IMPORTANCE: In the US, approximately 12.7% of reproductive age women seek treatment for infertility each year. This review summarizes current evidence regarding diagnosis and treatment of infertility. OBSERVATIONS: Infertility is defined a…
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ImportanceCrohn disease, a chronic gastrointestinal inflammatory disease, is increasing in incidence and prevalence in many parts of the world. Uncontrolled inflammation leads to long-term complications, including fibrotic strictures, enter…
IMPORTANCE: Preclinical and epidemiological studies indicate a potential chemopreventive role of statins in epithelial ovarian cancer risk. OBJECTIVE: To evaluate the association of genetically proxied inhibition of 3-hydroxy-3-methylgluta…
IMPORTANCE: Dietary supplements marketed for male fertility commonly contain folic acid and zinc based on limited prior evidence for improving semen quality. However, no large-scale trial has examined the efficacy of this therapy for improv…
IMPORTANCE: US health care spending has continued to increase and now accounts for 18% of the US economy, although little is known about how spending on each health condition varies by payer, and how these amounts have changed over time. O…
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IMPORTANCE: Chronic pancreatitis (CP) is a chronic inflammatory and fibrotic disease of the pancreas with a prevalence of 42 to 73 per 100 000 adults in the United States. OBSERVATIONS: Both genetic and environmental factors are thought to…
IMPORTANCE: Acupuncture is widely used by women undergoing in vitro fertilization (IVF), although the evidence for efficacy is conflicting. OBJECTIVE: To determine the efficacy of acupuncture compared with a sham acupuncture control perfor…
EndometriosisEndometriosis is a common condition in women.The endometrium is the inner lining of the uterus (womb); this tissue normally cycles through stages of growth and shedding during the menstrual cycle.Endometriosis occurs when the e…
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IMPORTANCE: Spontaneous pneumothorax is a common disease known to have an unusual epidemiological profile, but there are limited contemporary population-based data. OBJECTIVE: To estimate the incidence of hospital admissions for spontaneou…
IMPORTANCE: Despite lack of evidence of their utility, biomarkers of ovarian reserve are being promoted as potential markers of reproductive potential. OBJECTIVE: To determine the associations between biomarkers of ovarian reserve and repr…
ImportanceUS health care spending has continued to increase, and now accounts for more than 17% of the US economy. Despite the size and growth of this spending, little is known about how spending on each condition varies by age and across t…
CLINICAL QUESTION: What treatments are associated with improved outcomes for women with endometriosis? BOTTOM LINE: The levonorgestrel-releasing intrauterine system (LNG-IUD), gonadotropin-releasing hormone analogues (GnRHa; nafarelin, leu…
ImportanceThe likelihood of achieving a live birth with repeat in vitro fertilization (IVF) is unclear, yet treatment is commonly limited to 3 or 4 embryo transfers.ObjectiveTo determine the live-birth rate per initiated ovarian stimulation…
ImportanceIntracytoplasmic sperm injection (ICSI) is increasingly used in patients without severe male factor infertility without clear evidence of a benefit over conventional in vitro fertilization (IVF).ObjectiveTo assess national trends …
IMPORTANCE: The prevalence of oocyte donation for in vitro fertilization (IVF) has increased in the United States, but little information is available regarding maternal or infant outcomes to improve counseling and clinical decision making.…
CONTEXT: Chronic pelvic pain is a common condition with a major effect on health-related quality of life, work productivity, and health care use. Operative interruption of nerve trunks in the uterosacral ligaments by laparoscopic uterosacra…
CONTEXT: Although a quarter of US women undergo elective hysterectomy before menopause, controlled trials that evaluate the benefits and harms are lacking. OBJECTIVE: To compare the effect of hysterectomy vs expanded medical treatment on h…
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DR DALEY: MS B IS A 36-YEAR-OLD MARRIED MEDICAL WRITER with pelvic pain, endometriosis, and infertility. She lives near Boston with her husband and 1-year-old adopted daughter. She has managed care insurance. Ms B experienced menarche at ag…
CONTEXT: Short-term intermittent administration of parathyroid hormone (PTH) prevents bone loss from the spine in women treated with a gonadotropin-releasing hormone (GnRH) analog. However, the effects of a longer period of PTH administrati…