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van Kessel MA, Pham CT, Tros R, Oosterhuis GJE, Kuchenbecker WKH, Bongers MY, Mol BWJ, Koks CAM. The cost-effectiveness of transvaginal hydrolaparoscopy versus hysterosalpingography in the work-up for subfertility. Hum Reprod 2022; 37:2768-2776. [PMID: 36223599 DOI: 10.1093/humrep/deac219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 08/07/2022] [Indexed: 12/14/2022] Open
Abstract
STUDY QUESTION Is a strategy starting with transvaginal hydrolaparoscopy (THL) cost-effective compared to a strategy starting with hysterosalpingography (HSG) in the work-up for subfertility? SUMMARY ANSWER A strategy starting with THL is cost-effective compared to a strategy starting with HSG in the work-up for subfertile women. WHAT IS KNOWN ALREADY Tubal pathology is a common cause of subfertility and tubal patency testing is one of the cornerstones of the fertility work-up. Both THL and HSG are safe procedures and can be used as a first-line tubal patency test. STUDY DESIGN, SIZE, DURATION This economic evaluation was performed alongside a randomized clinical trial comparing THL and HSG in 300 subfertile women, between May 2013 and October 2016. For comparisons of THL and HSG, the unit costs were split into three main categories: costs of the diagnostic procedure, costs of fertility treatments and the costs for pregnancy outcomes. PARTICIPANTS/MATERIALS, SETTING, METHODS Subfertile women scheduled for tubal patency testing were eligible. Women were randomized to a strategy starting with THL or a strategy starting with HSG. The primary outcome of the study was conception leading to a live birth within 24 months after randomization. The mean costs and outcomes for each treatment group were compared. We used a non-parametric bootstrap resampling of 1000 re-samples to investigate the effect of uncertainty and we created a cost-effectiveness plane and cost-effectiveness acceptability curves. MAIN RESULTS AND THE ROLE OF CHANCE We allocated 149 women to THL and 151 to HSG, and we were able to achieve complete follow-up of 142 versus 148 women, respectively. After the fertility work-up women were treated according to the Dutch guidelines and based on a previously published prognostic model. In the THL group, 83 women (58.4%) conceived a live born child within 24 months after randomization compared to 82 women (55.4%) in the HSG group (difference 3.0% (95% CI: -8.3 to 14.4)). The mean total costs per woman were lower in the THL group compared to the HSG group (THL group €4991 versus €5262 in the HSG group, mean cost difference = -€271 (95% CI -€273 to -€269)). Although the costs of only the diagnostic procedure were higher in the THL group, in the HSG group more women underwent diagnostic and therapeutic laparoscopies and also had higher costs for fertility treatments. LIMITATIONS, REASONS FOR CAUTION Our trial was conducted in women with a low risk of tubal pathology; therefore, the results of our study are not generalizable to women with high risk of tubal pathology. Furthermore, this economic analysis was based on the Dutch healthcare system, and possibly our results are not generalizable to countries with different strategies or costs for fertility treatments. WIDER IMPLICATIONS OF THE FINDINGS After 2 years of follow-up, we found a live birth rate of 58.4% in the THL group versus 55.4% in the HSG group and a lower mean cost per woman in the THL group, with a cost difference of -€271. The findings of our trial suggest that a strategy starting with THL is cost-effective compared to a strategy starting with HSG in the workup for subfertile women. However, the cost difference between the two diagnostic strategies is limited compared to the total cost per woman in our study and before implementing THL as a first-line strategy for tubal patency testing, more research in other fields, such as patient preference and acceptance, is necessary. STUDY FUNDING/COMPETING INTEREST(S) The authors received no external financial support for the research. B.W.J.M. is supported by an NHMRC Investigator Grant (GNT1176437). B.W.J.M. reports consultancy for ObsEva, Merck KGaA, Guerbet. B.W.J.M. reports receiving travel support from Merck KGaA. C.T.P. reports consultancy for Guerbet, outside of this manuscript. All other authors have no conflicts to declare. TRIAL REGISTRATION NUMBER NTR3462.
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Affiliation(s)
- M A van Kessel
- Department of Obstetrics and Gynaecology, Dr. Horacio E. Oduber Hospital, Oranjestad, Aruba
| | - C T Pham
- Flinders Health and Medical Research Institute, Flinders University, Bedford Park, SA, Australia
| | - R Tros
- Department of Obstetrics and Gynaecology, Amsterdam UMC, Amsterdam, The Netherlands
| | - G J E Oosterhuis
- Department of Obstetrics and Gynaecology, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - W K H Kuchenbecker
- Department of Obstetrics and Gynaecology, Isala, Zwolle, The Netherlands
| | - M Y Bongers
- Department of Obstetrics and Gynaecology, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maxima Medical Center, Veldhoven, The Netherlands
| | - B W J Mol
- Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia.,Department of Obstetrics and Gynaecology, Aberdeen University, Aberdeen, UK
| | - C A M Koks
- Department of Obstetrics and Gynaecology, Maxima Medical Center, Veldhoven, The Netherlands
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Paulussen M, Va. Kessel MA, Tros R, Oosterhuis GJE, Kuchenbecker WKH, Bongers MY, Mol BW, Koks CAM. P–468 Fertility-related quality of life in subfertile women undergoing transvaginal hydrolaparoscopy versus hysterosalpingography as a first-line tubal patency test. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
Is there a difference in fertility-related quality of life (QoL) in subfertile women undergoing transvaginal hydrolaparoscopy (THL) versus hysterosalpingography (HSG) as a first-line tubal-patency test?
Summary answer
In subfertile women undergoing first-line tubal patency testing, THL and HSG resulted in comparable fertility-related QoL.
What is known already
Both subfertility itself and subfertility treatment can have a significant impact on QoL. Tubal patency testing as part of fertility work-up is also known as a potential stressor. Pain scores for THL are significantly lower than for HSG (VAS 4.7 vs 5.4 ;
SD: 2.5, p 0.038), but acceptability of the procedures was found to be comparable. Fertility-related QoL has not yet been studied in women undergoing tubal patency testing.
Study design, size, duration
We used data from a randomised clinical trial performed in 4 Dutch teaching hospitals, NTR3462. Between May 2013 and October 2016, we randomly assigned 300 subfertile women to THL or HSG with live birth as primary outcome. We performed a standardized questionnaire study as part of a randomised controlled trial comparing THL and HSG in the work-up for subfertility.
Participants/materials, setting, methods
Women were eligible if they were undergoing a fertility work-up with an indication for evaluation of tubal patency testing. Fertility-related QoL was measured six weeks after the procedure with the validated FertiQoL questionnaire, which produces a Core (total) score and four subscale domains: Emotional, Relational, Social, and Mind-Body. FertiQoL scores for the Core score and subscales between THL and HSG were compared using Mann-Whitney-U test and multiple linear regression analysis.
Main results and the role of chance
We allocated 149 women to THL and 151 to HSG. The questionnaire was completed by 84 women in the THL group (response rate 56%) and 96 women in the HSG group (response rate 64%). Core scores were 74.6 ±12.8 for THL and 73.4 ±12.4 for HSG (p = 0.39). Scores for the Emotional domain were 64.5 ±19.0 for THL versus 66.0 ±16.3 (p = 0.67) for HSG. Scores for the ‘Mind-body’ domain for THL were 76.9 ±15.6 versus 74.1 ±18.0 for HSG (p = 0.42), scores for the Relational domain were 79.2 ±12.9 for THL and 76.9 ±15.6 for HSG (p = 0.21). Scores for the Social domain for THL were 77.9 ±15.1 versus 76.7±14.1, (p = 0.42). The optional ‘Treatment FertiQol’ was completed by 156 women. Total scores were 77.5 ±12.1 for THL versus 73.8 ±13.1 (p = 0.08) for HSG. The multiple linear regression analysis showed only a statistical significant positive effect of higher age on the score for the Emotional domain (B:0.90, p = 0.015).
Limitations, reasons for caution
One of the main limitations of this study was a response rate of 60%. Although this is considered an acceptable rate within questionnaire research, this could lead to selection bias.
Wider implications of the findings: In subfertile women, tubal patency testing with THL versus HSG did not result in differences in fertility-related QoL.
Trial registration number
NTR3462
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Affiliation(s)
- M Paulussen
- Maxima Medical Center, Obstetrics and Gynaecology, Veldhoven, The Netherlands
| | - M A Va. Kessel
- dr. Horacio E. Oduber Hospital, Obestrics and Gynaecology, Oranjestad, Neth. Antilles
| | - R Tros
- Amsterdam UMC, Obstetrics and Gynaecology, Amsterdam, The Netherlands
| | - G J E Oosterhuis
- St. Antonius Hospital, Obstetrics and Gynaecology, Utrecht, The Netherlands
| | | | - M Y Bongers
- Maxima Medical Center, Obstetrics and Gynaecology, Veldhoven, The Netherlands
| | - B W Mol
- Amsterdam UMC, Obstetrics and Gynaecology, Amsterdam, The Netherlands
| | - C A M Koks
- Maxima Medical Center, Obstetrics and Gynaecology, Veldhoven, The Netherlands
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Tjon-Kon-Fat RI, Tajik P, Zafarmand MH, Bensdorp AJ, Bossuyt PMM, Oosterhuis GJE, van Golde R, Repping S, Lambers MDA, Slappendel E, Perquin D, Pelinck MJ, Gianotten J, Maas JWM, Eijkemans MJC, van der Veen F, Mol BW, van Wely M. IVF or IUI as first-line treatment in unexplained subfertility: the conundrum of treatment selection markers. Hum Reprod 2017; 32:1028-1032. [PMID: 28333222 DOI: 10.1093/humrep/dex037] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 02/09/2017] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION Are there treatment selection markers that could aid in identifying couples, with unexplained or mild male subfertility, who would have better chances of a healthy child with IVF with single embryo transfer (IVF-SET) than with IUI with ovarian stimulation (IUI-OS)? SUMMARY ANSWER We did not find any treatment selection markers that were associated with better chances of a healthy child with IVF-SET instead of IUI-OS in couples with unexplained or mild male subfertility. WHAT IS KNOWN ALREADY A recent trial, comparing IVF-SET to IUI-OS, found no evidence of a difference between live birth rates and multiple pregnancy rates. It was suggested that IUI-OS should remain the first-line treatment instead of IVF-SET in couples with unexplained or mild male subfertility and female age between 18 and 38 years. The question remains whether there are some couples that may have higher pregnancy chances if treated with IVF-SET instead of IUI. STUDY DESIGN, SIZE, DURATION We performed our analyses on data from the INeS trial, where couples with unexplained or mild male subfertility and an unfavourable prognosis for natural conception were randomly allocated to IVF-SET, IVF in a modified natural cycle or IUI-OS. In view of the aim of this study, we only used data of the comparison between IVF-SET (201 couples) and IUI-OS (207 couples). PARTICIPANTS/MATERIALS, SETTING, METHODS We pre-defined the following baseline characteristics as potential treatment selection markers: female age, ethnicity, smoking status, type of subfertility (primary/secondary), duration of subfertility, BMI, pre-wash total motile count and Hunault prediction score. For each potential treatment selection marker, we explored the association with the chances of a healthy child after IVF-SET and IUI-OS and tested if there was an interaction with treatment. Given the exploratory nature of our analysis, we used a P-value of 0.1. MAIN RESULTS AND THE ROLE OF CHANCE None of the markers were associated with higher chances of a healthy child from IVF-SET compared to IUI-OS (P-value for interaction >0.10). LIMITATIONS, REASONS FOR CAUTION Since this is the first large study that looked at potential treatment selection markers for IVF-SET compared to IUI-OS, we had no data on which to base a power calculation. The sample size was limited, making it difficult to detect any smaller associations. WIDER IMPLICATIONS OF THE FINDINGS We could not identify couples with unexplained or mild male subfertility who would have had higher chances of a healthy child from immediate IVF-SET than from IUI-OS. As in the original trial IUI-OS had similar effectiveness and was less costly compared to IVF-SET, IUI-OS should remain the preferred first-line treatment in these couples. STUDY FUNDING/COMPETING INTEREST(S) The study was supported by a grant from the Netherlands Organization for Health Research and Development, and a grant from the Netherlands' association of health care insurers. There are no conflicts of interest. TRIAL REGISTRATION NUMBER The trial was registered at the Dutch trial registry (NTR939).
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Affiliation(s)
- R I Tjon-Kon-Fat
- Department of Obstetrics and Gynaecology, Centre for Reproductive Medicine, Academic Medical Centre, Amsterdam, The Netherlands
| | - P Tajik
- Department of Obstetrics and Gynaecology, Centre for Reproductive Medicine, Academic Medical Centre, Amsterdam, The Netherlands.,Department of Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - M H Zafarmand
- Department of Obstetrics and Gynaecology, Centre for Reproductive Medicine, Academic Medical Centre, Amsterdam, The Netherlands.,Department of Public Health, Academic Medical Centre, Amsterdam, The Netherlands
| | - A J Bensdorp
- Department of Obstetrics and Gynaecology, Centre for Reproductive Medicine, Academic Medical Centre, Amsterdam, The Netherlands
| | - P M M Bossuyt
- Department of Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - G J E Oosterhuis
- Department of Obstetrics and Gynaecology, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - R van Golde
- Department of Obstetrics and Gynaecology, University Medical Centre Maastricht, Maastricht, The Netherlands
| | - S Repping
- Department of Obstetrics and Gynaecology, Centre for Reproductive Medicine, Academic Medical Centre, Amsterdam, The Netherlands
| | - M D A Lambers
- Department of Obstetrics and Gynaecology, Albert Schweitzer Hospital, Dordrecht, The Netherlands
| | - E Slappendel
- Elisabeth Tweesteden Ziekenhuis, Centrum Voortplantingsgeneeskunde Brabant, Tilburg, The Netherlands
| | - D Perquin
- Department of Obstetrics and Gynaecology, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | - M J Pelinck
- Department of Obstetrics and Gynaecology, Treant Zorggroep, locatie Scheper Hospital, Emmen, The Netherlands
| | - J Gianotten
- Department of Obstetrics and Gynaecology, Spaarne Gasthuis, Haarlem, The Netherlands
| | - J W M Maas
- Department of Obstetrics and Gynaecology, Maxima Medical Centre, Veldhoven, The Netherlands
| | - M J C Eijkemans
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - F van der Veen
- Department of Obstetrics and Gynaecology, Centre for Reproductive Medicine, Academic Medical Centre, Amsterdam, The Netherlands
| | - B W Mol
- School of Medicine, The Robinson Institute, University of Adelaide, Adelaide, Australia.,The South Australian Health and Medical Research Institute, Adelaide, Australia
| | - M van Wely
- Department of Obstetrics and Gynaecology, Centre for Reproductive Medicine, Academic Medical Centre, Amsterdam, The Netherlands
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van Oers AM, Groen H, Mutsaerts MAQ, Burggraaff JM, Kuchenbecker WKH, Perquin DAM, Koks CAM, van Golde R, Kaaijk EM, Schierbeek JM, Oosterhuis GJE, Broekmans FJ, Vogel NEA, Land JA, Mol BWJ, Hoek A. Effectiveness of lifestyle intervention in subgroups of obese infertile women: a subgroup analysis of a RCT. Hum Reprod 2016; 32:482. [PMID: 27989990 DOI: 10.1093/humrep/dew318] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A M van Oers
- Department of Obstetrics and Gynaecology, University of Groningen, University Medical Center Groningen, 9700RB Groningen, The Netherlands
| | - H Groen
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, 9700RB Groningen, The Netherlands
| | - M A Q Mutsaerts
- Department of Obstetrics and Gynaecology, University of Groningen, University Medical Center Groningen, 9700RB Groningen, The Netherlands.,Department of General Practice, University of Utrecht, University Medical Center Utrecht, 3508GA Utrecht, The Netherlands
| | - J M Burggraaff
- Department of Obstetrics and Gynaecology, Scheper Hospital, Department of Obstetrics and Gynaecology, 7800RA Emmen, The Netherlands
| | - W K H Kuchenbecker
- Department of Obstetrics and Gynaecology, Isala Clinics, 8000GK Zwolle, The Netherlands
| | - D A M Perquin
- Department of Obstetrics and Gynaecology, Medical Center Leeuwarden, 8901BR Leeuwarden, The Netherlands
| | - C A M Koks
- Department of Obstetrics and Gynaecology, Maxima Medical Center, 5500MB Veldhoven, The Netherlands
| | - R van Golde
- Department of Obstetrics and Gynaecology, University of Maastricht, Maastricht University Medical Center, 6202AZ Maastricht, The Netherlands
| | - E M Kaaijk
- Department of Obstetrics and Gynaecology, OLVG, 1090HM Amsterdam, The Netherlands
| | - J M Schierbeek
- Department of Obstetrics and Gynaecology, Deventer Hospital, 7400GC Deventer, The Netherlands
| | - G J E Oosterhuis
- Department of Obstetrics and Gynaecology, St. Antonius Hospital, 3430EM Nieuwegein, The Netherlands
| | - F J Broekmans
- Department for Reproductive Medicine, Division Female and Baby, University of Utrecht, University Medical Center Utrecht, 3508GA Utrecht, The Netherlands
| | - N E A Vogel
- Department of Obstetrics and Gynaecology, Martini Hospital, 9700RM Groningen, The Netherlands
| | - J A Land
- Department of Obstetrics and Gynaecology, University of Groningen, University Medical Center Groningen, 9700RB Groningen, The Netherlands
| | - B W J Mol
- The Robinson Research Institute, School of Pediatrics and Reproductive Health, University of Adelaide, 5000SA Adelaide, Australia
| | - A Hoek
- Department of Obstetrics and Gynaecology, University of Groningen, University Medical Center Groningen, 9700RB Groningen, The Netherlands
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van Oers AM, Groen H, Mutsaerts MAQ, Burggraaff JM, Kuchenbecker WKH, Perquin DAM, Koks CAM, van Golde R, Kaaijk EM, Schierbeek JM, Oosterhuis GJE, Broekmans FJ, Vogel NEA, Land JA, Mol BWJ, Hoek A. Effectiveness of lifestyle intervention in subgroups of obese infertile women: a subgroup analysis of a RCT. Hum Reprod 2016; 31:2704-2713. [PMID: 27798042 DOI: 10.1093/humrep/dew252] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Revised: 07/21/2016] [Accepted: 07/26/2016] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION Do age, ovulatory status, severity of obesity and body fat distribution affect the effectiveness of lifestyle intervention in obese infertile women? SUMMARY ANSWER We did not identify a subgroup in which lifestyle intervention increased the healthy live birth rate however it did increase the natural conception rate in anovulatory obese infertile women. WHAT IS KNOWN ALREADY Obese women are at increased risk of infertility and are less likely to conceive after infertility treatment. We previously demonstrated that a 6-month lifestyle intervention preceding infertility treatment did not increase the rate of healthy live births (vaginal live birth of a healthy singleton at term) within 24 months of follow-up as compared to prompt infertility treatment in obese infertile women. Natural conceptions occurred more frequently in women who received a 6-month lifestyle intervention preceding infertility treatment. STUDY DESIGN, SIZE, DURATION This is a secondary analysis of a multicentre RCT (randomized controlled trial), the LIFEstyle study. Between 2009 and 2012, 577 obese infertile women were randomly assigned to a 6-month lifestyle intervention followed by infertility treatment (intervention group) or to prompt infertility treatment (control group). Subgroups were predefined in the study protocol, based on frequently used cut-off values in the literature: age (≥36 or <36 years), ovulatory status (anovulatory or ovulatory), BMI (≥35 or <35 kg/m2) and waist-hip (WH) ratio (≥0.8 or <0.8). PARTICIPANTS/MATERIALS, SETTING, METHODS Data of 564 (98%) randomized women who completed follow-up were analyzed. We studied the effect of the intervention program in various subgroups on healthy live birth rate within 24 months, as well as the rate of overall live births (live births independent of gestational age, mode of delivery and health) and natural conceptions within 24 months. Live birth rates included pregnancies resulting from both treatment dependent and natural conceptions. Logistic regression models with randomization group, subgroup and the interaction between randomization group and subgroup were used. Significant interaction was defined as a P-value <0.1. MAIN RESULTS AND THE ROLE OF CHANCE Neither maternal age, ovulatory status nor BMI had an impact on the healthy live birth rate within 24 months, nor did they influence the overall live birth rate within 24 months after randomization. WH ratio showed a significant interaction with the effect of lifestyle intervention on healthy live birth rate (P = 0.05), resulting in a lower healthy live birth rate in women with a WH ratio <0.8. WH ratio had no interaction regarding overall live birth rate (P = 0.27) or natural conception rate (P = 0.38). In anovulatory women, the effect of lifestyle intervention resulted in more natural conceptions compared to ovulatory women (P-value for interaction = 0.02). There was no interaction between other subgroups and the effect of the intervention on the rate of natural conception. LIMITATIONS, REASONS FOR CAUTION Since this was a subgroup analysis of a RCT and sample size determination of the trial was based on the primary outcome of the study, the study was not powered for analyses of all subgroups. WIDER IMPLICATIONS OF THE FINDINGS Our finding that lifestyle intervention leads to increased natural conception in anovulatory obese women could be used in the counselling of these women, but requires further research using an appropriately powered study in order to confirm this result. STUDY FUNDING/COMPETING INTERESTS The study was supported by a grant from ZonMw, the Dutch Organisation for Health Research and Development (50-50110-96-518). The Department of Obstetrics and Gynaecology of the UMCG received an unrestricted educational grant from Ferring pharmaceuticals BV, The Netherlands. Ben Mol is a consultant for ObsEva, Geneva. Annemieke Hoek received a speaker's fee for a postgraduate education from MSD pharmaceutical company, outside the submitted work. TRIAL REGISTRATION NUMBER The LIFEstyle study was registered at the Dutch trial registry (NTR 1530).
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Affiliation(s)
- A M van Oers
- Department of Obstetrics and Gynaecology, University of Groningen, University Medical Center Groningen, 9700RB Groningen, The Netherlands
| | - H Groen
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, 9700RB Groningen, The Netherlands
| | - M A Q Mutsaerts
- Department of Obstetrics and Gynaecology, University of Groningen, University Medical Center Groningen, 9700RB Groningen, The Netherlands.,Department of General Practice, University of Utrecht, University Medical Center Utrecht, 3508GA Utrecht, The Netherlands
| | - J M Burggraaff
- Department of Obstetrics and Gynaecology, Scheper Hospital, 7800RA Emmen, The Netherlands
| | - W K H Kuchenbecker
- Department of Obstetrics and Gynaecology, Isala Clinics, 8000GK Zwolle, The Netherlands
| | - D A M Perquin
- Department of Obstetrics and Gynaecology, Medical Center Leeuwarden, 8901BR Leeuwarden, The Netherlands
| | - C A M Koks
- Department of Obstetrics and Gynaecology, Maxima Medical Center, 5500MB Veldhoven, The Netherlands
| | - R van Golde
- Department of Obstetrics and Gynaecology, University of Maastricht, Maastricht University Medical Center, 6202AZ Maastricht, The Netherlands
| | - E M Kaaijk
- Department of Obstetrics and Gynaecology, OLVG, 1090HM Amsterdam, The Netherlands
| | - J M Schierbeek
- Department of Obstetrics and Gynaecology, Deventer Hospital, 7400GC Deventer, The Netherlands
| | - G J E Oosterhuis
- Department of Obstetrics and Gynaecology, St. Antonius Hospital, 3430EM Nieuwegein, The Netherlands
| | - F J Broekmans
- Department for Reproductive Medicine, Division Female and Baby, University of Utrecht, University Medical Center Utrecht, 3508GA Utrecht, The Netherlands
| | - N E A Vogel
- Department of Obstetrics and Gynaecology, Martini Hospital, 9700RM Groningen, The Netherlands
| | - J A Land
- Department of Obstetrics and Gynaecology, University of Groningen, University Medical Center Groningen, 9700RB Groningen, The Netherlands
| | - B W J Mol
- The Robinson Research Institute, School of Pediatrics and Reproductive Health, University of Adelaide, 5000SA Adelaide, Australia
| | - A Hoek
- Department of Obstetrics and Gynaecology, University of Groningen, University Medical Center Groningen, 9700RB Groningen, The Netherlands
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Bensdorp AJ, Tjon-Kon-Fat RI, Bossuyt PMM, Koks CAM, Oosterhuis GJE, Hoek A, Hompes PGA, Broekmans FJM, Verhoeve HR, de Bruin JP, van Golde R, Repping S, Cohlen BJ, Lambers MDA, van Bommel PF, Slappendel E, Perquin D, Smeenk JM, Pelinck MJ, Gianotten J, Hoozemans DA, Maas JWM, Eijkemans MJC, van der Veen F, Mol BWJ, van Wely M. Prevention of multiple pregnancies in couples with unexplained or mild male subfertility: randomised controlled trial of in vitro fertilisation with single embryo transfer or in vitro fertilisation in modified natural cycle compared with intrauterine insemination with controlled ovarian hyperstimulation. BMJ 2015; 350:g7771. [PMID: 25576320 PMCID: PMC4288434 DOI: 10.1136/bmj.g7771] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
OBJECTIVES To compare the effectiveness of in vitro fertilisation with single embryo transfer or in vitro fertilisation in a modified natural cycle with that of intrauterine insemination with controlled ovarian hyperstimulation in terms of a healthy child. DESIGN Multicentre, open label, three arm, parallel group, randomised controlled non-inferiority trial. SETTING 17 centres in the Netherlands. PARTICIPANTS Couples seeking fertility treatment after at least 12 months of unprotected intercourse, with the female partner aged between 18 and 38 years, an unfavourable prognosis for natural conception, and a diagnosis of unexplained or mild male subfertility. INTERVENTIONS Three cycles of in vitro fertilisation with single embryo transfer (plus subsequent cryocycles), six cycles of in vitro fertilisation in a modified natural cycle, or six cycles of intrauterine insemination with ovarian hyperstimulation within 12 months after randomisation. MAIN OUTCOME MEASURES The primary outcome was birth of a healthy child resulting from a singleton pregnancy conceived within 12 months after randomisation. Secondary outcomes were live birth, clinical pregnancy, ongoing pregnancy, multiple pregnancy, time to pregnancy, complications of pregnancy, and neonatal morbidity and mortality RESULTS 602 couples were randomly assigned between January 2009 and February 2012; 201 were allocated to in vitro fertilisation with single embryo transfer, 194 to in vitro fertilisation in a modified natural cycle, and 207 to intrauterine insemination with controlled ovarian hyperstimulation. Birth of a healthy child occurred in 104 (52%) couples in the in vitro fertilisation with single embryo transfer group, 83 (43%) in the in vitro fertilisation in a modified natural cycle group, and 97 (47%) in the intrauterine insemination with controlled ovarian hyperstimulation group. This corresponds to a risk, relative to intrauterine insemination with ovarian hyperstimulation, of 1.10 (95% confidence interval 0.91 to 1.34) for in vitro fertilisation with single embryo transfer and 0.91 (0.73 to 1.14) for in vitro fertilisation in a modified natural cycle. These 95% confidence intervals do not extend below the predefined threshold of 0.69 for inferiority. Multiple pregnancy rates per ongoing pregnancy were 6% (7/121) after in vitro fertilisation with single embryo transfer, 5% (5/102) after in vitro fertilisation in a modified natural cycle, and 7% (8/119) after intrauterine insemination with ovarian hyperstimulation (one sided P=0.52 for in vitro fertilisation with single embryo transfer compared with intrauterine insemination with ovarian hyperstimulation; one sided P=0.33 for in vitro fertilisation in a modified natural cycle compared with intrauterine insemination with controlled ovarian hyperstimulation). CONCLUSIONS In vitro fertilisation with single embryo transfer and in vitro fertilisation in a modified natural cycle were non-inferior to intrauterine insemination with controlled ovarian hyperstimulation in terms of the birth of a healthy child and showed comparable, low multiple pregnancy rates.Trial registration Current Controlled Trials ISRCTN52843371; Nederlands Trial Register NTR939.
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Affiliation(s)
- A J Bensdorp
- Centre for Reproductive Medicine, Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, Netherlands
| | - R I Tjon-Kon-Fat
- Centre for Reproductive Medicine, Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, Netherlands
| | - P M M Bossuyt
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre, University of Amsterdam
| | - C A M Koks
- Máxima Medical Centre, Department of Obstetrics and Gynaecology, Veldhoven, Netherlands
| | - G J E Oosterhuis
- St Antonius Hospital, Department of Obstetrics and Gynaecology, Nieuwegein, Netherlands
| | - A Hoek
- University Medical Centre Groningen, University of Groningen, Department of Obstetrics and Gynaecology, Groningen, Netherlands
| | - P G A Hompes
- Vrije Universiteit Medical Centre, Centre for Reproductive Medicine, Amsterdam
| | - F J M Broekmans
- University Medical Centre Utrecht, Department for Reproductive Medicine, Utrecht, Netherlands
| | - H R Verhoeve
- Onze Lieve Vrouwe Gasthuis, Department of Obstetrics and Gynaecology, Amsterdam, Netherlands
| | - J P de Bruin
- Jeroen Bosch Hospital, Department of Obstetrics and Gynaecology, 's Hertogenbosch, Netherlands
| | - R van Golde
- University Medical Centre Maastricht, Department of Obstetrics and Gynaecology, Maastricht, Netherlands
| | - S Repping
- Centre for Reproductive Medicine, Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, Netherlands
| | - B J Cohlen
- Isala Clinics, Department of Obstetrics and Gynaecology, Zwolle, Netherlands
| | - M D A Lambers
- Albert Schweitzer Hospital, Department of Obstetrics and Gynaecology, Dordrecht, Netherlands
| | - P F van Bommel
- Amphia Hospital, Department of Obstetrics and Gynaecology, Breda, Netherlands
| | - E Slappendel
- Catharina Hospital, Department of Obstetrics and Gynaecology, Eindhoven, Netherlands
| | - D Perquin
- Medical Centre Leeuwarden, Obstetrics and Gynaecology, Leeuwarden, Netherlands
| | - J M Smeenk
- Elisabeth Hospital, Department of Obstetrics and Gynaecology, Tilburg, Netherlands
| | - M J Pelinck
- Scheper Hospital, Department of Obstetrics and Gynaecology, Emmen, Netherlands
| | - J Gianotten
- Kennemer Gasthuis, Department of Obstetrics and Gynaecology, Haarlem, Netherlands
| | - D A Hoozemans
- Medical Spectrum Twente, Department of Obstetrics and Gynaecology, Enschede, Netherlands
| | - J W M Maas
- Máxima Medical Centre, Department of Obstetrics and Gynaecology, Veldhoven, Netherlands
| | - M J C Eijkemans
- University Medical Centre Utrecht, Julius Centre for Health Sciences and Primary Care, Utrecht, Netherlands
| | - F van der Veen
- Centre for Reproductive Medicine, Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, Netherlands
| | - B W J Mol
- The Robinson Research Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, Australia
| | - M van Wely
- Centre for Reproductive Medicine, Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, Netherlands
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Nazzaro A, Salerno A, Di Iorio L, Landino G, Marino S, Pastore E, Fabregues F, Iraola A, Casals G, Creus M, Peralta S, Penarrubia J, Manau D, Civico S, Balasch J, Lindgren I, Giwercman YL, Celik E, Turkcuoglu I, Ata B, Karaer A, Kirici P, Berker B, Park J, Kim J, Rhee J, Krishnan M, Rustamov O, Russel R, Fitzgerald C, Roberts S, Hapuarachi S, Tan BK, Mathur RS, van de Vijver A, Blockeel C, Camus M, Polyzos N, Van Landuyt L, Tournaye H, Turhan NO, Hizli D, Kamalak Z, Kosus A, Kosus N, Kafali H, Lukaszuk A, Kunicki M, Liss J, Bednarowska A, Jakiel G, Lukaszuk K, Lukaszuk M, Olszak-Sokolowska B, Lukaszuk K, Kunicki M, Liss J, Jakiel G, Bednarowska A, Wasniewski T, Neuberg M, Lukaszuk M, Cavalcanti V, Peluso C, Lechado BL, Cordts EB, Christofolini DM, Barbosa CP, Bianco B, Venetis CA, Kolibianakis EM, Bosdou J, Tarlatzis BC, Onal M, Gungor DN, Acet M, Kahraman S, Kuijper E, Twisk J, Caanen M, Korsen T, Hompes P, Kushnir M, Rockwood A, Meikle W, Lambalk CB, Hizli D, Kamalak Z, Kosus A, Kosus N, Turhan NO, Kafali H, Yan X, Dai X, Wang J, Zhao N, Cui Y, Liu J, Yarde F, Maas AHEM, Franx A, Eijkemans MJC, Drost JT, van Rijn BB, van Eyck J, van der Schouw YT, Broekmans FJM, Martyn F, Anglim B, Wingfield M, Fang T, Yan GJ, Sun HX, Hu YL, Chrudimska J, Krenkova P, Macek M, Macek M, Teixeira da Silva J, Cunha M, Silva J, Viana P, Goncalves A, Barros N, Oliveira C, Sousa M, Barros A, Nelson SM, Lloyd SM, McConnachie A, Khader A, Fleming R, Lawlor DA, Thuesen L, Andersen AN, Loft A, Smitz J, Abdel-Rahman M, Ismail S, Silk J, Abdellah M, Abdellah AH, Ruiz F, Cruz M, Piro M, Collado D, Garcia-Velasco JA, Requena A, Kollmann Z, Bersinger NA, McKinnon B, Schneider S, Mueller MD, von Wolff M, Vaucher A, Kollmann Z, Bersinger NA, Weiss B, Stute P, Marti U, von Wolff M, Chai J, Yeung WYT, Lee CYV, Li WHR, Ho PC, Ng HYE, Kim SM, Kim SH, Jee BC, Ku S, Suh CS, Choi YM, Kim JG, Moon SY, Lee JH, Kim SG, Kim YY, Kim HJ, Lee KH, Park IH, Sun HG, Hwang YI, Sung NY, Choi MH, Cha SH, Park CW, Kim JY, Yang KM, Song IO, Koong MK, Kang IS, Kim HO, Haines C, Wong WY, Kong WS, Cheung LP, Choy TK, Leung PC, Fadini R, Coticchio G, Renzini MM, Guglielmo MC, Brambillasca F, Hourvitz A, Albertini DF, Novara P, Merola M, Dal Canto M, Iza JAA, DePablo JL, Anarte C, Domingo A, Abanto E, Barrenetxea G, Kato R, Kawachiya S, Bodri D, Kondo M, Matsumoto T, Maldonado LGL, Setti AS, Braga DPAF, Iaconelli A, Borges E, Iaconelli C, Setti AS, Braga DPAF, Figueira RCS, Iaconelli A, Borges E, Kitaya K, Taguchi S, Funabiki M, Tada Y, Hayashi T, Nakamura Y, Snajderova M, Zemkova D, Lanska V, Teslik L, Calonge RN, Ortega L, Garcia A, Cortes S, Guijarro A, Peregrin PC, Bellavia M, Pesant MH, Wirthner D, Portman L, de Ziegler D, Wunder D, Chen X, Chen SHL, Liu YD, Tao T, Xu LJ, Tian XL, Ye DSH, He YX, Carby A, Barsoum E, El-Shawarby S, Trew G, Lavery S, Mishieva N, Barkalina N, Korneeva I, Ivanets T, Abubakirov A, Chavoshinejad R, Hartshorne GM, Marei W, Fouladi-nashta AA, Kyrkou G, Trakakis E, Chrelias CH, Alexiou E, Lykeridou K, Mastorakos G, Bersinger N, Kollmann Z, Mueller MD, Vaucher A, von Wolff M, Ferrero H, Gomez R, Garcia-Pascual CM, Simon C, Pellicer A, Turienzo A, Lledo B, Guerrero J, Ortiz JA, Morales R, Ten J, Llacer J, Bernabeu R, De Leo V, Focarelli R, Capaldo A, Stendardi A, Gambera L, Marca AL, Piomboni P, Kim JJ, Choi YM, Kang JH, Hwang KR, Chae SJ, Kim SM, Yoon SH, Ku SY, Kim SH, Kim JG, Moon SY, Iliodromiti S, Kelsey TW, Anderson RA, Nelson SM, Lee HJ, Weghofer A, Kushnir VA, Shohat-Tal A, Lazzaroni E, Lee HJ, Barad DH, Gleicher NN, Shavit T, Shalom-Paz E, Fainaru O, Michaeli M, Kartchovsky E, Ellenbogen A, Gerris J, Vandekerckhove F, Delvigne A, Dhont N, Madoc B, Neyskens J, Buyle M, Vansteenkiste E, De Schepper E, Pil L, Van Keirsbilck N, Verpoest W, Debacquer D, Annemans L, De Sutter P, Von Wolff M, Kollmann Z, Vaucher A, Weiss B, Bersinger NA, Verit FF, Keskin S, Sargin AK, Karahuseyinoglu S, Yucel O, Yalcinkaya S, Comninos AN, Jayasena CN, Nijher GMK, Abbara A, De Silva A, Veldhuis JD, Ratnasabapathy R, Izzi-Engbeaya C, Lim A, Patel DA, Ghatei MA, Bloom SR, Dhillo WS, Colodron M, Guillen JJ, Garcia D, Coll O, Vassena R, Vernaeve V, Pazoki H, Bolouri G, Farokhi F, Azarbayjani MA, Alebic MS, Stojanovic N, Abali R, Yuksel A, Aktas C, Celik C, Guzel S, Erfan G, Sahin O, Zhongying H, Shangwei L, Qianhong M, Wei F, Lei L, Zhun X, Yan W, Vandekerckhove F, De Baerdemaeker A, Gerris J, Tilleman K, Vansteelandt S, De Sutter P, Oliveira JBA, Baruffi RLR, Petersen CG, Mauri AL, Nascimento AM, Vagnini L, Ricci J, Cavagna M, Massaro FC, Pontes A, Franco JG, El-khayat W, Elsadek M, Foroozanfard F, Saberi H, Moravvegi A, Kazemi M, Gidoni YS, Raziel A, Friedler S, Strassburger D, Hadari D, Kasterstein E, Ben-Ami I, Komarovsky D, Maslansky B, Bern O, Ron-El R, Izquierdo MP, Ten J, Guerrero J, Araico F, Llacer J, Bernabeu R, Somova O, Feskov O, Feskova I, Bezpechnaya I, Zhylkova I, Tishchenko O, Oguic SK, Baldani DP, Skrgatic L, Simunic V, Vrcic H, Rogic D, Juras J, Goldstein MS, Garcia De Miguel L, Campo MC, Gurria A, Alonso J, Serrano A, Marban E, Peregrin PC, Hourvitz A, Shalev L, Yung Y, Yerushalmi G, Giovanni C, Dal Canto M, Fadini R, Has J, Maman E, Monterde M, Gomez R, Marzal A, Vega O, Rubio JM, Diaz-Garcia C, Pellicer A, Eapen A, Datta A, Kurinchi-selvan A, Birch H, Lockwood GM, Ornek MC, Ates U, Usta T, Goksedef CP, Bruszczynska A, Glowacka J, Kunicki M, Jakiel G, Wasniewski T, Jaguszewska K, Liss J, Lukaszuk K, Oehninger S, Nelson S, Verweij P, Stegmann B, Ando H, Takayanagi T, Minamoto H, Suzuki N, Maman E, Rubinshtein N, Yung Y, Shalev L, Yerushalmi G, Hourvitz A, Saltek S, Demir B, Dilbaz B, Demirtas C, Kutteh W, Shapiro B, Witjes H, Gordon K, Lauritsen MP, Loft A, Pinborg A, Freiesleben NL, Mikkelsen AL, Bjerge MR, Andersen AN, Chakraborty P, Goswami SK, Chakravarty BN, Mittal M, Bajoria R, Narvekar N, Chatterjee R, Bentzen JG, Johannsen TH, Scheike T, Andersen AN, Friis-Hansen L, Sunkara S, Coomarasamy A, Faris R, Braude P, Khalaf Y, Makedos A, Kolibianakis EM, Venetis CA, Masouridou S, Chatzimeletiou K, Zepiridis L, Mitsoli A, Lainas G, Sfontouris I, Tzamtzoglou A, Kyrou D, Lainas T, Tarlatzis BC, Fermin A, Crisol L, Exposito A, Prieto B, Mendoza R, Matorras R, Louwers Y, Lao O, Kayser M, Palumbo A, Sanabria V, Rouleau JP, Puopolo M, Hernandez MJ, Diaz-Garcia C, Monterde M, Marzal A, Vega O, Rubio JM, Gomez R, Pellicer A, Ozturk S, Sozen B, Yaba-Ucar A, Mutlu D, Demir N, Olsson H, Sandstrom R, Grundemar L, Papaleo E, Corti L, Rabellotti E, Vanni VS, Potenza M, Molgora M, Vigano P, Candiani M, Andersen AN, Fernandez-Sanchez M, Bosch E, Visnova H, Barri P, Garcia-Velasco JA, De Sutter P, Fauser BJCM, Arce JC, Sandstrom R, Olsson H, Grundemar L, Peluso P, Trevisan CM, Cordts EB, Cavalcanti V, Christofolini DM, Fonseca FA, Barbosa CP, Bianco B, Bakas P, Vlahos N, Hassiakos D, Tzanakaki D, Gregoriou O, Liapis A, Creatsas G, Adda-Herzog E, Steffann J, Sebag-Peyrelevade S, Poulain M, Benachi A, Fanchin R, Gordon K, Zhang D, Andersen AN, Aybar F, Temel S, Kahraman S, Hamdine O, Macklon NS, Eijkemans MJC, Laven JS, Cohlen BJ, Verhoeff A, van Dop PA, Bernardus RE, Lambalk CB, Oosterhuis GJE, Holleboom CAG, van den Dool-Maasland GC, Verburg HJ, van der Heijden PFM, Blankhart A, Fauser BCJM, Broekmans FJ, Bhattacharya J, Mitra A, Dutta GB, Kundu A, Bhattacharya M, Kundu S, Pigny P, Dassonneville A, Catteau-Jonard S, Decanter C, Dewailly D, Pouly J, Olivennes F, Massin N, Celle M, Caizergues N, Fleming R, Gaudoin M, Messow M, McConnachie A, Nelson SM, Dewailly D, Vanhove L, Peigne M, Thomas P, Robin G, Catteau-Jonard S. Reproductive endocrinology. Hum Reprod 2013. [DOI: 10.1093/humrep/det221] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Tjon-Kon-Fat RI, Bensdorp AJ, Maas J, Oosterhuis GJE, Hoek A, Hompes PGA, Broekmans FJ, Verhoeve HR, de Bruin JP, Repping S, Cohlen BJ, Groen H, Mol BWJ, van der Veen F, Wely M, Peeraer K, Debrock S, De Loecker P, Laenen A, Welkenhuyzen M, Spiessens C, De Neubourg D, D'Hooghe TM, Puri S, Mohan B, Herbemont C, Adda E, Hugues JN, Sermondade N, Dupont C, Cedrin-Durnerin I, Poncelet C, Levy R, Sifer C, Bellver J, Pellicer A, Garcia-Velasco JA, Ballesteros A, Remohi J, Meseguer M. Session 45: Clinical female infertility. Hum Reprod 2013. [DOI: 10.1093/humrep/det178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Simsek E, Kilicdag EB, Haydardedeoglu B, Coban G, Iskender C, Simsek SY, Zeyneloglu HB, Glazebrook JE, Stocker LJ, Cheong Y, Di Florio C, Immediata V, Gagliano D, Zumpano A, Tartaglia C, Selvaggi L, Lanzone A, Guido M, Kanmaz G, Kahraman A, Varli B, Cetinkaya E, Taskin S, Ozmen B, Vij P, Cherian TK, Simsek M, Atilgan R, Ozkan ZS, Kavak B, Deveci D, Demirel I, Sapmaz E, Ashraf M, Ghourab G, Abuzeid O, Mitwally MF, Diamond MP, Abuzeid M, Coenders-Tros R, Van Kessel MA, Oosterhuis GJE, Vernooy E, Kuchenbecker WKH, Mol BWJ, Koks C, Al Rabiah H, Karins M, Faghih M, Choussein S, Bailey AP, Srouji SS, Gargiulo AR, Bosteels J, Pelckmans S, Weyers S, Mol BWJ, D'Hooghe T, Jayakrishnan KDK, Baheti BDS, Lee JH, Lee JR, Lee JY, Jee BC, Suh CS, Kim SH, Aboeighait S, Youssef MAF, Hosny AN, Yassin MS, Shokry MA, Gemei S, Sanad A, Esin S, Baser E, Okuyan E, Kucukozkan T. Reproductive surgery. Hum Reprod 2013. [DOI: 10.1093/humrep/det223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Dain L, Bider D, Levron J, Zinchenko V, Westler S, Dirnfeld M, Di Emidio G, Falone S, Vitti M, Santonocito M, Vento M, Artini PG, Di Pietro C, Amicarelli F, Tatone C, Herreboudt A, Colledge WH, Anastacio A, Pionneau C, Chardonnet S, Santos TA, Poirot C, Bensdorp AJ, Tjon-Kon-Fat RI, Koks C, Oosterhuis GJE, Hoek A, Hompes PGA, Broekmans FJ, Verhoeve HR, de Bruin JP, van Golde R, Repping S, Cohlen BJ, Mol BWJ, van der FV, van MW, Henningsen AA, Gissler M, Nygren KG, Skjaerven R, Tiitinen A, Wennerholm UB, Romundstad LB, Andersen AN, Lidegaard O, Forman JL, Pinborg A. Session 07: Female infertility: new developments. Hum Reprod 2013. [DOI: 10.1093/humrep/det229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Nahuis MJ, Oude Lohuis E, Kose N, Bayram N, Hompes P, Oosterhuis GJE, Kaaijk EM, Cohlen BJ, Bossuyt PPM, van der Veen F, Mol BW, van Wely M. Long-term follow-up of laparoscopic electrocautery of the ovaries versus ovulation induction with recombinant FSH in clomiphene citrate-resistant women with polycystic ovary syndrome: an economic evaluation. Hum Reprod 2012; 27:3577-82. [PMID: 23001778 DOI: 10.1093/humrep/des336] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Laparoscopic electrocautery of the ovaries and ovulation induction with gonadotrophins are both second line treatments for women with clomiphene citrate-resistant polycystic ovary syndrome (PCOS). Long-term follow-up after electrocautery versus ovulation induction with gonadotrophins has demonstrated at least comparable chances for a first live born child with a reduced need for ovulation induction or assisted reproduction treatment and increased chances for a second live born child. In this study, we report on the long-term economic consequences of both treatment modalities. METHODS Between February 1998 and October 2001, we performed a multi-centre randomized controlled trial (RCT) comparing a strategy of laparoscopic electrocautery of the ovaries, followed by clomiphene citrate and gonadotrophins when anovulation persisted, and a strategy of ovulation induction with gonadotrophins in women with clomiphene citrate-resistant PCOS. Eight to twelve years after randomization we performed a follow-up study on reproductive outcome in these women and the fertility treatments they had needed including data on direct medical costs of pregnancy and delivery. Clinical data included number of treatment cycles, live births, miscarriages, ectopic pregnancies and multiple pregnancies. We calculated mean costs per woman after randomization until the first live birth. Confidence intervals (CIs) were estimated by bootstrapping. RESULTS We obtained data for an economic analysis on 159 of the 168 randomized women (95%). In total, 71 of 83 women (86%) allocated to the electrocautery strategy and 69 of 85 women (81%) allocated to the gonadotrophin strategy had at least one live birth. Given the equivalence between the two treatment strategies in terms of a first live birth-the primary outcome measure-our analysis focused on the cost difference between the two strategies within a mean follow-up time of 8-12 years. The mean costs per first live birth after randomization were €11 176 (95% CI: €9689-€12 549) for the electrocautery group and €14 423 (95% CI: €12 239-€16 606) for the recombinant FSH group, resulting in significantly lower costs (P < 0.05) per first live birth for women allocated to the electrocautery group (mean difference €3247; 95% CI: €650-€5814). CONCLUSION In women with clomiphene-resistant PCOS, laparoscopic electrocautery of the ovaries results in significantly lower costs per live birth than ovulation induction with gonadotrophins for an at least equal effectiveness.
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Affiliation(s)
- M J Nahuis
- Center for Reproductive Medicine, Department of Obstetrics and Gynaecology, H4-205, Academic Medical Center, University of Amsterdam, Meibergdreef 9, Amsterdam 1105 AZ The Netherlands.
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Karasu Y, Dilbaz B, Demir B, Dilbaz S, Secilmis Kerimoglu O, Ercan CM, Keskin U, Korkmaz C, Duru NK, Ergun A, de Zuniga I, Horton M, Oubina A, Scotti L, Abramovich D, Pascuali N, Tesone M, Parborell F, Bouzas N, Yang XH, Chen SL, Chen X, Ye DS, Zheng HY, Nyboe Andersen A, Lauritsen MP, Thuesen LL, Khodadadi M, Shivabasavaiah S, Mozafari R, Ansari Z, Hamdine O, Broekmans F, Eijkemans MJC, Cohlen BJ, Verhoeff A, van Dop PA, Bernardus RE, Lambalk CB, Oosterhuis GJE, Holleboom C, van den Dool-Maasland GC, Verburg HJ, van der Heijden PFM, Blankhart A, Fauser BCJM, Laven JSE, Macklon NS, Agudo D, Lopez C, Alonso M, Huguet E, Bronet F, Garcia-Velasco JA, Requena A, Gonzalez Comadran M, Checa MA, Duran M, Fabregues F, Carreras R, Ersahin A, Kahraman S, Kavrut M, Gorgen B, Acet M, Dokuzeylul N, Aybar F, Lim SY, Park JC, Bae JG, Kim JI, Rhee JH, Mahran A, Abdelmeged A, El-Adawy A, Eissa M, Darne J, Shaw RW, Amer SA, Dai A, Yan G, He Q, Hu Y, Sun H, Ferrero H, Gomez R, Garcia-Pascual CM, Simon C, Gaytan F, Pellicer A, Garcia Pascual CM, Zimmermann RC, Ferrero H, Simon C, Pellicer A, Gomez R, Madani T, Mohammadi Yeganeh L, Khodabakhshi SH, Akhoond MR, Hasani F, Monzo C, Haouzi D, Assou S, Dechaud H, Hamamah S, Amer S, Mahran M, Eissa M, Darne J, Shaw R, Lan V, Nhu G, Tuong H, Mahmoud Youssef MA, Aboulfoutouh I, Al-inany H, Van Der Veen F, Van Wely M, Zhang Q, Fang T, Wu S, Zhang L, Wang B, Li X, Yan G, Sun H, Hu Y, He Q, Ding L, Day A, Wang B, Yan G, Hu Y, Sun H, Zhang L, Fang T, Zhang Q, Wu S, Yan G, Sun H, Hu Y, Fulford B, Boivin J, Alanbay I, Ercan CM, Sakinci M, Coksuer H, Ozturk M, Tapan S, Chung CK, Chung Y, Seo S, Aksoy S, Yakin K, Caliskan S, Salar Z, Ata B, Urman B, Devroey P, Pellicer A, Nyboe Andersen A, Arce JC, Harrison K, Irving J, Osborn J, Harrison M, Fusi F, Arnoldi M, Cappato M, Galbignani E, Galimberti A, Zanga L, Frigerio L, Taghavi SA, Ashrafi M, Karimian L, Mehdizadeh M, Joghataie M, Aflatoonian R, Xu B, Cui YG, Gao LL, Diao FY, Li M, Liu XQ, Liu JY, Jiang F, Li M, Cui YG, Diao FY, Liu JY, Jee BC, Yi G, Kim JY, Suh CS, Kim SH, Liu S, Cui YG, Liu JY, Cai LB, Liu JJ, Ma X, Geenen E, Bots RSGM, Smeenk JMJ, Chang E, Lee W, Seok H, Kim Y, Han J, Yoon T, Lazaros L, Xita N, Zikopoulos K, Makrydimas G, Kaponis A, Sofikitis N, Stefos T, Hatzi E, Georgiou I, Atilgan R, Kumbak B, Sahin L, Ozkan ZS, Simsek M, Sapmaz E, Karacan M, Alwaeely FA, Cebi Z, Berberoglugil M, Ulug M, Camlibel T, Kavrut M, Kahraman S, Ersahin A, Acet M, Yelke H, Kamalak Z, Carlioglu A, Akdeniz D, Uysal S, Inegol Gumus I, Ozturk Turhan N, Regan S, Yovich J, Stanger J, Almahbobi G, Kara M, Aydin T, Turktekin N, Youssef M, Aboulfoutouh I, Al-Inany H, van der Veen F, van Wely M, Hart R, Doherty D, Frederiksen H, Keelan J, Pennell C, Newnham J, Skakkebaek N, Main K, Salem HT, Ismail AA, Viola M, Siebert TI, Steyn DW, Kruger TF, Robin G, Dewailly D, Thomas P, Leroy M, Lefebvre C, soudan B, Pigny P, Decanter C, ElPrince M, Wang F, Zhu Y, Huang H, Valdez Morales F, Vital Reyes V, Mendoza Rodriguez A, Gamboa Dominguez A, Cerbon M, Aizpurua J, Ramos B, Luehr B, Moragues I, Rogel S, Cil AP, Guler ZB, Kisa U, Albu A, Radian S, Grigorescu F, Albu D, Fica S, Al Boghdady L, Ghanem ME, Hassan M, Helal AS, Ozdogan S, Ozdegirmenci O, Dilbaz S, Demir B, Cinar O, Dilbaz B, Goktolga U, Seeber B, Tsybulyak I, Bottcher B, Grubinger T, Czech T, Wildt L, Wojcik J, Howles CM, Destenaves B, Arriagada P, Tavmergen E, Sahin G, Akdogan A, Levi R, Goker ENT, Thuesen LL, Loft A, Smitz J, Nyboe Andersen A, Ricciardi L, Di Florio C, Busacca M, Gagliano D, Immediata V, Selvaggi L, Romualdi D, Guido M, Bouhanna P, Salama S, Kamoud Z, Torre A, Paillusson B, Fuchs F, Bailly M, Wainer R, Tagliaferri V, Busacca M, Gagliano D, Di Florio C, Tartaglia C, Cirella E, Romualdi D, Guido M, Aflatoonian A, Eftekhar M, Mohammadian F, Yousefnejad F, De Cicco S, Gagliano D, Busacca M, Di Florio C, Immediata V, Campagna G, Romualdi D, Guido M, Depalo R, Lippolis C, Vacca M, Nardelli C, Selvaggi L, Cavallini A, Panic T, Mitulovic G, Franz M, Sator K, Tschugguel W, Pietrowski D, Hildebrandt T, Cupisti S, Giltay EJ, Gooren LJ, Oppelt PG, Hackl J, Reissmann C, Schulze C, Heusinger K, Attig M, Hoffmann I, Beckmann MW, Dittrich R, Mueller A, Sharma S, Singh S, Chakravarty A, Sarkar A, Rajani S, Chakravarty BN, Dilbaz S, Ozturk E, Ozdegirmenci O, Demir B, Isikoglu S, Kul S, Dilbaz B, Cinar O, Goktolga U, Eftekhar M, Aflatoonian A, Mohammadian F, Broekmans F, Hillensjo T, Witjes H, Elbers J, Mannaerts B, Gordon K, Krasnopolskaya K, Galaktionova A, Gorskaya O, Kabanova D, Venturella R, Morelli M, Mocciaro R, Capasso S, Cappiello F, Zullo F, Monterde M, Gomez R, Marzal A, Vega O, Rubio-Rubio JM, Diaz-Garcia C, Pellicer A, Gordon K, Kolibianakis E, Griesinger G, Yding Andersen C, Witjes H, Mannaerts B, Ocal P, Guralp O, Aydogan B, Irez T, Cetin M, Senol H, Erol N, Yding Andersen C, Kolibianakis E, Devroey P, Witjes H, Mannaerts B, Gordon K, Griesinger G, Rombauts L, Van Kuijk J, Mannaerts B, Montagut J, Nogueira D, Porcu G, Chomier M, Giorgetti C, Nicollet B, Degoy J, Lehert P, Alviggi C, De Rosa P, Vallone R, Picarelli S, Coppola M, Conforti A, Strina I, Di Carlo C, De Placido G, Hackl J, Cupisti S, Haeberle L, Schulze C, Hildebrandt T, Oppelt PG, Reissmann C, Heusinger K, Attig M, Hoffmann I, Dittrich R, Beckmann MW, Mueller A, Akdogan A, Demirtas O, Sahin G, Tavmergen E, Goker ENT, Fatemi H, Shapiro BS, Griesinger G, Witjes H, Gordon K, Mannaerts BM, Chimote MN, Mehta BN, Chimote NN, Nath NM, Chimote NM, Karia S, Bonifacio M, Bowman M, McArthur S, Jung J, Cho S, Choi Y, Lee B, Seo S, Lee KH, Kim CH, Kwon SK, Kim SH, Kang BM, Jung KS, Basios G, Trakakis E, Hatziagelaki E, Vaggopoulos V, Tsiavou A, Panagopoulos P, Chrelias C, Kassanos D, Sarhan A, Elsamanoudy A, Harira M, Dogan S, Bozdag G, Esinler I, Polat M, Yarali H. REPRODUCTIVE ENDOCRINOLOGY. Hum Reprod 2012. [DOI: 10.1093/humrep/27.s2.88] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Colakoglu M, Toy H, Icen MS, Vural M, Mahmoud AS, Yazici F, Buendgen N, Cordes T, Schultze-Mosgau A, Diedrich K, Beyer D, Griesinger G, Oude Loohuis EJ, Nahuis MJ, Bayram N, Hompes PGA, Oosterhuis GJE, Bossuyt PM, van der Veen F, Mol BWJ, van Wely M, Nahuis MJ, Oude Loohuis EJ, Kose N, Bayram N, Hompes PGA, Oosterhuis GJE, Bossuyt PM, van der Veen F, Mol BWJ, van Wely M, Yaba A, Demir N, Allegra A, Pane A, Marino A, Scaglione P, Ruvolo G, Manno M, Volpes A, Lunger F, Wildt L, Seeber B, Kolibianakis EM, Venetis CA, Bosdou J, Toulis K, Goulis DG, Tarlatzi TB, Tarlatzis BC, Franz M, Keck C, Daube S, Pietrowski D, Demir N, Yaba A, Iannetta R, Santos RDS, Lima TP, Giolo F, Iannetta O, Martins WP, Paula FJ, Ferriani RA, Rosa e Silva ACJS, Martinelli CE, Reis RM, Devesa M, Rodriguez I, Coroleu B, Tur R, Gonzalez C, Barri PN, Nardo LG, Mohiyiddeen L, Mulugeta B, McBurney H, Roberts SA, Newman WG, Grynberg M, Lamazou F, Even M, Gallot V, Frydman R, Fanchin R, Abdalla H, Nicopoullos J, Leader A, Pang S, Witjes H, Gordon K, Devroey P, Arrivi C, Ferraretti AP, Magli MC, Tartaglia ML, Fasolino MC, Gianaroli L, Macek sr. M, Feldmar P, Kluckova H, Hrehorcak M, Diblik J, Cernikova J, Paulasova P, Turnovec M, Macek jr. M, Hillensjo T, Yeko T, Witjes H, Elbers J, Devroey P, Mardesic T, Abuzeid M, Witjes H, Mannaerts B, Okubo T, Matsuo R, Kuwayama M, Teramoto S, Chakraborty P, Goswami SK, Chakravarty BN, Nandi SS, Kabir SN, Ramos Vidal J, Prados N, Caligara C, Garcia J, Carranza FJ, Gonzalez-Ravina A, Salazar A, Tocino A, Rodriguez I, Fernandez-Sanchez M, Ito H, Iwasa T, Hasegawa E, Hatano K, Nakayama D, Kazuka M, Usuda S, Isaka K, Ventura V, Doria S, Fernandes S, Barros A, Valkenburg O, Lao O, Schipper I, Louwers YV, Uitterlinden AG, Kayser M, Laven JSE, Sharma S, Goswami S, Goswami SK, Ghosh S, Chattopadhyay R, Sarkar A, Chakravarty BN, Louwers YV, Valkenburg O, Lie Fong S, van Dorp W, de Jong FH, Laven JSE, Ghosh S, Chattopadhyay R, Goswami SK, Radhika KL, Chakravarty BN, Benkhalifa M, Demirol A, Montjeant D, Delagrange P, Gentien D, Giakoumakis G, Menezo Y, Dattilo M, Gurgan T, Engels S, Blockeel C, Haentjens P, De Vos M, Camus M, Devroey P, Dimitraki M, Koutlaki N, Gioka T, Messini CI, Dafopoulos K, Messinis IE, Gurlek B, Batioglu S, Ozyer S, Nafiye Y, Kale I, Karayalcin R, Uncu G, Kasapoglu I, Uncu Y, Celik N, Ozerkan K, Ata B, Ferrero H, Gomez R, Delgado F, Simon C, Gaytan F, Pellicer A, Osborn JC, Fien L, Wolyncevic J, Esler JH, Choi D, Kim N, Choi J, Jo M, Lee E, Lee D, Fujii R, Neyatani N, Waseda T, Oka Y, Takagi H, Tomizawa H, Sasagawa T, Makinoda S, Ajina M, Zorgati H, Ben Salem A, Ben Ali H, Mehri S, Touhami M, Saad A, Piouka A, Karkanaki A, Katsikis I, Delkos D, Mousatat T, Daskalopoulos G, Panidis D, Pantos K, Stavrou D, Sfakianoudis K, Angeli E, Chronopoulou M, Vaxevanoglou T, Jones R GMJ, Lee WD, Kim SD, Jee BC, Kim KC, Kim KH, Kim SH, Kim YJ, Park KA, Chae SJ, Lim KS, Hur CY, Kang YJ, Lee WD, Lim JH, Tomizawa H, Makinoda S, Fujita S, Waseda T, Fujii R, Utsunomiya R T, Vieira C, Martins WP, Fernandes JBF, Soares GM, Reis RM, Silva de Sa MF, Ferriani R RA, Yoo JH, Kim HO, Cha SH, Koong MK, Song IO, Kang IS, Hatakeyama N, Jinno M, Watanabe A, Hirohama J, Hiura R, Konig TE, Beemsterboer SN, Overbeek A, Hendriks ML, Heymans MW, Hompes P, Homburg R, Schats R, Lambalk CB, van der Houwen L, Konig TE, Overbeek A, Hendriks ML, Beemsterboer SN, Kuchenbecker WK, Renckens CNM, Bernardus RE, Schats R, Homburg R, Hompes P, Lambalk CB, Potdar N, Gelbaya TA, Nardo LG, de Groot PCM, Dekkers OM, Romijn JA, Dieben SWM, Helmerhorst FM, Guivarch Leveque A, Homer L, Broux PL, Moy L, Priou G, Vialard J, Colleu D, Arvis P, Dewailly D, Aghahosseini M, Aleyasin A, Sarvi F, Safdarian L, Rahmanpour H, Akhtar MA, Navaratnam K, Ankers D, Sharma SD, Son WY, Chung JT, Reinblatt S, Dahan M, Demirtas M, Holzer H, Aspichueta F, Exposito A, Crisol L, Prieto B, Mendoza R, Matorras R, Kim K, Lee J, Jee B, Lee W, Suh C, Moon J, Kim S, Sarapik A, Velthut A, Haller-Kikkatalo K, Faure GC, Bene MC, de Carvalho M, Massin F, Uibo R, Salumets A, Alhalabi M, Samawi S, Taha A, Kafri N, Modi S, Khatib A, Sharif J, Othman A, Hamamah S, Assou S, Anahory T, Loup V, Dechaud H, Dewailly D, Mousavi Fatemi H, Doody K, Witjes H, Mannaerts B, Basconi V, Jungblut L, Young E, Van Thillo G, Paz D, Pustovrh MC, Fabbri R, Pasquinelli G, Magnani V, Macciocca M, Parazza I, Battaglia C, Paradisi R, Venturoli S, Ono M, Teranisi A, Fumino T, Ohama N, Hamai H, Chikawa A, Takata R, Teramura S, Iwahasi K, Shigeta M, Heidari M, Farahpour M, Talebi S, Edalatkhah H, Zarnani AH, Ardekani AM, Pietrowski D, Szabo L, Sator M, Just A, Franz M, Egarter C, Hope N, Motteram C, Rombauts LJ, Lee W, Chang E, Han J, Won H, Yoon T, Seok H, Diao FY, Mao YD, Wang W, Ding W, Liu JY, Chang E, Yoon T, Lee W, Cho J, Kwak I, Kim Y, Afshan I, Cartwright R, Trew G, Lavery S, Lockwood G, Niyani K, Banerjee S, Chambers A, Pados G, Tsolakidis D, Billi H, Athanatos D, Tarlatzis B, Salumets A, Laanpere M, Altmae S, Kaart T, Stavreus-Evers A, Nilsson TK, van Dulmen-den Broeder E, van der Stroom E, Konig TE, van Montfrans J, Overbeek A, van den Berg MH, van Leeuwen FE, Lambalk CB, Taketani T, Tamura H, Tamura I, Asada H, Sugino N, Al - Azemi M, Kyrou D, Papanikolaou EG, Polyzos NP, Devroey P, Fatemi HM, Qiu Z, Yang L, Yan G, Sun H, Hu Y, Mohiyiddeen L, Higgs J, Roberts S, Newman W, Nardo LG, Ho C, Guijarro JA, Nunez R, Alonso J, Garcia A, Cordeo C, Cortes S, Caballero P, Soliman S, Baydoun R, Wang B, Shreeve N, Cagampang F, Sadek K, Hill CM, Brook N, Macklon N, Cheong Y, Santana R, Setti AS, Maldonado LG, Valente FM, Iaconelli C, Braga DPAF, Iaconelli Jr. A, Borges Jr. E, Yoon JS, Won MY, Kim SD, Jung JH, Yang SH, Lim JH, Kavrut M, Kahraman S, Sadek KH, Bruce KB, Macklon N, Cagampang FR, Cheong YC, Cota AMM, Oliveira JBA, Petersen CG, Mauri AL, Massaro FC, Silva LFI, Vagnini LD, Nicoletti A, Pontes A, Cavagna M, Baruffi RLR, Franco Jr. JG, Won MY, Kim SD, Yoon JS, Jung JH, Yang SH, Lim JH, Kim SD, Kim JW, Yoon TK, Lee WS, Han JE, Lyu SW, Shim SH, Kuwabara Y, Katayama A, Tomiyama R, Piao H, Ono S, Shibui Y, Abe T, Ichikawa T, Mine K, Akira S, Takeshita T, Hatzi E, Lazaros L, Xita N, Kaponis A, Makrydimas G, Sofikitis N, Stefos T, Zikopoulos K, Georgiou I, Guimera M, Casals G, Fabregues F, Estanyol JM, Balasch J, Mochtar MH, Van den Wijngaard L, Van Voorst S, Koks CAM, Van Mello NM, Mol BWJ, Van der Veen F, Van Wely M, Fabregues F, Iraola A, Casals G, Creus M, Carmona F, Balasch J, Villarroel C, Lopez P, Merino P, Iniguez G, Codner E, Xu B, Cui Y, Gao L, Xue KAI, Li MEI, Zhang YUAN, Diao F, Ma X, Liu J, Leonhardt H, Gull B, Kishimoto K, Kataoka M, Stener-Victorin E, Hellstrom M, Cui Y, Wang X, Zhang Z, Ding G, HU X, Sha J, Zhou Z, Liu J, Liu J, Kyrou D, Kolibianakis EM, Fatemi HM, Camus M, Tournaye H, Tarlatzis BC, Devroey P, Davari F, Rashidi B, Rahmanpour Zanjani H, Al-Inany H, Youssef M, Aboulghar M, Broekmans F, Sterrenburg M, Smit J, Abousetta A, Van Dessel H, Van Leeuwen J, McGee EA, Bodri D, Guillen JJ, Rodriguez A, Trullenque M, Coll O, Vernaeve V, Snajderova M, Keslova P, Sedlacek P, Formankova R, Kotaska K, Stary J, Weghofer A, Dietrich W, Barad DH, Gleicher N, Rustamov O, Pemberton P, Roberts S, Smith A, Yates A, Patchava S, Nardo L, Toulis KA, Mintziori G, Goulis DG, Kintiraki E, Eukarpidis E, Mouratoglou SA, Pavlaki A, Stergianos S, Poulasouhidou M, Tzellos TG, Tarlatzis BC, Nasiri R, Ramezanzadeh F, Sarafraz Yazdi M, Baghrei M, Lee RKK, Wu FS, Lin S, Lin MH, Hwu YM. POSTER VIEWING SESSION - REPRODUCTIVE ENDOCRINOLOGY. Hum Reprod 2011. [DOI: 10.1093/humrep/26.s1.90] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Verhoeve HR, Coppus SFPJ, van der Steeg JW, Steures P, Hompes PGA, Bourdrez P, Bossuyt PMM, van der Veen F, Mol BWJ, van Kasteren YM, van der Heijden PFM, Schols WA, Mochtar MH, Lips GLM, Dawson J, Verhoeve HR, Milosavljevic S, Hompes PGA, van Dam LJ, Sluijmer AV, Bobeck HE, Bernardus RE, Vermeer MCS, Dorr JP, van der Linden PJQ, Roelofs HJM, Burggraaff JM, Oosterhuis GJE, Schouwink MH, Emanuel MH, Bouckaert PXJM, Delemarre FMC, Hamilton CJCM, van Hoven M, Renckens CM, Land JA, Schagen-van Leeuwen JH, Kremer JAM, van Katwijk C, van Hooff MHA, van Dessel HJHM, Broekmans FJM, Ruis HJLA, Koks CAM, Bourdrez P, Riedijk WWJ, Cohlen BJ. The capacity of hysterosalpingography and laparoscopy to predict natural conception. Hum Reprod 2010; 26:134-42. [DOI: 10.1093/humrep/deq263] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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van der Steeg JW, Steures P, Eijkemans MJ, Habbema JDF, Hompes PG, Burggraaff JM, Oosterhuis GJE, Bossuyt PM, van der Veen F, Mol BW. Obesity affects spontaneous pregnancy chances in subfertile, ovulatory women. Hum Reprod 2007; 23:324-8. [DOI: 10.1093/humrep/dem371] [Citation(s) in RCA: 321] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Jansen GH, Oosterhuis GJE. [Diagnostic image (336). A woman with a calcified pelvic mass]. Ned Tijdschr Geneeskd 2007; 151:1788. [PMID: 17822251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
In a 34-year-old woman with uterine fibroids, one of the fibroids was calcified and was therefore visible on a conventional radiograph.
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Affiliation(s)
- G H Jansen
- Medisch Spectrum Twente, afd. Obstetrie en Gynaecologie, Enschede.
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Brandsma I, Oosterhuis GJE. [Laparoscopic electrocoagulation of the ovaries prior to in vitro fertilization in two females with polycystic ovary syndrome]. Ned Tijdschr Geneeskd 2005; 149:1350-2. [PMID: 16008040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
A 32-year-old woman with oligomenorrhoea/amenorrhoea and a 30-year-old woman with oligomenorrhoea as a result of the polycystic ovary syndrome (PCOS), with an active desire for children, were considered eligible for in-vitro fertilisation (IVF) because the semen of their partners was of inferior quality. However, the patients' polycystic ovaries proved to be difficult to stimulate. There was either no response to stimulation with gonadotropins or an excessive response, as a result of which treatment had to be stopped prematurely. However, when laparoscopic ovarian electrocautery was done and a stimulation cycle was subsequently started, adequate and controlled stimulation of the ovaries turned out to be quite possible in both cases. Afterwards, a follicle aspiration could be performed with success and intracytoplasmic sperm injection (ICSI) was carried out. Embryo transfer resulted in pregnancy only in the first patient. This procedure, which has never been described before in the Dutch literature, might also be effective in other women with PCOS who are eligible for IVF.
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Affiliation(s)
- I Brandsma
- Medisch Spectrum Twente, afd. Gynaecologie en Obstetrie, Postbus 50.000, 7500 KA Enschede
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Oosterhuis GJE, Vermes I. Apoptosis in human ejaculated spermatozoa. J BIOL REG HOMEOS AG 2004; 18:115-9. [PMID: 15471213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
After the introduction of assays determining apoptosis in human ejaculated spermatozoa, several studies have been published about the relationship between apoptosis in spermatozoa and semen quality. Apoptosis in spermatozoa is significantly correlated with conventional semen quality parameters, but also with the outcome of assisted reproductive techniques. The apoptotic process is probably set in motion before ejaculation. Determining apoptosis in spermatozoa can improve selection criteria in assisted reproduction.
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Affiliation(s)
- G J E Oosterhuis
- Medisch Spectrum Twente Hospital Group, Enschede, The Netherlands.
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