BackgroundOver 20 million people in the U.S. are behind on cervical cancer screenings (CCS). Sexual minority populations are 50% less likely to engage in routine screening, putting them at higher risk for cervical dysplasia and cancer due to undetected precancer and delayed diagnosis. Their barriers to speculum exams include access to care, sexual trauma, and provider bias. At-home HPV self-collection (SC) offers a clinically accurate, preferred alternative screening method.ObjectiveTo assess clinical agreement, usability, and screening experiences and preferences for an FDA-authorized at-home vaginal SC device among participants who identify as lesbian, gay, bisexual, pansexual, queer, or other non-heterosexual identities (LGBQ+).MethodsSELF-CERV was a prospective, multi-site method-comparison study conducted across 16 U.S. sites. Participants completed SC in a simulated at-home setting and underwent clinician collection with a speculum and cervical brush; paired specimens were tested for primary HPV using the Roche cobas. Surveys assessed barriers to screening, prior screening experiences, usability, and preferences. 609 participants were enrolled; 599 had paired samples, including 74 LGBQ+ participants.ResultsCompared with heterosexual participants, LGBQ+ participants more frequently delayed or avoided screening, had lower preventive care engagement, and described worse prior speculum-based screening experiences, including higher pain, discomfort, and aversion. Clinical agreement between self- and clinician-collected specimens was comparable, with no unanticipated safety concerns. The SC device was rated as easy to use and acceptable across groups; LGBQ+ participants reported greater comfort and empowerment and a stronger preference for at-home self-collection. Qualitative comments emphasized privacy and reduced distress, including trauma- and dysphoria-related concerns.ConclusionAt-home SC is a clinically valid, usable, and strongly preferred CCS option, particularly among LGBQ+ populations who experience disproportionate barriers to speculum-based CCS. Broader adoption of FDA-authorized at-home SC paired with telehealth will enable future impact assessment to reduce persistent disparities in CCS for LGBQ+ populations.

Around 10% of global births are preterm (before 37 weeks of gestation), posing a significant challenge to maternal and neonatal health. Preterm infants face an increased risk of mortality and long-term health complications, impacting their survival and development across all life stages. Despite decades (~ 80 years) of research, effective methods to predict and prevent idiopathic or spontaneous preterm birth remain limited. Therefore, a deeper understanding of the pathophysiology of spontaneous preterm birth is warranted. This review explores some aspects of recent progress in unravelling the complex pathophysiology of both normal and preterm human birth. We present parturition as an inflammatory event, triggered by stressors affecting the uterine reproductive tissues (myometrium, decidua, and cervix), and involving multiple endocrine and paracrine pathways. These pathways, along with signals from fetal membrane senescence and the vaginal microbiome, contribute to labor induction. Proposed perspectives in parturition research include using mathematical modeling and machine learning (artificial intelligence) to map pregnancy trajectories and identify patient phenotypes associated with preterm birth risk. Additionally, incorporating preterm birth history into routine life course medical surveillance for affected individuals and their offspring is recommended. Finally, increased investment and prioritization from national funding bodies, along with greater support for international collaborations, are essential to identify the causes of preterm birth across multiple populations and develop new, effective treatments.

Endometriosis (EMS) is a chronic inflammatory disorder affecting ~10% of reproductive-age women, with increasing evidence implicating the microbiome in its pathogenesis through immunomodulation and estrogen metabolism. This study investigated microbiome composition in the vagina, endometrium, and peritoneal fluid (PF) of women with and without EMS and further assessed the effects of Lactobacillus reuteri (L. reuteri) on endometrial (EM) cells in vitro. Samples from 41 patients were analyzed using 16S rRNA gene sequencing, targeting the V3-V4 regions. Western blotting, ELISA, and LC-MS/MS were employed to evaluate protein expression and estrogen metabolism during EM-L. reuteri co-culture with or without estradiol-17-glucuronide (E2G). Microbiome analysis revealed no significant differences in alpha or beta diversity between EMS and controls across all compartments. However, LEfSe analysis identified several taxa with differential abundance, with L. reuteri consistently altered in both vagina and EM. Across the menstrual cycle, EM and vaginal microbiomes were stable, whereas PF microbiota showed phase-dependent variation involving 60 genera and 76 species. In vitro, L. reuteri alone did not alter endometriosis-related proteins, but in the presence of E2G, it reduced BAX/Bcl-2 ratios and increased p-NF-κB, suggesting anti-apoptotic and pro-inflammatory shifts. Progesterone receptor α/β expression decreased, while estrogen receptor levels remained unchanged. L. reuteri increased β-glucuronidase activity but did not enhance E2G-to-estradiol conversion. These findings highlight L. reuteri as a potentially important species in EMS, with in vitro evidence suggesting survival-promoting effects under estrogenic conditions. Further research should explore multi-species interactions and hormonal contexts to clarify microbial contributions to EMS pathogenesis.

Gardnerella vaginalis is a key bacterium in the etiology of bacterial vaginosis (BV) and contributes to biofilm formation. Gardnerella is a facultative anaerobic bacterium, meaning it can grow both in the presence of oxygen and under anaerobic conditions. We conducted a prospective study in 2025, including 160 consecutive vaginal samples from women submitted for pathogenic bacteria. Clinical information on the referral form indicated in 87 women (54.4%), from which colpitis in 64 cases (73.6%). There were 43 pregnant women (26.9%), with an average age of 30.7 years. Each vaginal sample was cultured on Gardnerella agar and incubated in both CO2 and anaerobic atmospheres. The culture plates were examined after 24 and 48 h of incubation, independently of other results. In cases where suspicious colonies with beta-hemolysis were observed, bacterial identification was performed using MALDI-TOF mass spectrometry (Bruker). Gram-stained smears were evaluated according to the Nugent score. The bacteria Gardnerella vaginalis and Gardnerella leopoldii/swidsinskii were detected in 46 (28.8%) samples. The sensitivity of G. vaginalis and G. leopoldii/swidsinskii cultivation on Gardnerella agar in a CO2 atmosphere was 67.4% compared to anaerobic cultivation. Anaerobic cultivation on Gardnerella agar proved to be a superior method for the isolation of G. vaginalis and G. leopoldii/swidsinskii compared to cultivation in a CO2 atmosphere. The diagnosis of BV in clinical practice relies on standard Amsel's criteria, gram-stained vaginal smears evaluated using the Nugent scoring system or Ison-Hay criteria, and the isolation of G. vaginalis and G. leopoldii/swidsinskii.IMPORTANCEBacterial vaginosis (BV) is the most common vaginal infection among women of reproductive age and is associated with significant adverse outcomes, including preterm birth, spontaneous abortion, and increased susceptibility to sexually transmitted infections. Accurate and timely microbiological diagnosis is therefore clinically important. Our study demonstrates that anaerobic incubation on selective Gardnerella agar improves the detection of Gardnerella vaginalis and Gardnerella leopoldii/swidsinskii compared with incubation in a CO2-enriched atmosphere. Under anaerobic conditions, colonies were larger, hemolysis was more pronounced, and overall sensitivity was higher. Although BV diagnosis in clinical practice primarily relies on Amsel's criteria and Nugent scoring, optimized culture conditions provide valuable complementary microbiological evidence. These findings contribute to the optimization of laboratory procedures and may enhance the reliability of routine diagnostic workflows in women with suspected BV.

This study employed high-throughput sequencing to analyze the diversity of vaginal microbiota in healthy women of reproductive age, thereby establishing a foundational dataset that may inform future forensic applications such as individual identification.

Hepatoid adenocarcinoma (HAC) is a rare extrahepatic malignant tumor that exhibits histological features resembling those of hepatocellular carcinoma. It is typically accompanied by an abnormal elevation in serum alpha - fetoprotein (AFP) levels. HAC can occur in multiple organs, with the stomach being the most common site. It has also been reported in organs such as the esophagus, colon, pancreas, lung, ovary, and uterus. After reviewing the relevant literature, to date, there have been no reports of primary HAC in the vagina. This article presents the first case of primary vaginal hepatoid adenocarcinoma. The patient was a post - menopausal elderly woman. By presenting the characteristics of the disease onset, clinical manifestations, clinicopathological features, molecular characteristics, and the treatment process, and through a literature review, the objective is to improve the understanding of this rare disease and offer a reference for clinical diagnosis and treatment.