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Background: Vulvovaginal candidiasis (VVC) is the second most common vulvovaginitis (VV). About 20% of women will experience recurrent infections in their lifetime with non-albicans Candida (NAC) species being one of the causative agents. Although studies have looked at risk factors for recurrent VVC they are limited in scope. In this study, we explore whether risks of recurrent VVC are increased with NAC infections compared to Candida albicans infections. Methods: Through an institutional review board-approved retrospective chart review, we identified 174 women with positive yeast cultures and followed their charts to assess recurrent visits and treatments. We also assessed several baseline variables such as race, age, body mass index (BMI), obstetric history, probiotic use, contraceptive use, mycological therapy, steroid use, hormone replacement therapy, menopausal status, and medical comorbidities. Results: Women with NAC VV were more likely to have multiple visits for recurring infections compared to women who had C. albicans VV (66% vs. 34%). The women with multiple recurrences were younger, had a lower BMI, had lower parity, and endorsed higher use of probiotics. Conclusion: Women with positive NAC cultures were more likely to have multiple visits to their physicians for VV complaints. Identifying the causative species using vaginal fungal cultures can more accurately guide therapy and lead to better outcomes for these patients.

Objective To determine the effects of fibroids, and their removal, on ART outcomes. Materials and methods Single institution retrospective cohort study of infertility patients who underwent myomectomy prior to either in vitro fertilization (IVF) or intrauterine insemination (IUI) between August 2006 and October 2015 (N = 49). Two separate control groups were established: 1) women with fibroids left in situ during the ART process (N = 76), and 2) women with no fibroids (N = 103). The study was powered to detect a difference between a 42%, 11%, and 25% live birth (LB) rate in the myomectomy, fibroids in situ, and no fibroids groups at P Results There were no significant differences in IVF cycle parameters between groups. Fibroids that were either submucosal or intramural with associated cavity distortion were significantly more likely to be removed. Amongst women undergoing IVF, the cumulative incidence of clinical pregnancy (CP) was significantly higher in the myomectomy group than the in situ or no fibroids groups. Women who underwent pre-IVF myomectomy also achieved CP more quickly. Cumulative LB rates did not differ significantly amongst women undergoing IVF. CP and LB rates per cycle were similar between myomectomy, in situ, and no fibroids groups (CP 49% vs. 37.5% vs. 54.4%, P = 0.21; LB 41.7% vs. 27.1% vs. 43.9%, P = 0.17). Discussion IVF outcomes appear to be improved by judicious removal of clinically significant fibroids. Further prospective studies are required to confirm the role of fibroids, and their removal, on ART outcomes before advocating for routine myomectomy amongst women with fibroids undergoing ART.

There is an ongoing debate regarding the benefits and drawbacks of the various routes of hysterectomy. A number of studies have examined overall quality of life outcomes as well as specific patient-reported outcomes including physical, psychosocial, and sexual functioning after hysterectomy. Existing studies have used varied methodologies with widely heterogeneous results, but patient satisfaction appears to be very high after laparoscopic hysterectomy, with many studies favoring the laparoscopic approach over other routes of hysterectomy. There are many opportunities for further investigation into the impact of laparoscopic hysterectomy on quality of life-an outcome measure that may be 1 of the most important in surgeries for benign indications.

To evaluate the general knowledge of female graduate students on reproductive aging and fertility preservation options, as well as to investigate the perceptions, personal beliefs, and desires regarding fertility and preservation modalities.A cross-sectional online survey study of female graduate students and medical trainees from academic institutions in Ohio was performed. Women were excluded if the online survey was incomplete or if they were 45 years.Analysis of 590 surveys was performed (response rate of 26.3%). Ninety-four percent (557/590) of subjects were between 20 and 35 years. Our respondents tended to be nulliparous (87%), married or in a relationship (51%) and interested in future fertility (77%). The reasons cited for delaying childbearing were multi-factorial, with career building noted most commonly (69%). Nearly 60% of women reported they would consider fertility preservation in the future; however, the majority (87%) cited two or more barriers. When asked about their desire for information on fertility preservation, 28% desired to receive education on their choices and 36% wanted their Ob/Gyn to discuss fertility preservation options. Women 30 years were significantly more likely to desire future fertility, want more fertility preservation education and consider pursuing fertility preservation in the future.Graduate-level women often delay childbearing for professional pursuits. This study demonstrates a need for increased fertility preservation awareness and education, especially by Ob/Gyn providers.

Uterine fibroids are the most common benign tumor in reproductive-aged women. While the majority of women are asymptomatic, those with symptoms may suffer from abnormal uterine bleeding, infertility, pelvic pain or pressure, and urinary dysfunction. Fibroids represent a significant healthcare burden for women and society as a whole. Women with fibroids have compromised overall quality of life and impairment in many specific domains including work productivity, sexuality, self-image, relationships, and social emotional and physical well-being. Many women are reluctant to ask for help and delay seeking treatment. To date, myomectomy remains the gold standard for treating fibroid-related symptoms in reproductive-aged women. However, many less invasive uterine preserving approaches have been developed. Quality of life is improved in many women following treatment for fibroids. This article aims to provide an overview of the substantial impact of fibroids on health-related quality of life.

Background Every year millions of women experience vulvo-vaginal candida. While the majority of the women with vulvo-vaginal candida are infected with albicans, the distribution of non-albicans candida (NAC) species varies depending on geography, race and ethnicity, and past medical history. While there are studies that explore the relationship between these factors and the incidence of NAC many of these studies are outdated. In this study, we explore the clinical risk factors for development of NAC compared with the more common albicans candida infections. Methods We performed a retrospective cohort study. 174 women with a positive candida culture were identified via a database maintained by the Cleveland Clinic Microbiology department. Exclusion criteria were women with negative cultures, those under the age of 18, or with an initial encounter prior to 2004. Results The average age of women who presented with NAC was 41.5 [31.0, 53.0] and was not statistically significant from women with no NAC, 43.0 [42.0, 45.0] (P = 0.19). Among all initial positive yeast cultures 34.5% were C. glabrata followed by C. parapsilosis at 3.4%. Women who had a positive NAC culture were more likely to be post-menopausal than those with no NAC, 73.8 NAC vs. 26.2 no NAC (P ≤ 0.001). Additionally, women cultured with NAC were more likely to be on hormone replacement therapy, 77.8 NAC vs. 22.2 no NAC (P = 0.011). However, we found that recent antibiotic use, diabetes, and probiotic use had no impact. Conclusion This study shows that post-menopausal women and women who are hormone replacement therapy are more likely to be colonized by NAC indicating that these are risk factors. Disclosures All authors: No reported disclosures.