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CONTEXT Serum LH levels decrease with increasing body mass index (BMI) in women with polycystic ovarian syndrome (PCOS). OBJECTIVE The objective of this study was to determine whether pharmacokinetic factors contribute to the effect of obesity on LH in PCOS. PARTICIPANTS/INTERVENTIONS/SETTING: Twenty-one women with PCOS underwent frequent blood sampling,(More)
BACKGROUND The FMR1 premutation is associated with overt primary ovarian insufficiency (POI). However, its prevalence in women with occult POI (i.e. menstrual cycles, but impaired ovarian response) has not been examined. We hypothesized that both the FMR1 premutation and intermediate allele is more frequent in infertile women with occult POI than in(More)
OBJECTIVE To demonstrate 2 step-by-step techniques for contained morcellation of uterine tissue. DESIGN Instructional video showing laparoscopic electromechanical morcellation within an endoscopic pouch, and alternatively, tissue extraction via ultra-minilaparotomy. SETTING Academic medical center. PATIENT(S) Women undergoing laparoscopic myomectomy(More)
STUDY OBJECTIVE To evaluate risk of leakage and tissue dissemination associated with various contained tissue extraction (CTE) techniques. DESIGN In vitro study (Canadian Task Force classification: II-1). SETTING Academic hospital simulation laboratory. INTERVENTION Beef tongue specimens weighing 400 to 500 g were stained using 5 mL indigo carmine dye(More)
CONTEXT Studies in humans and animals indicate that estrogen negative feedback occurs at the level of the hypothalamus, but it is unclear whether estrogen also exerts an inhibitory effect directly at the pituitary. OBJECTIVES The aim of the study was to determine whether estrogen has a direct negative feedback effect at the pituitary and whether this(More)
CONTEXT Patients with polycystic ovarian syndrome (PCOS) have increased LH relative to FSH, but LH is modified by body mass index (BMI). OBJECTIVE The objective of the study was to determine whether the impact of BMI on neuroendocrine dysregulation in PCOS is mediated at the hypothalamic or pituitary level. PARTICIPANTS/INTERVENTIONS/SETTING: Twenty-four(More)
STUDY QUESTION What are the characteristics of the pregnancy outcomes in women undergoing robot-assisted laparoscopic myomectomy (RALM) for symptomatic leiomyomata uteri? SUMMARY ANSWER Despite a high prevalence of women with advanced maternal age, obesity and multiple pregnancy in our cohort, the outcomes are comparable with those reported in the(More)
BACKGROUND Safe tissue removal is a challenge for minimally invasive procedures such as myomectomy, supracervical hysterectomy, or total hysterectomy of a large uterine specimen. There is concern regarding disruption or dissemination of tissue during this process, which may be of particular significance in cases of undetected malignancy. Contained tissue(More)
OBJECTIVE. The purpose of this article is to evaluate the cost effectiveness of a treatment strategy for symptomatic uterine fibroids that uses MRI-guided focused ultrasound as a first-line therapy relative to uterine artery embolization (UAE) or hysterectomy. MATERIALS AND METHODS. We developed a decision-analytic model to compare the cost effectiveness of(More)
CONTEXT Complex changes in GnRH secretion occur with aging in women, but little is known about the effect of aging on the pituitary per se. OBJECTIVE The aim of the study was to determine whether pituitary responsiveness to GnRH is attenuated with aging. DESIGN AND SETTING A GnRH antagonist and graded doses of GnRH were used to isolate pituitary(More)