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The article discusses the best methods for the identification and treatment of polycystic ovarian syndrome (PCOS). Among the treatment methods for PCOS include the normalization of menstrual cycles and treatment of hirsutism by decreasing testosterone or gonadotrophin production and suppression of testosterone action using anti-androgens such as spironolactone. Recommended ways for the management of infertility include changes in lifestyle, use of metformin, insulin sensitizers, clomiphene citrate, gonadotrophins, GnRH analogues, aromatase inhibitors, surgical approaches such as ovarian wedge resection, laparoscopic ovarian drilling and vaginal ovarian drilling, and in-vitro maturation of oocytes.

Over the past four decades, the postponement of childbearing has continued to increase, significantly impacting the age of first-time mothers. Female age is the most significant factor influencing clinical outcome in in-vitro fertilization. To overcome the limits of the age-related decline of fertility is a challenge for fertility experts. In the decrease of fertility in late reproductive age, a lot of factors related with advancing women's age and general health can be considered, however the dominant regulator of this age-dependent loss of fertility is the ovary. The key factors in the ovarian aging are oxidative stress, abnormalities of the meiotic spindle, decrease of function and number of oocyte mitochondria, alteration of sirtuins and androgen deficiency. The aim of this review was to assess the main biological factors involved in the female reproductive ageing according to the recent literature, focusing on oocyte-dependent ones, as well as the possible therapeutic strategies in assisted reproductive technique.

The advent of robot-assisted laparoscopy (RAL) is an important innovation which has provided new perspectives for the treatment of endometriosis, and particularly of deep infiltrating endometriosis (DIE). RAL offers several technical advantages in the treatment of this complex disease, such as 3D view, tremor filtration and better surgical ergonomics, thus improving surgical performances without no increase in surgical time, blood loss, and intra- or postoperative complications, while also reducing the rate of conversion to laparotomy. Additionally, thanks to its reduced learning curve compared to conventional laparoscopy (CL), it facilitates the training of less experienced surgeons. For these reasons, DIE might be one of the best indications for RAL in gynecologic surgery. However, very few retrospective studies and small cases series, and only one randomized clinical trial have been published in this regard. Further randomized control trials comparing CL to RAL for different stages of endometriosis and different procedures performed are warranted in order to be able to define potential benefits of RAL for endometriosis surgery.

Anatomical uterine element and functional components play a fundamental role in the enhancing of fertility are the major actors. Uterine pathologies, including congenital or acquired lesions, have been reported in 21 to 47% of patients undergoing in vitro fertilization cycles. Hysteroscopy is an important procedure in the study of one of the most important element of fertility: the uterus, even if its use in the world of infertility is discussed. There are many studies on safety and feasibility of the procedure and on patient compliance, but there is no consensus on its systemic use. This study, thanks to the wide literature about the use of hysteroscopic surgery to enhance fertility in most of the congenital and acquired problems affecting women in fertility age, allows defining that diagnostic and operative hysteroscopy is a rapid and safety technology to improve fertility.