To assess the ability of histological dating to discriminate between women of fertile and infertile couples. The utility of histological dating of endometrium in the evaluation of infertile couples is uncertain. Prosp...To assess the ability of histological dating to discriminate between women of fertile and infertile couples. The utility of histological dating of endometrium in the evaluation of infertile couples is uncertain. Prospective multicenter st udy, with subjects randomly assigned to biopsy timing. Criterion standard for in fertility was 12 months of unprotected, regular intercourse without conception a nd for fertility at least one live birth within 2 years. University-based infer tility practices. Volunteer subjects (847) recruited at 12 clinical sites partic ipating in the National Institutes of Health-funded Reproductive Medicine Netwo rk. Inclusion criteria included ages 20-39 years, regular menstrual cycles, and no hormonal treatment or contraceptive use for 1 month before the study. Fertil e controls were excluded if they had a history of infertility, recurrent pregnan cy loss, or recent breastfeeding. Subjects underwent daily urinary LH testing. A fter detection of the LH surge, subjects were randomized to biopsy in the mid (d ays 21-22) or the late (days 26-27) luteal phase. Pathologists at each site es timated the cycle day based on standard criteria. For the primary analysis, an o ut-of-phase biopsy was defined as a greater than 2-day delay in the histologi cal maturation of the endometrium. The proportion of out-of-phase biopsies in fertile and infertile women was compared using logistic regression models with a ge at randomization as a covariate. Comparisons were also made between fertile v s. infertile at the midluteal or late luteal phase time points. Biopsies were ev aluated (301 mid and 318 late; N = 619). Out-of-phase biopsy results poorly di scriminated between women from fertile and infertile couples in either the midlu teal (fertile: 49.4%, infertile: 43.2%) or late luteal phase (fertile: 35.3%, infertile 23.0%). Results did not substantially differ using alternative defin itions of out-of-phase or standardized cycle day. Histological dating of the e ndometrium does not discriminate between women o展开更多
Objective: To prospectively compare pregnancy rates for couples undergoing IUI by a single healthcare provider with random assignment to either rigid (Tomcat; Kendall Sovereign, Mansfield, MA) or flexible (Soft Pass; ...Objective: To prospectively compare pregnancy rates for couples undergoing IUI by a single healthcare provider with random assignment to either rigid (Tomcat; Kendall Sovereign, Mansfield, MA) or flexible (Soft Pass; Cook, Spencer, IN) ca theters. Design: Randomized, controlled study. Setting: Tertiary care infertilit y practice. Patient(s): One hundred infertile women enrolled from a single infer tility practice who met the inclusion and exclusion criteria for IUI were enroll ed. Of the 100 patients, 95 underwent ovarian stimulation before IUI: 35 with cl omiphene citrate alone, 60 with clomiphene citrate combined with a single dose o f gonadotropins. Intervention(s): Timed IUI was performed with either rigid (Tom cat) or flexible (Cook) insemination catheters. Main Outcome Measure(s): Pregnan cy rate per cycle. Result(s): No differences were noted between groups for the f ollowing: age, length of infertility, day-3 FSH level, number of prior IUI cycl es, total motile sperm count, days of abstinence, infertility diagnoses, insemin ation ratings, and stimulation protocols. No difference in pregnancy rates was o bserved between rigid and flexible catheter groups. Conclusion(s): There is no s tatistically significant difference between flexible and rigid catheters for IUI .展开更多
文摘To assess the ability of histological dating to discriminate between women of fertile and infertile couples. The utility of histological dating of endometrium in the evaluation of infertile couples is uncertain. Prospective multicenter st udy, with subjects randomly assigned to biopsy timing. Criterion standard for in fertility was 12 months of unprotected, regular intercourse without conception a nd for fertility at least one live birth within 2 years. University-based infer tility practices. Volunteer subjects (847) recruited at 12 clinical sites partic ipating in the National Institutes of Health-funded Reproductive Medicine Netwo rk. Inclusion criteria included ages 20-39 years, regular menstrual cycles, and no hormonal treatment or contraceptive use for 1 month before the study. Fertil e controls were excluded if they had a history of infertility, recurrent pregnan cy loss, or recent breastfeeding. Subjects underwent daily urinary LH testing. A fter detection of the LH surge, subjects were randomized to biopsy in the mid (d ays 21-22) or the late (days 26-27) luteal phase. Pathologists at each site es timated the cycle day based on standard criteria. For the primary analysis, an o ut-of-phase biopsy was defined as a greater than 2-day delay in the histologi cal maturation of the endometrium. The proportion of out-of-phase biopsies in fertile and infertile women was compared using logistic regression models with a ge at randomization as a covariate. Comparisons were also made between fertile v s. infertile at the midluteal or late luteal phase time points. Biopsies were ev aluated (301 mid and 318 late; N = 619). Out-of-phase biopsy results poorly di scriminated between women from fertile and infertile couples in either the midlu teal (fertile: 49.4%, infertile: 43.2%) or late luteal phase (fertile: 35.3%, infertile 23.0%). Results did not substantially differ using alternative defin itions of out-of-phase or standardized cycle day. Histological dating of the e ndometrium does not discriminate between women o
文摘Objective: To prospectively compare pregnancy rates for couples undergoing IUI by a single healthcare provider with random assignment to either rigid (Tomcat; Kendall Sovereign, Mansfield, MA) or flexible (Soft Pass; Cook, Spencer, IN) ca theters. Design: Randomized, controlled study. Setting: Tertiary care infertilit y practice. Patient(s): One hundred infertile women enrolled from a single infer tility practice who met the inclusion and exclusion criteria for IUI were enroll ed. Of the 100 patients, 95 underwent ovarian stimulation before IUI: 35 with cl omiphene citrate alone, 60 with clomiphene citrate combined with a single dose o f gonadotropins. Intervention(s): Timed IUI was performed with either rigid (Tom cat) or flexible (Cook) insemination catheters. Main Outcome Measure(s): Pregnan cy rate per cycle. Result(s): No differences were noted between groups for the f ollowing: age, length of infertility, day-3 FSH level, number of prior IUI cycl es, total motile sperm count, days of abstinence, infertility diagnoses, insemin ation ratings, and stimulation protocols. No difference in pregnancy rates was o bserved between rigid and flexible catheter groups. Conclusion(s): There is no s tatistically significant difference between flexible and rigid catheters for IUI .
