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Biomedical subjects

M E Hull

Publications and source records attributed to M E Hull.

10 recordsLinked to original sources
PubMed1996

Ovarian cancer after successful ovulation induction: a case report.

BACKGROUND: Questions have been raised regarding the potential association of ovulation-inducing drugs and ovarian cancer. Worldwide there have been 13 cases of ovarian carcinoma reported to occur in women previously treated with ovulation-inducing drugs (clomiphene citrate and/or gonadotropins). CASE: A 40-year-old woman complained of secondary infertility. She conceived after five cycles of human menopausal gonadotropins with intrauterine insemination. Eight months after cesarean delivery, she presented with right lower quadrant pain and a right adnexal mass. At exploratory laparotomy the patient was found to have a poorly differentiated papillary serous carcinoma of the ovary. CONCLUSION: Ovarian carcinoma developed within 18 months of exposure to ovulation-inducing agents, human menopausal gonadotropins. It would be prudent to gather a registry of cases to assess the risk associated with human menopausal gonadotropins with or without gonadotropin-releasing hormone analogs.

Adult↗
PubMed1994

Nafarelin in the treatment of endometriosis. Dose management.

Nafarelin, a gonadotropin-releasing hormone agonist, has been shown to be effective in the treatment of endometriosis. The standard dosage is 200 micrograms bid intranasally. Side effects most commonly include those associated with estrogen deprivation. By assessing estrogen status, the standard dosage can be manipulated to minimize these side effects and increase patient compliance.

Administration, Intranasal↗
PubMed1987

Comparison of different treatment modalities of endometriosis in infertile women.

This study was designed to evaluate the effectiveness of three therapeutic modalities in the management of stage I and II endometriosis. Management modalities consisted of no treatment (controls, n = 56); oral medroxyprogesterone acetate (MPA), 30 mg orally per day for 90 days (n = 36); and danazol, 600 to 800 mg daily for 6 months (n = 52). All patients were followed for at least 18 months of exposure to pregnancy. Cumulative pregnancy rates were determined by life-table analysis. At 30 months, pregnancies resulted in 55% of group I (controls), 71% of group II (MPA), and 46% of group III (danazol). There were no significant differences among these rates. Similarly, there was no significant difference between the cumulative pregnancy rates for stage I (59%) and for stage II (57%). Abortion rates for the various treatment modalities were the following: MPA 6.3%, danazol 11%, and no treatment, 14.3%. The spontaneous abortion rate in stage I and stage II disease was not significantly different. The results of this study suggest that a period of expectant management with correction of other infertility factors may be warranted in patients with mild to moderate endometriosis before medical therapy is contemplated.

Adult↗
PubMed1986

Effects of norgestimate (0.250 mg) in combination with ethinyl estradiol (0.035 mg) on cervical mucus.

The antifertility effect of norgestimate (Ng), 0.250 mg, in combination with ethinyl estradiol (EE), 0.035 mg, on cervical mucus was investigated. The study was conducted over two consecutive cycles: a control cycle followed by a study cycle during which medication was given. Basal body temperature, cervical mucus and karyopyknotic index of vaginal cells were evaluated during both cycles. Disappearance of cyclicity of these parameters in the study cycle as well as monophasic basal body temperature were suggestive of inhibition of ovulation caused by the combination pill. Deterioration of sperm penetration may be reflective of anovulation and a direct antifertility effect of Ng on cervical mucus.

Adolescent↗
PubMed1986

Experience with intrauterine insemination for cervical factor and oligospermia.

In the past 100 years, interest in intrauterine insemination for cervical factor has waxed and waned. Recently the advent of in vitro fertilization, with improved methods of sperm washing and preparation, has revived interest in intrauterine insemination as a modality for the treatment of infertility. Twenty-seven couples with infertility resulting from cervical factor and/or oligospermia were entered into our intrauterine insemination protocol. A total of 107 intrauterine inseminations were performed in 85 menstrual cycles. Nineteen couples with a cervical factor as the major factor in their infertility experienced three pregnancies (16%). The remaining eight couples who had oligospermia with or without cervical factor produced no pregnancies. No major complications occurred from this procedure. In view of the low pregnancy rate experienced in this study, we must seriously question the value of intrauterine insemination in the treatment of cervical factors and/or oligospermia.

Adult↗
PubMed1986

Impact of beta-subunit human chorionic gonadotropin and ultrasonography in the management of suspected ectopic pregnancy.

The records of 346 women admitted to the Bronx Municipal Hospital Center with a diagnosis of suspected ectopic pregnancy between 1980 and 1982, when beta-subunit human chorionic gonadotropin and ultrasonography became generally available, were reviewed. The impact of these diagnostic tests on the gynecologic care this population received was to reduce the number of emergency room visits. That often meant a delay in diagnosis. There was no change in hospital stay or characteristics of the patient population. These data suggest that in this type of hospital, culdocentesis should not be abandoned in favor of this new technology.

Adult↗
PubMed1986

Correlation of serum estradiol levels and ultrasound monitoring to assess follicular maturation.

Thirty-eight patients underwent 38 cycles of induction of ovulation using stepwise human menopausal gonadotropin and human chorionic gonadotropin (hCG) administration. Ultrasonography was performed on the day of hCG injection. The mean age +/- standard error of the mean (SEM) of the patients was 32.9 +/- 0.8 years, and the duration of infertility ranged from 1 to 14 years (median, 2.8). Ultrasonographic measurements were obtained of the largest diameter and the volume of the dominant follicles as well as all other follicles in both ovaries. Data were analyzed by Student's t-test, regression analysis, and analysis of variance. The mean +/- SEM diameter of dominant follicles was 1.8 +/- 0.1 cm, and the volume of dominant follicles was 3.5 +/- 0.8 cm. The mean +/- SEM serum estradiol (E2) level before hCG administration was 659 +/- 62 pg/ml. Significant correlations were found between preovulatory serum E2 levels and the total follicular volume of both ovaries (r = 0.41, P less than 0.05) and follicular volume of the ovary containing the dominant follicle (r = 0.42, P less than 0.01). No significant correlation was observed between the diameter of the dominant follicle and serum E2 levels. These results suggest that ultrasound findings reflect growth, whereas serum E2 levels primarily detect functional activity of follicles.

Adult↗
PubMed1985

Is intraperitoneal dextran 70 safe for routine gynecologic use?

The routine use of intraperitoneal 32% dextran 70 has been suggested as an adjuvant to prevent postsurgical pelvic adhesions. Two hundred thirty-four women received an antiadhesion regimen consisting of intraperitoneal 32% dextran 70, dexamethasone, and promethazine. Ten women (4%) experienced spontaneous leakage of the dextran-peritoneal fluid mixture through their abdominal incisions. Painless bilateral swelling of the labia was noted in 18 women (8%). Mild abdominal bloating and weight gain of from 2.5 to 11 pounds were common. No anaphylactic reactions, peritonitis, or wound infections were experienced by any woman. Intraperitoneal dextran 70 appears to be a safe, well-tolerated antiadhesion adjuvant for routine use in gynecologic operations.

Anti-Bacterial Agents↗