Showing papers by "Alice D. Domar published in 2014"

The impact of lifestyle behaviors on infertility treatment outcome.

Abstract: Purpose of reviewThe impact of lifestyle behaviors on fertility is poorly understood, as is the impact of specific behaviors on the advanced reproductive technologies. It is vital for healthcare professionals to understand which lifestyle behaviors can have the greatest negative impact in an effort

Patients' administration preferences: progesterone vaginal insert (Endometrin®) compared to intramuscular progesterone for Luteal phase support.

Abstract: Administration of exogenous progesterone for luteal phase support has become a standard of practice. Intramuscular (IM) injections of progesterone in oil (PIO) and vaginal administration of progesterone are the primary routes of administration. This report describes the administration preferences expressed by women with infertility that were given progesterone vaginal insert (PVI) or progesterone in oil injections (PIO) for luteal phase support during fresh IVF cycles. A questionnaire to assess the tolerability, convenience, and ease of administration of PVI and PIO given for luteal phase support was completed by infertile women diagnosed with PCOS and planning to undergo IVF. The women participated in an open-label study of highly purified human menopausal gonadotropins (HP-hMG) compared with recombinant FSH (rFSH) given for stimulation of ovulation. Most women commented on the convenience and ease of administration of PVI, while a majority of women who administered IM PIO described experiencing pain. In addition, their partners often indicated that they had experienced at least some anxiety regarding the administration of PIO. The most distinguishing difference between PVI and PIO in this study was the overall patient preference for PVI. Despite the need to administer PVI either twice a day or three times a day, 82.6% of the patients in the PVI group found it “very” or “somewhat convenient” compared with 44.9% of women in the PIO group. The results of this comprehensive, prospective patient survey, along with findings from other similar reports, suggest that PVI provides an easy-to-use and convenient method for providing the necessary luteal phase support for IVF cycles without the pain and inconvenience of daily IM PIO. Moreover, ongoing pregnancy rates with the well-tolerated PVI were as good as the pregnancy rates with PIO. ClinicalTrial.gov, NCT00805935

The Role of the Mental Health Professional in the ART Clinic Setting

Abstract: Many mental health professionals (MHPs) in the ART clinic setting spend most or all of their time on third party evaluations. However, there is a far larger role for the MHP. The MHP can work with patients to treat and limit their distress, making the experience easier for patients, while potentially increasing pregnancy rates and decreasing dropouts. The MHP can also support nurses, to limit burnout. Finally, the MHP can work with the health care team to teach them empathic communication, which leads to increased patient-centered care.