Abstract:
OBJECTIVE:To prospectively establish the specificity, sensitivity, and positive predictive value (PPV) of a basal 17-hydroxyprogesterone (17-HP) level for the screening of 21-hydroxylase-deficient nonclassic adrenal hyperplasia (NCAH) among hyperandrogenic women. DESIGN:Prospective observational trial. SETTING:Tertiary care academic medical centers. PATIENT(S):Eight healthy controls, 20 patients with NCAH, and 284 consecutively seen patients with hyperandrogenism. INTERVENTION(S):All controls and patients with NCAH, and select patients with hyperandrogenism, underwent acute ACTH (1-24) stimulation. MAIN OUTCOME MEASURE(S):Specificity was determined by measuring 17-HP every other day during one menstrual cycle in 8 healthy women with normal ovulation (107 samples). Sensitivity was determined by measuring 17-HP between 7 and 9 A.M. and 3 and 5 P.M. on the same day in 20 patients with genetically confirmed NCAH. The PPV was determined by prospectively measuring 17-HP in 284 consecutively seen hyperandrogenic women at their initial evaluation. The diagnosis of NCAH was established by a stimulated 17-HP level of >10 ng/mL. RESULT(S):Among controls, 17-HP levels of <2, <3, and <4 ng/mL all had a specificity of 100% when obtained in the follicular phase; when obtained in the luteal phase, they had specificities of 53%, 82%, and 82%, respectively. Among patients with NCAH, 17-HP levels of >2, >3, and >4 ng/mL had sensitivities of 100%, 90%, and 90%, respectively, for the detection of the disorder when obtained in the morning, and sensitivities of 95%, 90%, and 85%, respectively, when obtained in the afternoon. Among the 284 consecutively seen hyperandrogenic women, the PPVs of the first and second 17-HP levels were 7.3% and 19% for a cutoff level of >2 ng/mL, 13% and 43% for a cutoff level of >3 ng/mL, and 33% and 40% for a cutoff level of >4 ng/mL, respectively. CONCLUSION(S):A basal 17-HP level is a useful screening tool for NCAH. A cutoff level of 4 ng/mL has maximum specificity and PPV, with little loss in sensitivity if testing is performed in the morning and during the follicular phase. However, a lower cutoff level (e.g., 2 or 3 ng/mL) is preferable if testing is performed at odd hours of the day, as is common in many practices, and maximum sensitivity is desired.
journal_name
Fertil Steriljournal_title
Fertility and sterilityauthors
Azziz R,Hincapie LA,Knochenhauer ES,Dewailly D,Fox L,Boots LRdoi
10.1016/s0015-0282(99)00383-0keywords:
subject
Has Abstractpub_date
1999-11-01 00:00:00pages
915-25issue
5eissn
0015-0282issn
1556-5653pii
S0015-0282(99)00383-0journal_volume
72pub_type
杂志文章abstract:OBJECTIVE:To determine whether men with azoospermia are at an elevated risk of developing cancer in the years following an infertility evaluation. DESIGN:Cohort study. SETTING:United States andrology clinic. PATIENT(S):A total of 2,238 men with complete records were evaluated for infertility at a single andrology cl...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/j.fertnstert.2013.05.022
更新日期:2013-09-01 00:00:00
abstract:OBJECTIVE:To describe and evaluate the surgical treatment of large ovarian endometriomas by an extraovarian endosurgical technique. DESIGN:Prospective case series study. SETTING:University center and tertiary referral center for endoscopic surgery. PATIENTS:Patients with large ovarian endometriomas. INTERVENTION:A ...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/s0015-0282(16)58561-6
更新日期:1996-10-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis that IVF-ET pregnancy rates (PRs) for patients with tubal factor infertility are decreased in patients with hydrosalpinges and that surgical correction reverses this effect. DESIGN:Retrospective chart review. SETTING:Private practice IVF-ET program. PATIENT(S):Patients (n = 160) unde...
journal_title:Fertility and sterility
pub_type: 杂志文章,评审
doi:10.1016/s0015-0282(97)00447-0
更新日期:1998-01-01 00:00:00
abstract::A case of coma due to embolization after HSG, using oil-soluble contrast medium is presented. The patient was in a comatose state 11 days and then spontaneously regained full consciousness. The safety of oil-contrast medium for HSG is questionable. ...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/s0015-0282(16)53537-7
更新日期:1990-05-01 00:00:00
abstract:OBJECTIVE:To evaluate the efficacy of controlled ovarian hyperstimulation (COH) followed by intratubal insemination in the treatment of infertility. DESIGN:Retrospective analysis of 179 intratubal insemination trials in 78 women over a 48-month period. SETTING:Reproductive endocrinology practice. PATIENTS:Seventy-ei...
journal_title:Fertility and sterility
pub_type: 临床试验,杂志文章
doi:10.1016/s0015-0282(16)57854-6
更新日期:1995-10-01 00:00:00
abstract::Daily leukocyte alkaline phosphatase activity (LAP), basal body temperature (BBT), fern test (FT) and serum luteinizing hormone (LH) were determined during 15 normal menstrual cycles and 10 cycles treated with clomiphene citrate. A rise in LAP activity, as determined by LAP-relative score (LAP-RS), was observed durin...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/s0015-0282(16)39623-6
更新日期:1973-04-01 00:00:00
abstract::The authors review the current approach to management of the adolescent varicocele which has evolved over the past two decades. Principles of observational, surgical and adjunctive management are discussed relative to significant clinical findings. A selective approach to surgical intervention is advocated with the go...
journal_title:Fertility and sterility
pub_type: 杂志文章,评审
doi:10.1016/j.fertnstert.2011.10.034
更新日期:2011-12-01 00:00:00
abstract:OBJECTIVE:To report the successful and feasible use of transperineal fine needle aspiration of seminal vesicles (FNASV) for sperm retrieval in obstructive azoospermia. DESIGN:Case report. SETTING:Outpatient care in institutional clinic. PATIENT(S):A 31-year-old man with obstructive azoospermia due to a middle prosta...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/j.fertnstert.2006.03.069
更新日期:2006-12-01 00:00:00
abstract:OBJECTIVE:To determine the efficacy and safety of Repronex SC as compared with Repronex IM and Pergonal IM in patients undergoing ovulation induction. DESIGN:Randomized, open-label, multicenter, parallel group study. SETTING:Ten academic and private fertility clinics with expertise in ovualtion induction. PATIENT(S)...
journal_title:Fertility and sterility
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/s0015-0282(01)01856-8
更新日期:2001-07-01 00:00:00
abstract:OBJECTIVE:To analyze the effect of human papilloma virus (HPV) sperm infection on sperm parameters and in vitro fertilization (IVF) outcomes. DESIGN:Systematic review and meta-analysis. SETTING:Not applicable. PATIENTS:Men with HPV sperm infection and couples undergoing IVF. INTERVENTIONS:Searches were conducted in...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/j.fertnstert.2020.01.010
更新日期:2020-05-01 00:00:00
abstract::Blood was collected from 20 patients with varicocele (15 in the infertile group and 5 in the incidental varicocele group) at the time of high ligation by insertion of a catheter into the internal spermatic vein toward the renal side. Simultaneously, blood was obtained from the antecubital vein. The levels of cortisol,...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/s0015-0282(16)46043-7
更新日期:1982-02-01 00:00:00
abstract:OBJECTIVE:To evaluate surgical sperm retrieval rates in adolescents with Klinefelter syndrome and testosterone replacement therapy (TRT). DESIGN:Case series. SETTING:Academic medical center. PATIENT(S):Ten patients with Klinefelter syndrome, aged 14-22 years, treated with testosterone replacement and aromatase inhib...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/j.fertnstert.2013.06.010
更新日期:2013-10-01 00:00:00
abstract::Nonaromatizable androgens, administered in high doses to an adult patient with partial androgen insensitivity, failed to result in a change in phallic size despite a clear decline in SHBG and gonadotropin levels. These findings raise the question of differential tissue sensitivity to androgens. Because ancillary labor...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/s0015-0282(16)56114-7
更新日期:1993-08-01 00:00:00
abstract::A total of 82 patients underwent 106 cycles in which immature oocytes were recovered after hCG priming and transferred at blastocyst-stage. After transfer, the implantation rate was 26.8%, and the clinical pregnancy rate was 51.9%. We found that the oocytes retrieved after hCG priming in women with high risk of ovaria...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/j.fertnstert.2006.11.027
更新日期:2007-06-01 00:00:00
abstract:OBJECTIVE:To determine whether cognitive behavior therapy (CBT) targeted to problematic attitudes common among women with functional hypothalamic amenorrhea would restore ovarian function. DESIGN:Randomized, prospective, controlled intervention. SETTING:Clinical research center in an academic medical institution. PA...
journal_title:Fertility and sterility
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0015-0282(03)01124-5
更新日期:2003-10-01 00:00:00
abstract:OBJECTIVE:To investigate the relation between the fetal environment and endometriosis. DESIGN:Prospective cohort study. SETTING:Nurses' Health Study II with 10 years of follow-up. PARTICIPANT(S):Eighty-four thousand, four hundred forty-six women aged 25-42 who had never been diagnosed with endometriosis, infertility...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/j.fertnstert.2004.04.065
更新日期:2004-12-01 00:00:00
abstract::Inflammatory exudates around intrauterine devices were found to produce large concentrations of prostaglandin F2alpha. To evaluate the effect of this substance, 100 semen specimens were incubated in concentrations 100 times greater than that found in normal semen. Motility indices were calculated, and significant inhi...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:
更新日期:1977-01-01 00:00:00
abstract:OBJECTIVE:To determine the possible effect of freezing on sperm escape force as measured by laser trap. DESIGN:Controlled clinical study. SETTING:Normal volunteers, academic setting. PATIENTS:Normal, healthy volunteers. INTERVENTION:Sperm selection, freezing and thawing. Measurement of relative (sperm) escape force...
journal_title:Fertility and sterility
pub_type: 临床试验,杂志文章
doi:
更新日期:1995-01-01 00:00:00
abstract:OBJECTIVE:To investigate the relative differences in outcomes among microdissection testicular sperm extraction (micro-TESE), conventional testicular sperm extraction (cTESE), and testicular sperm aspiration (TESA) in men with nonobstructive azoospermia. DESIGN:Systematic review and meta-analysis. SETTING:Outpatient ...
journal_title:Fertility and sterility
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.fertnstert.2015.07.1136
更新日期:2015-11-01 00:00:00
abstract:OBJECTIVE:To investigate the effects of thawing temperature on sperm function after cryopreservation. The technical aspects of sperm cryopreservation have significantly improved over the last few decades. However, a standard protocol designed to optimize sperm motility recovery after thawing has not yet been establishe...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/j.fertnstert.2008.10.021
更新日期:2010-02-01 00:00:00
abstract:OBJECTIVE:To measure the flow velocity of the uterine and ovarian arteries through the menstrual cycle to determine there are changes. DESIGN:Serial measurements throughout the menstrual cycle in women attending an infertility clinic, compared with volunteers coming for annual examinations. Transvaginal ultrasound-col...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/s0015-0282(16)54657-3
更新日期:1991-11-01 00:00:00
abstract::Intravaginal culture (IVC) is a new technique elaborated by the authors for the fertilization and culture of human oocytes. Its principle consists of fertilization and early development of the eggs in a closed, air-free milieu without the addition of CO2. One to five ovocytes are deposited in a tube completely filled ...
journal_title:Fertility and sterility
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0015-0282(16)59835-5
更新日期:1988-04-01 00:00:00
abstract:OBJECTIVE:To determine whether a history of prior cesarean delivery (CD) makes ET more difficult and impacts pregnancy outcomes. DESIGN:Prospective cohort study. SETTING:Tertiary care military facility. PATIENT(S):One hundred ninety-four patients with previous delivery undergoing IVF/intracytoplasmic sperm injection...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/j.fertnstert.2016.03.045
更新日期:2016-08-01 00:00:00
abstract::This study describes the results with immature human follicular oocytes harvested from unstimulated ovaries, matured in vitro, fertilized, and transferred to an agonadal recipient. Two hundred seventy immature oocytes were aspirated from 23 ovaries removed for various gynecological indications from August 1988 to Octo...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/s0015-0282(16)54068-0
更新日期:1991-01-01 00:00:00
abstract:OBJECTIVE:To analyze the results of ongoing pregnancies and deliveries after assisted reproductive technology (ART) in women aged >/=41 years, stratified by year of age. DESIGN:Retrospective study. SETTING:University hospital, IVF unit. PATIENT(S):A total of 431 IVF and intracytoplasmic sperm injection (ICSI) cycles...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/s0015-0282(00)00697-x
更新日期:2000-09-01 00:00:00
abstract:OBJECTIVE:To introduce a technique for hysteroscopic resection of submucous myoma arising from the uterine fundus. DESIGN:Case report. SETTING:University hospital. PATIENT(S):A 43-year-old nulliparous Japanese woman. INTERVENTION(S):An original combination technique of hysteroresectoscopy using circumferential myom...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/j.fertnstert.2006.03.066
更新日期:2006-11-01 00:00:00
abstract:OBJECTIVE:To characterize sperm parameters from thawed semen samples of men with different cancers who cryopreserved semen before oncologic therapy. DESIGN:Retrospective cohort study. SETTING:Tertiary academic medical center. PATIENT(S):1,010 semen samples collected between 1994 to 2010. INTERVENTION(S):None. MAIN...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/j.fertnstert.2012.09.031
更新日期:2013-02-01 00:00:00
abstract::Human GCs obtained from patients undergoing an IVF procedure and treated with CC, hMG, and hCG, lack cAMP responsiveness to hCG stimulation in vitro. After 48 hours in culture, recovery of cAMP production was significantly higher in hCG-stimulated cells grown on dishes coated with ECM than in cells grown on uncoated d...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/s0015-0282(16)49596-8
更新日期:1986-09-01 00:00:00
abstract::The relationship between the presence or absence of an ovulation stigma and (1) the fertility status, (2) the incidence of endometriosis, (3) the concentration of progesterone and estradiol in the peritoneal fluid, and (4) the blood levels of luteinizing hormone, follicle-stimulating hormone, progesterone, and estradi...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/s0015-0282(16)47900-8
更新日期:1984-06-01 00:00:00
abstract::Hormonal profiles were compared in 14 ovulatory women who were treated with two different doses of gonadotropins in successive in vitro fertilization cycles. All patients suffered from mechanical causes of infertility. Serum estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), and progesterone...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:
更新日期:1988-06-01 00:00:00