Cooper Institute for Reproductive and Hormonal Disorders

Laurel Springs, NJ, United States

Cooper Institute for Reproductive and Hormonal Disorders

Laurel Springs, NJ, United States
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Check J.H.,Rowan University | Check J.H.,Cooper Institute for Reproductive and Hormonal Disorders
Clinical and Experimental Obstetrics and Gynecology | Year: 2017

Purpose: To describe another previous unreported manifestation of the sympathetic neural hyperalgesia edema syndrome - autoimmune hearing loss. Materials and Methods: Dextroamphetamine sulfate 30 mg extended release capsules was given to a woman to try to help her conceive since, with her pelvic pain, chronic fatigue syndrome, and diarrhea, it was thought that an inflammatory condition related to permeation of unwanted chemicals into endometrial tissue related to the sympathetic neural hyperalgesia edema syndrome could be inhibiting her failure from conceiving despite three cycles of embryo transfer. Results: Not only did the symptoms mentioned above disappear, but she also noted marked improvement of hearing loss that had been present for several years. The improvement in hearing was documented by audiology tests and had not responded to many months of 15 mg/day prednisone. Conclusions: Autoimmune hearing loss (diagnosis established by her ear nose and throat specialist) should be added to the long list of manifestation of the sympathetic neural hyperalgesia edema syndrome. © 2017, S.O.G. Canada Inc. All rights reserved.


Check J.H.,Rowan University | Check J.H.,Cooper Institute for Reproductive and Hormonal Disorders | Rosenberg A.,Thomas Jefferson University | Check D.L.,Cooper Institute for Reproductive and Hormonal Disorders | And 4 more authors.
Clinical and Experimental Obstetrics and Gynecology | Year: 2017

Purpose: To determine if serum levels of the immunomodulatory protein, the progesterone induced blocking factor (PIBF), which is present in high levels during normal pregnancy, is present in higher levels in women with breast cancer positive for progesterone receptors. The study would also determine whether the presence or absence of the estrogen receptor in any way modifies PIBF expression. Materials and Methods: PIBF using a research ELISA was evaluated in the follicular phase in 21 women with receptor status as follows: seven with estrogen receptor (ER)+ and progesterone receptor (PR)+, seven with ER-And PR+, and seven with ER+ and PR. Results: The results showed no differences in serum PIBF in the three groups. The serum PIBF levels were no different than historical controls in the follicular phase. Conclusions: Measurement of serum PIBF does not seem to be an important marker to use to either detect women with breast cancer or to help determine tumor virulence or potential specific therapies. If PIBF plays a role in helping cancer cells to escape immune surveillance, it seems that the intracytoplasmic PIBF would be the form most likely operative.


Check J.H.,Rowan University | Check J.H.,Cooper Institute for Reproductive and Hormonal Disorders | Liss J.R.,Cooper Institute for Reproductive and Hormonal Disorders | Check D.,Cooper Institute for Reproductive and Hormonal Disorders
Clinical and Experimental Obstetrics and Gynecology | Year: 2017

Purpose: To compare pregnancy rates following ovulation induction in anovulatory women with clomiphcne citrate vs. letrozole and to determine the relative confounding effect of inducing menses or not. The study also evaluated whether starting these anti-estrogen drugs later in the menstrual cycle has less adverse effect on endometrial thickness. Materials and Methods: Prospective series with choice by physician of inducing menses or not or choosing clomiphene citrate or letrozole for ovulation induction. Peak endometrial thickness was compared between drugs and between those conceiving or not. Results: There were 21 first cycles using letrozole and 42 using clomiphene. Menses were not induced in 18/21 (86%) letrozole cycles and 24/42 (57%) clomiphene cycles. Clinical pregnancies occurred in four (22.2%) letrozole cycles without induced menses with one miscarriage vs. 4/24 (16.6%) clomiphene cycles, no miscarriage. One of three (33.3%) letrozole cycles with menses induced achieved a clinical pregnancy vs. only 1/18 (5.5%) of clomiphene cycles. There were no miscarriages. Conclusions: Though the endometrial thickness was higher with clomiphene without induced menses vs. menses induced (11 mm vs. 9.5 mm), one cannot explain the trend for lower pregnancy rates in women with induced menses because of thinner endometria since the thickness was 10.3 mm for clomiphene and 10.0 with letrozole.


Check J.H.,Rowan University | Check J.H.,Cooper Institute for Reproductive and Hormonal Disorders | Bollendorf A.,Rowan University
Clinical and Experimental Obstetrics and Gynecology | Year: 2017

Cooper Institute For Reproductive Hormonal Disorders. P.C., Mt. Laurel. NJ (USA) Objective: To determine the effect of extremely low sperm morphology on pregnancy rates following intrauterine insemination (IUI) where all other semen parameters were normal. Materials and Methods: Retrospective review of all IUI cycles over a two-year period on infertile women age < 35 where all parameters, but morphology had to be normal. The data were evaluated according to seven levels of percentage of normal morphology (NM): 0, 1, 2, 3,4, 5, and > 6%. Results: The percent live delivery was 9.5, 16.7, 8.8, 16.1, 11.4,12.3, and 10.9%. Conclusions: Morphology of 0% or 1% did not seem to impair pregnancy rates following IUI. More studies are needed but should include determining the confounding effect of the type of morphologic abnormality.


Check J.H.,Rowan University | Check J.H.,Cooper Institute for Reproductive and Hormonal Disorders
Clinical and Experimental Obstetrics and Gynecology | Year: 2017

Purpose: To demonstrate Thai it is important to consider all possibilities when confronted with a decision to terminate a pregnancy because it is likely to be chromosomally abnormal. Materials and Methods: A cell free DNA test was performed on a woman with di- chorionic diamniotic twins that followed the transfer of a single embryo. Results: The cell free DNA test was consistent with trisomy 21. Two perinatologists favored identical twins and thus suggested termination since both twins would be trisomy 21 and the couple did not want to raise a child with Down's syndrome. Our group suggested the possibility that these were fraternal twins with one occurring from natural conception. We suggested to forego termination by D&E but to undergo an amniocentesis at 16 weeks. One twin had obvious cardiac abnormalities by ultrasound and this one was reduced while amniocentesis with karyotype was performed on fetus 2. The results showed a normal male. Conclusions: One should consider all possibilities before suggesting termination of a very desired pregnancy. This woman had also been advised by other specialists in reproductive endocrinology that conception with her own oocytes (as did occur here) was not possible and she should consider donor oocytes based on her marked diminished oocyte reserve.

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