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Biomedical subjects

I Schiff

Publications and source records attributed to I Schiff.

114 records · Page 7Linked to original sources
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A controlled trial of intrauterine insemination for cervical factor and male factor: a preliminary report.

In a prospective, randomized, controlled trial, we evaluated the efficacy of intrauterine insemination (IUI) in 54 couples with cervical factor (CF) infertility and in 19 couples with male factor (MF) infertility. The diagnoses were confirmed by strict criteria and all other etiologies of infertility were ruled out prior to entry. Patients served as their own controls with alternating cycles of washed sperm IUI and whole-ejaculate intracervical insemination (ICI). In 113 paired cycles (mean 2.1 pairs/patient; range 1-7 paired cycles), 13% (n = 7) of CF patients became pregnant by IUI, 7% (n = 4) by ICI, and 6% (n = 3) by intercourse after missing inseminations. Seventy-one percent of IUI pregnancies occurred in the first 2 months. In 45 paired cycles for MF patients (mean 2.4 pairs/patient; range 1-6 paired cycles), two patients conceived, both in the first IUI cycle. These data suggest that pregnancies resulting from IUI occur during early treatment cycles.

Adult↗
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Results of human menopausal gonadotropin therapy at the Boston Hospital for Women (1979-1981).

To evaluate our results with induction of ovulation with human menopausal gonadotropins, we reviewed our experience from 1979 to 1981. Twenty-two women and 89 treatment cycles were evaluated. The patients were assigned to group 1 (amenorrhea, low FSH and LH, and no evidence of endogenous estrogens, as indicated by lack of withdrawal bleeding after medroxyprogesterone acetate) or group 2 (amenorrhea, with normal gonadotropins and evidence of endogenous estrogens by progestin withdrawal bleeding). Three patients underwent HMG therapy for inadequate luteal phase; none of them became pregnant. All patients from group 1 became pregnant (8/8), and 45% (5/11) of patients from group 2 became pregnant. The difference in pregnancy rates is significant (P less than .05). The cumulative pregnancy rate for each group was calculated by the life table method. All the cases of multiple gestation (three) came from group 1, and all the cases of ovarian hyperstimulation (five) came from group 2. In summary, in our experience patients from group 1 had a higher pregnancy rate and a greater incidence of multiple gestation than patients in group 2, who had a greater chance of developing ovarian hyperstimulation.

Actuarial Analysis↗
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Lower lifetime occurrence of breast cancer and cancers of the reproductive system among former college athletes.

The prevalence (lifetime occurrence) rate of cancers of the reproductive system (uterus, ovary, cervix, and vagina) and breast was determined for 5,398 living college alumnae, 2,622 of whom were former college athletes and 2,776 nonathletes, from data on medical and reproductive history, athletic training, and diet. The former athletes had a significantly lower risk of cancer of the breast and reproductive system than did the nonathletes. The relative risk (RR), nonathletes/athletes, for cancers of the reproductive system was 2.53, 95% confidence limits (CL) (1.17, 5.47). The RR for breast cancer was 1.86, 95% CL (1.00, 3.47). The analysis controlled for potential confounding factors, including age, family history of cancer, age at menarche, number of pregnancies, use of oral contraceptives, use of estrogen in the menopausal period, smoking, and leanness. Of the college athletes, 82.4% had been on precollege teams compared with 24.9% of the college nonathletes. We conclude that long-term athletic training lowers the risk of breast cancer and cancers of the reproductive system. The lowered risk may be related to changes in estrogen metabolism associated with increased leanness.

Adult↗
PubMedDate not supplied

Smoking and cysts of the ovary.

Endocrinologic and epidemiologic data indicate that cigarette smoking is antiestrogenic. We found that cigarette smoking is significantly associated with the occurrence of cysts of the ovary among 5,398 college alumnae ranging in age from 21 to 80 years. Data on ovarian cysts were obtained in response to the question: "Did you ever have ovarian cysts? If yes, age occurred and treatment." The prevalence (lifetime occurrence) of cysts of the ovary in the entire sample is 10.2%. Never smokers had a lower lifetime occurrence of ovarian cysts in every age decade than did former smokers or current smokers. The age-adjusted odds ratio (OR) for ever smokers compared to never smokers is 1.5 with 95% CL (1.2, 1.8), P less than .001. For former smokers compared to never smokers, the OR is 1.5, 95% CL (1.2, 1.9); for current vs. never smokers, the OR is 1.4, 95% CL (1.1, 1.8). Smoking was also associated with the earlier occurrence of cysts of the ovary. The 2,622 former college athletes in the sample were at significantly lower risk of ovarian cysts than were the 2,776 nonathletes; OR = 0.8, 95% CL (0.6, 0.9). Young women need to be made aware of the possible adverse effect of cigarette smoking on the ovary.

Adult↗
PubMedDate not supplied

Abnormal uterine bleeding in the perimenopause.

Abnormal uterine bleeding is probably one of the most common gynecologic complaints in the perimenopause. It is a significant cause of hysterectomy, which is the second most common surgical procedure performed on women in the United States, and thus is a major health issue. Management consists of a stepwise evaluation of all possible organic causes of uterine bleeding. Advancements in technology have allowed considerable improvements in the resolution of many diagnostic tools. Direct visualization of the uterine cavity is now an invaluable adjunct to blind endometrial sampling. Consequently, therapy can be tailored more appropriately and efficiently, either by newly developed medical strategies or through selective, minimally invasive surgery. In light of these perspectives, some of the recent diagnostic and therapeutic trends in the management of abnormal uterine bleeding in perimenopausal women are presented.

Adult↗