FSH administration at 12-hour intervals for the first 2 days, combined with mandatory GnRH-agonist trigger and blastocyst vitrification in women (<80Kg) with high AMH levels, results in higher cumulative live birth rates and is safer.

We aimed to determine if a programme change to 12 hourly injections of FSH (150 IU per injection) for the first 2 days of stimulation in women with high ovarian reserve (AMH ≥ 30 pmol/L), followed by 24 hourly injections, would elicit increased earlier follicular recruitment, higher egg yields and blastocyst embryos for cryopreservation, leading to potential higher cumulative pregnancy rates, than conventional daily injections throughout. For safety reasons, the approach required mandatory cryopreservation of all blastocysts (mFET group;  = 74), after ovulation trigger with GnRH-agonist, in GnRH-antagonist controlled cycles. The 'Comparator group' ( = 91) comprised women with the same high AMH levels treated with the same base dose of FSH, with the aim of fresh blastocyst transfer and cryopreservation of supernumerary embryos, treated over the preceding 2 years.

Soluble LH-HCG receptor and oestradiol as predictors of pregnancy and live birth in IVF.

Research Question: Circulating soluble LH-HCG receptor (sLHCGR) is a first-trimester marker for screening pregnancy pathologies and predicts premature or multiple births before fertility treatment. Oestradiol per oocyte at ovulation induction predicts IVF treatment outcomes. We asked whether sLHCGR levels are stable during fertility treatment and whether, alone or with oestradiol, they could improve prediction of fertility treatment outcomes.

Objective multicentre performance of the automated assays for AMH and estimation of established critical concentrations.

The measurement of AMH has now become widespread practice within the field of fertility treatment and research, despite technical issues with some of the original assays. The two new automated assays, with their potentially improved technical performance, require detailed examination and comparison under different conditions. In addition, the determination of categories of responses to ovarian stimulation, require re-evaluation for these new tests.

Premature and multiple births in IVF are associated with pretreatment circulating LH/hCG receptor concentration.

The luteinizing hormone (LH) and pregnancy hormone, human chorionic gonadotrophin (hCG), share a common receptor: LH/hCG-R or LHCGR. In this prospective study involving 290 patients undergoing in vitro fertilization (IVF) and embryo transfer, we have examined whether pretreatment circulating LHCGR (sLHCGR) influences the course of pregnancy and perinatal outcome after embryo transfer. The blood samples were collected before the fertility treatment began and sLHCGR concentrations were measured using an enzyme-linked immunosorbent assay (ELISA) test.

Antimüllerian hormone levels and antral follicle count as prognostic indicators in a personalized prediction model of live birth.

Objective: To compare antimüllerian hormone (AMH) and antral follicle count (AFC) separately and in combination with clinical characteristics for the prediction of live birth after controlled ovarian stimulation.

Design: Retrospective development and temporal external validation of prediction model.

Setting: Outpatient IVF clinic.

Stability of AMH measurement in blood and avoidance of proteolytic changes.

The new Gen II assay for anti-Müllerian hormone (AMH) shows good stability and reliability in serum, but analyses of stability in whole blood are lacking. Testing the effects of storage of whole-blood samples at room temperature revealed significant increases in the measured value of AMH of 31% over 4 days (P<0.001).

Women with recurrent postmenopausal bleeding should be re-investigated but are not more likely to have endometrial cancer.

Objectives: We aimed to determine the prevalence of endometrial cancer in patients presenting with recurrent postmenopausal bleeding (PMB) after initial negative investigations.

Study Design: This was a retrospective study carried out in a dedicated PMB clinic. All patients presenting with recurrent PMB between 1 January 2003 and 31 May 2009 were studied.

Anti-Müllerian hormone-based approach to controlled ovarian stimulation for assisted conception.

Background: Individualization of controlled ovarian stimulation (COS) for assisted conception is complicated by variable ovarian response to follicle stimulating hormone. We hypothesized that anti-Müllerian hormone (AMH), a predictor of oocyte yield, may facilitate treatment strategies for women undergoing COS, to optimize safety and clinical pregnancy rates.

Methods: Prospective cohort study of 538 patients in two centres with differential COS strategies based on a centralized AMH measurement.

Effectiveness of a nurse-led pregnancy termination clinic.

A new nurse-led service was developed for women requesting pregnancy termination. Compared with the previous service, the nurse-led clinic reduced waiting times and cost almost 40 per cent less.

Routine ultrasound for pregnancy termination requests increases women's choice and reduces inappropriate treatments.

This prospective observational study aimed to determine the correlation between gestational age based on menstrual dates and ultrasound scan in women requesting pregnancy termination and the proportion of cases where first trimester medical termination might be offered. Two hundred and sixty-two women (93%) had ongoing pregnancies. Two hundred and thirty-seven women (90%) were certain of their menstrual dates but there was a discrepancy of more than one week in gestational age in 38%.

Ovulation induction/intrauterine insemination in infertile couples is associated with low-birth-weight infants.

Objective: The study was undertaken to determine the outcome of singleton pregnancies conceived through ovulation induction and intrauterine insemination using a partner's (OI/IUI) or donor sperm (OI/IUID) by comparison with naturally conceived singletons within a national cohort.

Study Design: Retrospective cohort study in primigravid women who were treated with OI/IUI (n = 97) or OI/IUID (n = 35) at Glasgow Royal Infirmary between March 1993 and March 1997 and identified within the Scottish national cohort (n = 109,443) delivering during the same period. Univariate and multivariate logistic regression models were used to examine outcomes and to determine the factors associated with infertility treatment and low birth weight.