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Naghizadeh S, Faroughi F, Mirghafourvand M. Investigating the relationship between breast and gynecological cancers and infertility and its treatments: a case-control study. Eur J Cancer Prev 2023; 32:600-607. [PMID: 37283054 DOI: 10.1097/cej.0000000000000815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Due to the high prevalence of breast and gynecological cancers among women, it is crucial to identify the risk factors of these cancers. Thus, the present study aimed to evaluate the relationship between breast and gynecological cancers and infertility and its treatments in women suffering from these cancers. METHODS This case-control study was conducted with the participation of 400 people (200 women with breast and gynecological cancers and 200 healthy women without a history of cancer) in hospitals and health centers in Tabriz, Iran, in 2022. Data were collected using a four-part researcher-made questionnaire including sociodemographic characteristics, obstetric characteristics, information related to cancer, and information related to infertility and its treatments. RESULT s Based on the multivariable logistic regression model and by controlling sociodemographic and obstetric characteristics as possible confounding variables, women with cancer had an infertility history almost four times more than women who did not have a history of cancer (OR = 3.56; 95% CI: 1.36-9.33; P = 0.010). Women with breast cancer had an infertility history five times more than women without a history of breast cancer (OR = 5.11; 95% CI: 1.68-15.50; P = 0.004). The infertility history of women with gynecological cancer was more than three times that of the control group. However, there was no statistically significant difference between the two groups (OR = 3.36; 95% CI: 0.99-11.47; P = 0.053). CONCLUSION Infertility and its treatments may be involved in increasing the risk of breast and gynecological cancers.
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Affiliation(s)
- Somayyeh Naghizadeh
- Department of Midwifery, Faculty of Medical, Tabriz Medical Sciences, Islamic Azad University, Tabriz
| | - Farnaz Faroughi
- Department of Midwifery, Maragheh Branch, Islamic Azad University, Maragheh and
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Centre, Faculty of Nusrsing and Midwifery, Department of Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
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2
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Lester SP, Kaur AS, Vegunta S. OUP accepted manuscript. Oncologist 2022; 27:548-554. [PMID: 35536728 PMCID: PMC9256023 DOI: 10.1093/oncolo/oyac084] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 03/18/2022] [Indexed: 12/03/2022] Open
Abstract
In screening for breast cancer (BC), mammographic breast density (MBD) is a powerful risk factor that increases breast carcinogenesis and synergistically reduces the sensitivity of mammography. It also reduces specificity of lesion identification, leading to recalls, additional testing, and delayed and later-stage diagnoses, which result in increased health care costs. These findings provide the foundation for dense breast notification laws and lead to the increase in patient and provider interest in MBD. However, unlike other risk factors for BC, MBD is dynamic through a woman’s lifetime and is modifiable. Although MBD is known to change as a result of factors such as reproductive history and hormonal status, few conclusions have been reached for lifestyle factors such as alcohol, diet, physical activity, smoking, body mass index (BMI), and some commonly used medications. Our review examines the emerging evidence for the association of modifiable factors on MBD and the influence of MBD on BC risk. There are clear associations between alcohol use and menopausal hormone therapy and increased MBD. Physical activity and the Mediterranean diet lower the risk of BC without significant effect on MBD. Although high BMI and smoking are known risk factors for BC, they have been found to decrease MBD. The influence of several other factors, including caffeine intake, nonhormonal medications, and vitamins, on MBD is unclear. We recommend counseling patients on these modifiable risk factors and using this knowledge to help with informed decision making for tailored BC prevention strategies.
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Affiliation(s)
- Sara P Lester
- Corresponding author: Sara P. Lester, MD, Division of General Internal Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
| | - Aparna S Kaur
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Suneela Vegunta
- Division of Women’s Health Internal Medicine, Mayo Clinic, Scottsdale, AZ, USA
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3
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Farhud DD, Zokaei S, Keykhaei M, Hedayati M, Zarif Yeganeh M. In-Vitro Fertilization Impact on the Risk of Breast Cancer: A Review Article. IRANIAN JOURNAL OF PUBLIC HEALTH 2021; 50:438-447. [PMID: 34178791 PMCID: PMC8214614 DOI: 10.18502/ijph.v50i3.5583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background Due to the increasing prevalence of infertility, the number of referrals to infertility treatment centers has also increased. Nowadays, assisted reproductive technology (ART), including in vitro fertilization (IVF), is a treatment for infertility or genetic problems. Considering the possible consequences of this method among women undergoing in vitro fertilization (IVF) and kids conceived by IVF, extensive research has been conducted in this regard. Methods Overall, 100 articles were entered into the study, and relevant articles were searched and extracted from PubMed, Springer, and Google Scholar databases. In IVF procedure, medications such as Clomiphene citrate and gonadotropins are used to stimulate and mature follicles and thus increase ovulation. Results There are conflicting opinions on this issue. Some findings report a slight increase in cancer risk for hormone-sensitive cancers including breast cancer. The long-term use of IVF medications can increase estrogen hormones and cause excessive expression of genes, resulting in an increased risk of breast cancer, which is one of the most frequent cancers among women. Conclusion There are some risks to be aware of, which followed the hypothesis that long IVF treatment process may lead to breast cancer among IVF candidates. Furthermore, the risk of breast cancer may be increased in those women with a positive family history and related inherited genes. Therefore, women candidates for IVF should be informed of the probable implications of the reproductive therapy techniques.
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Affiliation(s)
- Dariush D Farhud
- School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Department of Basic Sciences, Iranian Academy of Medical Sciences, Tehran, Iran
| | - Shaghayegh Zokaei
- School of Advanced Medical Sciences, Tehran Medical Branch, Islamic Azad University, Tehran, Iran
| | - Mohammad Keykhaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Hedayati
- Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Marjan Zarif Yeganeh
- Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Automatic Breast and Fibroglandular Tissue Segmentation in Breast MRI Using Deep Learning by a Fully-Convolutional Residual Neural Network U-Net. Acad Radiol 2019; 26:1526-1535. [PMID: 30713130 DOI: 10.1016/j.acra.2019.01.012] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 01/03/2019] [Accepted: 01/13/2019] [Indexed: 12/17/2022]
Abstract
RATIONALE AND OBJECTIVES Breast segmentation using the U-net architecture was implemented and tested in independent validation datasets to quantify fibroglandular tissue volume in breast MRI. MATERIALS AND METHODS Two datasets were used. The training set was MRI of 286 patients with unilateral breast cancer. The segmentation was done on the contralateral normal breasts. The ground truth for the breast and fibroglandular tissue (FGT) was obtained by using a template-based segmentation method. The U-net deep learning algorithm was implemented to analyze the training set, and the final model was obtained using 10-fold cross-validation. The independent validation set was MRI of 28 normal volunteers acquired using four different MR scanners. Dice Similarity Coefficient (DSC), voxel-based accuracy, and Pearson's correlation were used to evaluate the performance. RESULTS For the 10-fold cross-validation in the initial training set of 286 patients, the DSC range was 0.83-0.98 (mean 0.95 ± 0.02) for breast and 0.73-0.97 (mean 0.91 ± 0.03) for FGT; and the accuracy range was 0.92-0.99 (mean 0.98 ± 0.01) for breast and 0.87-0.99 (mean 0.97 ± 0.01) for FGT. For the entire 224 testing breasts of the 28 normal volunteers in the validation datasets, the mean DSC was 0.86 ± 0.05 for breast, 0.83 ± 0.06 for FGT; and the mean accuracy was 0.94 ± 0.03 for breast and 0.93 ± 0.04 for FGT. The testing results for MRI acquired using four different scanners were comparable. CONCLUSION Deep learning based on the U-net algorithm can achieve accurate segmentation results for the breast and FGT on MRI. It may provide a reliable and efficient method to process large number of MR images for quantitative analysis of breast density.
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Ruby L, Sanabria SJ, Obrist AS, Martini K, Forte S, Goksel O, Frauenfelder T, Kubik-Huch RA, Rominger MB. Breast Density Assessment in Young Women with Ultrasound based on Speed of Sound: Influence of the Menstrual Cycle. Medicine (Baltimore) 2019; 98:e16123. [PMID: 31232962 PMCID: PMC6636937 DOI: 10.1097/md.0000000000016123] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
To investigate changes in breast density (BD) during the menstrual cycle in young women in comparison to inter-breast and -segment changes as well as reproducibility of a novel Speed-of-Sound (SoS) Ultrasound (US) method.SoS-US uses a conventional US system with a reflector and a software add-on to quantify SoS in the retro-mammillary, inner and outer segments of both breasts. Twenty healthy women (18-40 years) with regular menstrual cycles were scanned twice with two weeks in-between. Three of these were additionally measured twice per week for 25 days. Average SoS (m/s) and ΔSoS (segment-variation SoS; m/s) were measured. Variations between follicular and luteal phases and changes over the four-week period were assessed. Inter-examiner and inter-reader agreements were also evaluated. Variances between cycle phases, examiners and readers were compared.No significant SoS difference was observed between follicular and luteal phases for the twenty women (P = .126), and between all different days for the three more frequently measured women (P = .892). Inter-reader (ICC = 0.999) and inter-examiner (ICC = 0.990) agreements were high. The SoS variance due to menstrual variations was not significantly larger than the inter-examiner uncertainty (P = .461). Inter-reader variations were significantly smaller than menstrual and examiner variations (P < .001).SoS-US showed high inter-examiner and inter-reader reproducibility. The alterations during the menstrual cycles were not significantly larger than the confidence interval of measurements.
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Affiliation(s)
- Lisa Ruby
- Zurich Ultrasound Research and Translation (ZURT), Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Rämistrasse 100
| | - Sergio J. Sanabria
- Zurich Ultrasound Research and Translation (ZURT), Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Rämistrasse 100
- Computer-assisted Applications in Medicine, ETH Zurich, Sternwartstrasse 7, Zürich
| | - Anika S. Obrist
- Zurich Ultrasound Research and Translation (ZURT), Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Rämistrasse 100
| | - Katharina Martini
- Zurich Ultrasound Research and Translation (ZURT), Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Rämistrasse 100
| | - Serafino Forte
- Department of Radiology, Kantonsspital Baden, Im Ergel 1, Baden, Switzerland
| | - Orcun Goksel
- Computer-assisted Applications in Medicine, ETH Zurich, Sternwartstrasse 7, Zürich
| | - Thomas Frauenfelder
- Zurich Ultrasound Research and Translation (ZURT), Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Rämistrasse 100
| | - Rahel A. Kubik-Huch
- Department of Radiology, Kantonsspital Baden, Im Ergel 1, Baden, Switzerland
| | - Marga B. Rominger
- Zurich Ultrasound Research and Translation (ZURT), Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Rämistrasse 100
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Lo EM, Hotaling JM, Pastuszak AW. Urologic conditions associated with malignancy. Urol Oncol 2019; 38:23-30. [PMID: 30611645 DOI: 10.1016/j.urolonc.2018.12.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 12/11/2018] [Accepted: 12/18/2018] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Recent advances in cancer research have highlighted the role of genetics in malignancy. Genetic dysregulation of core cellular functions similarly influences benign conditions. These common genetic factors have led researchers to identify an association between certain urologic conditions and malignancy. The objective of this review is to evaluate the literature linking benign urologic conditions including male infertility, Peyronie's disease, cryptorchidism, and hypospadias, to malignancy. METHODS A search of PubMed was performed using the following search terms and their combinations: male infertility, female infertility, cancer, malignancy, mortality, male urologic conditions, azoospermia, Peyronie's disease, cryptorchidism, hypospadias, and genetics. Studies were assessed for quality and included or excluded based on study design and relevance to the topic of urologic conditions and malignancy. RESULTS A total of 52 studies were evaluated, of which 38 were included. Associations between male infertility and testicular cancer, prostate cancer, and other cancers including melanoma, bladder cancer, and thyroid cancer were examined. Several genetic alterations were found to be common in the pathogenesis of both male infertility and carcinogenesis. Associations between female infertility and breast, ovarian, and endometrial cancer are also assessed, as are the relationships between Peyronie's disease, cryptorchidism, and hypospadias and malignancy. CONCLUSIONS Recent work has identified associations between a number of malignancies and benign urologic conditions including male infertility, Peyronie's disease, cryptorchidism, and hypospadias. Molecular and genetic mechanisms have been proposed, but no definitive causal relationships have been identified to date. Future work will continue to better define the links between malignancy and benign urologic conditions and ultimately facilitate risk stratification, screening, and treatment of affected men.
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Affiliation(s)
- Eric M Lo
- Baylor College of Medicine, Houston, TX
| | - James M Hotaling
- Division of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT
| | - Alexander W Pastuszak
- Division of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT.
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Prediction of glandularity and breast radiation dose from mammography results in Japanese women. Med Biol Eng Comput 2018; 57:289-298. [PMID: 30099671 DOI: 10.1007/s11517-018-1882-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 07/30/2018] [Indexed: 02/07/2023]
Abstract
Glandularity has a marked impact on the incidence of breast cancer and the missed lesion rate of mammography. The aim of this study was to develop a novel model for predicting glandularity and patient radiation dose using physical factors that are easily determined prior to mammography. Data regarding glandularity and mean glandular dose were obtained from 331 mammograms. A stepwise multiple regression analysis model was developed to predict glandularity using age, compressed breast thickness and body mass index (BMI), while a model to predict mean glandular dose was created using quantified glandularity, age, compressed breast thickness, height and body weight. The most significant factor for predicting glandularity was age, the influence of which was 1.8 times that of BMI. The most significant factor for predicting mean glandular dose was compressed breast thickness, the influence of which was 1.4 times that of glandularity, 3.5 times that of age and 6.1 times that of height. Both models were statistically significant (both p < 0.0001). Easily determined physical factors were able to explain 42.8% of the total variance in glandularity and 62.4% of the variance in mean glandular dose. Graphical abstract Validation results of the above prediction model made using physical factors in Japanese women. The plotted points of actual vs. prediction glandularity shown in a are distributed in the vicinity of the diagonal line, and the residual plot for predicted glandularity shows an almost random distribution as shown in b. These distributions indicate the appropriateness of the prediction model.
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Lundberg FE, Iliadou AN, Rodriguez-Wallberg K, Bergh C, Gemzell-Danielsson K, Johansson ALV. Ovarian stimulation and risk of breast cancer in Swedish women. Fertil Steril 2017; 108:137-144. [PMID: 28600105 DOI: 10.1016/j.fertnstert.2017.05.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 05/04/2017] [Accepted: 05/04/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate whether ovarian stimulation for treating infertility is associated with the risk of breast cancer. DESIGN Nationwide register-based cohort study. SETTING Not applicable. PATIENT(S) In a cohort of 1,340,211 women who gave birth 1982-2012, we investigated the relationship between assisted reproductive technology (ART) and incidence of breast cancer. Associations between any ovarian stimulation since 2005 and breast cancer incidence were studied in a separate cohort of 1,877,140 women born 1960-92. Both cohorts were followed through 2012. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Hazard ratios (HRs) and 95% confidence intervals (CIs) for breast cancer. RESULT(S) There was no increased risk of breast cancer in women who gave birth after ART compared with women who gave birth after spontaneous conception (adjusted HR, 0.84; 95% CI, 0.74-0.95). The incidence of breast cancer was not increased among women who received controlled ovarian stimulation or among women who received other hormonal fertility treatments since 2005, regardless of live birth (adjusted HR, 0.86; 95% CI, 0.69-1.07; and adjusted HR, 0.79; 95% CI, 0.60-1.05, respectively). CONCLUSION(S) No increased incidence of breast cancer was found among women who had gone through ovarian stimulations, including ART. These results are consistent with other studies and reassuring given the widespread and increasing use of ART.
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Affiliation(s)
- Frida E Lundberg
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
| | - Anastasia N Iliadou
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Kenny Rodriguez-Wallberg
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden; Department of Obstetrics and Gynecology, Division of Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Christina Bergh
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
| | - Kristina Gemzell-Danielsson
- Department of Women's and Children's Health, Division of Obstetrics and Gynecology, Karolinska Institutet and Karolinska University Hospital, WHO Collaborating Centre, Stockholm, Sweden
| | - Anna L V Johansson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Vaughan DA, Leung A, Resetkova N, Ruthazer R, Penzias AS, Sakkas D, Alper MM. How many oocytes are optimal to achieve multiple live births with one stimulation cycle? The one-and-done approach. Fertil Steril 2017; 107:397-404.e3. [DOI: 10.1016/j.fertnstert.2016.10.037] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 10/26/2016] [Accepted: 10/26/2016] [Indexed: 11/24/2022]
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Hanson B, Johnstone E, Dorais J, Silver B, Peterson CM, Hotaling J. Female infertility, infertility-associated diagnoses, and comorbidities: a review. J Assist Reprod Genet 2016; 34:167-177. [PMID: 27817040 DOI: 10.1007/s10815-016-0836-8] [Citation(s) in RCA: 146] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 10/23/2016] [Indexed: 12/11/2022] Open
Abstract
PURPOSE The purpose of the study is to evaluate existing literature for possible associations between female infertility, infertility-associated diagnoses, and the following areas of disease: psychiatric disorders, breast cancer, ovarian cancer, endometrial cancer, cardiovascular disease, and metabolic dysfunction. METHODS The design of the study is a literature review. The patients were women included in 26 selected studies due to a diagnosis of infertility or a reproductive disorder associated with infertility. This study has no interventions, and the main outcome measure is the association between female infertility or a related diagnosis and psychiatric disorders, breast cancer, ovarian cancer, endometrial cancer, cardiovascular disease, and metabolic dysfunction. RESULTS Female infertility and related reproductive disorders may have ramifications for women beyond reproductive health. An analysis of publications shows that women with infertility had higher rates of psychiatric disorders and endometrial cancer than the general population [1-10]. Data is conflicting about whether infertile women are at increased risk for breast cancer and ovarian cancer [7, 8, 10-20]. A generalized diagnosis of infertility was not clearly associated with an increased risk of cardiovascular disease or metabolic dysfunction, but women with infertility related to polycystic ovarian syndrome (PCOS) do appear more likely to develop cardiovascular disease and metabolic disorders such as diabetes than the general population [16, 21-26]. CONCLUSIONS Female infertility and associated diagnoses have overall health implications. Beyond treatment of patients' immediate reproductive needs, healthcare professionals must be aware of the broader health impact of specific causes of infertility in order to provide accurate counseling regarding long-term risk.
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Affiliation(s)
- Brent Hanson
- Department of Obstetrics and Gynecology, University of Utah, 50 N Medical Drive, Salt Lake City, UT, 84132, USA.
| | - Erica Johnstone
- Department of Reproductive Endocrinology and Infertility, University of Utah, Salt Lake City, UT, USA.,Utah Center for Reproductive Medicine, 675 Arapeen Way, Suite 205, Salt Lake City, UT, 84108, USA
| | - Jessie Dorais
- Department of Reproductive Endocrinology and Infertility, University of Utah, Salt Lake City, UT, USA.,Utah Center for Reproductive Medicine, 675 Arapeen Way, Suite 205, Salt Lake City, UT, 84108, USA
| | - Bob Silver
- Department of Obstetrics and Gynecology, University of Utah, 50 N Medical Drive, Salt Lake City, UT, 84132, USA
| | - C Matthew Peterson
- Department of Reproductive Endocrinology and Infertility, University of Utah, Salt Lake City, UT, USA.,Utah Center for Reproductive Medicine, 675 Arapeen Way, Suite 205, Salt Lake City, UT, 84108, USA
| | - James Hotaling
- Department of Surgery - Urology, University of Utah Center for Reconstructive Urology and Men's Health, 675 Arapeen Way, Suite 205, Salt Lake City, UT, 84108, USA
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