This systematic review and meta-analysis compared reproductive, perinatal and neonatal outcomes between letrozole-based endometrial preparation, with or without adjuvant gonadotrophins, and programmed-cycle endometrial preparation for frozen embryo transfer (FET) in women with polyendocrine metabolic ovarian syndrome (PMOS), including only randomized controlled trials (RCTs). MEDLINE, Embase and the Cochrane Central Register of Controlled Trials were searched from inception through September 10, 2025. Four RCTs met inclusion criteria (n = 891). Random-effects models were used to pool risk ratios, risk of bias was assessed with RoB-2 and certainty of evidence was evaluated using Grading of Recommendations, Assessment, Development and Evaluations. No significant difference in live birth rate was observed between the two protocols (RR 0.92, 95% CI 0.79 to 1.07). Similarly, no significant differences were observed in clinical pregnancy, miscarriage, hypertensive disorders of pregnancy or cycle cancellation rates. A lower risk of gestational diabetes mellitus (GDM) was observed with programmed-cycle FET in a meta-analysis of two RCTs (RR 0.33, 95% CI 0.14 to 0.82, P = 0.02); however, this hypothesis-generating finding should be interpreted cautiously because of the unexpectedly high GDM rates and requires confirmation in larger studies. Other perinatal and neonatal outcomes did not differ significantly, although evidence was underpowered. In contrast to observational studies, current RCT evidence does not demonstrate superiority of letrozole-based over programmed-cycle endometrial preparation for reproductive outcomes in women with PMOS.

Premature ovarian insufficiency (POI) occurs when the ovaries stop working normally before the age of 40. Early menopause means menopause happens between ages 40 and 45. These conditions are more common than previously thought. In addition to causing menopausal symptoms such as hot flushes, mood changes and sleep disturbances, these conditions can have serious long-term effects on heart health, bone strength, memory and mental wellbeing. They can also have a profound emotional impact, particularly for patients who had hoped to have children. Hormone therapy is the main treatment for these conditions and is usually continued until the average age of natural menopause. Care should also include lifestyle support and psychological support. More research is still needed to identify the best hormone therapy options and better ways to detect these conditions early. Addressing these gaps could improve long-term health and quality of life for people with POI or early menopause.

Menopause is a stage of life that can affect thinking and memory, often colloquially called 'brain fog'. Brain fog, can affect daily life and relationships. Hormone treatments are often used to manage symptoms, but it is still not clear how well they work. Testosterone is sometimes prescribed for low sex drive, but its effects on thinking and memory are unclear. This study reviews the existing evidence. Five studies were identified. These studies looked at different areas of thinking and memory, including attention, planning, decision-making and learning. We found no clear evidence that testosterone impacts thinking and memory. However, there were only a few small studies, so the results need to be interpreted carefully. This research highlights a knowledge gap. More studies are needed on testosterone to guide effective treatment and support women to make informed decisions about their health.

Frozen embryo transfer (FET) has become widely used over the past decade, largely because of advances in vitrification techniques. To optimize pregnancy rates in FET cycles, accurate synchronization between embryo development and endometrial receptivity is essential. However, the optimal individualized approach to endo-metrial preparation remains a matter of ongoing debate. This review summarizes the current literature on endo-metrial preparation protocols and their impact on preg-nancy and perinatal outcomes, with a particular focus on artificial, natural, and stimulated cycles. Although many studies have methodological limitations, some well-de-signed randomized controlled trials suggest improved pregnancy rates and better perinatal outcomes with FET compared with fresh embryo transfer, including a low-er risk of preterm delivery and ovarian hyperstimulation syndrome (OHSS). Nonetheless, artificial endometrial preparation-characterized by the absence of a corpus luteum-has been associated with a higher incidence of hypertensive disorders of pregnancy and large-for-ges-tational-age (LGA) infants. This has renewed interest in whether transferring frozen embryos into a more physio-logic endometrium, as occurs in natural or modified nat-ural cycles, may not only enhance implantation but also reduce maternal and neonatal morbidity. The emergence of personalized luteal phase support across different protocols is another promising area that warrants further investigation. This narrative review provides a compre-hensive overview of endometrial preparation strategies for FET and their effects on clinical outcomes based on the most recent available evidence.

Extending women's health-span is a key challenge for the medical community. Although women live longer than men, they face a higher burden of chronic diseases, such as cardiovascular diseases (CVDs) and disabilities. Endogenous estrogens appear to benefit cardiovascular health, and their marked decline at menopause is associated with increased cardiovascular risk; conversely, poor cardiovascular health may hasten menopause onset. Systemic menopause hormone therapy (MHT) begun early-ideally soon after symptom onset and at most within 10 years of the final menstrual period-alleviates climacteric symptoms and is associated with long-term benefits. This joint position paper between the International Federation of Gynecology and Obstetrics (FIGO) and the World Heart Federation (WHF) aims at supporting both gynecologists and cardiologists in providing a tailored and evidence-based counseling on systemic MHT use to women with increased CVD risk or established ischemic heart disease (IHD). Women with CVD risk factors require thorough risk stratification to tailor MHT type, dose, and route. For those at high thromboembolic risk, transdermal estrogen, with micronized progesterone or dydrogesterone when needed, is considered the safest regimen. Women with established IHD may receive systemic MHT for symptom relief, provided risks and benefits are carefully reviewed. Transdermal low-dose estrogen, alone or with micronized progesterone or dydrogesterone, is the best choice. All primary and secondary prevention measures, including statins, should be continued. Managing the most complex cases warrants the adoption of a multidisciplinary approach between cardiologists, gynecologists, internists and primary care providers to offer the best possible care.

Adult growth hormone deficiency (GHD) is characterized by insulin resistance, visceral adiposity, and adverse body composition. Asprosin (ASP), an adipokine involved in glucose homeostasis and energy metabolism, has emerged as a potential biomarker of metabolic dysfunction. This study investigated longitudinal changes in circulating ASP and their relationships with metabolic, body composition, and bone parameters during 24 months of recombinant human growth hormone (rhGH) therapy. Nineteen adults with severe GHD were prospectively evaluated before and during rhGH replacement. Serum ASP, insulin-like growth factor-1 (IGF-1), metabolic and lipid parameters were assessed, while body composition and bone indices were determined by dual-energy X-ray absorptiometry. Associations between ASP and clinical variables were analyzed using Spearman's rank correlation. RhGH therapy significantly reduced circulating ASP concentrations at 12 and 24 months, while IGF-1 concentrations increased significantly throughout follow-up. Body fat percentage and fat mass decreased, whereas lean mass increased after 24 months of treatment. Significant changes in bone mineral content and lumbar spine Z-score were also observed after 24 months. ASP was consistently inversely correlated with fasting glucose and developed negative associations with IGF-1 and fat mass during follow-up. Time-dependent associations were also observed with visceral adiposity and lipid parameters, whereas no consistent associations between ASP and skeletal parameters were identified. Long-term rhGH replacement was associated with sustained reductions in circulating ASP concentrations and metabolic remodeling. These findings suggest that ASP may represent a candidate marker of metabolic adaptation during rhGH replacement, although validation in larger prospective cohorts is required.