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Levin I.,Tel Aviv Sourasky Medical Center | Almog B.,Sara Racine IVF Unit | Ata B.,ll Reproductive Center | Ratan G.,Tel Aviv Sourasky Medical Center | Many A.,Tel Aviv Sourasky Medical Center
Journal of Minimally Invasive Gynecology | Year: 2010

Study Objective: Our aim was to estimate whether there are clinical, sonographic, or intraoperative parameters that have good correlation with the final histologic study after hysteroscopic removal of suspected retained trophoblast of conception. Design: Retrospective case control study (Canadian Classification II-2). Setting: A tertiary referral hospital. Patients: Sixty-four patients after hysteroscopic removal of suspected retained pregnancy material. Interventions: We divided our patients into those with true trophoblast on histologic evaluation (group A, n = 40) and patients with other histologic findings (group B, n = 24). Clinical parameters, as well as sonographic evidence leading to hysteroscopy were correlated with final pathology report. Measurements and Main Results: Age, obstetric history, type of obstetric event, and time between primary event and hysteroscopy were not statistically different between the true trophoblast and nontrophoblast groups. Clinical signs and symptoms (fever, bleeding, and abdominal pain), as well as sonographic findings (size of retained mass and Doppler flow) were not statistically different between the 2 groups and thus could not predict the final disease. The only parameter correlated significantly to final histologic findings was the intraoperative surgeon's opinion of the retained material. Conclusions: Various clinical parameters, as well as sonographic findings including the size of the mass and Doppler test results in patients with suspected retained trophoblast, do not predict the final diagnosis. The surgeon's opinion regarding the tissue seen during hysteroscopy is the only parameter tested that correlates well with the final histologic evaluation. Thus selective removal of retained trophoblast can be performed on the basis of the surgeon's opinion during the procedure, whereas further potentially harmful interventions (curettage) can be avoided when true trophoblast is not suspected to minimize complications. © 2010 AAGL.


Amir H.,Sara Racine IVF Unit | Gophen R.,Gan Meir Community Health Center | Amir Levy Y.,Tel Aviv University | Hasson J.,Sara Racine IVF Unit | And 3 more authors.
Journal of Obstetrics and Gynaecology Research | Year: 2015

Aim The aim of this study was to explore lesbians' preferences when choosing obstetricians/gynecologists. Material and Methods This cross-sectional study included 100 lesbian and 100 heterosexual women. A 40-item questionnaire assessed the correlation between a patient's sexual identity and her specific preferences for obstetricians/gynecologists. Results The top five most important parameters for both groups in choosing obstetricians/gynecologists overlapped greatly. Four of those were experience, ability, knowledge and personality. Only one parameter differed: lesbians ranked 'sexually tolerant' as the third most important characteristic while heterosexuals ranked 'availability' as the fifth most important characteristic. Lesbians rated 'sexual tolerance' significantly higher than heterosexuals (P < 0.001). More lesbians (56%) preferred female obstetricians/gynecologists compared to heterosexuals (21%) (P < 0.001). When compared to heterosexuals, more lesbians preferred female obstetricians/gynecologists for intimate and non-intimate procedures (P < 0.001). But within the lesbian population, a higher percentage of subjects showed a preference for female obstetricians/gynecologists only for intimate procedures. Lesbians used the following to describe their preference for female obstetricians/gynecologists: feeling more comfortable; gentle; sympathetic; patient; more understanding of women's health; better physicians in general; and more sexually tolerant (P < 0.001 vs heterosexual). However, when we looked only at the lesbian population, the majority did not exhibit a preference for a female obstetrician/gynecologist for any of these reasons. The main reason given by the 56% of the lesbians who said they prefer female obstetricians/gynecologists was feeling more comfortable. Conclusion Overwhelmingly lesbians prefer sexually tolerant obstetricians/gynecologists regardless of their gender; however, only a small number of lesbian subjects in this study considered their obstetricians/gynecologists as displaying this characteristic. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.


Almog B.,Sara Racine IVF Unit | Azem F.,Sara Racine IVF Unit | Kapustiansky R.,Sara Racine IVF Unit | Azolai J.,Sara Racine IVF Unit | And 7 more authors.
Gynecological Endocrinology | Year: 2011

Objectives. To compare the effect of recombinant follicle-stimulating hormones (r-FSH) and human menopausal gonadotrophin (hMG) on leptin levels in serum and follicular fluid (FF) during in vitro fertilization IVF/ET treatment, and to investigate whether leptin levels in the follicular fluid and/or serum are correlated with IVF success. Methods. Sixty-three patients undergoing IVF cycle were subdivided into two groups. r-FSH was used to for controlled ovarian hyperstimulation in 29 patients (Group A) while, hMG was used in 34 patients (Group B). Our main outcomes were serum and FF leptin on the day of oocyte collection. Result(s). The two groups were comparable in age, body mass index (BMI), indications for IVF/ET, E2 level on human chorionic gonadotrophin day, number of retrieved oocytes, fertilization rate, number of transferred embryos and pregnancy rate. Serum and FF leptin levels were similar between the two study groups. Additionally, no correlation was found between levels of leptin in either serum or FF and cycle results such as: number of retrieved oocytes, fertilization rate and pregnancy rate. Conclusions. r-FSH and hMG have been found to have comparable effects on leptin levels in the serum and the FF of patients undergoing IVF/ET. Additionally, leptin levels in both serum and FF on day of retrieval have no correlation to IVF/ET outcome. © 2011 Informa UK, Ltd.

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