Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Reproductive Medicine”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 73 records · Page 4Linked to original sources
PubMed1988

Fundamental and clinical research and patient care: a triad for progress in reproductive medicine.

This essay reviews select instances in the modern history of reproductive medicine, with particular emphasis on the past 25 years since the establishment of the National Institute of Child Health and Human Development. It considers five examples of how fundamental and clinical research have contributed to patient care and, in turn, received stimulus from them; that is, fertility regulation and reproductive endocrinology, prematurity and the initiation of parturition, antenatal testing of fetal maturity, antenatal diagnosis, and neonatal intensive care. Finally, some lessons regarding the interrelationships between research and clinical obstetrics and gynecology are considered.

Female↗
PubMed2002

[Ethical problems in genetics and reproduction medicine].

Novel knowledge in the fields of molecular biology, genetics and reproductive medicine will revolutionize medicine in the near future. Among many new therapeutical aspects arise a number ethical questions that include preimplantation diagnostics, embryonic stem cell research and gene therapy. Believing in scientific progress is often criticized but today it is primarily ignorance as well as fundamentalism that block sensible discussions. In the future it shall be of importance to differentiate between "to be alive" and "to have a life", hence yielding a new definition of the term "life". Also important is to keep in mind the difference between individual moral claims and general ethics. Without doubt, the current developments in medicine will bring about interesting consequences but the inherent dangers are recognizable as well. However, only a positive attitude will result in beneficial developments. More flexibility on all sides will be needed in the concurrent discussion process.

Ethics, Clinical↗
PubMed2006

Do clinical prediction models improve concordance of treatment decisions in reproductive medicine?

OBJECTIVE: To assess whether the use of clinical prediction models improves concordance between gynaecologists with respect to treatment decisions in reproductive medicine. DESIGN: We constructed 16 vignettes of subfertile couples by varying fertility history, postcoital test, sperm motility, follicle-stimulating hormone level and Chlamydia antibody titre. SETTING: Thirty-five gynaecologists estimated three probabilities, i.e. the 1-year probability of spontaneous pregnancy, the pregnancy chance after intrauterine insemination (IUI) and the pregnancy chance after in vitro fertilisation (IVF). Subsequently they proposed therapeutic regimens for these 16 fictional couples, i.e. expectant management, IUI or IVF. Three months later, the participant gynaecologists again had to propose therapeutic regimes for the same 16 fictional cases but this time accompanied by pregnancy chances obtained from prediction models: predictions on spontaneous pregnancy, IUI and IVF. POPULATION: Thirty-five gynaecologists working in academic and nonacademic hospitals in the Netherlands. METHODS: Setting section. Main outcome measures The concordance between gynaecologists of probability estimates, expressed as interclass correlation coefficient (ICC) and the concordance between gynaecologists of treatment decisions, analysed by calculating Cohen's kappa (kappa). RESULTS: The gynaecologists differed widely in estimating pregnancy chances (ICC: 0.34). Furthermore, there was a huge variation in the proposed therapeutic regimens (kappa: 0.21). The treatment decisions made by gynaecologists were consistent with the ranking of their probability estimates. When prediction models were used, the concordance (kappa) for treatment decisions increased from 0.21 to 0.38. The number of gynaecologists counselling for expectant management increased from 39 to 51%, whereas counselling for IVF dropped from 23 to 14%. CONCLUSION: Gynaecologists differed widely in their estimation of prognosis in 16 fictional cases of subfertile couples. Their therapeutic regimens showed likewise huge variation. After confrontation with prediction models in the same 16 fictional cases, the proposed therapeutic regimens showed only slightly better concordance. Therefore a simple introduction of validated prediction models is insufficient to introduce concordant management between doctors.

Adult↗
PubMedDate not supplied

Cyclooxygenases in reproductive medicine and biology.

This review focuses on the role of cyclooxygenases in reproductive medicine and biology. The cyclooxygenase enzymes catalysis the role-limiting reactions for prostaglandins and thromboxane synthesis. Two separate isoforms, COX-1 and COX-2, are present, and differences in their roles are discussed in the context of inflammation and parturition.

Animals↗
PubMed1988

Anti-oestrogens: their clinical physiology and use in reproductive medicine.

The anti-oestrogens are important both as therapeutic agents in reproductive medicine and as tools to investigate the physiology of the oestrogen receptor and hormonal control mechanisms. Clomiphene occupies the oestradiol receptor and, although initially stimulatory, has a net antagonistic effect as oestrogen receptors are not replenished. The major fertility-enhancing effect is to cause an increase in LH and FSH output by increasing the frequency of pulsatile output of these hormones. Many effects due to an anti-oestrogenic effect have been postulated; some, such as an adverse effect on cervical mucus, have been proven. The clinical use of the anti-oestrogens is outlined in Table 1. In well chosen patients a rewarding pregnancy rate is obtained with minimal intervention and few important side-effects. The challenge for the reproductive biologist is successfully to manage the patient who is clomiphene-resistant, either because of failure to ovulate or failure to conceive once ovulation is induced.

Anovulation↗
PubMed2004

Fundamentals of cryobiology in reproductive medicine.

The aim of this review will be to provide a basic understanding of the biophysical processes that accompany the application of cryopreservation in reproductive medicine. The ability to store cells in 'suspended animation' outside the body has become a keystone practice in the development of many modern clinical therapies, and, in fact, the sciences of cryobiology and IVF have developed in parallel over the past 50 years. During this time, some of the underlying principles of the quantitative biophysical aspects of cryobiology have been clarified. Water is the universal biocompatible solvent, but also possesses unique properties for stability of living cells. Whilst low temperatures themselves have defined effects on cell structure and function, it is the phase transition of water to ice that is the most profound challenge for survival. The thermodynamics of dilute aqueous solutions dictate how cells and tissues respond to the freezing process. Current concepts of nucleation, ice crystal growth and solute exclusion from the ice lattice will be discussed to illustrate what cells must negotiate to avoid lethal damage, and the role of cryoprotectants in enhancing recovery. Quantitative formalisms now exist to model and predict how water and solutes move across cell membranes before and during freezing, or how nucleation events will proceed, and these will be outlined. Cryoprotectants have both positive and negative effects on cell function depending on the kinetics of exposure. The concept of tolerable osmotic excursion of cell volume will be discussed, along with the evidence for a 'pseudo-glassy' state for cells during traditional cryopreservation. This will be compared with the recent interest in promoting glassy states in the whole sample using vitrification protocols, outlining the advantages and drawbacks of each approach. Additional methods for controlling ice nucleation have a role to play here, and a brief outline of current technologies will be given. Finally, issues of safety and stability of cryopreserved samples will be set out.

Cell Physiological Phenomena↗
PubMed1997

[The internet--new information sources on reproductive medicine?].

Within the last two years Internet pages have become a highly interesting source of up-to-date information. The scientific value of those homepages for reproductive medicine differ in a wide range. The Internet still remains a very interesting source for up-to-date information covering the field of infertility treatment with a growing influence on patient decisions and with increasing economical impact.

Computer Communication Networks↗
PubMedDate not supplied

Transplantation in reproductive medicine: previous experience, present knowledge and future prospects.

The use of transplantation in reproductive medicine has been considered by physicians and scientists alike for many years. Despite being side-tracked into futile pursuits of rejuvenation in the early days, the possibility of usefulness remains, particularly for preserving fertility in patients undergoing ablative chemo- or radiotherapy. These aims have been enhanced by advances in tissue cryopreservation. When isolated primordial follicles are transferred in the mouse, or ovarian tissue slices are grafted into sheep, it is possible to obtain follicular survival with subsequent maturation and oestrogen secretion and even restore fertility to sterilized hosts. For preservation of fertility, autografts avoid both the immunological problems of allografts and the ethical dilemmas when using donor tissue. In the male, the concept of spermatogonial cell transfer after isolation and frozen storage of cells recovered from a testicular biopsy is most attractive, since it may provide another option for rescuing fertility in cancer patients, and provide a much needed one in children. Recent results demonstrate that gonocytes from immature mice injected into the tubules of sterilized hosts restore spermatogenesis and produce fertile spermatozoa. Furthermore, the gonocytes can be stored frozen prior to transfer and still produce fertile tubules. This review presents a broad history of transplantation in the male and female genital tracts as well as attempts to anticipate possible future developments.

Animals↗
PubMedDate not supplied

From transgression to pragmatism in reproductive medicine.

It is difficult to harmonise faith and the desire to follow religious teachings and obligations on the one hand, and scientific advances and their use for the benefit of suffering humanity on the other. This is an especially delicate matter for patients and health professionals in reproductive medicine. It deals with the conflicting issues of contraception, termination of pregnancy, assisted reproduction, cloning, stem cells and embryo research. Beyond the technical aspects of these matters, the theoretical, legal, philosophical and religious implications must be explored, including the concepts of personality, individuality, human dignity, autonomy, beneficence and justice. Most importantly, an analysis must be made of the beginnings of a human being, the protection it deserves, the concept and time of ensoulment, the need for pragmatism and the right of transgression (hence the title of this article).

Abortion, Induced↗
PubMed2003

A comment on the European Society of Human Reproduction and Embryology/American Society for Reproductive Medicine consensus of the polycystic ovarian syndrome.

This commentary on the European Society of Human Reproduction and Embryology/American Society for Reproductive Medicine (ESHRE/ASRM) consensus on diagnosis, nomenclature and long-term health risks of the polycystic ovarian syndrome (PCOS) (conference in Rotterdam, Netherlands, March 2003) questions whether the preservation of the term PCOS sufficiently considers the modern aspects of the aetiology and pathogenesis of this complex syndrome. The misleading and simplified term PCOS, which comprises a variety of different entities, carries with it the risk of misinterpretation and under- and overestimation of symptoms, as well as of overlooking contraindications. Additionally, bias in future studies is pre-programmed. In this commentary, it is proposed that the term polycystic should be substituted with polyfollicular, and the term PCOS with functional hyperandrogenism, which is further subdivided into five additional groups. By using this new classification, most of the patients' dysfunctions belonging to the unspecifically termed PCOS are clearly defined, which leads on to the assumption that the diagnostic and therapeutic approaches required will improve, and the amount of bias in both basic and clinical studies will be reduced, respectively.

Embryo, Mammalian↗
PubMed1993

[Possibilities of endoscopic diagnosis and therapy in reproduction medicine].

Endoscopic minimal invasive procedures have opened new horizons for preventive care and treatment in reproductive medicine. They provide best conditions for careful handling of tissues and preservation of organs. After exclusion of functional sterility factors, the basis of any further treatment is obtained by diagnostic pelviscopy, hysteroscopy and salpingoscopy, respectively falloposcopy, this even more for the endoscopic therapy of tubarian and uterine sterility factors as well as endometriosis. A large domain in the use of endoscopy is the organ and fertility preserving surgery in younger women. This applies mainly for the pelviscopic treatment of ectopic pregnancies and pelviscopic/hysteroscopic myomectomy. Despite of all controversial discussions pelviscopic ovarian surgery has many advantages for women who desire further pregnancies. Falloposcopy enlarges the possibilities for the diagnosis and treatment of ectopic pregnancies. More randomized studies are necessary in order to estimate the indications and advantages of endoscopic procedures. A wide and efficient use of these promising techniques requires an early and appropriate training of all gynecologic surgeons.

Female↗
PubMed2004

Can the Internet widen participation in reproductive medicine education for professionals?

BACKGROUND: Traditional campus-based models of education are unsuitable to many, particularly if in full-time employment supporting families, whereas the Internet now permits new models of education. Following an iterative process of development and evaluation in 2001, the University of Bristol launched a masters programme covering reproduction and development delivered principally over the Internet. METHODS: Students attend short biannual residential workshops and the rest of the course is delivered online. In 2003, the 20 active students were invited to complete a structured online questionnaire. RESULTS: The 18 students completing the questionnaire identified distance learning as the key factor in their course selection. Most students felt that residential workshops aided subsequent electronic communication. Discussion of ideas is an essential component of postgraduate courses and web-based discussion forums appeared to provide an acceptable medium for this. The use of web-based audio lectures and computer-assisted assessments was well received. Also these systems may reduce disadvantages overseas students encounter when completing assessments in their non-native language. CONCLUSIONS: The overall positive response from students (and their tutors) to using the Internet for multiprofessional reproductive medicine education is encouraging and has wider potential in the future.

Communication↗
PubMed2004

European Classification of Infertility Taskforce (ECIT) response to Habbema et al., 'Towards less confusing terminology in reproductive medicine: a proposal'.

The European Classification of Infertility Taskforce (ECIT) has been formed by ESHRE to develop a set of infertility-related codes (descriptions, interventions and outcomes) appropriate for computerization (http://www.ecit.info). In this article, ECIT reflects on previous suggestions in this Debate series, agreeing with the weaknesses of the current terminology used in reproductive medicine. Although ECIT is enthusiastic about the extension of terminology, caution is raised in abandoning familiar terms that may lead to greater rather than less confusion. Instead, ECIT suggests a way forward using structured computerized statements to retain current terms but extend their meaning.

Europe↗