Human reproduction
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Internationally, several organizations have developed clinical guidelines for subfertility care to supply patients with the best possible care. However, to improve the implementation of such guidelines, we first need to gain insight into the application of clinical guidelines in daily practice. Valid quality indicators are necessary to estimate actual guideline adherence. However, none of the existing subfertility guideline programmes is accompanied by a satisfactory set of quality indicators. In this study, we develop a set of valid guideline-based quality indicators for subfertility care. ⋯ This study describes the systematic, stepwise method used to develop 39 process and structure indicators that can be used to monitor subfertility care.
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Post-operative adhesion formation is a major clinical problem. Tissue oxygenation is one of the most important determinants in adhesion formation. The objective of this study was to investigate whether supplemental perioperative oxygen could reduce post-operative adhesion formation through increasing the peritoneal tissue oxygen tension (PitO(2)) in a mouse model. ⋯ Supplemental perioperative oxygen may help to reduce post-operative adhesion formation.
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Randomized Controlled Trial
The effects of the selective progesterone receptor modulator asoprisnil on the morphology of uterine tissues after 3 months treatment in patients with symptomatic uterine leiomyomata.
Asoprisnil is a selective progesterone receptor modulator with mixed progesterone agonist/antagonist activity which controls uterine bleeding via an endometrial effect. This study examined full-thickness endometrial, leiomyoma and myometrial morphology in hysterectomy specimens from patients with uterine leiomyomata, after treatment with asoprisnil for 3 months. ⋯ Asoprisnil induces unique morphological changes and is associated with low levels of glandular and stromal proliferation in endometrium, and in leiomyomata. These changes are likely to contribute to the amenorrhoea experienced after exposure to the medication.
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Review Meta Analysis
Metformin versus oral contraceptive pill in polycystic ovary syndrome: a Cochrane review.
The object of this review was to compare metformin versus oral contraceptive pill (OCP) treatment in polycystic ovary syndrome. ⋯ The limited RCT evidence to date does not show adverse metabolic risk with the use of the OCP compared with metformin. Further long-term RCTs are required.
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Comparative Study
Testing of nine different xeno-free culture media for human embryonic stem cell cultures.
Human embryonic stem cells (hESC) are excellent candidates for cell replacement therapies. However, currently used culture conditions contain animal-derived components that bear a risk of transmitting animal pathogens and incorporation of non-human immunogenic molecules to hESC. ⋯ None of the studied xeno-free media was able to maintain the undifferentiated growth of hESC. The medium containing 20% human serum was found to sustain undifferentiated hESC proliferation to some extent, yet was inferior to the conventional ko-SR-containing medium.