosis

    Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(2):65-69

    Summary

    Artigos Originais

    Analysis of VDR gene polymorphism Fok1 in infertile women with endometriosis

    Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(2):65-69

    DOI 10.1590/S0100-72032011000200002

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    PURPOSE: to evaluate the frequency of VDR gene polymorphism Fok1 in infertile women with endometriosis and Control and its relation to the disease. METHODS: a case-control study that included 147 infertile women with endometriosis and 154 fertile women without endometriosis as Control. Fok1 polymorphism (rs10735810, T2C), which promotes a T/C exchange in exon 2 of the VDR gene, was identified by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), that involves the combination of amplification by PCR and digestion with restriction endonuclease. The χ2 test was used to compare allele and genotype frequencies between groups. All p-values were two-tailed and a p-value < 0.05 was considered statistically significant. RESULTS: the TT, TC and CC genotype frequencies of VDR Fok1 polymorphism were 44.2%, 46.9% and 8.9% in infertile women with endometriosis and 41.6%, 50% and 8.4% in the Control Group. No significant difference was found (p=0.8), even when the patients were subdivided according to the stage of endometriosis (p=0.3 for minimal and mild endometriosis and p=0.2 for moderate and severe endometriosis). Alleles T and C were present, respectively, in 67.6% and 32.3% of infertile women with endometriosis (p=0.8), in 63.5% and 36.5% of women with minimal/mild endometriosis (p=0.5), in 72.5% and 27.5% of women with moderate/severe endometriosis (p=0.2), and in 66.6% and 33.4% of the Control Group. No statistically significant difference was found among any groups and the Control. CONCLUSION: the results suggest that VDR gene polymorphism Fok1 does not confer genetic susceptibility to endometriosis-associated infertility in the Brazilian population.

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    Analysis of VDR gene polymorphism Fok1 in infertile women with endometriosis
  • Artigos Originais

    Impact of body mass index on in vitro fertilization outcomes

    Revista Brasileira de Ginecologia e Obstetrícia. 2010;32(11):536-540

    Summary

    Artigos Originais

    Impact of body mass index on in vitro fertilization outcomes

    Revista Brasileira de Ginecologia e Obstetrícia. 2010;32(11):536-540

    DOI 10.1590/S0100-72032010001100004

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    PURPOSE: to evaluate the impact of body mass index (BMI) on in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) outcomes performed at the Human Reproduction Center of Faculdade de Medicina do ABC. METHODS: retrospective data from 488 IVF cycles of 385 patients. Patients were classified into two groups according to BMI: normal weight (18.5-24.9 kg/m²) and overweight/obesity (>25 kg/m²). We evaluated the dose of recombinant follicle stimulating hormone (FSHr), the cancellation rates for ovarian cycle response, and the results of the assisted reproduction laboratory such as number of oocytes, number of good quality embryos, number of embryos transferred, and pregnancy rates, chemical pregnancy rates, miscarriage rate and live birth rate. The t test was used for comparison of quantitative variables between groups, and the χ2 test for comparison between qualitative variables. P values <0.05 were considered significant. RESULTS: considering ovulation induction characteristics, there was no statistically significant difference between groups regarding the FSHr dose administered or the cancellation rates, p=0.47 and p=0.85, respectively. Regarding laboratory findings, the number of oocytes retrieved per cycle was similar for both groups (p=0.09), as also was the number of good quality embryos obtained and transferred (p=0.7 and p=0.6). The pregnancy rate per embryo transfer was 27.6% for the group of normal weight and 29.6% for the overweight/obese group (p=0.76). Miscarriage rates and birth rates were similar for both groups, p=0.54 and p=0.94. CONCLUSION: BMI did not influence IVF/ICSI outcomes evaluated.

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