Biomedical subjects

Patrick Vandekerckhove

Publications and source records attributed to Patrick Vandekerckhove.

4 recordsLinked to original sources

PubMed2005

Investigation and current management of recurrent IVF treatment failure in the UK.

OBJECTIVE: To determine current practice in the management of recurrent in vitro fertilisation (IVF) treatment failure in licensed UK infertility centres. DESIGN: National postal questionnaire study and literature review. SETTING: University Hospital, Centre for Reproductive Medicine, Coventry, UK. SAMPLE: Human Fertilisation and Embryology Authority licensed centres providing IVF/intracytoplasmic sperm injection (ICSI) in the UK (n = 79). METHODS: A survey was designed that sought to determine how recurrent treatment failure was defined and which, if any, investigations were initiated. Furthermore, we asked which therapeutic options were subsequently recommended. MAIN OUTCOME MEASURES: Definition of recurrent treatment failure. Investigations undertaken. Clinical or embryology changes recommended following recurrent treatment failure. RESULTS: The response rate was 82%. The most common definition was three unsuccessful IVF cycles (range 2-6). Nineteen percent included frozen embryo replacements (FERs) in this figure. Anticardiolipin antibodies and lupus anticoagulant were the most frequent investigations suggested, followed by hysteroscopy and karyotype. A majority of centres would use a different treatment strategy in a subsequent cycle with blastocyst culture and assisted hatching being most popular. CONCLUSIONS: The results of this survey suggest that there is considerable variation in the approach to investigation and management of recurrent IVF treatment failure in the UK, although in some areas (e.g. the definition) there was broad concordance. Not all of these approaches are evidence based.

Adult↗

PubMed2003

Any effect of adjuvant low dose prednisolone on follicular development and embryo implantation may be masked by the concomitant use of aspirin.

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Aspirin↗

PubMed2003

Managing the infertile man.

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Environmental Exposure↗

PubMed1999

Pharmacological adjuvants during infertility surgery: a systematic review of evidence derived from randomized controlled trials.

The aim of this study was to evaluate systematically the role of pharmacological agents used as adjuvants during infertility surgery to prevent or reduce postoperative adhesion formation and improve pregnancy rates. Meta-analyses were performed of the ten randomized controlled trials identified that evaluated the use of pharmacological adjuvants at infertility surgery. The administration of steroids, dextran 70, noxytioline, heparin, or promethazine have all been investigated for their adjuvant role in preventing adhesion formation during pelvic surgery for infertility. Outcome measures were taken as: pregnancy rates after infertility surgery; number of patients with absent, improved or deteriorated adhesions at second look laparoscopy (dichotomous outcomes); and changes in adhesion score from initial surgery to second look laparoscopy (ordinal outcome). None of the pharmacological adjuncts investigated in a randomized controlled fashion was shown to improve postoperative pregnancy rates. There was some evidence that steroids reduced the incidence or severity of postoperative adhesion formation; there was little evidence to support the use of dextran. The routine use of pharmacological adjuncts during infertility surgery cannot be recommended on the basis of the available evidence derived from randomized controlled trials. Dextran appears to offer no advantage. The evidence with regard to steroids is far from conclusive but tentatively indicates that they may be beneficial.

Journal Article↗