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Biomedical subjects

S G Oei

Publications and source records attributed to S G Oei.

33 records · Page 2Linked to original sources
PubMed1998

Effectiveness of the postcoital test: randomised controlled trial.

OBJECTIVES: To investigate the impact of the postcoital test on the pregnancy rate among subfertile couples and on the number of other diagnostic tests and treatments. DESIGN: Randomised controlled study. SETTING: A university and two non-university teaching hospitals in the Netherlands. SUBJECTS: New couples at infertility clinics, 1 March 1993 to 1 October 1995; randomisation to an intervention group (series of infertility investigations that include the postcoital test) or to a control group (series excluding the test). MAIN OUTCOME MEASURE: Cumulative pregnancy rate. RESULTS: Of 736 consecutive new couples, 444 fulfilled the inclusion criteria and consented to participate (intervention group, 227; control group, 217). Treatment was given more often in the intervention group than in the control group (54% v 41%; difference 13% (95% confidence interval 4% to 22%)). Yet cumulative pregnancy rates at 24 months in the intervention group (49% (42% to 55%)) and the control group (48% (42% to 55%)) were closely similar (difference 1% (-9.0% to 9.0%)). CONCLUSION: Routine use of the postcoital test in infertility investigations leads to more tests and treatments but has no significant effect on the pregnancy rate.

Adolescent↗
PubMed1998

[Acute myocardial infarct following sulprostone administration].

Because of intrauterine foetal death at 35 weeks, parturition in a woman aged 35 years was induced by intravenous sulprostone. A few hours after its start she sustained a myocardial infarction for which she was treated. Coronary angiography 4 weeks later showed normal coronary arteries and good left ventricular function. Mild cardiovascular reactions such as bradycardia and mild hypotension are frequently observed adverse effects. In some instances, sulprostone can induce myocardial ischaemia. However, the possibility of a myocardial infarction is not mentioned in the product information of sulprostone. As there was an obvious temporal relationship and other causative factors were sufficiently excluded, the causal relation between the administration of sulprostone and the occurrence of myocardial infarction can be regarded as almost certain. Several experimental studies provide support for the hypothesis that coronary spasms play a major role in the pathophysiology of a myocardial infarction during the administration of sulprostone.

Abortifacient Agents, Nonsteroidal↗
PubMed1997

Predicting optimal cervical mucus for infertility diagnosis.

OBJECTIVE: We studied the relationship between cervical mucus evaluations and daily fertility examinations in order to find monitoring techniques that can predict optimal mucus one day before it occurs. METHODS: Twenty-three healthy young female volunteers were followed during one spontaneous cycle with serial measurements of serum estradiol, progesterone, LH and FSH, urinary LH, and transvaginal ultrasound measurements of endometrial thickness and follicles. Data were related to cervical mucus scores. RESULTS: All cycles were ovulatory with optimal mucus, but in 14 optimal mucus was present for only one day. Echographic measurement of the leading follicle (mean diameter > or = 18 mm) could predict the day of optimal mucus in 78% and estradiol (> 700 pmol/l) in 83% of the cases. These two measurements combined predicted optimal mucus in 100% of the investigated women one day in advance. CONCLUSION: Optimal cervical mucus parameters can be predicted one day in advance by serial measurements of serum estradiol and follicular diameters.

Adolescent↗
PubMed1996

Evaluation of the postcoital test for assessment of 'cervical factor' infertility.

OBJECTIVE: To evaluate the test properties of the postcoital test (PCT). STUDY DESIGN: Retrospective analysis of prospectively collected data on a cohort of infertile couples with complete follow up. SETTING: Fertility clinic of a Dutch university hospital. SUBJECTS: A continuous series of 224 couples of whom 24 were excluded for reasons of anovulation, coital problems, proven sterility or incomplete follow-up. ANALYSIS: Cumulative pregnancy rates in relation to PCT results with and without treatment for 'cervical factor' infertility. RESULTS: The predictive values of normal and abnormal PCTs were 0.54 and 0.58 overall and 0.74 and 0.47 if only untreated women were considered. Sensitivity and specificity were, respectively, 0.47 and 0.65 for all women and 0.54 and 0.68 for untreated women only. Likelihood ratios for normal and abnormal PCTs were 0.83 and 1.32 overall and 0.67 and 1.72 in untreated women. CONCLUSION: The PCT has poor predictive power. This and the psychological impact on subfertile couples attest to the need for more rigorous study designs in evaluating this test.

Adult↗
PubMed1996

Effect of the postcoital test on the sexual relationship of infertile couples: a randomized controlled trial.

OBJECTIVE: To investigate the impact of the postcoital test (PCT) on the sexual relationship and functioning of infertile couples. DESIGN: Randomized controlled study. SETTING: University hospital. PATIENTS: New infertility patients were randomized to an infertility work-up with (PCT group) or without (non-PCT group) postcoital test as integral part of the investigation. INTERVENTION: Performance of the PCT. MAIN OUTCOME MEASURE: Both partners completed a questionnaire on their sexual relationship and functioning at the initial visit and after 3 months. RESULTS: Of 500 consecutive new couples, 304 fulfilled inclusion criteria and 290 consented to participate (PCT group: 152; non-PCT group: 138). Answers to both the first and second questionnaire were obtained from 84 couples (PCT: 43; non-PCT: 41). After 3 months, couples in the PCT group were at least as satisfied with their sexual relationship as couples in the non-PCT group with little difference having occurred in the 3 months of investigation. CONCLUSION: Overall, the influence of the PCT on the sexual relationship of infertile couples is more positive than negative.

Adult↗
PubMed1995

[Variations in fertility studies in The Netherlands].

OBJECTIVE: To determine how a standard infertility investigation is conducted and to determine the use of fertility tests used in such investigations in relation to WHO guidelines. DESIGN: Questionnaire survey. SETTING: Dutch medical schools. METHOD: A questionnaire survey among the heads of all 8 university and 20 non-university teaching departments of obstetrics and gynaecology or their fertility units was conducted. One non-university department failed to respond. RESULTS: The examinations recommended by the WHO (general physical examination, andrological and gynaecological examination, semen analysis, ovulation detection, tubal patency testing) in general were carried out, but general physical examination of the male as a rule was only carried out if indicated. Popular routine examinations not recommended by the WHO were the postcoital test and hysterosalpingography. Regarding the postcoital test, there was variation in the time interval after coitus and the standards for spermatozoal motility. CONCLUSION: Standard fertility investigations are usually based on empiricism and tradition, including the testing recommended by the WHO.

Fallopian Tube Patency Tests↗
PubMed1995

When is the post-coital test normal? A critical appraisal.

A systematic review was conducted of published studies, which related post-coital test (PCT) results to pregnancy, to evaluate the predictive power of the test and determine a definition of abnormality that yielded the best test properties. Well defined test results and valid outcome data for women attending fertility clinics were present in 11 out of 53 published reports relating to a total of 3093 women. The predictive values of normal and abnormal PCT were 0.37-0.92 and 0.58-0.85 respectively. Sensitivity was 0.10-0.90 and specificity 0.30-0.97. Likelihood ratios for normal and abnormal PCT were 0.77 and 1.85 respectively. When criteria for normality were set at a lower number of motile spermatozoa per field, sensitivity decreased with an increase in specificity and likelihood ratio for an abnormal test result. The discriminating ability of the PCT is poor, and altering definitions of normality hardly enhances its predictive power. As long as the value of the PCT for the assessment and treatment of so-called 'cervical factor infertility' remains unclear, a cut-off point with high specificity and a high likelihood ratio for an abnormal test result is recommended. Hence, an abnormal PCT is best defined as less than one motile spermatozoon per high power field.

Coitus↗
PubMed1995

Consistency and variation in fertility investigations in Europe.

A questionnaire survey among the teaching departments of obstetrics and gynaecology in Western Europe (response rate 71%) revealed only weak adherence to the World Health Organization recommendations for the standard investigation of the infertile couple. Both general and specific examinations were applied more frequently in the female than in the male partner. Although semen analysis and the ascertainment of ovulation were standard in virtually all departments, the criteria for normal semen and the methods used for the detection of ovulation varied greatly among both departments and countries. There were also large differences among countries in the preferred standard method for testing tubal patency. The data suggest that fertility investigations are based more on tradition and personal preferences than on the demonstrated utility of its components.

Europe↗
PubMed1995

European postcoital tests: opinions and practice.

OBJECTIVE: To assess differences in opinion and practice with regard to the postcoital test in Europe. DESIGN: Multilingual questionnaire survey among heads of departments of obstetrics and gynaecology with large fertility clinics in 16 European countries. SUBJECTS: Of 203 heads of departments, each responsible for 882 infertility cases per year (95% CI 657-1107) 145 (71%) responded. INFORMATION SOUGHT: Use of the postcoital test: its timing in relation to cycle and coitus, methodology used for the test, cut-off level of normality and treatments applied for abnormal test results. RESULTS: The postcoital test is used in 92% (and routinely in 68%) of departments. There are large differences in timing of the test in relation to menstrual cycle and coitus, in microscopic magnification used, and in cut-off levels of normality. More than 10 different treatments are applied for abnormal test results. CONCLUSION: Guidelines of the World Health Organisation are not followed and divergence in practice and opinion is wide enough to question whether infertile couples are better off with than without the test.

Attitude of Health Personnel↗
PubMed1995

A case of 16-ene-synthetase deficiency in male pseudohermaphroditism due to combined 17 alpha-hydroxylase/17,20-lyase deficiency.

A 17-year-old phenotypic female with primary hypergonadotropic amenorrhea, absence of secondary sexual development, hypertension and 46 XY karyotype is presented. Hormonal analysis revealed very low levels of testosterone, dehydroepiandrosterone, androstenedione, estrogens, cortisol and high levels of ACTH, progesterone, deoxycorticosterone and corticosterone. Enzyme studies of the testicular tissue after bilateral gonadectomy showed absence of 17 alpha-hydroxylase and 17,20-lyase activity as well as 16-ene-synthetase activity. This enzyme catalyzes the reaction from pregnenolone to 5,16-androstadien-3 beta-ol, a sex pheromone precursor. The other enzyme systems leading from pregnenolone to testosterone were intact. This is the first report of male pseudohermaphroiditism in which the combination of 17 alpha-hydroxylase, 17,20-lyase and 16-ene-synthetase deficiency is described, indicating that all these activities might be associated with the same protein.

Adolescent↗
PubMed1989

Primary ovarian carcinoid tumor in combination with carcinoid heart disease; a case report.

Primary ovarian carcinoid tumors (POCT) with secondary carcinoid heart disease are rare, only 13 cases have been reported in the literature to date. In most instances POCT can be completely removed surgically contrary to primary carcinoid tumor of the gastro-intestinal tract. Laparoscopy may be helpful in localizing the tumor. We present a case in which the carcinoid heart lesions progressed despite total eradication of the carcinoid.

Carcinoid Heart Disease↗