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STUDY OBJECTIVE To compare the effectiveness and safety of different techniques of hysteroscopic polypectomy. DESIGN Multicenter, prospective observational trial (Canadian Task Force classification II-2). SETTING Nineteen Italian gynecologic departments (university-affiliated or public hospitals). PATIENTS Consecutive patients suffering from endometrial polyps (EPs). INTERVENTIONS Hysteroscopic polypectomy, as performed through different techniques. MEASUREMENTS AND MAIN RESULTS Included in the study were 1404 patients (with 1825 EPs). The setting was an ambulatory care unit in 40.38% of the cases (567 women), of whom 97.7% (554) did not require analgesia/anesthesia. In the remaining 59.62% of women (837 women), the procedures were performed in an operating room under mild sedation, local or general anesthesia. Minor complications occurred in 32 patients (2.27%), without significant differences between the techniques used (p = ns). Uterine perforation occurred in 14 cases, all performed in the operating room with some kind of anesthesia, only 1 with a vaginoscopic technique and the remaining during blind dilatation (odds ratio [OR], 19.98; 95% confidence interval [CI], 1.19-335.79; p = .04). An incomplete removal of EPs was documented in 39 patients. Logistic regression analysis showed that a higher risk of residual EPs was associated with the use of a fiber-based 3.5-mm hysteroscope (OR, 6.78; 95% CI, 2.97-15.52; p

Purpose We use the historical data from the European Study of Daily Fecundability and we develop an algorithm to determine the fertile window in a woman’s cycle according to the rules of the C.A.Me.N. symptothermal method proposed by the Centro Ambrosiano Metodi Naturali. Our aim is to identify variables acting on the probability of conception by considering the fertile window and factors that cannot be explained by employing the observed covariates of individuals and couples. Methods We adopt the latent Markov model with covariates tailored for data collected at times when a latent process detects the dependence across fertile periods of each woman’s cycle. We consider measurement errors, transitions between conception and non-conception, and the prediction of conception rate over the fertile windows. Conclusion We find that the conception pattern is mainly related to sexual intercourse behavior during the fertile window and to previous pregnancies. For the cohort under study, we predict a steep decline in the average conception rate across fertile windows.