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Biomedical subjects

A F Goldfarb

Publications and source records attributed to A F Goldfarb.

At least 19 recordsLinked to original sources
PubMed1989

Peritubal adhesions in infertile women: diagnosis with hysterosalpingography.

We studied the efficacy of hysterosalpingography in the detection of peritubal adhesions without tubal occlusion by using laparoscopy as the gold standard for the diagnosis. Peritubal adhesions were diagnosed on hysterosalpingography by using the following radiographic criteria alone or in combination: (1) convoluted fallopian tube, (2) loculation of spillage of contrast medium into the peritoneal cavity, (3) ampullary dilatation, (4) peritubal halo effect (double-contour appearance of the tubal wall), and (5) vertical fallopian tube. The first 100 patients with the diagnosis of adhesions on hysterosalpingography who also had laparoscopy were included in the study. Seventy-five patients had the diagnosis confirmed on laparoscopy, resulting in a 25% false-positive diagnosis of adhesions with hysterosalpingography. Thirty-nine (52%) of these 75 patients had one radiographic finding alone, and 20 of these patients had loculation of spillage of contrast medium. Although the patients with adhesions tended to have two or more of the radiographic findings, the difference was not statistically significant. The most frequent radiographic findings found in combination were convoluted fallopian tube and loculation of spillage of contrast medium. These findings suggest that hysterosalpingography can be the diagnostic procedure of choice in the initial investigation of infertility due to peritubal adhesions.

Fallopian Tube Diseases↗
PubMed1988

Urinary follicle stimulating hormone treatment for luteal phase defect.

A deficiency in follicle stimulating hormone (FSH) levels during the early follicular phase of the menstrual cycle has been shown to result in luteal phase defect (LPD). A short course of human urinary FSH (uFSH) (Metrodin, Serono Laboratories) was given for a maximum of six cycles to 18 women with endometrial-biopsy-proven (EBX-proven) LPD. Adjunctive therapy in the form of midcycle human chorionic gonadotropin was given after the third therapy cycle. The uFSH therapy reduced the mean EBX lag time (2.0 +/- 0.6 days with therapy vs. 4.1 +/- 0.4 pretherapy, P less than .01), normalized the follicular phase length (15 +/- 0.4 days vs. 17.2 +/- 0.8 pretherapy, P less than .25) and increased the luteal phase length (12.7 +/- 0.4 days vs. 10.8 +/- 0.2 pretherapy, P less than .001). Twelve of 46 cycles (26%) in which uFSH was given without adjunctive therapy were anovulatory. Seven patients conceived; the result was seven viable pregnancies, all delivered at term. The cumulative pregnancy rate approached 48% by the sixth therapy cycle. uFSH therapy is useful for the correction of LPD and yields an acceptable pregnancy rate.

Adult↗
PubMed1982

A life-table analysis of pregnancy yield in fixed low-dose menotropin therapy for patients in whom clomiphene citrate failed to induce ovulation.

Forty-nine patients in whom clomiphene citrate failed to induce ovulation were treated for 177 cycles with a fixed low dosage of menotropin. Among these 49 patients, there were 24 pregnancies. Among these pregnancies were two that were multiple and three spontaneous abortions. In only one treatment cycle was there a hyperstimulation syndrome. These patients were divided into three clinical groups: the secondary amenorrheic patient, the oligo-amenorrheic patient, and the patient with poor corpus luteum function. There was no statistically significant difference in the pregnancy rate per month among all groups during the first three treatment cycles (average value, 0.07). However, there was a statistically significant improvement in the pregnancy rate per month in the group with secondary amenorrhea and the group with poor corpus luteum in the last three treatment cycles, as compared with the first three treatment cycles (P = 0.05; average value, 0.75). The oligo-amenorrheic patients, on the other hand, during the last 3 months of treatment, had no statistically significant increase in the pregnancy rate per month. These data suggest that menotropin therapy may have a priming effect. These data do not fit the currently accepted model of a constant pregnancy rate per month for all patients. The data suggest that caution should be exercised before combining patient groups when evaluating the results of menotropin therapy.

Amenorrhea↗
PubMed1977

Puberty and menarche.

The various factors that influence puberty and menarche reflect the total environment in which the youngster develops. These influences actually begin in intrauterine life and include genetics, hormones, and nutrition. During the prepubertal years the multifactorial influences on puberty include health, disease, family life, neuroendocrine integrity of the individual, and nltrition. In the female the culmination of the pubertal events is the occurrence of menarche.

Adolescent↗
PubMed1977

Polycystic ovarian disease: clinical considerations.

Although the pathogenesis of the PCO syndrome remains obscure, several endocrine aberrations are clinically measurable in this syndrome. It has been shown that this syndrome is associated with inappropriate gonadotropin secretion and elevated serum LH, A and T levels. Various levels of E2 and E1 have been noted. The evaluation of these individuals should include studies to determine the state of androgen production in them. Treatment should be based upon an understanding of the pathophysiology, a thorough evaluation of androgen production and the patient's expectations based upon age, marital status and desire for pregnancy. The physician's expectations should be related to prevention of endometrial hyperplasia, the restoring of ovulation and amelioration of many of the androgenic side effects seen.

Androstenedione↗
PubMed1968

Puberty.

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Adolescent↗