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Showing 201 - 316 of 316 Journals sorted by number of followers
Fisheries and Aquatic Sciences     Open Access   (Followers: 3, SJR: 0.199, CiteScore: 0)
Cancers of the Head & Neck     Open Access   (Followers: 3)
Clinical and Translational Allergy     Open Access   (Followers: 3, SJR: 1.425, CiteScore: 4)
J. of Clinical Movement Disorders     Open Access   (Followers: 3)
Advances in Rheumatology     Open Access   (Followers: 3)
J. of Animal Science and Technology     Open Access   (Followers: 3)
Flavour     Open Access   (Followers: 3)
Biomarker Research     Open Access   (Followers: 3)
Cancer Imaging     Open Access   (Followers: 3, SJR: 1.012, CiteScore: 3)
Inflammation and Regeneration     Open Access   (Followers: 2)
Asthma Research and Practice     Open Access   (Followers: 2)
Public Health Reviews     Open Access   (Followers: 2, SJR: 0.454, CiteScore: 1)
Intl. J. of Retina and Vitreous     Open Access   (Followers: 2)
Biology of Sex Differences     Open Access   (Followers: 2, SJR: 1.902, CiteScore: 4)
Tropical Diseases, Travel Medicine and Vaccines     Open Access   (Followers: 2)
J. of Angiogenesis Research     Open Access   (Followers: 2)
Animal Biotelemetry     Open Access   (Followers: 2, SJR: 1.067, CiteScore: 2)
BMC Materials     Open Access   (Followers: 2)
Urban Transformations     Open Access   (Followers: 2)
CABI Agriculture and Bioscience     Open Access   (Followers: 2)
J. of Biomedical Semantics     Open Access   (Followers: 2, SJR: 0.952, CiteScore: 2)
One Health Outlook     Open Access   (Followers: 2)
NeuroCommons     Open Access   (Followers: 2)
Signals     Open Access   (Followers: 2)
Contraception and Reproductive Medicine     Open Access   (Followers: 2)
Fertility Research and Practice     Open Access   (Followers: 2)
Chinese Medicine     Open Access   (Followers: 2, SJR: 0.57, CiteScore: 2)
J. of Inflammation     Open Access   (Followers: 2, SJR: 1.101, CiteScore: 3)
Molecular Neurodegeneration     Open Access   (Followers: 2, SJR: 3.418, CiteScore: 7)
Fluids and Barriers of the CNS     Open Access   (Followers: 2, SJR: 2.054, CiteScore: 5)
Cell Communication and Signaling     Open Access   (Followers: 2, SJR: 2.211, CiteScore: 4)
BMC Pharmacology     Open Access   (Followers: 2)
Cancer Nanotechnology     Open Access   (Followers: 2, SJR: 1.168, CiteScore: 4)
Neural Development     Open Access   (Followers: 2, SJR: 1.821, CiteScore: 2)
J. of Neuroinflammation     Open Access   (Followers: 2, SJR: 2.336, CiteScore: 5)
J. of Experimental & Clinical Cancer Research     Open Access   (Followers: 2, SJR: 2, CiteScore: 6)
Particle and Fibre Toxicology     Open Access   (Followers: 2, SJR: 2.253, CiteScore: 8)
Hereditary Cancer in Clinical Practice     Open Access   (Followers: 2, SJR: 0.848, CiteScore: 2)
BMC Proceedings     Full-text available via subscription   (Followers: 2, SJR: 0.302, CiteScore: 1)
Italian J. of Pediatrics     Open Access   (Followers: 2, SJR: 0.685, CiteScore: 2)
Reproductive Health     Open Access   (Followers: 2, SJR: 1.228, CiteScore: 2)
Plant Methods     Open Access   (Followers: 2, SJR: 1.885, CiteScore: 4)
Acta Neuropathologica Communications     Open Access   (Followers: 1, SJR: 2.683, CiteScore: 5)
Canine Genetics and Epidemiology     Open Access   (Followers: 1)
Cerebellum & Ataxias     Open Access   (Followers: 1)
Infectious Diseases of Poverty     Open Access   (Followers: 1, SJR: 1.212, CiteScore: 3)
Longevity & Healthspan     Open Access   (Followers: 1)
J. of Environmental Health Science & Engineering     Open Access   (Followers: 1, SJR: 0.802, CiteScore: 3)
Translational Neurodegeneration     Open Access   (Followers: 1, SJR: 1.901, CiteScore: 5)
Eye and Vision     Open Access   (Followers: 1)
Cancer Convergence     Open Access   (Followers: 1)
BMC Zoology     Open Access   (Followers: 1)
Bioelectronic Medicine     Open Access   (Followers: 1)
European J. of Medical Research     Open Access   (Followers: 1, SJR: 0.55, CiteScore: 1)
Scoliosis and Spinal Disorders     Open Access   (Followers: 1, SJR: 0.843, CiteScore: 2)
Women's Midlife Health     Open Access   (Followers: 1)
COPD Research and Practice     Open Access   (Followers: 1, SJR: 0.755, CiteScore: 2)
Genes and Environment     Open Access   (Followers: 1, SJR: 0.516, CiteScore: 1)
Gynecologic Oncology Research and Practice     Open Access   (Followers: 1)
Pilot and Feasibility Studies     Open Access   (Followers: 1)
Investigative Genetics     Open Access   (Followers: 1, SJR: 1.809, CiteScore: 3)
J. of Venomous Animals and Toxins including Tropical Diseases     Open Access   (Followers: 1, SJR: 0.573, CiteScore: 2)
Orphanet J. of Rare Diseases     Open Access   (Followers: 1, SJR: 1.413, CiteScore: 3)
Skeletal Muscle     Open Access   (Followers: 1, SJR: 2.32, CiteScore: 4)
J. of Medical Case Reports     Open Access   (Followers: 1, SJR: 0.331, CiteScore: 1)
Head & Face Medicine     Open Access   (Followers: 1, SJR: 0.62, CiteScore: 2)
BMC Ear, Nose and Throat Disorders     Open Access   (Followers: 1, SJR: 0.653, CiteScore: 2)
Cell Division     Open Access   (Followers: 1, SJR: 2.445, CiteScore: 4)
Respiratory Research     Open Access   (Followers: 1, SJR: 1.644, CiteScore: 4)
Proteome Science     Open Access   (Followers: 1, SJR: 0.792, CiteScore: 2)
Theoretical Biology and Medical Modelling     Open Access   (Followers: 1, SJR: 0.783, CiteScore: 2)
Biological Research     Open Access   (Followers: 1, SJR: 0.654, CiteScore: 2)
Hereditas     Open Access   (Followers: 1, SJR: 0.278, CiteScore: 1)
Thyroid Research     Open Access   (Followers: 1, SJR: 0.329, CiteScore: 1)
World Allergy Organization J.     Open Access   (Followers: 1, SJR: 1.936, CiteScore: 6)
World J. of Surgical Oncology     Open Access   (Followers: 1, SJR: 0.688, CiteScore: 2)
J. of Cardiovascular Magnetic Resonance     Open Access   (Followers: 1, SJR: 2.292, CiteScore: 5)
Molecular Cytogenetics     Open Access   (Followers: 1, SJR: 0.623, CiteScore: 1)
Measurement Instruments for the Social Sciences     Open Access  
BMC Energy     Open Access  
Sustainable Earth     Open Access  
BMC Biomedical Engineering     Open Access  
BMC Chemical Engineering     Open Access  
ExRNA     Open Access  
J. of Cotton Research     Open Access  
Biomedical Dermatology     Open Access  
Cancer Communications     Open Access  
Diagnostic and Prognostic Research     Open Access  
Porcine Health Management     Open Access  
Neurovascular Imaging     Open Access  
NeuroMetals     Open Access  
Chinese Neurosurgical J.     Open Access  
Cardio-Oncology     Open Access  
Neuropsychiatric Electrophysiology     Open Access  
Research Involvement and Engagement     Open Access  
J. of Biological Research - Thessaloniki     Open Access   (SJR: 0.32, CiteScore: 2)
J. of Therapeutic Ultrasound     Open Access   (SJR: 0.906, CiteScore: 3)
Cilia     Open Access   (SJR: 0.732, CiteScore: 1)
Israel J. of Health Policy Research     Open Access   (SJR: 0.488, CiteScore: 1)
Vascular Cell     Open Access   (SJR: 1.349, CiteScore: 4)
Clinical Sarcoma Research     Open Access  
Environmental Microbiome     Open Access   (SJR: 0.768, CiteScore: 2)
Mobile DNA     Open Access   (SJR: 3.783, CiteScore: 5)
J. of Neurodevelopmental Disorders     Open Access   (SJR: 1.71, CiteScore: 4)
Biological Procedures Online     Open Access   (SJR: 1.352, CiteScore: 4)
Basic and Clinical Andrology     Open Access   (SJR: 0.564, CiteScore: 2)
PMC Biophysics     Open Access  
Fibrogenesis & Tissue Repair     Open Access   (SJR: 1.531, CiteScore: 4)
J. of Ovarian Research     Open Access   (SJR: 1.008, CiteScore: 3)
Source Code for Biology and Medicine     Open Access   (SJR: 0.784, CiteScore: 2)
Retrovirology     Open Access   (SJR: 1.855, CiteScore: 3)
Lipids in Health and Disease     Open Access   (SJR: 0.915, CiteScore: 2)
J. of Negative Results in BioMedicine     Open Access   (SJR: 0.483, CiteScore: 1)
J. of Ethnobiology and Ethnomedicine     Open Access   (SJR: 0.693, CiteScore: 3)
Infectious Agents and Cancer     Open Access   (SJR: 0.855, CiteScore: 2)
Harm Reduction J.     Open Access   (SJR: 1.445, CiteScore: 3)

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Fertility Research and Practice
Number of Followers: 2  

  This is an Open Access Journal Open Access journal
ISSN (Online) 2054-7099
Published by BMC (Biomed Central) Homepage  [316 journals]
  • Congenital Zika syndrome arising from sexual transmission of Zika virus, a
           case report

    • Abstract: Background Sexual transmission of Zika virus is well documented and pregnant women are advised to abstain or use barrier protection if a sexual partner has risk for Zika infection. However, to date there has not been a documented case of the congenital Zika syndrome resulting from sexual transmission. Case presentation A 32 year-old woman who had not traveled to any area with local Zika transmission in years became pregnant via frozen embryo transfer. Her husband traveled to Haiti several times prior to embryo transfer and during the pregnancy. Neither partner was ever symptomatic. In her second trimester when recommendations were published by the Centers for Disease Control and Prevention (CDC) regarding prevention of sexual transmission during pregnancy she was counseled to abstain or use barrier protection with her partner. At delivery, the infant head circumference measured less than the first percentile. Placental samples were sent to the CDC and all were positive for Zika RNA by RT-PCR. Evaluation for other causes of microcephaly was negative. Consistent with the most up to date diagnostic parameters for congenital Zika, including viral infection of the placenta, the baby was diagnosed with congenital Zika syndrome. Conclusions Transmission via sexual contact during assisted reproductive therapies (ART) and pregnancy can result in Zika fetopathy. This case supports recommendations to counsel women undergoing ART and pregnant women to use barrier protection with partners with Zika exposure regardless of their symptoms.
      PubDate: 2019-01-03
  • ART implantation failure and miscarriage in patients with elevated
           intracellular cytokine ratios: response to immune support therapy

    • Abstract: Background The origins of adverse reproductive outcome can be multifactorial, but the contribution of the maternal immune system is considered debatable. Elevated intracellular cytokine ratios have been proposed, although not universally supported, as a marker for immunological dysfunction in implantation and early pregnancy. Poor patient selection or inadequate treatment or testing may be confounding factors. Specific immunomodulation, in carefully selected sub-populations of ART patients with poor reproductive history, despite transfer of good quality blastocysts, may potentially improve clinical outcomes. Methods Intracellular cytokine ratios (CKR) were prospectively assessed in 337 patients presenting with a history of implantation failure and/or pregnancy loss, prior to further treatment, and were found to be elevated in 150 (44.5%). Of this group, 134 agreed to initiate a standardised immunotherapy regime (nutraceuticals, prednisolone & intralipids) to evaluate the efficacy of this proposed therapy. Of the intervention population, a small cohort (n = 70) delayed commencing ART for ~ 10 weeks to assess if extended pre-treatment nutraceutical supplementation could normalise CKRs prior to starting ART, and if this conferred additional benefit. Results Baseline assessment in the intervention population (n = 134) identified 160 miscarriages from 180 total pregnancies (89% miscarriage rate, MR), conceived both spontaneously and by assisted reproduction. Post-treatment analysis of subsequent ART cycles revealed a significant improvement in both implantation (OR 3.0, 2.0–4.5) and miscarriage rates (41/97, 42.2% MR, P < 0.001). Interestingly, pre-treatment normalisation of CKRs appeared to impart marginal extra benefit prior to subsequent fertility treatment with immunotherapy. Conclusions Following immunomodulation, significant improvements in both implantation rate and miscarriage rate were seen in this poor prognosis population. This suggests a possible role for both detailed immuno-evaluation of patients with poor reproductive history with good embryo quality, and application of personalised immunotherapy regimes alongside ART in selected cases. Future randomised controlled trials are needed to definitively evaluate this potentially promising therapeutic approach.
      PubDate: 2018-10-17
  • Diagnosis and management of a heterotopic pregnancy and ruptured
           rudimentary uterine horn

    • Abstract: Background Heterotopic pregnancies implanted in a rudimentary uterine horn account for 1 in 2–3 million gestations, and confer significant risk of morbidity due to uterine rupture and hemorrhage. Case presentation A 34-year-old nullipara presented with acute pelvic pain at 17 weeks of gestation with dichorionic-diamniotic twins, one in each horn of an anomalous uterus first diagnosed in pregnancy as bicornuate. Three-dimensional ultrasound and MRI revealed myometrial disruption in the left rudimentary uterine horn, and the patient underwent an uncomplicated abdominal hemi-hysterectomy. Fourteen days later, an uncomplicated dilation and curettage was performed for a fetal anomaly in the remaining twin in the right unicornuate uterus. Conclusion This case demonstrates the utility of magnetic resonance imaging and three-dimensional ultrasound in the assessment of myometrial integrity in a gravid patient with a heterotopic pregnancy and ruptured rudimentary uterine horn. This case demonstrates the importance of pre-pregnancy diagnosis and management of mullerian anomalies.
      PubDate: 2018-09-29
  • The impact of endometrial thickness (EMT) on the day of human chorionic
           gonadotropin (hCG) administration on pregnancy outcomes: a 5-year
           retrospective cohort analysis in Malaysia

    • Abstract: Background Chances of pregnancy in relation to endometrial thickness (EMT) remain elusive albeit some literatures suggest poorer pregnancy outcomes below the threshold of 6-7 mm, notwithstanding others perceive detrimental effect at thicker EMT. We aim to examine the implication of EMT on pregnancy outcomes using a cut-off of 8 mm and further explore for any effect of ‘thick’ EMT in our patient population. Methods This was a retrospective cohort study performed for 162 women to assess the associations between EMT on the human chorionic ganadotropin (hCG) trigger day and pregnancy outcomes in infertile patients undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) and autologous fresh embryo transfer (ET) in controlled ovarian stimulation (COS) cycles under an assisted reproductive technology (ART) shared-care programme between public and private institutions from January 2012 through December 2016. The associations between pregnancy outcomes [Total Pregnancy Rate (TPR), Biochemical Pregnancy Rate (BPR), Clinical Pregnancy Rate (CPR), Ongoing Pregnancy Rate (OPR)/ Live Birth Delivery Rate (LBDR), Miscarriage Rate (MR) and Implantation Rate (IR)] and EMT (< 8 or ≥ 8 mm) on the hCG trigger day were evaluated. Besides, the associations between pregnancies outcomes with EMT ≥ 14 mm and ≥ 8 to < 14 mm were further assessed. Results We found that the ≥8 mm group had a higher TPR (55.4% vs 21.4%; p = 0.015) and CPR (52.0% vs 21.4%; p = 0.029). However, the BPR, MR, OPR/ LBDR and IR were not associated with the EMT (p > 0.05). All pregnancy outcomes were comparable for ≥14 mm and ≥ 8 to < 14 mm subgroups. Conclusions Our findings suggest that EMT < 8 mm on hCG trigger day could adversely affect TPR and CPR in infertile patients undergoing IVF/ICSI-ET. Besides, we also disprove the notion of reduced chances of pregnancy with EMT ≥ 14 mm. The findings are based on completed cycles which each has demonstrated a triple-line endometrial pattern on the hCG trigger day with fresh autologous ET consisted of high-quality morphological gradings. However, our findings are still preliminary to suggest decision for ET transfer, cycle cancellation or adjunctive therapies. Further studies with larger sample size from this geographical region are required to verify the findings.
      PubDate: 2018-08-11
  • Determinants of change in fertility pattern among women in Uganda during
           the period 2006–2011

    • Abstract: Background Studies on fertility in Uganda have attributed fertility reduction to a shift in the overall characteristics of women of reproductive age. It is not clear whether the reduction in fertility is due to changing socioeconomic and demographic characteristics over time or stems from the shifts in the reproductive behavior of women. In this paper we examine how fertility rates have changed between 2006 and 2011 and whether these changes have resulted from changing characteristics or from changing reproductive behavior of women. Methods Using the 2006 and 2011 Demographic and Health Survey data for Uganda, Multivariate Poisson Decomposition techniques were applied to evaluate observed changes in fertility. Results Changing characteristics of women aged 15–49 years significantly contributed to the overall change in fertility from 2006 to 2011. The change observed in older age at first marriage was the major contributor to the changes in fertility. The contribution that can be attributed to changes in reproductive behavior was not significant. Conclusions This study finds that the major contribution to the reduction in fertility between 2006 and 2011 was from increased education and delayed marriage among women. Continued improvement in secondary school completion, will lead to older age at first marriage and will continue to be an important factor in Uganda’s declining fertility rates.
      PubDate: 2018-06-27
  • Responses to fertility treatment among patients with cancer: a
           retrospective cohort study

    • Abstract: Background Cancer treatments have significant negative impacts on female fertility, but the impact of cancer itself on fertility remains to be clarified. While some studies have shown that compared with healthy women, those with cancer require higher doses of gonadotropins resulting in decreased oocyte yields, others have shown comparable oocyte yields between the two groups. The purpose of this study is to evaluate whether there is an association between any cancer and/or type of cancer, and response to ovarian stimulation for egg and embryo banking. Methods In this retrospective cohort study, ovarian stimulation cycles performed from June 2007 through October 2014 at a single academic medical center were reviewed to identify those undertaken for women with cancer undergoing fertility preservation (n = 147) or women with no cancer undergoing their first cycle due to male factor infertility (n = 664). Of the 147 women undergoing fertility preservation, 105 had local cancer (Stage I-III solid malignancies) and 42 had systemic cancer (hematologic or Stage IV solid malignancies). Response to ovarian stimulation was compared among these two groups and women with no cancer. Results Adjusting for age and BMI, women with systemic cancer had lower baseline antral follicle counts (AFC) than women with no cancer or local cancer. Women with systemic cancer required higher doses of FSH than women with no cancer or local cancer, and they had higher oocyte to AFC ratios than women with no cancer or local cancer, but greater odds of cycle cancellation as compared to women with no cancer or local cancer. No significant differences were observed among the three groups for duration of stimulation, number of oocytes and mature oocytes retrieved, or number of embryos created. Conclusions Women with cancer achieve similar oocyte and embryo yields as women with no cancer, although those with systemic cancer require higher FSH doses and are at greater risk of cycle cancellation.
      PubDate: 2018-04-17
  • Pyosalpinges after hysterosalpingography in a patient with lower genital
           tract infection and managed by laparoscopic surgery in a resource low
           tertiary hospital case report and literature review

    • Abstract: Background Pyosalpinges (a complication of pelvic inflammatory disease) is infection of the fallopian tubes and the morbidity associated with it has major health implications. We are reporting a case of pyosalpinges diagnosed after hysterosalpingography and managed by laparoscopic surgery at the Douala General Hospital, Cameroon. Case presentation A 29-year-old single woman, an assistant nurse of the Douala tribe in Cameroon. She is G1P0010 and came to our attention because of secondary infertility of three years duration. She has a history consistent with four lifetime sexual partners, self-medication for chlamydia trachomatis infection and induced abortion by dilatation and aspiration. Furthermore, she is HIV positive and had an ultrasound scan suggestive of bilateral hydrosalpinges. After a hysterosalpingography examination she developed painless muco-purulent vaginal discharge and bilateral adnexal tenderness on bimanual examination suggestive of pyosalpinges. Vaginal and cervical cultures isolated Ureaplasma urealyticum and Gardnerella vaginalis sensitive to ofloxacin and metronidazole, respectively. At laparoscopy, bilateral pyosalpinges, pelvic adhesions and peri-hepatic adhesions were found. Bilateral salpingectomy with adhesiolysis including lysis of perihepatic adhesions and peritoneal toileting was done. She was discharged from hospital 72 h later and her hospital stay was uneventful. She was counseled for in-vitro fertilization and to register in the national HIV treatment programme. Her husband was prescribed ofloxacin empirically. Conclusion Antimicrobial prophylaxis should be given to patients prior to HSG, especially those with a history of chlamydia or evidence of hydrosalpinges. There should also be universal STI testing in high risk and HIV positive patients or the danger for suboptimal antibiotic usage in areas where self-medication is common. In resource-low tertiary hospitals where computed tomography or magnetic resonance imaging is not readily available and/or affordable, clinical examination and pelvic ultrasound remains the key diagnostic tool. Surgical treatment is the best option for pyosalpinges and when plausible, laparoscopic surgery is the treatment of choice. Laparotomy is the mainstay in most hospitals in Cameroon. The parent of the patient did not consent to histo-pathologic examination.
      PubDate: 2018-04-13
  • Anti-oxidant mediated normalisation of raised intracellular cytokines in
           patients with reproductive failure

    • Abstract: Background Raised intracellular cytokine ratios (CKR) are proposed as a significant risk factor for adverse reproductive outcome. An elevated cytokine ratio, such as between TNFa and/or IFNg to IL-10 is associated with recurrent miscarriage (RM). The use of pharmacological immunomodulators such as TNFα inhibitors in these patients is controversial and not generally recommended due to a lack of conclusive data supporting their use. We evaluated whether the use of anti-oxidants/dietary supplements as an alternative could positively influence CKR’s in ART patients. Methods A prospective non-placebo control trial of antioxidant treatment for abnormal peripheral inflammatory cytokine ratios was performed. CKRs were assessed using flow cytometry in stimulated versus unstimulated whole blood samples in 337 IVF patients presenting with a previous history of poor outcome (RM or implantation failure). CKR’s were found to be elevated in 150/337. 70/150 patients in this elevated group agreed to a 10 week regime of Omega 3, vitamin D3, and B complex, followed by retesting to evaluate effect. Results Mean cytokine ratios significantly improved between tests. Pre-treatment TNFa:IL-10 ratio improved from 71.6 to 21.0 (p < 0.0001) and IFNg:IL-10 ratio dropped from 24.5 to 12.5 (p < 0.0001). The improved ratios were achieved primarily by an increase in IL-10 expression (P = 0.0007), but also by a moderate decrease in stimulated TNFa expression (p = 0.008). Mean IFNg expression was unchanged (p = 0.42). On an individual basis CKR levels were normalised in 43 patients, improved in 12 and remained unchanged in 15. No significant differences in improvement were found between RM and IF subgroups. Conclusions Intracellular cytokine expression levels and ratios were modifiable by the supplement regime employed. Elevated cytokine ratios have been linked with adverse reproductive outcomes, and proposed treatments have included biological immunomodulators which antagonise TNFa, but come with significant associated cost implications and more importantly, cytotoxic side-effects. A dietary regime is more patient friendly and lower risk, while still achieving a similar effect in many patients.
      PubDate: 2018-03-02
  • Characterization of reproductive endocrinology and infertility (REI)
           fellowship applicants: guiding our mentees toward success

    • Abstract: Background Advanced subspecialty training in reproductive endocrinology and infertility (REI) entails a competitive application process with many data points considered. It is not known what components weigh more heavily for applicants. Thus, we sought to study the REI fellow applicant and compare 1) those who apply but do not receive an interview, 2) those who receive an interview but do not match, and 3) those who successfully match. Methods This retrospective cohort study was conducted at a single REI fellowship program from 2013 to 2017. Academic variables assessed included standardized test scores and total number of publications listed on their curriculum vitae. Logistic regression models were constructed to determine variables that were predictive of being offered an interview in our program and of matching in any program. Results There were 270 applicants, of which 102 were offered interviews. Interviewed applicants had significantly higher mean USMLE 1 and CREOG scores, as well as total publications and total abstracts. There was no difference in Step 2 and Step 3 scores or in number of book chapters. Of those interviewed, USMLE scores remained predictive of matching in any program; however, publications and scientific abstracts were no longer predictive. Conclusions The decision to offer applicants interviews appears to be influenced by objective standardized test scores, as well as a threshold of academic productivity. These items are less predictive of matching once the interview process begins, indicating that other factors, such as performance during the interview day, may be more heavily weighted.
      PubDate: 2017-12-08
  • Intramuscular progesterone (Gestone) versus vaginal progesterone
           suppository (Cyclogest) for luteal phase support in cycles of in vitro
           fertilization–embryo transfer: patient preference and drug efficacy

    • Abstract: Background The requirement for luteal phase support (LPS) in stimulated IVF cycles is well established, however drug choice, and route of administration and duration of use are not. This report evaluates patients’ preference and satisfaction by using either vaginal or intramuscular (IM) progesterone (P) supplementation for luteal phase support after in vitro fertilization and embryo transfer (IVF-ET). Methods It is a prospective cohort study done in a reproductive and infertility unit in a tertiary care hospital from March 2013 through February 2015 for four hundred and nine patients undergoing IVF-ET. Patients were allowed to choose either vaginal or IM P for LPS. Patient preference and satisfaction, as well as differences in clinical pregnancy rates between the two groups were assessed at one or two time points throughout the study. Results There were no statistically significant differences in the patients’ characteristics and clinical outcomes between the two groups. There were 88 pregnancies (38.8%) among patients treated with vaginal p and 62 pregnancies (34%) among IM P patients. Average satisfaction score at the pregnancy test and ultrasound (U/S) visits was similar between both groups. Conclusions Patients’ satisfaction and pregnancy rates were similar between vaginal and IM P supplementation.
      PubDate: 2017-11-09
  • Fertility differential of women in Bangladesh demographic and health
           survey 2014

    • Abstract: Background The aim of this study was to examine the fertility differential of women age 15 to 49 using data from Bangladesh Demographic and Health Survey 2014- a survey of women who were born from 1963 to 1999. Methods The secondary data analysis was carried out using the BDHS 2014 in order to discuss differences in childbearing practices in Bangladesh. Descriptive statistics were used to analyze the data including education level, geographic location, and religion. A trend test used to assess the inferences. Results On average, women had 2.3 children in the BDHS 2014; more than 90% of them gave birth to at least one child by age 49 and the average age of first birth was 18 years. Fertility of women strongly differed by education (p < 0.001). The percentage of women with secondary education who had no child was 50.3% and never attended school 8.4%;those with secondary education were six times as likely as those who never attended school to have no child and this pattern was stronger among urban compared with rural women. Conclusions Fertility differential becomes robust as education increases. Women’s fertility is also related to religion and residence, but these factors were not strongly related as those educational attainments.
      PubDate: 2017-10-13
  • Fertility with early reduction of ovarian reserve: the last straw that
           breaks the Camel’s back

    • Abstract: Diminished fertility and poor ovarian response pose a conundrum to the experts in the field of reproductive medicine. There is limited knowledge about the risk factors of diminished ovarian reserve other than the iatrogenic ones. One of the leading causes of infertility in women today is diminished ovarian reserve (DOR). DOR is characterized by a low number of eggs in a woman’s ovaries and/or with poor quality of the remaining eggs, which boils down to impaired development of the existing eggs, even with assisted reproductive techniques. A good number of such women with low ovarian reserve may conceive with their own eggs, if they are given individualized treatment that is tailored for their profile. Such patients should be counseled appropriately for an aggressive approach towards achieving fertility. The sooner the treatment is started, the better the chances of pregnancy.
      PubDate: 2017-10-11
  • Vitamin D binding protein is lower in infertile patients compared to
           fertile controls: a case control study

    • Abstract: Background The importance of vitamin D in general health as well as in human reproductive success has been an area of focus. A better understanding of vitamin D metabolism, particularly vitamin D binding protein, is important when elucidating this relationship. Methods This case control trial seeks to characterize vitamin D metabolism in infertile patients undergoing natural cycle IVF as compared to normally cycling premenopausal women with proven fertility matched for age and body mass index (BMI). A total of 68 subjects were examined; 39 were infertile premenopausal women and 29 were regularly cycling fertile controls. Their 25-hydroxy vitamin D (25OHD), vitamin D binding protein (DBP), and albumin were measured and free and bioavailable 25OHD calculated. Between group comparisons were conducted with an unpaired t-test. A stepwise regression using age, BMI, 25OHD, estradiol & albumin in the model were used to determine predictors of DBP. Results Age, BMI, and total 25OHD did not differ between the two groups. However, vitamin D binding protein, free and bioavailable vitamin D were significantly different in the infertile patients as compared to the regularly cycling fertile controls (p < 0.01). Stepwise Regression using age, BMI, 25OHD, estradiol & albumin in the model showed that only albumin was a predictor of DBP (β-coefficient − 0.310; p = 0.01). Conclusion The implications of lower vitamin D binding protein associated with infertility is not clear from this pilot study, and requires further study.
      PubDate: 2017-10-10
  • Magnetic resonance imaging performance for diagnosis of ovarian torsion in
           pregnant women with stimulated ovaries

    • Abstract: Background To determine if asymmetric ovarian edema on non-contrast MRI can be used to distinguish torsed from non-torsed stimulated ovaries in pregnant women. Methods In this retrospective study, our radiology database was searched for women who were pregnant and who had undergone ovarian stimulation and underwent MRI abdomen/pelvis from 1/2000–12/2012. At our institution, ultrasound is typically performed as a first line study for pregnant women with pelvic pain, with MR for those patients with indeterminate findings. 64 pregnant women (gestational age range 3–37 weeks) were included. MRI indication, prospective interpretation, operative diagnosis, and follow-up were recorded. Two blinded radiologists (with a third radiologist tie-breaker) independently measured and described the ovaries, including the likelihood of torsion. If one or both ovaries/adnexa had an underlying lesion such as a dermoid, cystadenoma, or abscess, the patient was excluded from size and signal intensity comparison (N = 14). For the remaining 50 women, comparison was made of the ovaries in women with normal ovaries (N = 27), stimulated ovaries without torsion (N = 11), non-stimulated ovaries with torsion (N = 3), and stimulated ovaries with torsion (N = 3). Patients with asymmetric ovarian edema without stimulation or torsion (N = 3) and with polycystic ovary syndrome (N = 3) were analyzed separately. Results Average normal ovarian length was 3.2 cm, compared to 4.5 cm for asymmetric edema and 5.6–8.8 cm for the other four groups. Average difference in greatest right and left ovarian diameter was 19% for normal ovaries compared to 24–37% for the other 5 groups. Asymmetric signal on T2-weighted imaging (T2WI) was seen in 12% (3/27) of normal ovaries compared to 9% (1/11) of stimulated patients without torsion, 33% (1/3) of patients with PCOS and 67% (2/3) of patients with torsion both without and with stimulation. The correct diagnosis of torsion was made prospectively in 5/6 cases but retrospectively in only 3/6 cases. In patients with stimulation, correct diagnosis of torsion was made in 2/3 cases prospectively (both with asymmetric T2 signal) and retrospectively in only 1/3 cases. In 13/64 patients, other acute gynecologic and non-gynecologic findings were diagnosed on MRI. Conclusions Enlarged edematous ovary can be seen with ovarian stimulation, ovarian torsion, or both. Although asymmetric ovarian edema occurred more frequently in patients with torsion than without, in pregnant patients with stimulated ovaries referred for MRI (typically after non-diagnostic ultrasound), ovarian torsion could not be confidently diagnosed or excluded retrospectively with non-contrast MRI.
      PubDate: 2017-09-06
  • Contraception and fertility transition in AMHARA National Regional State
           of ETHIOPIA: an application of BONGAARTS’ model

    • Abstract: Background The overall decline of fertility in Amhara National Regional State between 2000 and 2011 was the highest in Ethiopia. The aim of the present study was to determine the most significant proximate determinant of fertility change during the last decade in the region using Bongaarts’ model. Methods The sources of data were the 2000, 2005, and 2011 Ethiopia Demographic and Health Surveys. The model indices were calculated for each survey. Decomposition of fertility change into components of proximal determinants was also carried out. An index value close to 1 is a negligible inhibiting effect while a large inhibiting effect when the value very closes to 0. Results The fertility-constraining effect of contraception increased from 0.93 in 2000 to 0.65 in 2011; however, it was lower than the effect of postpartum insusceptibility at all given times. The index of marriage remained unchanged in constraining fertility over the period (0.71 in 2000 and 0.70 in 2011) while the influence of postpartum insusceptibility slightly declined from 0.49 in 2000 to 0.54 in 2011 but was stronger than contraception and marriage. The contribution of contraception was most important in urban areas (0.46 in 2011 from 0.52 in 2005 and 0.64 in 2000); however, in rural areas, it became an important determinant over the period (0.95 in 2000 and 0.69 in 2011). The effect of postpartum insusceptibility in rural areas showed a decreasing trend (0.48 in 2000 and 0.53 in 2011). The index of marriage in rural areas was stable overtime (0.75 in 2000 and 0.73 in 2011) while in urban areas the effect declined from 0.42 in 2000 to 0.65 in 2011. Marriage was the most important proximate determinant of fertility among women with secondary and above education but the impact declined during the period (0.41 in 2000 and 0.61 in 2011). The importance of postpartum insusceptibility in limiting fertility among women with secondary and above education declined overtime (0.77 in 2000 and 0.87 in 2011) whereas the contribution of contraception became more important (0.44 in 2000 and 0.35 in 2011). Conclusions An increase in the level of contraceptive use and effectiveness overtime was the single most important contributing factor for the recent fertility decline in the region.
      PubDate: 2017-09-05
  • Perceptıon scale of barrıers to contraceptıve use: a
           methodologıcal study

    • Abstract: Background The objective of this study was to design and develop the Perception Scale of Barriers to Contraceptive Use (PSBCU) as a measurement tool for the qualitative assessment of the barriers and obstacles women perceived with regard to contraceptive use or low rates of contraceptive use in women using family planning services. Method The data for this methodological study were collected using the face-to-face interview technique from 320 married women between the ages of 15-49 who were attending clinics at the Hafsa Sultan Hospital, CBU. The data collection tools used in the study, which was carried out from May to September 2014, were the “Introductory Information Form” and the “Perception Scale of Barriers to Contraceptive Use”. Language validity and construct validity (explanatory factor analysis) were applied in order to test the validity of the Perception Scale of Barriers to Contraceptive Use. Results Kaiser Meier Olkin (KMO) analysis was performed to determine the availability of the scale for the size of participants. The sample adequacy calculated as the KMO value was 0.916 and the Bartlett’s Test of Sphericity (X2 = 6721.793 p < 0.000) sample size analysis value was found to be sufficient for factor analysis. The total Cronbach’s Alpha coefficient of 34 items which included three factors explaining 54.95% of the variance after Varimax rotation was calculated to be 0.95. The largest factor was the “cognitive domain” explaining 18.89% of the variance, followed by the “emotional domain” explaining 18.05% of the variance, and finally the “social domain” explaining 18.01% of the variance. Item-total score correlation coefficients of scale items were found to be between 0.54 and 0.83. Conclusions The study demonstrateded that the “Perception Scale of Barriers to Contraceptive Use” was valid and reliable. We believe that the scale is suitable for use by women in a family planning education and training programs in order to evaluate their situation. It should also be assessed for validity and reliability for different groups (adolescents, men, etc.).
      PubDate: 2017-08-03
  • Alcohol and fertility: how much is too much'

    • Abstract: Alcohol use is prevalent in the United States. Given that a substantial portion of the drinking population is of reproductive age, it is not uncommon for couples who are attempting conception, or for women who are already pregnant, to be regularly consuming alcohol. Alcohol use is associated with multiple reproductive risks, including having a child with a Fetal Alcohol Spectrum Disorder, increased risk of fetal loss, and decreased chance of live birth. This review serves to examine the risks of alcohol in the context of reproductive health.
      PubDate: 2017-07-10
  • Fertility preservation training for obstetrics and gynecology fellows: a
           highly desired but non-standardized experience

    • Abstract: Background Despite a large body of data suggesting that delivery of fertility care to cancer patients is inconsistent and frequently insufficient, there is a paucity of literature examining training in fertility preservation for those physicians expected to discuss options or execute therapy. The study objective was to compare fertility preservation training between Reproductive Endocrinology & Infertility (REI) and Gynecologic Oncology (GYN ONC) fellows and assess the need for additional education in this field. Methods A 38-item survey was administered to REI and GYN ONC fellows in the United states in April 2014. Survey items included: 1) Clinical exposure, perceived quality of training, and self-reported knowledge in fertility preservation; 2) an educational needs assessment of desire for additional training in fertility preservation. Results Seventy-nine responses were received from 137 REI and 160 GYN ONC fellows (response rate 27%). REI fellows reported seeing significantly more fertility preservation patients and rated their training more favorably than GYN ONC fellows (48% of REI fellows versus 7% of GYN ONC fellows rated training as ‘excellent’, p < 0.001). A majority of all fellows felt discussing fertility preservation was ‘very important’ but fellows differed in self-reported ability to counsel patients, with 43% of REI fellows and only 4% of GYN ONC fellows able to counsel patients ‘all the time’ (p = 0.002). Seventy-six percent of all fellows felt more education in fertility preservation was required, and 91% felt it should be a required component of fellowship training. Conclusion Significant variability exists in fertility preservation training for REI and GYN ONC fellows, with the greatest gap seen for GYN ONC fellows, both in perceived quality of fertility preservation training and number of fertility preservation patients seen. A majority of fellows in both disciplines support the idea of a standardized multi-disciplinary curriculum in fertility preservation.
      PubDate: 2017-07-04
  • Ovarian morphology is associated with insulin resistance in women with
           polycystic ovary syndrome: a cross sectional study

    • Abstract: Background Polycystic ovary syndrome (PCOS) is a very common disorder well known to be associated with insulin resistance and metabolic disease. Insulin resistance is likely involved in the promotion of the PCOS reproductive phenotype and may mediate some of the ovarian morphology seen in the disorder. The phenotype of each individual woman with PCOS can vary widely as can her metabolic risk. Methods This is a cross-sectional study of patients seen in a multidisciplinary PCOS clinic at the University of California at San Francisco between 2006 and 2014. All participants underwent systematic evaluation with anthropometric measurements, comprehensive skin exam, transvaginal ultrasound and laboratory studies at the time of their initial visit to the clinic. Serum samples were stored and androgen studies were carried out on all stored samples at the University of Virginia. Logistic regression was employed to evaluate the association between ovarian volume or follicle number and metabolic parameters (fasting insulin, HOMA-IR, fasting glucose, 2 h glucose, waist circumference) and hyperandrogenism (free testosterone, total testosterone, DHEAS, acanthosis nigricans), controlling for age. Results Three-hundred thirteen patients seen during the study period met Rotterdam criteria for PCOS and had sufficient measurements for inclusion in our analysis. The odds ratio of elevated HOMA-IR for patients with a maximum ovarian volume >10 cc was 1.9 compared to those with a maximum ovarian volume of ≤10 cc (95% CI 1.0–3.4). The odds ratio of abnormal fasting insulin for patients with higher ovarian volume was 1.8 (95% CI 1.0–3.4) compared with those with lower ovarian volume. Follicle number was not significantly associated with any metabolic parameters. Conclusions Increased ovarian volume is associated with markers of insulin resistance in PCOS. In concordance with prior studies, we did not find follicle number to be predictive of metabolic risk. Ovarian volume may serve as a useful tool to aid clinicians in their risk stratification and counseling of patients with PCOS.
      PubDate: 2017-05-30
  • Cardiovascular risk factors among women with self-reported infertility

    • Abstract: Background Amongst women with certain types of ovulatory disorder infertility, the studies are conflicting whether there is an increased risk of long-term cardiovascular disease risk. This paper evaluates the associations of several CVD risk factors among Framingham women with self-reported infertility. Methods Women who completed the Framingham Heart Study Third Generation and Omni Cohort 2 Exam 2 (2008–2011), and reported on past history of infertility and current cardiovascular disease status were included in this cross-sectional study. Directly measured CVD risk factors were: resting blood pressure, fasting lipid levels, fasting blood glucose, waist circumference, and body mass index (BMI). Multivariable models adjusted for age, smoking, physical activity, and cohort. Generalized estimating equations adjusted for family correlations. We performed sensitivity analyses to determine whether the association between infertility and CVD risk factors is modified by menopausal status and menstrual cycle length. Results Comparing women who self-reported infertility to those who did not, there was an average increase in BMI (β = 1.03 kg/m2, 95% CI: 0.18, 1.89), waist circumference (β = 3.08 in., 95% CI: 1.06, 5.09), triglycerides (β = 4.47 mg/dl, 95% CI:−1.54, 10.49), and a decrease in HDL cholesterol (β = −1.60 mg/dl, 95% CI: −3.76, 0.56). We estimated that infertile premenopausal women have an increased odds of obesity (BMI ≥ 30 kg/m2) (OR = 1.56, 95% CI: 1.11, 4.49) and diabetes (OR = 1.96, 95% CI: 0.86, 4.49). Conclusions BMI and waist circumference were the most strongly correlated CVD risk factors amongst women reporting a history of infertility.
      PubDate: 2017-04-11
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
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