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Evaluating the infertile male, Part 1An expert in infertility and microsurgery explains how to interpret semen analysis in Part 1 of a two-part series on male infertility. He also tells why much traditional treatment of male infertility, including varicocelectomy, is pointless.
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Letters to the EditorLetters discuss the myriad of issues affecting the practice of specialties. Joshua A. Copel responds.
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Are you ready for MOC?The American Board of Obstetrics and Gynecology stopped issuing their usual certificates in 2008 and have switched to a "maintenance of certification" protocol that requires all ob/gyns to walk through a more demanding 6-year process involving CME offerings, a written examination, and chart reviews.
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Sign Out: Can you see the silver lining in ob/gyn?Anyone who's been practicing ob/gyn for more than 20 years knows that our profession has changed tremendously, and largely to our great frustration.
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Genitourinary syndrome of menopause: Underdiagnosed and undertreatedDespite the prevalence of GSM, the condition continues to be under-recognized and undertreated due to a combination of patient and provider factors. Providers need to take the initiative in screening and patient education.
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Routine cystoscopy after minimally invasive hysterectomy associated with increased UTIsResults presented at the 2019 AAGL Congress demonstrated a higher rate of UTI among younger patients with increased estimated blood loss (EBL) following the procedure.
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Alternative approaches to overactive bladderAlthough traditional drugs work for most patients, potential side effects turn some patients off. Examining the evidence, two experts argue for trying approaches like magnetic and electrical stimulation, acupuncture, or Botox.
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Taking a rational approach to hypertension in the pregnant patientAshley S. Roman, MD, MPH, reviews some of the new updates discussed in ACOG Practice Bulletin #203: Chronic Hypertension in Pregnancy.
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NAMS Notes: Highlights of a new position statement on calciumTo guide health-care providers about the role of calcium in peri-and postmenopausal women, The North American Menopause Society recently developed an evidence-based statement.
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Sign Out: Our 40-year ride on the hormone therapy rollercoasterWhen I started practicing "menopause medicine" 40 years ago, Dr. Robert Wilson's book, Feminine Forever was on the bestseller list. Today, as I approach the pinnacle of my career, Suzanne Somers' Ageless: The Naked Truth About Bioidentical Hormones is on the shelves. The titles are different but the message is the same: the promise of eternal youth . . . .
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Sign Out: Protocols for High-Risk PregnanciesI truly believe that "Protocols for High-Risk Pregnancies" has contributed to improving perinatal care.
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ECG analysis: the next generation in electronic fetal monitoring?As fetal electrocardiograph analysis comes of age, there's a growing body of research to suggest it can serve as a valuable adjunct to traditional EFM. Here's an expert review on the technology and the data supporting it.
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Will screening for endometrial cancer soon be routine?A rigorous assessment of who, when, and how to screen may lead to regular testing in a broader population.
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Eight tips to improve outpatient visits for spinal cord injury patientsThese recommendations, based on the observations of a patient, is a Top 8 list of ways to optimize an outpatient visit for reproductive health care for women with spinal cord injury or disease.
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Hormonal contraceptives: Do patients understand the real benefits and risks?Misconceptions about oral contraceptives, the vaginal ring, and the transdermal patch can deprive patients of their full benefits.
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Ultrasound Clinics: Nuchal translucency assessment: What else can it tell us?Data from the FASTER and BUN trials show that first-trimester NT measurement can reveal a lot more than just trisomy 21. Although not ready for prime time as a screening test for congenital heart disease, we can't ignore the strong association between increased NT and an elevated risk of several cardiac birth defects and to a lesser degree diaphragmatic hernia. But what can we do about it?
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Oxytocin suspect in cases with poor outcomesOxytocin is one of the most frequently used drugs during labor but it can also become a major issue in a malpractice case filed after a labor and delivery if there is an adverse outcome. PLUS: Carolyn Zelop, MD, provides commentary on a lawsuit involving a patient death during pregnancy due to cardiomyopathy.
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Using GnRH Agonists and GnRH Antagonists in Clinical PracticeAn expert in obstetrics and gynecology comments on the utilization of GnRH agonists and GnRH antagonists in COS in IVF treatment.
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Protocols for High-Risk Pregnancies, 7th Edition: Snapshot: Protocol 18 - Peripartum CardiomyopathySnapshot: Protocol 18 - Peripartum Cardiomyopathy
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Is it vulvar vestibulitis?Diagnosing and treating women with vulvar vestibulitis can sometimes seem more art than science. Here an expert reviews the available evidence and describes his approach.
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Protocols for High-Risk Pregnancies, 7th Edition Prenatal testing for chromosomal abnormalitiesProtocol 5 - In this protocol, Norton reviews the pathophysiology of fetal aneuploidy and the wide range of tests for it. Included are perspectives on cell-free DNA testing, first-trimester combined screening, nuchal translucency (NT) sonography, and pregnancy-associated plasma protein A (PAPP-A) and human chorionic gonadotropin (hCG), as well as quad marker screening in the second trimester in appropriate cases, and combined first- and second-trimester screening.
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Grand Rounds: What's the best approach to spontaneous premature ovarian failure?Learning that she has what used to be called premature menopause can devastate a woman in her 20s or 30s. Diagnose this mysterious condition without delay, deliver the bad news in person, and provide sensitiveanswers to four basic questions.
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Q&A: Controversy: Gender selection via preimplantation genetic diagnosis: ethical pros and cons of the controversyIf choosing gender is okay before fertilization, why shouldn't it be with PGD after fertilization, is the thrust of the "pro" argument. The other side calls PGD gender discrimination.
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Was this uterine perforation properly managed?Complications following IUD removal were the focus of this lawsuit.
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Current choices in cervical cancer screeningIt is essential to expand access to all available, effective cervical cancer screening options for the most vulnerable populations. The targeted use of any particular screening modality in higher-risk populations is not supported by evidence-based guidelines; any effective screening is the priority.
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Sex and the 50-something woman: Strategies for restoring satisfactionFor many women, the 50s are a milestone decade. In addition to other changes, menopause can bring about sexual dysfunction.
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Grand Rounds: Office assessment of urinary incontinenceUrinary incontinence can often be successfully treated without referral, but first ob/gyns need to broach the subject! Two experts tell how to evaluate this widespread condition.
