Search PubMed⌕ Search

Biomedical subjects

J W Studd

Publications and source records attributed to J W Studd.

At least 73 records · Page 4Linked to original sources
PubMed1990

A comparison of the attitudes of volunteer donors and infertile patient donors on an ovum donation programme.

The attitudes of anonymous volunteer donors (n = 20) and infertile patients who were undergoing treatment in an IVF programme and who donated oocytes (n = 15) towards the donation, the recipient, the potential children conceived, the recording of information and their experience of the procedures were sought by posted questionnaires. All donations were made for altruistic reasons and no payments other than expenses were made. Both groups agree that donors should not be paid and they both deny any connection with the child resulting from their donation. The majority in both groups also did not object if their eggs were donated to unmarried single women and they did not wish to meet with the recipient. The majority of both groups would however agree to donate to known recipients. Over 80% had told others of their donation and a similar number in the volunteer group held no objection to the recipients knowing their name whilst only 40% held the same view in the patient donor group (17/20 versus 6/15 P less than 0.02). The feelings of the groups was also different in relation to their desire to know if a child was born from their eggs. Eighty five per cent in the volunteer group (17/20) would like to know the outcome and only 40% (6/15) of the patient donor would want to know the outcome, P less than 0.02. Although greater than 50% in both groups experienced side effects, 60% of volunteers and 90% of patient donors expressed a willingness to donate eggs again.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

A report on 100 cycles of oocyte donation; factors affecting the outcome.

Eighty-two patients had 100 cycles of oocyte donation from 68 donors resulting in 27 clinical pregnancies. The source of donated oocytes was 42 fertile volunteers and 26 patients from the assisted conception programme. The pregnancy rate was significantly higher when intra-Fallopian transfer was performed (36%; 21/59), compared with intrauterine transfer (15%; 6/41). The pregnancy rate following fresh gamete/embryo transfer (39%; 15/39) was slightly higher than for frozen embryo transfer (20%; 12/61). The age of the recipient significantly affected the pregnancy rate. The pregnancy rate was 50% in the 25-29 years age group and steadily dropped to 9.7% in the 45-49 age group. The pregnancy rate in patients with primary ovarian failure (50%; 8/16) was significantly higher than in patients with secondary ovarian failure (18%; 9/50). The pregnancy rate was significantly greater when parous donors (33%; 23/69) were used compared with non-parous donors (13%; 4/31). The number of gametes/embryos transferred significantly affected the pregnancy rate regardless of the treatment used. If one or two gametes/embryos were transferred, the pregnancy rate was 11% compared with 33% if three to four embryos were transferred. The age of the donors did not affect the pregnancy rate. The majority of the donors were under the age of 35 years. The best results (50% per cycle) were therefore achieved using gametes from parous donors and transferring three to four oocytes fresh to the Fallopian tubes of a young recipient.

Adult↗
PubMed1990

Hormone implants and tachyphylaxis.

The serum oestradiol levels of 1388 women treated with hormone implants at a menopause clinic were reviewed in 1988. Thirty-eight (3%) were found to be above 1750 pmol/l. Of these 38 women with supraphysiological oestradiol levels 23 had started therapy for menopausal symptoms and 15 for the premenstrual syndrome (PMS). Of the 23 women treated for menopausal symptoms 11 had a history of psychiatric referral for depression and nine had undergone a surgical menopause. Nine of the 15 women with PMS had a history of psychiatric referral for depressive symptoms. We conclude that the women who attain supraphysiological levels of oestradiol on implant therapy have a high frequency of psychopathology or surgical menopause and may require higher oestradiol levels for adequate control of symptoms.

Adult↗
PubMed1990

The long-term effects of estradiol implant therapy for the treatment of premenstrual syndrome.

Fifty patients receiving estradiol implants for long-term treatment of premenstrual syndrome were studied over 5.6 years (range 2-8 years). There was a continued beneficial response to treatment in all symptoms, varying between 74% for bloating and 96% for depression. Menstrual cycle control improved in 31 patients and periods were less painful in 30 patients. Cyclical progestogenic symptoms occurred in 58% of patients. These were partially relieved by alterations in dose, type and duration of progestogen treatment but in 7 patients the symptoms remained severe. Eight patients had a hysterectomy during treatment; 5 for continuing progestogenic symptoms, 1 for prolapse and 2 for prolonged menstrual bleeding despite adequate progestogen therapy. Attempts to reduce the dose of progestogen led to cystic hyperplasia in 4 patients. This was treated by hysterectomy in 2 patients and corrected with two 21-day courses of progestogen in the other 2. Uterine enlargement with a mean weight of 133 g (125-145 g) associated with myometrial hypertrophy occurred in all 8 hysterectomy patients. There were no complications form venous thrombosis, pulmonary embolus, breast disease or atypical endometrial hyperplasia.

Adult↗
PubMed1990

The premenstrual syndrome.

The recognition of the relationship between premenstrual syndrome and cyclical ovarian activity has enabled the rationalization of treatment. Placebo-controlled studies have established the efficacy of treatments that alter ovarian function, therefore it should no longer be necessary to rely on the placebo effect of unproven treatments such as progesterone.

Contraceptives, Oral↗
PubMed1989

Treatment of severe premenstrual syndrome with oestradiol patches and cyclical oral norethisterone.

40 patients with premenstrual symptoms were randomly allocated to receive placebo patches or active treatment with transdermal oestradiol patches (2 x 100 micrograms) to suppress ovulation. Norethisterone 5 mg was given in each group from day 19-26 of the cycle to ensure a regular withdrawal bleed. Treatment was for 6 months with crossover at 3 months. Patients completed the Moos menstrual distress questionnaire (MDQ) and the premenstrual distress questionnaire (PDQ) daily throughout the study. 5 patients withdrew, 4 because of skin reactions and 1 because of considerable improvement with initial (active) treatment. After 3 months, both groups showed improvement in MDQ and PDQ scores. In general, between 3 and 6 months, patients who switched from active treatment to placebo had deteriorating scores while patients who switched from placebo to active treatment maintained or improved upon their initial gains. Significant improvements occurred after changing to active treatment in five of six negative MDQ symptom clusters and in six of ten PDQ symptoms.

Administration, Cutaneous↗
PubMed1989

Timed oocyte collection in an assisted conception programme using GnRH analogue.

Three-hundred-and-twenty-five patients on an assisted conception programme underwent 378 cycles of oocyte retrieval (OPU) following ovarian stimulation using a GnRH analogue and human menopausal gonadotrophins (HMG), a regimen which allows programmed cycles and delayed oocyte retrieval. Eighteen cycles were excluded (failed OPU in three and failure of fertilization in 15). In 360 cycles, patients completed their treatment with either in-vitro fertilization/embryo transfer (IVF/ET) (116) or gamete intra-Fallopian transfer (GIFT) (244), of which 241 took place at the normal time and 119 were delayed for 24 h or more to avoid weekend operating. The overall pregnancy rate per OPU was 29.5%, with the IVF group being 24.1% and the GIFT group being 32.8%. In the group of patients in whom OPU was delayed, the pregnancy rate was significantly higher in each sub-group than in the corresponding non-delayed sub-group (overall, 37.0 versus 25.7%; IVF/ET, 38.5 versus 16.9%; GIFT, 36.3 versus 31.1%). There was a significantly higher number of oocytes collected, gametes/embryos transferred in the group whose OPU had been delayed. In patients receiving GnRH analogue and HMG for ovarian stimulation, delaying oocyte retrieval is not harmful, may result in an improved outcome and allows OPU to be performed on routine operating lists. This facility, together with the improved pregnancy rates associated with this protocol of ovarian stimulation should improve the cost-effectiveness of assisted conception programmes.

Adult↗
PubMed1989

Pregnancy in women with premature ovarian failure using tubal and intrauterine transfer of cryopreserved zygotes.

Twenty-nine women, mean age 36.3 (SD 5.5) years, with premature ovarian failure received donated ova on an ovum donation programme. Three had Turner's syndrome, four a surgical menopause, one a chemotherapy-induced menopause and 21 had idiopathic premature ovarian failure. All donated oocytes were fertilized with frozen-thawed spermatozoa from the recipient's partner, and the resulting zygotes were frozen until transfer had been arranged. Overall, 19 women had intrauterine embryo transfer (ET) and a mean of 2.7 (SD 0.9) embryos were transferred on 20 occasions; 10 women underwent zygote intrafallopian transfer (ZIFT) and a mean of 3.5 (SD 0.5) zygotes were transferred on 10 occasions. Both groups were matched for age. The pregnancy rate per transfer was 20% in the ET group and 40% in the ZIFT group. After excluding the 10 women in the ET group who had fewer than three embryos transferred, the pregnancy rates were similar in the two groups, 30% in the ET group and 40% in the ZIFT group. Cryopreserved embryos may be used for ovum donation to preserve anonymity and still show a high pregnancy rate of at least 30% per transfer.

Adult↗
PubMed1989

Comparative clinical trial of fenticonazole ovule (600 mg) versus clotrimazole vaginal tablet (500 mg) in the treatment of symptomatic vaginal candidiasis.

A multi-centre, randomized, single-blind, parallel-group clinical trial was undertaken in 50 patients (26 fenticonazole, 24 clotrimazole) with symptomatic vaginal candidiasis to compare the antifungal efficacy and tolerability of single-dose intra-vaginal treatment with a fenticonazole ovule (600 mg) or a clotrimazole vaginal tablet (500 mg). Assessment was by laboratory mycological investigation and symptomatic assessments for a period of 3 weeks from the day of treatment. Of the 50 patients, 43 (23 fenticonazole, 20 clotrimazole) returned for assessment 1 week after drug administration and 32 (17 fenticonazole, 15 clotrimazole) were re-assessed 3 weeks after drug administration. Both treatments resulted in very similar and highly significant improvements in symptoms, associated with disappearance of detectable Candida in approximately 70% of patients. There were no significant differences between treatments and no appreciable incidence of relapse during the 3-week period of observation. At the end of this period, 10 (59%) of 17 fenticonazole patients were totally disease-free, as compared with 10 (67%) of 15 patients after clotrimazole treatment. The cure rate observed was somewhat less than that previously seen when intra-vaginal cream formulations of the same two drugs were given on a multiple-dose basis. Both drugs were very well tolerated, with no reports of appreciable local or systemic adverse reactions to either drug.

Administration, Intravaginal↗
PubMed1989

Hormone replacement therapy and cancer.

The benefits of hormone replacement therapy in alleviating climacteric symptoms, preventing osteoporosis and reducing the incidence of cardiovascular disease and stroke are now generally agreed. Nonetheless, perhaps only 5% of postmenopausal women currently receive adequate treatment often because of patient or clinician fears that such treatment may be associated with harmful side effects.

Adult↗