Reviewer ’s report  
 
Title: Myometrial progesterone hyper -responsi veness associat ed with increased risk of human 
uterine fibroids  
 
Version: 4 Date: 31 May 2019  
 
Reviewer:  Rashmi Kudesia  
 
Reviewer's report:  
 
This manuscript revision is vastly improved relative to the original submission. I have two 
remaining recommendations: (1) though the English and proofing is substantially better, there 
are a few remaining errors and typos. One last fine -toothed edit should be performed, including 
also ensuring all abbreviations are defined (such as p.4 l. 48 MSC). A statistical point is that it is 
highly likely that with n=10, the distribution of demographics such as age may not be normal, in 
which case medi an [IQR] should be reported rather than mean (which needs a +/ - SD added at 
the minimum). (2) More importantly, I still do not see any discussion of the rather substantial 
limitations of this study. As there are many, which I detailed in the original revie w (namely 
limited generalizability due to race and sample size, the exploratory nature of these types of 
genetic association studies, the remaining question of whether these controls are truly controls - 
they are still listed as AUB in Table 2, so I am not  sure whether they were truly prolapse or 
AUB, etc.), this section is an absolutely critical component of the paper and should be added.  
 
Pending these revisions, I think the paper could be suitable for publication.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn ade quately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recomme nded, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before be ing published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five y ears received reimbursements, f ees, funding, or salary from an 
organisation that may in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may i n any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents  relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, fund ing, or salary from an organization that holds 
or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have  no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I  understand that my name will be included  
on my report to the authors and, if the manuscript is accepted f or publication, my nam ed report 
including any attachments I upload will be posted on the website along with the authors' 
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to the editors, which will not be published.  
 
I agree to the open pe er review policy of the journal