PubMed Health⌕ Search

Biomedical subjects

R D Visscher

Publications and source records attributed to R D Visscher.

13 recordsLinked to original sources
PubMed1995

Ideal residency curriculum in reproductive endocrinology and infertility.

OBJECTIVE: Knowledge in reproductive endocrinology and infertility is fundamental to the delivery of quality women's health care. In 1991, the American Fertility Society formed a resident education committee to gather data on the current status of reproductive endocrinology and infertility training and develop an ideal curriculum. METHODS: Program directors and reproductive endocrinology and infertility faculty from 288 residencies in obstetrics and gynecology were surveyed about training in reproductive endocrinology and infertility; 257 (89%) of the program directors (survey I) and 203 (82%) of the reproductive endocrinology and infertility faculty (survey II) responded. An ideal curriculum has been developed from consensus discussions, review of survey data, and polling of experienced educators. The curriculum was reviewed and approved by the board of directors of both the Society for Reproductive Endocrinologists and the American Fertility Society. RESULTS: The curriculum is divided into subject matter and therapeutics, which are prioritized into three levels of knowledge: critical core curriculum, less critical material, and material with which residents should have familiarity and general knowledge. In addition, other recommendations and suggestions are made regarding the number of rotations, duration of rotations, and teaching methods. CONCLUSION: The ideal curriculum may serve as a guide to assist program directors in the formulation of the most effective residency training in reproductive endocrinology and infertility. The curriculum can help prioritize what should be taught and where an emphasis can be placed. There is not enough time or resources to teach residents all aspects of reproductive endocrinology and infertility.

Curriculum↗
PubMed1995

An estimate of the cost of in vitro fertilization services in the United States in 1995.

OBJECTIVE: To estimate the cost of adding IVF treatment to a standard health care benefits package. In vitro fertilization cost is defined as the average charge for a single cycle of treatment in an existing IVF program. DESIGN: Cost analysis. SETTING: Two hundred sixty IVF centers active in the United States in 1993. MAIN OUTCOME MEASURES: In vitro fertilization utilization and outcomes for 1993 were estimated from data in an existing registry. In vitro fertilization charges were determined from a 1993 survey of IVF clinics. The resulting expenditures for benefits and premiums were projected to 1995 together with the additional cost if utilization were to increase by 300% or 500%. RESULTS: In the United States in 1993 there were 31,718 IVF cycles for which the average charge was $6,233, leading to a total expenditure of approximately $197.70 million for IVF services in 1993. The projected cost of adding IVF services to a typical employer health plan in 1995 would be $2.79 per annum and the premium would be $3.14. Benefits and premium costs for a 300% utilization increase were $8.37 and $9.41, respectively, and for a 500% increase, $13.95 and $15.69, respectively. CONCLUSIONS: The cost of IVF services would be a minute fraction of the annual cost of a typical family benefits program ($3,393). Savings from reduced utilization of alternative treatments would offset a portion of this increase. Increases in utilization rates should be controlled by clinical criteria.

Adolescent↗
PubMed1985

In vitro fertilization in a community hospital.

Blodgett Memorial Medical Center began developing an IVF program in September of 1982. It took 10 months to establish animal and human IVF laboratories and an andrology laboratory. All personnel were recruited from within the hospital. From August 1983 through March 1985, 49 patients went through 58 complete IVF laparoscopy cycles. hMG and hCG were used to stimulate folliculogenesis and ovum maturation. An average of 5.2 oocytes was obtained by laparoscopic follicular aspiration. Eighty-four percent were either mature or intermediate oocytes. The fertilization rate per oocyte was 67%. Eighty percent underwent cleavage. Forty-seven patients (81%) received 1 or more embryos, with an average of 2.8 embryos each. There have been 12 pregnancies, including 3 abortions and 3 multiple pregnancies. Eight healthy infants have been born to date. The pregnancy rate per laparoscopy cycle was 21% and per transfer cycle was 26%. As a result of the IVF program, other services for infertile couples have been developed.

Chorionic Gonadotropin↗
PubMed1977

Guidelines for the elective induction of labor with oral Prostaglandin E2.

Fifty multiparous patients at 37 weeks or more of gestation with a vertex presentation and a Bishop score of 7 or more had labor induced with oral Prostaglandin E2 tablets. All responded and delivered vaginally. The induction to delivery time averaged 4 hours and 44 minutes. The average number of tablets required was 3.64. Four women experienced nausea and an additional 4 women had some vomiting. Two patients showed hypertonus and 11 had frequent contractions. Many progressed rapidly after they began active labor. There was no evidence of fetal distress. Guidelines are suggested for the use of oral Prostaglandin E2 tablets to adequately control the labor process and prevent hypercontractility.

Administration, Oral↗