Objective: The aim of this study was to evaluate the effects of either a 2.5-mg or a 5-mg daily dose of letrozole in women undergoing superovulation and intrauterine insemination (IUI). Design: Prospective randomized ...Objective: The aim of this study was to evaluate the effects of either a 2.5-mg or a 5-mg daily dose of letrozole in women undergoing superovulation and intrauterine insemination (IUI). Design: Prospective randomized trial. Setting: Academic teaching hospital. Patient(s): Women < 40 years old, with patent fallopian tubes and infertility of > 1 year in duration. Intervention(s): Patients were randomized into either a 2.5-mg dose of letrozole (34 patients) or a 5-mg dose of letrozole (38 patients) daily for 5 days. When the leading follicle reached 18 mm in diameter, ovulation was triggered by an injection of hCG and IUI was performed 24 and 48 hours later. Main Outcome Measure(s): The number of follicles, endometrial thickness, and pregnancy rate. Result(s): Compared with those treated with 2.5 mg of letrozole, the total number of follicles was significantly higher in patients receiving 5 mg of letrozole. No difference in the endometrial thickness was found between the two groups. The pregnancy rate per cycle in patients receiving 5 mg of letrozole was statistically higher than in patients receiving 2.5 mg of letrozole (26.3%vs 5.9%, P < .05). No multiple pregnancies occurred. Conclusion(s): Compared with the daily dose of 2.5 mg, 5 mg of letrozole is associated with more follicles and a higher pregnancy rate. It appears that 5 mg daily for 5 days is a preferable letrozole dose for superovulation.展开更多
Objective: To assess the outcomes of patients who underwent uterine fibroid embolization (UFE) and to evaluate factors associated with failure of UFE. Design: Retrospective study. Setting: University teaching hospital...Objective: To assess the outcomes of patients who underwent uterine fibroid embolization (UFE) and to evaluate factors associated with failure of UFE. Design: Retrospective study. Setting: University teaching hospital. Patient(s): Two hundred thirty-three consecutive patients who underwent UFE from November 1997 to February 2004. Intervention(s): Uterine fibroid embolizations were performed by three interventional radiologists using 355-500-μpolyvinyl alcohol particles. Main Outcome Measure(s): Hysterectomy rate, myomectomy rate, and repeat UFE rate. Result(s): With a mean follow-up of 13 months, a total of 22 patients underwent surgery after UFE (9.4%); 16 had hysterectomies (6.9%), and 6 had myomectomies (2.6%). This included 3 patients who underwent repeat UFE and subsequently required surgical intervention. The mean (±SEM) time interval between UFE and subsequent treatment was 12.5 ±2.0 months. Among patients who required surgery, 13 (59.1%) presented with recurrent menorrhagia, and 5 (22.7%) complained of persistent abdominal pain. Histopathologic examination revelead concomitant findings of adenomyosis in 25%of hysterectomy specimens. Patients who failed UFE were more likely to have had a previous myomectomy (13%vs 2.4%) and significant reduction in the uterine size 6 months after UFE (57.1%vs 25.2%). Conclusion(s): The overall failure rate of UFE is 9.4%. Failure is mainly due to persistent menorrhagia and abdominal pain. Shrinkage of the uterus after UFE does not necessarily correlate with long-term success of UFE.展开更多
文摘Objective: The aim of this study was to evaluate the effects of either a 2.5-mg or a 5-mg daily dose of letrozole in women undergoing superovulation and intrauterine insemination (IUI). Design: Prospective randomized trial. Setting: Academic teaching hospital. Patient(s): Women < 40 years old, with patent fallopian tubes and infertility of > 1 year in duration. Intervention(s): Patients were randomized into either a 2.5-mg dose of letrozole (34 patients) or a 5-mg dose of letrozole (38 patients) daily for 5 days. When the leading follicle reached 18 mm in diameter, ovulation was triggered by an injection of hCG and IUI was performed 24 and 48 hours later. Main Outcome Measure(s): The number of follicles, endometrial thickness, and pregnancy rate. Result(s): Compared with those treated with 2.5 mg of letrozole, the total number of follicles was significantly higher in patients receiving 5 mg of letrozole. No difference in the endometrial thickness was found between the two groups. The pregnancy rate per cycle in patients receiving 5 mg of letrozole was statistically higher than in patients receiving 2.5 mg of letrozole (26.3%vs 5.9%, P < .05). No multiple pregnancies occurred. Conclusion(s): Compared with the daily dose of 2.5 mg, 5 mg of letrozole is associated with more follicles and a higher pregnancy rate. It appears that 5 mg daily for 5 days is a preferable letrozole dose for superovulation.
文摘Objective: To assess the outcomes of patients who underwent uterine fibroid embolization (UFE) and to evaluate factors associated with failure of UFE. Design: Retrospective study. Setting: University teaching hospital. Patient(s): Two hundred thirty-three consecutive patients who underwent UFE from November 1997 to February 2004. Intervention(s): Uterine fibroid embolizations were performed by three interventional radiologists using 355-500-μpolyvinyl alcohol particles. Main Outcome Measure(s): Hysterectomy rate, myomectomy rate, and repeat UFE rate. Result(s): With a mean follow-up of 13 months, a total of 22 patients underwent surgery after UFE (9.4%); 16 had hysterectomies (6.9%), and 6 had myomectomies (2.6%). This included 3 patients who underwent repeat UFE and subsequently required surgical intervention. The mean (±SEM) time interval between UFE and subsequent treatment was 12.5 ±2.0 months. Among patients who required surgery, 13 (59.1%) presented with recurrent menorrhagia, and 5 (22.7%) complained of persistent abdominal pain. Histopathologic examination revelead concomitant findings of adenomyosis in 25%of hysterectomy specimens. Patients who failed UFE were more likely to have had a previous myomectomy (13%vs 2.4%) and significant reduction in the uterine size 6 months after UFE (57.1%vs 25.2%). Conclusion(s): The overall failure rate of UFE is 9.4%. Failure is mainly due to persistent menorrhagia and abdominal pain. Shrinkage of the uterus after UFE does not necessarily correlate with long-term success of UFE.
