Browsing by Author "Siebert, T. I."
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- ItemAssisted reproduction in the HIV-serodiscordant couple(Health & Medical Publishing Group, 2007-01) Nosarka, S.; Hoogendijk, C. F.; Siebert, T. I.; Kruger, T. F.ENGLISH ABSTRACT: No abstract available
- ItemIs the use of a GnRH antagonist effective in patients with polycystic ovarian syndrome? A South African perspective(Health & Medical Publishing Group, 2012-01-19) Siebert, T. I.; Kruger, T. F.; Grieve, C. L.; Steyn, D. W.Introduction. Polycystic ovarian disease (PCOS) can account for up to 35 - 40% of the female factor causes of infertility. These patients present as medically complex cases and are challenging to manage and treat successfully. They are resistant to treatment and are often offered controlled ovarian stimulation (COS) and in vitro fertilisation (IVF) technology. Aim. The aim of this study was to assess whether there was a difference in the pregnancy outcomes of women with PCOS when a standard gonadotrophin-releasing hormone (GnRH) antagonist (cetrorelix) protocol was used for ovarian stimulation, compared with non-PCOS patients undergoing IVF. Methods. A retrospective patient record audit was performed on 142 patients with PCOS and 501 non-PCOS patients undergoing a similar cetrorelix-based COS treatment protocol during a specified time period. Results. The main primary outcome was an ongoing pregnancy at 12 weeks, achieved in 34% of patients in the PCOS group and 27% in the non-PCOS group. This was not significantly different (p=0.07). No patient in the PCOS group experienced severe hyperstimulation syndrome. Conclusion. There was no significant difference in pregnancy rates in patients with PCOS undergoing GnRH-antagonist ovarian stimulation compared with non-PCOS patients. The fact that no hyperstimulation syndrome occurred makes this an attractive option for women with PCOS.
- ItemLaparoscopic myomectomy for infertile patients with intramural fibroids : a retrospective study at a tertiary endoscopic centre(Health & Medical Publishing Group, 2011-09) Lourens, Renardo J.; Siebert, T. I.; Kruger, T. F.; Van der Merwe, J. P.Background. The safety of laparoscopic myomectomy has been questioned, especially in the case of fibroids. Objectives. To assess the safety of laparoscopic myomectomy for intramural fibroids and study the subsequent effect on fertility. Methods and settings. A retrospective study of a tertiary endoscopic centre specialising in laparoscopic myomectomy. Results. Eighty-seven patients were studied, and there were no major complications. The conversion rate from laparoscopy to laparotomy was 3.4% (3/87), in all cases due to multiple fibroids. There was 1 case of uterine perforation during hysteroscopy. The overall pregnancy rate was 29/64 (45.3%), with a spontaneous pregnancy rate of 18/29 (62.0%). Conclusions. Laparoscopic myomectomy can be regarded as a safe alternative to abdominal myomectomy in the hands of the experienced surgeon, resulting in good subsequent pregnancy rates.
- ItemA study of different clinical and biochemical parameters in polycystic ovary syndrome affecting ovulation induction outcome and fertility potential(Stellenbosch : Stellenbosch University, 2008-12) Siebert, T. I.; Kruger, T. F.; Stellenbosch University. Faculty of Health Sciences. Dept. of Obstetrics and Gynaecology.Chapter 1 presents a literature study on the diagnostic debate of PCOS. The literature study includes a discussion of the recent Rotterdam consensus statement regarding the diagnosis of PCOS. This is followed by a discussion on the essential work-up of the patient presenting with PCOS. Finally, chapter 1 presents a discussion on the complexity of the different variations in women presenting with PCOS. Chapter 2 is a literature review on ovulation induction methods in patients who present with PCOS. This literature study puts special emphasis on the different available methods used for ovulation induction in women with PCOS and the profounding effect weight loss will have in managing these patients. This chapter also addresses the use of newer agents, like aromatase inhibitors (Letrozole), and the current role of each of these agents in ovulation induction protocols. Chapter 3 is a literature overview on the effect of Metformin in Clomiphene-resistant PCOS women. The inclusion criteria of this review was all prospective randomized trials where Metformin was added for ovulation in the Clomiphene-resistant PCOS patient. The data is presented as a metaanalysis. Chapter 4 is a prospective randomise control trial to evaluate the benefit of metformin if added to Clomiphene in a primary ovulation induction protocol in comparison to Clomiphene alone. This chapter also evaluates all factors influencing ovulation outcome. Finally in the discussion section all the recent studies published addressing this topic were reviewed. Chapter 5 is a literature review to evaluate the classification systems for semen parameters and the in vivo fertility potential. This data is also used to establish fertility/subfertility thresholds for semen parameters. This chapter also presents the results of a prospective and retrospective study of the semen analysis of the partners of women with PCOS. We believe that this population presents the best reference group to study the semen profile of the general male population. Chapter 6 is a summary of the results of these studies and serves as an evidence based approach for ovulation induction in women with PCOS.