Endometrial and subendometrial blood flow measured by three-dimensional power Doppler ultrasound in patients with small intramural uterine fibroids during IVF treatment.

Background: The impact of intramural fibroids on the success of IVF treatment is controversial and the mechanisms leading to poor treatment outcomes remain unknown. We compared endometrial and subendometrial blood flow between women with and without intramural fibroids during IVF treatment.

Methods: Three-dimensional (3D) ultrasound examination with power Doppler was performed on the day of oocyte retrieval in 50 patients with intramural fibroids not distorting the uterine cavity and in 50 matched controls to measure endometrial thickness, uterine pulsatility index (PI)/resistance index (RI), endometrial volume and vascularization index (VI)/flow index (FI)/vascularization flow index (VFI) of endometrial and subendometrial regions.

A randomized trial to compare 24 h versus 12 h double dose regimen of levonorgestrel for emergency contraception.

Background: Levonorgestrel (0.75 mg given for two doses 12 h apart) has been proven to be an effective regimen for emergency contraception when the first dose is given within 72 h of unprotected coitus. However, the dosing interval is inconvenient for those taking the first dose in the afternoon.

Comparison of endometrial and subendometrial blood flow measured by three-dimensional power Doppler ultrasound between stimulated and natural cycles in the same patients.

Background: Low implantation rates in stimulated IVF cycles may be related to suboptimal endometrial perfusion. Endometrial and subendometrial blood flow was compared between stimulated and natural cycles in the same patients undergoing IVF.

Methods: Three-dimensional (3D) ultrasound examination with power Doppler was performed in stimulated and natural cycles of 67 consecutive patients to measure endometrial thickness, uterine artery pulsatility index/resistance index, endometrial volume, vascularization index (VI)/flow index (FI)/vascularization flow index (VFI) of endometrial and subendometrial regions.

The role and comparison of two techniques of paracervical block for pain relief during suction evacuation for first-trimester pregnancy termination.

This prospective study assessed the role and compared two techniques of paracervical block (PCB) for pain relief during suction evacuation for first-trimester termination of pregnancy following cervical priming with misoprostol. One-hundred and thirty-five women undergoing suction evacuation up to 12 weeks of gestation were randomized into three groups: (a) 5 mL of 1% lignocaine injected at the 4 and 8 o'clock positions of the vaginal vault; (b) 5 mL of 1% lignocaine injected at the 4 and 8 o'clock positions of the cervix and (c) no PCB. Pain scores during PCB, cervical dilatation and during and after suction evacuation were compared among the three groups.

Effect of age on ovarian stromal flow measured by three-dimensional ultrasound with power Doppler in Chinese women with proven fertility.

Background: Increasing age is associated with reduced ovarian stromal blood flow detected by three-dimensional (3D) power Doppler ultrasound in infertile patients. However, little information exists in the literature regarding the effect of age on the ovarian stromal blood flow in fertile women.

Methods: On the second to fourth day of their menstrual cycle, fertile Chinese women who had regular monthly cycles and no history of tubal and ovarian surgery underwent a transvaginal scan with 3D power Doppler to determine total antral follicle count (AFC), total ovarian volume, total ovarian vascularization index (VI)/flow index (FI)/vascularization flow index (VFI).

Concentrations of endometrial protein PP 14 and CA-125 in uterine flushings performed in natural and stimulated cycles.

Background: Impaired implantation in assisted reproduction cycles with high serum estradiol (E(2)) concentrations may be attributed to abnormal endometrial development. This study compared concentrations of endometrial proteins in uterine flushings of infertile patients between natural and stimulated cycles.

Methods: Patients received a standard regimen of ovarian stimulation.

Endometrial and subendometrial blood flow measured during early luteal phase by three-dimensional power Doppler ultrasound in excessive ovarian responders.

Background: Impaired implantation in assisted reproduction cycles with high serum estradiol (E(2)) concentrations may be related to suboptimal endometrial perfusion. Endometrial and subendometrial blood flow were compared between excessive responders (serum E(2) on the day of HCG >20 000 pmol/l) and moderate responders (E(2) < or =20 000 pmol/l).

Methods: Three-dimensional (3D) ultrasound examination with power Doppler was performed 2, 4 and 7 days after HCG in 32 patients who did not have embryo transfer in order to measure endometrial thickness, pulsatility index (PI)/resistance index (RI) of uterine vessels, and endometrial volume, vascularization index (VI)/flow index (FI)/vascularization flow index (VFI) of endometrial and subendometrial regions.

A prospective, randomized, placebo-controlled trial on the use of mifepristone with sublingual or vaginal misoprostol for medical abortions of less than 9 weeks gestation.

Background: A combination of mifepristone and misoprostol provides an effective method of medical abortion for early pregnancy. This is the first randomized trial comparing the use of sublingual misoprostol with vaginal misoprostol in combination with mifepristone for termination of early pregnancies up to 63 days.

Methods: A total of 224 women who requested legal termination of pregnancy up to 63 days were randomized by computer- generated list into two groups and given 200 mg of oral mifepristone followed 48 h later by either 800 micro g of sublingual (n = 112) or vaginal (n = 112) misoprostol.

Bioavailability of hCG after intramuscular or subcutaneous injection in obese and non-obese women.

Background: Obese women require higher gonadotrophin doses for ovarian stimulation and to trigger ovulation. The bioavailability of a drug is affected by its route of administration. Herein, the bioavailability of hCG was compared after intramuscular (i.

A randomised comparison of side effects and patient inconvenience of two vaginal progesterone formulations used for luteal support in in vitro fertilisation cycles.

Objective: To compare side effects and patient inconvenience of two vaginal progesterone (P) formulations for luteal support in in vitro fertilisation cycles.

Study Design: Sixty infertile patients at risk of developing ovarian hyperstimulation syndrome were randomised to receive either Cyclogest vaginal suppositories 400mg twice daily or Crinone 8% vaginal gel once daily for 14 days as the luteal support. On Day 6 and Day 16 after embryo transfer, they rated side effects and patient inconvenience into four grades: none, mild, moderate and severe by completing a questionnaire.

Effects of age on hormonal and ultrasound markers of ovarian reserve in Chinese women with proven fertility.

Background: A woman's fertility is remarkably reduced with increasing age. Reproductive age can be assessed by a number of ovarian reserve tests. There are very few studies addressing the effects of age on these markers in fertile women, especially in Asia.

A randomized comparison of three insemination methods in an artificial insemination program using husbands' semen.

Objective: To compare pregnancy rates with single intrauterine insemination (SIUI), double intrauterine insemination (DIUI) and fallopian tube sperm perfusion (FSP).

Study Design: Ninety patients undergoing a standard ovarian stimulation regimen were randomized to receive SIUI, DIUI or FSP. The end point was either pregnancy or completion of 3 treatment cycles without pregnancy.

Oocyte and embryo quality in patients with excessive ovarian response during in vitro fertilization treatment.

Purpose: This study examined oocyte and embryo quality in patients having excessive ovarian responses during assisted reproduction treatment.

Methods: Two hundred and seventy-eight women of age <40 years using a long protocol of pituitary downregulation in their first intracytoplasmic sperm injection cycle indicated for severe male factors were retrospectively evaluated. Those with serum estradiol concentration on the day of HCG <10,000, 10,000-20,000, and >20,000 pmol/L were classified into Group A, Group B, and Group C, respectively.

A randomized double-blind study to compare the effectiveness of three different doses of lignocaine used in paracervical block during oocyte retrieval.

Purpose: To compare the effectiveness of three different doses of lignocaine used in paracervical block (PCB) during transvaginal ultrasound-guided oocyte retrieval (TUGOR) METHODS: In this double-blind study, 153 patients undergoing TUGOR in their first in vitro fertilization cycle were randomized to receive 50, 100, and 150 mg of lignocaine in PCB. Pain levels were measured by a 100-mm linear visual analogue scale (0 = none to 100 = intolerable).

Results: No differences were seen in the demographic data, the ovarian responses, the duration of TUGOR, and the number of follicles punctured.

The significance of the ionophore-challenged acrosome reaction in the prediction of successful outcome of controlled ovarian stimulation and intrauterine insemination.

Background: This prospective study compared the acrosome reaction following ionophore challenge (ARIC) versus conventional sperm parameters and sperm velocities in predicting successful outcome following ovarian stimulation and intrauterine insemination.

Methods: All patients were offered a maximum of three treatment cycles. Conventional semen analysis was performed and sperm velocities were measured using computer-aided sperm analysis.

Characterization of epithelial cell culture from human hydrosalpinges and effects of its conditioned medium on embryo development and sperm motility.

Background: Recent studies have reported the negative impact of hydrosalpinx on IVF outcome. Toxic effects of hydrosalpinx fluid (HF) have been the main reason for the recommendation of functional surgery, salpingectomy, prior to IVF. The present study characterized hydrosalpinx epithelial cell culture and examined the effects of its conditioned medium (CM) on sperm motility, acrosome reaction and embryo development.

A prospective randomized study to compare the use of repeated doses of vaginal with sublingual misoprostol in the management of first trimester silent miscarriages.

Background: A randomized controlled trial comparing sublingual with vaginal administration of misoprostol for medical management of silent miscarriages.

Methods: Eighty women who had silent miscarriages (<13 weeks) were randomized to receive 600 micro g of misoprostol every 3 h for a maximum of three doses either sublingually or vaginally.

Results: The success rates of medical management were the same in both groups (87.

Cycle-to-cycle variation in utero-ovarian hemodynamic indices in ovarian stimulation and natural cycles of the same women and its effect on the outcome of assisted reproduction treatment.

Objective: To investigate the blood flow parameters between cycles of the same women to assess whether parameters predicting a successful pregnancy in a stimulation cycle could be used to determine the outcome of subsequent natural cycles.

Design: A prospective study.

Setting: Assisted reproduction unit, the University of Hong Kong.

Gender selection in China: its meanings and implications.

With the advancement of assisted reproduction technologies, people are offered wider choices to choose the gender of their offspring and to construct 'ideal-typed' families with specific gender structure. Gender selection is welcomed by many societies with gender-specific preference, especially those patriarchal societies such as Chinese communities. It is not only a medical procedure but also a social orientation, which reveals much of the underlying preference towards gender.

A randomized double-blind comparison of perifollicular vascularity and endometrial receptivity in ovulatory women taking clomiphene citrate at two different times.

Background: It is still controversial whether the day of clomiphene citrate initiation has any impact on the pregnancy rate. This study aimed to compare the perifollicular vascularity and endometrial receptivity of ovulatory women who started clomiphene citrate on day 2 and day 5.

Methods: Thirty-five women with regular ovulatory cycles were first monitored in a natural cycle and then randomized by computer-generated random numbers put in sealed opaque envelopes to receive 50 mg clomiphene citrate on days 2-6 or on days 5-9.

Attitude of at-risk subjects towards preimplantation genetic diagnosis of alpha- and beta-thalassaemias in Hong Kong.

Objectives: The aim of the study was to assess whether preimplantation genetic diagnosis (PGD) was an acceptable alternative to prenatal diagnosis in couples at risk of giving birth to a child with alpha- or beta-thalassaemia in an Asian population.

Methods: An information leaflet was distributed to the women at risk. They were asked to complete a questionnaire after having an interview with a designated investigator.