Long-term reproductive outcomes in patients with unexplained infertility: follow-up of the Fast Track and Standard Treatment Trial participants.

Objective: To evaluate long-term reproductive outcomes in couples who were enrolled in a large randomized controlled trial that studied optimal treatment for unexplained infertility.

Design: Telephone survey, administered between March 2019 and February 2020.

Setting: Large urban university-affiliated fertility center.

Dietary Energy Density and Fertility: Results from the Lifestyle and Fertility Study.

Background: Diet is a modifiable lifestyle factor linked with fertility in a growing number of studies.

Objective: The objective of this study was to evaluate the association between dietary energy density (ED), a summary measure of diet quality that estimates the amount of energy per unit food (kcal/g) consumed, and conception and pregnancy outcomes.

Methods: A prospective cohort study of couples planning their first pregnancy was conducted in the Northeast region of the USA.

Dietary quality, as measured by the Alternative Healthy Eating Index for Pregnancy (AHEI-P), in couples planning their first pregnancy.

Objective: Dietary quality (DQ), as assessed by the Alternative Healthy Eating Index for Pregnancy (AHEI-P), and conception and pregnancy outcomes were evaluated.

Design: In this prospective cohort study on couples planning their first pregnancy. Cox proportional hazards regression assessed the relationship between AHEI-P score and clinical pregnancy, live birth and pregnancy loss.

Prophylactic Negative Pressure Wound Therapy and Wound Complication After Cesarean Delivery in Women With Class II or III Obesity: A Randomized Controlled Trial.

Objective: To compare the occurrence of superficial surgical site infections in obese women using prophylactic negative pressure therapy with standard dressings after cesarean delivery.

Methods: We conducted a randomized controlled, nonblinded, two-center study of prophylactic negative pressure therapy compared with standard surgical dressings placed at the time of primary closure at cesarean delivery in obese women with body mass indexes (BMI) of 35 or higher (ie, class II and III obesity). Our primary outcome was occurrence of a superficial surgical site infection.

A randomized controlled trial comparing two types of retractors at caesarean delivery.

The aim of this study was to determine if the use of a self-retaining, symmetrical retractor (OB/Mobius) during caesarean delivery is associated with differences in post-operative pain experience. Consenting women undergoing caesarean delivery were randomly assigned to OB/Mobius versus conventional retraction instruments. Women were blinded to retractor type and filled out surgical pain surveys each post-operative day.

Association of vitamin D intake and serum levels with fertility: results from the Lifestyle and Fertility Study.

Objective: To evaluate the role of vitamin D intake and serum levels on conception of clinical pregnancy and live birth.

Design: Prospective cohort study.

Setting: Academic medical centers.

Re-imagining dementia in the fourth age: the ironic fictions of Alice Munro.

This paper analyses two stories by Alice Munro to explore how her fiction interrogates the prevailing social imaginary of the fourth age. Drawing on the theory of Gilleard and Higgs, I show how Munro's stories rely on irony and surreal imagery to subvert the logic that engenders and normalises the opposition between the third and fourth ages, and, by extension, the social death of people coping with later-life dementia. Ultimately, I argue that Munro's fiction does not so much reveal the Truth about the fourth age, as expose the reader's complicity in the construction of the prevailing gothic social imaginary.

When is clomiphene or gonadotropin intrauterine insemination futile? Results of the Fast Track and Standard Treatment Trial and the Forty and Over Treatment Trial, two prospective randomized controlled trials.

Objective: To determine whether day 3 FSH and E2 levels at the upper limits of normal affect live-birth rates and treatment trajectory in a conventional versus "fast track" treatment program for IVF.

Design: Secondary analysis of two randomized controlled trials, FASTT and FORT-T.

Setting: Not applicable.

A randomized clinical trial to determine optimal infertility treatment in older couples: the Forty and Over Treatment Trial (FORT-T).

Objective: To determine the optimal infertility therapy for women at the end of their reproductive potential.

Design: Randomized clinical trial.

Setting: Academic medical centers and private infertility center in a state with mandated insurance coverage.

Female dietary antioxidant intake and time to pregnancy among couples treated for unexplained infertility.

Objective: To determine whether increased antioxidant intake in women is associated with shorter time to pregnancy (TTP) among a cohort of couples being treated for unexplained infertility.

Design: Secondary data analysis of a randomized controlled trial.

Setting: Academic medical center associated with a private infertility center.

Gonadotropin therapy: a 20th century relic.

Gonadotropin therapy has been a cornerstone of infertility therapy for half a century. From the very beginning, its use has been associated with a high rate of multiple births, particularly high order multiples, and ovarian hyperstimulation syndrome. Initially, success rates seemed acceptable when used for superovulation (SO)/IUI therapy.

A randomized clinical trial to evaluate optimal treatment for unexplained infertility: the fast track and standard treatment (FASTT) trial.

Objective: To determine the value of gonadotropin/intrauterine insemination (FSH/IUI) therapy for infertile women aged 21-39 years.

Design: Randomized controlled trial.

Setting: Academic medical center associated with a private infertility center.

Impact of oxidative stress on female fertility.

Purpose Of Review: To review the role of oxidative stress in the context of female fertility.

Recent Findings: Oxidative stress is associated with decreased female fertility in animal and in-vitro models, but no studies to date have directly assessed the relationship in women. Exposures associated with oxidative stress and with evidence to influence the timing and maintenance of a viable pregnancy include pregnancy complications (e.

Oxidative stress and antioxidants: exposure and impact on female fertility.

Background: Reproductive failure is a significant public health concern. Although relatively little is known about factors affecting fertility and early pregnancy loss, a growing body of literature suggests that environmental and lifestyle factors play an important role. There is sufficient evidence to hypothesize that diet, particularly its constituent antioxidants, and oxidative stress (OS) may influence the timing and maintenance of a viable pregnancy.

Urodynamic leak point pressures weakly correlate with subjective urinary incontinence severity.

Objective: To evaluate preoperative abdominal leak point pressures (ALPP) with pre- and postoperative Incontinence Severity Index (ISI) scores.

Methods: A review of women who underwent a midurethral sling procedure between August 2004 and April 2006 was conducted. Eligible women completed preoperative urodynamic testing with ALPP determination and subjective incontinence severity assessment using the ISI before and 6 weeks after surgery.

Optimizing the number of cleavage stage embryos to transfer on day 3 in women 38 years of age and older: a Society for Assisted Reproductive Technology database study.

Objective: To determine the optimal number of day 3 embryos to transfer in women >or=38 years by conducting an evidence-based evaluation.

Design: Retrospective analysis of 2000-2004 national SART data.

Setting: National writing group.

Optimizing the number of blastocyst stage embryos to transfer on day 5 or 6 in women 38 years of age and older: a Society for Assisted Reproductive Technology database study.

Objective: To develop evidence-based recommendations for the optimum numbers of blastocyst stage embryos to transfer in women >or=38 years old.

Design: Retrospective analysis of national Society for Assisted Reproductive Technology data from 2000 to 2004.

Setting: National writing group.

Assessing quality obstetrical care: development of standardized measures.

Background: No nationally accepted set of quality indicators exists in obstetrics. A set of 10 outcome measures and three quality improvement tools was developed as part of a study evaluating the effects of teamwork on obstetric care in 15 institutions and > 28,000 patients. Each outcome was assigned a severity weighting score.

Effects of teamwork training on adverse outcomes and process of care in labor and delivery: a randomized controlled trial.

Objective: To evaluate the effect of teamwork training on the occurrence of adverse outcomes and process of care in labor and delivery.

Methods: A cluster-randomized controlled trial was conducted at seven intervention and eight control hospitals. The intervention was a standardized teamwork training curriculum based on crew resource management that emphasized communication and team structure.

Impact of subgroup analysis on estimates of infertility.

Conclusions regarding estimates of infertility may reflect study bias based on the definition of infertility used. Careful consideration of how the infertile population is defined, as well its use in subgroup analysis that may not be generalizable to the population of infertile women as a whole, is needed.

Circulating angiogenic proteins in trisomy 13.

Objective: Women who are carrying a trisomy 13 fetus are more prone to develop preeclampsia. Excess circulating soluble fms-like tyrosine kinase-1 has been implicated recently in the pathogenesis of preeclampsia. Since the fms-like tyrosine kinase-1/soluble fms-like tyrosine kinase-1 gene is located on chromosome 13q12, we hypothesized that the extra copy of this gene in trisomy 13 may lead to excess circulating soluble fms-like tyrosine kinase-1, reduced free placental growth factor level, and increased soluble fms-like tyrosine kinase-1/placental growth factor ratio.

One last chance for pregnancy: a review of 2,705 in vitro fertilization cycles initiated in women age 40 years and above.

Objective: To describe live birth rates and predictors of success in 1-year age increments for women > or =40 years when initiating assisted reproductive technologies (ART).

Design: Retrospective database analysis.

Setting: A large university-affiliated infertility center.

Issues in the reporting of epidemiological studies: a survey of recent practice.

Objectives: To review current practice in the analysis and reporting of epidemiological research and to identify limitations.

Design: Examination of articles published in January 2001 that investigated associations between risk factors/exposure variables and disease events/measures in individuals.

Setting: Eligible English language journals including all major epidemiological journals, all major general medical journals, and the two leading journals in cardiovascular disease and cancer.