Swati Kumari

Cultured meat has progressed from early in vitro cell culture concepts to regulatory approvals and preliminary commercialization, with recent advancements propelled by interdisciplinary innovations in cell line engineering, serum-free media, bioreactor design, and three-dimensional (3D) assembly technologies.

Objectives: To assess the diagnostic accuracy of adenomyosis on transvaginal ultrasound (TVUS) in a community hospital.Design: Retrospective cohort studyParticipants: A total of 124 patients who underwent hysterectomy between September 2022 and August 2024.Setting: A tertiary referral academic centerMethods: All patients were referred to the Fibroid Clinic (BronxCare Health System) with symptomatic uterine fibroids or adenomyosis and underwent total hysterectomy. Postoperative pathological results were used as the reference standard. Collective data on TVUS, history, physical examination, and preoperative diagnosis were all studied. The primary goal was to evaluate the accuracy of TVUS in diagnosing adenomyosis by either radiologists or minimally invasive gynecologic surgeon (MIGS). The secondary objective was to identify the clinical factors associated with preoperative diagnosis of adenomyosis.Result: According to histologic reports from the surgical specimen, 61 (49.2%) patients had uterine fibroids only, 50 (40.3%) had concomitant fibroids and adenomyosis, and 13 (10.5 %) had adenomyosis only. There were no significant differences in age, race, or BMI among patients in the three groups. The accuracy of radiologist-interpreted TVUS for adenomyosis was found to be low in patients with pure adenomyosis (0 out of 13) and in those with both fibroids and adenomyosis (0 out of 50). In contrast, MIGS interpretation demonstrated 83.3% sensitivity for pure adenomyosis, which decreased to 30.6% in the presence of concomitant fibroids. The presence of uterine tenderness (UT) on bimanual examination is an independent predictor of adenomyosis, even with the presence of uterine fibroids or a uterine size larger than 14 weeks. When the uterine size was less than 14 weeks, the clinical presence of dysmenorrhea, dyspareunia, or UT was significantly associated with adenomyosis. The clinical assessment and TVUS interpretation by MIGS resulted in a 62.0% sensitivity and 84.0% specificity for adenomyosis in our cohort.Conclusion: The diagnosis of adenomyosis based on TVUS or a radiologist’s interpretation of TVUS can be underestimated. A comprehensive assessment, including clinical history, physical examination, and ultrasound interpretation by gynecologists, is essential for accurate diagnosis, patient counseling, and appropriate management.

Pelvic inflammatory disease (PID) remains a major cause of tubal factor infertility. Although in vitro fertilization (IVF) has largely replaced reconstructive surgery, selected patients with mild tubal damage may still achieve natural conception after surgical repair. This case highlights a spontaneous conception following bilateral fimbrioplasty in a patient with mild post-PID distal tubal occlusion.A 33-year-old, gravida 4 para 2, woman presented with three years of secondary infertility. Hysterosalpingogram (HSG) showed mild bilateral hydrosalpinx and distal tubal occlusion, with normal ovarian reserve and hormonal evaluation. The patient underwent robotic fimbrioplasty on July 23, 2025. Operative findings included Fitz-Hugh-Curtis changes, bilateral filmy adhesions, and grade-I distal occlusion. Bilateral adhesiolysis and fimbrioplasty were performed with restoration of tubal patency on chromotubation. The postoperative course was uncomplicated. Ten weeks after surgery, the patient conceived spontaneously with a normal intrauterine pregnancy. Tubal reconstructive surgery remains a valuable fertility-preserving option for selected patients who decline or lack access to IVF. Success depends on careful patient selection, minimal tubal damage, and meticulous microsurgical technique.Tubal reconstruction can offer selected women an affordable, fertility-preserving option, especially in low-resource settings where IVF is inaccessible.