Reviewer’ s report
Title: Myometrial progesterone hyper-responsiveness associated with increased risk of human
uterine fibroids
Version: 2Date: 26 Mar 2019
Reviewer: Rashmi Kudesia
Reviewer's report:
The authors undertake this study to determine the comparative presence of progesterone-regulated
genes in 5 Caucasian women with fibroids, as compared to 5 other Caucasian women with eitherAUB or uterine prolapse. This paper is primarily hampered by the need for English-languageediting to improve the flow and readability of their study and its findings. There are innumerablegrammatical errors throughout the paper, and I would advise hiring a service or another consultantwith native English fluency to address this issue. In some cases, this will help explanation of someof the biological background of the paper, such as the contradicting findings regarding the impactof LNG-IUD versus systemic progesterone (page 3, line 57), etc. Also, the introduction mentionsthe "incidence" of fibroids multiple times, however, perhaps the "prevalence" of fibroids is what isactually of concern. On page 9, l. 26 it states "(list 5 genes here)" - I think this was meant toactually list the 5 genes in question. Please correct this. Otherwise, I have two overarching points:(1) On p.8, the authors give a rationale for why only Caucasian women were included in thisstudy. I find this to be insufficient of an explanation; more detail is needed as to the thoughtprocess here and how such findings could be generalized - if at all - to women of otherbackgrounds, including those with the greatest burden of fibroid disease (African-Americanwomen). How was race identified? (2) AUB as a reason for hysterectomy seems likely to have an
altered hormonal profile than a completely "normal" or "control" uterus, as the definition of AUB
implies. I am not sure that these cases are appropriate controls. Please revisit both of these issues ifyou choose to submit a revised manuscript.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
NoDoes the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
NoAre the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
No
Are you able to assess any statistics in the manuscript or would you recommend an
additional statistical review?If an additional statistical review is recommended, please specify what aspects require furtherassessment in your comments to the editors.
I am able to assess the statisticsQuality of written English
Please indicate the quality of language in the manuscript:
Not suitable for publication unless extensively edited
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