Cost-effectiveness analysis comparing continuation of assisted reproductive technology with conversion to intrauterine insemination in patients with low follicle numbers.

Objective: To compare the cost effectiveness of proceeding with oocyte retrieval vs. converting to intrauterine insemination (IUI) in patients with ≤4 mature follicles during assisted reproductive technology (ART) cycles.

Design: Probabilistic decision analysis.

Biological variability in serum anti-Müllerian hormone throughout the menstrual cycle in ovulatory and sporadic anovulatory cycles in eumenorrheic women.

Study Question: Does serum anti-Müllerian hormone (AMH) vary significantly throughout both ovulatory and sporadic anovulatory menstrual cycles in healthy premenopausal women?

Summary Answer: Serum AMH levels vary statistically significantly across the menstrual cycle in both ovulatory and sporadic anovulatory cycles of healthy eumenorrheic women.

What Is Known Already: Studies to date evaluating serum AMH levels throughout the menstrual cycle have conflicting results regarding intra-woman cyclicity. No previous studies have evaluated an association between AMH and sporadic anovulation.

Cadmium and Reproductive Health in Women: A Systematic Review of the Epidemiologic Evidence.

An evolving body of evidence supports that cadmium, a non-essential heavy metal, may be associated with multiple adverse women's reproductive health outcomes. Our objective was to conduct a systematic review of epidemiologic studies that evaluated cadmium exposure and the following reproductive health outcomes: puberty/menarche, fertility, time to pregnancy, pregnancy loss, preeclampsia, endometriosis, uterine leiomyoma, and menopause. Twenty-two studies were identified based upon our search criteria.

Assessment of anovulation in eumenorrheic women: comparison of ovulation detection algorithms.

Objective: To compare previously used algorithms to identify anovulatory menstrual cycles in women self-reporting regular menses.

Design: Prospective cohort study.

Setting: Western New York.

Lipid concentrations and couple fecundity: the LIFE study.

Context: A role of lipids in human fecundity is hypothesized as cholesterol is the main substrate for steroid synthesis and has also been shown to affect the hormonal milieu and steroidogenesis in both men and women.

Objective: The objective of the study was to evaluate the association between male and female serum lipid concentrations and time to pregnancy (TTP).

Design/setting: A population-based prospective cohort study recruiting couples from 16 counties in Michigan and Texas (2005-2009) using sampling frameworks allowing for identification of couples planning pregnancy in the near future.

Reproductive impact of MRI-guided focused ultrasound surgery for fibroids: a systematic review of the evidence.

Purpose Of Review: Magnetic-resonance-guided focused ultrasound surgery (MRgFUS) is a minimally invasive technique for the treatment of uterine fibroids. The purpose of this review is to highlight the impact of MRgFUS on fertility and reproductive outcomes.

Recent Findings: The role of MRgFUS in the treatment of fibroids has been evolving since its introduction in 2004.

Preconception low-dose aspirin and pregnancy outcomes: results from the EAGeR randomised trial.

Background: Preconception-initiated low-dose aspirin might positively affect pregnancy outcomes, but this possibility has not been adequately assessed. Our aim was to investigate whether low-dose aspirin improved livebirth rates in women with one to two previous pregnancy losses.

Methods: In this multicentre, block-randomised, double-blind, placebo-controlled trial, women aged 18-40 years who were attempting to become pregnant were recruited from four medical centres in the USA.

Association of cadmium, lead and mercury with paraoxonase 1 activity in women.

Background: The activity of paraoxonase 1 (PON1), an antioxidant enzyme whose polymorphisms have been associated with cancer risk, may be associated with metals exposure.

Objective: To evaluate PON1 activity in relation to cadmium, lead, and mercury levels in healthy, premenopausal women.

Methods: Women from upstate New York were followed for ≥ two menstrual cycles.

Increased androgen, anti-Müllerian hormone, and sporadic anovulation in healthy, eumenorrheic women: a mild PCOS-like phenotype?

Context: Hyperandrogenism is a hallmark of polycystic ovary syndrome (PCOS) in women with irregular menses, yet the relationship between androgens and ovarian dysfunction remains poorly understood in eumenorrheic women.

Objective: The objective of the study was to evaluate whether sporadic anovulation was associated with higher T and anti-müllerian hormone (AMH; marker of ovarian follicle count) concentrations in eumenorrheic women.

Design: This was a prospective cohort study from 2005 to 2007.

Luteal phase deficiency in regularly menstruating women: prevalence and overlap in identification based on clinical and biochemical diagnostic criteria.

Context: Although adequate luteal hormone production is essential for establishing pregnancy, luteal phase deficiency (LPD) is poorly characterized among eumenorrheic women.

Objective: We assessed the prevalence and overlap of two established LPD diagnostic criteria: short luteal phase duration less than10 days (clinical LPD) and suboptimal luteal progesterone of 5 ng/mL or less (biochemical LPD) and their relationship with reproductive hormone concentrations.

Design, Setting, And Participants: We conducted a prospective study in western New York (2005-2007) following 259 women, aged 18-44 years, for up to two menstrual cycles.

Lipid concentrations and semen quality: the LIFE study.

The decline in sperm count rates over the last 50 years appears to parallel the rising prevalence of obesity. As lipid levels are strongly associated with obesity, high lipids levels or hyperlipidaemia may thus play an important role in the decline in fertility in addition to other environmental or lifestyle factors. The objective of this population based cohort study was to evaluate the association between men's serum lipid concentrations and semen quality parameters among 501 male partners of couples desiring pregnancy and discontinuing contraception.

Urinary cytokine and chemokine profiles across the menstrual cycle in healthy reproductive-aged women.

Objective: To assess the utility of urinary cytokines for monitoring reproductive function by considering detection, variation across the menstrual cycle, and relations with hormones.

Design: Longitudinal cohort study.

Setting: Academic institution.

Higher urinary lignan concentrations in women but not men are positively associated with shorter time to pregnancy.

Phytoestrogens have been associated with subtle hormonal changes, although effects on fecundity are unknown. Our objective was to evaluate the association between male and female urinary phytoestrogen (isoflavone and lignan) concentrations and time to pregnancy (TTP) in a population-based cohort of 501 couples desiring pregnancy and discontinuing contraception. Couples were followed for 12 mo or until pregnancy.

The effect of physical activity across the menstrual cycle on reproductive function.

Purpose: To evaluate the association between physical activity (PA) across the menstrual cycle and reproductive function.

Methods: The BioCycle Study (2005-2007) followed 259 healthy premenopausal women not using hormonal contraceptives for up to two menstrual cycles (N = 509 cycles). Serum leptin, estradiol, progesterone, luteinizing hormone, follicle-stimulating hormone, and testosterone were measured five to eight times per cycle.

Serum leptin levels and reproductive function during the menstrual cycle.

Objective: The purpose of this study was to investigate the role of leptin on reproductive hormones and ovulation.

Study Design: The BioCycle Study (2005-2007) followed 259 healthy premenopausal women not using hormonal contraceptives for ≤2 menstrual cycles (n = 509 cycles). Serum leptin, estradiol, progesterone, luteinizing hormone (LH), follicle-stimulating hormone, and testosterone were measured ≤8 times per cycle.

A randomised trial to evaluate the effects of low-dose aspirin in gestation and reproduction: design and baseline characteristics.

Background: Low-dose aspirin (LDA) has been proposed to improve pregnancy outcomes in couples experiencing recurrent pregnancy loss. However, results from studies of LDA on pregnancy outcomes have been inconsistent, perhaps because most studies evaluated LDA-initiated post-conception. The purpose of the Effects of Aspirin in Gestation and Reproduction (EAGeR) trial was to determine whether preconception-initiated LDA improves livebirth rates in women with one to two prior losses.

Failure to consider the menstrual cycle phase may cause misinterpretation of clinical and research findings of cardiometabolic biomarkers in premenopausal women.

Biomarker assessment plays a critical role in the study and prevention of disease. However, variation in biomarkers attributable to the menstrual cycle in premenopausal women may impair understanding the role of certain biomarkers in disease development and progression. Thus, in light of the recently increasing evidence of menstrual cycle variability in multiple cardiometabolic biomarkers, a reexamination of approaches for appropriately studying and diagnosing cardiovascular disease in premenopausal women is warranted.

Customized large-for-gestational-age birthweight at term and the association with adverse perinatal outcomes.

Objective: Using a cohort of 110,447 singleton, term pregnancies, we aimed to validate the previously proposed customized standard of large-for-gestational-age (LGA) birthweight, derive an additional customized LGA model excluding maternal weight, and evaluate the association between differing definitions of customized LGA and perinatal morbidities.

Study Design: Three customized LGA classifications, in addition to a population-based 90th percentile, were made according to the principals described by Gardosi: (1) customized LGA using Gardosi's previously published coefficients (LGA-Gardosi), (2) customized LGA using coefficients derived by a similar method but from our larger cohort, and (3) derived without customization for maternal weight. Associations between the LGA classifications and various perinatal morbidity outcomes were evaluated.

At the borders of medical reasoning: aetiological and ontological challenges of medically unexplained symptoms.

Medically unexplained symptoms (MUS) remain recalcitrant to the medical profession, proving less suitable for homogenic treatment with respect to their aetiology, taxonomy and diagnosis. While the majority of existing medical research methods are designed for large scale population data and sufficiently homogenous groups, MUS are characterised by their heterogenic and complex nature. As a result, MUS seem to resist medical scrutiny in a way that other conditions do not.

Usual dietary isoflavone intake and reproductive function across the menstrual cycle.

Objective: To assess the association of total isoflavone intake with ovulatory function, including sporadic anovulation in healthy premenopausal women.

Design: Prospective cohort study.

Setting: University.

Serum Retinol and Carotenoids in Association with Biomarkers of Insulin Resistance among Premenopausal Women.

Objective: The aim of this study was to investigate how serum retinol and carotenoids (-carotene, -cryptoxanthin, lutein/zeaxanthin, lycopene) are associated with biomarkers of insulin resistance.

Research Methods And Procedures: The BioCycle Study (2005-2007) is a prospective cohort of 259 healthy premenopausal women. Fasting serum samples were collected at up to sixteen clinic visits, from which retinol, carotenoids, insulin, glucose, and sex hormone-binding globulin (SHBG) were measured.

The association between a medical history of depression and gestational diabetes in a large multi-ethnic cohort in the United States.

Background: Both major depression and gestational diabetes mellitus (GDM) are prevalent among women of reproductive age. Our objective was to determine whether a medical history of depression is related to subsequent development of GDM.

Methods: The Consortium on Safe Labor was a US retrospective cohort study of 228,562 births between 2002 and 2008.

Emergence of MD type infectious hematopoietic necrosis virus in Washington State coastal steelhead trout.

Infectious hematopoietic necrosis virus (IHNV) occurs in North America as 3 major phylogenetic groups designated U, M, and L. In coastal Washington State, IHNV has historically consisted of U genogroup viruses found predominantly in sockeye salmon Oncorhynchus nerka. M genogroup IHNV, which has host-specific virulence for rainbow and steelhead trout O.

Habitual dietary isoflavone intake is associated with decreased C-reactive protein concentrations among healthy premenopausal women.

Isoflavones have been associated with lower cardiovascular disease risk, but existing research focused on very high isoflavone intakes, as seen in Asian populations, as well as on risk factor reductions primarily in postmenopausal women. We investigated whether habitual low isoflavone intake among premenopausal women was associated with serum C-reactive protein (CRP) concentration, a commonly used biomarker associated with prediction of cardiovascular disease risk in healthy women. Between 2005 and 2007, 259 healthy, regularly menstruating women were enrolled in the BioCycle Study, and followed for up to 2 menstrual cycles.

The influence of sporadic anovulation on hormone levels in ovulatory cycles.

Study Question: Do ovulatory hormone profiles among healthy premenopausal women differ between women with and without sporadic anovulation?

Summary Answer: Women with one anovulatory cycle tended to have lower estradiol, progesterone and LH peak levels during their ovulatory cycle.

What Is Known Already: Anovulation occurs sporadically in healthy premenopausal women, but the influence of hormones in a preceding cycle and the impact on a subsequent cycle's hormone levels is unknown.

Study Design, Size, Duration: The BioCycle Study was a prospective cohort including 250 healthy regularly menstruating women, 18-44 years of age, from Western New York with no history of menstrual or ovulation disorders.