1.  Peer Reviewed Title: Adjuncts for ovarian stimulation: when do we adopt "orphan indications" for approved drugs? Author: Meldrum DR; Chang RJ; de Ziegler D; Schoolcraft WB; Scott RT Jr; Pellicer A Source: Fertility and Sterility. 2009 Jul;92(1):13-8. Abstract: Several drugs, shown to be safe for other uses, have proven to be highly effective adjuncts for ovarian stimulation. The authors evaluate these "orphan" indications and make recommendations so that more patients will benefit from their use. Language: English Keywords: GLOBAL | CRITIQUE | DRUGS | FERTILITY AGENTS | REPRODUCTIVE TECHNOLOGIES | IN VITRO | CLOMIPHENE | GONADOTROPINS, CHORIONIC | ANDROGENS | ADMINISTRATION AND DOSAGE | OVULATION | PRODUCT APPROVAL | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Reproductive Control Agents | Family Planning | Reproduction | Clinical Research | Research Methodology | Gonadotropins | Hormones | Endocrine System | Physiology | Biology | Legislation | Political Factors | Sociocultural Factors Document Number: 342316 |
| 2. Peer Reviewed Title: Contraceptive failure related to estimated cycle day of conception relative to the start of the last bleeding episode. Author: Wiebe ER; Trussell J Source: Contraception. 2009 Mar;79(3):178-81. Abstract: BACKGROUND: The objective of this study was to estimate the menstrual cycle day of conception in women presenting for abortion. STUDY DESIGN: This was a retrospective chart survey in two urban free-standing abortion clinics. RESULTS: There were 913 charts reviewed of women presenting for an abortion at less than 63 days' gestation as determined by endovaginal ultrasound who were "sure" of the date of their last normal menstrual period. The estimated mean cycle day of conception determined by sonographically estimating length of gestation was 14.6. There were 26 (26.3%) of 99 women using cyclic hormonal contraception who conceived before 10 days after the onset of withdrawal bleeding compared to 100 (14.7%) of 679 who conceived before 10 days after the onset of their last menstrual period who were using all other forms of contraception, including "none" (p=.005). No other differences in the proportions conceiving early in the cycle were observed with respect to age, ethnicity or obesity. CONCLUSION: These data suggest that there is a sizeable subset of women who ovulate earlier after onset of withdrawal bleeding when using 21/7 hormonal contraceptives than after onset of menses when not using hormonal contraception. It is possible that women using hormonal contraceptives may have a higher risk of pregnancy if they ovulate sooner after the onset of bleeding. Language: English Keywords: NORTH AMERICA, NORTHERN | UNITED KINGDOM | RESEARCH REPORT | CLINICAL RESEARCH | RETROSPECTIVE STUDIES | WOMEN | URBAN POPULATION | ABORTION | CONTRACEPTION FAILURE | MENSTRUATION | TIME FACTORS | CONTRACEPTIVE PREVALENCE | OVULATION | Americas | Developed Countries | Europe, Western | Europe | Research Methodology | Studies | Demographic Factors | Population | Population Characteristics | Fertility Control, Postconception | Family Planning | Contraceptive Usage | Contraception | Reproduction | Population Dynamics Document Number: 330060 Notification |
3.  Peer Reviewed Title: Use of metformin in polycistic ovary syndrome: A meta-analysis. Author: Creanga AA; Bradley HM; McCormick C; Witkop CT Source: Obstetrics and Gynecology. 2008 Apr;111(4):959-968. Abstract: The objective was to update the state of evidence on the efficacy of metformin, used either alone or in combination with clomiphene citrate in women with polycystic ovary syndrome, by examining three outcomes: ovulation, pregnancy, and live birth. Sources of heterogeneity among the published randomized controlled trials are systematically assessed. An electronic literature search was performed using MEDLINE, EMBASE, SCOPUS, CENTRAL, Cochrane, and U.S. Food and Drug Administration databases, restricted to studies conducted on humans and published in English. Of the 406 potentially relevant articles identified, 17 met criteria for inclusion in the meta-analysis, rendering a total sample of 1,639 women. Study quality was examined in terms of randomization scheme, masking process, adequacy of allocation concealment, statistical power, and loss to follow-up; publication bias was also assessed. Meta-analytic procedures were used to compare metformin with placebo, and metformin plus clomiphene with clomiphene alone, for all study outcomes. Exploratory analyses were conducted to assess differences in treatment effects between clomiphene-resistant and nonresistant patients, obese and nonobese patients, and trials with long and short durations of follow-up. Metformin improved the odds of ovulation in women with polycystic ovary syndrome when compared with placebo (odds ratio [OR] 2.94; 95% confidence interval [CI] 1.43-6.02; number-needed-to-treat 4.0) and appears more effective for non-clomiphene-resistant women. Metformin and clomiphene increased the likelihood of ovulation (OR 4.39; 95% CI 1.94 -9.96; number-needed-to-treat 3.7) and pregnancy (OR 2.67; 95% CI 1.45-4.94; number-needed-to-treat 4.6) when compared with clomiphene alone, especially in clomiphene-resistant and obese women with polycystic ovary syndrome. These treatment effects were greater for trials with shorter follow-up. Using all available evidence, this metaanalysis suggests that metformin increases the likelihood of ovulation and, in combination with clomiphene, increases the odds of both ovulation and pregnancy in women with polycystic ovary syndrome. (author's) Language: English Keywords: GLOBAL | RESEARCH REPORT | LITERATURE REVIEW | WOMEN | OVARIAN EFFECTS | GLUCOSE METABOLISM EFFECTS | DRUGS | DRUG RESISTANCE | DRUG INTERACTIONS | INFERTILITY | OVULATION | PREGNANCY | PREGNANCY OUTCOMES | Demographic Factors | Population | Ovary | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Carbohydrate Metabolic Effects | Metabolic Effects | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Reproduction Document Number: 325771 |
| 4. Peer Reviewed Title: Effect of female age on the diagnostic categories of infertility. Author: Maheshwari A; Hamilton M; Bhattacharya S Source: Human Reproduction. 2008;23(3):538-542. Abstract: As more women choose to delay childbearing, increasing numbers of them face age-related fertility problems. We aimed to explore the association between age and diagnosed causes of female infertility. Anonymized data (age of male and female partner, year of first visit, diagnosis, duration and type of infertility) were obtained on all couples attending Aberdeen Fertility Centre from 1993-2006. The prevalence of different causes of infertility was determined for women less than 35 and greater than or equal to 35 years of age at the time of their first clinic visit. Binary logistic regression and multinomial regression were used to determine the association between age and diagnostic categories of infertility. Of a total of 7172 women, 26.9% were over the age of 35 years and 51.4% of the total had primary infertility. The mean female age was 31.2 (5.2 SD) years. There was an association between female age and the cause of female infertility (likelihood ratio, P less than 0.001). More women over 35 had unexplained infertility (26.6 versus 21.0%, P less than 0.001). Compared with women under 30 years, the adjusted odds ratio (95% confidence intervals, CI) of the following diagnoses in women over 35 were: unexplained infertility 5 1.8 (1.4-2.2), ovulatory dysfunction 5 0.3 (0.3-0.4) and tubal factor 5 2.2 (1.7-2.7). The causes of infertility in older women are different from those in younger women. Women over 35 years of age are nearly twice as likely to present with unexplained infertility. (author's) Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | STATISTICAL REGRESSION | WOMEN | INFERTILITY | AGE FACTORS | EXAMINATIONS AND DIAGNOSES | TIME FACTORS | PREVALENCE | OVULATION | TUBAL EFFECTS | MATERNAL AGE, 35 AND OVER | Developed Countries | Europe, Western | Europe | Data Analysis | Research Methodology | Demographic Factors | Population | Reproduction | Population Characteristics | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Population Dynamics | Measurement | Fallopian Tubes | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Maternal Age | Parental Age Document Number: 324959 |
| 5. Title: Laparoscopic surgery in polycystic ovary syndrome: Reproductive and metabolic effects. Author: Seow KM; Juan CC; Hwang JL; Ho LT Source: Seminars in Reproductive Medicine. 2008 Jan;26(1):101-. Abstract: Polycystic ovary syndrome (PCOS) is the most common cause of chronic anovulation. Clomiphene citrate (CC) is the first-line treatment for ovulation induction for infertile women with PCOS. In CC-resistant women, a particular surgical method, laparoscopic ovarian drilling (LOD), has been proposed in recent years as an alternative treatment. LOD produces overall spontaneous ovulation and pregnancy rates of 30 to 90% and 13 to 88%, respectively, for CC-resistant PCOS women. The mechanism of LOD is still unknown. The reduction of serum androgen level is believed to be the possible mechanism of LOD to improve spontaneous ovulation and promote fertility in women with PCOS. In addition, LOD may cause a significant reduction in serum luteinizing hormone and insulin levels. However, it should be kept in mind that postoperative adhesion is the most common adverse effect of LOD, and more punctures may be responsible for premature ovarian failure. (author's) Language: English Keywords: TAIWAN | RESEARCH REPORT | WOMEN | ANOVULATION | OVARIAN CYSTS | SURGERY | TREATMENT | OVULATION | PREGNANCY RATE | METABOLIC EFFECTS | HORMONES | DRUG RESISTANCE | Asia, Eastern | Asia | Developed Countries | Demographic Factors | Population | Ovarian Effects | Ovary | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Reproduction | Fertility Measurements | Fertility | Population Dynamics | Endocrine System Document Number: 323540 |
| 6. Peer Reviewed Title: The postpartum visit: It's time for a change in order to optimally initiate contraception. Author: Speroff L; Mishell DR Jr Source: Contraception. 2008 Aug;78(2):90-98. Abstract: The 6-week postpartum visit is an anachronism. Performing the initial pelvic examination at this duration after delivery is based upon statements in old textbooks and teachings from a time when infection was prevalent and before modern methods of contraception were available. The basis for this clinical advice was derived from the understanding that a 6-week period of time would result in sufficient involution of the changes of pregnancy to allow an effective pelvic examination that would confirm the return of normal pelvic anatomy. Many women resume sexual activity before the sixth postpartum week, and because ovulation frequently occurs before 6 weeks, the obstetrical tradition of scheduling the postpartum visit at 6 weeks should be changed. A 3-week visit would be more effective in preventing postpartum conception by initiating effective contraception at this time, instead of after the 6-week visit. There is no reason why a complete physical examination cannot be deferred in an asymptomatic woman until the 3-month follow-up visit that is part of good contraceptive care. (excerpt) Language: English Keywords: GLOBAL | CRITIQUE | POSTPARTUM | POSTPARTUM PROGRAMS | EXAMINATIONS AND DIAGNOSES | OVULATION | OVULATION DETECTION | TIME FACTORS | BREASTFEEDING | LACTATIONAL AMENORRHEA METHOD | CONTRACEPTIVE METHODS | Puerperium | Reproduction | Family Planning Programs | Family Planning | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Laboratory Procedures | Laboratory Examinations and Diagnoses | Population Dynamics | Demographic Factors | Population | Infant Nutrition | Nutrition | Family Planning, Behavioral Methods | Contraception Document Number: 327961 |
| 7. Peer Reviewed Title: Levonorgestrel administration in emergency contraception: Bleeding pattern and pituitary-ovarian function. Author: Tirelli A; Cagnacci A; Volpe A Source: Contraception. 2008 May;77(5):328-332. Abstract: This study was conducted to evaluate the effects of levonorgestrel administration for emergency contraception (EC) on bleeding pattern and pituitary-ovarian function. In 69 women with a reported stable menstrual cycle length of 24-34 days, we investigated bleeding patterns following EC administration in the follicular (n=26), periovulatory (n=14) and luteal (n=29) phase. In a subgroup of 8 women, hormonal evaluation and ultrasonography were performed. EC taken in the follicular, but not in the periovulatory or luteal phase, significantly shortened cycle length by 10.9 plus or minus 1 days. The subsequent cycle was not affected. EC taken in the late preovulatory phase, prior to the gonadotrophin surge, suppressed ovulation (n=7), while ovulation was not blocked when EC was given during an ongoing luteinizing hormone (LH) pulse (n=1). Our data indicate that EC given before the onset of the lueteinizing hormone (LH) surge inhibits ovulation and hastens the end of the current menstrual cycle. Subsequently, the length of the following menstrual cycle returned as prior to treatment. By contrast, levonorgestrel administered after the expected ovulation has no effect on menstrual cycle length. (author's) Language: English Keywords: ITALY | RESEARCH REPORT | PROSPECTIVE STUDIES | EMERGENCY CONTRACEPTION | LEVONORGESTREL | ADMINISTRATION AND DOSAGE | MENSTRUAL CYCLE | OVULATION | ENDOCRINE EFFECTS | OVARIAN EFFECTS | LUTEINIZING HORMONE | CONTRACEPTIVE AGENTS, SIDE EFFECTS | Europe, Southern | Europe | Developed Countries | Studies | Research Methodology | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Menstruation | Reproduction | Endocrine System | Physiology | Biology | Ovary | Genitalia, Female | Genitalia | Urogenital System | Gonadotropins, Pituitary | Gonadotropins | Hormones Document Number: 325970 |
| 8. Peer Reviewed Title: Obesity affects spontaneous pregnancy chances in subfertile, ovulatory women. Author: van der Steeg JW; Steures P; Eijkemans MJ; Habbema JD; Hompes PG Source: Human Reproduction. 2008;23(2):324-328. Abstract: Obesity is increasing rapidly among women all over the world. Obesity is a known risk factor for subfertility due to anovulation, but it is unknown whether obesity also affects spontaneous pregnancy chances in subfertile, ovulatory women. We evaluated whether obesity affected the chance of a spontaneous pregnancy in a prospectively assembled cohort of 3029 consecutive subfertile couples. Women had to be ovulatory and had to have at least one patent tube, whereas men had to have a normal semen analysis. Time to spontaneous ongoing pregnancy within 12 months was the primary endpoint. The probability of a spontaneous pregnancy declined linearly with a body mass index (BMI) over 29 kg/m/2. Corrected for possible related factors, women with a high BMI had a 4% lower pregnancy rate per kg/m/2 increase [hazard ratio: 0.96 (95% CI 0.91-0.99)]. These results indicate that obesity is associated with lower pregnancy rates in subfertile ovulatory women. (author's) Language: English Keywords: GLOBAL | NETHERLANDS | RESEARCH REPORT | WOMEN | REPRODUCTION | FERTILITY | OBESITY | PREGNANCY | OVULATION | Developed Countries | Europe, Western | Europe | Demographic Factors | Population | Population Dynamics | Body Weight | Physiology | Biology Document Number: 323877 |
| 9. Peer Reviewed Title: A new strategy to understand how HIV infects women: identification of a window of vulnerability during the menstrual cycle [editorial] Author: Wira CR; Fahey JV Source: AIDS. 2008 Oct 1;22(15):1909-17. Abstract: Although 85% of new HIV cases are due to sexual transmission from men to women, little attention is being paid to the immune system in the female reproductive tract (FRT), and to how it meets the conflicting challenges of protecting from pathogens and permitting procreation. As a new approach we have tried to envision how HIV evades FRT mucosal immune protection and have been led to the unexpected conclusion that in a normal menstrual cycle, there is a window of vulnerability (7-10 days following ovulation) in which the potential for viral infectivity in the FRT is enhanced. During that period, aspects of the innate, humoral, and cell-mediated immune systems are suppressed by sex hormones to optimize conditions for procreation. Suppression occurs in the upper (Fallopian tubes, uterus, endocervix) and lower (ectocervix and vagina) FRT, and coincides with the recruitment of potentially infectable cells and upregulation of coreceptors essential for viral uptake. Implications of these findings are that the entire FRT is a potential target for HIV infection, immune cells and antibodies in blood are not surrogate markers for immune protection in the FRT, and immune protection against HIV will require an understanding of the hormone-induced regulation of humoral, cellmediated, and innate immune systems throughout the FRT. (excerpt) Language: English Keywords: GLOBAL | RESEARCH REPORT | WOMEN | MENSTRUAL CYCLE | TRANSMISSION | HIV INFECTIONS | ENDOCRINE EFFECTS | PHYSIOLOGY | IMMUNE SYSTEM | OVULATION | ORAL CONTRACEPTIVES | MENOPAUSE | Demographic Factors | Population | Menstruation | Reproduction | Infections | Diseases | Viral Diseases | Endocrine System | Biology | Contraceptive Methods | Contraception | Family Planning Document Number: 329336 |
| 10. Peer Reviewed Title: Effect of a single vaginal administration of levonorgestrel in Carraguard gel on the ovulatory process: A potential candidate for “dual protection” emergency contraception. Author: Brache V; Croxatto H; Sitruk-Ware R; Maguire R; Montero JC Source: Contraception. 2007 Aug;76(2):111-116. Abstract: The study was conducted to evaluate the effect of Carraguard vaginal gel containing 0.75 mg of levonorgestrel (CARRA/LNG gel) administered in a single dose at different stages of follicle development over subsequent follicle rupture and hormonal levels. Randomized, blinded, cross-over study comparing the effects of a single administration of CARRA/LNG gel or Carraguard (CARRA) gel. Twenty-four healthy women were enrolled in two centers. The gels were administered when the follicle had reached diameters of 12-14, 15-17 and >/= 18 mm in eight women each. Volunteers were followed for one treatment, one washout cycle and a second treatment cycle. Follicle rupture or nonrupture was assessed by transvaginal ultrasound. Luteinizing hormone, estradiol and progesterone levels were measured daily for 5 days following treatment, and three times per week until menses. No follicular rupture within the 5-day period following administration was observed in 74% and 30% of the CARRA/LNG and CARRA gel treatment cycles, respectively, while ovulation was documented in 4% and 61%, respectively. The overall proportion of cycles with lack of follicular rupture or ovulatory dysfunction (follicle rupture preceded by an inadequate LH surge) was 96% for CARRA/LNG and 39% in the CARRA gel cycles. Single vaginal administration of 0.75 mg LNG in CARRA gel in the late follicular phase is effective for interfering with the ovulatory process. (author's) Language: English Keywords: CHILE | DOMINICAN REPUBLIC | RESEARCH REPORT | PROSPECTIVE STUDIES | DOUBLE-BLIND STUDIES | WOMEN | VAGINAL GEL | LEVONORGESTREL | ADMINISTRATION AND DOSAGE | OVULATION | EMERGENCY CONTRACEPTION | CONTRACEPTIVE USE-EFFECTIVENESS | Developing Countries | South America, Southern | South America | Latin America | Americas | Caribbean | Studies | Research Methodology | Demographic Factors | Population | Vaginal Spermicides | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Reproduction | Contraceptive Effectiveness Document Number: 318907 |
| 11. Peer Reviewed Title: Effects of ovarian high response on implantation and pregnancy outcome during controlled ovarian hyperstimulation (with GnRH agonist and rFSH). Author: Chen QJ; Sun XX; Li L; Gao XH; Wu Y Source: Acta Obstetrica et Gynecologica Scandinavica. 2007;88(7):849-854. Abstract: The study was aimed at investigating the effects of ovarian high response during controlled ovarian hyperstimulation (COH) on implantation and pregnancy outcome in fresh IVF/ICSI cycles, and subsequent frozen-thawed embryo transfer (FET) cycles. An analysis of 1,196 cycles using a long protocol with GnRHa and rFSH was performed. A serum oestrial level (peak E2) was obtained on the day of hCG administration, and patients were grouped by peak E2 percentile distribution into 3 groups. Normal responder was set as cut-off concentrations between percentile (P)25 and P75 (Group A: 1,199-3,047 pg/ml, 595 cycles). Moderate high responders were classified as peak E2 between P75-P90 (Group B: 3,048-4,127 pg/ml, 180 cycles). For the high response group, the E2 cut-off concentration was set as P90 and above (Group C: >/= 4,128 pg/ml, 119 cycles). Oocyte/embryo parameters and clinical outcomes were compared among the 3 groups in fresh cycles and subsequent FET cycles. Comparisons between groups revealed no difference in the quality of oocyte retrieved and in fertilisation rates. Group C showed decreased trends in implantation and pregnancy rates compared with Group A, but statistical significance was reached only for the difference in implantation rates. Implantation and pregnancy rates in FET cycles were similar among the 3 groups. High serum estrogen levels were detrimental to implantation, but not to the quality of oocytes, which may be due to an adverse effect on endometrial receptivity in COH cycles. (author's) Language: English Keywords: CHINA | RESEARCH REPORT | WOMEN | OVULATION | GONADOTROPINS | FOLLICLE STIMULATING HORMONE | ADMINISTRATION AND DOSAGE | IN VITRO | FERTILIZATION | IMPLANTATION | PREGNANCY RATE | PREGNANCY OUTCOMES | Developing Countries | Asia, Eastern | Asia | Demographic Factors | Population | Reproduction | Hormones | Endocrine System | Physiology | Biology | Gonadotropins, Pituitary | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Clinical Research | Research Methodology | Pregnancy, First Trimester | Pregnancy | Fertility Measurements | Fertility | Population Dynamics Document Number: 317961 |
| 12. Peer Reviewed Title: Diagnostic criteria for polycystic ovary syndrome in Taiwanese Chinese women: Comparison between Rotterdam 2003 and NIH 1990. Author: Hsu MI; Liou TH; Chou SY; Chang CY; Hsu CS Source: Fertility and Sterility. 2007 Sep;88(3):727-729. Abstract: Roughly 61% of patients diagnosed with polycystic ovary syndrome (PCOS) using the 2003 Rotterdam criteria fulfilled the 1990 National Institutes of Health (NIH) criteria. Patients meeting the 1990 NIH diagnostic criteria have more severe clinical and biochemical PCOS symptoms than those who did not. (author's) Language: English Keywords: TAIWAN | RESEARCH REPORT | WOMEN | OVARIAN CYSTS | PREVALENCE | ULTRASONICS | EXAMINATIONS AND DIAGNOSES | ANDROGENS | OVULATION | Asia, Eastern | Asia | Developed Countries | Demographic Factors | Population | Diseases | Measurement | Research Methodology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Hormones | Endocrine System | Physiology | Biology | Reproduction Document Number: 320393 |
| 13. Peer Reviewed Title: Effect of octapeptide: FSH binding inhibitor on cyclicity of bonnet monkeys (Macaca radiata). Author: Kulkarni-Chitnis S; Nandedkar T Source: Contraception. 2007 Dec;76(6):467-473. Abstract: The gonadotropins follicle-stimulating hormone (FSH) and luteinizing hormone play an important role in the development of ovarian follicles, and a number of autocrine/paracrine factors secreted by the ovary are known to directly or indirectly regulate gonadotropin action. The objective of the present study was to elucidate the effect of octapeptide (OP) on cyclicity and hormonal profile of bonnet monkeys, the menstruating Old World primates. Our group has purified one such factor from human ovarian follicular fluid, which inhibits the binding of FSH to the granulosa cells. N-terminal eight-amino-acid sequence of this peptide has been deduced, which is referred to as the OP. It has shown an antifertility effect in marmosets, the New World primates. In the present study, the bonnet monkeys were divided into two groups, namely, the treated group (n=5), which was administered with OP (250 mcg/kg body weight/day) intramuscularly during the follicular phase, and the control group (n=6), which was injected with vehicle (saline). Blood was collected every other day, and progesterone levels were estimated by enzyme-linked immunosorbent assay. Animals in the control group demonstrated normal plasma progesterone levels and exhibited normal cyclicity. On the other hand, in the treated group, progesterone levels decreased by 65.8%, as compared with that in pretreatment cycles. This probably disturbed the cyclicity, thus causing amenorrhea (73.0+or-6.7 days). (author's) Language: English Keywords: INDIA | RESEARCH REPORT | LABORATORY ANIMALS | FOLLICLE STIMULATING HORMONE | PROGESTERONE | MENSTRUATION | OVULATION | Developing Countries | Asia, Southern | Asia | Clinical Research | Research Methodology | Gonadotropins, Pituitary | Gonadotropins | Hormones | Endocrine System | Physiology | Biology | Progestational Hormones | Reproduction Document Number: 323342 |
| 14. Title: Relation of supplementary feeding to resumptions of menstruation and ovulation in lactating postpartum women. Author: Li W; Qiu Y Source: Chinese Medical Journal. 2007 May 20;120(10):868-870. Abstract: Resumption of menstrual cycles is one of the indicators for restoration of reproductive capability in postpartum women. However, menstruation does not necessarily mean that ovulation has taken place. The aim of this study was to investigate the relation of supplementary feeding to return of menstruation and ovulation after delivery. A questionnaire was used to obtain data from 101 breastfeeding mothers. The following elements were analyzed: age, education level, breastfeeding practice, time of return of menstruation, contraceptive practice, and starting time of supplementary feeding during the lactation at intervals of 6 weeks to 18 months after delivery. The ovulation was continuously monitored by ultrasonography and basal body temperature (BBT) measurement. By ultrasonography, 53 of the 101 women (52.5%) had the first ovulation (follicle >1.8 cm in diameter) within 154 days after delivery on average, among whom 11 (10.9%, 11/101) had restoration of ovulation within 4 months and 42 (41.6%, 42/101) had it after 4 months. In women with follicles >1.8 cm in diameter (n=53), the menstruation resumed (138+or-84) days after delivery, and the supplementary feeding was started at (4.0+or-1.1) months, which were significantly earlier than those in the women with follicular diameter <1.7 cm (n=48; (293+or-88) days, (5.1+or-1.3) months; t=9.003, P<0.01 and t=4.566, P<0.01). In the women with follicles >1.8 cm in diameter, 30 had return of menstruation before the end of ultrasonographic monitoring, while only 8 in the women with follicular diameter <1.7 cm had menstrual resumption at the same time ( X(2)=16.91, P<0.01). The starting time of supplementary feeding was positively correlated with the time of the restoration of menstruation (n=100, r=0.4764, P<0.01) and first ovulation after delivery (n=53, r=0.5554, P<0.01). In this series, no woman had pregnancy within 18 months postpartum. Supplementary feeding can affect the restoration of menstrual cycles and ovulation in lactating postpartum women. (author's) Language: English Keywords: CHINA | RESEARCH REPORT | QUESTIONNAIRES | POSTPARTUM WOMEN | BREASTFEEDING | LACTATION | SUPPLEMENTARY FEEDING | MENSTRUATION | TIME FACTORS | OVULATION | Asia, Eastern | Asia | Developing Countries | Puerperium | Reproduction | Infant Nutrition | Nutrition | Health | Maternal Physiology | Physiology | Biology | Population Dynamics | Demographic Factors | Population Document Number: 319871 |
| 15. Peer Reviewed Title: Leiomyoma of the vagina that caused cyclic urinary retention. Author: Park SJ; Choi SJ; Han KH; Park KH; Chung H Source: Acta Obstetrica et Gynecologica Scandinavica. 2007 Jan;86(1):102-110. Abstract: Leiomyomas that primarily arise in the vagina are uncommon tumors with approximately 300 cases having been reported in the world literature. The diagnosis of vaginal leiomyoma is seldom made preoperatively. The only way to achieve a correct diagnosis is on histological examination. (excerpt) Language: English Keywords: REPUBLIC OF KOREA | RESEARCH REPORT | WOMEN | OVULATION | UROGENITAL EFFECTS | RETENTION | SIGNS AND SYMPTOMS | PELVIC EXAM | EXAMINATIONS AND DIAGNOSES | VAGINA | FIBROIDS | Developed Countries | Asia, Eastern | Asia | Demographic Factors | Population | Reproduction | Urogenital System | Physiology | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Diseases | Physical Examinations and Diagnoses | Genitalia, Female | Genitalia | Neoplasms, Benign | Neoplasms Document Number: 309966 |
| 16. Title: The salivary ferning test and ovulation in clomiphene citrate-stimulated cycles. Author: Pattanasuttinont S; Sereepapong W; Suwajanakorn S Source: Journal of the Medical Association of Thailand. 2007 May;90(5):876-883. Abstract: The objective was to determine the day of ovulation by the salivary ferning test in clomiphene citrate-treated women. A descriptive study was the design used. The setting used was the Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. Seventy-five infertile women with regular menstrual cycles were studied. Infertile women were given 100 mg of clomiphene citrate for five days and collected their saliva samples daily until seven days after ovulation. Transvaginal ultrasound was performed daily to detect ovulation. The salivary ferning formation was examined by a normal light microscope and graded from 1-3, according to its extent and intensity. The salivary ferning score, the peak salivary ferning day, and the day of ovulation detected by ultrasound. The patients' age and cycle length (mean ± SD) were 32.9 ± 3.7 years and 28.4 ± 1.3 days. The peak salivary ferning day corresponded with the ultrasound ovulation day in only 7.1%. There were two peaks of median salivary ferning scores; one was two days prior ovulation and the other was five days post ovulation. There was no correlation between the peak salivary ferning day and day of ovulation detected by ultrasound (r = 0.102, p > 0.05). In clomiphene citrate-stimulated cycles, the saliva ferning test does not seem to associate with ovulation. (author's) Language: English Keywords: THAILAND | RESEARCH REPORT | QUALITATIVE RESEARCH | WOMEN | INFERTILITY | CLOMIPHENE | OVULATION | MENSTRUAL CYCLE | FOLLICLE STIMULATING HORMONE | LUTEINIZING HORMONE | GONADOTROPINS, PITUITARY | Asia, Southeastern | Asia | Developing Countries | Research Methodology | Demographic Factors | Population | Reproduction | Fertility Agents | Reproductive Control Agents | Family Planning | Menstruation | Gonadotropins | Hormones | Endocrine System | Physiology | Biology Document Number: 317807 |
| 17. Peer Reviewed Title: The seasonality of conception. Author: Rizzi EL; Dalla-Zuanna G Source: Demography. 2007 Nov;44(4):705-728. Abstract: Individual data on menstrual cycles of noncontracepting women living in Western countries were used in order to verify whether the biological seasonality of conception persists after sexual behavior is controlled for. Episodes of intercourse were recorded daily, and the time of ovulation was detected by a marker. We find that the seasonality of conception changes with woman's age and frequency of episodes of sexual intercourse. In particular, for women aged 27-31 having only one act of intercourse during the six most fertile days of the menstrual cycle, the seasonality of fecundability is stronger. In this age group in the Northern Hemisphere, if seasonality of acts of sexual intercourse is controlled, the monthly distribution of probability of conception is bimodal, with two maxima (September and January) and two minima (December and March). When unobserved characteristics of the couples are considered, this seasonal pattern of conception persists. (author's) Language: English Keywords: EUROPE | NEW ZEALAND | RESEARCH REPORT | PROSPECTIVE STUDIES | WOMEN | MENSTRUAL CYCLE | SEXUAL INTERCOURSE | OVULATION | FERTILIZATION | PREGNANCY | SEASONAL VARIATION | PROBABILITY | Developed Countries | Oceania | Studies | Research Methodology | Demographic Factors | Population | Menstruation | Reproduction | Population Dynamics | Statistical Studies Document Number: 322847 |
| 18. Title: [Central retinal artery blood flow variation during menstrual cycle] Variacao do fluxo sanguineo da arteria central da retina durante as diferentes fases do ciclo menstrual ovulatorio. Author: Viana LC; Burmann MA; Sampaio M; Geber S Source: Revista Brasileira de Ginecologia e Obstetricia. 2007 Mar;29(3):147-152. Abstract: PURPOSE: to evaluate the vascular blood fl ow of the central retinal arteries using doppler velocimetry in the different phases of the ovulatory menstrual cycle. METHODS: we performed an observational, longitudinal and prospective study evaluating 34 healthy and ovulatory women. All women were submitted to Doppler scan of the eye to evaluate the vascular resistance of the central retinal arteries, either lying down or on a seated position, during four phases of the menstrual cycle. Confirmation of ovulation was performed by measuring serum progesterone during the luteal phase. We analyzed the pulsatility and resistance index and the maximum, minimum and mean velocity. RESULTS: mean age was 29.7 years. No differences were observed between the indexes obtained in both eyes, therefore a mean index was used for comparisons. As the comparison between the positions used for the exams showed a higher PI for the seated position, the analyses were performed separately. The pulsatility index in the lying position was different among the different phases of the menstrual cycle. The arterial resistance was significantly lower during the intermediate follicular and the periovulatory phases, as compared to the early follicular and luteal phases. When the comparison was performed with the patient in the seated position, no differences were observed. CONCLUSIONS: Our results demonstrate a reduction in the vascular resistance of the cerebral microcirculation and a posterior reversal, as shown by changes in the PI. Language: Portuguese Keywords: RESEARCH REPORT | CLINICAL RESEARCH | PROSPECTIVE STUDIES | LONGITUDINAL STUDIES | COMPARATIVE STUDIES | EVALUATION INDEXES | WOMEN | OPHTHALMOLOGICAL EFFECTS | MENSTRUAL CYCLE | PHYSICAL EXAMINATIONS AND DIAGNOSES | OVULATION | VASCULAR DISEASES | Research Methodology | Studies | Quantitative Evaluation | Evaluation | Demographic Factors | Population | Physiology | Biology | Menstruation | Reproduction | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Diseases Document Number: 324608 |
| 19. Peer Reviewed Title: Female infertility: role of vaginal hormonal cytology, endometrial biopsy and endocrinological evaluation. Author: Afroz N; Singh M; Verma M; Bansal V Source: Journal of the Indian Medical Association. 2006 Mar;104(3):[3] p.. Abstract: Female infertility can be categorised into those who fail to ovulate (anovulatory infertility) because of some defect at hypothalamic-pituitary-ovarian axis and those who are ovulatory (ovulatory infertility), but are infertile because of some lesion present in genital tract. The role of vaginal hormonal cytology, endometrial biopsy and endocrinological evaluation in the detection of ovulation and various ovulatory dysfunction was studied in 42 infertile female patients. On the basis of cytological findings, of the 42 patients, 14 were found to be ovulatory, 26 anovulatory (which include 5 cases of atrophic changes) and 2 inconsistent due to inflammatory changes. Endometrial biopsy showed evidence of ovulation in 15, anovulation in 27 cases. Hormonal evaluation indicated some sort of endocrinological disorders in 15 patients, which may underlie anovulatory infertility in these patients, while results were within normal range in the rest 27 patients. Results of vaginal cytology and endometrial biopsy showed correlation in respect to ovulation in 93.33 % of the cases. (author's) Language: English Keywords: INDIA | RESEARCH REPORT | WOMEN | INFERTILITY | VAGINA | CYTOLOGY | ENDOMETRIAL EFFECTS | OVULATION | ANOVULATION | ENDOCRINE EFFECTS | EVALUATION | Asia, Southern | Asia | Developing Countries | Demographic Factors | Population | Reproduction | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Endometrium | Uterus | Ovarian Effects | Ovary | Endocrine System Document Number: 307597 |
| 20. Peer Reviewed Title: Letrozole vs. clomiphene citrate in patients with ovulatory infertility. Author: Bayar U; Tanriverdi HA; Barut A; Ayoglu F; Ozcan O Source: Fertility and Sterility. 2006 Apr;85(4):1045-1048. Abstract: Objective: To compare the effectiveness of letrozole and clomiphene citrate (CC) in ovulatory patients with borderline male factor infertility, early stage endometriosis, and unexplained infertility. Design: Prospective quasi-randomized trial. Setting: University infertility clinic. Patient(s): Forty-six consecutive patients with ovulatory infertility were recruited. Twenty-five patients (67 cycles) were given CC and 21 patients (52 cycles) were given letrozole. Both drugs were given orally on days 3-7 of menses. Intervention(s): Letrozole, CC, ovulation induction, IUI, timed intercourse. Main Outcome Measure(s): Number of follicles, endometrial thickness, and pregnancy rates. Result(s): The median serum E(-2) concentration on the day of hCG administration in the letrozole and CC groups were 191.5 pmol/L and 476.0 pmol/L, respectively. The median endometrial thickness on the day of hCG were 8 mm in both groups. Ovulation occurred in 81% (42/52) of the letrozole-treated and 85% (57/67) of the CC-treated patients. Pregnancy rate (PR) per cycle was 9% (5/52) in the letrozole group and 12% (8/67) in the CC group. Conclusion(s): Letrozole and CC have comparable effectiveness in ovulatory patients with borderline male factor infertility, early stage endometriosis, and unexplained infertility. (author's) Language: English Keywords: TURKEY | RESEARCH REPORT | CLINICAL TRIALS | PROSPECTIVE STUDIES | WOMEN | INFERTILITY | DRUGS | ADMINISTRATION AND DOSAGE | OVULATION | ENDOMETRIAL EFFECTS | PREGNANCY RATE | CONTRACEPTIVE USE-EFFECTIVENESS | Europe, Southeastern | Europe | Developing Countries | Clinical Research | Research Methodology | Studies | Demographic Factors | Population | Reproduction | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Endometrium | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Fertility Measurements | Fertility | Population Dynamics | Contraceptive Effectiveness | Contraception | Family Planning Document Number: 298573 |
| 21. Title: Effects of partner conception risk phase on male perception of dominance in faces. Author: Burriss RP; Little AC Source: Evolution and Human Behavior. 2006;27:297-305. Abstract: Several studies have suggested that women may prefer to engage in extra-pair copulations with males who appear dominant and to do so near ovulation. While there is some evidence that males are more jealous of dominant rivals and more proprietary when their partners are near ovulation, there is none that suggests the existence of counter-strategic perceptual shifts that mirror those seen in women. We provide such evidence here. Composites of male faces that were either high or low in rated dominance were presented to male participants who provided ratings of dominance. A three-way interaction between stimulus-face dominance, partner conception risk phase, and partner oral contraceptive use was found; men whose partners did not use an oral contraceptive and were in the high conception risk phase of their cycle displayed increased dominance ratings of high-dominance male faces. We conclude that males have evolved counterstrategies to deal with female infidelity that include an over-attribution of dominance to those rivals most likely to present a threat at times when that threat is greatest. This over-attribution is likely to lead to increases in jealousy and mate-retention behaviors. (author's) Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | SEXUAL PARTNERS | MEN | WOMEN | OVULATION | SEX BEHAVIOR | RETENTION | FERTILIZATION | ORAL CONTRACEPTIVES | Europe, Western | Europe | Developed Countries | Behavior | Demographic Factors | Population | Reproduction | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Methods | Contraception | Family Planning Document Number: 306641 |
| 22. Peer Reviewed Title: Effective use of hormonal contraceptives Part II: combined hormonal injectables, progestogen-only injectables and contraceptive implants. Author: Chrisman CE; Curtis KM; Mohllajee AP; Gaffield ME; Peterson HB Source: Contraception. 2006 Feb;73(2):125-133. Abstract: Our objective in this systematic review was to evaluate evidence regarding controversial issues in the clinical management of women using injectable and implantable contraceptives. We searched MEDLINE and EMBASE for reports of primary research, published from 1966 through April 2005 in peer-reviewed journals, related to the initiation of combined or progestogen-only injectables and contraceptive implants, the effects of late contraceptive injections or the duration of levonorgestrel implant effectiveness. Results of the studies we reviewed showed that initiating injectable and implantable contraceptives through day 7 of the menstrual cycle suppresses follicular activity. Time to ovulation after study participants discontinued using injectables varied widely: from 4 to 8 weeks after the last administration of combined injectables, from 15 to 49 weeks after the last injection of depot medroxyprogesterone acetate and from 5 to 19 weeks after the last injection of norethisterone enanthate. Norplant implants left in place for up to seven completed years remained effective among women who weighed < 70 kg at the time of implant insertion, but their effectiveness decreased among women weighing = 70 kg. (author's) Language: English Keywords: UNITED STATES OF AMERICA | NORTH CAROLINA | RESEARCH REPORT | DATA ANALYSIS | STUDIES | WOMEN | INJECTABLES | CONTRACEPTIVE IMPLANTS | CONTRACEPTIVE AGENTS, PROGESTIN | PROGESTERONE | OVULATION | TIME FACTORS | CONTRACEPTIVE USE-EFFECTIVENESS | Developed Countries | North America | Americas | Research Methodology | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Female | Contraceptive Agents | Progestational Hormones | Hormones | Endocrine System | Physiology | Biology | Reproduction | Population Dynamics | Contraceptive Effectiveness Document Number: 296200 |
| 23. Peer Reviewed Title: Feasibility study of Nestorone - ethinylestradiol vaginal contraceptive ring for emergency contraception. [Estudio de factibilidad sobre el uso de nestorona: anillo anticonceptivo vaginal de etinilestradiol para anticoncepción de emergencia] Author: Croxatto HB; Brache V; Massai R; Alvarez F; Forcelledo ML Source: Contraception. 2006;73:46-52. Abstract: Objective: The Nestorone®/ethinylestradiol (NES/EE) vaginal ring is being developed as a regular contraceptive method by the Population Council. This ring is designed to release NES 150 µg/day and EE 15 µg/day during 1 year. Here, we report a Phase I clinical trial to determine the usefulness of this ring for emergency contraception. To that end, we tested the ability of this ring to interfere with ovulation when it is inserted during the follicular phase. Method: Forty-eight women protected from the risk of pregnancy by nonhormonal methods were divided into three groups, which differed by the size of the dominant follicle at the time of ring insertion: 12-14 mm (n =16), 15-17 mm (n =18) and =18 mm (n =14) diameter. The NES/EE ring was left in the vagina for 7 consecutive days, after which it was removed. The growth of the leading follicle and plasma levels of estradiol, progesterone (P), luteinizing hormone (LH) and follicle stimulating hormone (FSH) in the ensuing 5 days after ring insertion were determined. Afterwards, steroid hormones were measured twice a week, until menses took place. All women had a control cycle before the ring cycle, and the range of maximum follicular diameter assigned to each volunteer was the same for the control and the ring cycle at the time when placebo was ingested or the ring inserted. Results: During the 5-day period after ring insertion with follicles 12-17 mm, ovulation was absent in 25 of 34 cycles (p<.01 vs. control), and ovulatory dysfunction (absent, blunted or mistimed LH peak) occurred in 8 of the 9 remaining cycles (33/34 ovulatory processes altered; pb.005 vs. control). After ring insertion with follicles =18 mm in diameter, ovulation did not occur in 2 of 14 cycles or was dysfunctional in 7 of the 12 remaining cycles (9/14 ovulatory processes altered; p<.025 vs. control). Altogether, 87.5% of ring cycles (42/48) had either no ovulation or ovulatory dysfunction in the 5-day study period, in contrast to 39.6% (19/48 cycles) in control cycles (p<.001). Among follicles that failed to rupture within the 5-day study period, none ruptured later on in the ring-treated cycles, while 9 of 16 did so in control cycles. Sixty-two percent of ring-treated cycles were shorter than 24 days. Nausea, vaginal discharge and abdominal pain were the most frequently reported adverse events during ring use. Conclusion: Interference with 87.5% of ovulatory processes, without ovulation occurring later in the cycle and shortening of cycle length, suggests the NES/EE ring may be used as an emergency contraceptive method, with the potential advantage of providing continuing contraception after it has performed its emergency function. (author's) Spanish Abstract: Objetivo: El Consejo de Población está desarrollando el anillo anticonceptivo vaginal de etinilestradiol Nestorone(r) (NES/EE) como método anticonceptivo corriente. Este dispositivo está diseñado para liberar 150 mg diarios de nestorona durante 1 año. Este trabajo presenta un ensayo clínico en fase I que se llevó a cabo para determinar la utilidad del anillo como anticonceptivo de emergencia. A tal fin, se evaluó la capacidad del anillo para interferir con la ovulación al insertarse durante la fase folicular. Método: Se asignaron cuarenta y ocho mujeres protegidas del riesgo de embarazo con métodos no hormonales a uno de tres grupos que diferían por el tamaño del folículo dominante al momento de la inserción del anillo: 12-14 mm (n = 16), 15-17 mm (n = 18) y = 18 mm (n = 14) de diámetro. El anillo anticonceptivo vaginal de etinilestradiol Nestorone(r) se dejó en la vagina durante 7 días, al cabo de los cuales se lo retiró. Se determinaron el crecimiento del folículo dominante y los niveles plasmáticos de estradiol, progesterona (P), hormona luteinizante (LH, luteinizing hormone) y hormona folículo estimulante (FSH, follicle-stimulating hormone) en los 5 días siguientes a la inserción. Posteriormente se midieron las hormonas esteroides dos veces por semana, hasta el momento de la menstruación. Todas las mujeres tuvieron un ciclo control antes del ciclo del anillo, asignándose a cada voluntaria el mismo rango de diámetro folicular máximo para ambos ciclos en el momento de ingerir el placebo o insertarse el anillo. Resultados: Durante el período de 5 días posterior a la inserción del anillo, con folículos de 12 a 17 mm, la ovulación estuvo ausente en 25 de los 34 ciclos (p < 0,01 versus control), y fue disfuncional (sin pico de hormona luteinizante, o bien, con pico más leve o en un momento inadecuado) en 8 de los 9 ciclos restantes (33/34 procesos ovulatorios alterados; pb. 0,005 versus control). Luego de insertar el anillo con folículos de 18 mm, la ovulación estuvo ausente en 2 de los 14 ciclos o fue disfuncional en 7 de los 12 ciclos restantes (9/14 procesos ovulatorios alterados; p < 0,025 versus control). En total, el 87,5% de los ciclos del anillo (42/48) se caracterizaron por falta de ovulación o disfunción ovulatoria en el período de 5 días del estudio, en comparación con el 39,6% (19/48 ciclos) en los ciclos control (p < 0,001). Ninguno de los folículos que no se rompieron en el período de 5 días del estudio se rompió posteriormente en los ciclos tratados con el anillo, mientras que 9 de 16 lo hicieron durante los ciclos control. El sesenta y dos por ciento de los ciclos tratados con el anillo duró menos de 24 días. Los eventos adversos referidos con mayor frecuencia incluyeron náuseas, flujo vaginal y dolor abdominal. Conclusión: La interferencia con el 87,5% de los procesos ovulatorios, sin ovulación posterior en el ciclo ni reducción de la duración de este último, sugiere que el anillo anticonceptivo vaginal de etinilestradiol Nestorone(r) puede utilizarse como método anticonceptivo de emergencia, con la posible ventaja de continuar brindando protección anticonceptiva luego de haber cumplido con su función de emergencia. (del autor) Language: English Keywords: LATIN AMERICA | RESEARCH REPORT | CLINICAL TRIALS | WOMEN IN DEVELOPMENT | ETHINYL ESTRADIOL | EMERGENCY CONTRACEPTION | VAGINAL RING | IUD, HORMONE RELEASING | FOLLICLE STIMULATING HORMONE | ADMINISTRATION AND DOSAGE | CONTRACEPTIVE AGENTS, SIDE EFFECTS | OVULATION | Americas | Developing Countries | Clinical Research | Research Methodology | Economic Development | Economic Factors | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Contraceptive Methods | IUD | Gonadotropins, Pituitary | Gonadotropins | Hormones | Endocrine System | Physiology | Biology | Drugs | Treatment | Reproduction Document Number: 293359 |
| 24. Peer Reviewed Title: Effective use of hormonal contraceptives Part I: combined oral contraceptive pills. Author: Curtis KM; Chrisman CE; Mohllajee AP; Peterson HB Source: Contraception. 2006 Feb;73(2):115-124. Abstract: This systematic review examines evidence regarding when during the menstrual cycle a woman can initiate combined oral contraceptive (COC) use and what can be done if a woman misses COCs. We searched the MEDLINE and EMBASE databases for articles published from 1966 to March 2005 related to COC initiation and to the effects of late or missed COCs. We identified 11 studies related to COC initiation and 25 studies related to the effects of missed pills. Evidence from these studies suggested that taking hormonally active pills for 7 consecutive days prevents normal ovulation and that initiating COCs through Day 5 of the menstrual cycle suppresses follicular activity. Studies on the effects of missed COCs generally showed that the risk of ovulation is greatest when the pill-free interval lasts > 7 days. Limitations of this body of evidence include small sample sizes that may not reflect variation in larger populations, lack of a standard measurement of ovulation and difficulty in discerning how ovulation resulting from late or missed COCs corresponds to the risk of conception. (author's) Language: English Keywords: UNITED STATES OF AMERICA | NORTH CAROLINA | RESEARCH REPORT | DATA ANALYSIS | STUDIES | WOMEN | ORAL CONTRACEPTIVES, COMBINED | CONTRACEPTIVE USE-EFFECTIVENESS | TIME FACTORS | OVULATION | MENSTRUAL CYCLE | Developed Countries | North America | Americas | Research Methodology | Demographic Factors | Population | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Contraceptive Effectiveness | Population Dynamics | Reproduction | Menstruation Document Number: 296199 |
| 25. Peer Reviewed Title: Changes in menstrual pattern and ovarian function following bipolar electrocauterization of the fallopian tubes for voluntary surgical contraception. Author: Dede FS; Dilbaz B; Akyuz O; Caliskan E; Kurtaran V Source: Contraception. 2006;73:88-91. Abstract: Our aim was to investigate the changes in menstrual pattern, ovarian reserve and presence of dysmenorrhea and ovulation after tubal ligation via bipolar electrocautery. Sixty patients requesting voluntary tubal ligation were recruited in the study. Laparoscopic tubal sterilization via bipolar electrocoagulation was performed in all patients in the early follicular phase. Blood samples were collected on day 3, one cycle before the procedure, in the same cycle when the procedure was carried out and on the third cycle following the procedure for determination of folliclestimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E/2), and on day 21 for progesterone (P) levels. All patients were followed for 3 months, and changes in menstrual pattern, presence or absence of dysmenorrhea and ovulation were noted. Menstrual changes occurred in six patients (10%), although only one patient had mild dysmenorrhea (1.6%) after the procedure. The incidence of ovulation was 33% preoperatively, rising to 40% in the cycle when surgery was performed and maintained a constant level at 40% 3 months after tubal ligation. There was no statistically significant difference in the serum FSH, LH and estradiol levels in preoperative and postoperative assessments (p > .05). Tubal ligation has been blamed for causing luteal phase defect as a result of an effect on ovarian circulation. In our study, the rate of ovulation was slightly improved after the procedure, and ovarian reserve was not negatively affected. Bipolar electrocoagulation of the fallopian tubes did not alter the ovarian reserve and function. (author's) Language: English Keywords: TURKEY | RESEARCH REPORT | PROSPECTIVE STUDIES | WOMEN | LAPAROSCOPY | TUBAL LIGATION | CONTRACEPTION | MENSTRUATION | CHANGES | DYSMENORRHEA | OVARIAN EFFECTS | OVULATION | Developing Countries | Europe, Southeastern | Europe | Studies | Research Methodology | Demographic Factors | Population | Endoscopy | Physical Examinations and Diagnoses | Examinations and Diagnoses | Female Sterilization | Sterilization, Sexual | Family Planning | Reproduction | Social Change | Menstruation Disorders | Diseases | Ovary | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology Document Number: 293367 |
| 26. Title: Day-specific pregnancy probability estimation in barrier contraceptive effectiveness trials. Author: Dominik R; Chen PL Source: Paediatric and Perinatal Epidemiology. 2006 Nov;20 Suppl 1:38-42. Abstract: We apply an extension of a statistical model developed in the fertility research setting to the barrier contraceptive trial setting to obtain estimates of the probability of pregnancy per cycle day in the presence or absence of barrier use among participants of a randomised trial of female barrier contraceptives. The per cycle day pregnancy curve for the barrier trial participants was similar to previously published results from a fertility study that included a precise indicator of ovulation day. In addition, our analysis showed strong contraceptive effects for the diaphragm. The proposed modelling approach should allow evaluation of the effects of other coitus-specific exposures on the chance of pregnancy in other prospective studies, including fertility studies. (author's) Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | CLINICAL TRIALS | WOMEN | MENSTRUAL CYCLE | OVULATION | SEXUAL INTERCOURSE | FERTILIZATION | PROBABILITY | BARRIER METHODS | CERVICAL CAP | CONTRACEPTION | North America | Americas | Developed Countries | Clinical Research | Research Methodology | Demographic Factors | Population | Menstruation | Reproduction | Statistical Studies | Studies | Contraceptive Methods | Family Planning | Vaginal Barrier Methods Document Number: 311792 |
| 27. Title: Effect of an oral contraceptive pill on follicular development in IVF / ICSI patients receiving a GnRH antagonist: a randomized study. Author: Huirne JA; van Loenen AC; Donnex J; Pirard C; Homburg R Source: Reproductive BioMedicine Online. 2006;13(2):235-245. Abstract: This randomized controlled study compared the effectiveness of a gonadotrophin releasing hormone (GnRH) antagonist protocol with or without oral contraceptive (OC) pretreatment on the number of oocytes retrieved in IVF or intracytoplasmic sperm injection (ICSI) patients. Sixty-four patients were randomized to start recombinant human FSH (r-hFSH) on day 2 or 3 after OC withdrawal (OC group) or on day 2 of a natural cycle (control group). From stimulation day 6 onwards, all patients were treated with daily (0.5 mg/ml) GnRH antagonist (Antide). OC pretreatment resulted in significantly lower starting concentrations of FSH, LH and oestradiol (P < 0.001) and a thinner endometrium (P < 0.0001). In the early stimulation period, fewer large follicles were found after OC pretreatment, leading to a significantly extended stimulation period (11.6 versus 8.7 days, P < 0.0001) with more follicles on the day of recombinant human chorionic gonadotrophin administration (15.4 versus 12.5, P = 0.02) and more oocytes retrieved (13.5 versus 10.2, P < 0.001) as compared with the control group. GnRH antagonist regimen, pretreated with OC, prevented the early endogenous FSH rise and improved follicular homogeneity, resulting in more oocytes. As a consequence of the extended treatment period, more rhFSH was required. (author's) Language: English Keywords: NETHERLANDS | RESEARCH REPORT | CLINICAL RESEARCH | CASE CONTROL STUDIES | WOMEN | FOLLICLE STIMULATING HORMONE | ORAL CONTRACEPTIVES | IN VITRO | FERTILIZATION | CONTRACEPTION TERMINATION | GONADOTROPINS, CHORIONIC | ENDOMETRIAL EFFECTS | ADMINISTRATION AND DOSAGE | OVULATION | Developed Countries | Europe, Western | Europe | Research Methodology | Studies | Demographic Factors | Population | Gonadotropins, Pituitary | Gonadotropins | Hormones | Endocrine System | Physiology | Biology | Contraceptive Methods | Contraception | Family Planning | Reproduction | Endometrium | Uterus | Genitalia, Female | Genitalia | Urogenital System | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 311107 |
| 28. Title: Estimation of the day-specific probabilities of conception: current state of the knowledge and the relevance for epidemiological research. Author: Lynch CD; Jackson LW; Louis GM Source: Paediatric and Perinatal Epidemiology. 2006 Nov;20 Suppl 1:3-12. Abstract: Conception, as defined by the fertilisation of an ovum by a sperm, marks the beginning of human development. Currently, a biomarker of conception is not available; as conception occurs shortly after ovulation, the latter can be used as a proxy for the time of conception. In the absence of serial ultrasound examinations, ovulation cannot be readily visualised leaving researchers to rely on proxy measures of ovulation that are subject to error. The most commonly used proxy measures include: charting basal body temperature, monitoring cervical mucus, and measuring urinary metabolites of oestradiol and luteinising hormone. Establishing the timing of the ovulation and the fertile window has practical utility in that it will assist couples in appropriately timing intercourse to achieve or avoid pregnancy. Identifying the likely day of conception is clinically relevant because it has the potential to facilitate more accurate pregnancy dating, thereby reducing the iatrogenic risks associated with uncertain gestation. Using data from prospective studies of couples attempting to conceive, several researchers have developed models for estimating the day-specific probabilities of conception. Elucidating these will allow researchers to more accurately estimate the day of conception, thus spawning research initiatives that will expand our current limited knowledge about the effect of exposures at critical periconceptional windows. While basal body temperature charting and cervical mucus monitoring have been used with success in field-based studies for many years, recent advances in science and technology have made it possible for women to get instant feedback regarding their daily fertility status by monitoring urinary metabolites of reproductive hormones in the privacy of their own homes. Not only are innovations such as luteinising hormone test kits and digital fertility monitors likely to increase study compliance and participation rates, they provide valuable prospective data that can be used in epidemiological research. Although we have made great strides in estimating the timing and length of the fertile window, more work is needed to elucidate the day-specific probabilities of conception using proxy measures of ovulation that are inherently subject to error. Modelling approaches that incorporate the use of multiple markers of ovulation offer great promise to fill these important data gaps. (author's) Language: English Keywords: UNITED STATES OF AMERICA | LITERATURE REVIEW | WOMEN | OVULATION | LUTEINIZING HORMONE | MEASUREMENT | FERTILIZATION | PROBABILITY | TIME FACTORS | FAMILY PLANNING | North America | Americas | Developed Countries | Demographic Factors | Population | Reproduction | Gonadotropins, Pituitary | Gonadotropins | Hormones | Endocrine System | Physiology | Biology | Research Methodology | Statistical Studies | Studies | Population Dynamics Document Number: 311790 |
| 29. Title: Incidence of migraine relative to menstrual cycle phases of rising and falling estrogen. Author: MacGregor EA; Frith A; Ellis J; Aspinall L; Hackshaw A Source: Neurology. 2006 Dec;67(12):2154-2158. Abstract: The objective was to investigate the association between urinary hormone levels and migraine, with particular reference to rising and falling levels of estrogen across the menstrual cycle in women with menstrual and menstrually related migraine. Women with regular menstrual cycles, who were not using hormonal contraception or treatments and who experienced between one and four migraine attacks per month, one of which regularly occurred on or between days 1 ± 2 of menstruation, were studied for three cycles. Women used a fertility monitor to identify ovulation, conducting a test each day as requested by the monitor, using a sample of early morning urine. Urine samples were collected daily for assay of estrone-3-glucuronide, pregnanediol 3-glucuronide, follicle-stimulating hormone, and luteinizing hormone. All women kept a daily migraine diary and continued their usual treatment for migraine. Of 40 women recruited, data from 38 women were available for analysis. Compared with the expected number of attacks, there was a significantly higher number of migraine attacks during the late luteal/early follicular phase of falling estrogen and lower number of attacks during rising phases of estrogen. These findings confirm a relationship between migraine and changing levels of estrogen, supporting the hypothesis of perimenstrual but not postovulatory estrogen "withdrawal" migraine. In addition, rising levels of estrogen appear to offer some protection against migraine. (author's) Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | WOMEN | MENSTRUAL CYCLE | OVULATION | MONITORING | ESTROGENS | CHANGES | INCIDENCE | MIGRAINE | Europe, Western | Europe | Developed Countries | Demographic Factors | Population | Menstruation | Reproduction | Evaluation | Hormones | Endocrine System | Physiology | Biology | Social Change | Sociocultural Factors | Measurement | Research Methodology | Vascular Diseases | Diseases Document Number: 314733 |
| 30. Peer Reviewed Title: The relationship between total motile sperm count and pregnancy rate after intrauterine insemination. Author: Mehrannia T Source: Pakistan Journal of Medical Sciences. 2006 Jul-Sep;22(3):223-227. Abstract: The objective was to determine the relationship between the total motile sperm count and the success of IUI treatment cycles with postwashed husband spermatozoa in couples with infertility in a large patient population. Design: Retrospective descriptive study. Setting: Academic University Hospital-based infertility center. Patients: Eight hundred twenty four infertile couples undergoing 824 cycles of IUI. Main outcome measure(s): To assess the significance of prognostic factors including a woman's age, duration of infertility, diagnoses, use of ovulation induction and sperm parameters for predicting the outcomes of clinical pregnancy after the first cycle of IUI. The pregnancy rate per cycle was 18.2% (150/824). Postwashed semen parameters including total motile sperm count > 10 × 10/6,motility > 50%. There was a trend toward an increased success rate with increased total motile Sperm count. Our finding suggest that a final postwashed total motile sperm count used for IUI may be considered predictive of the success for pregnancy. (author's) Language: English Keywords: IRAN | RESEARCH REPORT | CLINICAL RESEARCH | RETROSPECTIVE STUDIES | WOMEN IN DEVELOPMENT | COUPLES | SPERM COUNT | PREGNANCY RATE | ARTIFICIAL INSEMINATION | AGE FACTORS | TIME FACTORS | OVULATION | Middle East | Developing Countries | Research Methodology | Studies | Economic Development | Economic Factors | Family Characteristics | Family and Household | Sociocultural Factors | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population | Reproductive Technologies | Reproduction | Population Characteristics Document Number: 307741 |
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