The Experts below are selected from a list of 168 Experts worldwide ranked by ideXlab platform
J H Check - One of the best experts on this subject based on the ideXlab platform.
-
higher pregnancy rates following treatment of cervical factor with intrauterine insemination without superovulation versus intercourse the importance of a well timed Postcoital Test for infertility
Archives of Andrology, 1995Co-Authors: J H Check, P SpiritoAbstract:A randomized study comparing the efficacy of timed intrauterine insemination (IUI) without hyper-stimulation to sexual intercourse was performed in women with cervical factor infertility. Among the strict requirements for inclusion in the study were a normal semen analysis in the male partner, as well as the failure to demonstrate any sperm with progressive forward motion in a Postcoital Test performed 8–12 h after intercourse at the time of a mature follicle. All other infertility factors were negative. The data demonstrated a statistically significant fecundity rate at 1 month when IUI was compared to intercourse (21.2 vs. 3.9%). These data suggest that carefully timed IUI in nonhyperstimulated cycles is an effective treatment for cervical factor infertility.
-
an in vivo technique for screening immunologic factors in the etiology of the unexplained poor Postcoital Test
International Journal of Fertility, 1990Co-Authors: J H Check, K Nowroozi, H G Adelson, A Bollendorf, R Chern, M PressAbstract:: A study was designed to determine the incidence and etiology of the unexplained poor Postcoital Test. An in vivo comparison of sperm penetration by husband's versus donor sperm in the wife's estrogen-stimulated mucus was performed. The 8 of 30 women showing improvement of husband's penetration in mucus (group 1) were treated with high-dose estrogen (HDE) and hMG, and 4/8 conceived. Anti-sperm antibodies (ASA) were insignificant in this group. In group 2, in which donor sperm penetrated but husband's sperm did not, 8 men of 17 were found to have an ASA level over 50% on the sperm surface; 6/8 treated with high-dose methylprednisolone (MP) had an improved Postcoital Test, and 5 achieved a pregnancy. Two patients with levels under 50% were still treated with MP, and one achieved a pregnancy. In five group-3 couples, positive ASA were found in the cervical mucus of two women; and one woman improved on the Postcoital Test and conceived following MP therapy. The 30 unexplained poor Postcoital Tests occurred in 5,000 couples evaluated. In general, those patients considered to have significant clinical antibody had levels over 50%. Because side effects of MP may be severe, and positive ASA may be found in normal donors, it is important to use a comparison penetration Test to help determine if treatment with corticosteroids seems reasonable.
M Press - One of the best experts on this subject based on the ideXlab platform.
-
an in vivo technique for screening immunologic factors in the etiology of the unexplained poor Postcoital Test
International Journal of Fertility, 1990Co-Authors: J H Check, K Nowroozi, H G Adelson, A Bollendorf, R Chern, M PressAbstract:: A study was designed to determine the incidence and etiology of the unexplained poor Postcoital Test. An in vivo comparison of sperm penetration by husband's versus donor sperm in the wife's estrogen-stimulated mucus was performed. The 8 of 30 women showing improvement of husband's penetration in mucus (group 1) were treated with high-dose estrogen (HDE) and hMG, and 4/8 conceived. Anti-sperm antibodies (ASA) were insignificant in this group. In group 2, in which donor sperm penetrated but husband's sperm did not, 8 men of 17 were found to have an ASA level over 50% on the sperm surface; 6/8 treated with high-dose methylprednisolone (MP) had an improved Postcoital Test, and 5 achieved a pregnancy. Two patients with levels under 50% were still treated with MP, and one achieved a pregnancy. In five group-3 couples, positive ASA were found in the cervical mucus of two women; and one woman improved on the Postcoital Test and conceived following MP therapy. The 30 unexplained poor Postcoital Tests occurred in 5,000 couples evaluated. In general, those patients considered to have significant clinical antibody had levels over 50%. Because side effects of MP may be severe, and positive ASA may be found in normal donors, it is important to use a comparison penetration Test to help determine if treatment with corticosteroids seems reasonable.
Christine K Mauck - One of the best experts on this subject based on the ideXlab platform.
-
the Postcoital Test in the development of new vaginal contraceptives
Biology of Reproduction, 2020Co-Authors: Christine K Mauck, Kathleen L VincentAbstract:Postcoital Tests (PCTs) have been used for over a century in the clinical evaluation of infertile couples, and for nearly 70 years in the evaluation of new vaginal contraceptive products. PCTs have been largely replaced by more modern methods in the study of infertility, but they remain the most useful way to obtain preliminary data on the effectiveness of vaginal contraceptive products. The World Health Organization has described important aspects of the procedure. It involves collection of cervical mucus at a certain time point after intercourse and the counting and characterization of sperm found in the mucus. A wide range of progressively motile sperm (PMS) has been associated with pregnancy rates in infertility studies. Eligibility for contraceptive trials includes the requirement that couples achieve a certain threshold number of PMS per high power field at midcycle in a baseline cycle without the Test product. The primary endpoint, or definition of a satisfactory result in Test cycles, is predefined. A literature review identified 10 PCT studies of vaginal contraceptives involving nine Test products. Phase II trials of vaginal contraceptives have not been deemed feasible in the development of any vaginal contraceptive to date. A PCT study of a Test product can be predictive of contraceptive efficacy, although ultimate contraceptive effectiveness is influenced by the ease of use of the product, along with patient compliance. PCT results similar to results seen with products that later showed satisfactory performance in efficacy trials is the best indicator of likely success of a Test product.
-
A phase I randomized Postcoital Testing and safety study of the Caya diaphragm used with 3% Nonoxynol-9 gel, ContraGel or no gel.
Contraception, 2017Co-Authors: Christine K Mauck, Vivian Brache, Thomas Kimble, Andrea Ries Thurman, Leila Cochon, Sarah Littlefield, Kim Linton, Gustavo F. Doncel, Jill L. SchwartzAbstract:Abstract Objectives The Caya® Diaphragm is a newly approved single-size, nonlatex diaphragm. Contragel® is a personal lubricant containing lactic acid approved in Europe and other countries for use with vaginal barrier devices. This study assessed the effectiveness in preventing sperm from penetrating midcycle cervical mucus of Caya with Contragel, Caya with 3% nonoxynol-9 (N-9) and Caya alone. Study design Phase I multicenter, single-blind, randomized, crossover, nonsignificant risk study at two sites: Eastern Virginia Medical School, Norfolk, VA, USA, and Profamilia, Santo Domingo, Dominican Republic. Healthy, sexually active women 18–45 years old, not at risk for pregnancy due to tubal occlusion, were eligible. Each participant was seen in nine visits, completing a baseline cycle (without product use) followed by three Test cycles (sequence determined by randomization), each consisting of a cervical mucus check visit and a Postcoital Test visit. To proceed to Test cycles, the baseline Postcoital Test had to show adequate cervical mucus and >5 progressively motile sperm per high power field (PMS/HPF). Results All women had an average of Conclusion This study supports that Caya with ContraGel is safe and functions as well as Caya with N-9 in preventing PMS from reaching midcycle cervical mucus. Implications A single-size diaphragm used with a personal lubricant gel containing lactic acid appears to be safe and to function as well as the same diaphragm used with N-9 in preventing PMS from reaching midcycle cervical mucus.
-
SILCS diaphragm: Postcoital Testing of a new single-size contraceptive device☆☆☆
Contraception, 2008Co-Authors: Jill L. Schwartz, Christine K Mauck, Mitchell D. Creinin, Susan A. Ballagh, Robert W. Rountree, Maggie Kilbourne-brook, Marianne M. CallahanAbstract:Abstract Background This study was conducted to compare the effectiveness of a new, single-size silicone contraceptive diaphragm used with either spermicide [2% nonoxynol-9 (N-9)] or lubricant in preventing sperm from penetrating midcycle cervical mucus. Study design A crossover Postcoital Test (PCT) in healthy, sexually active women not at risk for pregnancy due to tubal occlusion was conducted. Couples had a baseline PCT without a device to verify normal fertility parameters. Qualified couples underwent up to two Test cycles using the SILCS diaphragm with a metal spring. A subgroup of couples underwent a third Test cycle with the SILCS polymer spring diaphragm used with N-9 gel. Results Fifteen couples completed a baseline cycle and were randomized to order of study gel. Of these, 14 couples completed a baseline cycle and at least one Test cycle, 12 couples completed a baseline cycle and two Test cycles and 8 couples completed a third Test cycle with the polymer spring prototype. Sperm was detected in the vaginal pool in all completed Test cycles. The SILCS metal spring diaphragms used with N-9 gel reduced the average number of progressively motile sperm per high power field in the cervical mucus from a baseline of 12.5 to 0, while use of this device with lubricant reduced the number to 0.5. The SILCS polymer spring diaphragm used with N-9 performed the same as the metal spring used with N-9. Conclusion The SILCS diaphragm used with N-9 gel performed well. It is likely that the SILCS diaphragm will give acceptable results in a contraceptive effectiveness study but that adjunctive use of a chemical barrier such as N-9 gel will be necessary for it to be most effective.
-
Original research article SILCS diaphragm: Postcoital Testing of a new single-size contraceptive device ☆,☆☆
2008Co-Authors: Jill L. Schwartz, Christine K Mauck, Mitchell D. Creinin, Susan A. Ballagh, Robert W. Rountree, Maggie Kilbourne-brook, Marianne M. CallahanAbstract:Background: This study was conducted to compare the effectiveness of a new, single-size silicone contraceptive diaphragm used with either spermicide [2% nonoxynol-9 (N-9)] or lubricant in preventing sperm from penetrating midcycle cervical mucus. Study design: A crossover Postcoital Test (PCT) in healthy, sexually active women not at risk for pregnancy due to tubal occlusion was conducted. Couples had a baseline PCT without a device to verify normal fertility parameters. Qualified couples underwent up to two Test cycles using the SILCS diaphragm with a metal spring. A subgroup of couples underwent a third Test cycle with the SILCS polymer spring diaphragm used with N-9 gel. Results: Fifteen couples completed a baseline cycle and were randomized to order of study gel. Of these, 14 couples completed a baseline cycle and at least one Test cycle, 12 couples completed a baseline cycle and two Test cycles and 8 couples completed a third Test cycle with the polymer spring prototype. Sperm was detected in the vaginal pool in all completed Test cycles. The SILCS metal spring diaphragms used with N-9 gel reduced the average number of progressively motile sperm per high power field in the cervical mucus from a baseline of 12.5 to 0, while use of this device with lubricant reduced the number to 0.5. The SILCS polymer spring diaphragm used with N-9 performed the same as the metal spring used with N-9. Conclusion: The SILCS diaphragm used with N-9 gel performed well. It is likely that the SILCS diaphragm will give acceptable results in a contraceptive effectiveness study but that adjunctive use of a chemical barrier such as N-9 gel will be necessary for it to be most effective.
-
A phase I comparative Postcoital Testing study of three concentrations of C31G.
Contraception, 2004Co-Authors: Christine K Mauck, David F Archer, Mitchell D. Creinin, Kurt T. Barnhart, Susan A. Ballagh, Marianne M. Callahan, Susan W. SchmitzAbstract:Abstract Background C31G is a broad-spectrum antibacterial agent that shows contraceptive properties in vitro. This Postcoital Testing study evaluated the ability of three C31G concentrations, 0.5%, 1.0% and 1.7%, administered as a 3.5-mL dose of a vaginal gel to prevent sperm from entering mid-cycle cervical mucus. Irritation of the genitalia and acceptability were also assessed. Method At baseline, a mid-cycle cervical mucus Test and a Postcoital Test were performed within 24 h of each other without use of any study products to establish normal mid-cycle cervical mucus and sperm penetration. Subjects then completed up to three Test cycles using one of the three concentrations of study product during intercourse. Results Twenty-two of the 61 women enrolled completed a baseline cycle and at least one Test cycle. An average of 14.6 progressively motile sperm per high power field was seen at baseline. This was reduced to 0.3 after use of 0.5% C31G, 0.5 after use of 1.0% C31G, and 0.4 after use of 1.7% C31G. There was no significant difference between Test products (p ≥ 1.000) but each Test product was significantly different from baseline (p Conclusion This study suggests that all three concentrations of C31G are likely to give reasonable results in a contraceptive effectiveness trial. Based on the results of this and other trials, the 1.0% concentration has been selected for further development, including Phase III trials of contraceptive effectiveness.
Margaret E Weber - One of the best experts on this subject based on the ideXlab platform.
-
effects of ethinyl estradiol and ibuprofen compared to placebo on endometrial bleeding cervical mucus and the Postcoital Test in levonorgestrel subcutaneous implant users
Contraception, 2008Co-Authors: David F Archer, Christine B Philput, Adam S Levine, Vanessa Cullins, Thomas G Stovall, Janice L Bacon, Margaret E WeberAbstract:Abstract Background The study was conducted to evaluate ethinyl estradiol (EE) or ibuprofen (IBU) compared to placebo (PL) on spotting and bleeding (S/B) and a Postcoital Test (PCT) in women using the levonorgestrel subcutaneous implant. Women experiencing excessive S/B were enrolled in a multicenter prospective randomized study using EE, IBU or PL. Outcome Measures Duration of S/B and a PCT were evaluated. Statistical analysis used a general linear model procedure with Duncan's multiple range Tests for individual variables. Results One hundred seven women were evaluated, and there was no difference in the duration of bleeding among the three therapies, while the mean number of spotting days were 1.8 for EE and 2.8 for PL (p=.04). There was no effect of IBU on S/B. No effect on cervical mucus or sperm was found between treatments. Conclusion There was a decrease in spotting but no effect on bleeding with EE compared to PL.
-
original research article effects of ethinyl estradiol and ibuprofen compared to placebo on endometrial bleeding cervical mucus and the Postcoital Test in levonorgestrel subcutaneous implant users
2008Co-Authors: David F Archer, Christine B Philput, Adam S Levine, Vanessa Cullins, Thomas G Stovall, Janice L Bacon, Margaret E WeberAbstract:Background: The study was conducted to evaluate ethinyl estradiol (EE) or ibuprofen (IBU) compared to placebo (PL) on spotting and bleeding (S/B) and a Postcoital Test (PCT) in women using the levonorgestrel subcutaneous implant. Women experiencing excessive S/B were enrolled in a multicenter prospective randomized study using EE, IBU or PL. Outcome Measures: Duration of S/B and a PCT were evaluated. Statistical analysis used a general linear model procedure with Duncan's multiple range Tests for individual variables. Results: One hundred seven women were evaluated, and there was no difference in the duration of bleeding among the three therapies, while the mean number of spotting days were 1.8 for EE and 2.8 for PL (p=.04). There was no effect of IBU on S/B. No effect on cervical mucus or sperm was found between treatments. Conclusion: There was a decrease in spotting but no effect on bleeding with EE compared to PL.
K Nowroozi - One of the best experts on this subject based on the ideXlab platform.
-
an in vivo technique for screening immunologic factors in the etiology of the unexplained poor Postcoital Test
International Journal of Fertility, 1990Co-Authors: J H Check, K Nowroozi, H G Adelson, A Bollendorf, R Chern, M PressAbstract:: A study was designed to determine the incidence and etiology of the unexplained poor Postcoital Test. An in vivo comparison of sperm penetration by husband's versus donor sperm in the wife's estrogen-stimulated mucus was performed. The 8 of 30 women showing improvement of husband's penetration in mucus (group 1) were treated with high-dose estrogen (HDE) and hMG, and 4/8 conceived. Anti-sperm antibodies (ASA) were insignificant in this group. In group 2, in which donor sperm penetrated but husband's sperm did not, 8 men of 17 were found to have an ASA level over 50% on the sperm surface; 6/8 treated with high-dose methylprednisolone (MP) had an improved Postcoital Test, and 5 achieved a pregnancy. Two patients with levels under 50% were still treated with MP, and one achieved a pregnancy. In five group-3 couples, positive ASA were found in the cervical mucus of two women; and one woman improved on the Postcoital Test and conceived following MP therapy. The 30 unexplained poor Postcoital Tests occurred in 5,000 couples evaluated. In general, those patients considered to have significant clinical antibody had levels over 50%. Because side effects of MP may be severe, and positive ASA may be found in normal donors, it is important to use a comparison penetration Test to help determine if treatment with corticosteroids seems reasonable.