Chlamydia trachomatis antibody testing is more accurate than hysterosalpingography in predicting tubal factor infertility
|
|
- Morris Potter
- 5 years ago
- Views:
Transcription
1 FERTILITY AND STERILITY Copyright c 1994 The American Fertility Society Vol. 61, No.5, May 1994 Printed on acid-free paper in U. S. A. Chlamydia trachomatis antibody testing is more accurate than hysterosalpingography in predicting tubal factor infertility Yvonne A. J. M. Dabekausen, M.D.t Johannes L. H. Evers, M.D.t Jolande A. Land, M.D.t:J: Frans S. Stals, M.D. Academisch Ziekenhuis Maastricht and the University of Limburg, Maastricht, The Netherlands Objective: To compare the likelihood of abnormal Chlamydia trachomatis antibody test results with that of abnormal hysterosalpingography (HSG) test results in patients with tubal factor infertility. Design: Anti-C. trachomatis immunoglobulin G antibodies were determined prospectively in 211 consecutive infertility patients by means of an indirect fluorescent antibody technique. The results were compared with the results of HSG with respect to their predictive value of tubal factor infertility. Likelihood ratio calculations were used. Setting: University hospital-based, tertiary care infertility clinic. Patients: A series of 211 consecutive infertility patients. Interventions: C. trachomatis antibody testing, HSG,. Main Outcome Measures: Likelihood ratios for abnormal C. trachomatis antibody test results and abnormal HSG results in infertility patients, as assessed by. Results: The positive likelihood ratio for C. trachomatis antibody testing was 9.1, indicating a patient with tubal factor infertility to be 9.1 times more likely to have abnormal serology results than a patient without tubal factor infertility. This was superior to HSG, which had a positive likelihood ratio of 2.6 in our study and of 1.6 to 6.1 in the literature. The odds ratio of C. trachomatis antibody testing was 31.5 in our study. Its 90% confidence interval (8.3 to 138.5) did not overlap that of HSG as calculated from a meta-analysis of literature reports (5.3 to 7.9). Conclusions: C. trachomatis antibody testing is simple, inexpensive, and causes minimal inconvenience to the patient. It is more likely than HSG to be abnormal in patients with tubal factor infertility. C. trachomatis antibody testing deserves to become an integral component of the initial fertility work-up. Fertil Steril1994;61:833-7 Key Words: Chlamydia trachomatis antibody, hysterosalpingography, tubal factor infertility, likelihood ratio, odds ratio Infertility affects approximately 10% of couples. Fourteen percent (1) to 38% (2) of female infertility Received September 13, 1993; revised and accepted January 12,1994. * Presented in part at the 49th Annual Meeting of The American Fertility Society, Montreal, Quebec, Canada, October 9 to 14,1993. t Department of Obstetrics and Gynaecology. :j: Reprint requests: Jolande A. Land, M.D., Department of Obstetrics and Gynaecology, Academisch Ziekenhuis Maastricht, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands (FAX: ). Department of Medical Microbiology. is associated with a "tubal factor." The single most important cause of tubal pathology is inflammatory disease. The incidence of genital infections with Chlamydia trachomatis is increasing worldwide (3). In 50% to 80% of the female patients the course of this infection is asymptomatic (4). C. trachoma tis causes damage to the ciliated epithelium of the tubes, compromising tubal transport and increasing the risk for ectopic pregnancy and infertility. Current C. trachomatis infections can be detected by culturing or staining a direct specimen. Cultures, however, can be false-negative, especially in ascending infections of the genital tract (5). Vol. 61, No.5, May 1994 Dabekausen et al. Chlamydia antibody and tubal infertility 833
2 Extinct C. trachomatis infections can be revealed still by serologic tests (5) because C. trachomatis antibodies persist after pelvic inflammatory disease (6). Because the majority of C. trachomatis infections remain unnoticed by the patient but give rise to tuboperitoneal pathology and persistent antibody formation, serologic C. trachomatis antibody testing has been introduced into the infertility work-up (7). The first aim of this study was to investigate the prevalence of C. trachomatis antibodies in serum in an infertility population and to determine their suitability in screening for tuboperitoneal disease, as found at. The second aim was to compare the diagnostic test properties of serum C. trachomatis antibody testing with those of hysterosalpingography (HSG) with respect to their predicting tubal factor infertility. C. trachomatis antibody testing and HSG were compared by calculating their respective odds and likelihood ratios (8). MATERIALS AND METHODS Two hundred eleven female infertility patients who presented consecutively to our infertility clinic participated in a prospective study. Blood was drawn at their initial visit and an indirect microimmunofluorescent antibody technique for C. trachomatis immunoglobulin (Ig) G antibodies (9, 10) was used. In short, 20 JLL of serum was diluted eight times in phosphate-buffered saline (PBS), ph 7.4, and incubated on the C. trachomatis-spot immunofluorescence substitute slides (Egg-grown C. trachomatis biovar L2; BioMerieux, 's Hertogenbosch, The Netherlands) for 30 minutes at 37 C in a moist chamber. The slides were washed three times for 5 minutes in PBS and incubated with fluoresceinconjugated rabbit anti-human IgG (Dako; ITK Diagnostics B.V., Uithoorn, The Netherlands) diluted in PBS for 30 minutes at 37 C. After three washings in PBS and one in ultrapure water processed through a milli-q purifying system (Millipore, Bedford, MA), slides were embedded in Fluoprep mounting medium (BioMerieux) under a coverslip. A positive reaction is characterized by specific fluorescence of the C. trachomatis elementary body. For a quantitative determination, serial dilution in PBS was performed. After a follow-up period of 6 to 18 months, both an HSG and a had been performed in 34 patients; 37 additional patients had undergone only a. Therefore, results were available to compare C. trachomatis antibody tests with findings for 71 patients, and HSG results could be compared with the findings at for 34 patients. All HSGs were performed in the proliferative phase of the menstrual cycle with oil-soluble contrast medium (Lipiodol Ultrafluide; Laboratoire Guerbet, Aulnay-sous-bois, France). An HSG was considered abnormal if one or both tubes did not allow passage of contrast medium. Peritubal adhesions were suspected whenever the contrast medium failed to spread freely in the peritoneal cavity and/or pockets of contrast medium were apparent on the delayed picture. Laparoscopy was performed in the proliferative phase of the cycle. Tubal testing was done with methylene blue dye. Patients were classified as having tuboperitoneal abnormalities if evidence of fimbrial, peritubal, and/or periovarian adhesions; obstruction of one or both fallopian tubes; hydrosalpinx; or a combination of these was encountered during. At the time of and HSG, the investigators were blind to the Chlamydia serology results. The most suitable clinical cutoff level of the anti C. trachoma tis antibody titer in serum was calculated by means of construction of a receiver operating characteristics curve (11). An antibody titer of 8 appeared to be the optimal cutoff level. Consequently, patients in whom a titer of >8 was found were considered seropositive. The diagnostic value of the C. trachomatis antibody test was compared with the value of HSG in predicting tubal factor infertility in the individual patient using likelihood ratios. Likelihood ratios, in contrast to the more conventionally used positive and negative predictive values, are not affected by the prevalence of disease in the population studied. Therefore, they can be used to compare the outcome of the same test in different populations and to compare various tests of the same disease entity in the same population. The likelihood ratio of a positive test result (LR+) indicates the likelihood of a positive test in a patient with the disease over the likelihood of a positive test in a patient without the disease. The LR- indicates the likelihood of a negative test in a patient with the disease over the likelihood of a negative test in a patient without the disease. The LR+ is calculated as [sensitivity/(1 - specificity)]. The LR- is calculated as [(1 - sen- 834 Dabekausen et ai. Chlamydia antibody and tubal infertility Fertility and Sterility
3 Table 1 Tuboperitoneal ities at Laparoscopy in Seropositive and Seronegative* Infertility Patients C. trachomatis antibody testing Positive Negative 25t * C. trachomatis antibody titer> 8 for seropositive patients; :$8 for seronegative patients. t p < (X 2 test); sensitivity: 74%; specificity: 92%; LR+: 9.1; X2 LR-: 0.3; OR: 31.5 (90% confidence interval: 8.3 to 138.5). sitivity)/specificity). Calculation of LRs yields a score that allows categorization of test results: an LR+ between 2 and 5 indicates a fair clinical test, between 5 and 10 is good, and> 10 is excellent. An LR- between 0.5 and 0.2 indicates a fair clinical test, between 0.2 and 0.1 is good, and <0.1 is excellent (8). The odds ratio (OR) can be calculated from the LRs: OR = LR+ /LR- (12). The OR reflects the probability of a patient with an abnormal test to have tubal factor infertility. The OR equals 1 if the level of the test equals the prevalence of the disease. When the level exceeds the prevalence the OR is >1 (12). We calculated the LR+, LR-, and OR for C. trachomatis antibody testing and for HSG, both for our own study and for those literature reports allowing their calculation. The LRs and the OR for C. trachomatis antibody testing in our study were compared with the LRs and the OR for HSG, both from our study and from the literature. RESULTS In 60 of 211 patients studied (28.5%), the C. trachomatis antibody test was positive (anti-c. trachomatis IgG titer> 8). In 71 of 211 patients, a was performed (Table 1): 25 of the 28 seropositive patients (89%) had tuboperitoneal abnormalities. Of the 43 seronegative patients, only 9 (21 %) had adhesions or tubal obstruction. This difference is statistically highly significant (P < ; X 2 test). In 34 of 211 patients, an HSG as well as a was performed. In 24 of these 34 patients the results corresponded, but in 10 patients a discrepancy between HSG and was found (P = 0.06; Fisher's exact test) (Table 2). According to Bayes' theorem, the probability of tubal factor infertility for a patient in our population is 88% if she has abnormal C. trachomatis antibody testing and 59% if she has an abnormal HSG. To obtain a prevalence independent measure of the reliability of C. trachomatis antibody testing, likelihood ratios were calculated. The LR+ of C. trachomatis antibody testing was 9.1, indicating a patient with tubal factor infertility to be 9.1 times more likely to have a positive test result (i.e., titer > 8) than a patient without tubal factor infertility. In comparison, the LR+ for HSG in the same group of patients was only 2.6. The LR - for C. trachomatis antibody testing was 0.3, indicating a patient with tubal factor infertility to be 0.3 times as likely to have a negative test (i.e., titer::;; 8) as a patient without the disease. The LR- for HSG was 0.5. The respective ORs were 31.5 for C. trachomatis antibody testing and 4.8 for HSG. DISCUSSION In the infertility patient, is the most accurate method to diagnose tuboperitoneal pathology but, for screening purposes, HSG is used widely. Hysterosalpingography is a disagreeable, annoying test to the patient. It may be painful and has a high false-positive and false-negative rate. The false-positive outcome (in most studies around 25 %) (13-23) is thought to result from tubal spasm, dissimilar tubal filling pressure, too high viscosity of the contrast medium, and faulty technique. False-negative findings have been reported in around 40% (13-23) and are considered to be due to peritubal adhesions not visualized on the delayed picture. We investigated the value of serum C. trachomatis antibody testing in screening for tubal factor infertility. With as a gold standard, we compared the predictive value of the C. trachomatis antibody titer with HSG. For this comparison we used LRs, prevalence independent test characteristics. Table 2 Tuboperitoneal ities at Laparoscopy in Infertility Patients with and HSG HSG 7* * p = 0.06 (Fisher's exact test); sensitivity: 58%; specificity: 77%; LR+: 2.6; LR-: 0.5; OR: 4.8 (90% confidence interval: 1.0 to 21.8). Vol. 61, No.5, May 1994 Dabekausen et al. Chlamydia antibody and tubal infertility 835
4 Table 3 LR+ and LR- of HSGs and Corresponding ORs in Predicting Tuboperitoneal ities as Calculated From Literature Reports Studies LR+ LR- OR* Snowden et ai., 1984 (13) Moghissi and Kim, 1975 (14) Keirse and Vandervellen, 1973 (15) Gabos, 1976 (16) Swolin and Rosencrantz, 1972 (17) Present study Cumming and Taylor, 1980 (18) Ismajovich et ai., 1986 (19) Philipsen and Hansen, 1981 (20) World Health Organization, 1986 (21) Maathuis et ai., 1972 (22) Reshef et ai., 1989 (23) * Cumulative OR (90% confidence interval): 6.4 (5.3 to 7.9). The LR+ of C. trachomatis antibody testing was 9.1; the LR+ ofthe HSG in this study was only 2.6. Theoretically, a poor performance of HSG in our clinic might be a reason for this disappointing test outcome. A review of the literature, however, showed LR+ of the HSG to range from 1.6 to 6.1 in those reports giving sufficient details for their calculation (Table 3). Even when the best LR+ of HSG in literature is compared with the LR+ ofthe C. trachomatis antibody test in our study, the latter reflects tuboperitoneal abnormalities better than HSG. The LR- of C. trachomatis antibody testing is 0.3 in our study and is comparable to the HSG studies with the best discriminatory value reported in the literature (Table 3). The group of patients who had HSG results available in our study was too small to allow for a reliable positioning of the new test, C. trachomatis antibody testing, in the diagnostic armamentarium to which the old test, HSG, belongs. Therefore, we estimated the cumulative OR and its confidence limits for HSG from a meta-analysis of those literature reports that provided sufficient details for their calculation. The cumulative OR for HSG was 6.4 with 90% confidence limits of 5.3 and 7.9. The OR of C. trachoma tis antibody testing differed significantly with an 0 R of 31.5 and 90% confidence limits of 8.3 and Of the seronegative patients in our study, 9 of 43 (21 %) had tuboperitoneal abnormalities. These were due to previous pelvic surgery, endometriosis, or pelvic inflammatory disease caused by microorganisms other than C. trachomatis. In the present study, the likelihood of disease increased with the height of the titer. All patients with a titer> 128 had tuboperitoneal disease. These results are in accordance with the findings by Minassian and Wu (24), who reported a correlation between the height of the titer and the severity of pelvic adhesions. Toye and co-workers (25) recently published a study of the association between antibody to the chlamydial heat-shock protein and tubal infertility. Their results suggest that chlamydial heat-shock protein determination allows further differentiation within the group of C. trachomatis-positive patients between those with and those without tubal damage. In conclusion, our study focused on serum anti -C. trachomatis IgG antibody screening in women presenting with infertility. C. trachomatis antibody testing by microimmunofluorescence is simple, inexpensive (Dfl 24 [$13] compared with Dfl 323 [$179] in The Netherlands) and causes minimal inconvenience to the patient. It is more likely than HSG to give abnormal results in patients with tubal factor infertility. C. trachomatis antibody testing deserves to become an integral component of the initial fertility work-up. REFERENCES 1. Hull MGR, Glazener CMA, Kelly NJ, Conway DI, Foster P A, Hinton RA, et al. Population study of causes, treatment, and outcome of infertility. Br Med J 1985;291: Arronet GH, Eduljee SY, O'Brien JR. A nine year survey of fallopian tube dysfunction in human infertility. Fertil Steril 1969;20: Paavonen J, Wolner-Hanssen P. Chlamydia trachomatis: a major threat to reproduction. Hum Reprod 1989;4: Thejls H, Rahm VA, Rosen G, Gnarpe H. Correlation between chlamydia infection and clinical evaluation, vaginal wet smear, and cervical swab test in female adolescents. Am J Obstet Gynecol 1987;157: Schoenwald E, Schmidt BL, Steinmetz G, Hosmann J, Pohla Gubo G, Luger A, et al. Diagnosis of Chlamydia trachomatis infections. Culture versus serology. Eur J Epide miol 1988;4: Puolakkainen M, Vesterinen E, Purola E, Saikku P, Paavonen J. Persistence of Chlamydial antibodies after pelvic inflammatory disease. J Clin Microbiol 1986;23: Moore DE, Foy HM, Daling JR, Grayston JT, Spadoni LR, Wang S, et al. Increased frequency of serum antibodies to chlamydia trachomatis in infertility due to tubal disease. Lancet 1982;1: Collins JA. Male infertility: the interpretation of the diagnostic assessment. In: Mishell DR, Paulsen CA, Lobo RA, editors. Yearbook of infertility Chicago: Year Book Medical Publishers, 1989: Treharne JD, Darougar S, Jones BR. Modification of the micro-immunofluorescence test to provide a routine sero- 836 Dabekausen et al. Chlamydia antibody and tubal infertility Fertility and Sterility
5 diagnostic test for chlamydial infection. J Clin Pathol 1977;30: Barnes RC. Laboratory diagnosis of human chlamydial infections. Clin Microbiol Rev 1989;2: McNeil BJ, Hanley JA. Statistical approaches to the analysis of receiver operating characteristics. Med Decis Making 1984;4: Kraemer HC. Evaluating medical tests, objective and quantitative guidelines. Newbury Park: Sage Publications, 1992: Snowden EU, Jarrett JC II, Dawood MY. Comparison of diagnostic accuracy of, hysteroscopy, and hysterosalpingography in evaluation of female infertility. Fertil Steril1984;41: Moghissi KS, Sim GS. Correlation between hysterosalpingography and pelvic endoscopy for the evaluation of tubal factor. Fertil Steril 1975;26: Keirse MJ CN, Vandervellen R. A comparison of hysterosalpingography and in the investigation of infertility. Obstet Gynecol 1973;41: Gabos P. A comparison of hysterosalpingography andendoscopy in evaluation of tubal function in infertile women. Fertil Steril 1976;27: Swolin K, Rosencrantz M. Laparoscopy vs. hysterosalpingography in sterility investigations: a comparative study. Fertil Steril 1972;23: Cumming DC, Taylor PJ. Combined and hysteroscopy in the investigation of the ovulatory infertile female. Fertil SteriI1980;33: Ismajovich B, Wexler S, Golan A, Langer L, David MP. The accuracy of hysterosalpingography versus in evaluation of infertile women. Int J Gynaecol Obstet 1986;24: Philipsen T, Hansen BB. Comparative study of hysterosalpingography and in infertile patients. Acta Obstet Gynecol Scand 1981;60: WHO study. Comparative trial of tubal insufflation, hysterosalpingography, and with dye hydrotubation for assessment of tubal patency. Fertil Steril1986;46: Maathuis JB, Horbach JGM, van Hall EV. A comparison of the results of hysterosalpingography and in the diagnosis of fallopian tube dysfunction. Fertil Steril 1972;23: Reshef E, Daniel WW, Foster JC, Bradley EL, Blackwell RE, Younger JB. Comparison between I-hour and 24-hour follow-up radiographs in hysterosalpingography using oil based contrast media. Fertil Steril 1989;52: Minassian SS, Wu CH. Chlamydia antibody by enzymelinked immunosorbent assay and associated severity of tubal factor infertility. Fertil Steril1992;58: Toye B, Caferriere C, Claman P, Jessamine P, Peeling R. Association between antibody to the Chlamydial heat-shock protein and tubal infertility. J Infect Dis 1993;168: Vol. 61, No.5, May 1994 Dabekausen et al. Chlamydia antibody and tubal infertility 837
Chlamydia pneumoniae and screening for tubal factor subfertility*
Human Reproduction Vol.16, No.3 pp. 487 491, 2001 Chlamydia pneumoniae and screening for tubal factor subfertility* Anna P.Gijsen 1,4, Jolande A.Land 1, Valère J.Goossens 2, Pieter Leffers 3, Cathrien
More informationreproducibility of the interpretation of hysterosalpingography pathology
Human Reproduction vol.11 no.6 pp. 124-128, 1996 Reproducibility of the interpretation of hysterosalpingography in the diagnosis of tubal pathology Ben WJ.Mol 1 ' 2 ' 3, Patricia Swart 2, Patrick M-M-Bossuyt
More informationPart II Serology Caroline Bax BW.indd 55 Caroline Bax BW.indd : :17
Part II Serology part II Chapter 4 Comparison of serological assays for detection of Chlamydia trachomatis antibodies in different groups of obstetrical and gynaecological patients C.J. Bax J.A.E.M. Mutsaers
More informationThe accuracy of hysterosalpingography in the diagnosis of tubal pathology: a meta-analysis
FERTILITY AND STERILITY Vol. 64, No.3, September 1995 Copyright ~ 1995 American Society for Reproductive Medicine Printed on acid-free paper in U. S. A The accuracy of hysterosalpingography in the diagnosis
More informationA COMPARISON OF HYSTEROSALPINGOGRAPHY AND LAPAROSCOPY IN THE INVESTIGATION OF INFERTILITY
Basrah Journal of Surgery A COMPARISON OF HYSTEROSALPINGOGRAPHY AND LAPAROSCOPY IN THE INVESTIGATION OF INFERTILITY Fouad Hamad Al-Dahhan * & Zainab Baker @ *FRCOG, Assistant Professor, @ M.B.Ch.B. Department
More informationChapter. Department of Obstetrics and Gynaecology, Medical Center Haaglanden, The Hague, The Netherlands
Chapter 4 The value of Chlamydia trachomatis specific IgG antibody testing and hysterosalpingography for predicting tubal pathology and occurrence of pregnancy Denise A. M. Perquin, M.D. 1, Matthias F.
More informationCan diagnostic laparoscopy be avoided in routine investigation for infertility?
BJOG 000,10(), pp. 118 Can diagnostic laparoscopy be avoided in routine investigation for infertility? N. P. Johnson Senior Registrar, K. Taylor Medical Student, A. A. Nadgir Specialist Registrar, D. J.
More informationEctopic pregnancy and antibodies to Chlamydia trachomatis*
FERTILITY AND STERILITY Copyright 1985 The American Fertility Society Vol. 44, No.3, Septemher 1985 Prinred in U.SA. Ectopic pregnancy and antibodies to Chlamydia trachomatis* Lars Svensson, M.D.t Per-Anders
More informationTubal subfertility and ectopic pregnancy. Evaluating the effectiveness of diagnostic tests Mol, B.W.J.
UvA-DARE (Digital Academic Repository) Tubal subfertility and ectopic pregnancy. Evaluating the effectiveness of diagnostic tests Mol, B.W.J. Link to publication Citation for published version (APA): Mol,
More informationTubal subfertility and ectopic pregnancy. Evaluating the effectiveness of diagnostic tests Mol, B.W.J.
UvA-DARE (Digital Academic Repository) Tubal subfertility and ectopic pregnancy. Evaluating the effectiveness of diagnostic tests Mol, B.W.J. Link to publication Citation for published version (APA): Mol,
More informationChlamydia trachomatis antibody titers and hysterosalpingography in predicting tubal disease in infertility patients
FERTILITY AND STERILITY Copyright c 1994 The American Fertility Society Printed on acid-free paper in U. S. A. Chlamydia trachomatis antibody titers and hysterosalpingography in predicting tubal disease
More informationInternational Federation of Fertility Societies. Global Standards of Infertility Care. Assessment of tubal patency. Recommendations for Practice
International Federation of Fertility Societies Name Version number Author Global Standards of Infertility Care Standard 7. Assessment of tubal patency Recommendations for Practice Date of first release
More informationComparative trial of tubal insufflation, hysterosalpingography, and laparoscopy with dye hydrotubation for assessment of tubal patency*
FERTILITY AND STERILITY Copyright c 1986 The American Fertility Society Printed in U.SA. Comparative trial of tubal insufflation, hysterosalpingography, and laparoscopy with dye hydrotubation for assessment
More informationCost-effectiveness of Chlamydia antibody tests in subfertile women
Human Reproduction Page 1 of 8 Hum. Reprod. Advance Access published November 11, 2004 doi:10.1093/humrep/deh608 Cost-effectiveness of Chlamydia antibody tests in subfertile women A.A.A.Fiddelers 1,4,
More informationInfertile work up. WHICH METHOD Non invasive tools (HSG-USG) 19/11/2014. Basic test (spermogram, ovulation, hormonal test etc..)
G.Chauvin A.Watrelot Centre de Recherche et d Etude de la Stérilité (CRES ) Hôpital privé NATECIA Lyon-FRANCE Infertile work up Basic test (spermogram, ovulation, hormonal test etc..) Pelvic evaluation:
More informationDiagnostic L/S: Is it ever indicated? Prof. Dr. Nilgün Turhan Fatih University Medical School
Diagnostic L/S: Is it ever indicated? Prof. Dr. Nilgün Turhan Fatih University Medical School Diagnostic Laparoscopy (DLS) DLS is the gold standard in diagnosing tubal pathology and other intraabdominal
More informationAbstract. Introduction. RBMOnline - Vol 19. No Reproductive BioMedicine Online; on web 12 October 2009
RBMOnline - Vol 19. No 6. 2009 847 851 Reproductive BioMedicine Online; www.rbmonline.com/article/4130 on web 12 October 2009 Article Significance of positive Chlamydia serology in women with normal-looking
More informationTubal subfertility and ectopic pregnancy. Evaluating the effectiveness of diagnostic tests Mol, B.W.J.
UvA-DARE (Digital Academic Repository) Tubal subfertility and ectopic pregnancy. Evaluating the effectiveness of diagnostic tests Mol, B.W.J. Link to publication Citation for published version (APA): Mol,
More informationDiagnostic laparoscopy in primary and secondary infertility
Diagnostic laparoscopy in primary and secondary infertility Al-Sakkkal Ghada Saddallah C.A.B.O.G. Department of Obs. And Gyn., Hawler Medical University ABSTRACT Objective: To compare the diagonstic effficacy
More informationINFERTILITY CAUSES. Basic evaluation of the female
INFERTILITY Infertility is the inability to conceive after 12 months of unprotected intercourse. There are multiple causes of infertility and a systematic way to evaluate the condition. Let s look at some
More informationJMSCR Vol 3 Issue 10 Page October 2015
www.jmscr.igmpublication.org Impact Factor 3.79 ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: http://dx.doi.org/10.18535/jmscr/v3i10.46 Comparison of Laparoscopy and Hysterosalpingography in Diagnosis of
More informationAn audit of investigation of tubal disease in couples seen in fertility clinic at Shrewsbury and Telford Hospitals, 2009
An audit of investigation of tubal disease in couples seen in fertility clinic at Shrewsbury and Telford Hospitals, 2009 Dr. Vanishree L Rao, ST3 LAT Shrewsbury and Telford Hospitals NHS Trust Welsh Obstetrics
More informationInfections with Neisseria gonorrhoeae and
Infections with Neisseria gonorrhoeae and Chlamydia trachomatis in women with acute salpingitis Genitourin Med 1985;61:179-84 G B KRISTENSEN,* A C BOLLERUP,t K LIND,* P-A MARDH, P LADEHOFF,* S LARSEN,*
More informationPrognostic factors of fimbrial microsurgery
FERTILITY AND STERILITY Copyright. 1986 The American Fertility Society Printed in U.SA. Prognostic factors of fimbrial microsurgery Jacques Donnez, M.D., Ph.D.* Fran.;oise Casanas-Roux, B.S. Physiology
More informationComparison of hysterosalpingography and laparoscopy in predicting fertility outcome
Human Reproduction vol.14 no.5 pp.1237 1242, 1999 Comparison of hysterosalpingography and in predicting fertility outcome Ben W.J.Mol 1,2,5, John A.Collins 3,4, Elizabeth A.Burrows 4, Fulco van der Veen
More informationInfertility Following Pelvic Inflammatory Disease
Infectious Diseases in Obstetrics and Gynecology 7:145-152 (1999) (C) 1999 Wiley-Liss, Inc. Infertility Following Pelvic Inflammatory Disease A.J. Pavletic, 1. P. W61ner-Hanssen, 2 J. Paavonen, 3 S.E.
More informationFactor Infertility. Shock Protein in Women With Tubal. Antibodies to the Chlamydial 60 Kilodalton Heat
Infectious Diseases in Obstetrics and Gynecology 6:163-167 (1998) (C) 1998 Wiley-Liss, Inc. Antibodies to the Chlamydial 60 Kilodalton Heat Shock Protein in Women With Tubal Factor Infertility K.A. Ault,
More informationInfertility: failure to conceive within one year of unprotected regular sexual intercourse. Primary secondary
Subfertility Infertility: failure to conceive within one year of unprotected regular sexual intercourse. Primary secondary Infertility affects about 15 % of couples. age of the female. Other factors that
More informationTUBAL PLASTIC SURGERY is an accepted form of therapy in the treatment
Tubal Plastic Surgery ADNAN MROUEH, M.D., ROBERT H. GLASS, M.D., and C. LEE BUXTON, M.D. TUBAL PLASTIC SURGERY is an accepted form of therapy in the treatment of infertility. However, reports have differed
More informationCauses Infectious (chlamydia) Dystrophic (endometriosis) Congenital anbormalities Iatrogenic (sterilisation) No cause found = about 30 % Epidemiology
Tubo-peritoneal infertility: laparoscopic diagnosis and treatment Alain Audebert Bordeaux Introduction (1) Tubo-peritoneal infertility? Deteriorations of the tube Pelvic adhesions Endometriosis, etc. Introduction
More informationPrevalence of Chlamydia trachomatis and Neisseria gonorrhoeae infections in Greenland A seroepidemiological study
Br J Vener Dis 8; :-. Prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae infections in Greenland A seroepidemiological study P-A MARDH,* I LIND,t E ROM,* AND A-L ANDERSEN* rom the *Institute
More informationCase 1 Dear Dr Re: Joan and John Baldwin, 2 Union Road, Clifton, Bristol. General investigation of infertility. Case 3
General investigation of infertility What is relevant in Primary Care? Case 1 Re: Joan and John Baldwin, 2 Union Road, Clifton, Bristol Would you please see this couple. Mr and Mrs Baldwin present to the
More informationThe major causes of female infertility include ovulatory dysfunction, tubal and peritoneal
Focused Issue of This Month YoungMin Choi, MD Department of Obstetrics and Gynecology, Seoul National University College of Medicine Email : ymchoi@snu.ac.kr J Korean Med Assoc 2007; 50(5): 400-405 Abstract
More informationPerformance of ve serological chlamydia antibody tests in subfertile women
Human Reproduction Vol.18, No.12 pp. 2621±2627, 2003 DOI: 10.1093/humrep/deg479 Performance of ve serological chlamydia antibody tests in subfertile women J.A.Land 1,4, A.P.Gijsen 1, A.G.H.Kessels 2, M.E.P.Slobbe
More informationChlamydia trachomatis infection in women with secondary infertility
Chlamydia trachomatis infection in women with secondary infertility Abida Malik, M.D., a Suchitra Jain, M.D., a Meher Rizvi, M.D., a Indu Shukla, M.D., a and Seema Hakim, M.D. b a Department of Microbiology,
More informationEvaluation of the Infertile Couple
Overview and Definition Infertility is defined as the inability of a couple to fall pregnant after one year of unprotected intercourse. Infertility is a very common condition as in any given year about
More informationTubal damage in infertile women: prediction using chlamydia serology
Human Reproduction Vol.18, No.9 pp. 1841±1847, 2003 DOI: 10.1093/humrep/deg347 Tubal damage in infertile women: prediction using chlamydia serology Valentine A.Akande 1,4, Linda P.Hunt 2, David J.Cahill
More informationBioline International
Bioline International HOME JOURNALS REPORTS NEWSLETTERS BOOKS SAMPLE PAPERS RESOURCES HELP African Journal of Reproductive Health, ISSN: 1118-4841 Women's Health and Action Research Centre African Journal
More informationComparison between hysterosalpingography and laparoscopic chromopertubation for the assessment of tubal patency in infertile women
International Journal of Reproduction, Contraception, Obstetrics and Gynecology Choudhary A et al. Int J Reprod Contracept Obstet Gynecol. 2017 Nov;6(11):4825-4829 www.ijrcog.org DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20174626
More informationAdhesion formation after tubal surgery: results of the eighth-day laparoscopy in 188 patients
FERTILITY AND STERILITY Copyright 1985 The American Fertility Society Vol. 43, No.3, March 1985 Printed in U.SA. Adhesion formation after tubal surgery: results of the eighth-day laparoscopy in 188 patients
More information* K.O. Ibadin, ** O. I. Enabulele, ** N. O. Eghafona, *** A. P. Osemwenkha
SEROEVIDENCE OF CHLAMYDIA TRACHOMATIS INFECTION IN INFERTILE MALE AND ITS ASSOCIATION WITH SEMEN QUALITY IN UNIVERSITY OF BENIN TEACHING HOSPITAL, BENIN CITY, NIGERIA * K.O. Ibadin, ** O. I. Enabulele,
More informationChlamydia trachomatis and chlamydial heat shock protein 60-specific antibody and cell-mediated responses predict tubal factor infertility
Human Reproduction Page 1 of 6 Hum. Reprod. Advance Access published February 14, 2006 doi:10.1093/humrep/del014 Chlamydia trachomatis and chlamydial heat shock protein 60-specific antibody and cell-mediated
More informationEndometrial antibodies versus CA-125 for the detection of endometriosis*
FERTILITY AND STERILITY Copyright 99 The American Fertility Society Vol. 55, No., January 99 Printed on acid-free paper in U.S.A. Endometrial antibodies versus CA-5 for the detection of endometriosis*
More informationBe sure! Your Power for Health. PelvoCheck CT/NG Your test kit for Chlamydia trachomatis screening and Neisseria gonorrhoeae infections
Your Power for Health Laboratory Information CT/NG DNA-Chip Be sure! Your test kit for Chlamydia trachomatis screening and Neisseria gonorrhoeae infections is part of the ocheck product line from Greiner
More informationSALPINGITIS IN OVARIAN ENDOMETRIOSIS
FERTILITY AND STERILITY Copyright 1978 The American Fertility Society Vol. 30, No. 1, July 1978 Printed in U.S.A. SALPINGITIS IN OVARIAN ENDOMETRIOSIS BERNARD CZERNOBILSKY, M.D.*t ALAN SILVERSTEIN, M.D.
More information1. Ortiz, M. E et al. Mechanisms of action of intrauterine devices. Obstet & Gynl Survey 1996; 51(12), 42S-51S.
1 2 1. Ortiz, M. E et al. Mechanisms of action of intrauterine devices. Obstet & Gynl Survey 1996; 51(12), 42S-51S. The contraceptive action of all IUDs is mainly in the uterine cavity. The major effect
More informationPatterns of adnexal inflammatory damage: Chlamydia, the intrauterine device, and history of pelvic inflammatory disease*
FERTILITY AND STERILITY Copyright 1984 The American Fertility Society Printed in U.SA. Patterns of adnexal inflammatory damage: Chlamydia, the intrauterine device, and history of pelvic inflammatory disease*
More informationNature and Science 2017;15(8)
Saline infusion sonohysterography versus laparoscopy for the assessment of tubal patency Yehia Abd El Salam Wafa 1, Mohamed El Sayed Hammour 1, Reda Talaat Hussein Mosly 2 1 Obstetrics and Gynecology Department,
More informationIsrael Jeremiah, Ola Okike, Chris Akani
International journal of Biomedical science ORIGINAL ARTICLE The Prevalence of Serum Immunoglobulin G Antibody to Chlamydia Trachomatis in Subfertile Women Presenting at the University of Port Harcourt
More informationInvestigating Hysteroscopy Implementation in Infertile Women Candidate With a Normal Uterine Cavity for Laparoscopy in Hysterosalpingography
http://www.ijwhr.net Open Access doi 10.15296/ijwhr.2019.13 Original Article International Journal of Women s Health and Reproduction Sciences Vol. 7, No. 1, January 2019, 79 84 ISSN 2330-4456 Investigating
More informationThe Presence of Hydrosalpinx May Not Adversely Affect the Implantation and Pregnancy Rates in In Vitro Fertilization Treatment1
CLINICAL ASSISTED REPRODUCTION The Presence of Hydrosalpinx May Not Adversely Affect the Implantation and Pregnancy Rates in In Vitro Fertilization Treatment1 ERNEST HUNG-YU NG,2,3 WILLIAM SHU-BIU YEUNG,2
More informationRADIOLOGICAL ASSESSMENT OF THE UTERUS AND FALLOPIAN TUBES IN INFERTILE WOMEN AT ABAKALIKI, NIGERIA.
Nigerian Journal of Clinical Practice Sept 2008 Vol 11(3) :211-21 RADIOLOGICAL ASSESSMENT OF THE UTERUS AND FALLOPIAN TUBES IN INFERTILE WOMEN AT ABAKALIKI, NIGERIA. *A.O.C Imo, **I. Sunday-Adeoye *Department
More informationSecond-Look Laparoscopy Assessment of Tubal Conditions for Previous Ectopic Pregnancy after Methotrexate Therapy or Laparoscopic Salpingotomy
Clinical Research Enliven: Gynecology and Obstetrics Second-Look Laparoscopy Assessment of Tubal Conditions for Previous Ectopic Pregnancy after Methotrexate Therapy or Laparoscopic Salpingotomy Xiaoming
More informationA Study Evaluation of Tubal Factors of Infertility by Hysterosalpingography and Diagnostic Laparoscopy
MVP Journal of Medical Sciences, Vol 3(1), 11-17, January 2016 ISSN (Print) : 2348 263X ISSN (Online) : 2348-2648 DOI: 10.18311/mvpjms/2016/v3i1/722 A Study Evaluation of Tubal Factors of Infertility by
More informationHysteroscopy - current trends and challenges
J Obstet Gynecol India Vol. 58, No. 1 : January/February 2008 pg 57-62 Original Article Hysteroscopy - current trends and challenges Gour A, Zawiejska A, Mettler L Department of Obstetrics and Gynaecology,
More informationSimplified Serological Test for Antibodies to Chlamydia trachomatis
JOURNAL OF CLINICAL MICROBIOLOGY, JUlY 1976, P. 6-10 Copyright 1976 American Society for Microbiology Vol. 4, No. 1 Printed in U.S.A. Simplified Serological Test for Antibodies to Chlamydia trachomatis
More informationThe role of chlamydia genus-speci c and species-speci c IgG antibody testing in predicting tubal disease in subfertile women
Human Reproduction Page 1 of 5 Hum. Reprod. Advance Access published April 22, 2004 DOI: 10.1093/humrep/deh267 The role of chlamydia genus-speci c and species-speci c IgG antibody testing in predicting
More informationSecond-look laparoscopy after ectopic pregnancy*
FERTILITY AND STERILITY Copyright 10 1990 The American Fertility Society Printed on acid-free paper in U.S.A. Second-look laparoscopy after ectopic pregnancy* Per Lundorff, M.D.t Jane Thorburn, M.D., Ph.D.
More informationThe length of the fertile window is associated with the chance of spontaneously conceiving an ongoing pregnancy in subfertile couples
Human Reproduction Vol.22, No.6 pp. 1652 1656, 2007 Advance Access publication on April 20, 2007 doi:10.1093/humrep/dem051 The length of the fertile window is associated with the chance of spontaneously
More informationResults of microsurgical reconstruction in patients with combined proximal and distal tubal occlusion: double obstruction
FERTILITY AND STERILITY Copyright 987 The American Fertility Society Printed in U.S.A. Results of microsurgical reconstruction in patients with combined proximal and distal tubal occlusion: double obstruction
More informationGenital Tuberculosis in Infertile Women: Assessment of Endometrial TB PCR Results with Laparoscopic and Hysteroscopic Features
JOGI_Pg 301-316:JOGI 6/25/2011 4:18 PM Page 301 The Journal of Obstetrics and Gynecology of India May / June 2011 pg 301-306 Original Article Genital Tuberculosis in Infertile Women: Assessment of Endometrial
More informationComparison of Hysterosalpingography and Combined Laparohysteroscopy for the Evaluation of Primary Infertility Nigam A, 1 Saxena P, 2 Mishra A 2
Comparison of Hysterosalpingography and Combined Laparohysteroscopy for the Evaluation of Primary Infertility Nigam A, 1 Saxena P, 2 Mishra A 2 ABSTRACT Background 1 Department of Obstetrics and Gynaecology
More informationChlamydia Rapid Screen Test (RAP-2858) RUO in the USA. Revised 28 Jul 2006
INDICATION For the rapid detection of Chlamydia Trachomatis antigens in swab specimens. For in vitro diagnostic use only, except in the United States where it is intended for Research Use Only. SUMMARY
More informationDiagnosis and prevalence of persistent chlamydia infection in infertile women: tissue culture, direct antigen detection, and serology*t
FERTILITY AND STERILITY Copyright" 1991 The American Fertility Society Vol. 55, No.2, Fehruary 1991 Printed on acid free paper in U.S.A. Diagnosis and prevalence of persistent chlamydia infection in infertile
More informationInternational Journal of Medical Science and Education pissn eissn
A COMPARATIVE STUDY FOR DETECTION OF MYCOBACTERIA BY DIRECT AFB SMEAR EXAMINATION, CULTURE BY LOWENSTEIN JENSEN MEDIA, FLUORESCENT SENSOR TECHNOLOGY BASED BACTEC TM MICRO MGIT TM SYSTEM & PCR Pratibha
More informationThe basic fertility workup in women with polycystic ovary syndrome: a systematic review
The basic fertility workup in women with polycystic ovary syndrome: a systematic review Marleen J. Nahuis, M.D., a,b,c G. Jurjen E. Oosterhuis, M.D., b Peter G. A. Hompes, M.D., c Madelon van Wely, M.D.,
More informationMedicaid Family Planning Waiver Services CPT Codes and ICD-10 Diagnosis Codes
CPT Code Description of Covered Codes Evaluation and Management 99384FP 99385FP Family planning new visit 99386FP 99394FP 99395FP Family planning established visit 99396FP 99401FP HIV counseling (pre-test)
More informationRapid Diagnosis of Chlamydial Infection in Young Women at Reproductive Age
Feb. 2012, Volume 9, No. 2 (Serial No. 87), pp. 112 116 Journal of US-China Medical Science, ISSN 1548-6648, USA D DAVID PUBLISHING Rapid Diagnosis of Chlamydial Infection in Young Women at Reproductive
More informationLUTEINIZED UNRUPTURED FOLLICLE SYNDROME: A SUBTLE CAUSE OF INFERTILITY*
FERTILITY AND STERILITY Copyright c 1978 The American Fertility Society Vol. 29, No.3, March 1978 Printed in U.S.A. LUTEINIZED UNRUPTURED FOLLICLE SYNDROME: A SUBTLE CAUSE OF INFERTILITY* JAROSLA V MARIK,
More informationPersistence of Chlamydial Antibodies
JOURNAL OF CLINICAL MICROBIOLOGY, May 1986, p. 924-928 0095-1137/86/050924-05$02.00/0 Copyright 1986, American Society for Microbiology Vol. 23, No. 5 Persistence of Chlamydial Antibodies after Pelvic
More informationRealizing dreams booklet.indd 1 5/20/ :26:52 AM
Realizing dreams. 18891booklet.indd 1 5/20/2010 11:26:52 AM The Journey To Parenthood The first Gator Baby was born in 1988 through the in vitro fertilization program at the University of Florida. Since
More informationComparison of hysterosalpingography and laparoscopy in evaluation of female infertility
Comparison of hysterosalpingography and laparoscopy in evaluation of female infertility Authors: Farideh Gharekhanloo 1 Fereshteh Rastegar 2 Affiliations: Hamadan University of Medical Sciences, Hamadan,
More informationFollow this and additional works at:
Virginia Commonwealth University VCU Scholars Compass Obstetrics and Gynecology Publications Dept. of Obstetrics and Gynecology 1998 Clinical Utility of CA125 Levels in Predicting Laparoscopically Confirmed
More informationPregnancy Outcome ABSTRACT. KEY WORDS heat shock proteins; chlamydia; infertility
Infectious Diseases in Obstetrics and Gynecology 7:35-38 (1999) (C) 1999 Wiley-Liss, Inc. Immunity to Heat Shock Proteins and Pregnancy Outcome S.S. Witkin* Division of Immunology and Infectious Diseases,
More informationGynaecology. Pelvic inflammatory disesase
Gynaecology د.شيماءعبداألميرالجميلي Pelvic inflammatory disesase Pelvic inflammatory disease (PID) is usually the result of infection ascending from the endocervix causing endometritis, salpingitis, parametritis,
More information(DES) exposure, congenital anomalies or intrauterine disease (P = 0.03), and history of chlamydia infection (P = 0.02).
formed during the follicular phase by one of the authors (G.D.A.) with patients' prior informed consent. Some patients also had other infertility factors that were treated whenever possible. From February
More informationSalpingo-ovariolysis by laparoscopy in infertility*
FERTILITY AND STERILITY Copyright c 1983 The American Fertility Society Printed in U.SA. Salpingo-ovariolysis by laparoscopy in infertility* Victor Gomel, M.D. t Department of Obstetrics and Gynaecology,
More informationIdentification of main risk factors for tubal infertility*
FERTILITY AND STERILITY Copyright 1994 The American Fertility Society Printed on acid-free paper in U. S. A. Identification of main risk factors for tubal infertility* Luis Bahamondes, M.D., Ph.D.t:j:
More informationMehreen Babar et al, /J. Pharm. Sci. & Res. Vol.2 (8), 2010,
Diagnostic Significance Of Laparoscopy In Infertility & Identification Of Various Unsuspected Factors Associated With Infertility In Females Mehreen Babar 1 *, Wafa Batool Shah 1, Khawaja Tahir Mehmood
More informationTUBAL INTRAMURAL POLYPS AND THEIR RELATIONSHIP TO INFERTILITY
FERTHJTY AND STERILITY Copyright c 98 The American Fertility Society Vol. 36, No.6. May 98 Printed. in U.SA. TUBAL INTRAMURAL POLYPS AND THEIR RELATIONSHIP TO INFERTILITY MENACHEM P; DAVID, M.D.* DAVIDBEN-ZWI,
More informationArticle Routine Chlamydia antibody testing is of limited use in subfertile women with anovulation
RBMOnline - Vol 14. No 3. 2007 322-327 Reproductive BioMedicine Online; www.rbmonline.com/article/2433 on web 5 February 2007 Article Routine Chlamydia antibody testing is of limited use in subfertile
More informationInfertility after acute salpingitis with special reference to Chlamydia trachomatis
FERTILITY AND STERILITY Copyright" 1983 The American Fertility Society Printed in U.SA. Infertility after acute salpingitis with special reference to Chlamydia trachomatis Lars Svensson, M.D. *t Per-Anders
More informationChlamydia trachomatis in sexually active teenage
Genitourin Med 1991;67:317-321 Chlamydia trachomatis in sexually active teenage girls. Factors related to genital chlamydial infection: A prospective study V A Rahm, V Odlind, R Pettersson Abstract The
More informationAn Overview of Uterine Factors That Influence Implantation
An Overview of Uterine Factors That Influence Implantation Bulent Urman, M.D. Dept. of Obstetrics and Gynecology Koc University School of Medicine Assisted Reproduction Unit, American Hospital, ISTANBUL
More informationIndian Journal of Basic and Applied Medical Research; September 2015: Vol.-4, Issue- 4, P
Original article: To study post intrauterine insemination conception rate among infertile women with polyp and women with normal uterine endometrium cavity 1Dr. Archana Meena, 2 Dr. Renu Meena, 3 Dr. Kusum
More informationREVIW ARTICLES Evidence Based Diagnostic Approach to Tubal Factor Infertility
. REVIW ARTICLES Evidence Based Diagnostic Approach to Tubal Factor Infertility KHANUM S a, AHMED JU b, RAHIM MA c, SULTANA N d, BEGUM R e Summary: Infertility has been classified with respect to a number
More informationLAPAROSCOPIC EVALUATION OF TUBAL FACTORS IN INFERTILE PATIENTS
The Professional Medical Journal DOI: 10.17957/TPMJ/16.3294 1. MBBS, FCPS Assistant Professor 2. MBBS, FCPS Assistant professor 3. MBBS, FCPS Assistant professor Correspondence Address: Dr. Iram Aslam
More informationWhat You Should Know About Pelvic Adhesions & Gynecologic Surgery
ETHICON, a Johnson & Johnson company, is dedicated to providing innovative solutions for common women s health conditions. Our goal is to provide you access to advanced technology and valuable, easy-to-understand
More informationHistopathological Study of Spectrum of Lesions Seen in Surgically Resected Specimens of Fallopian Tube
Original Article Print ISSN: 2321-6379 Online ISSN: 2321-595X DOI: 10.17354/ijss/2016/613 Histopathological Study of Spectrum of Lesions Seen in Surgically Resected Specimens of Fallopian Tube Pratima
More informationSelected risk factors of infertility in women: case control study
International Journal of Reproduction, Contraception, Obstetrics and Gynecology Mallikarjuna M et al. Int J Reprod Contracept Obstet Gynecol. 2015 Dec;4(6):1714-1719 www.ijrcog.org pissn 2320-1770 eissn
More informationInternational Journal of Medical and Health Sciences
International Journal of Medical and Health Sciences Journal Home Page: http://www.ijmhs.net ISSN:2277-4505 Original article Laparoscopic Evaluation of Female Infertility Bhabani Pegu 1*, Bhanu Pratap
More informationREPRODUCTIVE ENDOCRINOLOGY
FERTILITY AND STERILITY VOL. 79, NO. 2, FEBRUARY 2003 Copyright 2003 American Society for Reproductive Medicine Published by Elsevier Science Inc. Printed on acid-free paper in U.S.A. REPRODUCTIVE ENDOCRINOLOGY
More informationHost immune response to Chlamydia pneumoniae heat shock protein 60 is associated with asthma
Eur Respir J 21; 17: 178 182 Printed in UK all rights reserved Copyright #ERS Journals Ltd 21 European Respiratory Journal ISSN 93-1936 Host immune response to Chlamydia pneumoniae heat shock protein 6
More informationHysterosalpingo-contrast sonography: is possible to quantify the therapeutic effect of a diagnostic test?
ORIGINAL ARTICLE pissn 2233-8233 eissn 2233-8241 Clin Exp Reprod Med 2012;39(4):161-165 Hysterosalpingo-contrast sonography: is possible to quantify the therapeutic effect of a diagnostic test? Emilio
More informationPALM-COEIN: Your AUB Counseling Guide
PALM-COEIN: Your AUB Counseling Guide 10 million+ Treat the cause, not the symptom In the U.S, more than 10 million women between the ages of 35 and 49 are affected by AUB 1 Diagnosis Cause Structural
More informationChapter 1. Chapter 2. Chapter 3
Summary To perform IUI some conditions are required. This includes 1) a certain amount of progressively motile spermatozoa, 2) the presence of ovulation, 3) the presence of functional fallopian tubes,
More informationAuthor Manuscript Faculty of Biology and Medicine Publication
Serveur Académique Lausannois SERVAL serval.unil.ch Author Manuscript Faculty of Biology and Medicine Publication This paper has been peer-reviewed but dos not include the final publisher proof-corrections
More informationCitation for published version (APA): Coppus, S. F. P. J. (2012). Diagnostic and prognostic aspects of tubal patency testing
UvA-DARE (Digital Academic Repository) Diagnostic and prognostic aspects of tubal patency testing Coppus, S.F.P.J. Link to publication Citation for published version (APA): Coppus, S. F. P. J. (2012).
More informationX/01/$ DOI: /CDLI Received 6 November 2000/Returned for modification 6 February 2001/Accepted 27 February 2001
CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY, May 2001, p. 588 592 Vol. 8, No. 3 1071-412X/01/$04.00 0 DOI: 10.1128/CDLI.8.3.588 592.2001 Comparison of Two Commercial Microimmunofluorescence Kits and
More information