Impact of micronised progesterone and medroxyprogesterone acetate in combination with transdermal oestradiol on cardiovascular markers in women diagnosed with premature ovarian insufficiency or an early menopause: a randomised pilot trial.

Objective: To compare the difference between micronised progesterone (MP) and medroxyprogesterone acetate (MPA) in combination with transdermal oestradiol (t-E) on cardiovascular disease (CVD) risk markers in women diagnosed with an early menopause and premature ovarian insufficiency (EMPOI).

Background: The European Society for Cardiology has identified carotid femoral pulse wave velocity (cfPWV) as the gold standard cardiogenic biomarker for risk stratification of arterial disease. Menopause has been shown to augment the age-dependent increase in arterial stiffness, with hormone replacement therapy (HRT) being the mainstay of management of women diagnosed with EMPOI.

The effect of micronized progesterone and medroxyprogesterone acetate in combination with transdermal estradiol on hemostatic biomarkers in postmenopausal women diagnosed with POI and early menopause: a randomized trial.

Objective: To compare the impact of micronized progesterone (MP) or medroxyprogesterone acetate (MPA) in combination with transdermal estradiol (t-E2) on traditional coagulation factors and thrombin generation parameters in postmenopausal women diagnosed with premature ovarian insufficiency or early menopause.

Method: Randomized prospective trial conducted in women diagnosed with premature ovarian insufficiency or early menopause and an intact uterus, recruited over 28 months. All participants were prescribed t-E2 and randomized to either cyclical MP or MPA using a web-based computer randomization software, Graph Pad.

Socioeconomic status and fertility treatment outcomes in high-income countries: a review of the current literature.

The association between socioeconomic status and fertility is a subject that has received much attention. Yet, little is known as to whether the socioeconomic status has an impact on the outcomes of fertility treatment. This systematic review aims to assess any possible relationship between socioeconomic deprivation and treatment outcomes.

A direct comparison of women's perceptions and acceptability of micronised progesterone and medroxyprogesterone acetate in combination with transdermal oestradiol in the management of young postmenopausal women, under 45 years of age.

Objective: To assess the acceptability and perception of postmenopausal women, to two different hormone replacement therapy regimens, in relation to the control of their symptoms and development of adverse effects.

Study Design: Prospectively recruited postmenopausal women, <45 years, were randomised to one of two treatment arms for 12-months: cyclical micronised progesterone or medroxyprogesterone acetate in combination with transdermal oestradiol. A self-reported questionnaire with matrix rating scales was completed and repeated after 3, 6 and 12-months.

Is the clinician an independent variable in embryo transfer outcomes under standardized direct and indirect supervision? A 5-year observational cohort study.

To compare the cumulative pregnancy rate (CPR) for experienced clinicians and trainees naive to the skill of embryo transfer (ET) during an assisted reproductive treatment (ART) cycle. To establish the minimum number of procedures required to achieve consistent outcomes. A non-interventional retrospective observational cohort study looking at all consecutive ETs undertaken over a 5-year study period.

Fertility desires, choice of hormone replacement and the effect of length of time since menopause on bone density in women with premature ovarian insufficiency: a review of 223 consecutive new referrals to a tertiary centre.

Premature ovarian insufficiency can have significant implications for the affected women. This review assesses the fertility desires, choice of hormone replacement, and the effect of time since menopause on the bone density of these women. This is a retrospective analysis of 223 consecutive new referrals.

A cross-sectional national questionnaire survey assessing the clinical attitudes of members of the British Menopause Society to the management of women with premature ovarian insufficiency.

Objective: To explore the current clinical attitudes of members of the British Menopause Society to the management of premature ovarian insufficiency.

Design: An electronic cross-sectional questionnaire survey.

Setting: Members of the British Menopause Society.

A randomised controlled trial comparing the effects of micronized progesterone to medroxyprogesterone acetate on cardiovascular health, lipid metabolism and the coagulation cascade in women with premature ovarian insufficiency: study protocol and review of the literature.

Premature ovarian insufficiency (POI) can have significant health implications for the affected patient population, but remains a largely under researched area. There is lack of evidence from randomised controlled trials to guide clinical practice, regarding the optimal hormone replacement therapy regimens, dose and route of administration. Furthermore, little research has addressed the effect of the various progestogens used on health parameters in women with POI.

Sperm donor recruitment, attitudes and provider practices--5 years after the removal of donor anonymity.

Study Question: Has the change in donor anonymity legislation in UK affected the recruitment of men wanting to be sperm donors and also affected the attitudes of the practitioners who provide donor sperm treatment?

Summary Answer: We have performed fewer IUI and IVF treatments using donor sperm following the change in legislation in April 2005 than before. However, we have seen an overall increase in men wanting to donate their sperm, including a small increase in men from ethnic minorities.

What Is Known Already: Sweden, which removed donor anonymity in 1985, had an initial drop in men wanting to donate and then 10 years later started to have an increase.

Large loop excision of transformation zone and cervical length in the prediction of spontaneous preterm delivery.

Objectives: To investigate the association between previous large loop excision of transformation zone (LLETZ) and risk for subsequent spontaneous preterm delivery (sPD) and whether this effect is reflected in the measurement of cervical length at mid-gestation.

Design And Setting: A secondary analysis of data from women recruited for clinical trials of interventions to prevent preterm labour.

Population: A total of 26,867 women with singleton pregnancies attending for routine antenatal care.

Contraception and medical gynaecology for HIV-positive women in a one-stop clinic.

HIV-positive women may be reluctant to attend gynaecology or family planning clinics for fear of divulging their condition. Therefore, a referral clinic was opened within the HIV clinic. Retrospective case-note reviews of 197 new patients revealed 109 with a variety of medical gynaecology conditions (menorrhagia being the commonest) and 88 sought contraception.

Outcome analysis of 4 years' follow-up of patients referred for colposcopy with one smear showing mild dyskaryosis.

Objective: To assess the 4-year outcome of patients after one smear showing mild dyskaryosis with respect to smear regression rate, prevalence of cervical intraepithelial neoplasia (CIN) and the effect of age.

Methods: Retrospective analysis of patients diagnosed with initial mildly dyskaryotic smear during the year 2000 with a follow-up period of 48 months. These women had not had any previous abnormal smears.

A comparative study of glycodelin concentrations in uterine flushings in women with subseptate uteri, history of unexplained recurrent miscarriage and healthy controls.

Objective: To compare the concentration of glycodelin in uterine flushing at the implantation window obtained from women with subseptate uteri, women with a history of recurrent first trimester miscarriage and fertile controls.

Study Design: Glycodelin concentration was assessed using Enzyme Linked Immunohistochemistry (ELISA) at The Early Pregnancy & Gynaecology Assessment Unit, King's College Hospital, London, England. Eight women with a subseptate uterus, 20 women with a history of unexplained recurrent first trimester miscarriage and 16 fertile controls had uterine cavity flushing, for glycodelin concentration, done 7 days after the luteinising hormone surge.

Prospective evaluation of three different models for the pre-operative diagnosis of ovarian cancer.

Objective: To test the accuracy of the risk of malignancy index, the revised risk of malignancy index and Tailor's regression model to diagnose malignancy in women with known adnexal masses.

Design: Prospective collaborative study.

Setting: Gynaecology Assessment Unit, Department of Obstetrics and Gynaecology, King's College Hospital, London.

A comparison of 25 mg and 50 mg oestradiol implants in the control of climacteric symptoms following hysterectomy and bilateral salpingo-oophorectomy.

Objectives: 1. To compare the effects of 25 mg and 50 mg oestradiol implants on serum follicle stimulating hormone and oestradiol levels; and 2. to assess the relationship of the dose of oestradiol implant and serum oestradiol on the effectiveness and duration of climacteric symptom control.

Prospective evaluation of logistic regression models for the diagnosis of ovarian cancer.

Objective: To test the accuracy of three logistic regression models in diagnosing malignancy in women with adnexal masses.

Methods: This was a prospective collaborative study. Women were recruited from three hospitals and all assessments were performed at the Gynaecology Ultrasound Unit, King's College Hospital.

The diagnostic value of endometrial thickness and volume measurements by three-dimensional ultrasound in patients with postmenopausal bleeding.

We compared endometrial thickness and volume in patients with postmenopausal bleeding, and examined the value of each parameter in differentiating between benign and malignant endometrial pathology. A total of 103 patients with a history of postmenopausal bleeding were recruited into the study. Patients who were taking hormone replacements therapy or other hormonal preparations with a known effect on the endometrium were excluded.

Bone loss after hysterectomy with ovarian conservation.

Objective: To examine the long-term effects of hysterectomy with conservation of the ovaries on bone density of the lumbar spine and proximal femur.

Methods: A cross-sectional study of the bone density of 40 postmenopausal women who had undergone hysterectomy with ovarian conservation before menopause compared with a matched group of 40 women who had not had hysterectomy. The 40 women who had undergone hysterectomy were also compared with a control population, using multiple linear regression analysis.

Type III collagen content in the skin of postmenopausal women receiving oestradiol and testosterone implants.

Objective: To investigate the effect of subcutaneous oestradiol and testosterone on the proportion of type III collagen in the skin of postmenopausal women.

Design: A cross sectional comparison.

Setting: Dulwich Hospital menopause clinic.