Treatment options I. Ovulation induction

2011 ◽  
pp. 57-64
Author(s):  
Selwyn P Oskowitz
Keyword(s):  
Ovulation Induction ◽  
Treatment Options

scholarly journals Prospective observational study on prescribing pattern of infertility treatment options and their success rates in women with polycystic ovary syndrome at tertiary care teaching hospital

2021 ◽  
Vol 8 (12) ◽  
pp. 5860
Author(s):  
Rishitha Sanjana Abbagoni ◽  
Madhuri Mushan ◽  
Pooja Kosika ◽  
Prathyusha Vemula ◽  
Manognya Pattepura
Keyword(s):  
Folic Acid ◽  
Polycystic Ovary Syndrome ◽  
Teaching Hospital ◽  
Ovulation Induction ◽  
Polycystic Ovary ◽  
Treatment Options ◽  
Tertiary Care ◽  
Infertility Treatment ◽  
Ovary Syndrome ◽  
Prescribing Pattern

Background: Polycystic ovary syndrome or in shortcut PCOS previously called as Stein-Leventhal syndrome is a primary and major cause of anovulatory infertility in women of child bearing ages. 3 in every 5 women with PCOS have trouble getting pregnant. Various therapeutic options are available in managing several PCOS symptoms and in increasing chances of pregnancy. The aim of the study was to observe the prescribing pattern of infertility treatment options and their individual success rates.Methods: The study was conducted in out-patient department of obstetrics and gynaecology, tertiary care teaching hospital, Telangana, India. The study included women aged between 18-37 years who were seeking treatment for infertility due to PCOS. Patients were divided into two categories based on their age and treatment they received which was further grouped accordingly.Results: The frequency of infertility was found to be significantly higher among PCOS women of age group between 23-27 when compared to other age groups. Among infertility treatment options, ovulation induction drugs were mostly prescribed and among supplements folic acid and myo-inositol were widely prescribed as supplements as well as an adjuvant. Patients who received treatment with ovulation inducing drugs showed high success rate.Conclusions: Lifestyle modifications were chosen as primary therapeutic option. Ovulation induction drugs among infertility treatment options, folic acid and myo-inositol among supplements were the mostly prescribed medicines to treat or improve infertility in PCOS women. Ovulation inducing drugs showed high success rate.

P–712 Ovulation induction in type 1 anovulation: a comparative study using gonadotrophins and the GnRH pump

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
E Burt ◽  
M Davies ◽  
V Talaulikar ◽  
X Foo ◽  
T Lukaszewski ◽  
...  
Keyword(s):  
Cohort Study ◽  
Pregnancy Rate ◽  
Retrospective Cohort Study ◽  
Ovulation Induction ◽  
Retrospective Cohort ◽  
Treatment Options ◽  
Releasing Hormone ◽  
The Mean ◽  
Cycle Cancellation

Abstract Study question Is there a difference in treatment outcome between gonadotrophin releasing hormone (GnRH) pump or hMG for women with Type 1 anovulation undergoing ovulation induction? Summary answer Treatment with GnRH was more efficient compared to hMG, with fewer number of cycles to pregnancy, fewer days of stimulation and fewer cycle cancellations. What is known already Whilst there is a lot of information on ovulation induction in WHO type II anovulation (PCOS), type 1 anovulation is under-represented in research. WHO type 1 anovulation is characterised by low pituitary gonadotrophins and oestradiol. Treatment options used to include induction of ovulation using gonadotrophins (hMG) or the Gonadotrophin hormone releasing hormone (GnRH) pump delivering pulsatile GnRH. Since the withdrawal of GnRH pump, options have become limited. One study reveals that monofollicular cycles are lower and cycle cancellation higher in women with Type 1 anovulation women treated with gonadotrophins. Study design, size, duration: This is a single centre retrospective cohort study. All women with a diagnosis of WHO type 1 anovulation attending the Reproductive Medicine Unit at the University College London Hospital who received ovulation induction treatment using either hMG or GnRH pump between 1993 and 2020 were included in the study Participants/materials, setting, methods 147 women with WHO type 1 anovulation were included in the study. Diagnosis was based on the presence of primary or secondary amenorrhoea in combination with low gonadotrophins and oestradiol. Demographic and clinical data were obtained by reviewing medical records stored within an electronic database. A total of 599 treatment cycles were identified. Statistical analysis between the groups was performed using the independent T test and chi squared test. Main results and the role of chance 147 women with WHO type 1 anovulation underwent ovulation induction. hMG was used in 500 cycles (83.5%) and the GnRH pump in 99 cycles (16.5%). Per cycle started the pregnancy rate in the hMG cycles was 107/500 (21.4%) and in the GnRH pump cycles was 19/99 (19.2%) p = 0.36. Cycle cancellation was significantly greater in hMG than GnRH pump cycles (hMG 137/ 500 27.4% vs GnRH pump 17/99 17.2% p = 0.02). Over response was more common in hMG cycles than GnRH pump cycles (66/130 50.8% vs 3/16 18.8% p = 0.01). A total of 363/500 (72.5%) cycles in the hMG and 82/99 (82.8%) cycles in the GnRH pump group reached ovulation. There was no difference in the pregnancy rate after ovulation (hMG 107/363 29.5% vs GnRH pump 19/82 23.2% p = 0.15). The mean number of treatment cycles to achieve pregnancy was significantly fewer with the GnRH pump compared to hMG (1.8 (min 1 – max 3) vs 2.4 ( min 1 – max 8) p = 0.03).The mean days of stimulation required to reach ovulation was also significantly less with the GnRH pump compared to hMG (16.7 (min 8 – max 34) vs 23.4 (min 7 – max 72) p = <0.001). Limitations, reasons for caution This is a retrospective cohort study and is reliant on the quality and quantity of the data entry at the time of clinical treatment. Wider implications of the findings: Ovulation induction for women with type 1 anovulation is now restricted to a single treatment, namely hMG. hMG is not as effective or optimal as GnRH. Reinstating GnRH in routine clinical practice should be promoted to allow more individualised treatment options and prevent the premature need for in vitro fertilisation.. Trial registration number NA

Treatment Options: I. Ovulation Induction

2017 ◽  
pp. 63-71
Author(s):  
Selwyn P. Oskowitz ◽  
Alan S. Penzias
Keyword(s):  
Ovulation Induction ◽  
Treatment Options

The Collaborative Network Approach: a model for advancing patient-centric research for Castleman disease and other rare diseases

2019 ◽  
Vol 3 (1) ◽  
pp. 97-105
Author(s):  
Mary Zuccato ◽  
Dustin Shilling ◽  
David C. Fajgenbaum
Keyword(s):  
Rare Diseases ◽  
Treatment Options ◽  
Castleman Disease ◽  
High Impact ◽  
Collaborative Network ◽  
Network Approach ◽  
Grant Applications ◽  
Research Questions ◽  
Novel Strategy ◽  
Patient Centric

Abstract There are ∼7000 rare diseases affecting 30 000 000 individuals in the U.S.A. 95% of these rare diseases do not have a single Food and Drug Administration-approved therapy. Relatively, limited progress has been made to develop new or repurpose existing therapies for these disorders, in part because traditional funding models are not as effective when applied to rare diseases. Due to the suboptimal research infrastructure and treatment options for Castleman disease, the Castleman Disease Collaborative Network (CDCN), founded in 2012, spearheaded a novel strategy for advancing biomedical research, the ‘Collaborative Network Approach’. At its heart, the Collaborative Network Approach leverages and integrates the entire community of stakeholders — patients, physicians and researchers — to identify and prioritize high-impact research questions. It then recruits the most qualified researchers to conduct these studies. In parallel, patients are empowered to fight back by supporting research through fundraising and providing their biospecimens and clinical data. This approach democratizes research, allowing the entire community to identify the most clinically relevant and pressing questions; any idea can be translated into a study rather than limiting research to the ideas proposed by researchers in grant applications. Preliminary results from the CDCN and other organizations that have followed its Collaborative Network Approach suggest that this model is generalizable across rare diseases.

Establishing a Group Educational Session for Hyperacusis Patients

2019 ◽  
Vol 28 (2) ◽  
pp. 245-250
Author(s):  
Ann E. Perreau ◽  
Richard S. Tyler ◽  
Patricia C. Mancini ◽  
Shelley Witt ◽  
Mohamed Salah Elgandy
Keyword(s):  
Therapeutic Process ◽  
Treatment Options ◽  
Clinical Group ◽  
Education Session ◽  
Group Approach ◽  
Treatment Protocols ◽  
Educational Session ◽  
Evidence Based Treatment ◽  
Relationship Of ◽  
The Relationship

Purpose Audiologists should be treating hyperacusis patients. However, it can be difficult to know where to begin because treatment protocols and evidence-based treatment studies are lacking. A good place to start in any tinnitus and hyperacusis clinic is to incorporate a group educational session. Method Here, we outline our approach to establishing a hyperacusis group educational session that includes specific aspects of getting to know each patient to best meet their needs, understanding the problems associated with hyperacusis, explaining the auditory system and the relationship of hyperacusis to hearing loss and tinnitus, describing the influence of hyperacusis on daily life, and introducing treatment options. Subjective responses from 11 adults with hyperacusis, who participated in a recent clinical group education session, were discussed to illustrate examples from actual patients. Conclusions Due to the devastating nature of hyperacusis, patients need to be reassured that they are not alone and that they can rely on audiologists to provide support and guidance. A group approach can facilitate the therapeutic process by connecting patients with others who are also affected by hyperacusis, and by educating patients and significant others on hyperacusis and its treatment options. Supplemental Material https://doi.org/10.23641/asha.8121197

Surgery for Lung Cancer and the Consequences for the Swallow

2016 ◽  
Vol 1 (13) ◽  
pp. 162-168
Author(s):  
Pippa Hales ◽  
Corinne Mossey-Gaston
Keyword(s):  
Lung Cancer ◽  
Treatment Options ◽  
Vocal Cord Palsy ◽  
Subsequent Treatment ◽  
Physiological Reserve ◽  
Palliative Phase ◽  
And Function ◽  
The Impact ◽  
Swallow Function

Lung cancer is one of the most commonly diagnosed cancers across Northern America and Europe. Treatment options offered are dependent on the type of cancer, the location of the tumor, the staging, and the overall health of the person. When surgery for lung cancer is offered, difficulty swallowing is a potential complication that can have several influencing factors. Surgical interaction with the recurrent laryngeal nerve (RLN) can lead to unilateral vocal cord palsy, altering swallow function and safety. Understanding whether the RLN has been preserved, damaged, or sacrificed is integral to understanding the effect on the swallow and the subsequent treatment options available. There is also the risk of post-surgical reduction of physiological reserve, which can reduce the strength and function of the swallow in addition to any surgery specific complications. As lung cancer has a limited prognosis, the clinician must also factor in the palliative phase, as this can further increase the burden of an already compromised swallow. By understanding the surgery and the implications this may have for the swallow, there is the potential to reduce the impact of post-surgical complications and so improve quality of life (QOL) for people with lung cancer.

An Overview of Dementias

2012 ◽  
Vol 21 (3) ◽  
pp. 75-84
Author(s):  
Venkata Vijaya K. Dalai ◽  
Jason E. Childress ◽  
Paul E Schulz
Keyword(s):  
Clinical Presentation ◽  
Treatment Options ◽  
Current Treatment ◽  
Great Variability ◽  
Health Concern ◽  
Public Health Concern ◽  
Life Threatening ◽  
The Common ◽  
Neurodegenerative Dementias ◽  
Made In

Dementia is a major public health concern that afflicts an estimated 24.3 million people worldwide. Great strides are being made in order to better diagnose, prevent, and treat these disorders. Dementia is associated with multiple complications, some of which can be life-threatening, such as dysphagia. There is great variability between dementias in terms of when dysphagia and other swallowing disorders occur. In order to prepare the reader for the other articles in this publication discussing swallowing issues in depth, the authors of this article will provide a brief overview of the prevalence, risk factors, pathogenesis, clinical presentation, diagnosis, current treatment options, and implications for eating for the common forms of neurodegenerative dementias.

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