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Migdal Ha‘Emeq, Israel

Wheeler R.,University of Southampton | Kohler J.,University of Southampton | Paget J.,Fertility Unit | Major J.,Beachcroft Healthcare Law
Clinical Risk | Year: 2011

People under the age of 18 with cancer sometimes require treatments that render them infertile. It may therefore be necessary, during the brief interval between diagnosis and the commencement of cancer treatment, to offer them the opportunity to produce sperm, through masturbation, for cryopreservation. The article provides a framework for justifying this as a clinical activity, and avoiding it being construed as a sexual activity under the terms of the criminal law. Of equal importance, the article puts into place measures to ensure that this clinical activity is entirely consistent with the safeguarding principles of child protection. Source


Akhtar M.A.,Reproductive Medicine | Sur S.,Imperial College London | Raine-Fenning N.,University of Nottingham | Jayaprakasan K.,Fertility Unit | And 3 more authors.
Fertility and Sterility | Year: 2015

It is suggested that heparin given in the peri-implantation period may improve clinical outcomes in women undergoing assisted reproduction techniques (ART). This systematic review evaluates the use of heparin in subfertile women undergoing ART. ©2015 by American Society for Reproductive Medicine. Source


Bello S.O.,University of Nigeria | Bello S.O.,Fertility Unit | Chika A.,University of Nigeria | AbdulGafar J.O.,University of Nigeria
African Journal of Infectious Diseases | Year: 2010

The purpose of this study is to summarize the available data on the efficacy of Artesunate plus Amodiaquine (AS+AQ) versus Artemether -Lumefantrine (AL) for the treatment of uncomplicated Plasmodium falciparum malaria in sub-Saharan Africa using uncorrected parasitaemia as a clinically relevant endpoint. Studies and conference abstracts identified through Pubmed, Medline, Embase, Ansinet, AJOL, Bioline, Cochrane Infectious Diseases Group trials register, The Cochrane Controlled Trials Register, Science Citation Index, Lilacs, African Index Medicus, Clusty, Google, Yahoo and Microsoft search engines. Randomized controlled clinical trials comparing Artesunate-Amodiaquine versus Artemether-Lumefantrine, in Sub-Saharan Africa from January 2004 to June 2009, and which had at least 30 patients per study arm. The authors independently applied the inclusion criteria, assessed methodological quality and extracted data into a predesigned form. The outcome of interest was uncorrected day 28 parasitological failure. Data were then checked for agreement and double entered into RevMan version 5 for further analyses. Fifteen trials (4265 participants) met the inclusion criteria. Day 28 parasitological failure was lower for AL (286 of 2201 participants or 13.0 % failures) when compared with AS+AQ (446 of 2424 participants or 18.4% failures). The relative risk of parasitological failure with AS+AQ was higher when compared with AL (RR 1.65, 95% CI, 1.18-2.32). There were significant heterogeneity and inconsistencies in the studies. AL appears more effective at avoiding parasitological failure at days 28 than AS+AQ. Source


Jayaprakasan K.,University of Nottingham | Jayaprakasan K.,Fertility Unit | Chan Y.,University of Nottingham | Islam R.,University of Nottingham | And 4 more authors.
Fertility and Sterility | Year: 2012

Objective: To estimate the probability of live birth, adverse treatment outcome, and extremes of ovarian response at different antral follicle count (AFC) cutoff levels in a large prospective cohort of women undergoing IVF treatment. Design: Prospective study. Setting: University-based assisted conception unit. Patient(s): A total of 1,012 consecutive subjects of all ages undergoing their first cycle of assisted reproductive techniques. Intervention(s): Transvaginal three-dimensional ultrasound assessment and venipuncture in the early follicular phase of the menstrual cycle. Main Outcome Measure(s): Live birth rate, poor ovarian response, and ovarian hyperstimulation syndrome (OHSS). Result(s): Analysis was performed in 1,012 subjects. Both age (r = 0.88) and AFC (r = 0.92) thresholds show significant linear relationship with the probability of live birth, but AFC demonstrates a stronger correlation. At AFC quartiles of 3-10, 11-15, 16-22, and ≥23, the mean live birth rates were 23%, 34%, 39%, and 44%, respectively. No live birth was observed in women with AFC <4. Antral follicle count was predictive of ovarian response, with a 67% likelihood of poor ovarian response for AFC ≤4. Although the risk of moderate or severe OHSS is 2.2% with AFC of ≤24, the risk increases to 8.6% at AFC of ≥24. The risk of OHSS increases further to 11% if there are signs and symptoms of polycystic ovary syndrome. Conclusion(s): Although age and AFC are significantly correlated with live birth, AFC demonstrates a stronger correlation. Antral follicle count thresholds are useful to predict live birth rates and risks of poor ovarian response and OHSS during IVF treatment. © 2012 by American Society for Reproductive Medicine. Source


Norling A.,Karolinska University Hospital | Hirschberg A.L.,Karolinska University Hospital | Karlsson L.,Karolinska University Hospital | Rodriguez-Wallberg K.A.,Fertility Unit | And 3 more authors.
Sexual Development | Year: 2014

Ovarian dysfunction before the age of 40 years, characterized by hypergonadotropic hypogonadism and presenting with either primary or secondary amenorrhea, is called primary ovarian insufficiency (POI). POI has a significant genetic component, but the specific genetic cause is often unknown. A novel candidate gene for POI, PSMC3IP, has recently been identified. The aim of this study was to investigate a group of patients with POI for possible PSMC3IP mutations. Therefore, DNA samples from 50 patients with POI of primarily Swedish origin were used in the study, 27 with secondary amenorrhea (median age of diagnosis 23 years) and 23 with primary amenorrhea. Control material consisting of DNA samples from 95 women without POI was used for investigation of novel sequence variants. All exons and intron/exon boundaries of the PSMC3IP gene were analyzed by PCR and sequencing. As a result, no pathogenic mutation in the PSMC3IP gene was detected in the cohort. A previously unreported variant, NM-016556.3:c.337+33A>G, was detected in heterozygous form in 1 patient with secondary amenorrhea, likely constituting a normal variant. Two reported single nucleotide polymorphisms were detected in the cohort at the expected frequency. In conclusion, PSMC3IP gene mutations are not common causes of POI in this Swedish cohort. © 2014 S. Karger AG, Basel. Source

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