Abstract:
OBJECTIVE:To estimate whether progestin-induced endometrial shedding, before ovulation induction with clomiphene citrate, metformin, or a combination of both, affects ovulation, conception, and live birth rates in women with polycystic ovary syndrome (PCOS). METHODS:A secondary analysis of the data from 626 women with PCOS from the Eunice Kennedy Shriver National Institute of Child Health and Human Development Cooperative Reproductive Medicine Network trial was performed. Women had been randomized to up to six cycles of clomiphene citrate alone, metformin alone, or clomiphene citrate plus metformin. Women were assessed for occurrence of ovulation, conception, and live birth in relation to prior bleeding episodes (after either ovulation or exogenous progestin-induced withdrawal bleed). RESULTS:Although ovulation rates were higher in cycles preceded by spontaneous endometrial shedding than after anovulatory cycles (with or without prior progestin withdrawal), both conception and live birth rates were significantly higher after anovulatory cycles without progestin-induced withdrawal bleeding (live births per cycle: spontaneous menses 2.2%; anovulatory with progestin withdrawal 1.6%; anovulatory without progestin withdrawal 5.3%; P<.001). The difference was more marked when rate was calculated per ovulation (live births per ovulation: spontaneous menses 3.0%; anovulatory with progestin withdrawal 5.4%; anovulatory without progestin withdrawal 19.7%; P<.001). CONCLUSION:Conception and live birth rates are lower in women with PCOS after a spontaneous menses or progestin-induced withdrawal bleeding as compared with anovulatory cycles without progestin withdrawal. The common clinical practice of inducing endometrial shedding with progestin before ovarian stimulation may have an adverse effect on rates of conception and live birth in anovulatory women with PCOS. LEVEL OF EVIDENCE:II.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Diamond MP,Kruger M,Santoro N,Zhang H,Casson P,Schlaff W,Coutifaris C,Brzyski R,Christman G,Carr BR,McGovern PG,Cataldo NA,Steinkampf MP,Gosman GG,Nestler JE,Carson S,Myers EE,Eisenberg E,Legro RS,Eunice Kennedy Shrdoi
10.1097/AOG.0b013e31824da35csubject
Has Abstractpub_date
2012-05-01 00:00:00pages
902-8issue
5eissn
0029-7844issn
1873-233Xpii
00006250-201205000-00005journal_volume
119pub_type
杂志文章,随机对照试验abstract::A fiberoptic colposcope was converted through minor alterations into an instrument suitable for use in gynecologic microsurgery. Magnification up to 24x may be obtained, and the extreme mobility, price consideration, and reduction in space at the operating table make it an attractive alternative to a bulky, expensive ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1979-10-01 00:00:00
abstract:BACKGROUND:Pelvic vein thrombosis may occur in nonpuerperal patients with hypercoagulable conditions and have significant sequelae. The purpose of this report is to describe a nonpuerperal woman with factor V Leiden mutation who developed acute pelvic pain secondary to pelvic varix thrombosis. CASE:A multiparous woman...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(01)01589-7
更新日期:2002-05-01 00:00:00
abstract:OBJECTIVE:To estimate the association between vaginal birth after cesarean delivery (VBAC) rates and primary cesarean delivery rates in California hospitals. METHODS:Hospital VBAC rates were calculated using birth certificate and discharge data from 2009, and hospitals were categorized by quartile of VBAC rate. Multiv...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3182a91e0f
更新日期:2013-11-01 00:00:00
abstract:OBJECTIVE:To evaluate whether cesarean delivery is a risk factor for emergent postpartum hysterectomy. METHODS:We performed a case-control study of patients who delivered at Women & Infants Hospital between January 1989 and February 2000. Fifty cases of emergent postpartum hysterectomy performed within 14 days of deli...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(03)00404-6
更新日期:2003-07-01 00:00:00
abstract::The hospital-based alternative birth room has become a popular alternative to the conventional labor and delivery room setting. Responses to a mailed questionnaire from 78 of 82 (95%) Washington State hospitals with obstetric services were used to relate available birth options to alternative birth room status and obs...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1981-11-01 00:00:00
abstract::A rare case of a paraganglioma (extraadrenal pheochromocytoma) that complicated both pregnancy and the puerperium is described. The patient presented a confusing clinical picture simulating pregnancy-induced hypertension, which, after delivery, masqueraded as intractable fever of unknown origin. Computed tomography pr...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1982-06-01 00:00:00
abstract:OBJECTIVE:To compare stage distribution, tumor characteristics, and survival outcome in pregnancy-associated and non-pregnancy-associated breast cancer, and to evaluate pregnancy as a risk factor for mortality in breast cancer. METHODS:The California Cancer Registry (1991-1999) was linked with the California Patient D...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e31817c4ebc
更新日期:2008-07-01 00:00:00
abstract::Six girls with suspected Rokitansky syndrome underwent magnetic resonance imaging (MRI) and then sonography and laparoscopy to confirm the clinical diagnosis and define the precise characteristics of the malformation. The uterus was missing in all; four had müllerian rudiments in place of the uterus, which were cavita...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1990-10-01 00:00:00
abstract::For direct laparoscopic entry using a sharp and dull trocar technique, the sharp trocar is inserted with a twisting motion under constant pressure, then replaced with a dull trocar when a slight loss of resistance is felt. A slow, gradual entry into the peritoneal cavity is accomplished by twisting the dull trocar und...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(96)00215-3
更新日期:1996-10-01 00:00:00
abstract:OBJECTIVE:To estimate the risk for nodal metastasis in women with endometrial cancer based on uterine characteristics on pathology. METHODS:From a study of staging for uterine cancer, women were identified as being at low risk for nodal metastasis based on three specific criteria on final pathology reports: 1) less th...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e318240de51
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVE:To determine whether obstetric admissions to the intensive care unit (ICU) are useful quality-assurance indicators. METHODS:We analyzed retrospectively obstetric ICU admissions at two tertiary care centers from 1991 to 1997. RESULTS:The 131 obstetric admissions represented 0.3% of all deliveries. The majori...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(99)00274-4
更新日期:1999-08-01 00:00:00
abstract::To evaluate the effects of maternal magnesium sulfate treatment on neonatal magnesium and calcium homeostasis, the authors studied 23 term neonates whose mothers had received intravenous magnesium sulfate for pre-eclampsia and compared them with 14 control neonates. Total and ionized calcium, magnesium, phosphorus, an...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1980-11-01 00:00:00
abstract:BACKGROUND:The placement of a transabdominal cervical cerclage has been regarded as considerably more morbid than a transvaginal cerclage, in part due to the need for two laparotomies. We describe a technique for the laparoscopic placement and removal of a transabdominal cerclage. CASES:Two cases of women with insuffi...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(97)00655-8
更新日期:1998-05-01 00:00:00
abstract::The serum concentration of placental protein 12 was measured by radioimmunoassay in 111 apparently healthy pregnant women at 33 to 40 weeks, and the results were compared with those of 39 women with preeclampsia either with or without proteinuria at similar stages of pregnancy. Because the placental protein 12 levels ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1986-07-01 00:00:00
abstract:OBJECTIVE:To estimate the incidence of endocervical dysplasia in women with cervical cytology of atypical squamous cells of undetermined significance (ASCUS) or low-grade squamous intraepithelial lesion (SIL) who have a satisfactory and normal colposcopic examination. METHODS:An electronic colposcopy database was revi...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(00)00821-8
更新日期:2000-06-01 00:00:00
abstract:OBJECTIVE:To assess the rate of wound complications and evaluate the effectiveness of antibiotic prophylaxis in vulvar wide local excision procedures. METHODS:We performed a single-institution, retrospective cohort study of women undergoing vulvar surgery for premalignant lesions between January 2007 and January 2017....
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000003185
更新日期:2019-04-01 00:00:00
abstract::Restriction enzyme digestion and Southern blot hybridization were used to analyze deoxyribonucleic acid (DNA) extracted from exfoliated cervical cells for the presence of human papillomavirus sequences and these results were correlated with cytologic findings on Papanicolaou smears. Specimens (N = 204) were obtained f...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1986-10-01 00:00:00
abstract:BACKGROUND:Pregnancy-induced hemolytic anemia is a rare maternal complication that occurs during pregnancy and resolves soon after delivery. The mechanism is unclear, and the disease is often referred to as unexplained hemolytic anemia associated with pregnancy. CASE:We report a case of life-threatening hemolytic anem...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000287292.74846.f2
更新日期:2008-02-01 00:00:00
abstract::A new fetal scalp electrode applicator system uses a guide tube with increased curvature and a plunger mechanism to advance, rotate, and release the spiral electrode. Results of a preliminary survey among house staff who used the system in 51 patients indicated a favorable impression, with 96.1% of the applications ra...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1991-03-01 00:00:00
abstract:OBJECTIVE:To determine if scores from first attempts at the United States Medical Licensure Examination step 1 correlated with obstetrics-gynecology examination scores and identified students at risk of failure. METHODS:All students in obstetrics-gynecology clerkships at the University of Illinois at Chicago from July...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(99)00477-9
更新日期:1999-12-01 00:00:00
abstract::The short luteal phase is commonly found in ovulating women presenting with infertility, or in amenorrheic women induced to ovulate with clomiphene. When the short luteal phase defect is accompanied by the discovery of galactorrhea, the two abnormalities may share a common underlying cause. Two cases are presented to ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1976-04-01 00:00:00
abstract::The histologic diagnoses of premalignant and malignant lesions of the cervix obtained by examining the colposcopically directed biopsy material from 643 patients were compared with those of the surgical material subsequently obtained. The procedures during which samples were acquired included hysterectomy (370), cervi...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1981-08-01 00:00:00
abstract::Cerebral hemodynamics were studied in eight nonpregnant women and 24 women in late pregnancy by internal carotid artery velocimetry with a 3.5-MHz continuous-wave Doppler system. Criteria for supine hypotensive syndrome were a mean blood pressure decrease of 15 mmHg and a 2-minute sustained increase in pulse of 20 bea...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1992-01-01 00:00:00
abstract:OBJECTIVE:To estimate variation across hospitals in the rate of postpartum sterilization. METHODS:All hospitals with deliveries in California and Texas in 2009 were included. Proportion of live singleton deliveries with postpartum sterilization was calculated by hospital, insurance status (Medicaid compared with priva...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/aog.0b013e318278f241
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:The diagnosis of uterine rupture is aided by the identification of risk factors, such as oxytocin administration. In several experiments, cocaine has been shown to stimulate uterine contractility. Complications from cocaine abuse during pregnancy have increased dramatically in the United States, and cocaine ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1994-05-01 00:00:00
abstract:OBJECTIVE:To determine if suppressive acyclovir therapy given to term gravidas experiencing a first episode of genital herpes simplex virus (HSV)-infection during pregnancy decreases the need for cesarean delivery for that indication. METHODS:Forty-six pregnant women with first episodes of genital herpes during pregna...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0029-7844(95)00357-6
更新日期:1996-01-01 00:00:00
abstract::Nine cases of condylomatous carcinoma (squamous cell carcinoma arising in condyloma acuminatum) of the vulva were studied for their clinical history, histopathology, and presence of human papillomavirus (HPV) DNA. Condylomatous carcinoma occurred primarily in an elderly population with a mean age of 70 years. There wa...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1988-07-01 00:00:00
abstract:OBJECTIVE:The effect of exogenous hormones on the incidence of breast cancer has been extensively studied. Most studies regarding hormonal contraception have focused on combined oral contraceptives, and there is paucity of literature regarding nonoral and progestin-only contraceptives. The present study analyzed the re...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000178754.88912.b9
更新日期:2005-10-01 00:00:00
abstract:OBJECTIVE:To comprehensively review and critically assess the available gynecologic surgery venous thromboembolism prophylaxis literature and provide clinical practice guidelines. DATA SOURCES:MEDLINE and Cochrane databases from inception to July 2010. We included randomized controlled trials in gynecologic surgery po...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/AOG.0b013e318232a394
更新日期:2011-11-01 00:00:00
abstract::Inherited thrombophilias are associated with an increased risk of venous thromboembolism and also have been linked to adverse outcomes in pregnancy. However, there is limited evidence to guide screening for and management of these conditions in pregnancy. The purpose of this document is to review common thrombophilias...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3181d9d82d
更新日期:2010-04-01 00:00:00