Miniature hygrometric hot flush recorder as an objective indicator of hot flushes: a validation study.

Objective: Hot flushes are a very common symptom of menopause for which many women seek medical help. Accurate assessment of clinical severity and of the impact of treatment is limited by a lack of methods for objective hot flush recording. The aim of the current study is to test the diagnostic value of a miniature hygrometric hot flush recorder (HFR).

Luteinizing hormone-releasing hormone receptor antagonist may reduce postmenopausal flushing.

Objective: Hormone therapy (HT) is the most effective treatment of postmenopausal (PMP) flushing; however, its use is often contraindicated. As an alternative option, we explored the efficacy of the luteinizing hormone-releasing hormone (LHRH) receptor antagonist cetrorelix in women with severe PMP flushing.

Methods: We conducted an open-label treatment with cetrorelix 250 μg twice a day on 10 women with a baseline daily flush score of 15 or higher for a period of 4 to 6 weeks.

Reconsidering the number of offspring per gamete donor in the Dutch open-identity system.

The introduction of legislation in the Netherlands in 2004 enabling donor offspring to identify and make contact with their donors has led to a need to reconsider the number of offspring that an individual semen donor may produce. To this end, we made a survey on the limits for offspring per donor in 29 different countries, distinguishing between systems with anonymous and open-identity sperm donation. We counted donations as individual offspring conceived, or as the number of women/families helped, by a single donor.

Expected poor ovarian response in predicting cumulative pregnancy rates: a powerful tool.

Poor ovarian response in IVF cycles is associated with poor pregnancy rates. Expected poor responders may represent the worst prognostic group. Data were used from 222 patients starting the first of three IVF treatment cycles.

Variation in subfertility care measured by guideline-based performance indicators.

Background: About 30-40% of patients do not receive care based on available scientific evidence. For subfertility, this may imply unnecessary and expensive diagnostic tests and treatments. It is therefore important to identify gaps in performance by monitoring current subfertility care.

The accuracy of multivariate models predicting ovarian reserve and pregnancy after in vitro fertilization: a meta-analysis.

BACKGROUND To review the accuracy of multivariate models for the prediction of ovarian reserve and pregnancy in women undergoing IVF compared with the antral follicle count (AFC) as single test. METHODS We performed a computerized MEDLINE and EMBASE search to identify articles published on multivariate models for ovarian reserve testing in patients undergoing IVF. In order to be selected, articles had to contain data on the outcome of IVF in terms of either pregnancy and/or poor response and on the prediction of these events based on a multivariate model.

The clomiphene citrate challenge test for the prediction of poor ovarian response and nonpregnancy in patients undergoing in vitro fertilization: a systematic review.

Objective: To systematically review the value of the clomiphene citrate challenge test (CCCT) in the prediction of poor ovarian response and pregnancy in IVF.

Design: Systematic review.

Setting: All studies that evaluated the CCCT in the prediction of poor ovarian response or pregnancy after IVF.

Single and repeated GnRH agonist stimulation tests compared with basal markers of ovarian reserve in the prediction of outcome in IVF.

Purpose: To study the value of a single or repeated GnRH agonist stimulation test (GAST) in predicting outcome in IVF compared to basal ovarian reserve tests.

Methods: A total of 57 women was included. In a cycle prior to the IVF treatment, on day 3, an antral follicle count (AFC) was performed and blood taken for basal FSH, inhibin B and E2 measurements, followed by a subcutaneous injection of 100 microg triptorelin for the purpose of the GAST.

Antral follicle count in the prediction of poor ovarian response and pregnancy after in vitro fertilization: a meta-analysis and comparison with basal follicle-stimulating hormone level.

Objective: To assess the predictive performance of the antral follicle count (AFC) as a test for ovarian reserve in IVF patients and to compare this performance with that of basal FSH level.

Design: Meta-analysis.

Setting: Tertiary fertility center.

Repeated clomiphene citrate challenge testing in the prediction of outcome in IVF: a comparison with basal markers for ovarian reserve.

Background: The aim of this study was to investigate the predictive accuracy and clinical value of performing either a single or a repeated clomiphene citrate challenge test (CCCT) in predicting poor response in IVF, compared to that of currently used basal ovarian reserve markers.

Methods: Sixty-three patients undergoing their first IVF treatment were prospectively included. After measurement of basal markers on cycle day 3 (cd3) [FSH, inhibin B and antral follicle count (AFC)], a CCCT was performed.

Use of stimulated serum estradiol measurements for the prediction of hyperresponse to ovarian stimulation in in vitro fertilization (IVF).

Purpose: In ovarian stimulation an exaggerated ovarian response is often seen and is related to medical complications, such as ovarian hyperstimulation syndrome (OHSS), and increased patient discomfort. If it were possible to identify hyperresponders at an early stage of the stimulation phase, adaptation of the stimulation protocol would become feasible to minimize potential complications. Therefore, we studied the usefulness of measuring stimulated serum estradiol (E2) levels in predicting ovarian hyperresponse.

Predicting poor ovarian response in IVF: use of repeat basal FSH measurement.

Objective: To evaluate the additional value of a second basal follicle stimulating hormone (FSH) level, in a different cycle, in the prediction of poor response in in vitro fertilization (IVF) by a single basal FSH measurement.

Study Design: In 120 patients, basal FSH was determined prospectively in 2 spontaneous cycles. The additional value of a second basal FSH measurement in the prediction of poor ovarian response in IVF by a single basal FSH measurement was studied.

Impact of repeated antral follicle counts on the prediction of poor ovarian response in women undergoing in vitro fertilization.

Objective: To study the value of a single antral follicle count and the additional value of repeated counts in different cycles for the prediction of poor ovarian response in IVF.

Design: Prospective.

Setting: Tertiary fertility center.

Performance of basal follicle-stimulating hormone in the prediction of poor ovarian response and failure to become pregnant after in vitro fertilization: a meta-analysis.

Objective: To assess the predictive performance and clinical value of basal FSH as a test for ovarian reserve in in vitro fertilization (IVF) patients.

Design: Meta-analysis.

Setting: Tertiary fertility center.

Women older than 40 years of age and those with elevated follicle-stimulating hormone levels differ in poor response rate and embryo quality in in vitro fertilization.

Objective: To investigate whether IVF outcome of patients older than 40 years of age with basal FSH levels less than 15 IU/L differs from that in patients 40 years of age or younger with basal FSH levels of 15 IU/L or greater.

Design: Prospective observational study.

Setting: Tertiary academic fertility center.

Serum anti-Müllerian hormone levels: a novel measure of ovarian reserve.

Background: Anti-Müllerian hormone (AMH) is produced by the granulosa cells of preantral and small antral follicles and its levels can be assessed in serum. Since the number of ovarian follicles declines with increasing age, AMH levels might be used as a marker for ovarian ageing. Therefore, we studied the relationship between AMH levels and ovarian response during ovarian stimulation for IVF.

Quantitative transvaginal two- and three-dimensional sonography of the ovaries: reproducibility of antral follicle counts.

Objective: To assess the intra- and interobserver reproducibilities in addition to the between-method reliability of antral follicle counts using two (2D)- and three (3D)-dimensional transvaginal sonography (TVS).

Methods: Two groups of women with regular menstrual cycles were studied. One group consisted of healthy volunteers with proven fertility and the other group consisted of patients visiting the general infertility clinic.

Predictors of poor ovarian response in in vitro fertilization: a prospective study comparing basal markers of ovarian reserve.

Objective: To identify and quantify predictors of poor ovarian response in in vitro fertilization (IVF). DESIGN; Prospective study. SETTING; Tertiary fertility center.

Basal follicle-stimulating hormone levels are of limited value in predicting ongoing pregnancy rates after in vitro fertilization.

Objective: To evaluate whether basal FSH (bFSH; measured on menstrual day 1-4) adds relevant clinical information to the prediction of ongoing pregnancy rates (OPRs) after IVF, once age and diagnostic characteristics have been taken into account.

Design: Retrospective.

Setting: Academic fertility center.

Ovarian reserve tests in infertility practice and normal fertile women.

The decline in fecundity with the age of the woman is mainly attributed to the loss of follicles from the ovary and a decrease in oocyte quality. Evaluation of the aging status of the ovary in an individual woman has been hampered by a lack of knowledge with regard to the relative contribution of these two factors. Most if not all so called ovarian reserve tests (ORT) reflect indirectly the remaining follicle pool in the ovary.

Beta 2-glycoprotein I deficiency and the risk of thrombosis.

beta 2-glycoprotein I (beta 2-GP I) is a plasma protein with a high affinity for negatively charged surfaces. In vitro this protein shows a variety of anticoagulant properties (inhibition of contact activation and platelet dependent prothrombinase activity). Therefore we studied the possibility that a hereditary beta 2-GP I deficiency is a risk factor for (familial) thrombophilia.