Biomedical subjects

J N Gutmann

Publications and source records attributed to J N Gutmann.

22 records · Page 2Linked to original sources

PubMedDate not supplied

Female reproductive endocrinology at the turn of the millennium.

The mainstays of female reproductive endocrinology, even as the millennium occurs and we cite highly technological advances in assisted reproduction, continue to be-as for the past decade-and-a-half-the use of GnRH analogs, both agonists and antagonists; the use of other gonadotropins, both alone and in combination, as well as with other types of drugs; testing for "ovarian reserve," as we attempt infertility treatment for populations that now include more nulliparous women of older reproductive age; and diagnosing and treating polycystic ovarian syndrome (PCOS), for both its reproductive and general health effects, especially as concerns insulin resistance. These topics are covered in detail, with reviews of well-controlled, and sometimes contrasting, studies.

Adult↗

PubMedDate not supplied

Estrogen replacement therapy (ERT) in high-risk cancer patients.

Menopausal estrogens are now being prescribed not only for symptom relief, but also to prevent the long-term sequelae of estrogen deficiency, namely osteoporosis and atherosclerotic disease. The well-established association between endometrial cancer and estrogen replacement therapy (ERT) has become less of a clinical concern due to the recognition of the protective effect of progestogens in this setting. A small literature has emerged suggesting that extending ERT to the woman with a history of endometrial carcinoma imposes no increased risk of recurrence and may improve survival. Candidates for ERT should be women with a better prognostic profile with reference to their cancer. The relationship between ERT and breast cancer remains a topic of intense debate and investigation. Overall, the current literature finds no significant increase in risk among healthy women without a family history of breast cancer. There are no guidelines with reference to the woman with a history of breast cancer and the use of ERT. The most prudent approach with this population is to consider alternative treatments until more is known.

Breast Neoplasms↗

PubMedDate not supplied

Ovulation induction with GnRH agonist and human menopausal gonadotropins: response in patients with one versus two ovaries.

OBJECTIVE: To examine the effect of oophorectomy on response to gonadotropin releasing hormone-agonist/human menopausal gonadotropin (GnRH-a/hMG) for in vitro fertilization (IVF). DESIGN: Retrospective review. SETTING: Tertiary care academic institution. PATIENTS: Ninety-one infertile patients undergoing IVF. Eighty-four women had two ovaries and seven had only one ovary. RESULTS: There was no difference observed between women with one versus two ovaries with regard to response to medications, hormone production, number of oocytes retrieved and fertilized, or the number of embryos cleaved and transferred. CONCLUSION: Women with only one ovary are at no reproductive disadvantage when undergoing ovulation induction for IVF.

Adult↗

PubMedDate not supplied

A double-blind comparison of nafarelin and leuprolide acetate for down-regulation in IVF cycles.

OBJECTIVE: To compare nafarelin (NAF) with leuprolide acetate (LA) for pituitary down-regulation in IVF cycles. MATERIALS AND METHODS: Patients in a private IVF program who received both nasal spray and subcutaneous injections starting in the luteal phase prior to intended stimulation with any one route containing active drug in a randomized, prospective, double-blind study. Variables measured included the usual hormonal values as well as oocyte data, but not pregnancy rates, because of sample size and the heterogeneity of the study group. RESULTS: There were no differences between the two groups in the areas studied. CONCLUSION: Either NAF or LA can be used satisfactorily as an agent for pituitary down-regulation in IVF cycles.

Adult↗