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Results for “Reproductive Medicine”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

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At least 163 records · Page 9Linked to original sources
PubMed2003

Reproductive medicine in a late effects of cancer clinic.

This review discusses the most commonly observed problems in young people who have survived childhood cancer, with particular emphasis on the issues of fertility. It also describes the role of the late effects clinic in transitional care and the multidisciplinarity of the clinicians required to meet the needs of these young people. There is a need for evidence-based guidelines for management of long-term survivors.

Adolescent↗
PubMed2002

Alternative treatments in reproductive medicine. The vexing problem of 'seemingly impeccable trials...'.

The problem of 'seemingly impeccable trials' that produce unbelievable results is approached from basic notions of the philosophy of science: facts and theory are interdependent, and 'crucial experiments' do not exist. This does not lead to an 'anything goes' attitude, but obliges us to consider arguments and counter-arguments in the spirit of the 'crossword' analogy by Susan Haack. The role of editors and readers might be different: while editors might be under some obligation to publish 'seemingly impeccable trials', readers are not obliged to accept the findings.

Clinical Trials as Topic↗
PubMed2003

Evaluating economic studies in reproductive medicine.

Healthcare professionals are under increasing pressure to stem the rise of healthcare costs and national healthcare expenditures. This has led to great interest in cost-effective therapy for patients. This article reviews the different types of economic analysis of medical practice and the components of a cost-effective analysis. It also reviews how to evaluate a cost-effectiveness paper and apply it to clinical practice. Economic analysis of a medical practice is a formal and quantitative method of comparing alternative strategies with respect to cost and outcomes. These analyses are frequently poorly performed, limiting their applicability to clinic practice. After reading this review, a physician should be better equipped to effectively evaluate economic analyses.

Cost Control↗
PubMed2001

Outcome of intracytoplasmic sperm injection in azoospermic patients: stressing the liaison between the urologist and reproductive medicine specialist.

OBJECTIVES: To analyze the outcome of intracytoplasmic sperm injection (ICSI) cycles in infertile couples in whom the main diagnosis of infertility was azoospermia of obstructive and nonobstructive origin. METHODS: Eighty-three consecutive ICSI cycles were carried out with retrieved testicular or epididymal spermatozoa, 60 cycles in 32 patients with obstructive azoospermia and 23 cycles in 12 patients with nonobstructive azoospermia. Fifty-four testicular biopsies (testicular sperm extraction) and 18 epididymal aspirations (microepididymal sperm aspiration) were performed.Results. Motile spermatozoa were recovered in 65 cycles (90.3%). In another 3 (4.2%), nonmotile spermatozoa were retrieved. In 4 patients (5.5%), sperm could not be recovered. In 11 cycles, frozen sperm from a previous procedure were used. A significantly lower fertilization rate (64% versus 73%, P = 0.02), clinical pregnancy rate (13% versus 47%, P <0.001), and good embryo quality rates (35% versus 56%, P = 0.009) were observed in patients with nonobstructive azoospermia. In patients with obstructive azoospermia, no significant differences were observed when the outcome was analyzed on the basis of the sperm origin (ie, from testicular sperm extraction or microepididymal sperm aspiration). CONCLUSIONS: When combining testicular sperm extraction or microepididymal sperm aspiration with ICSI in patients with obstructive azoospermia, the results in terms of fertilization, implantation, and pregnancy rates were similar to those found in patients with nonazoospermic obstruction who underwent ICSI with ejaculated sperm. Patients with nonobstructive azoospermia had lower fertilization, embryo quality, and pregnancy rates than did those with obstructive azoospermia, probably because of severe defects in spermatogenesis, leading to poor gamete quality. The urologist and reproductive endocrinologist now have an excellent therapeutic option to offer men with previously intractable infertility.

Adult↗
PubMed2005

Use of GNRH antagonists in reproductive medicine.

Gonadotrophin-releasing hormone (GnRH) plays a key role in the secretion of gonadotrophins, follicle-stimulating hormone (FSH) and luteinizing hormone (LH), which regulate steroidogenesis and folliculogenesis. Two GnRH antagonists, Cetrorelix and Ganirelix, deprived of histaminergic side-effects, have been introduced into ovarian stimulation protocols to prevent premature LH surges and proved their safety in clinical trials. At present, most of the published studies have not found significant differences in follicular recruitment, oocyte quality, and so on, except for a decrease in pregnancy and implantation rates in in vitro fertilization and embryo transfer (IVF-ET) cycles when the GnRH antagonist rather than the agonist was used. This decrease in pregnancy rates was in relation with a necessary learning curve of the physicians. Another possibility is the impact of the GnRH antagonist on endometrium through its GnRH receptor; this effect was cancelled after cryopreserved embryo transfers because the pregnancy rates were similar between GnRH antagonist and agonist in this case. GnRH antagonists were also interesting in poor responders and polycystic ovarian syndrome, where the agonists have not permitted to obtain the better results in IVF-ET cycles. Similarly, the GnRH antagonists could prevent the LH surge in the intrauterine insemination cycles.

Female↗
PubMed2000

Extracorporeal perfusion of the human uterus as an experimental model in gynaecology and reproductive medicine.

Experimental perfusion of various organs has primarily been used in transplantation medicine to study the physiology, pathophysiology and metabolism of tissues and cells. The purpose of this study was to establish an experimental model for the extracorporeal perfusion of the human uterus with recirculation of a modified, oxygenated Krebs-Henselait solution, in comparison with a non-recirculating perfusion system. With consent of the patients we obtained 25 uteri after standard hysterectomy. We performed an isovolumetric exchange of the perfusion medium at different intervals from 1 to 6 h and examined pH, pO(2), pCO(2), lactate, lactate dehydrogenase and creatine kinase by taking arterial and venous samples every hour for 24 h. We found the perfusions to be adequate when maintaining flow rates at 15-35 ml/min and at pressures ranging from 70 to 130 mmHg. Isovolumetric exchange of the perfusate every 3-4 h was the maximum interval to keep pH, the arterio-venous gradients of pO(2) and pCO(2), and the other biochemical parameters in physiological ranges. Examination by light and electron microscopy showed well-preserved features of myometrial and endometrial tissue. However, a 6 h exchanging interval led to increasing hypoxic and cytolytic parameters during the whole perfusion period. X-ray studies using digital subtraction angiography and perfusion studies with methylene blue demonstrated the homogeneous distribution of the perfusion fluid throughout the entire organ.

Adult↗
PubMed1996

Prospects for human reproductive medicine--applications of experimental techniques used in farm animal breeding.

Can assisted reproduction techniques performed in farm animal breeding be considered as future methods in human sterility treatment? The answer is no because, at the moment, the goals in human and animal reproduction are totally different. The methods that scientists are using or developing for farm animals are either without any therapeutic value for humans or they are forbidden by the German Embryo Protection Law. However, there are a few aspects which might be of value in the future of human assisted reproduction. The technique of in vitro maturation of immature follicles and oocytes, which is prerequisite in animal in vitro fertilization the female gamete pool after slaughter, might be used to obtain mature human oocytes from unstimulated cycles in women who do not respond to hormonal stimulation. Further more, it can be used in cancer patients to save their oocytes shortly before cancer treatment. Although still forbidden at the moment by the Embryo Protection Law, it is possible that the pre-implantation diagnosis of early embryos by the polymerase chain reaction technique after blastomere biopsy will become a valuable tool in preventing genome aberration in future.

Animals↗
PubMed2002

Reproductive medicine of companion marsupials.

Marsupials have recently become popular as exotic pets. Marsupial reproduction is considerably different than that of placental mammals. The reproductive parameters and artificial milk formulations specific for marsupials are discussed.

Animals↗
PubMed2003

Gonadotropin-releasing hormone and reproductive medicine.

The hypothalamic gonadotropin-releasing hormone (GnRH) is a key regulator of the reproductive system, mainly through its effects on pituitary luteinizing hormone (LH) and follicle-stimulating hormone (FSH) release. Gonadotropin-releasing hormone analogues are modifications of the natural decapeptide, being either agonists (GnRHa) or antagonists. GnRHa may imitate the native hormone and induce an endogenous LH surge; however, sustained treatment with GnRHa results in complete refractoriness of LH and FSH production. This aspect of GnRHa action is the main application of the GnRHa in reproduction today. The hypogonadotropic hypogonadal state that results from the sustained treatment is the basis for additional applications of the GnRHa. The agonists appear to be effective, to some extent, for the treatment of endometriosis and were proved to be beneficial prior to surgery for fibroma uteri. GnRHa is used in assisted reproduction for both induction of an endogenous LH surge and for induction of ovulation, and its capacity to cause refractoriness of the pituitary may be used to avoid a premature LH surge. It is suggested that the GnRHa have a direct effect on ovarian steroidogenesis, which is independent of its action on the pituitary. This unwanted effect and other possible drawbacks of the agonists are thought to be eliminated with the use of the antagonists. The mechanism of action of these antagonists is through competitive blocking of the GnRH receptor, which results in a rapid but reversible suppression of gonadotropin secretion. As for GnRHa, GnRH antagonists have been proven effective to prevent the LH surge and to reduce the incidence of severe ovarian hyperstimulation syndrome in controlled ovarian stimulation cycles.

Embryo Implantation↗
PubMed1996

Inhibin, activin, and follistatin in reproductive medicine.

OBJECTIVE: To review the available information regarding the polypeptide factors inhibin, activin, and follistatin in reproductive physiology. DESIGN: The protein structure, tissue expression, regulation, and effects of these factors are outlined, with an emphasis on the reproductive tissues in both females and males. Although some information is only available in animal model systems, human data has been selected whenever possible. CONCLUSIONS: Inhibin and activin are closely related peptides with opposing actions, whereas follistatin is a structurally unrelated peptide that may act indirectly through modulation of inhibin-activin effects. These three peptides are secreted in highest levels by the adult gonads; however, they are also present in a wide variety of reproductive and nonreproductive tissues where they are believed to exert local, tissue-specific effects. Within the reproductive system, these peptides play a role in the regulation of gonadotropin biosynthesis and secretion, ovarian and placental steroidogenesis, and oocyte and spermatogonial maturation.

Activins↗