Comparing gestational carrier to uterine transplantation in uterine-factor infertility: a cost-effectiveness analysis.

Objective: To compare the cost-effectiveness of a gestational carrier to a uterine transplantation in the treatment of absolute uterine-factor infertility.

Design: We performed a cost-effectiveness analysis using a decision-tree mathematical model comparing a gestational carrier to a uterine transplantation.

Subjects: Published literature was used to derive costs for solid organ transplant, immunosuppression, gestational carrier obtainment, in vitro fertilization, preimplantation genetic testing, and frozen embryo transfer.

Analgesia Using Transcutaneous Electric Nerve Stimulation in Office Bladder Chemodenervation, a Randomized Controlled Trial.

Importance: Office bladder chemodenervation, performed via cystoscopy with intradetrusor onabotulinumtoxinA (BOTOX) injections, is a common treatment for overactive bladder/urge urinary incontinence. Transcutaneous electric nerve stimulation (TENS) has shown to provide analgesia during office hysteroscopy. Adjuvant analgesia using TENS during bladder chemodenervation has not been studied.

Examining reasons that patients discard cryopreserved oocytes.

Purpose: Assess the rate, rationale, and characteristics of patients who cryopreserved and subsequently discarded their oocytes, and compare their characteristics to patients with continued cryopreservation of oocytes.

Methods: All patients who disposed of cryopreserved oocytes between 2009 and 2022 reported their reason for discarding their oocytes. This was a retrospective cohort study.

Preimplantation genetic testing for sickle cell disease: a cost-effectiveness analysis.

Objective: To evaluate the cost-effectiveness of in vitro fertilization with preimplantation genetic testing for monogenic disease (IVF + PGT-M) in the conception of a nonsickle cell disease (non-SCD) individual compared with standard of care treatment for a naturally conceived, sickle cell disease (SCD)-affected individual.

Design: A Markov simulation model was constructed to evaluate a one-time IVF + PGT-M treatment compared with the lifetime standard of care costs of treatment for an individual potentially born with SCD. Using an annual discount rate of 3% for cost and outcome measures, quality-adjusted life years were constructed from utility weights and life expectancy values and then used as the effectiveness measurement.

Reproductive genetics laboratory may impact euploid blastocyst and live birth rates: a comparison of 4 national laboratories' PGT-A results from vitrified donor oocytes.

Objective: To evaluate potential variation in the euploid blastocyst rate and live birth rate (LBR) per single frozen euploid blastocyst transfer, among 4 unique United States reproductive genetics laboratories. Analyses were limited to blastocysts derived from vitrified donor oocytes, to minimize variation in oocyte quality.

Design: Retrospective cohort study from 2016 to 2020.

The impact of the COVID-19 pandemic on gestational carriers.

Reproductive medicine has been significantly impacted by the coronavirus (COVID-19) pandemic, and this includes the gestational carrier (GC) process. The objectives of this commentary are to evaluate the impact of COVID-19 on the GC process, as well to communicate Shady Grove Fertility's considerations of and response to COVID-19 on the GC process to the larger assisted reproductive technology (ART) community. We also gathered conclusions drawn from available data on the impact of COVID-19 infection on maternal and neonatal morbidity and mortality as well as on counseling patients on vaccination.

Live birth after transfer of a single euploid vitrified-warmed blastocyst according to standard timing vs. timing as recommended by endometrial receptivity analysis.

Objective: To determine whether endometrial receptivity analysis (ERA) improves live births in patients with and without a history of unsuccessful frozen embryo transfers (FETs).

Design: Retrospective cohort study.

Setting: Large reproductive center.

Clarifying the relationship between total motile sperm counts and intrauterine insemination pregnancy rates.

Objective: To study the relationship between postwash total motile sperm count (TMSC) and intrauterine insemination (IUI) outcomes.

Design: Retrospective review SETTING: Large fertility clinic PATIENT(S): A total of 92,471 insemination cycles from 37,553 patients were included in this study.

Intervention(s): All stimulated clomiphene citrate, letrozole, and/or injectable gonadotropin IUI cycles performed at a single institution from 2002 through 2018 were reviewed.

Views of parents of children with sickle cell disease on pre-implantation genetic diagnosis.

Pre-implantation genetic diagnosis (PGD) is an option for parents who have a child with sickle cell disease (SCD) to have another child without SCD. We conducted a survey of 19 parents with at least one child with SCD to investigate views on PGD. Before education, 44% of parents were aware of PGD.

Cautery artifact understages urothelial cancer at initial transurethral resection of large bladder tumours.

Introduction: We sought to determine how frequently cautery (thermal) artifact precludes an accurate determination of stage at initial transurethral resection of bladder tumour (TURBT) of large bladder tumours.

Methods: We queried our institution's billing data to identify patients who underwent TURBT for large bladder tumours >5cm (CPT 52240) by two urologists at an academic centre from January 2009 through April 2013. Only patients who underwent initial-staging TURBT for urothelial cancer were included.

Suppression of ERβ signaling via ERβ knockout or antagonist protects against bladder cancer development.

Epidemiological studies showed that women have a lower bladder cancer (BCa) incidence, yet higher muscle-invasive rates than men, suggesting that estrogen and the estrogen receptors, estrogen receptor alpha (ERα) and estrogen receptor beta (ERβ), may play critical roles in BCa progression. Using in vitro cell lines and an in vivo carcinogen N-butyl-N-(4-hydroxybutyl) nitrosamine (BBN)-induced mouse BCa model, we found that ERβ plays a positive role in promoting BCa progression. Knockdown of ERβ with ERβ-shRNA in ERβ-positive human BCa J82, 647v and T24 cell lines led to suppressed cell growth and invasion.

Redefining abnormal follicle-stimulating hormone in the male infertility population.

Unlabelled: Study Type - Diagnostic (validating cohort). Level of Evidence 2a. What's known on the subject? and What does the study add? FSH is a hormone released by the anterior pituitary gland via stimulation from gonadotrophin-releasing hormone and potentially other factors.

(Almost) painless surgery: a historical review of the evolution of intraurethral anesthesia in urology.

Objective: The discovery of local anesthesia revolutionized urologic surgery. We investigate the evolution of intraurethral anesthesia in urologic surgery beginning in 1884.

Methods: A review of the literature was performed, reviewing the history of local anesthesia for urologic surgery, with a specific emphasis on intraurethral anesthesia.

Wine and treatment of genitourinary disease: from antiquity to modern times.

Objective: Wine is one of the oldest documented medicinal remedies, dating back thousands of years. We explore the medicinal uses of wine, with a focus on the treatment of genitourinary disease, beginning in ancient Egypt, India, and Israel, and then moving forward to include Greek, Roman, and Arabic medicine. Our review continues into the Middle Ages and renaissance, and finally evaluates the medicinal properties of wine as we understand them in our current scientific paradigm and its specific application to urology.

Selective disruption of ER{alpha} DNA-binding activity alters uterine responsiveness to estradiol.

In vitro models have been used to demonstrate that estrogen receptors (ERs) can regulate estrogen-responsive genes either by directly interacting with estrogen-responsive element (ERE) DNA motifs or by interacting with other transcription factors such as AP1. In this study, we evaluated estrogen (E(2))-dependent uterine gene profiles by microarray in the KIKO mouse, an in vivo knock-in mouse model that lacks the DNA-binding function of ERalpha and is consequently restricted to non-ERE-mediated responses. The 2- or 24-h E(2)-mediated uterine gene responses were distinct in wild-type (WT), KIKO, and alphaERKO genotypes, indicating that unique sets of genes are regulated by ERE and non-ERE pathways.

The "infertility" of Catherine de Medici and its influence on 16th century France.

Objective: Catherine de Medici, queen consort of King Henry II of France, was a powerful woman at a time when power for her sex was determined by fecundity. A decade long history of infertility might have placed her at risk for condemnation, but her husband's known urologic abnormalities played in her favor. This presentation will address the penile deformity of her husband, Henry II, and how this likely played a crucial role in her eventual rise to power, the interventions undertaken with regard to her purported infertility, and the historical ramifications when Catherine de Medici went on to have children.

Urology and the scientific method in ancient Egypt.

Objectives: To examine the practice of urology in ancient Egypt using various sources, including the Edwin Smith and Ebers Papyri. The sources of knowledge of ancient Egyptian medicine include medical papyri, paleopathology, art, and hieroglyphic carvings.

Methods: A brief overview of the medical system in ancient Egypt was completed, in addition to an examination of the training and specialization of the physician in the ancient world.