41 results on '"Kaaijk, E M"'
Search Results
2. Determinants of successful lifestyle change during a 6-month preconception lifestyle intervention in women with obesity and infertility
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Karsten, Matty D. A., van Oers, Anne M., Groen, Henk, Mutsaerts, Meike A. Q., van Poppel, Mireille N. M., Geelen, Anouk, van de Beek, Cornelieke, Painter, Rebecca C., Mol, Ben W. J., Roseboom, Tessa J., Hoek, Annemieke, Burggraaff, J. M., Kuchenbecker, W. K. H., Perquin, D. A. M., Koks, C. A. M., van Golde, R., Kaaijk, E. M., Schierbeek, J. M., Oosterhuis, G. J. E., Broekmans, F. J., Vogel, N. E. A., Lambalk, C. B., van der Veen, F., Klijn, N. F., Mercelina, P. E. A. M., van Kasteren, Y. M., Nap, A. W., Mulder, R. J. A. B., Gondrie, E. T. C. M., de Bruin, J. P., Obstetrie & Gynaecologie, MUMC+: MA Medische Staf Obstetrie Gynaecologie (9), RS: GROW - R4 - Reproductive and Perinatal Medicine, Reproductive Origins of Adult Health and Disease (ROAHD), Value, Affordability and Sustainability (VALUE), Public and occupational health, Pediatric surgery, Obstetrics and gynaecology, Amsterdam Reproduction & Development (AR&D), ACS - Atherosclerosis & ischemic syndromes, Amsterdam Neuroscience - Cellular & Molecular Mechanisms, Plastic, Reconstructive and Hand Surgery, APH - Aging & Later Life, APH - Health Behaviors & Chronic Diseases, Graduate School, Obstetrics and Gynaecology, and Epidemiology and Data Science more...
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Counseling ,Male ,0301 basic medicine ,Gerontology ,Lifestyle intervention ,DIABETES PREVENTION PROGRAM ,TERM WEIGHT-LOSS ,Nutrition and Disease ,Psychological intervention ,Medicine (miscellaneous) ,Overweight ,0302 clinical medicine ,Weight loss ,Voeding en Ziekte ,SOCIOECONOMIC-STATUS ,PREDICTORS ,Determinants ,Nutrition and Dietetics ,Preconception ,Original Contribution ,3. Good health ,Weight Reduction Programs ,PREGNANCY ,Female ,medicine.symptom ,Adult ,Infertility ,Adolescent ,030209 endocrinology & metabolism ,HEALTH BEHAVIOR ,Health Promotion ,CLASSIFICATION ,Young Adult ,03 medical and health sciences ,Intervention (counseling) ,Weight Loss ,CORONARY RISK-FACTORS ,medicine ,Humans ,Obesity ,Exercise ,Life Style ,Socioeconomic status ,VLAG ,Pregnancy ,030109 nutrition & dietetics ,OVERWEIGHT ,business.industry ,Feeding Behavior ,ADULTS ,medicine.disease ,business ,Program Evaluation - Abstract
Purpose To identify demographic, (bio)physical, behavioral, and psychological determinants of successful lifestyle change and program completion by performing a secondary analysis of the intervention arm of a randomized-controlled trial, investigating a preconception lifestyle intervention. Methods The 6-month lifestyle intervention consisted of dietary counseling, physical activity, and behavioral modification, and was aimed at 5–10% weight loss. We operationalized successful lifestyle change as successful weight loss (≥ 5% weight/BMI ≤ 29 kg/m2), weight loss in kilograms, a reduction in energy intake, and an increase in physical activity during the intervention program. We performed logistic and mixed-effect regression analyses to identify baseline factors that were associated with successful change or program completion. Results Women with higher external eating behavior scores had higher odds of successful weight loss (OR 1.10, 95% CI 1.05–1.16). Women with the previous dietetic support lost 0.94 kg less during the intervention period (95% CI 0.01–1.87 kg). Women with higher self-efficacy reduced energy intake more than women with lower self-efficacy (p more...
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- 2019
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3. Is home-based monitoring of ovulation to time frozen embryo transfer a cost-effective alternative for hospital-based monitoring of ovulation? Study protocol of the multicentre, non-inferiority Antarctica-2 randomised controlled trial
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Zaat, T R, primary, de Bruin, J P, additional, Goddijn, M, additional, van Baal, M, additional, Benneheij, E B, additional, Brandes, E M, additional, Broekmans, F, additional, Cantineau, A E P, additional, Cohlen, B, additional, van Disseldorp, J, additional, Gielen, S C J P, additional, Groenewoud, E R, additional, van Heusden, A, additional, Kaaijk, E M, additional, Koks, C, additional, de Koning, C H, additional, Klijn, N F, additional, Lambalk, C B, additional, van der Linden, P J Q, additional, Manger, P, additional, van Oppenraaij, R H F, additional, Pieterse, Q, additional, Smeenk, J, additional, Visser, J, additional, van Wely, M, additional, and Mol, F, additional more...
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- 2021
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4. P–633 lifestyle intervention prior to IVF does not improve embryo utilization rate and cumulative live birth rate in women with obesity
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Wang, Z, primary, Groen, H, additional, Va. Zomeren1, K C, additional, Cantineau, A E P, additional, Va. Oers, A, additional, Va. Montfoort, A P A, additional, Kuchenbecker, W K H, additional, Pelinck, M J, additional, Broekmans, F J, additional, Klijn, N F, additional, Kaaijk, E M, additional, Mol, B W J, additional, Hoek, A, additional, and Echten-Arends, J Va, additional more...
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- 2021
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5. Gonadotrophins versus clomiphene citrate with or without IUI in women with normogonadotropic anovulation and clomiphene failure: a cost-effectiveness analysis
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Bordewijk, E. M., Weiss, N. S., Nahuis, M. J., Bayram, N., van Hooff, M. H. A., Boks, D. E. S., Perquin, D. A. M., Janssen, C. A. H., van Golde, R. J. T., Lambalk, C. B., Goddijn, M., Hompes, P. G., van der Veen, F., Mol, B. W. J., van Wely, M., Smeenk, J. M. J., Hoek, A., Broekmans, F. J. M., Fleischer, K., de Bruin, J. P., Kaaijk, E. M., Laven, J. S. E., Hendriks, D. J., Gerards, M. H., Bourdrez, P., Gianotten, J., Koks, C., van Hooff, M., Kwee, J., Lambeek, A. F., van Unnik, A. F., Vrouenraets, F. P. J., Cohlen, B. J., van de Laar-van Asseldonk, T. A. M., Nap, A. W., van Rijn-van Weert, J. M., Vollebergh, J. H. A., Klijn, N. F., Rijnsaardt-Lukassen, H. G. M., Sluijmer, A. V., Gastroenterology & Hepatology, Obstetrics & Gynecology, Emergency Medicine, Erasmus School of Economics, Orthopedics and Sports Medicine, Neurology, Erasmus MC other, Obstetrics and gynaecology, APH - Health Behaviors & Chronic Diseases, Amsterdam Reproduction & Development (AR&D), VU University medical center, ACS - Atherosclerosis & ischemic syndromes, Amsterdam Neuroscience - Cellular & Molecular Mechanisms, Graduate School, APH - Methodology, APH - Personalized Medicine, ARD - Amsterdam Reproduction and Development, Center for Reproductive Medicine, Obstetrie & Gynaecologie, MUMC+: MA Medische Staf Obstetrie Gynaecologie (9), and RS: GROW - R4 - Reproductive and Perinatal Medicine more...
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Male ,Pregnancy Rate ,Cost effectiveness ,Cost-Benefit Analysis ,medicine.medical_treatment ,M-OVIN ,law.invention ,IUI ,Indirect costs ,0302 clinical medicine ,Randomized controlled trial ,Pregnancy ,law ,FSH ,Treatment Failure ,030212 general & internal medicine ,Birth Rate ,Insemination, Artificial ,CLOMIFENE CITRATE ,Netherlands ,030219 obstetrics & reproductive medicine ,Obstetrics ,Rehabilitation ,CYCLES ,Obstetrics and Gynecology ,Health Care Costs ,Cost-effectiveness analysis ,POLYCYSTIC-OVARY-SYNDROME ,Female ,Live birth ,Infertility, Female ,Live Birth ,Anovulation ,Adult ,medicine.medical_specialty ,Clomiphene ,Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18] ,03 medical and health sciences ,clomiphene citrate ,medicine ,Humans ,cost-effectiveness ,gonadotrophins ,business.industry ,INFERTILE WOMEN ,Fertility Agents, Female ,medicine.disease ,Pregnancy rate ,OVULATION INDUCTION ,Reproductive Medicine ,polycystic ovary syndrome ,SINGLETON ,Ovulation induction ,business ,Gonadotropins - Abstract
STUDY QUESTION: Are six cycles of ovulation induction with gonadotrophins more cost-effective than six cycles of ovulation induction with clomiphene citrate (CC) with or without IUI in normogonadotropic anovulatory women not pregnant after six ovulatory cycles with CC?SUMMARY ANSWER: Both gonadotrophins and IUI are more expensive when compared with CC and intercourse, and gonadotrophins are more effective than CC.WHAT IS KNOWN ALREADY: In women with normogonadotropic anovulation who ovulate but do not conceive after six cycles with CC, medication is usually switched to gonadotrophins, with or without IUI. The cost-effectiveness of these changes in policy is unknown.STUDY DESIGN, SIZE, DURATION: We performed an economic evaluation of ovulation induction with gonadotrophins compared with CC with or without IUI in a two-by-two factorial multicentre randomized controlled trial in normogonadotropic anovulatory women not pregnant after six ovulatory cycles with CC. Between December 2008 and December 2015 women were allocated to six cycles with gonadotrophins plus IUI, six cycles with gonadotrophins plus intercourse, six cycles with CC plus IUI or six cycles with CC plus intercourse. The primary outcome was conception leading to a live birth achieved within 8 months of randomization.PARTICIPANTS/MATERIALS, SETTING, METHODS: We performed a cost-effectiveness analysis on direct medical costs. We calculated the direct medical costs of ovulation induction with gonadotrophins versus CC and of IUI versus intercourse in six subsequent cycles. We included costs of medication, cycle monitoring, interventions, and pregnancy leading to live birth. Resource use was collected from the case report forms and unit costs were derived from various sources. We calculated incremental cost-effectiveness ratios (ICER) for gonadotrophins compared to CC and for IUI compared to intercourse. We used non-parametric bootstrap resampling to investigate the effect of uncertainty in our estimates. The analysis was performed according to the intention-to-treat principle.MAIN RESULTS AND THE ROLE OF CHANCE: We allocated 666 women in total to gonadotrophins and IUI (n = 166), gonadotrophins and intercourse (n = 165), CC and IUI (n = 163), or CC and intercourse (n = 172). Mean direct medical costs per woman receiving gonadotrophins or CC were (sic)4495 versus (sic)3006 (cost difference of (sic)1475 (95% CI: (sic)1457-(sic)1493)). Live birth rates were 52% in women allocated to gonadotrophins and 41% in those allocated to CC (relative risk (RR) 1.24: 95% CI: 1.05-1.46). The ICER was (sic)15 258 (95% CI: (sic)8721 to (sic)63 654) per additional live birth with gonadotrophins. Mean direct medical costs per woman allocated to IUI or intercourse were (sic)4497 versus (sic)3005 (cost difference of (sic)1510 (95% CI: (sic)1492-(sic)1529)). Live birth rates were 49% in women allocated to IUI and 43% in those allocated to intercourse (RR = 1.14: 95% CI: 0.97-1.35). The ICER was (sic)24 361 (95% CI: (sic)-11 290 to (sic)85 172) per additional live birth with IUI.LIMITATIONS, REASONS FOR CAUTION: We allowed participating hospitals to use their local protocols for ovulation induction and IUI, which may have led to variation in costs, but which increases generalizability. Indirect costs generated by transportation or productivity loss were not included. We did not evaluate letrozole, which is potentially more effective than CC.WIDER IMPLICATIONS OF THE FINDINGS: Gonadotrophins are more effective, but more expensive than CC, therefore, the use of gonadotrophins in women with normogonadotropic anovulation who have not conceived after six ovulatory CC cycles depends on society's willingness to pay for an additional child. In view of the uncertainty around the cost-effectiveness estimate of IUI, these data are not sufficient to make recommendations on the use of IUI in these women. In countries where ovulation induction regimens are reimbursed, policy makers and health care professionals may use our results in their guidelines.STUDY FUNDING/COMPETING INTEREST(S): This trial was funded by the Netherlands Organization for Health Research and Development (ZonMw number: 80-82310-97-12067). The Eudract number for this trial is 2008-006171-73. The Sponsor's Protocol Code Number is P08-40. CBLA reports unrestricted grant support from Merck and Ferring. BWM is supported by a NHMRC Practitioner Fellowship (GNT1082548) and reports consultancy for Merck, ObsEva and Guerbet.TRIAL REGISTRATION NUMBER: NTR1449. more...
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- 2019
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6. Is home-based monitoring of ovulation to time frozen embryo transfer a cost-effective alternative for hospital-based monitoring of ovulation?: Study protocol of the multicentre, non-inferiority Antarctica-2 randomised controlled trial
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MS VPG/Gynaecologie, Child Health, Zaat, T R, de Bruin, J P, Goddijn, M, van Baal, M, Benneheij, E B, Brandes, E M, Broekmans, F, Cantineau, A E P, Cohlen, B, van Disseldorp, J, Gielen, S C J P, Groenewoud, E R, van Heusden, A, Kaaijk, E M, Koks, C, de Koning, C H, Klijn, N F, Lambalk, C B, van der Linden, P J Q, Manger, P, van Oppenraaij, R H F, Pieterse, Q, Smeenk, J, Visser, J, van Wely, M, Mol, F, MS VPG/Gynaecologie, Child Health, Zaat, T R, de Bruin, J P, Goddijn, M, van Baal, M, Benneheij, E B, Brandes, E M, Broekmans, F, Cantineau, A E P, Cohlen, B, van Disseldorp, J, Gielen, S C J P, Groenewoud, E R, van Heusden, A, Kaaijk, E M, Koks, C, de Koning, C H, Klijn, N F, Lambalk, C B, van der Linden, P J Q, Manger, P, van Oppenraaij, R H F, Pieterse, Q, Smeenk, J, Visser, J, van Wely, M, and Mol, F more...
- Published
- 2021
7. Transfer of fresh or frozen embryos: a randomised controlled trial
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Wong, K M, primary, van Wely, M, additional, Verhoeve, H R, additional, Kaaijk, E M, additional, Mol, F, additional, van der Veen, F, additional, Repping, S, additional, and Mastenbroek, S, additional more...
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- 2021
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8. Home- or hospital-based monitoring to time frozen embryo transfer in the natural cycle? Patient-reported outcomes and experiences from the Antarctica-2 randomised controlled trial
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Zaat, T R, primary, de Bruin, J P, additional, Goddijn, M, additional, Visser, J, additional, Kaaijk, E M, additional, Lambalk, C B, additional, Groenewoud, E R, additional, van Wely, M, additional, and Mol, F, additional more...
- Published
- 2020
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9. Gonadotrophins versus clomiphene citrate with or without IUI in women with normogonadotropic anovulation and clomiphene failure: a cost-effectiveness analysis
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MS VPG/Gynaecologie, Child Health, Circulatory Health, Bordewijk, E. M., Weiss, N. S., Nahuis, M. J., Bayram, N., Van Hooff, M. H.A., Boks, D. E.S., Perquin, D. A.M., Janssen, C. A.H., Van Golde, R. J.T., Lambalk, C. B., Goddijn, M., Hompes, P. G., Van Der Veen, F., Mol, B. W.J., Van Wely, M., Smeenk, J. M.J., Hoek, A., Broekmans, F. J.M., Fleischer, K., De Bruin, J. P., Kaaijk, E. M., Laven, J. S.E., Hendriks, D. J., Gerards, M. H., Bourdrez, P., Gianotten, J., Koks, C., Van Hooff, M., Kwee, J., Lambeek, A. F., Van Unnik, A. F., Vrouenraets, F. P.J., Cohlen, B. J., Van De Laar-Van Asseldonk, T. A.M., Nap, A. W., Van Rijn-Van Weert, J. M., Vollebergh, J. H.A., Klijn, N. F., Rijnsaardt-Lukassen, H. G.M., Sluijmer, A. V., MS VPG/Gynaecologie, Child Health, Circulatory Health, Bordewijk, E. M., Weiss, N. S., Nahuis, M. J., Bayram, N., Van Hooff, M. H.A., Boks, D. E.S., Perquin, D. A.M., Janssen, C. A.H., Van Golde, R. J.T., Lambalk, C. B., Goddijn, M., Hompes, P. G., Van Der Veen, F., Mol, B. W.J., Van Wely, M., Smeenk, J. M.J., Hoek, A., Broekmans, F. J.M., Fleischer, K., De Bruin, J. P., Kaaijk, E. M., Laven, J. S.E., Hendriks, D. J., Gerards, M. H., Bourdrez, P., Gianotten, J., Koks, C., Van Hooff, M., Kwee, J., Lambeek, A. F., Van Unnik, A. F., Vrouenraets, F. P.J., Cohlen, B. J., Van De Laar-Van Asseldonk, T. A.M., Nap, A. W., Van Rijn-Van Weert, J. M., Vollebergh, J. H.A., Klijn, N. F., Rijnsaardt-Lukassen, H. G.M., and Sluijmer, A. V. more...
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- 2019
10. Determinants of successful lifestyle change during a 6-month preconception lifestyle intervention in women with obesity and infertility
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MS Verloskunde, MS VPG/Gynaecologie, UMC Utrecht, Child Health, Circulatory Health, Karsten, Matty D.A., van Oers, Anne M., Groen, Henk, Mutsaerts, Meike A.Q., van Poppel, Mireille N.M., Geelen, Anouk, van de Beek, Cornelieke, Painter, Rebecca C., Mol, Ben W.J., Roseboom, Tessa J., Hoek, Annemieke, Burggraaff, J. M., Kuchenbecker, W. K.H., Perquin, D. A.M., Koks, C. A.M., van Golde, R., Kaaijk, E. M., Schierbeek, J. M., Oosterhuis, G. J.E., Broekmans, F. J., Vogel, N. E.A., Lambalk, C. B., van der Veen, F., Klijn, N. F., Mercelina, P. E.A.M., van Kasteren, Y. M., Nap, A. W., Mulder, R. J.A.B., Gondrie, E. T.C.M., de Bruin, J. P., the LIFEstyle study group, MS Verloskunde, MS VPG/Gynaecologie, UMC Utrecht, Child Health, Circulatory Health, Karsten, Matty D.A., van Oers, Anne M., Groen, Henk, Mutsaerts, Meike A.Q., van Poppel, Mireille N.M., Geelen, Anouk, van de Beek, Cornelieke, Painter, Rebecca C., Mol, Ben W.J., Roseboom, Tessa J., Hoek, Annemieke, Burggraaff, J. M., Kuchenbecker, W. K.H., Perquin, D. A.M., Koks, C. A.M., van Golde, R., Kaaijk, E. M., Schierbeek, J. M., Oosterhuis, G. J.E., Broekmans, F. J., Vogel, N. E.A., Lambalk, C. B., van der Veen, F., Klijn, N. F., Mercelina, P. E.A.M., van Kasteren, Y. M., Nap, A. W., Mulder, R. J.A.B., Gondrie, E. T.C.M., de Bruin, J. P., and the LIFEstyle study group more...
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- 2019
11. Effectiveness of lifestyle intervention in subgroups of obese infertile women : a subgroup analysis of a RCT
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Oers, A. M., Henk Groen, Mutsaerts, M. A. Q., Burggraaff, J. M., Kuchenbecker, W. K. H., Perquin, D. A. M., Koks, C. A. M., Golde, R., Kaaijk, E. M., Schierbeek, J. M., Oosterhuis, G. J. E., Broekmans, F. J., Vogel, N. E. A., Land, J. A., Mol, B. W. J., Hoek, A., and LIFEstyle study group more...
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Journal Article - Abstract
STUDY QUESTION: Do age, ovulatory status, severity of obesity and body fat distribution affect the effectiveness of lifestyle intervention in obese infertile women? SUMMARY ANSWER: We did not identify a subgroup in which lifestyle intervention increased the healthy live birth rate however it did increase the natural conception rate in anovulatory obese infertile women. WHAT IS KNOWN ALREADY: Obese women are at increased risk of infertility and are less likely to conceive after infertility treatment. We previously demonstrated that a 6-month lifestyle intervention preceding infertility treatment did not increase the rate of healthy live births (vaginal live birth of a healthy singleton at term) within 24 months of follow-up as compared to prompt infertility treatment in obese infertile women. Natural conceptions occurred more frequently in women who received a 6-month lifestyle intervention preceding infertility treatment. STUDY DESIGN, SIZE, DURATION: This is a secondary analysis of a multicentre RCT (randomized controlled trial), the LIFEstyle study. Between 2009 and 2012, 577 obese infertile women were randomly assigned to a 6-month lifestyle intervention followed by infertility treatment (intervention group) or to prompt infertility treatment (control group). Subgroups were predefined in the study protocol, based on frequently used cut-off values in the literature: age (≥36 or more...
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- 2016
12. Electrocautery strategy and ovulation induction with FSH had similar 12-month pregnancy rates in women with PCOS
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Bayram, N., van Wely, M., Kaaijk, E. M., Bossuyt, P. M.M., van der Veen, F., Farquhar, Cynthia M., Obstetrics and Gynaecology, Epidemiology and Data Science, Amsterdam Public Health, Center for Reproductive Medicine, and Amsterdam Reproduction & Development (AR&D) more...
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Obstetrics and Gynecology - Published
- 2005
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13. Cost-effectiveness of a structured lifestyle program in overweight and obese subfertile women. Preliminary data from a randomised controlled trial - the LIFEstyle study
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van Oers, A. M., Mutsaerts, M. A. Q., Burggraaff, J. M., Kuchenbecker, W. K. H., Perquin, D. A. M., Koks, C. A. M., Van Golde, R., Kaaijk, E. M., Schierbeek, J. M., Oosterhuis, G. J. E., Broekmans, F. J., Land, J. A., Mol, B. W., Hoek, A., Groen, H., Reproductive Origins of Adult Health and Disease (ROAHD), and Methods in Medicines evaluation & Outcomes research (M2O) more...
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- 2014
14. The effectiveness of a structured lifestyle program in overweight and obese subfertile women. Preliminary data from a randomised controlled trial (LIFEstyle study)
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Mutsaerts, M. A. Q., Van Oers, A. M., Groen, H., Burggraaff, J. M., Kuchenbecker, W. K. H., Perquin, D. A. M., Koks, C. A. M., Van Golde, R., Kaaijk, E. M., Schierbeek, J. M., Oosterhuis, G. J. E., Broekmans, F. J., Land, J. A., Mol, B. W., Hoek, A., Methods in Medicines evaluation & Outcomes research (M2O), and Reproductive Origins of Adult Health and Disease (ROAHD) more...
- Published
- 2014
15. A randomized controlled, non-inferiority trial of modified natural versus artificial cycle for cryo-thawed embryo transfer
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Groenewoud, E. R., Cohlen, B. J., Al-Oraiby, A., Brinkhuis, E. A., Broekmans, F. J M, De Bruin, J. P., Van Den Dool, G., Fleisher, K., Friederich, J., Goddijn, M., Hoek, A., Hoozemans, D. A., Kaaijk, E. M., Koks, C. A M, Laven, J. S E, Van Der Linden, P. J Q, Manger, A. P., Slappendel, E., Spinder, T., Kollen, B. J., Macklon, N. S., Groenewoud, E. R., Cohlen, B. J., Al-Oraiby, A., Brinkhuis, E. A., Broekmans, F. J M, De Bruin, J. P., Van Den Dool, G., Fleisher, K., Friederich, J., Goddijn, M., Hoek, A., Hoozemans, D. A., Kaaijk, E. M., Koks, C. A M, Laven, J. S E, Van Der Linden, P. J Q, Manger, A. P., Slappendel, E., Spinder, T., Kollen, B. J., and Macklon, N. S. more...
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- 2016
16. Effectiveness of lifestyle intervention in subgroups of obese infertile women : a subgroup analysis of a RCT
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van Oers, A M, Groen, H, Mutsaerts, M A Q, Burggraaff, J M, Kuchenbecker, W K H, Perquin, D A M, Koks, C A M, van Golde, R, Kaaijk, E M, Schierbeek, J M, Oosterhuis, G J E, Broekmans, F J, Vogel, N E A, Land, J A, Mol, B W J, Hoek, A, LIFEstyle study group, van Oers, A M, Groen, H, Mutsaerts, M A Q, Burggraaff, J M, Kuchenbecker, W K H, Perquin, D A M, Koks, C A M, van Golde, R, Kaaijk, E M, Schierbeek, J M, Oosterhuis, G J E, Broekmans, F J, Vogel, N E A, Land, J A, Mol, B W J, Hoek, A, and LIFEstyle study group more...
- Published
- 2016
17. Effectiveness of lifestyle intervention in subgroups of obese infertile women: a subgroup analysis of a RCT
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MS VPG/Gynaecologie, Circulatory Health, Child Health, van Oers, A M, Groen, H, Mutsaerts, M A Q, Burggraaff, J M, Kuchenbecker, W K H, Perquin, D A M, Koks, C A M, van Golde, R, Kaaijk, E M, Schierbeek, J M, Oosterhuis, G J E, Broekmans, F J, Vogel, N E A, Land, J A, Mol, B W J, Hoek, A, LIFEstyle study group, MS VPG/Gynaecologie, Circulatory Health, Child Health, van Oers, A M, Groen, H, Mutsaerts, M A Q, Burggraaff, J M, Kuchenbecker, W K H, Perquin, D A M, Koks, C A M, van Golde, R, Kaaijk, E M, Schierbeek, J M, Oosterhuis, G J E, Broekmans, F J, Vogel, N E A, Land, J A, Mol, B W J, Hoek, A, and LIFEstyle study group more...
- Published
- 2016
18. A randomized controlled, non-inferiority trial of modified natural versus artificial cycle for cryo-thawed embryo transfer
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MS VPG/Gynaecologie, Circulatory Health, Child Health, Groenewoud, E. R., Cohlen, B. J., Al-Oraiby, A., Brinkhuis, E. A., Broekmans, F. J M, De Bruin, J. P., Van Den Dool, G., Fleisher, K., Friederich, J., Goddijn, M., Hoek, A., Hoozemans, D. A., Kaaijk, E. M., Koks, C. A M, Laven, J. S E, Van Der Linden, P. J Q, Manger, A. P., Slappendel, E., Spinder, T., Kollen, B. J., Macklon, N. S., MS VPG/Gynaecologie, Circulatory Health, Child Health, Groenewoud, E. R., Cohlen, B. J., Al-Oraiby, A., Brinkhuis, E. A., Broekmans, F. J M, De Bruin, J. P., Van Den Dool, G., Fleisher, K., Friederich, J., Goddijn, M., Hoek, A., Hoozemans, D. A., Kaaijk, E. M., Koks, C. A M, Laven, J. S E, Van Der Linden, P. J Q, Manger, A. P., Slappendel, E., Spinder, T., Kollen, B. J., and Macklon, N. S. more...
- Published
- 2016
19. Problemen vroeg in de zwangerschap vereisen speciale zorg: 'Jonge zwangerschapsunits'
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Goddijn, M., de Jager, F., Kaaijk, E. M., van der Veen, F., Ankum, W. M., Hajenius, P. J., Amsterdam Reproduction & Development (AR&D), Center for Reproductive Medicine, Other Research, and Obstetrics and Gynaecology more...
- Abstract
Problems in the first trimester of pregnancy frequently occur. - Examples are miscarriage, ectopic pregnancy and recurrent miscarriage.- In Dutch hospitals there is a growing interest in the setting up of 'early pregnancy units' (EPUs). - The aim of these EPUs is to improve the quality of care for women with early pregnancy problems by centralising the care and knowledge available.- This centralisation could prevent over- and underdiagnosis and over- and undertreatment. - Moreover, EPUs could improve the logistics of clinical research. - The potential effectiveness of these units in the Netherlands still needs to be investigated more...
- Published
- 2009
20. Cost-effectiveness analysis of lifestyle intervention in obese infertile women.
- Author
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van Oers, A. M., Mutsaerts, M. A. Q., Burggraaff, J. M., Kuchenbecker, W. K. H., Perquin, D. A. M., Koks, C. A. M., van Golde, R., Kaaijk, E. M., Schierbeek, J. M., Klijn, N. F., van Kasteren, Y. M., Land, J. A., Mol, B. W. J., Hoek, A., Groen, H., and LIFEstyle study group more...
- Subjects
COST effectiveness ,LIFESTYLES ,INFERTILITY treatment ,OVERWEIGHT women ,OBESITY ,HEALTH promotion ,OBESITY treatment ,CRYOPRESERVATION of organs, tissues, etc. ,FERTILIZATION in vitro ,OBESITY complications ,BIRTH rate ,EMBRYO transfer ,FAMILIES ,LONGITUDINAL method ,INFERTILITY ,EVALUATION of medical care ,MEDICAL care costs ,INDUCED ovulation ,PREGNANCY ,WEIGHT loss ,BODY mass index ,HUMAN research subjects ,PATIENT dropouts ,DISEASE complications ,ECONOMICS - Abstract
Study Question: What is the cost-effectiveness of lifestyle intervention preceding infertility treatment in obese infertile women?Summary Answer: Lifestyle intervention preceding infertility treatment as compared to prompt infertility treatment in obese infertile women is not a cost-effective strategy in terms of healthy live birth rate within 24 months after randomization, but is more likely to be cost-effective using a longer follow-up period and live birth rate as endpoint.What Is Known Already: In infertile couples, obesity decreases conception chances. We previously showed that lifestyle intervention prior to infertility treatment in obese infertile women did not increase the healthy singleton vaginal live birth rate at term, but increased natural conceptions, especially in anovulatory women. Cost-effectiveness analyses could provide relevant additional information to guide decisions regarding offering a lifestyle intervention to obese infertile women.Study Design, Size, Duration: The cost-effectiveness of lifestyle intervention preceding infertility treatment compared to prompt infertility treatment was evaluated based on data of a previous RCT, the LIFEstyle study. The primary outcome for effectiveness was the vaginal birth of a healthy singleton at term within 24 months after randomization (the healthy live birth rate). The economic evaluation was performed from a hospital perspective and included direct medical costs of the lifestyle intervention, infertility treatments, medication and pregnancy in the intervention and control group. In addition, we performed exploratory cost-effectiveness analyses of scenarios with additional effectiveness outcomes (overall live birth within 24 months and overall live birth conceived within 24 months) and of subgroups, i.e. of ovulatory and anovulatory women, women <36 years and ≥36 years of age and of completers of the lifestyle intervention. Bootstrap analyses were performed to assess the uncertainty surrounding cost-effectiveness.Participants/materials, Settings, Methods: Infertile women with a BMI of ≥29 kg/m2 (no upper limit) were allocated to a 6-month lifestyle intervention programme preceding infertility treatment (intervention group, n = 290) or to prompt infertility treatment (control group, n = 287). After excluding women who withdrew informed consent or who were lost to follow-up we included 280 women in the intervention group and 284 women in the control group in the analysis.Main Results and the Role Of Chance: Total mean costs per woman in the intervention group within 24 months after randomization were €4324 (SD €4276) versus €5603 (SD €4632) in the control group (cost difference of -€1278, P < 0.05). Healthy live birth rates were 27 and 35% in the intervention group and the control group, respectively (effect difference of -8.1%, P < 0.05), resulting in an incremental cost-effectiveness ratio of €15 845 per additional percentage increase of the healthy live birth rate. Mean costs per healthy live birth event were €15 932 in the intervention group and €15 912 in the control group. Exploratory scenario analyses showed that after changing the effectiveness outcome to all live births conceived within 24 months, irrespective of delivery within or after 24 months, cost-effectiveness of the lifestyle intervention improved. Using this effectiveness outcome, the probability that lifestyle intervention preceding infertility treatment was cost-effective in anovulatory women was 40%, in completers of the lifestyle intervention 39%, and in women ≥36 years 29%.Limitations, Reasons For Caution: In contrast to the study protocol, we were not able to perform the analysis from a societal perspective. Besides the primary outcome of the LIFEstyle study, we performed exploratory analyses using outcomes observed at longer follow-up times and we evaluated subgroups of women; the trial was not powered on these additional outcomes or subgroup analyses.Wider Implications Of the Findings: Cost-effectiveness of a lifestyle intervention is more likely for longer follow-up times, and with live births conceived within 24 months as the effectiveness outcome. This effect was most profound in anovulatory women, in completers of the lifestyle intervention and in women ≥36 years old. This result indicates that the follow-up period of lifestyle interventions in obese infertile women is important. The scenario analyses performed in this study suggest that offering and reimbursing lifestyle intervention programmes in certain patient categories may be cost-effective and it provides directions for future research in this field.Study Funding/competing Interest(s): The study was supported by a grant from ZonMw, the Dutch Organization for Health Research and Development (50-50110-96-518). The department of obstetrics and gynaecology of the UMCG received an unrestricted educational grant from Ferring pharmaceuticals BV, The Netherlands. B.W.J.M. is a consultant for ObsEva, Geneva.Trial Registration Number: The LIFEstyle RCT was registered at the Dutch trial registry (NTR 1530). http://www.trialregister.nl/trialreg/admin/rctview.asp?TC = 1530. [ABSTRACT FROM AUTHOR] more...- Published
- 2017
- Full Text
- View/download PDF
21. Short-term changes in hormonal profiles after laparoscopic ovarian laser evaporation compared with diagnostic laparoscopy for PCOS
- Author
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Hendriks, M. L., primary, Konig, T., additional, Korsen, T., additional, Melgers, I., additional, Dekker, J., additional, Mijatovic, V., additional, Schats, R., additional, Hompes, P. G. A., additional, Homburg, R., additional, Kaaijk, E. M., additional, Twisk, J. W. R., additional, and Lambalk, C. B., additional more...
- Published
- 2014
- Full Text
- View/download PDF
22. How long should we continue clomiphene citrate in anovulatory women?
- Author
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Weiss, N. S., primary, Braam, S., additional, Konig, T. E., additional, Hendriks, M. L., additional, Hamilton, C. J., additional, Smeenk, J. M. J., additional, Koks, C. A. M., additional, Kaaijk, E. M., additional, Hompes, P. G. A., additional, Lambalk, C. B., additional, van der Veen, F., additional, Mol, B. W. J., additional, and van Wely, M., additional more...
- Published
- 2014
- Full Text
- View/download PDF
23. Session 04: PCOS
- Author
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Papunen, L. M. -, primary, West, S., additional, Pinola, P., additional, Bloigu, A., additional, Pouta, A., additional, Jarvelin, M. R., additional, Franks, S., additional, Lashen, H., additional, Tapanainen, J. S., additional, Homburg, R., additional, Ray, A., additional, Bhide, P., additional, Gudi, A., additional, Shah, A., additional, Timms, P., additional, Grayson, K., additional, Hendriks, M. L., additional, Konig, T., additional, Korsen, T., additional, Schats, R., additional, Hompes, P. G. A., additional, Kaaijk, E. M., additional, Twisk, J. W. R., additional, Lambalk, C. B., additional, De Cicco, S., additional, Lanzone, A., additional, Gagliano, D., additional, Immediata, V., additional, Tartaglia, C., additional, Zumpano, A., additional, Cirella, E., additional, Romualdi, D., additional, Guido, M., additional, Grigorescu, V., additional, Zhang, Y., additional, Kissin, D., additional, Sauber-Schatz, E., additional, Sunderam, M., additional, Kirby, R., additional, Diop, H., additional, McKane, P., additional, Jamieson, D., additional, Soleman, R., additional, Kreukels, B. P. C., additional, Veltman, D. J., additional, Cohen-Kettenis, P. T., additional, and Drent, M. L., additional more...
- Published
- 2013
- Full Text
- View/download PDF
24. Unilateral oophorectomy in polycystic ovary syndrome: a treatment option in highly selected cases?
- Author
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Kaaijk, E. M., Beek, J. F., Hamerlynck, J. V., van der Veen, F., and Other departments
- Abstract
We performed unilateral oophorectomy (UO) in three patients with polycystic ovary syndrome (PCOS) and long-standing infertility. The indication for performing this procedure was a combination of ovarian pathology and the long-standing infertility. All three patients were resistant to clomiphene citrate and before UO all patients had been treated unsuccessfully with gonadotrophins and in-vitro fertilization. All three patients became ovulatory within the first month after UO. Two patients conceived 11 and 12 months after surgery respectively and delivered healthy babies. Testosterone concentrations decreased in two patients to upper values of the normal range and remained unchanged in one patient. We conclude that restoration of ovulation can be a beneficial side-effect of UO in clomiphene citrate resistant patients with PCOS and long-standing infertility more...
- Published
- 1997
25. Transvaginal interstitial laser treatment of the ovary: a feasibility study in cows
- Author
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Kaaijk, E. M., Pieterse, M. C., Beek, J. F., van der Veen, F., ten Kate, F. J., Lammes, F. B., van Gemert, M. J., and Other departments
- Abstract
In 12 cows, transvaginal interstitial laser treatment (TILT) of the ovaries was performed using a neodynium:yttrium aluminium-garnet laser to investigate the feasibility of a new treatment approach for clomiphene-resistant patients with chronic hyperandrogenic anovulation. Powers of 1 and 2 W during 5 min of exposure were used. Sonographic changes of thermal damage during TILT, the extent and healing of the lesions by light microscopy and ultrasound during 3 month follow-up and adhesion formation were studied. During laser irradiation, a hyperechogenic zone developed around the fibre tip, with a mean +/- SD diameter of 4.4 +/- 2.0 mm at 1 W and 6.9 +/- 1.5 mm at 2. W. The mean diameters of the histological lesions 2 days after treatment were 7.3 +/- 2.5 mm at 1 W and 13.0 +/- 2.1 mm at 2 W. During follow-up, the mean diameter of both the histologically and the sonographically assessed lesions decreased, although transvaginal sonography (TVS) systematically and significantly underestimated the thermal damage. Lesions healed by fibrosis and no adhesions were present. TILT of the ovaries in cows is easy to perform and produces central or subcapsular necrosis without adhesions. TVS gives an indication of thermal damage but underestimates the extent of tissue damage in cow ovaries. Obviously, this study does not allow conclusions to be drawn concerning its safety and efficacy in man more...
- Published
- 1996
26. Interstitial laser treatment of the ovary: an experimental study in goats
- Author
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Beek, J. F., Kaaijk, E. M., van der Veen, F., de Boer, K., Ankum, W. M., ten Kate, F. J., Lammes, F. B., van Gemert, M. J., and Other departments
- Abstract
BACKGROUND and OBJECTIVE: Interstitial laser treatment (ILT) of the ovary might be a new surgical approach to restore ovulation with a minimal risk of adhesion formation in patients with chronic hyperandrogenic anovulation who are unresponsive to hormone therapy. The objective was to investigate the feasibility of inducing a lesion limited to the center of the ovary in an animal model. STUDY DESIGN/MATERIALS and METHODS: ILT was performed in seven goats using Nd:YAG laser in combination with ultrasound monitoring. The extent of direct thermal damage was investigated in two goats, treating both ovaries during a laparotomy at 2, 4, 6, and 8 W, respectively, for 5 min. Adhesion formation was evaluated in five goats 81 days after an unilateral laparoscopic ILT at 1, 2, 4, 6, or 8 W for 5 min. During treatment temperatures on the surface of the ovary were measured. RESULTS: Histology after 1 day showed sharply demarcated necrotic lesions located centrally or subcapsularly at low powers, whereas at higher powers the lesions extended to the surface of the ovary. At low powers no adhesions were observed, whereas higher powers resulted in periovarian adhesions. Temperatures measured on the ovarian surface during treatment ranged between 38 degrees C and 90 degrees C. Ultrasound monitoring of the extent of thermal damage failed due to poor positioning. CONCLUSION: Although this pilot study does not warrent firm conclusions, the results indicate that ILT of the ovary is feasible and that lesions without adhesions can be produced at low powers. The use of ultrasound to monitor the extent of thermal damage in the ovary should be a subject of further evaluation more...
- Published
- 1996
27. Further thoughts on surgical therapy for polycystic ovary syndrome
- Author
-
Kaaijk, E. M., Beek, J. F., van der Veen, F., and Other departments
- Published
- 1996
28. Long-term follow-up of laparoscopic electrocautery of the ovaries versus ovulation induction with recombinant FSH in clomiphene citrate-resistant women with polycystic ovary syndrome: an economic evaluation
- Author
-
Nahuis, M. J., primary, Oude Lohuis, E., additional, Kose, N., additional, Bayram, N., additional, Hompes, P., additional, Oosterhuis, G. J. E., additional, Kaaijk, E. M., additional, Cohlen, B. J., additional, Bossuyt, P. P. M., additional, van der Veen, F., additional, Mol, B. W., additional, and van Wely, M., additional more...
- Published
- 2012
- Full Text
- View/download PDF
29. The effect of recombinant LH on embryo quality: a randomized controlled trial in women with poor ovarian reserve
- Author
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Musters, A. M., primary, van Wely, M., additional, Mastenbroek, S., additional, Kaaijk, E. M., additional, Repping, S., additional, van der Veen, F., additional, and Mochtar, M. H., additional
- Published
- 2011
- Full Text
- View/download PDF
30. Clinical outcome after unilateral oophorectomy in patients with polycystic ovary syndrome
- Author
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Kaaijk, E. M., primary
- Published
- 1999
- Full Text
- View/download PDF
31. Case Report: Unilateral oophorectomy in polycystic ovary syndrome: a treatment option in highly selected cases?
- Author
-
Kaaijk, E. M., primary, Beek, J. F., additional, Hamerlynck, J. V.T.H., additional, and van der Veen, F., additional
- Published
- 1997
- Full Text
- View/download PDF
32. Laparoscopic surgery of chronic hyperandrogenic anovulation.
- Author
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Kaaijk, Eugenie M., Beek, Johan F., van der Veen, Fulco, Kaaijk, E M, Beek, J F, and van der Veen, F
- Published
- 1995
- Full Text
- View/download PDF
33. Transvaginal interstitial laser treatment of the ovary for the management of chronic hyperandrogenic anovulation: first clinical experience.
- Author
-
Kaaijk, Eugenie, van der Veen, Fulco, Beek, Johan F., van Gemert, Martin J.C., Lammes, Frits B., Kaaijk, E M, van der Veen, F, Beek, J F, van Gemert, M J, and Lammes, F B
- Published
- 1997
- Full Text
- View/download PDF
34. Effectiveness of lifestyle intervention in subgroups of obese infertile women: a subgroup analysis of a RCT.
- Author
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van Oers, A M, Groen, H, Mutsaerts, M A Q, Burggraaff, J M, Kuchenbecker, W K H, Perquin, D A M, Koks, C A M, van Golde, R, Kaaijk, E M, Schierbeek, J M, Oosterhuis, G J E, Broekmans, F J, Vogel, N E A, Land, J A, Mol, B W J, Hoek, A, and LIFEstyle study group more...
- Subjects
PUBLISHED articles ,HUMAN reproduction ,PUBLICATIONS - Published
- 2017
- Full Text
- View/download PDF
35. A Randomized Trial of Progesterone in Women with Recurrent Miscarriages.
- Author
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Coomarasamy, A., Williams, H., Truchanowicz, E., Seed, P. T., Small, R., Quenby, S., Gupta, P., Dawood, F., Root, Y. E. M., Atik, R. Bender, Bloemenkamp, K. W. M., Brady, R., Briley, A. L., Cavallaro, R., Cheong, Y. C., Chu, J. J., Eapen, A., Ewies, A., Hoek, A., and Kaaijk, E. M. more...
- Subjects
- *
PROGESTERONE , *RECURRENT miscarriage , *COMPARATIVE studies , *GESTATIONAL age , *RESEARCH methodology , *EVALUATION of medical care , *MEDICAL cooperation , *PREGNANCY , *FIRST trimester of pregnancy , *RESEARCH , *VAGINAL medication , *EVALUATION research , *BODY mass index , *RANDOMIZED controlled trials , *TREATMENT effectiveness , *BLIND experiment , *PREVENTION , *THERAPEUTICS - Abstract
Background: Progesterone is essential for the maintenance of pregnancy. However, whether progesterone supplementation in the first trimester of pregnancy would increase the rate of live births among women with a history of unexplained recurrent miscarriages is uncertain.Methods: We conducted a multicenter, double-blind, placebo-controlled, randomized trial to investigate whether treatment with progesterone would increase the rates of live births and newborn survival among women with unexplained recurrent miscarriage. We randomly assigned women with recurrent miscarriages to receive twice-daily vaginal suppositories containing either 400 mg of micronized progesterone or matched placebo from a time soon after a positive urinary pregnancy test (and no later than 6 weeks of gestation) through 12 weeks of gestation. The primary outcome was live birth after 24 weeks of gestation.Results: A total of 1568 women were assessed for eligibility, and 836 of these women who conceived naturally within 1 year and remained willing to participate in the trial were randomly assigned to receive either progesterone (404 women) or placebo (432 women). The follow-up rate for the primary outcome was 98.8% (826 of 836 women). In an intention-to-treat analysis, the rate of live births was 65.8% (262 of 398 women) in the progesterone group and 63.3% (271 of 428 women) in the placebo group (relative rate, 1.04; 95% confidence interval [CI], 0.94 to 1.15; rate difference, 2.5 percentage points; 95% CI, -4.0 to 9.0). There were no significant between-group differences in the rate of adverse events.Conclusions: Progesterone therapy in the first trimester of pregnancy did not result in a significantly higher rate of live births among women with a history of unexplained recurrent miscarriages. (Funded by the United Kingdom National Institute of Health Research; PROMISE Current Controlled Trials number, ISRCTN92644181.). [ABSTRACT FROM AUTHOR] more...- Published
- 2015
- Full Text
- View/download PDF
36. The effect of recombinant LH on embryo quality: a randomized controlled trial in women with poor ovarian reserve.
- Author
-
Musters AM, van Wely M, Mastenbroek S, Kaaijk EM, Repping S, van der Veen F, and Mochtar MH
- Subjects
- Abortion, Spontaneous, Adult, Embryo Transfer, Female, Fertilization in Vitro methods, Follicle Stimulating Hormone metabolism, Humans, Luteinizing Hormone metabolism, Ovarian Follicle cytology, Ovary metabolism, Pregnancy, Pregnancy Outcome, Pregnancy Rate, Risk, Ovary drug effects, Ovary physiology, Ovulation Induction methods, Recombinant Proteins therapeutic use
- Abstract
Background: Poor ovarian response is a common clinical problem, affecting up to 26% of IVF cycles. For these women, addition of recombinant luteinizing hormone (rLH) to ovarian hyperstimulation with recombinant FSH has a beneficial effect on ongoing pregnancy rates, but its effect on the yield of top-quality embryos is unknown., Methods: We conducted a randomized controlled trial in women expected to respond poorly under ovarian hyperstimulation during their first IVF cycle [all women aged 35-41 and women with FSH > 12 IU/ml and antral follicle count (AFC) ≤ 5]. Women were randomly allocated to rFSH and rLH (2:1 ratio) or rFSH alone (control group) after down-regulation with a GnRH agonist. The primary outcome was the proportion of top-quality embryos per woman on the day of transfer. Secondary outcomes were the number of stimulation days, the number of follicles ≥17 mm, the number of oocytes, the fertilization rate, the number of embryos, the number of women with ≥1 top-quality embryo, the biochemical, clinical and ongoing pregnancy rates and the miscarriage rate., Results: There were 116 women allocated to the rLH group and 128 allocated to the control group. The proportion of top-quality embryos per woman was 17% in the rLH group and 11% in the control group [mean difference 0.06; 95% confidence interval (CI) -0.01-0.14]. In the rLH and control groups respectively, 47 (41%) and 41 (32%) women had at least one top-quality embryo on the day of transfer (relative risk: 1.3, 95% CI 0.91-1.77). The ongoing pregnancy rate was 13 versus 12% (relative risk: 1.1; 95% CI 0.57-2.16) for the rLH group compared with the control group., Conclusions: This study found no significant difference in embryo quality after the addition of rLH to rFSH for ovarian stimulation in women with poor ovarian reserve., Clinical Trials Identifier: NTR1457. more...
- Published
- 2012
- Full Text
- View/download PDF
37. Distribution of steroidogenic enzymes involved in androgen synthesis in polycystic ovaries: an immunohistochemical study.
- Author
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Kaaijk EM, Sasano H, Suzuki T, Beek JF, and van Der Veen F
- Subjects
- 3-Hydroxysteroid Dehydrogenases metabolism, Adult, Androgens biosynthesis, Cholesterol Side-Chain Cleavage Enzyme metabolism, DNA-Binding Proteins metabolism, Female, Fushi Tarazu Transcription Factors, Homeodomain Proteins, Humans, Immunohistochemistry methods, Ovary cytology, Ovary pathology, Receptors, Cytoplasmic and Nuclear, Steroid 17-alpha-Hydroxylase metabolism, Steroidogenic Factor 1, Transcription Factors metabolism, Enzymes metabolism, Ovary enzymology, Polycystic Ovary Syndrome enzymology
- Abstract
To find an explanation for the possible working mechanism of laparoscopic ovarian electrocautery for the treatment of anovulation in polycystic ovarian syndrome (PCOS), we evaluated the distribution of steroidogenic enzymes involved in the synthesis of ovarian androgens in surgical pathology specimens of entire polycystic ovaries. A total of 13 formalin-fixed and paraffin-embedded samples of the ovaries of patients with clinically proven PCOS were immunostained with specific antibodies against cholesterol side-chain-cleavage enzyme (P450scc), 3beta-hydroxysteroid dehydrogenase (3beta-HSD), 17alpha-hydroxylase (P450c17) and adrenal 4-binding protein (Ad4BP), a transcription factor of steroidogenic enzymes. Follicular theca cells of all ovaries demonstrated marked immunoreactivity for Ad4BP, P450scc, 3beta-HSD and P450c17. Granulosa cells of seven ovaries expressed Ad4BP, while granulosa cells of three ovaries also showed P450scc. In the granulosa cells of all ovaries, 3beta-HSD and P450c17 immunoreactivity was not observed. In the stroma, luteinized cells of most ovaries demonstrated Ad4BP, P450scc, 3beta-HSD and P450c17 immunoreactivity, but at a much lower level compared with the follicular theca cells. Non-luteinized stromal cells sporadically demonstrated Ad4BP, P450scc, 3beta-HSD and P450c17 immunoreactivity. The stromal steroidogenic cells were mainly located in the ovarian cortex, except for some hilus steroidogenic cells. These data demonstrate that in polycystic ovaries, androgens are mainly produced in the follicular theca cells and to some extent in luteinized stromal cells. This suggests that the working mechanism of laparoscopic electrocautery of the ovary is primarily explained through the reduction of ovarian hyperandrogenism by coagulation of follicular theca cells and concomitant stroma. more...
- Published
- 2000
- Full Text
- View/download PDF
38. Unilateral oophorectomy in polycystic ovary syndrome: a treatment option in highly selected cases?
- Author
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Kaaijk EM, Beek JF, Hamerlynck JV, and van der Veen F
- Subjects
- Adult, Female, Humans, Ovary physiopathology, Ovary surgery, Ovulation, Pregnancy, Pregnancy Outcome, Infertility, Female surgery, Ovariectomy, Polycystic Ovary Syndrome surgery
- Abstract
We performed unilateral oophorectomy (UO) in three patients with polycystic ovary syndrome (PCOS) and long-standing infertility. The indication for performing this procedure was a combination of ovarian pathology and the long-standing infertility. All three patients were resistant to clomiphene citrate and before UO all patients had been treated unsuccessfully with gonadotrophins and in-vitro fertilization. All three patients became ovulatory within the first month after UO. Two patients conceived 11 and 12 months after surgery respectively and delivered healthy babies. Testosterone concentrations decreased in two patients to upper values of the normal range and remained unchanged in one patient. We conclude that restoration of ovulation can be a beneficial side-effect of UO in clomiphene citrate resistant patients with PCOS and long-standing infertility. more...
- Published
- 1997
- Full Text
- View/download PDF
39. Further thoughts on surgical therapy for polycystic ovary syndrome.
- Author
-
Kaaijk EM, Beek JF, and van der Veen F
- Subjects
- Animals, Female, Humans, Laser Therapy, Ovulation Induction methods, Polycystic Ovary Syndrome surgery
- Published
- 1996
40. Transvaginal interstitial laser treatment of the ovary: a feasibility study in cows.
- Author
-
Kaaijk EM, Pieterse MC, Beek JF, van der Veen F, ten Kate FJ, Lammes FB, and van Gemert MJ
- Subjects
- Animals, Cattle, Female, Follow-Up Studies, Ovary diagnostic imaging, Ovary injuries, Ultrasonography, Anovulation surgery, Laser Therapy methods, Ovary surgery
- Abstract
In 12 cows, transvaginal interstitial laser treatment (TILT) of the ovaries was performed using a neodynium:yttrium aluminium-garnet laser to investigate the feasibility of a new treatment approach for clomiphene-resistant patients with chronic hyperandrogenic anovulation. Powers of 1 and 2 W during 5 min of exposure were used. Sonographic changes of thermal damage during TILT, the extent and healing of the lesions by light microscopy and ultrasound during 3 month follow-up and adhesion formation were studied. During laser irradiation, a hyperechogenic zone developed around the fibre tip, with a mean +/- SD diameter of 4.4 +/- 2.0 mm at 1 W and 6.9 +/- 1.5 mm at 2. W. The mean diameters of the histological lesions 2 days after treatment were 7.3 +/- 2.5 mm at 1 W and 13.0 +/- 2.1 mm at 2 W. During follow-up, the mean diameter of both the histologically and the sonographically assessed lesions decreased, although transvaginal sonography (TVS) systematically and significantly underestimated the thermal damage. Lesions healed by fibrosis and no adhesions were present. TILT of the ovaries in cows is easy to perform and produces central or subcapsular necrosis without adhesions. TVS gives an indication of thermal damage but underestimates the extent of tissue damage in cow ovaries. Obviously, this study does not allow conclusions to be drawn concerning its safety and efficacy in man. more...
- Published
- 1996
- Full Text
- View/download PDF
41. Interstitial laser treatment of the ovary: an experimental study in goats.
- Author
-
Beek JF, Kaaijk EM, van der Veen F, de Boer K, Ankum WM, ten Kate FJ, Lammes FB, and van Gemert MJ
- Subjects
- Aluminum Silicates, Animals, Anovulation surgery, Body Temperature, Disease Models, Animal, Feasibility Studies, Female, Goats, Hot Temperature adverse effects, Hyperandrogenism surgery, Laparotomy, Monitoring, Intraoperative, Necrosis, Neodymium, Ovary pathology, Ovulation, Pilot Projects, Risk Factors, Tissue Adhesions prevention & control, Ultrasonography, Interventional, Yttrium, Laser Therapy methods, Ovarian Diseases prevention & control, Ovary surgery
- Abstract
Background and Objective: Interstitial laser treatment (ILT) of the ovary might be a new surgical approach to restore ovulation with a minimal risk of adhesion formation in patients with chronic hyperandrogenic anovulation who are unresponsive to hormone therapy. The objective was to investigate the feasibility of inducing a lesion limited to the center of the ovary in an animal model., Study Design/materials and Methods: ILT was performed in seven goats using Nd:YAG laser in combination with ultrasound monitoring. The extent of direct thermal damage was investigated in two goats, treating both ovaries during a laparotomy at 2, 4, 6, and 8 W, respectively, for 5 min. Adhesion formation was evaluated in five goats 81 days after an unilateral laparoscopic ILT at 1, 2, 4, 6, or 8 W for 5 min. During treatment temperatures on the surface of the ovary were measured., Results: Histology after 1 day showed sharply demarcated necrotic lesions located centrally or subcapsularly at low powers, whereas at higher powers the lesions extended to the surface of the ovary. At low powers no adhesions were observed, whereas higher powers resulted in periovarian adhesions. Temperatures measured on the ovarian surface during treatment ranged between 38 degrees C and 90 degrees C. Ultrasound monitoring of the extent of thermal damage failed due to poor positioning., Conclusion: Although this pilot study does not warrent firm conclusions, the results indicate that ILT of the ovary is feasible and that lesions without adhesions can be produced at low powers. The use of ultrasound to monitor the extent of thermal damage in the ovary should be a subject of further evaluation. more...
- Published
- 1996
- Full Text
- View/download PDF
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