Retreatment with nafarelin for recurrent endometriosis symptoms: efficacy, safety, and bone mineral density.

Objective: To assess the efficacy, safety, and effect on bone mineral density of a 3-month course of retreatment with intranasal nafarelin acetate for recurrent symptoms of endometriosis.

Design: Multicenter, open-label, nonrandomized clinical trial.

Setting: Eleven hospital-based and private practices.

Prediction of pregnancy in infertile women based on the American Society for Reproductive Medicine's revised classification of endometriosis.

Objective: To estimate the empirical relationship between the revised American Society for Reproductive Medicine's classification of endometriosis and pregnancy rates after treatment.

Design: Retrospective analysis.

Patient(s): Patients seen by four practicing physicians.

Prospective randomized double-blind trial of 3 versus 6 months of nafarelin therapy for endometriosis associated pelvic pain.

Objectives: To determine the effectiveness of a 3-month course of nafarelin and, furthermore, to determine the long-term efficacy in patients treated for 3 and 6 months with nafarelin for symptoms associated with endometriosis.

Design: Double-blind, prospective, multicenter, clinical trial.

Setting: Fifteen reproductive endocrine clinics throughout the United States.

Nafarelin therapy in endometriosis: long-term effects on bone mineral density.

Objective: The study intent was to examine long-term effects on bone mass of 3 or 6 months of nafarelin therapy for endometriosis.

Study Design: Women with established endometriosis (N = 173) were randomized to receive nafarelin (200 micrograms intranasally twice a day) for either 3 or 6 months in a double-blind fashion. Bone mineral density was measured by dual energy x-ray absorptiometry at lumbar spine and proximal femoral sites for 18 months.

Presence of Chlamydia, Mycoplasma, ureaplasma, and other bacteria in the upper and lower genital tracts of fertile and infertile populations.

Objective: The genital mycoplasmas (Mycoplasma hominis and Ureaplasma urealyticum) and Chlamydia trachomatis have been implicated as possible etiologic factors in infertility. Their role in patients with infertility needs to be further defined.

Methods: Seventy-nine infertile patients underwent laparoscopy with cultures obtained for aerobic and anaerobic bacteria, Chlamydia, Mycoplasma, and Ureaplasma from the peritoneal fluid, fallopian tube, endometrium, and endocervix.

Tubal pregnancy with normal hysterosalpingogram and negative serum pregnancy test.

A patient undergoing evaluation for primary infertility with regular menses had a normal hysterosalpingogram in the follicular phase and underwent diagnostic laparoscopy the next day, with the finding of a tubal pregnancy. The patient had a negative serum pregnancy test. Although a normal hysterosalpingogram and negative serum pregnancy test are each rare with a tubal pregnancy, the combination of the two occurring in a tubal pregnancy is previously unreported and did not exclude the diagnosis in this case.

Use of danazol in conservative surgery.

Any type of injury, inflammation or noninfectious condition can cause an adhesion. Among noninfectious conditions that cause adhesions, endometriosis is the most common. a six-month preoperative regimen of Danocrine (danazol) resulted in a reduction in pelvic vascularity and inflammation, theoretically reducing the risk of postoperative adhesions.

Classification of endometriosis.

The classification of endometriosis has evolved during this century under the influence of many factors. Although classifications initially paralleled the staging of pelvic malignancies, more modern systems follow the natural progression of this pathologic process. The diagnosis of endometriosis at earlier stages has been limited by the technology of the era.

Recombinant tissue plasminogen activator reduces adhesion formation in a rabbit uterine horn model.

To evaluate the potential benefit of recombinant tissue plasminogen activator (rt-PA) as an agent for reducing postoperative adhesions, a rabbit uterine horn model was studied. Fifty-five rabbits underwent laparotomy, at which time the uterus was abraded with scalpel and a thermal injury was induced with electrocautery. Before abdominal closure, rt-PA was applied topically in various dosages.

Administration of nasal nafarelin as compared with oral danazol for endometriosis. A multicenter double-blind comparative clinical trial.

Treatment with nafarelin, a gonadotropin-releasing hormone agonist, reversibly inhibits ovarian function and induces hypoestrogenemia. To determine the efficacy of such hormonal manipulation in the treatment of endometriosis, we randomly assigned 213 patients with laparoscopically confirmed endometriosis to receive, for six months, either nafarelin by nasal spray (400 or 800 micrograms per day) or oral danazol (800 mg per day). Placebo nasal spray and placebo tablets were used to double blind the study.

Linear regression analysis of ultrasound follicular growth series: evidence for an abnormality of follicular growth in endometriosis patients.

Follicular diameter growth is a highly linear function of time. Recently, the potential utility of linear regression-derived parameters for describing and comparing cycles of follicular growth was described. The linearity of growth, growth rate constant (K), calculated date of growth onset (Do), total growth period (TGP), menstrual age at apparent ovulation (MAov), and peak follicular diameter (PFD) have been calculated from the follicular growth series of a group of patients with laparoscopically diagnosed endometriosis (n = 46).

Serum and peritoneal fluid proteins in women with and without endometriosis.

We examined the proteins in serum and peritoneal fluid of women with endometriosis (and of healthy controls) for evidence of an autoimmune response that might account for their impaired fertility. No antibodies against endometrial glycoproteins or against "progestin dependent endometrial protein" (PEP) were found in any serum or peritoneal fluid sample. Levels of PEP were not different in serum from women with moderate to severe endometriosis (n = 6), with mild endometriosis (n = 21), or from disease-free cycling controls (n = 19).

Peritoneal fluid plasminogen activator activity in endometriosis and pelvic adhesive disease.

Plasminogen activator activity in PF was assayed by the fibrinolysis method described by Strickland and Beers. In 45 patients studied, there were no discernible differences according to whether patients had endometriosis and/or pelvic adhesive disease. No differences were detected according to when in the menstrual cycle the sample of PF was obtained.

Treatment of endometriosis with danazol: report of a 6-year prospective study.

Presented are the results of a 6-year prospective study designed to evaluate the effectiveness of danazol for the treatment of endometriosis. Ninety-six patients completed 6 months of therapy at a dosage of 800 mg daily, and 107 patients completed therapy with 400 mg daily. No difference was reported in the incidence of side effects, regardless of dosage.

Transplantation of normal and ectopic human endometrial tissue into athymic nude mice.

Implants or tiny circumscribed nodules of endometrial tissue were found in all female mice given intraperitoneal injections of fragments of human normal (proliferative and secretory) or ectopic (endometrioma) endometrium. Half of these animals received estrogen supplementation and the other half received none. The endometriosis tissue present in these animals at 28 or 56 days after inoculation consisted of glands and stroma with an infiltration of hemosiderin-laden macrophages.

Genetics studies in incomplete müllerian fusion.

No formal genetic studies of incomplete müllerian fusion anomalies have been conducted previously, despite several reports of familial aggregates. Accordingly, the authors sought to determine the frequency with which symptomatic müllerian fusion anomalies occurred in relatives of a small but genetically unbiased sample of 24 probands. Only one of 37 (2.

Naproxen sodium vs. a combination of aspirin, phenacetin, caffeine and codeine phosphate for pain after major gynecologic surgery. A multicenter comparison.

In this multicenter study a nonnarcotic analgesic available for moderate pain, naproxen sodium, 550 mg, was compared to a combination that is used extensively for moderate to severe pain, aspirin, phenacetin, caffeine and codeine phosphate (APC/C) (60 mg of codeine phosphate). Women with pain after major gynecologic surgery reported a similar pattern in pain reduction with the two medications except for a relatively sharper increase in pain intensity between four and six hours after administration of APC/C. A smaller number of patient complaints suggested that naproxen sodium was better tolerated than APC/C.