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Full-Text Articles in Medicine and Health Sciences
A Mandatory Single Blastocyst Transfer Policy With Educational Campaign In A United States Ivf Program Reduces Multiple Gestation Rates Without Sacrificing Pregnancy Rates, Ginny Ryan, Amy Sparks, C. Sipe, Craig Syrop, A. Dokras, Bradley Van Voorhis
A Mandatory Single Blastocyst Transfer Policy With Educational Campaign In A United States Ivf Program Reduces Multiple Gestation Rates Without Sacrificing Pregnancy Rates, Ginny Ryan, Amy Sparks, C. Sipe, Craig Syrop, A. Dokras, Bradley Van Voorhis
Bradley J Van Voorhis
OBJECTIVE: To reduce the twin rate in our IVF program. DESIGN: A prospective educational study of infertile couples; a retrospective review of IVF outcomes before vs. after mandatory single embryo transfer (mSBT) policy change. SETTING: University-based infertility center. PATIENT(S): One hundred ten of 120 consecutive new infertile couples completed the educational study. Outcomes of all embryo transfers (n = 693) performed 17 months before and 17 months after mSBT were evaluated. INTERVENTION(S): A 1-page educational summary of comparative risks of twins vs. singletons to maternal and child health. MAIN OUTCOME MEASURE(S): Knowledge of twin risks and desired number of embryos …
Early Diagnosis Of Ovarian Torsion By Color Doppler Ultrasonography, Bradley Van Voorhis, J. Schwaiger, Craig Syrop, F. Chapler
Early Diagnosis Of Ovarian Torsion By Color Doppler Ultrasonography, Bradley Van Voorhis, J. Schwaiger, Craig Syrop, F. Chapler
Bradley J Van Voorhis
Ovarian torsion is often difficult to diagnose because of the nonspecific nature of the clinical findings. We report on the use of color Doppler ultrasonography in diagnosing early ovarian torsion. This technique provides a highly specific finding, the absence of blood flow to the ovary, that greatly facilitates the diagnosis of ovarian torsion.
Ethical Obligation For Restricting The Number Of Embryos Transferred To Women: Combating The Multiple-Birth Epidemic From In Vitro Fertilization, Bradley Van Voorhis, Ginny Ryan
Ethical Obligation For Restricting The Number Of Embryos Transferred To Women: Combating The Multiple-Birth Epidemic From In Vitro Fertilization, Bradley Van Voorhis, Ginny Ryan
Bradley J Van Voorhis
In vitro fertilization (IVF) is an increasingly effective and popular means of achieving pregnancy for infertile women, but contributes to a growing incidence of risky twin pregnancies. Despite studies demonstrating cost-effective means to achieve IVF pregnancy while strictly limiting the number of embryos transferred, multiple-embryo transfer remains the most common practice in the United States, and twin pregnancies continue to increase. IVF providers resist restricting these practices, arguing that this is counter to principles of procreative liberty, patient and professional autonomy, and free-market economics. We counter that physicians have a professional fiduciary responsibility to weigh issues of nonmaleficence to patients …
An Unusual Cause Of Adolescent Dysmenorrhea, Ginny Ryan, A. Stolpen, Bradley Van Voorhis
An Unusual Cause Of Adolescent Dysmenorrhea, Ginny Ryan, A. Stolpen, Bradley Van Voorhis
Bradley J Van Voorhis
No abstract provided.
In Vitro Fertilization Patients Support A Single Blastocyst Transfer Policy, S. Martini, Bradley Van Voorhis, B. Stegmann, Amy Sparks, T. Shochet, M. Zimmerman, Ginny Ryan
In Vitro Fertilization Patients Support A Single Blastocyst Transfer Policy, S. Martini, Bradley Van Voorhis, B. Stegmann, Amy Sparks, T. Shochet, M. Zimmerman, Ginny Ryan
Bradley J Van Voorhis
OBJECTIVE: To determine whether patients support a mandatory single blastocyst transfer (mSBT) policy in IVF. DESIGN: Prospective survey study. SETTING: Academic hospital-based infertility center. PATIENT(S): Two hundred sixty-two female patients presenting for fresh or cryopreserved/thawed ET after IVF. INTERVENTION(S): Internet-based in-clinic survey after ET. Follow-up at-home survey after pregnancy test results. MAIN OUTCOME MEASURE(S): Patient support for an mSBT policy and attitudes regarding patient input into IVF treatment. Logistic regression analyses tested associations among main outcome measures, patient characteristics, and treatment results. RESULT(S): Ninety-four percent of patients endorsed support for our mSBT policy; 95% and 87% felt they had the …
The Desire Of Infertile Patients For Multiple Births, Ginny Ryan, S. Zhang, A. Dokras, Craig Syrop, Bradley Van Voorhis
The Desire Of Infertile Patients For Multiple Births, Ginny Ryan, S. Zhang, A. Dokras, Craig Syrop, Bradley Van Voorhis
Bradley J Van Voorhis
OBJECTIVE: To determine the proportion of infertile women who prefer a multiple birth over a singleton, patient characteristics associated with this desire, and patient knowledge about the risks of multiple births. DESIGN: Prospective analysis. SETTING: Academic university hospital-based infertility center and private general gynecology clinic. PATIENT(S): Four hundred sixty-four female patients with infertility who presented for their initial visit. MAIN OUTCOME MEASURE(S): Demographic characteristics, infertility history, desire regarding multiple births, knowledge of the risks of multiple births, and goals of infertility evaluation and treatment were determined by using a 41-question survey. Univariate analysis was performed to assess patient characteristics associated …
Detection Of Enlarged Yolk Sac On Early Ultrasound Is Associated With Adverse Pregnancy Outcomes, D. Berdahl, J. Blaine, Bradley Van Voorhis, A. Dokras
Detection Of Enlarged Yolk Sac On Early Ultrasound Is Associated With Adverse Pregnancy Outcomes, D. Berdahl, J. Blaine, Bradley Van Voorhis, A. Dokras
Bradley J Van Voorhis
Pregnancies with mean yolk sac diameter>or=5 mm on early ultrasound require monitoring and counseling about a threefold increased risk for first-trimester loss independent of maternal risk factors such as age, body mass index, polycystic ovary syndrome, smoking, and diabetes. In addition, our study shows for the first time that enlarged yolk sac diameter may be associated with an increased risk of preterm delivery.
Oral Ovulation Induction Agents Combined With Low-Dose Gonadotropin Injections And Intrauterine Insemination: Cost- And Clinical Effectiveness, Ginny Ryan, V. Moss, W. Davis, Amy Sparks, A. Dokras, Bradley Van Voorhis
Oral Ovulation Induction Agents Combined With Low-Dose Gonadotropin Injections And Intrauterine Insemination: Cost- And Clinical Effectiveness, Ginny Ryan, V. Moss, W. Davis, Amy Sparks, A. Dokras, Bradley Van Voorhis
Bradley J Van Voorhis
OBJECTIVE: To compare the efficacy and cost-effectiveness of different induction protocols involving gonadotropins with intrauterine insemination (IUI). STUDY DESIGN: We performed a retrospective chart review of 648 IUI cycles. Some patients had gonadotropin injections alone before human chorionic gonadotropin (hCG) and IUI (human menopausal gonadotropin protocol); others were given oral medications, then gonadotropins before hCG and IUI (combination protocol). Outcomes included pregnancy rates, multiple birth rates, endometrial thickness, number of ovarian follicles, injection days, ampules of gonadotropins and cost. RESULTS: The combination protocol was more cost-effective. In first cycles, pregnancy rates, multiple birth rates, number of large follicles produced and …
Cost-Effectiveness Of Infertility Treatments: A Cohort Study, Bradley Van Voorhis, Amy Sparks, B. Allen, D. Stovall, Craig Syrop, F. Chapler
Cost-Effectiveness Of Infertility Treatments: A Cohort Study, Bradley Van Voorhis, Amy Sparks, B. Allen, D. Stovall, Craig Syrop, F. Chapler
Bradley J Van Voorhis
OBJECTIVE: To determine the cost-effectiveness of infertility treatments. DESIGN: Retrospective cohort study. SETTING: Academic medical center infertility practice. PATIENT(S): All patients treated for infertility in a 1-year time span. INTERVENTION(S): Intrauterine inseminations, clomiphene citrate and IUI (CC-IUI), hMG and IUI (hMG-IUI), assisted reproductive techniques (ART), and neosalpingostomy by laparotomy. MAIN OUTCOME MEASURE(S): All medical charges and pregnancy outcomes associated with the treatments were obtained. Cost-effectiveness ratios defined as cost per delivery were determined for each procedure. The effects of a woman's age and the number of spermatozoa inseminated on cost-effectiveness of the procedures was also determined. RESULT(S): Intrauterine inseminations, CC-IUI, …
Microsurgical Epididymal Sperm Aspiration, J. Sandlow, J. Donovan, Amy Sparks, Craig Syrop, Bradley Van Voorhis, D. Stovall
Microsurgical Epididymal Sperm Aspiration, J. Sandlow, J. Donovan, Amy Sparks, Craig Syrop, Bradley Van Voorhis, D. Stovall
Bradley J Van Voorhis
No abstract provided.
Expression And Localization Of Inducible And Endothelial Nitric Oxide Synthase In The Rat Ovary. Effects Of Gonadotropin Stimulation In Vivo, Bradley Van Voorhis, K. Moore, P. Strijbos, S. Nelson, S. Baylis, D. Grzybicki, C. Weiner
Expression And Localization Of Inducible And Endothelial Nitric Oxide Synthase In The Rat Ovary. Effects Of Gonadotropin Stimulation In Vivo, Bradley Van Voorhis, K. Moore, P. Strijbos, S. Nelson, S. Baylis, D. Grzybicki, C. Weiner
Bradley J Van Voorhis
Nitric oxide is reportedly involved in the regulation of several ovarian processes, yet the isoforms of nitric oxide synthase (NOS) expressed in the ovary are unknown. Our purpose was to identify and localize NOS isoenzymes in the rat ovary and to examine++ if mRNA expression of NOS isoenzymes change after gonadotropin stimulation. Using reverse transcriptase-PCR, we demonstrated that inducible (iNOS) and endothelial (eNOS), but not neuronal, NOS mRNAs are expressed in the ovary. In a gonadotropin-stimulated rat model, unstimulated ovaries had the highest levels of iNOS mRNA as quantified by ribonuclease protection assay. After gonadotropin injection, iNOS mRNA declined to …
Autoantibodies And Infertility: A Review Of The Literature, Bradley Van Voorhis, D. Stovall
Autoantibodies And Infertility: A Review Of The Literature, Bradley Van Voorhis, D. Stovall
Bradley J Van Voorhis
The role that autoantibodies play in infertility remains uncertain. There are conflicting data regarding the prevalence of autoantibodies in women with endometriosis. Certainly no one has demonstrated an association between the presence of antibodies in women with endometriosis and infertility. Despite intensive study, there is also no consensus on a role of autoantibodies to the zona pellucida as a cause of infertility. Recently, much attention has been focused on autoantibodies and infertility particularly with regards to phospholipid antibodies and their effect on IVF success rates. The literature suggests that women with infertility have an increased prevalence of phospholipid antibodies compared …
Computational Models For Prediction Of Ivf/Icsi Outcomes With Surgically Retrieved Spermatozoa, M. Wald, Amy Sparks, J. Sandlow, Bradley Van Voorhis, Craig Syrop, C. Niederberger
Computational Models For Prediction Of Ivf/Icsi Outcomes With Surgically Retrieved Spermatozoa, M. Wald, Amy Sparks, J. Sandlow, Bradley Van Voorhis, Craig Syrop, C. Niederberger
Bradley J Van Voorhis
IVF/intracytoplasmic sperm injection (ICSI) using surgically retrieved spermatozoa (SRS) is a key option in the treatment of severe male infertility. It was aimed to develop a computational model for the prediction of this modality's outcome. A dataset of 113 exemplars, derived from patients who underwent IVF/ICSI with SRS, was retrospectively analysed. The dataset, containing input features maternal age, sperm retrieval technique, type of spermatozoa used, type of male factor and output intrauterine pregnancy, was randomized into a modelling ('training') set of 83 and cross-validation ('test') set of 30. neUROn++, a set of C++ programs, was used to model the dataset …
Achievement Test Performance In Children Conceived By Ivf, L. Mains, M. Zimmerman, J. Blaine, B. Stegmann, Amy Sparks, T. Ansley, Bradley Van Voorhis
Achievement Test Performance In Children Conceived By Ivf, L. Mains, M. Zimmerman, J. Blaine, B. Stegmann, Amy Sparks, T. Ansley, Bradley Van Voorhis
Bradley J Van Voorhis
BACKGROUND: Long-term follow-up studies of children conceived by IVF are limited. We examine academic performance on standardized tests [Iowa Tests of Basic Skills/Educational Development (ITBS/ITED)] of children conceived by IVF. METHODS: Parents of children 8-17 years of age at the onset of the study (March 2008) who were conceived by IVF at the University of Iowa Hospitals and Clinics and living in the state of Iowa were contacted by mail. Parents completed questionnaires on their child's health and education and parental education. ITBS/ITED scores from school grades 3-12 were obtained on IVF children and a group of anonymous children matched …
Outcomes From Assisted Reproductive Technology, Bradley Van Voorhis
Outcomes From Assisted Reproductive Technology, Bradley Van Voorhis
Bradley J Van Voorhis
The use of assisted reproductive technology (ART) for treating the infertile couple is increasing in the United States. The purpose of this paper is to review the short-term outcomes after ART. Pregnancy rates after ART have shown nearly continuous improvement in the years since its inception. A number of factors affect the pregnancy rate, with the most important being a woman's age. Certain clinical diagnoses are associated with a poorer outcome from ART, including the presence of hydrosalpinges, uterine leiomyomata that distort the endometrial cavity, and decreased ovarian reserve. Multiple gestations are the major complication after ART. New laboratory techniques, …
Colon Carcinoma Complicating Pregnancy. A Report Of Two Cases, Bradley Van Voorhis, D. Cruikshank
Colon Carcinoma Complicating Pregnancy. A Report Of Two Cases, Bradley Van Voorhis, D. Cruikshank
Bradley J Van Voorhis
Two cases occurred of colon carcinoma complicating pregnancy. Both patients presented with occult blood in the stool and iron deficiency anemia; that makes their cases different from the 20 previously reported ones of colon carcinoma above the peritoneal reflection associated with pregnancy. These cases illustrate the importance of a rectal examination and stool guiaic test in evaluating iron deficiency anemia in pregnancy.
Immunohistochemical Localization Of Prostaglandin H Synthase In The Female Reproductive Tract And Endometriosis, Bradley Van Voorhis, P. Huettner, M. Clark, J. Hill
Immunohistochemical Localization Of Prostaglandin H Synthase In The Female Reproductive Tract And Endometriosis, Bradley Van Voorhis, P. Huettner, M. Clark, J. Hill
Bradley J Van Voorhis
Prostaglandin H synthase, also known as cyclooxygenase, is an essential enzyme in prostaglandin synthesis. Using a monoclonal antibody and immunohistochemical techniques, we studied the localization of this enzyme in the female reproductive tract and in endometriosis. In the uterus, prostaglandin H synthase was primarily localized to endometrial epithelium with surface epithelium containing more immunoreactive prostaglandin H synthase than glandular epithelium. Fallopian tube secretory epithelial cells also contained prostaglandin H synthase while ciliated epithelial cells did not. Cervical epithelium and myometrial cells did not contain prostaglandin H synthase. A higher percentage of glands in endometriosis and adenomyosis, as compared with eutopic …
Clinical Predictors Of Human Blastocyst Formation And Pregnancy After Extended Embryo Culture And Transfer, M. Thomas, Amy Sparks, Ginny Ryan, Bradley Van Voorhis
Clinical Predictors Of Human Blastocyst Formation And Pregnancy After Extended Embryo Culture And Transfer, M. Thomas, Amy Sparks, Ginny Ryan, Bradley Van Voorhis
Bradley J Van Voorhis
OBJECTIVE: To determine the clinical factors associated with blastocyst development and pregnancy. DESIGN: Evaluation of a prospectively collected IVF database. SETTING: An academic IVF practice. PATIENT(S): Couples (n = 529) undergoing their first IVF cycle who qualified for extended embryo culture (more than six zygotes) over the past 5 years. INTERVENTION(S): Seven or eight zygotes were cultured for 5 days, assessed for quality, and then transferred with excess zygotes cryopreserved at the pronuclear stage. MAIN OUTCOME MEASURE(S): Clinical predictors of blastocyst development and pregnancy. RESULT(S): The mean blastocyst development rate was 49.8%, with a median number of total and good-quality …
Clinical Practice. In Vitro Fertilization, Bradley Van Voorhis
Clinical Practice. In Vitro Fertilization, Bradley Van Voorhis
Bradley J Van Voorhis
No abstract provided.
Ultrasound-Assisted Repair Of A Unique Case Of Distal Vaginal Agenesis, J. Kresowik, Ginny Ryan, J. Austin, Bradley Van Voorhis
Ultrasound-Assisted Repair Of A Unique Case Of Distal Vaginal Agenesis, J. Kresowik, Ginny Ryan, J. Austin, Bradley Van Voorhis
Bradley J Van Voorhis
OBJECTIVE: To describe a unique vaginal outlet obstruction and its ultrasound-assisted surgical correction. DESIGN: Case report. SETTING: An academic medical center. PATIENT(S): A 12-year-old girl was seen with cyclic abdominal pain, nausea, and an abdominal mass. External genital examination revealed no vaginal opening or dimple. Transabdominal ultrasound revealed a large hematometrocolpos 5 cm proximal to the perineum, with an otherwise normal-appearing uterus and ovaries. INTERVENTION(S): Surgical treatment included perineal incision, creation of a 5-cm passage through connective tissue, drainage of the hematometrocolpos, and mobilization of the proximal vagina, allowing for pull-through vaginoplasty. Ultrasound guidance was used throughout the surgery and …
Nitric Oxide: An Autocrine Regulator Of Human Granulosa-Luteal Cell Steroidogenesis, Bradley Van Voorhis, M. Dunn, G. Snyder, C. Weiner
Nitric Oxide: An Autocrine Regulator Of Human Granulosa-Luteal Cell Steroidogenesis, Bradley Van Voorhis, M. Dunn, G. Snyder, C. Weiner
Bradley J Van Voorhis
We investigated the presence of nitric oxide (NO) synthase in ovarian follicular cells obtained from women undergoing in vitro fertilization procedures. Endothelial NO synthase messenger RNA was demonstrated by polymerase chain reaction amplification of reverse transcribed RNA. NO synthase was localized to granulosa-luteal cells by immunocytochemistry, using a monoclonal antibody. Ovarian follicular cell NO synthase enzyme activity was confirmed by measuring the conversion of L-arginine to citrulline. To investigate the effect of NO on granulosa-luteal cell steroidogenesis, NO synthase inhibitors and NO donors were added to cell cultures. NG-Monomethyl-L-arginine and N-nitro-arginase methyl ester, selective inhibitors of NO synthase, significantly increased …
Semantic And Spatial Components Of Selective Attention, V. Dark, K. Vochatzer, Bradley Van Voorhis
Semantic And Spatial Components Of Selective Attention, V. Dark, K. Vochatzer, Bradley Van Voorhis
Bradley J Van Voorhis
Semantic and spatial effects on selective processing were examined. A prime presented 250 ms or 1,000 ms before a pair of masked words was related to 1 of the words on 1/3 of the trials. Although Experiments 1 and 2 required report of both words, processing was selective; typically, just 1 word could be reported. In Experiment 1, reported words were more often top words, showing spatial selectivity, and more often words related to the prime, showing semantic selectivity. Experiment 2 included to-be-ignored peripheral cues 50 ms before the pair. Related words were reported more often at both delays, and …
The Effects Of Smoking On Ovarian Function And Fertility During Assisted Reproduction Cycles, Bradley Van Voorhis, J. Dawson, D. Stovall, Amy Sparks, Craig Syrop
The Effects Of Smoking On Ovarian Function And Fertility During Assisted Reproduction Cycles, Bradley Van Voorhis, J. Dawson, D. Stovall, Amy Sparks, Craig Syrop
Bradley J Van Voorhis
OBJECTIVE: To investigate the effects of cigarette smoking on ovarian function and fertility in women undergoing assisted reproduction cycles. METHODS: We assessed the effects of smoking on ovarian function and fertility in a cohort of 499 women. Questionnaires were designed to quantify past smoking exposure and to determine whether the woman was smoking during the treatment cycle. Ovarian function characteristics and pregnancy rates were compared among current smokers, past smokers, and nonsmokers. RESULTS: Compared with nonsmokers, both current and past smokers have reduced gonadotropin-stimulated ovarian function. A history of increasing tobacco exposure was associated with decreasing serum estradiol concentrations, numbers …
Metabolism Of Arachidonic Acid To Epoxyeicosatrienoic Acids By Human Granulosa Cells May Mediate Steroidogenesis, Bradley Van Voorhis, M. Dunn, J. Falck, R. Bhatt, M. Vanrollins, G. Snyder
Metabolism Of Arachidonic Acid To Epoxyeicosatrienoic Acids By Human Granulosa Cells May Mediate Steroidogenesis, Bradley Van Voorhis, M. Dunn, J. Falck, R. Bhatt, M. Vanrollins, G. Snyder
Bradley J Van Voorhis
Epoxyeicosatrienoic acids (EETs), cytochrome P-450 metabolites of arachidonic acid, have attracted attention because of their effects on stimulus-response coupling in endocrine, renal, and vascular cells. To investigate a possible role for EETs in ovarian physiology, we conducted a series of experiments using human luteinized granulosa cells. Granulosa cell microsomes produce EETs, which are identified by their comigration with known standards using reverse phase high pressure liquid chromatography. EET synthesis by granulosa cells is NADPH dependent and inhibited by ketoconazole, suggesting an enzymatic mechanism of production. Intact granulosa cells synthesize EETs from exogenous arachidonic acid, and EET production is increased by …
The Effects Of Ru 486 On Immune Function And Steroid-Induced Immunosuppression In Vitro, Bradley Van Voorhis, D. Anderson, J. Hill
The Effects Of Ru 486 On Immune Function And Steroid-Induced Immunosuppression In Vitro, Bradley Van Voorhis, D. Anderson, J. Hill
Bradley J Van Voorhis
The effect of RU 486 [17 beta-hydroxy-11 beta-(4-dimethylamino-phenol)17 alpha-(prop-1-ynyl)estra- 4,9diene-3-one] on [3H]thymidine incorporation into Concanavalin-A-stimulated human peripheral blood mononuclear cells and its influence on the suppressive effects of cortisol and progesterone were investigated. Cortisol suppressed lymphocyte thymidine incorporation at 10(-5), 10(-6), and 10(-7) M (17.6%, 20%, and 38% of control, respectively; P less than 0.01). Cortisol-induced suppression was reversed when low concentrations of RU 486 (10(-7) and 10(-6) M) were added. RU 486 at 10(-5) M further suppressed lymphocyte thymidine incorporation when added to cultures with cortisol. Progesterone significantly inhibited lymphocyte thymidine incorporation at 10(-5) M (8.2% of control; P …
In Vitro Fertilization Is Associated With An Increase In Major Birth Defects, C. Olson, K. Keppler-Noreuil, P. Romitti, W. Budelier, Ginny Ryan, Amy Sparks, Bradley Van Voorhis
In Vitro Fertilization Is Associated With An Increase In Major Birth Defects, C. Olson, K. Keppler-Noreuil, P. Romitti, W. Budelier, Ginny Ryan, Amy Sparks, Bradley Van Voorhis
Bradley J Van Voorhis
OBJECTIVE: To determine the risk of major birth defects in cohorts of children conceived through IVF or through IUI as compared with naturally conceived children. DESIGN: Retrospective cohort study. SETTING: Academic medical center. PATIENT(S): Children conceived by IVF or IUI at the University of Iowa from 1989 through 2002, compared with a matched cohort of naturally conceived children. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Outcome data were obtained from Iowa state birth and fetal death certificates and from the Iowa Birth Defects Registry. RESULT(S): Ninety of 1,462 IVF-conceived children (6.2%) and 17 of 343 IUI-conceived children (5.0%) had a major birth …
Sextuplets: An Unusual Complication Of Single Embryo Transfer, L. Mains, Ginny Ryan, Amy Sparks, Bradley Van Voorhis
Sextuplets: An Unusual Complication Of Single Embryo Transfer, L. Mains, Ginny Ryan, Amy Sparks, Bradley Van Voorhis
Bradley J Van Voorhis
OBJECTIVE: To describe an unusual case of a sextuplet gestation after IVF and transfer of a single blastocyst. DESIGN: Case report. SETTING: University-based IVF clinic. PATIENT(S): A 32-year-old female with secondary infertility undergoing IVF-ET. INTERVENTION(S): Transvaginal oocyte retrieval, transfer of a single blastocyst, and multifetal pregnancy reduction. MAIN OUTCOME MEASURE(S): Ultrasound determination of pregnancy viability. RESULT(S): Six intrauterine gestational sacs, each with a fetus having cardiac activity, reduced to a triplet gestation. CONCLUSION(S): Physicians should consider advising patients undergoing IVF-ET to abstain from unprotected intercourse at least 4 days before the anticipated oocyte retrieval. Incomplete aspiration of ovarian follicles is …
A 41-Year-Old Woman With Menorrhagia, Anemia, And Fibroids: Review Of Treatment Of Uterine Fibroids, Bradley Van Voorhis
A 41-Year-Old Woman With Menorrhagia, Anemia, And Fibroids: Review Of Treatment Of Uterine Fibroids, Bradley Van Voorhis
Bradley J Van Voorhis
Uterine fibroids are common tumors that can cause heavy menstrual bleeding, pelvic pressure symptoms, and reproductive disorders. The incidence of fibroids peaks in the fifth decade of age and they are more common in African American women. Often, fibroids are asymptomatic and require no treatment. However, the case of Ms P, a 41-year-old woman with recurrent uterine fibroids, menorrhagia, anemia, and fatigue who wishes to retain fertility, illustrates the symptoms that require treatment. Evaluation usually begins with a pelvic examination and an ultrasound to determine both the size and location of the fibroids within the uterus. Standard treatment of symptomatic …
Effects Of Smoking On Ovulation Induction For Assisted Reproductive Techniques, Bradley Van Voorhis, Craig Syrop, D. Hammitt, M. Dunn, G. Snyder
Effects Of Smoking On Ovulation Induction For Assisted Reproductive Techniques, Bradley Van Voorhis, Craig Syrop, D. Hammitt, M. Dunn, G. Snyder
Bradley J Van Voorhis
OBJECTIVE: To determine the effects of smoking on ovulation induction for assisted reproductive techniques. DESIGN: Matched, retrospective, cohort study. SETTING: Outpatient University endocrine/infertility program. PATIENTS: Eighteen smokers and 36 nonsmokers: 2 nonsmokers matched to each smoker for age, weight, and history of ovarian surgery. MAIN OUTCOME MEASURES: During a stimulation cycle, the serum estradiol (E2) level, number of follicles, number of oocytes, number of embryos, and ampules of gonadotropins used were compared in the smoking versus the nonsmoking groups by Wilcoxon's signed rank test for paired data. Follicular fluid (FF), testosterone (T), androstenedione (A), E2, A:E2 ratios, and T:E2 ratios …
Use Of Oocytes From Anonymous, Matched, Fertile Donors For Prevention Of Heritable Genetic Diseases, Bradley Van Voorhis, R. Williamson, J. Gerard, D. Hammitt, Craig Syrop
Use Of Oocytes From Anonymous, Matched, Fertile Donors For Prevention Of Heritable Genetic Diseases, Bradley Van Voorhis, R. Williamson, J. Gerard, D. Hammitt, Craig Syrop
Bradley J Van Voorhis
Heritable genetic diseases can be prevented with the use of donor oocytes. We report our experience in using donor oocytes from anonymous, matched, fertile donors in four women with heritable genetic disorders. Our results show that use of donor oocytes is a practical, successful, and currently available technique for the prevention of genetic disorders.