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S J Steigrad

Publications and source records attributed to S J Steigrad.

23 records · Page 2Linked to original sources
PubMedDate not supplied

A spontaneous luteinizing hormone surge is beneficial in women with unexplained infertility undergoing controlled ovarian hyperstimulation without in vitro fertilization.

OBJECTIVE: To determine whether a spontaneous luteinizing hormone (LH) surge influences the pregnancy and miscarriage rate in women with unexplained infertility undergoing controlled ovarian hyperstimulation (COH) without in vitro fertilization. DESIGN: Retrospective cohort study. SETTING: Ovulation Induction Clinic, Royal Hospital for Women, Sydney, Australia. PATIENTS: 145 patients with unexplained infertility who underwent 374 cycles of COH. METHODS: Two types of ovarian stimulation protocols were used: human menopausal gonadotrophin (hMG) alone or hMG and clomiphene citrate (CC). A spontaneous LH surge occurred in 54% of the total cycles. All patients received human chorionic gonadotrophin, whether or not a spontaneous LH surge occurred. All cycles were covered by natural intercourse. MAIN OUTCOME MEASURES: Cycle pregnancy rate and miscarriage rate in cycles with or without a spontaneous LH surge. RESULTS: The cycle pregnancy rate of the LH surge group was significantly higher than that of the no LH surge group for CC/hMG cycles (16.4% and 4.3% respectively, p = 0.02) but not for hMG alone cycles (12.8% and 10% respectively, P > .05). The miscarriage rate was not significantly different between the LH surge group and no LH surge group in either the CC/hMG cycles (30% and 75% respectively, P > .05) or the hMG alone cycles (22% and 38% respectively, P > .05). CONCLUSIONS: In women with unexplained infertility undergoing COH with CC/hMG, the occurrence of a spontaneous LH surge is a favorable event associated with a significantly increased pregnancy rate. The data showed a lower miscarriage rate, but there was insufficient power to confirm or refute this result.

Adult↗
PubMedDate not supplied

The significance of pelvic ultrasound abnormalities detected on routine ultrasound scanning prior to assisted reproduction.

OBJECTIVE: To determine the benefit of screening patients with pelvic ultrasound before commencing treatment with in vitro fertilization or gamete intra-fallopian transfer, as well as before each subsequent treatment cycle was performed. SUBJECTS AND SETTING: Seven hundred and seventy-nine patients who were enrolled in the Royal Hospital for Women Fertility Group assisted reproduction program. METHOD: A retrospective analysis was performed. RESULTS: It was found that the majority of abnormalities were detected by the initial ultrasound. However, ultrasound contributed little to their diagnosis and management. CONCLUSION: As a result of this review of pelvic ultrasound examinations performed, the policy of screening prior to the initial cycle of treatment will be continued to exclude significant ovarian tumors and to identify patients with polycystic ovaries, who are more likely to be stimulated to levels at which there is a risk of ovarian hyperstimulation syndrome. The policy of screening before each subsequent treatment cycle has been discontinued, since few additional abnormalities were detected.

Adult↗