43 results on '"van Heusden, A. M."'
Search Results
2. IS HOME-BASED MONITORING OF OVULATION TO TIME FROZEN EMBRYO TRANSFER AN EFFECTIVE ALTERNATIVE FOR HOSPITAL-BASED MONITORING OF OVULATION?
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Zaat, Tjitske, primary, De Bruin, Jan Peter P., additional, Groenewoud, Eva, additional, Baart, Esther B., additional, Van Baal, Wilhelmina, additional, Brandes, Monique, additional, Cantineau, Astrid E.P., additional, Broekmans, Frank, additional, Gielen, Susanne, additional, Goddijn, Mariette, additional, Van Disseldorp, Jeroen, additional, van Heusden, Arne M., additional, Kaaijk, Eugenie M., additional, Klijn, Nicole, additional, Koks, Carolien A.M., additional, De Koning, Cornelia, additional, Van Der Linden, Paul J.Q., additional, Manger, Petra, additional, Moolenaar, Lobke, additional, Van Oppenraaij, Robbert, additional, Pieterse, Quirine, additional, Smeenk, Jesper M.J., additional, Visser, Jantien, additional, Van Wely, Madelon, additional, and Mol, Femke, additional
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- 2022
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3. Economic evaluation of endometrial scratching before the second IVF/ICSI treatment:a cost-effectiveness analysis of a randomized controlled trial (SCRaTCH trial)
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van Hoogenhuijze, N. E., van Eekelen, R., Mol, F., Schipper, I., Groenewoud, E. R., Traas, M. A.F., Janssen, C. A.H., Teklenburg, G., de Bruin, J. P., van Oppenraaij, R. H.F., Maas, J. W.M., Moll, E., Fleischer, K., van Hooff, M. H.A., de Koning, C. H., Cantineau, A. E.P., Lambalk, C. B., Verberg, M., van Heusden, A. M., Manger, A. P., van Rumste, M. M.E., van der Voet, L. F., Pieterse, Q. D., Visser, J., Brinkhuis, E. A., den Hartog, J. E., Glas, M. W., Klijn, N. F., van der Zanden, M., Bandell, M. L., Boxmeer, J. C., van Disseldorp, J., Smeenk, J., van Wely, M., Eijkemans, M. J.C., Torrance, H. L., Broekmans, F. J.M., van Hoogenhuijze, N. E., van Eekelen, R., Mol, F., Schipper, I., Groenewoud, E. R., Traas, M. A.F., Janssen, C. A.H., Teklenburg, G., de Bruin, J. P., van Oppenraaij, R. H.F., Maas, J. W.M., Moll, E., Fleischer, K., van Hooff, M. H.A., de Koning, C. H., Cantineau, A. E.P., Lambalk, C. B., Verberg, M., van Heusden, A. M., Manger, A. P., van Rumste, M. M.E., van der Voet, L. F., Pieterse, Q. D., Visser, J., Brinkhuis, E. A., den Hartog, J. E., Glas, M. W., Klijn, N. F., van der Zanden, M., Bandell, M. L., Boxmeer, J. C., van Disseldorp, J., Smeenk, J., van Wely, M., Eijkemans, M. J.C., Torrance, H. L., and Broekmans, F. J.M.
- Abstract
STUDY QUESTION: Is a single endometrial scratch prior to the second fresh IVF/ICSI treatment cost-effective compared to no scratch, when evaluated over a 12-month follow-up period? SUMMARY ANSWER: The incremental cost-effectiveness ratio (ICER) for an endometrial scratch was €6524 per additional live birth, but due to uncertainty regarding the increase in live birth rate this has to be interpreted with caution. WHAT IS KNOWN ALREADY: Endometrial scratching is thought to improve the chances of success in couples with previously failed embryo implantation in IVF/ICSI treatment. It has been widely implemented in daily practice, despite the lack of conclusive evidence of its effectiveness and without investigating whether scratching allows for a cost-effective method to reduce the number of IVF/ICSI cycles needed to achieve a live birth. STUDY DESIGN, SIZE, DURATION: This economic evaluation is based on a multicentre randomized controlled trial carried out in the Netherlands (SCRaTCH trial) that compared a single scratch prior to the second IVF/ICSI treatment with no scratch in couples with a failed full first IVF/ICSI cycle. Follow-up was 12 months after randomization.Economic evaluation was performed from a healthcare and societal perspective by taking both direct medical costs and lost productivity costs into account. It was performed for the primary outcome of biochemical pregnancy leading to live birth after 12 months of follow-up as well as the secondary outcome of live birth after the second fresh IVF/ICSI treatment (i.e. the first after randomization). To allow for worldwide interpretation of the data, cost level scenario analysis and sensitivity analysis was performed. PARTICIPANTS/MATERIALS, SETTING, METHODS: From January 2016 until July 2018, 933 women with a failed first IVF/ICSI cycle were included in the trial. Data on treatment and pregnancy were recorded up until 12 months after randomization, and the resulting live birth outcomes (even if after 12 mo
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- 2022
4. Economic evaluation of endometrial scratching before the second IVF/ICSI treatment: a cost-effectiveness analysis of a randomized controlled trial (SCRaTCH trial)
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MS VPG/Gynaecologie, Infection & Immunity, Biostatistiek Onderzoek, Child Health, Circulatory Health, JC onderzoeksprogramma Infectieziekten, JC onderzoeksprogramma Methodologie, van Hoogenhuijze, N. E., van Eekelen, R., Mol, F., Schipper, I., Groenewoud, E. R., Traas, M. A.F., Janssen, C. A.H., Teklenburg, G., de Bruin, J. P., van Oppenraaij, R. H.F., Maas, J. W.M., Moll, E., Fleischer, K., van Hooff, M. H.A., de Koning, C. H., Cantineau, A. E.P., Lambalk, C. B., Verberg, M., van Heusden, A. M., Manger, A. P., van Rumste, M. M.E., van der Voet, L. F., Pieterse, Q. D., Visser, J., Brinkhuis, E. A., den Hartog, J. E., Glas, M. W., Klijn, N. F., van der Zanden, M., Bandell, M. L., Boxmeer, J. C., van Disseldorp, J., Smeenk, J., van Wely, M., Eijkemans, M. J.C., Torrance, H. L., Broekmans, F. J.M., MS VPG/Gynaecologie, Infection & Immunity, Biostatistiek Onderzoek, Child Health, Circulatory Health, JC onderzoeksprogramma Infectieziekten, JC onderzoeksprogramma Methodologie, van Hoogenhuijze, N. E., van Eekelen, R., Mol, F., Schipper, I., Groenewoud, E. R., Traas, M. A.F., Janssen, C. A.H., Teklenburg, G., de Bruin, J. P., van Oppenraaij, R. H.F., Maas, J. W.M., Moll, E., Fleischer, K., van Hooff, M. H.A., de Koning, C. H., Cantineau, A. E.P., Lambalk, C. B., Verberg, M., van Heusden, A. M., Manger, A. P., van Rumste, M. M.E., van der Voet, L. F., Pieterse, Q. D., Visser, J., Brinkhuis, E. A., den Hartog, J. E., Glas, M. W., Klijn, N. F., van der Zanden, M., Bandell, M. L., Boxmeer, J. C., van Disseldorp, J., Smeenk, J., van Wely, M., Eijkemans, M. J.C., Torrance, H. L., and Broekmans, F. J.M.
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- 2022
5. Economic evaluation of endometrial scratching before the second IVF/ICSI treatment: a cost-effectiveness analysis of a randomized controlled trial (SCRaTCH trial)
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van Hoogenhuijze, N E, primary, van Eekelen, R, additional, Mol, F, additional, Schipper, I, additional, Groenewoud, E R, additional, Traas, M A F, additional, Janssen, C A H, additional, Teklenburg, G, additional, de Bruin, J P, additional, van Oppenraaij, R H F, additional, Maas, J W M, additional, Moll, E, additional, Fleischer, K, additional, van Hooff, M H A, additional, de Koning, C H, additional, Cantineau, A E P, additional, Lambalk, C B, additional, Verberg, M, additional, van Heusden, A M, additional, Manger, A P, additional, van Rumste, M M E, additional, van der Voet, L F, additional, Pieterse, Q D, additional, Visser, J, additional, Brinkhuis, E A, additional, den Hartog, J E, additional, Glas, M W, additional, Klijn, N F, additional, van der Zanden, M, additional, Bandell, M L, additional, Boxmeer, J C, additional, van Disseldorp, J, additional, Smeenk, J, additional, van Wely, M, additional, Eijkemans, M J C, additional, Torrance, H L, additional, and Broekmans, F J M, additional
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- 2021
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6. Endometrial scratching in women with one failed IVF/ICSI cycle-outcomes of a randomised controlled trial (SCRaTCH)
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MS VPG/Gynaecologie, Infection & Immunity, Biostatistiek Onderzoek, Child Health, Circulatory Health, JC onderzoeksprogramma Infectieziekten, JC onderzoeksprogramma Methodologie, van Hoogenhuijze, N E, Mol, F, Laven, J S E, Groenewoud, E R, Traas, M A F, Janssen, C A H, Teklenburg, G, de Bruin, J P, van Oppenraaij, R H F, Maas, J W M, Moll, E, Fleischer, K, van Hooff, M H A, de Koning, C H, Cantineau, A E P, Lambalk, C B, Verberg, M, van Heusden, A M, Manger, A P, van Rumste, M M E, van der Voet, L F, Pieterse, Q D, Visser, J, Brinkhuis, E A, den Hartog, J E, Glas, M W, Klijn, N F, van der Meer, S, Bandell, M L, Boxmeer, J C, van Disseldorp, J, Smeenk, J, van Wely, M, Eijkemans, M J C, Torrance, H L, Broekmans, F J M, MS VPG/Gynaecologie, Infection & Immunity, Biostatistiek Onderzoek, Child Health, Circulatory Health, JC onderzoeksprogramma Infectieziekten, JC onderzoeksprogramma Methodologie, van Hoogenhuijze, N E, Mol, F, Laven, J S E, Groenewoud, E R, Traas, M A F, Janssen, C A H, Teklenburg, G, de Bruin, J P, van Oppenraaij, R H F, Maas, J W M, Moll, E, Fleischer, K, van Hooff, M H A, de Koning, C H, Cantineau, A E P, Lambalk, C B, Verberg, M, van Heusden, A M, Manger, A P, van Rumste, M M E, van der Voet, L F, Pieterse, Q D, Visser, J, Brinkhuis, E A, den Hartog, J E, Glas, M W, Klijn, N F, van der Meer, S, Bandell, M L, Boxmeer, J C, van Disseldorp, J, Smeenk, J, van Wely, M, Eijkemans, M J C, Torrance, H L, and Broekmans, F J M
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- 2021
7. Endometrial scratching in women with one failed IVF/ICSI cycle—outcomes of a randomised controlled trial (SCRaTCH)
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van Hoogenhuijze, N E, primary, Mol, F, additional, Laven, J S E, additional, Groenewoud, E R, additional, Traas, M A F, additional, Janssen, C A H, additional, Teklenburg, G, additional, de Bruin, J P, additional, van Oppenraaij, R H F, additional, Maas, J W M, additional, Moll, E, additional, Fleischer, K, additional, van Hooff, M H A, additional, de Koning, C H, additional, Cantineau, A E P, additional, Lambalk, C B, additional, Verberg, M, additional, van Heusden, A M, additional, Manger, A P, additional, van Rumste, M M E, additional, van der Voet, L F, additional, Pieterse, Q D, additional, Visser, J, additional, Brinkhuis, E A, additional, den Hartog, J E, additional, Glas, M W, additional, Klijn, N F, additional, van der Meer, S, additional, Bandell, M L, additional, Boxmeer, J C, additional, van Disseldorp, J, additional, Smeenk, J, additional, van Wely, M, additional, Eijkemans, M J C, additional, Torrance, H L, additional, and Broekmans, F J M, additional
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- 2020
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8. Treatment Policy After Poor Fertilization in the First IVF Cycle
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Roest, Jan, van Heusden, Arne M., Zeilmaker, Gerard H., and Verhoeff, Arie
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- 1998
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9. Electron densities from the Brueckner Doubles method
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van Heusden, Caroline M., Kobayashi, Rika, Amos, Roger D., and Handy, Nicholas C.
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- 1993
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10. Improving cycle control in progestogen-only contraceptive pill users by intermittent treatment with a new anti-progestogen
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Danielsson, K. Gemzell, van Heusden, A. M., Killick, S. R., Croxatto, H. B., Bouchard, P., Cameron, S., and Bygdeman, M.
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- 2002
11. Residual ovarian activity during oral steroid contraception
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van Heusden, A. M. and Fauser, B. C.J.M.
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- 2002
12. FSH and ovarian response: spontaneous recovery of pituitary–ovarian activity during the pill-free period vs. exogenous recombinant FSH during high-dose combined oral contraceptives
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van Heusden, A. M, Coelingh Bennink, H. J. T, and Fauser, B. C. J. M
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- 2002
13. The OPTIMIST study: optimisation of cost effectiveness through individualised FSH stimulation dosages for IVF treatment. A randomised controlled trial
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van Tilborg Theodora C, Eijkemans Marinus JC, Laven Joop SE, Koks Carolien AM, de Bruin Jan, Scheffer Gabrielle J, van Golde Ron JT, Fleischer Kathrin, Hoek Annemieke, Nap Annemiek W, Kuchenbecker Walter KH, Manger Petra A, Brinkhuis Egbert A, van Heusden Arne M, Sluijmer Alexander V, Verhoeff Arie, van Hooff Marcel HA, Friederich Jaap, Smeenk Jesper MJ, Kwee Janet, Verhoeve Harold R, Lambalk Cornelis B, Helmerhorst Frans M, van der Veen Fulco, Mol Ben Willem J, Torrance Helen L, and Broekmans Frank JM
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Ovarian reserve ,Antral follicle count ,IVF ,Individualised FSH stimulation dosages ,Live birth rate ,Gynecology and obstetrics ,RG1-991 ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Costs of in vitro fertilisation (IVF) are high, which is partly due to the use of follicle stimulating hormone (FSH). FSH is usually administered in a standard dose. However, due to differences in ovarian reserve between women, ovarian response also differs with potential negative consequences on pregnancy rates. A Markov decision-analytic model showed that FSH dose individualisation according to ovarian reserve is likely to be cost-effective in women who are eligible for IVF. However, this has never been confirmed in a large randomised controlled trial (RCT). The aim of the present study is to assess whether an individualised FSH dose regime based on an ovarian reserve test (ORT) is more cost-effective than a standard dose regime. Methods/Design Multicentre RCT in subfertile women indicated for a first IVF or intracytoplasmic sperm injection cycle, who are aged Discussion The results of this study will be integrated into a decision model that compares cost-effectiveness of the three dose-adjustment strategies to a standard dose strategy. The study outcomes will provide scientific foundation for national and international guidelines. Trial registration NTR2657
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- 2012
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14. The inSIGHT study: costs and effects of routine hysteroscopy prior to a first IVF treatment cycle. A randomised controlled trial
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Smit Janine G, Kasius Jenneke C, Eijkemans Marinus JC, Koks Carolien AM, Van Golde Ron, Oosterhuis Jurjen GE, Nap Annemiek W, Scheffer Gabrielle J, Manger Petra AP, Hoek Annemiek, Kaplan Mesrure, Schoot Dick BC, van Heusden Arne M, Kuchenbecker Walter KH, Perquin Denise AM, Fleischer Kathrin, Kaaijk Eugenie M, Sluijmer Alexander, Friederich Jaap, Laven Joop SE, van Hooff Marcel, Louwe Leonie A, Kwee Janet, Boomgaard Jantien J, de Koning Corry H, Janssen Ineke CAH, Mol Femke, Mol Ben WJ, Torrance Helen L, and Broekmans Frank JM
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Hysteroscopy ,Subfertility ,IVF ,Gynecology and obstetrics ,RG1-991 ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background In in vitro fertilization (IVF) and intracytoplasmatic sperm injection (ICSI) treatment a large drop is present between embryo transfer and occurrence of pregnancy. The implantation rate per embryo transferred is only 30%. Studies have shown that minor intrauterine abnormalities can be found in 11–45% of infertile women with a normal transvaginal sonography or hysterosalpingography. Two randomised controlled trials have indicated that detection and treatment of these abnormalities by office hysteroscopy after two failed IVF cycles leads to a 9–13% increase in pregnancy rate. Therefore, screening of all infertile women for intracavitary pathology prior to the start of IVF/ICSI is increasingly advocated. In absence of a scientific basis for such a policy, this study will assess the effects and costs of screening for and treatment of unsuspected intrauterine abnormalities by routine office hysteroscopy, with or without saline infusion sonography (SIS), prior to a first IVF/ICSI cycle. Methods/design Multicenter randomised controlled trial in asymptomatic subfertile women, indicated for a first IVF/ICSI treatment cycle, with normal findings at transvaginal sonography. Women with recurrent miscarriages, prior hysteroscopy treatment and intermenstrual blood loss will not be included. Participants will be randomised for a routine fertility work-up with additional (SIS and) hysteroscopy with on-the-spot-treatment of predefined intrauterine abnormalities versus the regular fertility work-up without additional diagnostic tests. The primary study outcome is the cumulative ongoing pregnancy rate resulting in live birth achieved within 18 months of IVF/ICSI treatment after randomisation. Secondary study outcome parameters are the cumulative implantation rate; cumulative miscarriage rate; patient preference and patient tolerance of a SIS and hysteroscopy procedure. All data will be analysed according to the intention-to-treat principle, using univariate and multivariate logistic regression and cox regression. Cost-effectiveness analysis will be performed to evaluate the costs of the additional tests as routine procedure. In total 700 patients will be included in this study. Discussion The results of this study will help to clarify the significance of hysteroscopy prior to IVF treatment. Trial registration NCT01242852
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- 2012
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15. TREATMENT POLICY AFTER POOR FERTILIZATION IN THE FIRST IVF CYCLE: PP-15-338
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Roest, J., Mous, H., van Heusden, A. M., Verhoeff, A., and Zeilmaker, G. H.
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- 1997
16. CUMULATIVF PREGNANCY RAH AND SELECTIVE DROPOUT IN IVF: PP-14-312
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van Heusden, A. M., Roest, J., Mous, H., Zeilmaker, G. H., and Verhoeff, A.
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- 1997
17. THE EFFICACY OF INTRANASAI. GNRH-A IN THE FLARE-UP REGIMFN FOR IVF: PP-10-176
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Roest, J., van Heusden, A. M., Mous, H., Zeilmaker, G. H., and Verhoeff, A.
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- 1997
18. Editorial comment: Hysteroscopy Before In-Vitro Fertilisation (inSIGHT): A Multicentre, Randomised Controlled Trial (Lancet 2016;387:2622–2629)
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Smit, Janine G., Kasius, Jenneke C., Eijkemans, Marinus J. C., Koks, Carolien A. M., van Golde, Ron, Nap, Annemiek W., Scheffer, Gabrielle J., Manger, Petra A. P., Hoek, Annemieke, Schoot, Benedictus C., van Heusden, Arne M., Kuchenbecker, Walter K. H., Perquin, Denise A. M., Fleischer, Kathrin, Kaaijk, Eugenie M., Sluijmer, Alexander, Friederich, Jaap, Dykgraaf, Ramon H. M., van Hooff, Marcel, Louwe, Leonie A., Kwee, Janet, de Koning, Corry H., Janssen, Ineke C. A. H., Mol, Femke, Mol, Ben W. J., Broekmans, Frank J. M., Torrance, Helen L., Obstetrie & Gynaecologie, MUMC+: MA Medische Staf Obstetrie Gynaecologie (9), and RS: GROW - R4 - Reproductive and Perinatal Medicine
- Abstract
Since the first successful live birth after in vitro fertilization (IVF) was reported in 1978, more than 5 million children have been born with the help of this and intracytoplasmic sperm injection (ICSI) procedures. However, only approximately 25% to 30% of cycles of IVF and ICSI lead to the birth of a child. The reasons for implantation failure are poorly understood. One major cause of implantation failure is abnormalities of the uterine cavity such as polyps, myoma, and adhesions. Hysteroscopy has been generally regarded as the standard procedure to detect these uterine abnormalities. It is thought to improve pregnancy rates in women scheduled for IVF by detection and surgical removal of uterine cavity abnormalities, dilatation of the cervical canal, or induction of inflammatory reactions in the endometriumby the procedure itself. Hysteroscopy is often performed routinely in infertile women scheduled for their first IVF cycle. However, there are no data from well-designed randomized controlled trials to support this practice. The inSIGHT trial is a pragmatic multicenter randomized clinical trial designed to determine whether routine hysteroscopy before the first IVF treatment cycle increases the live birth rate. The trial was conducted in 7 university hospitals and 15 large general hospitals in the Netherlands. Women eligible for the trial were infertile, scheduled to start their first IVF or ICSI treatment, had no previous hysteroscopy, and had a normal transvaginal ultrasound of the uterine cavity. Subjects were randomly assigned in a 1: 1 ratio to hysteroscopy with treatment of detected intracavitary abnormalities before starting IVF followed by IVF (hysteroscopy group) or to immediate start of IVF treatment (immediate IVF group). Web-based randomization was done with a variable block size to allocate patients to groups and was stratified by center. The doctors, outcome assessors, and participants were not masked to the assigned group. The primary study outcome was an ongoing pregnancy (detection of a fetal heartbeat at > 12weeks of gestation) within 18 months of randomization and a live birth. Analysis was done according to intention to treat. Between May 25, 2011, and August 27, 2013, 750 women were randomized: 373 to the hysteroscopy group and 377 to the immediate IVF group. A live birth occurred during the trial period in 209 (57%) of 369 women in the hysteroscopy group and 200 (54%) of 373 in the immediate IVF group; the relative riskwas 1.06, with a 95% confidence interval of 0.93 to 1.20; P = 0.41. These findings demonstrate that hysteroscopy does not improve live birth rates in infertile women scheduled for their first IVF cycle, who have a normal transvaginal ultrasound of the uterine cavity. Therefore, routine hysteroscopy should not be performed in women with a normal transvaginal ultrasound.
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- 2016
19. Hysteroscopy before In-Vitro Fertilisation (inSIGHT) : A Multicentre, Randomised Controlled Trial
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Smit, Janine G., Kasius, Jenneke C., Eijkemans, Marinus J C, Koks, Carolien A M, Van Golde, Ronald, Nap, Annemiek W., Scheffer, Gabrielle J., Manger, Petra A P, Hoek, Annemieke, Schoot, Benedictus C., Van Heusden, Arne M., Kuchenbecker, Walter K H, Perquin, Denise A M, Fleischer, Kathrin, Kaaijk, Eugenie M., Sluijmer, Alexander, Friederich, Jaap, Dykgraaf, Ramon H M, Van Hooff, Marcel, Louwe, Leonie A., Kwee, Janet, De Koning, Corry H., Janssen, Ineke C A H, Mol, Femke, Mol, Ben W J, Broekmans, Frank J M, Torrance, Helen L., Smit, Janine G., Kasius, Jenneke C., Eijkemans, Marinus J C, Koks, Carolien A M, Van Golde, Ronald, Nap, Annemiek W., Scheffer, Gabrielle J., Manger, Petra A P, Hoek, Annemieke, Schoot, Benedictus C., Van Heusden, Arne M., Kuchenbecker, Walter K H, Perquin, Denise A M, Fleischer, Kathrin, Kaaijk, Eugenie M., Sluijmer, Alexander, Friederich, Jaap, Dykgraaf, Ramon H M, Van Hooff, Marcel, Louwe, Leonie A., Kwee, Janet, De Koning, Corry H., Janssen, Ineke C A H, Mol, Femke, Mol, Ben W J, Broekmans, Frank J M, and Torrance, Helen L.
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- 2016
20. Hysteroscopy before In-Vitro Fertilisation (inSIGHT): A Multicentre, Randomised Controlled Trial
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MS VPG/Gynaecologie, Arts-assistenten DV&B, Biostatistiek Onderzoek, Circulatory Health, JC onderzoeksprogramma Infectieziekten, JC onderzoeksprogramma Methodologie, Child Health, Fertiliteitartsen, Smit, Janine G., Kasius, Jenneke C., Eijkemans, Marinus J C, Koks, Carolien A M, Van Golde, Ronald, Nap, Annemiek W., Scheffer, Gabrielle J., Manger, Petra A P, Hoek, Annemieke, Schoot, Benedictus C., Van Heusden, Arne M., Kuchenbecker, Walter K H, Perquin, Denise A M, Fleischer, Kathrin, Kaaijk, Eugenie M., Sluijmer, Alexander, Friederich, Jaap, Dykgraaf, Ramon H M, Van Hooff, Marcel, Louwe, Leonie A., Kwee, Janet, De Koning, Corry H., Janssen, Ineke C A H, Mol, Femke, Mol, Ben W J, Broekmans, Frank J M, Torrance, Helen L., MS VPG/Gynaecologie, Arts-assistenten DV&B, Biostatistiek Onderzoek, Circulatory Health, JC onderzoeksprogramma Infectieziekten, JC onderzoeksprogramma Methodologie, Child Health, Fertiliteitartsen, Smit, Janine G., Kasius, Jenneke C., Eijkemans, Marinus J C, Koks, Carolien A M, Van Golde, Ronald, Nap, Annemiek W., Scheffer, Gabrielle J., Manger, Petra A P, Hoek, Annemieke, Schoot, Benedictus C., Van Heusden, Arne M., Kuchenbecker, Walter K H, Perquin, Denise A M, Fleischer, Kathrin, Kaaijk, Eugenie M., Sluijmer, Alexander, Friederich, Jaap, Dykgraaf, Ramon H M, Van Hooff, Marcel, Louwe, Leonie A., Kwee, Janet, De Koning, Corry H., Janssen, Ineke C A H, Mol, Femke, Mol, Ben W J, Broekmans, Frank J M, and Torrance, Helen L.
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- 2016
21. Hysteroscopy Before In-Vitro Fertilisation (inSIGHT): A Multicentre, Randomised Controlled Trial
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Smit, Janine G., primary, Kasius, Jenneke C., additional, Eijkemans, Marinus J. C., additional, Koks, Carolien A. M., additional, van Golde, Ronald, additional, Nap, Annemiek W., additional, Scheffer, Gabrielle J., additional, Manger, Petra A. P., additional, Hoek, Annemieke, additional, Schoot, Benedictus C., additional, van Heusden, Arne M., additional, Kuchenbecker, Walter K. H., additional, Perquin, Denise A. M., additional, Fleischer, Kathrin, additional, Kaaijk, Eugenie M., additional, Sluijmer, Alexander, additional, Friederich, Jaap, additional, Dykgraaf, Ramon H. M., additional, van Hooff, Marcel, additional, Louwe, Leonie A., additional, Kwee, Janet, additional, de Koning, Corry H., additional, Janssen, Ineke C. A. H., additional, Mol, Femke, additional, Mol, Ben W. J., additional, Broekmans, Frank J. M., additional, and Torrance, Helen L., additional
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- 2016
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22. The empty follicle syndrome is dead!
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van Heusden, Arne M., primary, van Santbrink, Evert J., additional, Schipper, Izaäk, additional, and de Jong, Diederick, additional
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- 2008
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23. Cumulative pregnancy rates and selective drop-out off patients in in-vitro fertilization treatment
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Roest, J., primary, van Heusden, A. M., additional, Zeilmaker, G. H., additional, and Verhoeff, A., additional
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- 1998
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24. Manipulation of Human Ovarian Function: Physiological Concepts and Clinical Consequences*
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Fauser, Bart C. J. M., primary and van Heusden, Arne M., additional
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- 1997
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25. A triplet pregnancy after in vitro fertilization is a procedure-related complication that should be prevented by replacement of two embryos only
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Roest, Jan, primary, van Heusden, Arne M., additional, Verhoeff, Arie, additional, Mous, Harold V.H., additional, and Zeilmaker, Gerard H., additional
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- 1997
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26. The ovarian response as a predictor for successful in vitro fertilization treatment after the age of 40 years
- Author
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Roest, Jan, primary, van Heusden, Arne M., additional, Mous, Harold, additional, Zeilmaker, Gerard H., additional, and Verhoeff, Arie, additional
- Published
- 1996
- Full Text
- View/download PDF
27. Minimal monitoring of ovarian hyperstimulation: a useful simplification of the clinical phase of in vitro fertilization treatment
- Author
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Roest, Jan, primary, Verhoeff, Arie, additional, van Heusden, Arne M., additional, and Zeilmaker, Gerard H., additional
- Published
- 1995
- Full Text
- View/download PDF
28. A randomized, comparative study of a single oral dose of fluconazole versus a single topical dose of clotrimazole in the treatment of vaginal candidosis among general practitioners and gynaecologists
- Author
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van Heusden, Arne M., primary, Merkus, Hans.M.W.M., additional, Euser, Robert, additional, and Verhoeff, Arie, additional
- Published
- 1994
- Full Text
- View/download PDF
29. Pregnancy and protein C deficiency
- Author
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van Heusden, Arne M., primary, Merkus, Hans M.W.M., additional, and Dullemond-Westland, Alberdina C., additional
- Published
- 1992
- Full Text
- View/download PDF
30. Single-Dose Oral Fluconazole Versus Single-Dose Topical Miconazole for the Treatment of Acute Vulvovaginal Candidosis
- Author
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VAN HEUSDEN, ARNE M., primary, MERKUS, HANS M. W. M., additional, CORBEIJ, RUUD S. A. C. M., additional, OOSTERBAAN, HERMAN P., additional, STOOT, JAN E. G. M., additional, UBACHS, HANS M. H., additional, and VERHOEFF, ARIE, additional
- Published
- 1991
- Full Text
- View/download PDF
31. Delayed interval delivery in a triplet pregnancy; a case report
- Author
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van Heusden, Arne M., primary and Bots, Robert S.G.M., additional
- Published
- 1991
- Full Text
- View/download PDF
32. Single-Dose Oral Fluconazole Versus Single-Dose Topical Miconazole for the Treatment of Acute Vulvovaginal Candidosis
- Author
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van Heusden, Arne M., primary, Merkus, Hans M.W.M., additional, Corbeij, Ruud S.A.C.M., additional, Oosterbaan, Herman P., additional, Stoot, Jan E.G.M., additional, Ubachs, Hans M.H., additional, and Verhoeff, Arie, additional
- Published
- 1990
- Full Text
- View/download PDF
33. Single monthly administration of the anti-progestagen Org 31710 in users of the 75 microg desogestrel progestagen-only pill: effects on pituitary-ovarian activity.
- Author
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van Heusden, A M, Killick, S R, Coelingh Bennink, H J, and Fauser, B C
- Subjects
OVARIAN physiology ,PITUITARY gland physiology ,CLINICAL trials ,COMPARATIVE studies ,DRUG administration ,ENDOMETRIUM ,ESTRADIOL ,FOLLICLE-stimulating hormone ,HETEROCYCLIC compounds ,HORMONE antagonists ,LUTEINIZING hormone ,RESEARCH methodology ,MEDICAL cooperation ,ORAL contraceptives ,OVARIES ,OVULATION ,PITUITARY gland ,PLACEBOS ,PROGESTERONE ,RESEARCH ,STEROIDS ,EVALUATION research ,RANDOMIZED controlled trials ,BLIND experiment - Abstract
Endocrine and ultrasound effects were studied of an intermittent (every 28 days) oral administration of 150 mg of the anti-progestagen Org 31710 during the continued daily use of 75 microg desogestrel (DSG) for progestagen-only contraception. A randomized, double-blind, placebo-controlled two-centre study was conducted in 50 healthy volunteers. Serum luteinizing hormone (LH), follicle stimulating hormone (FSH), oestradiol and progesterone concentrations, and follicle number and size were studied, as well as endometrial thickness, which was assessed by transvaginal sonography at least twice weekly during a single medication cycle (cycle 3-5). Forty-eight women were evaluated (Org 31710, n = 25; placebo, n = 23). Seven ovulations were observed in the treated group versus none in the placebo group. LH concentrations were higher on days 9 and 11 and oestradiol concentrations lower on day 3 in the treated group, irrespective of whether ovulation occurred. No parameter could predict ovulation. Endometrial thickness was greater on cycle days 7-13 and 19 in the treated group. However, within the Org 31710 group, no significant differences were found in volunteers who did or did not ovulate. Observed differences may be attributed to a competitive effect of Org 31710 with progestagen-induced suppression of the pituitary-ovarian axis, altered oestradiol feedback mechanisms, and/or altered receptor availability. [ABSTRACT FROM AUTHOR]
- Published
- 2000
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34. Improving cycle control in progestogen-only contraceptive pill users by intermittent treatment with a new anti-progestogen.
- Author
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Gemzell-Danielsson, K, van Heusden, A M, Killick, S R, Croxatto, H B, Bouchard, P, Cameron, S, and Bygdeman, M
- Abstract
The safety and efficacy of the anti-progestogen Org 31710 in improving cycle control in healthy women using the desogestrel progestogen-only pill was investigated in this randomized, double-blind, placebo-controlled study.
- Published
- 2002
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- View/download PDF
35. Economic evaluation of endometrial scratching before the second IVF/ICSI treatment: a cost-effectiveness analysis of a randomized controlled trial (SCRaTCH trial).
- Author
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van Hoogenhuijze NE, van Eekelen R, Mol F, Schipper I, Groenewoud ER, Traas MAF, Janssen CAH, Teklenburg G, de Bruin JP, van Oppenraaij RHF, Maas JWM, Moll E, Fleischer K, van Hooff MHA, de Koning CH, Cantineau AEP, Lambalk CB, Verberg M, van Heusden AM, Manger AP, van Rumste MME, van der Voet LF, Pieterse QD, Visser J, Brinkhuis EA, den Hartog JE, Glas MW, Klijn NF, van der Zanden M, Bandell ML, Boxmeer JC, van Disseldorp J, Smeenk J, van Wely M, Eijkemans MJC, Torrance HL, and Broekmans FJM
- Subjects
- Birth Rate, Cost-Benefit Analysis, Female, Humans, Live Birth, Male, Pregnancy, Pregnancy Rate, Fertilization in Vitro methods, Sperm Injections, Intracytoplasmic methods
- Abstract
Study Question: Is a single endometrial scratch prior to the second fresh IVF/ICSI treatment cost-effective compared to no scratch, when evaluated over a 12-month follow-up period?, Summary Answer: The incremental cost-effectiveness ratio (ICER) for an endometrial scratch was €6524 per additional live birth, but due to uncertainty regarding the increase in live birth rate this has to be interpreted with caution., What Is Known Already: Endometrial scratching is thought to improve the chances of success in couples with previously failed embryo implantation in IVF/ICSI treatment. It has been widely implemented in daily practice, despite the lack of conclusive evidence of its effectiveness and without investigating whether scratching allows for a cost-effective method to reduce the number of IVF/ICSI cycles needed to achieve a live birth., Study Design, Size, Duration: This economic evaluation is based on a multicentre randomized controlled trial carried out in the Netherlands (SCRaTCH trial) that compared a single scratch prior to the second IVF/ICSI treatment with no scratch in couples with a failed full first IVF/ICSI cycle. Follow-up was 12 months after randomization.Economic evaluation was performed from a healthcare and societal perspective by taking both direct medical costs and lost productivity costs into account. It was performed for the primary outcome of biochemical pregnancy leading to live birth after 12 months of follow-up as well as the secondary outcome of live birth after the second fresh IVF/ICSI treatment (i.e. the first after randomization). To allow for worldwide interpretation of the data, cost level scenario analysis and sensitivity analysis was performed., Participants/materials, Setting, Methods: From January 2016 until July 2018, 933 women with a failed first IVF/ICSI cycle were included in the trial. Data on treatment and pregnancy were recorded up until 12 months after randomization, and the resulting live birth outcomes (even if after 12 months) were also recorded.Total costs were calculated for the second fresh IVF/ICSI treatment and for the full 12 month period for each participant. We included costs of all treatments, medication, complications and lost productivity costs. Cost-effectiveness analysis was carried out by calculating ICERs for scratch compared to control. Bootstrap resampling was used to estimate the uncertainty around cost and effect differences and ICERs. In the sensitivity and scenario analyses, various unit costs for a single scratch were introduced, amongst them, unit costs as they apply for the United Kingdom (UK)., Main Results and the Role of Chance: More live births occurred in the scratch group, but this also came with increased costs over a 12-month period. The estimated chance of a live birth after 12 months of follow-up was 44.1% in the scratch group compared to 39.3% in the control group (risk difference 4.8%, 95% CI -1.6% to +11.2%). The mean costs were on average €283 (95% CI: -€299 to €810) higher in the scratch group so that the point average ICER was €5846 per additional live birth. The ICER estimate was surrounded with a high level of uncertainty, as indicated by the fact that the cost-effectiveness acceptability curve (CEAC) showed that there is an 80% chance that endometrial scratching is cost-effective if society is willing to pay ∼€17 500 for each additional live birth., Limitations, Reasons for Caution: There was a high uncertainty surrounding the effects, mainly in the clinical effect, i.e. the difference in the chance of live birth, which meant that a single straightforward conclusion could not be ascertained as for now., Wider Implications of the Findings: This is the first formal cost-effectiveness analysis of endometrial scratching in women undergoing IVF/ICSI treatment. The results presented in this manuscript cannot provide a clear-cut expenditure for one additional birth, but they do allow for estimating costs per additional live birth in different scenarios once the clinical effectiveness of scratching is known. As the SCRaTCH trial was the only trial with a follow-up of 12 months, it allows for the most complete estimation of costs to date., Study Funding/competing Interest(s): This study was funded by ZonMW, the Dutch organization for funding healthcare research. A.E.P.C., F.J.M.B., E.R.G. and C.B. L. reported having received fees or grants during, but outside of, this trial., Trial Registration Number: Netherlands Trial Register (NL5193/NTR 5342)., (© The Author(s) 2021. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology.)
- Published
- 2022
- Full Text
- View/download PDF
36. Endometrial scratching in women with one failed IVF/ICSI cycle-outcomes of a randomised controlled trial (SCRaTCH).
- Author
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van Hoogenhuijze NE, Mol F, Laven JSE, Groenewoud ER, Traas MAF, Janssen CAH, Teklenburg G, de Bruin JP, van Oppenraaij RHF, Maas JWM, Moll E, Fleischer K, van Hooff MHA, de Koning CH, Cantineau AEP, Lambalk CB, Verberg M, van Heusden AM, Manger AP, van Rumste MME, van der Voet LF, Pieterse QD, Visser J, Brinkhuis EA, den Hartog JE, Glas MW, Klijn NF, van der Meer S, Bandell ML, Boxmeer JC, van Disseldorp J, Smeenk J, van Wely M, Eijkemans MJC, Torrance HL, and Broekmans FJM
- Subjects
- Belgium, Birth Rate, Female, Fertilization in Vitro, Humans, Netherlands, Pregnancy, Pregnancy Rate, Live Birth, Sperm Injections, Intracytoplasmic
- Abstract
Study Question: Does endometrial scratching in women with one failed IVF/ICSI treatment affect the chance of a live birth of the subsequent fresh IVF/ICSI cycle?, Summary Answer: In this study, 4.6% more live births were observed in the scratch group, with a likely certainty range between -0.7% and +9.9%., What Is Known Already: Since the first suggestion that endometrial scratching might improve embryo implantation during IVF/ICSI, many clinical trials have been conducted. However, due to limitations in sample size and study quality, it remains unclear whether endometrial scratching improves IVF/ICSI outcomes., Study Design, Size, Duration: The SCRaTCH trial was a non-blinded randomised controlled trial in women with one unsuccessful IVF/ICSI cycle and assessed whether a single endometrial scratch using an endometrial biopsy catheter would lead to a higher live birth rate after the subsequent IVF/ICSI treatment compared to no scratch. The study took place in 8 academic and 24 general hospitals. Participants were randomised between January 2016 and July 2018 by a web-based randomisation programme. Secondary outcomes included cumulative 12-month ongoing pregnancy leading to live birth rate., Participants/materials, Setting, Methods: Women with one previous failed IVF/ICSI treatment and planning a second fresh IVF/ICSI treatment were eligible. In total, 933 participants out of 1065 eligibles were included (participation rate 88%)., Main Results and the Role of Chance: After the fresh transfer, 4.6% more live births were observed in the scratch compared to control group (110/465 versus 88/461, respectively, risk ratio (RR) 1.24 [95% CI 0.96-1.59]). These data are consistent with a true difference of between -0.7% and +9.9% (95% CI), indicating that while the largest proportion of the 95% CI is positive, scratching could have no or even a small negative effect. Biochemical pregnancy loss and miscarriage rate did not differ between the two groups: in the scratch group 27/153 biochemical pregnancy losses and 14/126 miscarriages occurred, while this was 19/130 and 17/111 for the control group (RR 1.21 (95% CI 0.71-2.07) and RR 0.73 (95% CI 0.38-1.40), respectively). After 12 months of follow-up, 5.1% more live births were observed in the scratch group (202/467 versus 178/466), of which the true difference most likely lies between -1.2% and +11.4% (95% CI)., Limitations, Reasons for Caution: This study was not blinded. Knowledge of allocation may have been an incentive for participants allocated to the scratch group to continue treatment in situations where they may otherwise have cancelled or stopped. In addition, this study was powered to detect a difference in live birth rate of 9%., Wider Implications of the Findings: The results of this study are an incentive for further assessment of the efficacy and clinical implications of endometrial scratching. If a true effect exists, it may be smaller than previously anticipated or may be limited to specific groups of women undergoing IVF/ICSI. Studying this will require larger sample sizes, which will be provided by the ongoing international individual participant data-analysis (PROSPERO CRD42017079120). At present, endometrial scratching should not be performed outside of clinical trials., Study Funding/competing Interest(s): This study was funded by ZonMW, the Dutch organisation for funding healthcare research. J.S.E. Laven reports grants and personal fees from AnshLabs (Webster, Tx, USA), Ferring (Hoofddorp, The Netherlands) and Ministry of Health (CIBG, The Hague, The Netherlands) outside the submitted work. A.E.P. Cantineau reports 'other' from Ferring BV, personal fees from Up to date Hyperthecosis, 'other' from Theramex BV, outside the submitted work. E.R. Groenewoud reports grants from Titus Health Care during the conduct of the study. A.M. van Heusden reports personal fees from Merck Serono, personal fees from Ferring, personal fees from Goodlife, outside the submitted work. F.J.M. Broekmans reports personal fees as Member of the external advisory board for Ferring BV, The Netherlands, personal fees as Member of the external advisory board for Merck Serono, The Netherlands, personal fees as Member of the external advisory for Gedeon Richter, Belgium, personal fees from Educational activities for Ferring BV, The Netherlands, grants from Research support grant Merck Serono, grants from Research support grant Ferring, personal fees from Advisory and consultancy work Roche, outside the submitted work. C.B. Lambalk reports grants from Ferring, grants from Merck, grants from Guerbet, outside the submitted work., Trial Registration Number: Registered in the Netherlands Trial Register (NL5193/NTR 5342)., Trial Registration Date: 31 July 2015., Date of First Patient’s Enrolment: 26 January 2016., (© The Author(s) 2020. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology.)
- Published
- 2021
- Full Text
- View/download PDF
37. Cervical length measured by transvaginal ultrasonography versus Bishop score to predict successful labour induction in term pregnancies.
- Author
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Groeneveld YJ, Bohnen AM, and Van Heusden AM
- Abstract
Objectives: To compare the value of transvaginal ultrasonographic measurement of the cervical length versus the Bishop score, prior to induction of labour, in predicting the mode of delivery within four days., Materials and Methods: This longitudinal study included 110 women (at term, singleton, vertex presentation) in whom induction of labour was performed at 37-42 weeks of gestation. Cervical length on transvaginal ultrasound and the Bishop score were assessed prior to induction according to standard protocol. Medical records were reviewed for relevant-- demographic and clinical data. Primary outcome criterion was successful vaginal delivery within 96 h. Univariate analyses and receiver operating characteristic (ROC) curves were used to examine differences between variables possibly predicting outcome., Results: Of the 110 women 66 were nulliparous and 44 multiparous. Vaginal delivery within 96 h was successful in 48 (73%) nulliparous and in 40 (91%) multiparous women ( i.e. in 80% of the total population). The overall rate of caesarean delivery was 17%. THERE WAS A SIGNIFICANT DIFFERENCE BETWEEN NULLIPAROUS AND MULTIPAROUS WOMEN IN AGE, CERVICAL LENGTH (MEAN IN MM IN NULLIPAROUS WOMEN: 29.31, range: 5.00-56.00; in multiparous women: 37.04, range: 12.00-56.00), Bishop score and successful induction, but no significant difference between these subgroups in neonatal outcomes. Only the Bishop score in nulliparous women showed a significant relationship between this variable and predicting successful labour induction (area under the ROC curve 0.679; standard error 0.73; p < 0.05; 95% CI: 0.536-0.823). The best cut-off value for the Bishop score was 3, with a sensitivity of 56.3% and a specificity of 72.2%., Conclusion: In this study group significant independent prediction of vaginal delivery within 96 h is provided by the Bishop score but only in nulliparous women. Transvaginal ultrasonographic measurement of cervical length is not a significant independent predictor of vaginal delivery within 96 h.
- Published
- 2010
38. Activity of the pituitary-ovarian axis in the pill-free interval during use of low-dose combined oral contraceptives.
- Author
-
van Heusden AM and Fauser BC
- Subjects
- Adolescent, Adult, Contraceptives, Oral, Synthetic administration & dosage, Desogestrel administration & dosage, Estradiol blood, Ethinyl Estradiol administration & dosage, Female, Follicle Stimulating Hormone blood, Humans, Luteinizing Hormone blood, Norpregnenes administration & dosage, Ovarian Follicle anatomy & histology, Contraceptives, Oral, Combined administration & dosage, Ovary physiology, Pituitary Gland physiology
- Abstract
This study was performed to evaluate pituitary-ovarian recovery in the pill-free interval during use of three low-dose combined oral contraceptives (COC). Either the estrogen component or the progestin component was comparable in the study groups, to evaluate their relative influence. Serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), and estradiol (E2) levels were measured and follicle number and size estimated by transvaginal sonography daily during the 7-day pill-free interval in 44 healthy volunteers using three different low-dose oral contraceptives. Healthy volunteers were enrolled using 20 micrograms ethinyl estradiol (EE) + 75 micrograms gestodene (GSD) (Harmonet, Wyeth-Lederle; n = 15), 20 micrograms EE + 150 micrograms desogestrel (DSG) (Mercilon, Organon n = 17), or 30 micrograms EE + 150 micrograms DSG (Marvelon, Organon, n = 12) given according to the usual regimen of one tablet daily during 3 weeks and 1 week pill-free interval. No ovulations were observed. Pituitary hormones were not statistically significantly different at the beginning of the pill-free interval between the study groups. FSH concentrations were significantly higher at the end of the pill-free interval in the 30 micrograms EE group compared with both 20 micrograms EE groups (7.0 [0.6-12.4] IU/L vs 4.9 [1.4-6.1] IU/L and 4.5 [2.4-7.4] IU/L; p = 0.001). In both 20 micrograms EE groups, a single persistent follicle (24 and 28 mm) was present in one subject. Follicle diameters were statistically significantly smaller at the beginning and at the end of the pill-free period in the 30 micrograms EE group compared with both 20 micrograms EE study groups. Dominant follicles (defined as follicle diameter > or = 10 mm) were observed at the end of the pill-free interval in both 20 micrograms EE groups (in 27% and 18% of women, respectively) but not in the 30 micrograms EE group. Finally, the area-under-the-curve for E2 was statistically significantly lower in the 30 micrograms EE group compared with both 20 micrograms EE groups. In conclusion, the EE content rather than the progestin component in the studied COC determined the extent of residual ovarian activity at the beginning of the pill-free interval. Dominant follicles were encountered only in the 20 micrograms EE study groups.
- Published
- 1999
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- View/download PDF
39. A randomized, comparative study of a single oral dose of fluconazole versus a single topical dose of clotrimazole in the treatment of vaginal candidosis among general practitioners and gynaecologists.
- Author
-
van Heusden AM, Merkus HM, Euser R, and Verhoeff A
- Subjects
- Administration, Intravaginal, Administration, Oral, Adolescent, Adult, Aged, Clotrimazole adverse effects, Family Practice, Female, Fluconazole adverse effects, Follow-Up Studies, Gynecology, Humans, Middle Aged, Candidiasis, Vulvovaginal drug therapy, Clotrimazole administration & dosage, Fluconazole administration & dosage, Patient Satisfaction
- Abstract
Objectives: To compare efficacy, acceptability and patient preference of a single oral dose of fluconazole with a single intravaginal dose of 500 mg clotrimazole (medication groups) in women with vaginal candidosis visiting gynaecologists or general practitioners (study groups)., Design: A comparative, randomized multicenter study. EVENTS: Baseline visit and treatment, short-term follow-up after 1 week and long-term follow-up after 4 weeks. At each visit, symptoms were graded and cultures were obtained., Results: Symptomatic and mycological efficacy did not differ statistical significant in the medication groups or study groups. A complicated history regarding vaginal candidosis was more often found among gynaecologists, yielding poorer results of treatment. Patients preferred oral treatment over intra-vaginal treatment., Conclusions: No differences were found in the clinical and mycological efficacy of both drugs. Clinical results were related to parameters originating from the patients history, resulting in less favourable results in the study group of gynaecologists.
- Published
- 1994
- Full Text
- View/download PDF
40. Pregnancy and protein C deficiency.
- Author
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van Heusden AM, Merkus HM, and Dullemond-Westland AC
- Subjects
- Adult, Coumarins therapeutic use, Female, Fetal Death etiology, Heparin therapeutic use, Humans, Pregnancy, Pulmonary Embolism etiology, Thromboembolism etiology, Thrombophlebitis etiology, Pregnancy Complications, Hematologic, Protein C Deficiency
- Abstract
This report examines a patient with recurrent attacks of thrombo-embolism due to a protein C deficiency. Alterations in the coagulation during pregnancy and the possible consequences of an altered coagulation during pregnancy will be discussed.
- Published
- 1992
- Full Text
- View/download PDF
41. Delayed interval delivery in a triplet pregnancy; a case report.
- Author
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van Heusden AM and Bots RS
- Subjects
- Adult, Delivery, Obstetric, Female, Humans, Infant, Newborn, Pregnancy, Pregnancy Outcome, Tocolysis, Obstetric Labor, Premature prevention & control, Pregnancy, Multiple, Triplets
- Abstract
A case report is presented in which a triplet pregnancy ended in an immature delivery of triplet A at 20 weeks gestation, followed by a successful delay in delivery of 49 days of triplets B and C by means of a cervical cerclage and tocolysis. This is the first reported case in which two living infants could be vaginally delivered after a preceding vaginal delivery of the third infant in a triplet pregnancy.
- Published
- 1991
- Full Text
- View/download PDF
42. Chronic vulvovaginal candidosis: the role of oral treatment.
- Author
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Merkus JM and Van Heusden AM
- Subjects
- Administration, Oral, Antifungal Agents administration & dosage, Chronic Disease, Female, Humans, Itraconazole, Ketoconazole administration & dosage, Ketoconazole analogs & derivatives, Ketoconazole therapeutic use, Recurrence, Antifungal Agents therapeutic use, Candidiasis, Vulvovaginal drug therapy
- Abstract
Fluor vaginalis may have a diversity of causes, among which are fungal infections by Candida spp. It has been estimated that up to 75% of women will have at least one episode of vaginal candidosis during their reproductive years. Most of these women have had only one occasional episode of discomfort. However, a small group presents with a chronic recurrence of vaginal candidosis accompanied by symptomatic infections many times a year. Until now, investigations into the pathogenesis and treatment of these recurrent episodes gave no clear answer to the question as to why this occurs in these patients. The opportunity to treat vaginal candidosis with a systemic antifungal drug can have advantages over a topical drug, if extravaginal Candida spp. that may contribute to recurrence can be eliminated at the same time. In this trial, 18 patients with chronic recurrent vaginal candidosis (greater than 4 attacks of candidosis vaginalis per year) were treated with itraconazole 200 mg/day monthly for two days--Days 5 and 6 after menstruation. After the first therapeutic treatment, 17 patients were culture-negative and symptom-free. Results show that prophylaxis for six months with itraconazole was beneficial, as far as complaints were concerned, in 11 patients (64.7%).
- Published
- 1990
43. Chronic recurrent vaginal candidosis: easy to treat, difficult to cure. Results of intermittent treatment with a new oral antifungant.
- Author
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van Heusden AM and Merkus JM
- Subjects
- Administration, Oral, Adult, Antifungal Agents administration & dosage, Chronic Disease, Drug Administration Schedule, Female, Humans, Itraconazole, Ketoconazole administration & dosage, Ketoconazole therapeutic use, Menstrual Cycle, Middle Aged, Recurrence, Antifungal Agents therapeutic use, Candidiasis, Vulvovaginal drug therapy, Ketoconazole analogs & derivatives
- Abstract
Research into the pathogenesis and treatment of chronic recurrent candidosis vaginalis did not come up with a clear answer of curing this phenomenon. In this investigation, data are presented of a therapy with a new antifungal agent, itraconazole. After a therapeutic treatment course, 17 patients received a prophylaxis for CRCV over 6 months. The treatment schedule for prophylaxis consisted of 4 capsules of 50 mg itraconazole on day 5 and 6 of the menstrual cycle. Eleven remained symptom-free in this period. Although there is no explanation for recurrence in most cases of CRCV, intermittent treatment schedules can be used to treat but not to cure these patients. Data of this investigation and data mentioned in the literature prove the necessity to discriminate between a sympatomtic and a mycological cure.
- Published
- 1990
- Full Text
- View/download PDF
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