Setting CME standards in Europe: guiding principles for medical education.

Objective: The requirement for formal Continuing Medical Education (CME) is growing in Europe with a concomitant focus on quality and independence of medical educational programmes, together with a need for measurable effects on patient outcomes. However, during this rapid evolution, it has become clear that there are misunderstandings and confusion amongst CME providers in relation to standard and regulations. To address this challenging situation, the Good CME Practice Group undertook an initiative to establish a set of standard core principles with a view to adoption by European CME providers and other key organisations involved in provision of CME programmes.

Discrimination between chronological and ovarian age in infertile women aged 35 years and older: predicting pregnancy using basal follicle stimulating hormone, age and number of ovulation induction/intra-uterine insemination cycles.

A marked decline in fertility rates has been demonstrated in women > 35 years of age. We have previously demonstrated the importance of basal follicle stimulating hormone (FSH) concentrations plus chronological age to predict pregnancies in women aged >/=40 years undergoing ovulation induction therapy. The purpose of the current study was to extend our previous study and determine the impact of age, basal FSH concentrations and ovulation induction/inter-uterine insemination (IUI) treatment cycles on pregnancy rates in infertile women age >/=35 years.

Spontaneous pregnancies despite failed attempts at ovulation induction in a woman with latrogenic premature ovarian failure.

Background: Women with premature ovarian failure may conceive spontaneously or following different regimens of ovulation induction.

Case: A 29-year-old woman with eight years of hypergonadotropic hypogonadism following chemotherapy and radiotherapy for Hodgkin's disease conceived spontaneously and spontaneously aborted after discontinuation of estrogen replacement. Subsequently she underwent pituitary gonadotrope downregulation and attempted controlled ovarian hyperstimulation without an ovarian response or follicular development.

Short-term endocrine response to gonadotropin-releasing hormone agonist initiated in the early follicular, midluteal, or late luteal phase in normally cycling women.

Objective: To determine short-term pituitary and ovarian hormonal responses to GnRH agonist (GnRH-a) administered during various phases of the menstrual cycle, in the absence of controlled ovarian hyperstimulation (COH), to determine its independent effect on hormonal parameters previously demonstrated to influence assisted reproductive technology cycle outcome.

Design: Prospective, randomized, controlled crossover study of five regularly cycling women. The GnRH-a, leuprolide acetate (LA), was administered 1 mg SC daily for 5 days beginning on cycle day 3 (early follicular); 8 days post-LH surge (midluteal); or 13 days post-LH surge (late-luteal).

The temporal relation between the urine LH surge and sonographic evidence of ovulation: determinants and clinical significance.

Objectives: 1) To define the temporal relation between self-detection of the urine LH surge and sonographic evidence of ovulation, 2) to identify clinical factors that affect this interval, and 3) to determine whether differences in the day of sonographic detection of ovulation could potentially influence pregnancy rates during timed supracervical insemination cycles.

Methods: Two hundred sixty-nine cycles in 145 women treated in an infertility center were analyzed. The subjects were referred for urine LH-timed supracervical insemination and were managed prospectively by protocol, including transvaginal sonographic confirmation of ovulation.