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ObjetivO: verificar a freqüência de gestação intra-uterina em pacientes que foram submetidas à recanalização tubária no Hospital Regional da Asa Sul nos últimos 30 anos e avaliar o índice de gestação ectópica destes procedimentos e a influência da idade e do tempo decorrido entre a laqueadura e a recanalização no sucesso terapêutico. MétOdOs: foram analisados 71 prontuários, tendo sido excluídos os que apresentavam outras alterações que pudessem influenciar no prognóstico de fertilidade do casal e os casos em que não foi possível a cirurgia de recanalização. As variáveis coletadas foram: a ocorrência de gestação intra-uterina, chegando esta a termo ou a abortamento; a ocorrência de gestação ectópica após a cirurgia; a não-concepção após a reversão; a idade das mulheres na data da recanalização e o tempo decorrido entre a laqueadura e a sua reversão. ResultadOs: verificaram-se um índice de gravidez de 67,6%, sendo 73,2% para as recanalizações bilaterais e 46,6% para as unilaterais, e um percentual de gravidez ectópica de 5,6%. Nas faixas etárias entre 20 e 24 anos, foi observado 33% de gravidez; entre 25 e 29, 60%; entre 30 e 34, 69,2%; entre 35 e 39, 65%, e entre 40 e 44, 42,9%. A casuística foi pequena para análise dos grupos de 20 e 24 e 40 e 44 anos. O intervalo de tempo entre a laqueadura e a recanalização (ITLR) variou de um a 18 anos. O intervalo de tempo entre a ITLR foi dividido em três grupos que apresentaram as taxas de gravidez: de um a seis anos, 59%; de sete a 12 anos, 66,6%; de 13 a 18 anos, 57%. COnClusões: o índice de gestação foi de 67,6%, sendo 5,6%, ectópicas. Comparando as faixas etárias, não houve influência significativa da idade no sucesso terapêutico entre 25 e 39 anos. Verificou-se que não houve influência do tempo de esterilidade sobre os resultados da reversão. AbstractPuRPOse: to verify the ratio of intra-uterine gestation in patients submitted to recanalization in the Hospital Regional da Asa Sul in the last 30 years and to assess the rate of ectopic gestation of such procedures, the influence of age and time interval between salpingectomy and recanalization in the therapeutic success. MethOds: medical files of 71 patients were analyzed, after exclusion of those presenting other alterations that could influence fertility prognosis, plus the cases when recanalization was impossible. Variables collected were: occurrence of intra-uterine gestation, coming to term or to abortion; occurrence of ectopic pregnancy after salpingectomy; no-conception after reversion, women's age at the recanalization, and time interval between salpingectomy and its reversion. Results: there has been a pregnancy rate of 67.6%, 73.2% for bilateral recanalization and 46.6% for unilateral, as well as 5.6% of ectopic pregnancies. Concerning the patients' age group, it was observed a pregnancy rate of 33%, from 20 to 24; 60%, from 25 to 29; 69.2%, from 30 to 34; 65%, from 35 to 39, and 42.9%, from 40 to 44 years old. The number of cases was small for age the groups 20 to 24 and 40 to 44 years old. The time interval...

ObjectiveThis study aimed to analyze the results of hysterosonography performed prior to in vitro fertilization (IVF) and to correlate anomalous findings with hysteroscopy.MethodsFindings from 197 hysterosonograms of patients examined in an assisted reproduction clinic between January 2012 and August 2014 were included. Enrollment criteria: patients in preparation for IVF not recently submitted to uterine examination through hysterosalpingography or hysteroscopy referred to hysterosonography. Uterine cavity evaluation was considered anomalous when one or more of the following were found: polyps, submucous myomas, uterine synechiae, Müllerian duct anomalies. Individuals with cavity abnormalities that might interfere with IVF results were referred to hysteroscopy.ResultsNormal test results were seen in 170/197 of the cases (86.3%). Eighteen of the 197 cases (9.1%) were suspected for polyps, two (1%) for submucous myoma, six (3.5%) for synechiae, and one (0.5%) for Müllerian duct anomalies. Sixteen of the patients diagnosed with abnormalities underwent hysteroscopy to confirm or treat the suspected pathology. In only two cases there was no agreement between tests: one patient suspected for synechiae and another for polyps were not confirmed; another individual suspected for polyps was found to have focal endometrial thickening in hysteroscopy. The positive predictive value (PPV) in our study was 93.7%.ConclusionIn most cases, the diagnoses obtained by hysterosonography showed normal uterine cavities. The most common anomalous findings were polyps, followed by synechiae, submucous myoma, and Müllerian duct anomalies. Hysterosonography is a good option for evaluating the uterus and offers a high positive predictive value, while hysteroscopy stands as the gold standard.

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Although there are several situations that can potentially lead to lower androgen levels, until now is not defined a syndrome or biochemical criteria to diagnose androgen deficiency in women. Benefits of androgen therapy in these situations are controversial.• Girls with delayed puberty manifesting primarily as a lack of development of secondary sex characters and primary amenorrhea may be deficient in sex hormone production, including androgen production deficiency. • Due to surgical menopause and premature ovarian failure, androgen levels may be reduced compared to agematched normal controls. • Young women with hypopituitarism, anorexia nervosa, and adrenal insufficiency may have lower serum androgen levels. • The use of androgens and anabolic steroids for aesthetic purposes has increased considerably due to issues related to the cult of the body and beauty. However, this is associated with undesirable and potentially irreversible aesthetic manifestations, in addition to an increase in morbidity. Recommendations• There is no evidence for the use of androgen therapy in adolescent women, even in cases of hypogonadism due to ovarian (premature ovarian failure) or central causes. • There is no evidence for routine androgen therapy in adult women with hypopituitarism, hypogonadotropic hypogonadism, adrenal insufficiency and anorexia nervosa. • Androgen therapy, preferably by the transdermal route, may be considered for women with premature ovarian insufficiency (POI) or surgical menopause complaining of female sexual dysfunction (FSD), in addition to estrogen therapy. • The use of androgens and anabolic steroids for aesthetic purposes is not recommended.• The measurement of total testosterone or the calculation of the free androgen index can be used to control androgen replacement in women, but the available laboratory techniques do not present adequate sensitivity.Although the mass spectrometry technique has greater sensitivity, it is costly, which limits the use in clinical practice. FEBRASGO POSITION STATEMENTUse of androgens at different stages of life: reproductive period