Biomedical subjects

J S Chase

Publications and source records attributed to J S Chase.

24 records · Page 2Linked to original sources

PubMedDate not supplied

The efficacy of progesterone in achieving successful pregnancy: I. Prophylactic use during luteal phase in anovulatory women.

We have previously shown that prophylactic supplementation of progesterone beginning in the luteal phase of patients treated with human menopausal gonadotropins (hMG) could reduce the risk of spontaneous abortions. The present study was initiated with 100 patients to evaluate the efficacy of a new progesterone therapeutic regime in patients requiring either hMG or clomiphene citrate. A significantly decreased risk of spontaneous abortion (6% vs. 28%) was seen in 50 patients prophylactically treated with progesterone as compared with 50 control patients. The progesterone regimen was then tried on 566 consecutive patients who were treated and conceived with hMG or clomiphene citrate, and approximately the same risk (6.2% by 20 weeks) was found. This incidence of spontaneous abortion is even less than the accepted risk for the general population.

Abortion, Spontaneous↗

PubMedDate not supplied

Progesterone therapy to decrease first-trimester spontaneous abortions in previous aborters.

A study was designed to see if the use of prophylactic progesterone vaginal suppositories (PVS) reduced the risk of spontaneous abortions in women with a history of at least one spontaneous abortion. PVS was employed during the luteal phase to the end of the first trimester. The dosage was initially 50 mg/day, but was increased according to the endometrial biopsy and doubled as soon as pregnancy was established. Only 10 women (10%) aborted, and 8 of these 10 were successful in their next PVS-treated pregnancies. Overall there were 12 losses in 132 pregnancies (9%) in these PVS-treated patients. Forty-two percent of untreated controls aborted (10/24). The results suggest that PVS is effective in reducing the risk of spontaneous abortions in high-risk patients.

Abortion, Habitual↗

PubMedDate not supplied

Spontaneous abortion rate in patients with endometriosis treated with progesterone.

Several reports suggest that women with endometriosis have a higher risk of spontaneous abortions when left untreated; however, these studies did not control for the presence of possible luteal phase defects. This study was designed to document the frequency of spontaneous abortions in women with endometriosis and ovulation defects treated prophylactically with progesterone, compared with similar patients without endometriosis. All the women had late luteal phase endometrial biopsies dating perfectly normal. Our findings show an increase in the rate of spontaneous abortions (25.7%) in women with endometriosis as compared with the entire group (3.8%). However, when the result for the group with endometriosis is compared with the subgroup of patients at diagnostic laparoscopy not showing endometriosis, the results are similar (30%). We conclude that when properly matched groups are compared, there is no increased risk of spontaneous abortions in women with endometriosis. Since we perform laparoscopies only in women failing to conceive after a reasonable number of seemingly normal cycles, the apparently high incidence of abortions in this group may be secondary to other factors that not only may lengthen the time needed for conception but also increase the abortion risk after conception.

Abortion, Spontaneous↗

PubMedDate not supplied

The importance of laparoscopic coagulation of mild endometriosis in infertile women.

To evaluate the effect of fulguration of endometriotic implants in patients with mild endometriosis, we divided 123 patients into two groups: (A) patients whose endometriotic implants were coagulated, and (B) patients whose implants were left intact. In group A, 42 of 69 (60.8%) patients achieved a pregnancy within eight cycles following laparoscopic fulguration, in comparison with 10 of 54 (18.5%) patients from group B. The difference between this study and others is that all other infertility factors were meticulously corrected prior to laparoscopic treatment, and patients were allowed at least eight "normal" cycles before their endometriosis was treated. This is a report of 8 months' postoperative follow-up. The study was prospective and treatment was assigned randomly. We feel that laparoscopic fulguration significantly improves fertility in these carefully selected patients.

Electrocoagulation↗

PubMedDate not supplied

Diagnosis and treatment of the cervical factor. I. Improvement with a short-course treatment of high-dose estrogen.

A new technique for improving cervical factor is described. This technique employs the use of high-dose estrogen at the time that a mature follicle is determined by ultrasound in patients who have inadequate postcoital tests despite the use of low-dose estrogen, guaifenesin, and tetracycline. Previously, a technique based on high-dose estrogen early in the follicular phase was employed; this suppressed pituitary gonadotropins, thus requiring the concomitant use of hMG. Seventy-three percent of the patients for whom this more expensive and intricate technique would have been necessary were able to achieve a good postcoital test through this modified technique of merely using high-dose estrogen when the follicle has already matured. Thirty-three percent achieved a pregnancy within 6 months on this therapy.

Cervix Mucus↗

PubMedDate not supplied

Diagnosis and treatment of the cervical factor. II. Employment of pelvic sonography in diagnosis.

A study was performed to evaluate the relationship between the postcoital test, follicle size, and the basal body temperature (BBT). We found 17% of the patients to have good postcoital tests before the rise in the BBT, at which time, however, the follicle was still too small. By the time the follicle reached maturity, the mucus quality regressed to poor. The problem was corrected in 88% of the patients by the human menopausal gonadotropin (hMG)-high-dose estrogen technique, and 53% achieved pregnancies. Twenty-two percent had a poor postcoital test just before the rise in the BBT. However, ultrasound data indicated that ovulation had already taken place, and the mucus had been of good quality a few days before, when the follicle was at the proper size. Thus, ultrasound may be useful in eliminating false positive and negative cervical factor diagnoses, and is also helpful in some new techniques for treating the cervical factor.

Body Temperature↗