1
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Arab S, Suarthana E, Buckett W. P–433 Pregnancy and livebirth after fertility preservation in cancer patients. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
What do we know about pregnancy and livebirth after IVF- fertility preservation treatment in women with cancer?
Summary answer
Most women conceived spontaneously (60%) and more than 50% of those who returned to use their cryopreserved reproductive material have delivered at least one child.
What is known already
Diminishing ovarian reserve and declining future reproductive potential are important issues in cancer survivors after anti-cancer treatment exposure. Publications on pregnancy and livebirth after fertility preservation in women with cancer are sparse. Studies report most cancer patient who underwent fertility preservation do not come back and use their frozen reproductive material. The purpose of this study was to investigate the fertility preservation outcome among cancer survivors.
Study design, size, duration
A retrospective cohort study was conducted at a single academic fertility center from including 336 cancer patients who underwent IVF-fertility preservation from January 2009 to June 2020.
Participants/materials, setting, methods
We included all women with cancer aged ≤40 years old who were referred for fertility preservation treatment prior to chemotherapy.
Primary outcome: Number of pregnancies and livebirths after spontaneous conception and/or using their stored frozen material.
Secondary outcomes: We also evaluated the utilization rate of the stored reproductive material and mortality rate among those with follow up data.
Main results and the role of chance
Of 336 patients who underwent IVF-fertility preservation, 214 (63.69%) elected oocyte cryopreservation, 86 (25.5%) underwent both embryo and oocyte cryopreservation and 36 (10.7`%) underwent embryo cryopreservation. Follow up data were available in 198 (58.9%) patients with a mean follow up of 3.2 years. Of 198, 16 (8%) patients died, 40 (20%) became pregnant. Of those pregnant patients, 24 (60%) became spontaneously pregnant and 16 (40%) became pregnant after frozen oocyte or frozen embryo treatment cycles. Almost a quarter (72.5%) of the pregnancies resulted in livebirths. In total, only 23 (7%) patients had returned for frozen oocyte or frozen embryo treatment cycle, of which 16 (70%) achieved a pregnancy and 10 (63%) achieved at least one live birth. Of 142 patients who were still alive at follow up but did not get pregnant, 51 (39%) were in remission from their cancer but had not chosen to use their stored reproductive material; 44 (31%) were still on anti-cancer treatment and had not started trying yet; 13 (9%) were suffering from the end-stage cancer disease; and 7 (5%) had used their stored reproductive material but failed and stopped trying to get pregnant.
Limitations, reasons for caution
The main limitation was the retrospective cohort study design which could introduce unidentified selection biases.
Wider implications of the findings: Of women who underwent IVF-fertility preservation for cancer, most did not come back for treatment for a variety of reasons. Of those who became pregnant, 60% conceived spontaneously. Of those who used their cryopreserved reproductive material, 63% delivered at least one child.
Trial registration number
2021/6935
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Affiliation(s)
- S Arab
- McGill university, Department of Obstetrics and Genecology . Reproductive Endocrinology and Infertility Center., Montreal, Canada
| | - E Suarthana
- McGill university, Department of obstetrics and Gynecology. Research Institute of the McGill University Health Center., Montreal, Canada
| | - W Buckett
- McGill university, Department of Obstetrics and Genecology . Reproductive Endocrinology and Infertility Center., Montreal, Canada
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Bellemare V, Kadou. Peero E, Feferkorn I, Buckett W. P–367 A comparison of frozen-thawed embryo transfer protocols in 3,478 frozen embryo transfers. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
What frozen-thawed embryo transfer (FET) protocol is associated with the highest live birth rate (LBR)? Summary answer: Natural cycle FET (NC-FET), with or without hCG triggering are associated with higher LBR and clinical pregnancy rate (CPR) compared to artificial HRT-FET cycles.
What is known already
FET cycles (as opposed to fresh ET) are now the most frequently performed treatment in ART. There are many reasons for this including better laboratory cryopreservation techniques, increased single ET cycles, freeze-all cycles to reduce OHSS, as well as PGT-A and personalized ET. Nevertheless, there is no clear consensus on the most effective protocol.
Study design, size, duration
Retrospective cohort study with FET of cleavage (n = 220) and blastocyst (n = 3258) embryos thawed 2013–2018 in a single academic center. FET protocols were NC-FET (n = 182), artificial HRT-FET (n = 3159) and modified NC (mNC) with hCG triggering (n = 137). Other cycles (gonadotrophin or GnRH agonist) and women with uterine anomalies were excluded. Primary outcome was LBR. Secondary outcomes were CPR, visits per cycle and endometrial thickness. Adjustment was made for potential known confounders.
Participants/materials, setting, methods
In NC-FET, no medication was given and ET timing was by serum LH surge. In mNC-FET, hCG was given when the lead follicle reached 18mm rather than awaiting the LH surge. In artificial HRT-FET, estradiol valerate was given and once endometrial thickness reached 8mm, progesterone was added and ET was planned. Adjustment for female age at oocyte retrieval, embryo stage, embryo grade, year of freezing, year of thawing, infertility cause and endometrial thickness was performed.
Main results and the role of chance
There were no significant differences between the groups with regard to female age at oocyte retrieval, embryo stage, embryo grade, embryo number, cycle number and endometrial thickness. As expected, more women with irregular cycles were included in the artificial HRT-FET compared to NC-FET (16.1% vs. 8.2%, p = 0.003) and mNC-FET (16.1% vs. 4.1%, p < 0.0001). There were more visits per cycle in NC-FET and mNC-FET compared to artificial HRT_FET (p < 0.0001). LBR was higher in the mNC-FET (38.0%) and NC-FET (31.9%) compared to artificial HRT_FET (20.2%) (p = 0.0001 and p = 0.0003 respectively). CPR was higher in mNC-FET compared to artificial HRT-FET (45.3% vs. 32.3%, p = 0.0002), and in NC-FET compared to artificial HRT-FET (44.5% vs. 32.3%, p = 0.0009). There was no significant difference in LBR or CPR between NC-FET and mNC-FET. Sub-analysis of the first FET showed similar results. Biochemical pregnancy loss and miscarriage rates were similar in all groups. The higher LBR with NC-FET and mNC-FET remained significant even after adjusting for potential confounders, (aOR 2.42, 95%CI: 1.53–3.66, p < 0.0001).
Limitations, reasons for caution
The interpretation of the findings of this study is limited by the retrospective nature of the analysis and the potential for unmeasured confounding variables.
Wider implications of the findings: Although artificial HRT FET cycles are more common, convenient and practical for clinicians, with less visits per cycle, its use must be cautiously reconsidered in light of the potential negative effect on LBR when compared with natural cycle FET.
Trial registration number
Not applicable
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Affiliation(s)
- V Bellemare
- McGill University- Montreal- QC- Canada, MUHC Fertility Center, Montreal, Canada
| | - E Kadou. Peero
- McGill University- Montreal- QC- Canada, MUHC Fertility Center, Montreal, Canada
| | - I Feferkorn
- McGill University- Montreal- QC- Canada, MUHC Fertility Center, Montreal, Canada
| | - W Buckett
- McGill University- Montreal- QC- Canada, MUHC Fertility Center, Montreal, Canada
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3
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Ruiter-Ligeti J, Arab S, Buckett W. P–325 The impact of letrozole on endometrial thickness in IVF cycles. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
Does daily administration of letrozole during IVF stimulation affect endometrial thickness ?
Summary answer
Patients treated with letrozole during fresh IVF cycles had a thinner endometrium on the day of trigger compared to patients who did not receive letrozole.
What is known already
Letrozole supplementation is commonly used during fertility preservation for breast cancer patients to reduce peak estrogen levels with no adverse effects on embryo outcomes. Studies in poor responders have found that letrozole use resulted in a shorter duration of stimulation and a lower total dose of gonadotropin, with no detrimental effect on IVF outcomes. In normal responders, studies have shown an increase in blastocysts obtained, but have not yet shown an increase in clinical pregnancy rates. There is concern that when a fresh embryo transfer is planned letrozole use may negatively affect endometrial thickness and subsequently diminish pregnancy rates.
Study design, size, duration
In a retrospective cohort study between January 2009 and June 2019 at a single academic fertility center, we compared the endometrial thickness in 97 cancer patients who underwent IVF-fertility preservation with daily letrozole use to 158 cancer patients who underwent IVF-fertility preservation without letrozole.
Participants/materials, setting, methods
All women diagnosed with cancer were referred for fertility preservation prior to gonadotoxic treatment exposure and were less than 40 years old at the time of oocyte retrieval. All patients who received letrozole started on day one of stimulation and continued until the day of oocyte retrieval. The primary outcome was endometrial thickness on the day of trigger. The secondary outcomes were number of oocytes retrieved, number of MII retrieved, and maximal estradiol level.
Main results and the role of chance
During the study period, 336 cancer patients underwent fertility preservation. Eighty-one patients were excluded; 50 because they had an intrauterine device or were on long term oral contraceptives and 31 because endometrial thickness was not documented. Of the remaining 255 patients, 86 had breast cancer, 95 had a hematological cancer and 74 had various other cancers. Ninety-seven cancer patients treated with letrozole were compared to 158 cancer patients who did not receive letrozole. Patients who received letrozole were significantly older (34 vs 28yrs, P < 0.0001). There were no significant differences in baseline characteristics such as BMI, AFC nor in the total duration for stimulation. Endometrial thickness on the day of trigger was significantly less in letrozole treated patients (8 vs 9mm, P < 0.003). There were no significant differences in total number of oocytes retrieved (12.5 vs 11, P = 0.126) nor in the number of mature oocytes (8 vs 8, P = 0.312). Patients in the letrozole group received a higher total gonadotropin dose (2680IU vs 1980IU, P = 0.016). The maximum estradiol level was significantly lower in patients treated with letrozole (1068 vs 3838ml/dl, P = <0.0001). A regression analysis showed that using letrozole during stimulation decreased the endometrial thickness by 0.81mm (CI –1.37 to –0.253, P = 0.005).
Limitations, reasons for caution
The retrospective nature of this study could have introduced selection and misinformation bias. We report on cancer patients where all oocytes or embryos were vitrified. Without fresh embryo transfer data, it is unclear if a thinner endometrium due to letrozole will effect the implantation or pregnancy rate.
Wider implications of the findings: As the use of letrozole expands beyond cancer patients and poor responders, it is important to understand the impact on the endometrium. This study shows that letrozole reduces endometrial thickness. However, the effect on endometrial function remains unknown. Further study is needed before letrozole can be used with fresh transfers.
Trial registration number
2020–6370
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Affiliation(s)
| | - S Arab
- Mcgill University, OBGYN, montreal, Canada
| | - W Buckett
- Mcgill University, OBGYN, montreal, Canada
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4
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Slim R, Khawajkie Y, Hoffner L, Tan L, Ab. Rafea B, Aguinagua M, Horowitz NS, Ao A, Tan SL, Brown R, Buckett W, Surti U, Hovanes K, Sahoo T, Sauthier P. P–553 Women with molar pregnancies have a genetic susceptibility to aneuploid miscarriages. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
What causes non-molar miscarriages in women with one hydatidiform mole (HM)?
Summary answer
We found a higher rate of aneuploidies in the non-molar miscarriages of women with HM than in those from women with sporadic or recurrent miscarriages.
What is known already
Women with hydatidiform moles have higher rates of miscarriages and women with recurrent miscarriages have higher rates of moles than women from the general population.
Study design, size, duration
We retrieved archived formalin-fixed paraffin embedded tissues from non-molar miscarriages of patients with one HM and analyzed them for the presence of aneuploidies using single nucleotide polymorphism (SNP)-microarray. We next determined the meiotic origin of the aneuploidies by genotyping the aneuploid non-molar miscarriages along with the parental genomes using microsatellite markers.
Participants/materials, setting, methods
All participants and some of their partners provided written consent to participate in our study, agreed to a blood draw for genotyping analysis, and agreed for us to retrieve their molar and non-molar tissues from various histopathology laboratories for research purposes.
Main results and the role of chance
We demonstrate for the first time that patients with an HM and miscarriages are at higher risk for aneuploid miscarriages [83.3%, 95% confidence interval (CI): 0.653–0.944] than women with sporadic (51.5%, 95% CI: 50.3–52.7%, p value = 0.0003828) or recurrent miscarriages (43.8%, 95% CI: 40.7–47.0%, p value = 0.00002). Genotyping the aneuploid miscarriages and the parental genomes demonstrated that most of the aneuploidies originated from errors in maternal meiosis I or II.
Limitations, reasons for caution
We were able to retrieve only 30 non-molar miscarriages from women with one HM for analysis. Expanding such analysis to a larger and independent cohort of miscarriages from such patients will be important to validate our observations.
Wider implications of the findings: Our data suggest common genetic female germline defects predisposing to HM and aneuploid non-molar miscarriages in some patients.
Trial registration number
Not applicable
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Affiliation(s)
- R Slim
- McGill University Health Center Research Institute, Department of Human Genetics and Obstetrics and Gynecology, Montreal- QC, Canada
| | - Y Khawajkie
- McGill University Health Center, Department of Obstetrics and Gynecology, Montreal- QC, Canada
| | - L Hoffner
- University of Pittsburgh- School of Medicine, Department of Pathology, Pittsburgh- PA, USA
| | - L Tan
- London Health Sciences Centre, The Fertility Clinic, London- ON, Canada
| | - B Ab. Rafea
- London Health Sciences Centre, The Fertility Clinic, London- ON, Canada
| | - M Aguinagua
- Instituto Nacional de Perinatologia, Genetics and Genomics Department, Mexico City, Mexico
| | - N S Horowitz
- Brigham and Women’s Hospital- Harvard Medical School, Division of Gynecologic Oncology- Department of Obstetrics- Gynecology and Reproductive Biology, Boston- MA, Canada
| | - A Ao
- McGill University Health Center, Department of Obstetrics and Gynecology, Montreal- QC, Canada
| | - S L Tan
- McGill University Health Center, Department of Obstetrics and Gynecology, Montreal- QC, Canada
| | - R Brown
- McGill University Health Center, Department of Obstetrics and Gynecology, Montreal- QC, Canada
| | - W Buckett
- McGill University Health Center, Department of Obstetrics and Gynecology, Montreal- QC, Canada
| | - U Surti
- University of Pittsburgh- School of Medicine, Department of Pathology, Pittsburgh- PA, USA
| | | | - T Sahoo
- Irvine, Invitae, ca 92618, USA
| | - P Sauthier
- Centre Hospitalier de l’Université de Montréal, Department of Obsterics and Gynecology- Gynecology Oncology Division, Montreal- QC, Canada
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5
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Bissonnette F, Phillips S, Sampalis J, Dahdouh E, St-Michel P, Buckett W, Kadoch I, Mahutte N. Impact of government health coverage for ART: The results of a 5-year experience in Quebec. Reprod Biomed Soc Online 2019; 8:32-37. [PMID: 31016250 PMCID: PMC6468154 DOI: 10.1016/j.rbms.2019.01.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 12/19/2018] [Accepted: 01/25/2019] [Indexed: 06/09/2023]
Abstract
An analysis of national registry data for 5 years of in-vitro fertilization (IVF) funding in Quebec, Canada was compared with the previous complete year of non-funded IVF cycles, as well as the first complete year following the end of funding. The number of cycles, livebirth rates, age group of patients treated, use of donor gametes, multiple pregnancy rates and cycle cancellation rates were assessed. The total number of IVF cycles performed increased dramatically during the funded period, averaging over 10,000 cycles per year. There was no change in the age group distribution of patients treated, but less egg donation was performed. Interestingly, funding was also associated with an increase in the IVF cycle cancellation rate (17.0% versus 34.4%, P < 0.001), a dramatic decline in the multiple pregnancy rate (25.6% versus 4.9%, P < 0.001), and a decline in the livebirth rate per fresh embryo transfer in stimulated IVF cycles (32.3% versus 25.5%, P < 0.001). Although the livebirth rate for stimulated IVF declined, over 9000 babies were born as a result of the coverage. Lessons learned from this experience could help develop a more fiscally responsible programme that still facilitates access to IVF care.
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Affiliation(s)
- F. Bissonnette
- Clinique OVO, Montreal, Quebec, Canada
- University of Montreal, Montreal, Quebec, Canada
| | - S. Phillips
- Clinique OVO, Montreal, Quebec, Canada
- University of Montreal, Montreal, Quebec, Canada
| | | | - E.M. Dahdouh
- University of Montreal, Montreal, Quebec, Canada
- ART Center, CHU Sainte-Justine, Montreal, Quebec, Canada
| | | | - W. Buckett
- McGill University, Montreal, Quebec, Canada
- MUHC Reproductive Centre, Montreal, Quebec, Canada
| | - I.J. Kadoch
- Clinique OVO, Montreal, Quebec, Canada
- University of Montreal, Montreal, Quebec, Canada
| | - N. Mahutte
- The Montreal Fertility Centre, Montreal, Quebec, Canada
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6
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Herrero MB, Lusignan MF, Son WY, Sabbah M, Buckett W, Chan P. ICSI outcomes using testicular spermatozoa in non-azoospermic couples with recurrent ICSI failure and no previous live births. Andrology 2019; 7:281-287. [PMID: 30734539 DOI: 10.1111/andr.12591] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 12/21/2018] [Accepted: 01/09/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND The use of testicular over ejaculated spermatozoa for ICSI has been presented as an alternative to overcome infertility in men with poor semen parameters or high levels of sperm DNA fragmentation. OBJECTIVE To evaluate the efficacy of testicular ICSI outcomes in couples with no previous live birth and recurrent ICSI failure using ejaculated spermatozoa by comparison to the outcomes of couples with similar history of recurrent ICSI using ejaculated spermatozoa only. MATERIALS AND METHODS A total of 145 couples undergoing ejaculated or testicular ICSI cycles with no previous live births and with at least two previous failed ICSI cycles with ejaculated spermatozoa were evaluated retrospectively. ICSI was performed either with ejaculated (E-ICSI) or with testicular (T-ICSI) spermatozoa. Semen parameters and sperm DNA quality were assessed prior to the oocyte collection day. Primary outcomes included cumulative live birth and pregnancy rates. Secondary analysis included percentage of DNA fragmentation in ejaculated spermatozoa (SCSA® and TUNEL). RESULTS Patients undergoing T-ICSI (n = 77) had a significantly higher clinical pregnancy rate/fresh embryo transfer (ET) (27.9%; 17/61) and cumulative live birth rate (23.4%; 15/64) compared to patients using E-ICSI (n = 68) (clinical pregnancy rate/fresh ET: 10%; 6/60 and cumulative live birth rate: 11.4%; 7/61). Further, T-ICSI yield significantly better cumulative live birth rates than E-ICSI for men with high TUNEL (≥36%) (T-ICSI: 20%; 3/15 vs. E-ICSI: 0%; 0/7, p < 0.025), high SCSA® (≥25%) scores (T-ICSI: 21.7%; 5/23 vs. E-ICSI: 9.1%; 1/11, p < 0.01), or abnormal semen parameters (T-ICSI: 28%; 7/25 vs. E-ICSI: 6.7%; 1/15, p < 0.01). CONCLUSIONS The use of testicular spermatozoa for ICSI in non-azoospermic couples with no previous live births, recurrent ICSI failure, and high sperm DNA fragmentation yields significantly better live birth outcomes than a separate cohort of couples with similar history of ICSI failure entering a new ICSI cycle with ejaculated spermatozoa.
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Affiliation(s)
- M B Herrero
- MUHC Reproductive Centre, McGill University Health Centre, Montreal, QC, Canada
| | - M F Lusignan
- The Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - W-Y Son
- MUHC Reproductive Centre, McGill University Health Centre, Montreal, QC, Canada
| | - M Sabbah
- The Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - W Buckett
- MUHC Reproductive Centre, McGill University Health Centre, Montreal, QC, Canada
| | - P Chan
- MUHC Reproductive Centre, McGill University Health Centre, Montreal, QC, Canada.,The Research Institute of the McGill University Health Centre, Montreal, QC, Canada.,Department of Surgery, McGill University, Montreal, QC, Canada
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7
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Behbehani S, Buckett W, Son Y, Polesello S, Hasson J. In vitro Fertilization Treatment Outcomes After Single Blastocyst Transfer in Patients with Markers of Diminished Ovarian Reserve-Does Age Make a Difference? J Minim Invasive Gynecol 2018. [DOI: 10.1016/j.jmig.2018.09.730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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8
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Genest G, Elliott B, Spitzer K, Laskin CA, Buckett W, Lapensée LL, Kadoch I, Gol P. Intravenous Immunoglobulin (IVIg) for unexplained infertility: a case series. CLIN EXP OBSTET GYN 2018. [DOI: 10.12891/ceog4566.2018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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9
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Ruiter-Ligeti J, Al Mamari N, Dahan M, Buckett W. Intrauterine inseminations in patients 43 years of age and older. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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10
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Ruiter-Ligeti J, Al Mamari N, Volodarsky-Perel A, Dahan M, Buckett W. A trial of three intrauterine inseminations: an analysis by patient age and sperm source. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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11
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Al Mamari N, Tannus S, Ruiter-Ligeti J, Alzawawi N, Cohen Y, Son W, Buckett W. High estradiol levels during controlled ovarian stimulation for art is not associated with poor oocyte maturation (but is still a predictor of high oocyte number). Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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12
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Gilman AR, Younes G, Tannus S, Son WY, Chan P, Buckett W. Does using testicular sperm retrieval rather than ejaculated spermatozoa improve reproductive outcomes in couples with previous ART failure and poor ovarian response? A case-controlled study. Andrology 2017; 6:142-145. [PMID: 29195015 DOI: 10.1111/andr.12447] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 09/16/2017] [Accepted: 10/24/2017] [Indexed: 01/23/2023]
Abstract
The objective of this study was to assess whether testicular-retrieved spermatozoa improve reproductive outcomes compared to fresh ejaculate in women with poor ovarian response and a history of previous ART failure. The study was performed as a retrospective case-control study at a university-based reproductive center in Montreal, Quebec, Canada. Eighteen poor-responder patients were matched 3 : 1 with 54 controls. Poor responders were defined as those with ≤3 oocytes retrieved at oocyte pickup. Cases were identified as poor responders, and only those with previous IVF failure(s) as an indication for testicular-retrieved spermatozoa were included. Controls were age and cycle attempt number matched. All patients were included only once. From January 1, 2009 to December 31, 2015, all patients and controls underwent an IVF cycle using ICSI with either testicular spermatozoa or ejaculated spermatozoa, respectively. Outcomes included live birth rate, pregnancy rate, miscarriage rate, oocyte number, and embryo transfer (ET) day. The results showed live birth rates, pregnancy rates, and miscarriage rates were similar. There were fewer day 2 ETs (8.5% vs. 48.6%, p = 0.01) and more day 5 blastocyst transfers (25.0% vs. 5.4%, p = 0.05) in the testicular sperm retrieval group compared to controls and thus an overall suggestion of better embryo quality in the testicular sperm group. Overall, however, the use of testicular sperm retrieval appears to add little. Women with poor ovarian response typically have a poor prognosis with respect to live birth rates, and this is further supported in this study. The suggestion of better embryo quality in the testicular-retrieved sperm group would need to be further assessed in a larger multicentered study.
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Affiliation(s)
- A R Gilman
- MUHC Reproductive Centre, Montréal, QC, Canada
| | - G Younes
- MUHC Reproductive Centre, Montréal, QC, Canada
| | - S Tannus
- MUHC Reproductive Centre, Montréal, QC, Canada
| | - W Y Son
- MUHC Reproductive Centre, Montréal, QC, Canada
| | - P Chan
- MUHC Reproductive Centre, Montréal, QC, Canada
| | - W Buckett
- MUHC Reproductive Centre, Montréal, QC, Canada
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13
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Hasson J, Behbehani S, Shavit T, Son W, Tulandi T, Buckett W. Elective single blastocyst transfer (ESBT) in women of advanced maternal age (AMA, over 39 years) - a viable option? Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.1006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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14
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Gilman AR, Buckett W, Son WY, Lefebvre J, Mahfoudh AM, Dahan MH. The relationship between fat and progesterone, estradiol, and chorionic gonadotropin levels in Quebec cow's milk. J Assist Reprod Genet 2017; 34:1567-1569. [PMID: 28840413 DOI: 10.1007/s10815-017-1025-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 08/11/2017] [Indexed: 11/27/2022] Open
Abstract
PURPOSE The majority of milk in industrialized countries is obtained from pregnant cows, which contains increased levels of estrogen and progesterone compared to non-pregnant cows. The aim of this study was to quantify the amount of hormones present in milk with different fat content because previous studies on humans have shown potential effects of increased milk consumption on serum and urine hormone levels as well as on sperm parameters. However, it is unclear whether consumption of milk at the currently recommended levels would lead to systemic effects. METHODS Samples of cow's milk of varying fat concentrations (0, 1, 2, 3.25, 10, and 35%) were analyzed via competitive ELISA assays. RESULTS Progesterone concentrations were significantly correlated to increasing fat content of milk (r = 0.8251, p = 0.04). CONCLUSIONS Research on conditions in which additional progesterone may have an effect on human health should consider inclusion of limitation of milk intake and its effects. Further studies are needed to determine the concentration of progesterone in milk of different fat content in other regions and countries and to quantify the potential pathophysiologic role.
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Affiliation(s)
- A R Gilman
- MUHC Reproductive Centre, Department of Obstetrics and Gynecology, 888 Boul de Maisonneuve E #200, Montreal, Quebec, H2L 4S8, Canada.
| | - W Buckett
- MUHC Reproductive Centre, Department of Obstetrics and Gynecology, 888 Boul de Maisonneuve E #200, Montreal, Quebec, H2L 4S8, Canada
| | - W Y Son
- MUHC Reproductive Centre, Department of Obstetrics and Gynecology, 888 Boul de Maisonneuve E #200, Montreal, Quebec, H2L 4S8, Canada
| | - J Lefebvre
- MUHC Reproductive Centre, Department of Obstetrics and Gynecology, 888 Boul de Maisonneuve E #200, Montreal, Quebec, H2L 4S8, Canada
| | - A M Mahfoudh
- MUHC Reproductive Centre, Department of Obstetrics and Gynecology, 888 Boul de Maisonneuve E #200, Montreal, Quebec, H2L 4S8, Canada
| | - M H Dahan
- MUHC Reproductive Centre, Department of Obstetrics and Gynecology, 888 Boul de Maisonneuve E #200, Montreal, Quebec, H2L 4S8, Canada
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Shavit T, Weibel H, Hershko Klement A, Hasson Y, Son W, Buckett W. Blastocyst expansion score may predict successful pregnancy and live birth rate in single blastocyst vitrified-warmed cycles. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Creux H, Monnier P, Son W, Tulandi T, Buckett W. In vitro maturation oocyte collection at different phases of the menstrual cycle among women requiring urgent chemotherapy. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Shaulov T, Alserri A, Son W, Chung J, Buckett W. Is there a difference in clinical outcome when a vitrified-warmed blastocyst is transferred after five versus six days of progesterone supplementation in an artificial cycle? Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Younes G, Gilman A, Tannus S, Son W, Chan P, Buckett W. Reproductive outcomes following surgical sperm retrieval in couples with obstructive azoospermia (OA), non-obstructive azoospermia (NOA) and repeated in vitro fertilization (IVF) failure. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Behbehani S, Hasson Y, Son W, Tulandi T, Buckett W. Do trained reproductive endocrinologists do better than their trainees? comparing implantation rates and clinical pregnancy rates after transfer of fresh single blastocysts. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Shavit T, Weibel H, Hershko Klement A, Hasson Y, Son W, Tannus S, Buckett W. Fresh single embryo transfer outcome may predict the result of a subsequent vitrified-warmed single blastocyst transfer originating from the same cohort. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Gilman A, Younes G, Tannus S, Son W, Chan P, Buckett W. Reproductive outcomes in poor-responder patients using surgically retrieved sperm. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Herrero B, Lusignan M, Son W, Buckett W, Chan P. Effects of sperm quality on the success of intracytoplasmic sperm injection (ICSI) with testicular sperm in couples with recurrent ICSI failure with ejaculated sperm. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Herrero MB, García A, Buckett W, Tulandi T, Chan P. Quebec public funding facilitates fertility preservation for male cancer patients. ACTA ACUST UNITED AC 2016; 23:20-5. [PMID: 26966400 DOI: 10.3747/co.23.2793] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Sperm cryopreservation remains the only clinically feasible option to preserve male fertility. The quality of counselling provided by the treating physicians and the cost of sperm cryopreservation can both influence a patient's decision about whether to preserve sperm. On 5 August 2010, the Quebec government introduced provincial coverage of assisted reproductive technologies, with sperm cryopreservation included as a covered service. The aim of the present study was to evaluate whether and how such a program affects the behaviour of cancer patients with respect to sperm cryopreservation. METHODS We analyzed the database derived from male patients undergoing sperm cryopreservation from August 2008 to August 2012 at our centre. The retrieved data included patient age, male infertility or oncologic diagnosis, sperm quality parameters, and details about the number of visits for sperm cryopreservation. RESULTS The number of cancer patients who cryopreserved sperm before and after the policy change did not differ significantly, but a marked increase in the number of non-cancer patients was observed. Further analysis revealed that, after implementation of the public funding program, the total number of sperm cryopreservation sessions per patient increased significantly in cancer patients but not in non-cancer patients. CONCLUSIONS It appears that cancer patients who are willing to freeze sperm are keen to return for more sessions of sperm banking when no fees are associated with the service. Those findings suggest that cost reduction is an important factor for improving delivery of fertility preservation services to male cancer patients.
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Affiliation(s)
- M B Herrero
- Obstetrics and Gynecology Department, McGill University Health Centre, Montreal, QC
| | - A García
- Obstetrics and Gynecology Department, McGill University Health Centre, Montreal, QC
| | - W Buckett
- Obstetrics and Gynecology Department, McGill University Health Centre, Montreal, QC
| | - T Tulandi
- Obstetrics and Gynecology Department, McGill University Health Centre, Montreal, QC
| | - P Chan
- Obstetrics and Gynecology Department, McGill University Health Centre, Montreal, QC;; Department of Urology, McGill University Health Centre, Montreal, QC
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Shavit T, Oron G, Tulandi T, Son W, Holzer H, Buckett W. Single embryo transfer of frozen-thawed embryos is associated with increased maternal complications. Fertil Steril 2015. [DOI: 10.1016/j.fertnstert.2015.07.607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Garcia Cerrudo E, Henderson S, Nayot D, Son WY, Holzer H, Buckett W. No adverse effect of hepatitis-B virus infection on assisted reproduction outcomes. Fertil Steril 2013. [DOI: 10.1016/j.fertnstert.2013.07.422] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Yee S, Buckett W, Campbell S, Yanofsky RA, Barr RD. A national study of the provision of oncology sperm banking services among Canadian fertility clinics. Eur J Cancer Care (Engl) 2013; 22:440-9. [PMID: 23374018 DOI: 10.1111/ecc.12045] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2012] [Indexed: 11/30/2022]
Abstract
The purpose of this study was to survey the current state of oncology sperm banking services provided by fertility clinics across Canada. A total of 78 Canadian fertility facilities were invited to complete a questionnaire related to the availability, accessibility, affordability and utilisation of sperm banking services for cancer patients. The total response rate was 59%, with 20 (69%) in vitro fertilisation clinics and 26 (53%) other fertility centres returning the survey. A total of 24 responding facilities accepted oncology sperm banking referrals. The time frame to book the first banking appointment for 19 (79%) facilities was within 2 days. Inconsistent practice was found regarding the consent process for cancer patients who are of minority age. Eight (33%) facilities did not provide any subsidy and charged a standard banking fee regardless of patients' financial situations. Overall, the utilisation of oncology sperm banking services was low despite its availability and established efficacy, suggesting that Canadian cancer patients are notably underserved. The study has highlighted some important issues for further consideration in improving access to sperm banking services for cancer patients, especially for adolescents. Better collaboration between oncology and reproductive medicine to target healthcare providers would help to improve sperm banking rates.
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Affiliation(s)
- S Yee
- Center for Fertility and Reproductive Health, Mount Sinai Hospital, Toronto, Ontario, Canada
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Messaed C, Chebaro W, Roberto RBD, Rittore C, Cheung A, Arseneau J, Schneider A, Chen MF, Bernishke K, Surti U, Hoffner L, Sauthier P, Buckett W, Qian J, Lau NM, Bagga R, Engert JC, Coullin P, Touitou I, Slim R. NLRP7 in the spectrum of reproductive wastage: rare non-synonymous variants confer genetic susceptibility to recurrent reproductive wastage. J Med Genet 2011; 48:540-8. [DOI: 10.1136/jmg.2011.089144] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Acar-Perk B, Weimer J, Koch K, Salmassi A, Arnold N, Mettler L, Schmutzler AG, Ottolini CS, Griffin DK, Handyside AH, Summers MC, Thornhill AR, Montjean D, Benkhalifa M, Cohen-Bacrie P, Siffroi JP, Mandelbaum J, Berthaut I, Bashamboo A, Ravel C, McElreavey K, Ao A, Zhang XY, Yilmaz A, Chung JT, Demirtas E, Son WY, Dahan M, Buckett W, Holzer H, Tan SL, Perheentupa A, Vierula M, Jorgensen N, Skakkebaek NE, Chantot-Bastaraud S, McElreavey K, Toppari J, Muzii L, Magli MC, Gioia L, Mattioli M, Ferraretti AP, Gianaroli L, Koscinski I, Elinati E, Fossard C, Kuentz P, Kilani Z, Demirol A, Gurgan T, Schmitt F, Velez de la Calle J, Iqbal N, Louanjli N, Pasquier M, Carre-Pigeon F, Muller J, Barratt C, Viville S, Magli C, Grugnetti C, Castelletti E, Paviglianiti B, Gianaroli L, Pepas L, Braude P, Grace J, Bolton V, Khalaf Y, El-Toukhy T, Galeraud-Denis I, Bouraima H, Sibert L, Rives N, Carreau S, Janse F, de With LM, Fauser BCJM, Lambalk CB, Laven JSE, Goverde AJ, Giltay JC, De Leo V, Governini L, Quagliariello A, Margollicci MA, Piomboni P, Luddi A, Miyamura H, Nishizawa H, Ota S, Suzuki M, Inagaki A, Egusa H, Nishiyama S, Kato T, Nakanishi I, Fujita T, Imayoshi Y, Markoff A, Yanagihara I, Udagawa Y, Kurahashi H, Alvaro Mercadal B, Imbert R, Demeestere I, De Leener A, Englert Y, Costagliola S, Delbaere A, Velilla E, Colomar A, Toro E, Chamosa S, Alvarez J, Lopez-Teijon M, Fernandez S, Hosoda Y, Hasegawa A, Morimoto N, Wakimoto Y, Ito Y, Komori S, Sati L, Zeiss C, Demir R, McGrath J, Ku SY, Kim YJ, Kim YY, Kim HJ, Park KE, Kim SH, Choi YM, Moon SY, Minor A, Chow V, Ma S, Martinez Mendez E, Gaytan M, Linan A, Pacheco A, San Celestino M, Nogales C, Ariza M, Cernuda D, Bronet F, Lendinez Ramirez AM, Palomares AR, Perez-Nevot B, Urraca V, Ruiz Martin A, Reche A, Ruiz Galdon M, Reyes-Engel A, Treff NR, Tao X, Taylor D, Levy B, Ferry KM, Scott Jr. RT, Vasan S, Acharya KK, Vasan B, Yalaburgi R, Ganesan KK, Darshan SC, Neelima CH, Deepa P, Akhilesh B, Sravanthi D, Sreelakshmi KS, Deepti H, van Doorninck JH, Eleveld C, van der Hoeven M, Birnie E, Steegers EAP, Galjaard RJ, Laven JSE, van den Berg IM, Fiorentino F, Spizzichino L, Bono S, Biricik A, Kokkali G, Rienzi L, Ubaldi FM, Iammarrone E, Gordon A, Pantos K, Oitmaa E, Tammiste A, Suvi S, Punab M, Remm M, Metspalu A, Salumets A, Rodrigo L, Mir P, Cervero A, Mateu E, Mercader A, Vidal C, Giles J, Remohi J, Pellicer A, Martin J, Rubio C, Mozdarani H, Moghbeli Nejad S, Behmanesh M, Alleyasin A, Ghedir H, Ibala-Romdhane S, Mamai O, Brahem S, Elghezal H, Ajina M, Gribaa M, Saad A, Mateu E, Rodrigo L, Martinez MC, Mercader A, Peinado V, Milan M, Al-Asmar N, Pellicer A, Remohi J, Rubio C, Mercader A, Buendia P, Delgado A, Escrich L, Amorocho B, Simon C, Remohi J, Pellicer A, Martin J, Rubio C, Petrussa L, Van de Velde H, De Munck N, De Rycke M, Altmae S, Martinez-Conejero JA, Esteban FJ, Ruiz-Alonso M, Stavreus-Evers A, Horcajadas JA, Salumets A, Bug B, Raabe-Meyer G, Bender U, Zimmer J, Schulze B, Vogt PH, Laisk T, Peters M, Salumets A, Grabar V, Feskov A, Zhilkova E, Sugawara N, Maeda M, Seki T, Manome T, Nagai R, Araki Y, Georgiou I, Lazaros L, Xita N, Chatzikyriakidou A, Kaponis A, Grigoriadis N, Hatzi E, Grigoriadis I, Sofikitis N, Zikopoulos K, Gunn M, Brezina PR, Benner A, Du L, Kearns WG, Shen X, Zhou C, Xu Y, Zhong Y, Zeng Y, Zhuang G, Benner A, Brezina PR, Gunn MC, Du L, Richter K, Kearns WG, Andreeva P, Dimitrov I, Konovalova M, Kyurkchiev S, Shterev A, Daser A, Day E, Turley H, Immesberger A, Haaf T, Hahn T, Dear PH, Schorsch M, Don J, Golan N, Eldar T, Yaverboim R. POSTER VIEWING SESSION - REPRODUCTIVE (EPI) GENETICS. Hum Reprod 2011. [DOI: 10.1093/humrep/26.s1.89] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Zhang X, Ata B, Son WY, Buckett W, Tan S, Ao A. The chromosome constitution of IVM embryos generated from oocytes at different maturation interval. Fertil Steril 2010. [DOI: 10.1016/j.fertnstert.2010.07.572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Ocal P, Sahmay S, Irez T, Senol H, Cepni I, Purisa S, Lin W, Liu X, Donjacour A, Maltepe E, Rinaudo P, Baumgarten MN, Stoop D, Haentjes P, Verheyen G, De Schrijver F, Liebaers I, Camus M, Bonduelle M, Devroey P, Nelissen ECM, Van Montfoort APA, Coonen E, Derhaag JG, Evers JLH, Dumoulin JCM, Costa Lopes JR, Mendes dos Santos J, Portugal Silva Lima S, Portugal Silva Souza S, Rodrigues Pereira T, Barguil Brasileiro JP, Pina H, Lessa ML, Genovese Soares M, Medina Lopes V, Ribeiro CG, Adami K, Hughes C, Emerson G, Grundy K, Kelly P, Mocanu E, Rodrigues Pereira T, Medina Lopes V, Barguil Brasileiro JP, Coelho Cafe T, de Souza Costa JBM, Zavattiero Tierno NI, Portugal Silva Lima S, Portugal Silva Souza S, Mendes dos Santos J, Costa Lopes JR, Rinaudo P, Lin W, Liu X, Donjacour A, Singh S, Vitthala S, Zosmer A, Sabatini L, Tozer A, Davis C, Al-Shawaf T, Neri QV, Monahan D, Rosenwaks Z, Palermo GD, Kalu E, Thum MY, Abdalla HA, Sazonova A, Bergh C, Kallen K, Thurin-Kjellberg A, Wennerholm UB, Griesinger G, Doody K, Witjes H, Mannaerts B, Tarlatzis B, Witjes H, Mannaerts B, Rombauts L, Heijnen E, Marintcheva-Petrova M, Elbers J, Koning A, Mutsaerts MAQ, Hoek A, Mol BW, Fadini R, Guarnieri T, Mignini Renzini M, Comi R, Mastrolilli M, Villa A, Colpi E, Coticchio G, Dal Canto M, Dolleman M, Broer SL, Opmeer BC, Fauser BC, Mol BW, Broekmans FJM, Alama P, Requena A, Crespo J, Munoz M, Ballesteros A, Munoz E, Fernandez M, Meseguer M, Garcia-Velasco JA, Pellicer A, Munk M, Smidt-Jensen S, Blaabjerg J, Christoffersen C, Lenz S, Lindenberg S, Bosch E, Labarta E, Cruz F, Simon C, Remohi J, Pellicer A, Esler J, Osborn J, Boissonnas Chalas C, Marszalek A, Fauque P, Wolf JP, De Ziegler D, Cabanes L, Jouannet P, Han AR, Park CW, Cha SW, Kim HO, Yang KM, Kim JY, Song IO, Koong MK, Kang IS, Roszaman R, Omar MH, Nazri Y, Azantee YW, Murad AZ, Zainulrashid MR, Wang N, Le F, Wang LY, Ding GL, Sheng JZ, Huang HF, Jin F, Reinblatt S, Holzer H, Son WY, Shalom-Paz E, Chian RC, Buckett W, Dahan M, Demirtas E, Tan SL, Revel A, Schejter-Dinur Y, Revel-Vilk S, Hermens RPMG, van den Boogaard E, Leschot NJ, Vollebergh JHA, Bernardus R, Kremer JAM, van der Veen F, Goddijn M, Nahuis MJ, Kose N, Bayram N, Hompes PGA, Mol BWJ, van der veen F, van Wely M, Van Disseldorp J, Broer SL, Dolleman MD, Broeze K, Opmeer BC, Mol BW, Broekmans FJM, De Rycke M, Petrussa L, Liebaers I, Van de Velde H, Cerrillo M, Pacheco A, Rodriguez S, Gomez R, Delagado F, Pellicer A, Garcia Velasco JA, Desmyttere S, Verpoest W, De Rycke M, Staessen C, De Vos A, Liebaers I, Bonduelle M, Kohls G, Ruiz FJ, De la Fuente G, Toribio M, Martinez M, Pellicer A, Garcia-Velasco JA, Soderstrom - Anttila V, Salevaara M, Suikkari AM, Clua E, Tur R, Alcaniz N, Boada M, Rodriguez I, Barri PN, Veiga A, Nelen WLDM, Van Empel IWH, Cohlen BJ, Laven JS, Aarts JWM, Kremer JAM, Ricciarelli E, Gomez-Palomares JL, Andres-Criado L, Hernandez ER, Courbiere B, Aye M, Perrin J, Di Giorgio C, De Meo M, Botta A, Castilla Alcala J, Luceno Maestre F, Cabello Y, Gomez-Palomares JL, Hernandez J, Marqueta J, Pareja A, Hernandez E, Coroleu B, Helmgaard L, Klein BM, Arce JC, Aarts JWM, van Empel IWH, Boivin J, Kremer JAM, Verhaak CM, Ding G, Yin R, Wang N, Sheng J, Huang H, Mancini F, Tur R, Gomez MJ, Rodriguez I, Coroleu B, Barri PN, van den Boogaard NM, van der Steeg JW, van der Veen F, Hompes P, Mol BW, Boyer P, Gervoise-Boyer M, Meddeb L, Rossin B, Audibert F, Sakian S, Chan Wong E, Ma S, Pathak R, Mustafa MD, Ahmed RS, Tripathi AK, Guleria K, Banerjee BD, Vela G, Luna M, Flisser ED, Sandler B, Brodman M, Grunfeld L, Copperman AB, Baronio M, Carrascosa P, Capunay C, Vallejos J, Papier S, Borghi M, Sueldo C, Carrascosa J, Martin Lopez E, Marcucci A, Marcucci I, Salacone P, Sebastianelli A, Caponecchia L, Pacini N, Rago R, Alvarez M, Carreras O, Gomez MJ, Tur R, Coroleu B, Barri PN, Arnoldi M, Diaferia D, Corbucci MG, De Lauretis L, Kook MJ, Jung JY, Lee JH, Jung YJ, Hwang HK, Kang A, An SJ, Kim HM, Kwon HC, Lee SJ, Satoh M, Imada J, Ito K, Migishima F, Inoue T, Ohnishi Y, Kawato H, Nakaoka Y, Fukuda A, Morimoto Y, Mourad S, Hermens RPMG, Nelen WLDM, Grol RPTM, Kremer JAM, Polyzos NP, Valachis A, Patavoukas E, Papanikolaou EG, Messinis IE, Tarlatzis BC, Kang H, Kim CH, Park E, Kim S, Chae HD, Kang BM, Jung KS, Song HJ, Ahn YS, Petkova L, Canov I, Milachich T, Shterev A, Patrat C, Fauque P, Pocate K, Juillard JC, Gayet V, Blanchet V, de Ziegler D, Wolf JP, van der JW, Leushuis E, Steures P, Koks C, Oosterhuis J, Bourdrez P, Bossuyt PM, van der Veen F, Mol BWJ, Hompes PGA. Posters * Safety & Quality (I.E. Guidelines, Multiple Pregnancy, Outcome, Follow-Up etc.). Hum Reprod 2010. [DOI: 10.1093/humrep/de.25.s1.310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Abstract
BACKGROUND Endometriomata are endometriotic deposits within the ovary. The surgical management of these blood filled cysts is controversial. The laparoscopic approach to the management of endometriomata is favoured over a laparotomy approach as it offers the advantage of a shorter hospital stay, faster patient recovery and decreased hospital costs. Currently the commonest procedures for the treatment of ovarian endometriomata are either excision of the cyst capsule or drainage and electrocoagulation of the cyst wall. OBJECTIVES The objective of this review was to determine the most effective technique of treating an ovarian endometrioma; either excision of the cyst capsule or drainage and electrocoagulation of the cyst wall. The end-points assessed were the relief of pain, recurrence of the endometrioma, recurrence of symptoms and in women desiring to conceive the subsequent pregnancy rate, either spontaneous or as part of fertility treatment. SEARCH STRATEGY The reviewers searched the Cochrane Menstrual Disorders and Subfertility Group specialised register of trials (searched 3rd March 2007), the Cochrane Register of Controlled Trials (The Cochrane Library, Issue 3, 2007), MEDLINE (1966-August 2007), EMBASE (1980- March 2007) and reference lists of articles, the handsearching of relevant journals and conference proceedings and by contacting leaders in the field of endoscopic surgery throughout the world. The Cochrane Menstrual Disorders and Subfertility Group Trials Register is based on regular searches of MEDLINE, EMBASE, CINHAL and CENTRAL. SELECTION CRITERIA Randomised controlled trials of excision of the cyst capsule versus drainage and electrocoagulation of the cyst in the management of ovarian endometriomata. DATA COLLECTION AND ANALYSIS Reviewers assessed eligibility and trial quality. MAIN RESULTS No randomised studies of the management of endometriomata by laparotomy were found. Two randomised studies of the laparoscopic management of ovarian endometriomata of greater than 3cm in size, for the primary symptom of pain were included. Laparoscopic excision of the cyst wall of the endometrioma was associated with a reduced recurrence rate of the symptoms of dysmenorrhea (OR 0.15 CI 0.06-0.38), dyspareunia (OR 0.08 CI 0.01-0.51) and non-menstrual pelvic pain (OR 0.10 CI 0.02-0.56), a reduced rate of recurrence of the endometrioma (OR 0.41 CI 0.18-0.93) and with a reduced requirement for further surgery (OR 0.21 CI 0.05-0.79) than surgery to ablate the endometrioma. For those women subsequently attempting to conceive it was also associated with a subsequent increased spontaneous pregnancy rate in women who had documented prior sub-fertility (OR 5.21 CI 2.04-13.29). A further randomised study was identified that demonstrated an increased ovarian follicular response to gonadotrophin stimulation for women who had undergone excsional surgery when compared to ablative surgery (WMD 0.6 CI 0.04-1.16). There is insufficient evidence to favour excisional surgery over ablative surgery with respect to the chance of pregnancy after controlled ovarian stimulation and intra-uterine insemination (OR 1.40 CI 0.47-4.15) . AUTHORS' CONCLUSIONS There is good evidence that excisional surgery for endometriomata provides for a more favourable outcome than drainage and ablation with regard to the recurrence of the endometrioma, recurrence of pain symptoms, and in women who were previously subfertile, subsequent spontaneous pregnancy . Consequently this approach should be the favoured surgical approach. However in women who may subsequently may undergo fertility treatment insufficient evidence exists to determine the favoured surgical approach.
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Affiliation(s)
- R J Hart
- University of Western Australia, King Edward Memorial Hospital, School of Women's and Infants Health, 374 Bagot Road, Subiaco, Western Australia, Australia, WA 6008.
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Abstract
BACKGROUND Endometriomata are endometriotic deposits within the ovary. The surgical management of these blood filled cysts is controversial. The laparoscopic approach to the management of endometriomata is favoured over a laparotomy approach as it offers the advantage of a shorter hospital stay, faster patient recovery and decreased hospital costs. Currently the commonest procedures for the treatment of ovarian endometriomata are either excision of the cyst capsule or drainage and electrocoagulation of the cyst wall. OBJECTIVES The objective of this review was to determine the most effective technique of treating an ovarian endometrioma; either excision of the cyst capsule or drainage and electrocoagulation of the cyst wall. The end-points assessed were the relief of pain, recurrence of the endometrioma, recurrence of symptoms and in women desiring to conceive the subsequent pregnancy rate, either spontaneous or as part of fertility treatment. SEARCH STRATEGY The reviewers searched the Cochrane Menstrual Disorders and Subfertility Group specialised register of trials (searched 3rd March 2007), the Cochrane Register of Controlled Trials (The Cochrane Library, Issue 3, 2007), MEDLINE (1966-August 2007), EMBASE (1980- March 2007) and reference lists of articles, the handsearching of relevant journals and conference proceedings and by contacting leaders in the field of endoscopic surgery throughout the world. The Cochrane Menstrual Disorders and Subfertility Group Trials Register is based on regular searches of MEDLINE, EMBASE, CINHAL and CENTRAL. SELECTION CRITERIA Randomised controlled trials of excision of the cyst capsule versus drainage and electrocoagulation of the cyst in the management of ovarian endometriomata. DATA COLLECTION AND ANALYSIS Reviewers assessed eligibility and trial quality. MAIN RESULTS No randomised studies of the management of endometriomata by laparotomy were found. Two randomised studies of the laparoscopic management of ovarian endometriomata of greater than 3cm in size, for the primary symptom of pain were included. Laparoscopic excision of the cyst wall of the endometrioma was associated with a reduced recurrence rate of the symptoms of dysmenorrhea (OR 0.15 CI 0.06-0.38), dyspareunia (OR 0.08 CI 0.01-0.51) and non-menstrual pelvic pain (OR 0.10 CI 0.02-0.56), a reduced rate of recurrence of the endometrioma (OR 0.41 CI 0.18-0.93) and with a reduced requirement for further surgery (OR 0.21 CI 0.05-0.79) than surgery to ablate the endometrioma. For those women subsequently attempting to conceive it was also associated with a subsequent increased spontaneous pregnancy rate in women who had documented prior sub-fertility (OR 5.21 CI 2.04-13.29). A further randomised study was identified that demonstrated an increased ovarian follicular response to gonadotrophin stimulation for women who had undergone excsional surgery when compared to ablative surgery (WMD 0.6 CI 0.04-1.16). There is insufficient evidence to favour excisional surgery over ablative surgery with respect to the chance of pregnancy after controlled ovarian stimulation and intra-uterine insemination (OR 1.40 CI 0.47-4.15) . AUTHORS' CONCLUSIONS There is good evidence that excisional surgery for endometriomata provides for a more favourable outcome than drainage and ablation with regard to the recurrence of the endometrioma, recurrence of pain symptoms, and in women who were previously subfertile, subsequent spontaneous pregnancy . Consequently this approach should be the favoured surgical approach. However in women who may subsequently may undergo fertility treatment insufficient evidence exists to determine the favoured surgical approach.
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Affiliation(s)
- R J Hart
- University of Western Australia, King Edward Memorial Hospital, School of Women's and Infants Health, 374 Bagot Road, Subiaco, Western Australia, Australia, WA 6008.
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Kabli N, Sylvestre C, Holzer H, Tulandi T, Buckett W. Comparison of ovarian stimulation using daily and alternate day FSH protocols for intrauterine insemination. Fertil Steril 2007. [DOI: 10.1016/j.fertnstert.2007.07.972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
BACKGROUND Many women undergoing an Assisted Reproductive Technology (ART) cycle will not achieve a live birth. Failure at the embryo transfer stage may be due to poor embryo quality, lack of uterine receptivity, or the transfer technique itself. Numerous methods, including the use of ultrasound guidance for proper catheter placement in the endometrial cavity, have been suggested as a means of improving the technique of embryo transfer. This review evaluates the effectiveness of ultrasound (UGET) in comparison with 'clinical touch' embryo transfer (CTET) the traditional method of embryo transfer. OBJECTIVES :To determine whether ultrasound guidance influences treatment outcomes in women undergoing embryo transfer (ET) during assisted reproductive technology (ART) cycles. SEARCH STRATEGY All electronic databases were searched on 20 th August 2006. We searched the Cochrane Menstrual Disorders and Subfertility Group trials register (searched August 2006), the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 1, 2006), MEDLINE (1970-2006), EMBASE (1985-2006), BIO Extracts (1980-2006). Relevant conference proceedings were also hand searched (ASRM, ESHRE and FIGO). SELECTION CRITERIA Only randomised controlled trials were included. DATA COLLECTION AND ANALYSIS Two reviewers independently assessed eligibility and quality of trials and extracted data from those selected. MAIN RESULTS Thirteen out of fifteen identified studies were eligible for analysis. No study reported live births, however, personal communication resulted in data relating to this outcome being obtained in two of the studies. Six studies reported on ongoing pregnancies. The live birth/ ongoing pregnancies per woman randomised associated with UGET (452/1376) was significantly higher than for clinical touch (353/1338) OR 1.40, 95%CI 1.18 to 1.66, P<0.0001). This means, for example, that for a population of women with a 25% chance of pregnancy using clinical touch this would be increased to 32% (28% to 46%) by using UGET. There were no statistically significant differences in the incidence of adverse events between the two comparison groups with the exception of blood on the catheter. AUTHORS' CONCLUSIONS The studies are limited by their quality with only one of the thirteen studies reporting details of both computerised randomisation techniques and adequate allocation concealment. Ultrasound guidance does appear to improve the chances of live/ongoing and clinical pregnancies compared with clinical touch methods. The quality of future studies should be improved with adequate reporting of randomisation, allocation concealment, and power calculations. The primary outcome measure of future studies should be the reporting of live births per woman randomised.
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Affiliation(s)
- J A Brown
- University of Auckland, Obstetrics and Gynaecology, FMHS, Auckland, New Zealand.
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Brown J, Abou-Setta AM, Buckett W, Buckingham K. Ultrasound versus 'clinical touch' for catheter guidance during embryo transfer in women. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2006. [DOI: 10.1002/14651858.cd006107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Buckett W, Chian RC, Holzer H, Dean N, Usher R, Tan SL. Congenital Abnormalities and Perinatal Outcome in Pregnancies Following IVM, IVF, and ICSI Delivered in a Single Center. Fertil Steril 2006. [DOI: 10.1016/j.fertnstert.2006.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Al-Fadhli R, Buckett W, Sylvestre C, Tulandi T. A Randomized Study On Laparoscopic Chromopertubation With Lipiodol Versus Saline In Infertile Women. Fertil Steril 2005. [DOI: 10.1016/j.fertnstert.2005.07.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Abstract
BACKGROUND Endometriomata are endometriotic deposits within the ovary. The surgical management of these blood filled cysts is controversial. The laparoscopic approach to the management of endometriomata is favoured for as it offers the advantage of a shorter hospital stay, faster patient recovery and decreased hospital costs. Currently the commonest procedures for the treatment of ovarian endometriomata are either excision of the cyst capsule or drainage and electrocoagulation of the cyst wall. OBJECTIVES The objective of this review was to determine the most effective technique of treating an ovarian endometrioma; either excision of the cyst capsule or drainage and electrocoagulation of the cyst wall, with regard to relief of pain, recurrence of the endometrioma, recurrence of symptoms and the subsequent spontaneous pregnancy rate. SEARCH STRATEGY The reviewers searched the Cochrane Menstrual Disorders and Subfertility Group specialised register of trials (searched 15 Nov 2004), the Cochrane Register of Controlled Trials (The Cochrane Library, Issue 4, 2004), MEDLINE (1966-Nov 2004), EMBASE (1980- Nov 2004) and reference lists of articles, the handsearching of relevant journals and conference proceedings and by contacting leaders in the field of endoscopic surgery throughout the world. SELECTION CRITERIA Randomised controlled trials of excision of the cyst capsule versus drainage and electrocoagulation of the cyst in the management of ovarian endometriomata. DATA COLLECTION AND ANALYSIS Reviewers assessed eligibility and trial quality. MAIN RESULTS No randomised studies of the management of endometriomata by laparotomy were found. Two randomised studies of the laparoscopic management of ovarian endometriomata of greater than 3cm in size were included. Laparoscopic excision of the cyst wall of the endometrioma was associated with a reduced rate of recurrence of the endometrioma (OR 0.41 CI 0.18-0.93), reduced requirement for further surgery (OR 0.21 CI 0.05-0.79), reduced recurrence rate of the symptoms of dysmenorrhoea (OR 0.15 CI 0.06-0.38), dyspareunia OR 0.08 CI 0.01-0.51) and non-menstrual pelvic pain (OR 0.10 CI 0.02-0.56). It was also associated with a subsequent increased rate of spontaneous pregnancy women who had documented prior sub-fertility (OR 5.21 CI 2.04-13.29). AUTHORS' CONCLUSIONS There is some evidence that excisional surgery for endometriomata provides for a more favourable outcome than drainage and ablation, with regard to the recurrence of the endometrioma, recurrence of symptoms and subsequent spontaneous pregnancy in women who were previously subfertile. Consequently this approach should be the favoured surgical approach. However we found no data as to the effect of either approach in women who subsequently undergo assisted reproductive techniques.
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Affiliation(s)
- R J Hart
- School of Women's and Infants' Health, University of Western Australia, King Edward Memorial Hospital, 374 Bagot Road, Subiaco, Western Australia, Australia, WA 6008.
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Abstract
This study was designed to compare outcomes of spontaneous labor in uncomplicated term and post-term pregnancy. It comprised of a case matched study of 285 women with uncomplicated singleton post-term pregnancy (290-301 days of gestation) and 855 women with uncomplicated singleton term pregnancy (259-287 days of gestation). Term controls were matched to post-term cases on a 3:1 basis. The main outcome measures were cesarian section, Apgar scores and admission to the Neonatal intensive care unit (NICU). Cesarian section was significantly more common in women with post-term pregnancy (Relative Risk = 1.90, 95% CI = 1.29-2.85). The increase was equally distributed between cesarian sections performed for failure to progress in labor (RR = 1.74, 95% CI = 1.02-3.04) and fetal distress (RR = 2.00, 95% CI = 1.14-3.61). There were no differences in low Apgar scores, but admission to the NICU was more common in the post-term group (RR = 2.69, 95% CI = 1.39-5.54). There was no difference in significant neonatal pathology in either group. Uncomplicated post-term pregnancy is associated with increased rates of obstetric and neonatal interventions in terms of cesarian section and NICU admissions. This effect does not appear to be a result of underlying pathology associated with post-term pregnancy. We suggest that a lower threshold for clinical intervention in pregnancies perceived to be "at-risk" may be a significant contributing factor.
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Affiliation(s)
- M Luckas
- Department of Obstetrics and Gynecology, University of Liverpool, Liverpool Women's Hospital, UK.
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Buckett W, Carlin A, Kingsland C. Prolapse of Filshie clips following vaginal hysterectomy. Acta Obstet Gynecol Scand 1998; 77:471-2. [PMID: 9598965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- W Buckett
- Liverpool Women's Hospital, United Kingdom
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Abstract
As well as athletes and competitive body builders, recreational body builders attending gymnasia are known to abuse anabolic steroids, using doses from 10- to 40-fold above physiological levels. Androgenic steroids induce hypogonadotrophic hypogonadism with associated azoospermia, leading to infertility. Little literature exists on the treatment of steroid-induced azoospermia following the cessation of abuse. We present four cases of steroid-induced azoospermia, its conservative management and eventual return of normal semen density.
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Affiliation(s)
- M R Gazvani
- Reproductive Medicine Unit, Liverpool Women's Hospital, UK
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Luckas M, Buckett W. Acute colonic pseudo-obstruction in the obstetric patient. Br J Hosp Med (Lond) 1997; 57:378-81. [PMID: 9274662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Buckett W, Bentick B. The epidemiology of infertility in a rural population. Acta Obstet Gynecol Scand 1997; 76:233-7. [PMID: 9093137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND To study the prevalence of infertility, outcome of pregnancy, and uptake of medical services in a rural population. METHODS 1000 women aged 45-54 years, randomly selected from the Shropshire FHSA primary care register were sent a postal questionnaire. OUTCOME MEASURES Response rate, time to pregnancy, pregnancy outcome, medical advice sought, diagnoses, and any treatments. RESULTS Of the initial one thousand women, two had to be excluded by age and 142 women were excluded because of wrong address. A total of 728 completed questionnaires were returned leading to a response rate of 85.0%. A total of 74.6% women reported no infertility and 8.1% women were voluntarily sterile. The prevalence of infertility at 12 months was 17.3% and 12.0% at 24 months. The prevalence of primary infertility was 10.6%, of whom 77.9% eventually conceived, and 6.7% had secondary infertility, of whom 71.4% eventually conceived. There were a total of 1680 pregnancies, of which 8.6% ended in spontaneous abortion. The highest proportion of spontaneous abortions (11.4%) was amongst women who had experienced primary infertility. Of all infertile women 51.6% did not seek any advice or treatment and only 34.1% attended for hospital appointments. Ovulatory disorder was the commonest diagnosis. There appeared no association between occupation and infertility, outcome of pregnancy, or uptake of services. CONCLUSION These findings are similar to other epidemiological studies, although in this population the uptake of medical services is low.
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Affiliation(s)
- W Buckett
- Royal Shrewsbury Hospitals NHS Trust, United Kingdom
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Luckas M, Buckett W, Aird I. Folate prophylaxis for neural tube defects in infertility units in the UK. Int J Gynaecol Obstet 1997; 56:187-8. [PMID: 9061398 DOI: 10.1016/s0020-7292(96)02820-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- M Luckas
- Reproductive Medicine Unit, Liverpool Women's Hospital, UK
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Luckas M, Buckett W, Aird I, Kingsland C. Serum cholesterol concentration and postpartum depression. Oestrogen may have been a confounder. BMJ 1997; 314:143-4. [PMID: 9006482 PMCID: PMC2125615 DOI: 10.1136/bmj.314.7074.143a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Buckett W, Aird L, Luckas M, Kingsland C, Lewis-Jones I, Howard P. Intracytoplasmic sperm injection. Karyotyping should be done before treatment. BMJ 1996; 313:1334. [PMID: 8942713 PMCID: PMC2352712 DOI: 10.1136/bmj.313.7068.1334b] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Narayan H, Buckett W, McDougall W, Cullimore J. Pregnancy after fifty: profile and pregnancy outcome in a series of elderly multigravidae. Eur J Obstet Gynecol Reprod Biol 1992; 47:47-51. [PMID: 1426511 DOI: 10.1016/0028-2243(92)90213-i] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
A series of seven women aged 50 years and over was studied over two years to analyse patient profile and pregnancy outcome. All were first-generation immigrant Asian multigravidae who were Muslims of low socio-economic status and who had never used contraception. The median age at booking was 52 (range 51-59 years) and the median parity was nine. One woman had gestational diabetes and one had an antepartum haemorrhage. There were few intrapartum or puerperal problems but an increased rate of Caesarean section (28.6%) was noted. There were no stillbirths, neonatal deaths or congenital anomalies in this series. The mean birth weight was 3.3 kg and the mean gestation at delivery was 39.2 weeks. There was no significant perinatal morbidity. Five of the seven women declined further family planning advice. A possible relationship between race, parity and age at menopause is discussed.
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Affiliation(s)
- H Narayan
- Department of Obstetrics and Gynaecology, University of Leicester, UK
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