Teeter-Totter or Tapestry: A Life in Academic Medicine.

Constructing a career in academic medicine involves more than a focus on work-life balance. That image of a teeter-totter suggests that life is what happens when you are not working. The nature of the scope of interests (clinical, research, teaching) and values (service, leadership, curiosity, transparency, and honesty) creates a larger framework through which home life and work life become one interwoven tapestry.

An Estimation of the Risk of Pseudotumor Cerebri among Users of the Levonorgestrel Intrauterine Device.

Because of a previous association of pseudotumor cerebri (PTC) with levonorgestrel, we wished to evaluate the use of levonorgestrel-eluting intrauterine devices ("levonorgestrel intrauterine systems", LNG-IUS) in our University of Utah and Rigshospitalet PTC patients. In our retrospective series, PTC prevalence was approximately 0.18% and 0.

Progestins for contraception: modern delivery systems and novel formulations.

Since the development of combined oral contraceptives over 50 years ago, significant innovations have occurred in the domain of the progestin. Evolving knowledge of progestin mechanism of action and physiology has allowed for development of novel progestins with limited steroid receptor cross-reactivity, decreased side effect profiles, and pharmacokinetics optimized for modern delivery systems. This review summarizes current knowledge of progestin physiology, modern delivery systems, and developments of progestin agonists and antagonists for contraception.

Lactogenesis after early postpartum use of the contraceptive implant: a randomized controlled trial.

Objective: To evaluate lactogenesis after early postpartum insertion of the etonogestrel contraceptive implant.

Methods: Healthy peripartum women with healthy, term newborns who desired the etonogestrel implant for contraception were randomly assigned to early (1-3 days) or standard (4-8 weeks) postpartum insertion. The primary outcomes, time to lactogenesis stage II and lactation failure, were documented by a validated measure.

Gynecologic care in hematopoietic stem cell transplant patients: a review.

Unlabelled: Over 4500 hematopoietic stem cell transplants (HSCT) are performed on patients in the United States each year. As HSCT patients shift their survivorship care from large transplant centers to community health care providers, many gynecologists are assuming their pre- and post-HSCT gynecologic care. This article reviews recommendations, current research, and expert opinions on the gynecologic care of HSCT patients.

Characterization of therapy and costs for patients with uterine fibroids in Utah Medicaid.

Objectives: To determine in an eligible Utah Medicaid population (1) medical and drug costs associated with treating uterine fibroids (UFs) and (2) the cost and incidence of hysterectomy complications.

Methods: Medical and drug cost analyses were based on data from 897 premenopausal patients with UFs included in the Utah Medicaid database from 1996 to 2004. UF-related medical and pharmacy costs were determined from first diagnosis of UFs until a related procedure or until estimated menopause.

Sperm protamine 1/protamine 2 ratios are related to in vitro fertilization pregnancy rates and predictive of fertilization ability.

Objective: To evaluate whether aberrant sperm P1/P2 ratios are predictive of abnormal fertilizing ability and are related to in vitro fertilization (IVF) outcome.

Design: Prospective case-control study.

Setting: University-based infertility and IVF clinic.

Elevated sperm chromosome aneuploidy and apoptosis in patients with unexplained recurrent pregnancy loss.

Objective: To evaluate sperm chromosome aneuploidy and semen quality in 24 partners of women with unexplained recurrent pregnancy loss and to analyze the data in relation to sperm apoptosis data.

Methods: Semen quality parameters and sperm chromosome aneuploidy for chromosomes X, Y, 13, 18, and 21 were evaluated in the recurrent pregnancy loss patients, fertile controls, and a control group of men from the general population.

Results: The mean aneuploidy rate in the recurrent pregnancy loss group was 2.

Body mass index is inversely related to intrafollicular HCG concentrations, embryo quality and IVF outcome.

Decreased periovulatory human chorionic gonadotrophin (HCG) concentrations have been shown to be associated with diminished fertilization rates. This study evaluated if intra-follicular HCG concentration may be related to body mass in 247 IVF patients using their own oocytes and 58 patients receiving donor oocytes, and evaluated if such a relationship might affect IVF outcome. A significant inverse correlation (r = -0.

Prospective, randomized, blinded evaluation of donor semen quality provided by seven commercial sperm banks.

Objective: To evaluate variability in donor semen quality between seven commercial donor sperm banks, within sperm banks, and between intracervical insemination and intrauterine insemination.

Design: Prospective, randomized, blind evaluation of commercially available donor semen samples.

Setting: An academic andrology laboratory.