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1. The Relation between Patient-Centered Care and Quality of Life in Women with Endometriosis.

Author

Schreurs, A.M.F., Dancet, E.A.F., Apers, S., Kuchenbecker, W. K. H., Ven, P.M. van de, Maas, J.W.M., Lambalk, C.B., Nelen, W.L.D.M., Houwen, L.E.E. van der, Mijatovic, V, Schreurs, A.M.F., Dancet, E.A.F., Apers, S., Kuchenbecker, W. K. H., Ven, P.M. van de, Maas, J.W.M., Lambalk, C.B., Nelen, W.L.D.M., Houwen, L.E.E. van der, and Mijatovic, V

Abstract

Contains fulltext : 296142.pdf (Publisher’s version ) (Open Access), OBJECTIVE: The objective of this study was to examine the hypothesis that experiences with patient-centered endometriosis care are related to the endometriosis-specific quality of life dimensions "emotional well-being" and "social support." DESIGN: A secondary regression analysis of two cross-sectional studies was conducted. Participants/Materials: In total, data from 300 women were eligible for analysis. The participating women all had surgically proven endometriosis. SETTING: The study was conducted in one secondary and two tertiary endometriosis clinics in the Netherlands. Questionnaires were disseminated between 2011 and 2016. METHODS: Both included studies investigated patient-centeredness of endometriosis care and endometriosis-specific quality of life using, respectively, the ENDOCARE questionnaire (ECQ) and the Endometriosis Health Profile 30 (EHP-30). To increase power, the regression analysis focused on the previously found relation between the ten dimensions of the ECQ and the EHP-30 domains "emotional well-being" and "social support" rather than all five EHP-30 domains. After the Bonferroni correction to limit type 1 errors, the adjusted p value was 0.003 (0.05/20). RESULTS: The participating women had a mean age of 35.7 years and had predominantly been diagnosed with moderate to severe endometriosis. None of the relations between patient-centered endometriosis care and the EHP-30 domain "emotional well-being" were significant. Three dimensions of patient-centered endometriosis care proved to be significantly related to the EHP-30 domain "social support": "information, communication, and education" (p < 0.001, beta = 0.436), "coordination and integration of care" (p = 0.001, beta = 0.307), and "emotional support and alleviation of fear and anxiety" (p = 0.002, beta = 0.259). LIMITATIONS: This cross-sectional study identified relations rather than proving causality between experiencing less patient-centeredness of care and having lower quality of life.

Published
2023

6. The cost-effectiveness of transvaginal hydrolaparoscopy versus hysterosalpingography in the work-up for subfertility.

Author

Kessel, M A van, Pham, C T, Tros, R, Oosterhuis, G J E, Kuchenbecker, W K H, Bongers, M Y, Mol, B W J, Koks, C A M, and van Kessel, M A

Subjects
HYSTEROSALPINGOGRAPHY, EVALUATION research, INFERTILITY, COST benefit analysis, PREGNANCY outcomes, RANDOMIZED controlled trials, BIRTH rate, RESEARCH, RESEARCH methodology, COMPARATIVE studies
Abstract

Study Question: Is a strategy starting with transvaginal hydrolaparoscopy (THL) cost-effective compared to a strategy starting with hysterosalpingography (HSG) in the work-up for subfertility?Summary Answer: A strategy starting with THL is cost-effective compared to a strategy starting with HSG in the work-up for subfertile women.What Is Known Already: Tubal pathology is a common cause of subfertility and tubal patency testing is one of the cornerstones of the fertility work-up. Both THL and HSG are safe procedures and can be used as a first-line tubal patency test.Study Design, Size, Duration: This economic evaluation was performed alongside a randomized clinical trial comparing THL and HSG in 300 subfertile women, between May 2013 and October 2016. For comparisons of THL and HSG, the unit costs were split into three main categories: costs of the diagnostic procedure, costs of fertility treatments and the costs for pregnancy outcomes.Participants/materials, Setting, Methods: Subfertile women scheduled for tubal patency testing were eligible. Women were randomized to a strategy starting with THL or a strategy starting with HSG. The primary outcome of the study was conception leading to a live birth within 24 months after randomization. The mean costs and outcomes for each treatment group were compared. We used a non-parametric bootstrap resampling of 1000 re-samples to investigate the effect of uncertainty and we created a cost-effectiveness plane and cost-effectiveness acceptability curves.Main Results and the Role Of Chance: We allocated 149 women to THL and 151 to HSG, and we were able to achieve complete follow-up of 142 versus 148 women, respectively. After the fertility work-up women were treated according to the Dutch guidelines and based on a previously published prognostic model. In the THL group, 83 women (58.4%) conceived a live born child within 24 months after randomization compared to 82 women (55.4%) in the HSG group (difference 3.0% (95% CI: -8.3 to 14.4)). The mean total costs per woman were lower in the THL group compared to the HSG group (THL group €4991 versus €5262 in the HSG group, mean cost difference = -€271 (95% CI -€273 to -€269)). Although the costs of only the diagnostic procedure were higher in the THL group, in the HSG group more women underwent diagnostic and therapeutic laparoscopies and also had higher costs for fertility treatments.Limitations, Reasons For Caution: Our trial was conducted in women with a low risk of tubal pathology; therefore, the results of our study are not generalizable to women with high risk of tubal pathology. Furthermore, this economic analysis was based on the Dutch healthcare system, and possibly our results are not generalizable to countries with different strategies or costs for fertility treatments.Wider Implications Of the Findings: After 2 years of follow-up, we found a live birth rate of 58.4% in the THL group versus 55.4% in the HSG group and a lower mean cost per woman in the THL group, with a cost difference of -€271. The findings of our trial suggest that a strategy starting with THL is cost-effective compared to a strategy starting with HSG in the workup for subfertile women. However, the cost difference between the two diagnostic strategies is limited compared to the total cost per woman in our study and before implementing THL as a first-line strategy for tubal patency testing, more research in other fields, such as patient preference and acceptance, is necessary.Study Funding/competing Interest(s): The authors received no external financial support for the research. B.W.J.M. is supported by an NHMRC Investigator Grant (GNT1176437). B.W.J.M. reports consultancy for ObsEva, Merck KGaA, Guerbet. B.W.J.M. reports receiving travel support from Merck KGaA. C.T.P. reports consultancy for Guerbet, outside of this manuscript. All other authors have no conflicts to declare.Trial Registration Number: NTR3462. [ABSTRACT FROM AUTHOR]

Published
2022
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8. Determinants of successful lifestyle change during a 6-month preconception lifestyle intervention in women with obesity and infertility

Author

Karsten, Matty D. A., van Oers, Anne M., Groen, Henk, Mutsaerts, Meike A. Q., van Poppel, Mireille N. M., Geelen, Anouk, van de Beek, Cornelieke, Painter, Rebecca C., Mol, Ben W. J., Roseboom, Tessa J., Hoek, Annemieke, Burggraaff, J. M., Kuchenbecker, W. K. H., Perquin, D. A. M., Koks, C. A. M., van Golde, R., Kaaijk, E. M., Schierbeek, J. M., Oosterhuis, G. J. E., Broekmans, F. J., Vogel, N. E. A., Lambalk, C. B., van der Veen, F., Klijn, N. F., Mercelina, P. E. A. M., van Kasteren, Y. M., Nap, A. W., Mulder, R. J. A. B., Gondrie, E. T. C. M., de Bruin, J. P., Obstetrie & Gynaecologie, MUMC+: MA Medische Staf Obstetrie Gynaecologie (9), RS: GROW - R4 - Reproductive and Perinatal Medicine, Reproductive Origins of Adult Health and Disease (ROAHD), Value, Affordability and Sustainability (VALUE), Public and occupational health, Pediatric surgery, Obstetrics and gynaecology, Amsterdam Reproduction & Development (AR&D), ACS - Atherosclerosis & ischemic syndromes, Amsterdam Neuroscience - Cellular & Molecular Mechanisms, Plastic, Reconstructive and Hand Surgery, APH - Aging & Later Life, APH - Health Behaviors & Chronic Diseases, Graduate School, Obstetrics and Gynaecology, and Epidemiology and Data Science

Subjects
Counseling, Male, 0301 basic medicine, Gerontology, Lifestyle intervention, DIABETES PREVENTION PROGRAM, TERM WEIGHT-LOSS, Nutrition and Disease, Psychological intervention, Medicine (miscellaneous), Overweight, 0302 clinical medicine, Weight loss, Voeding en Ziekte, SOCIOECONOMIC-STATUS, PREDICTORS, Determinants, Nutrition and Dietetics, Preconception, Original Contribution, 3. Good health, Weight Reduction Programs, PREGNANCY, Female, medicine.symptom, Adult, Infertility, Adolescent, 030209 endocrinology & metabolism, HEALTH BEHAVIOR, Health Promotion, CLASSIFICATION, Young Adult, 03 medical and health sciences, Intervention (counseling), Weight Loss, CORONARY RISK-FACTORS, medicine, Humans, Obesity, Exercise, Life Style, Socioeconomic status, VLAG, Pregnancy, 030109 nutrition & dietetics, OVERWEIGHT, business.industry, Feeding Behavior, ADULTS, medicine.disease, business, Program Evaluation
Abstract

Purpose To identify demographic, (bio)physical, behavioral, and psychological determinants of successful lifestyle change and program completion by performing a secondary analysis of the intervention arm of a randomized-controlled trial, investigating a preconception lifestyle intervention. Methods The 6-month lifestyle intervention consisted of dietary counseling, physical activity, and behavioral modification, and was aimed at 5–10% weight loss. We operationalized successful lifestyle change as successful weight loss (≥ 5% weight/BMI ≤ 29 kg/m2), weight loss in kilograms, a reduction in energy intake, and an increase in physical activity during the intervention program. We performed logistic and mixed-effect regression analyses to identify baseline factors that were associated with successful change or program completion. Results Women with higher external eating behavior scores had higher odds of successful weight loss (OR 1.10, 95% CI 1.05–1.16). Women with the previous dietetic support lost 0.94 kg less during the intervention period (95% CI 0.01–1.87 kg). Women with higher self-efficacy reduced energy intake more than women with lower self-efficacy (p

Published
2019

10. P–633 lifestyle intervention prior to IVF does not improve embryo utilization rate and cumulative live birth rate in women with obesity

Author

Wang, Z, primary, Groen, H, additional, Va. Zomeren1, K C, additional, Cantineau, A E P, additional, Va. Oers, A, additional, Va. Montfoort, A P A, additional, Kuchenbecker, W K H, additional, Pelinck, M J, additional, Broekmans, F J, additional, Klijn, N F, additional, Kaaijk, E M, additional, Mol, B W J, additional, Hoek, A, additional, and Echten-Arends, J Va, additional

Published
2021
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11. Septum resection in women with a septate uterus

Author

Rikken, J.F.W., Verhorstert, K.W.J., Emanuel, M.H., Bongers, M.Y., Spinder, T., Kuchenbecker, W., Jansen, F.W., Steeg, J.W. van der, Janssen, C.A.H., Kapiteijn, K., Schols, W.A., Torrenga, B., Torrance, H.L., Verhoeve, H.R., Huirne, J.A.F., Hoek, A., Nieboer, T.E., Rooij, I.A.J. van, Clark, T.J., Robinson, L., Stephenson, M.D., Mol, B.W.J., Veen, F. van der, Wely, M. van, and Goddijn, M.

Published
2020

12. Erratum: Septum resection in women with a septate uterus: A cohort study (Human Reproduction (2020) 35:7 (1722) DOI: 10.1093/humrep/deaa1722)

Author

Rikken, J. F.W., Verhorstert, K. W.J., Emanuel, M. H., Bongers, M. Y., Spinder, T., Kuchenbecker, W. K.H., Jansen, F. W., van der Steeg, J. W., Janssen, C. A.H., Kapiteijn, K., Schols, W. A., Torrenga, B., Torrance, H. L., Verhoeve, H. R., Huirne, J. A.F., Hoek, A., Nieboer, T. E., van Rooij, I. A.J., Clark, T. J., Robinson, L., Stephenson, M. D., Mol, B. W.J., van der Veen, F., van Wely, M., Goddijn, M., Center for Reproductive Medicine, APH - Methodology, APH - Personalized Medicine, and ARD - Amsterdam Reproduction and Development

Abstract

The authors of the above article would like to apologise for an error in one of the authors' names. W. Kuchenbecker should be W.K.H. Kuchenbecker, as above. The electronic version of this article has been updated at https:// doi.org/10.1093/humrep/dez284. The print version is correct. The Authors would like to assure readers that this does not affect any other content of the article.

Published
2020

13. Towards more patient-centred endometriosis care: a cross-sectional survey using the ENDOCARE questionnaire

Author

Schreurs, A.M.F., Hoefen Wijsard, M. van, Dancet, Eline A. F., Apers, S., Kuchenbecker, W. K. H., Ven, P.M. van de, Nelen, W.L.D.M., Houwen, L.E.E. van der, Mijatovic, V, Schreurs, A.M.F., Hoefen Wijsard, M. van, Dancet, Eline A. F., Apers, S., Kuchenbecker, W. K. H., Ven, P.M. van de, Nelen, W.L.D.M., Houwen, L.E.E. van der, and Mijatovic, V

Abstract

Contains fulltext : 245136.pdf (Publisher’s version ) (Open Access)

Published
2020

14. Septum resection in women with a septate uterus: a cohort study

Author

Rikken, J.F.W., Verhorstert, K.W.J., Emanuel, M.H., Bongers, M.Y., Spinder, T., Kuchenbecker, W., Jansen, F.W., Steeg, J.W. van der, Janssen, C.A.H., Kapiteijn, K., Schols, W.A., Torrenga, B., Torrance, H.L., Verhoeve, H.R., Huirne, J.A., Hoek, A., Nieboer, T.E., Rooij, I.A.J. van, Clark, T.J., Robinson, L., Stephenson, M.D., Mol, B.W.J., Veen, F. van der, Wely, M. van, Goddijn, M., Rikken, J.F.W., Verhorstert, K.W.J., Emanuel, M.H., Bongers, M.Y., Spinder, T., Kuchenbecker, W., Jansen, F.W., Steeg, J.W. van der, Janssen, C.A.H., Kapiteijn, K., Schols, W.A., Torrenga, B., Torrance, H.L., Verhoeve, H.R., Huirne, J.A., Hoek, A., Nieboer, T.E., Rooij, I.A.J. van, Clark, T.J., Robinson, L., Stephenson, M.D., Mol, B.W.J., Veen, F. van der, Wely, M. van, and Goddijn, M.

Abstract

Contains fulltext : 225382.pdf (Publisher’s version ) (Open Access), STUDY QUESTION: Does septum resection improve reproductive outcomes in women with a septate uterus? SUMMARY ANSWER: In women with a septate uterus, septum resection does not increase live birth rate nor does it decrease the rates of pregnancy loss or preterm birth, compared with expectant management. WHAT IS KNOWN ALREADY: The septate uterus is the most common uterine anomaly with an estimated prevalence of 0.2-2.3% in women of reproductive age, depending on the classification system. The definition of the septate uterus has been a long-lasting and ongoing subject of debate, and currently two classification systems are used worldwide. Women with a septate uterus may be at increased risk of subfertility, pregnancy loss, preterm birth and foetal malpresentation. Based on low quality evidence, current guidelines recommend removal of the intrauterine septum or, more cautiously, state that the procedure should be evaluated in future studies. STUDY DESIGN, SIZE, DURATION: We performed an international multicentre cohort study in which we identified women mainly retrospectively by searching in electronic patient files, medical records and databases within the time frame of January 2000 until August 2018. Searching of the databases, files and records took place between January 2016 and July 2018. By doing so, we collected data on 257 women with a septate uterus in 21 centres in the Netherlands, USA and UK. PARTICIPANTS/MATERIALS, SETTING, METHODS: We included women with a septate uterus, defined by the treating physician, according to the classification system at that time. The women were ascertained among those with a history of subfertility, pregnancy loss, preterm birth or foetal malpresentation or during a routine diagnostic procedure. Allocation to septum resection or expectant management was dependent on the reproductive history and severity of the disease. We excluded women who did not have a wish to conceive at time of diagnosis. The primary outcome was live birth.

Published
2020

15. Septum resection in women with a septate uterus: A cohort study.

Author

Goddijn M., van Rooij I.A.J., Clark T.J., Robinson L., Stephenson M.D., Mol B.W.J., van der Veen F., van Wely M., Rikken J.F.W., Verhorstert K.W.J., Emanuel M.H., Bongers M.Y., Spinder T., Kuchenbecker W., Jansen F.W., van der Steeg J.W., Janssen C.A.H., Kapiteijn K., Schols W.A., Torrenga B., Torrance H.L., Verhoeve H.R., Huirne J.A.F., Hoek A., Nieboer T.E., Goddijn M., van Rooij I.A.J., Clark T.J., Robinson L., Stephenson M.D., Mol B.W.J., van der Veen F., van Wely M., Rikken J.F.W., Verhorstert K.W.J., Emanuel M.H., Bongers M.Y., Spinder T., Kuchenbecker W., Jansen F.W., van der Steeg J.W., Janssen C.A.H., Kapiteijn K., Schols W.A., Torrenga B., Torrance H.L., Verhoeve H.R., Huirne J.A.F., Hoek A., and Nieboer T.E.

Abstract

STUDY QUESTION: Does septum resection improve reproductive outcomes in women with a septate uterus? SUMMARY ANSWER: In women with a septate uterus, septum resection does not increase live birth rate nor does it decrease the rates of pregnancy loss or preterm birth, compared with expectant management. WHAT IS KNOWN ALREADY: The septate uterus is the most common uterine anomaly with an estimated prevalence of 0.2-2.3% in women of reproductive age, depending on the classification system. The definition of the septate uterus has been a long-lasting and ongoing subject of debate, and currently two classification systems are used worldwide. Women with a septate uterus may be at increased risk of subfertility, pregnancy loss, preterm birth and foetal malpresentation. Based on low quality evidence, current guidelines recommend removal of the intrauterine septum or, more cautiously, state that the procedure should be evaluated in future studies. STUDY DESIGN, SIZE, DURATION: We performed an international multicentre cohort study in which we identified women mainly retrospectively by searching in electronic patient files, medical records and databases within the time frame of January 2000 until August 2018. Searching of the databases, files and records took place between January 2016 and July 2018. By doing so, we collected data on 257 women with a septate uterus in 21 centres in the Netherlands, USA and UK. PARTICIPANTS/MATERIALS, SETTING, METHODS: We included women with a septate uterus, defined by the treating physician, according to the classification system at that time. The women were ascertained among those with a history of subfertility, pregnancy loss, preterm birth or foetal malpresentation or during a routine diagnostic procedure. Allocation to septum resection or expectant management was dependent on the reproductive history and severity of the disease. We excluded women who did not have a wish to conceive at time of diagnosis. The primary outcome was live birth.

Published
2020

16. Erratum: Septum resection in women with a septate uterus: A cohort study (Human Reproduction (2020) 35:7 (1722) DOI: 10.1093/humrep/deaa1722).

Author

Jansen F.W., Rikken J.F.W., Verhorstert K.W.J., Emanuel M.H., Bongers M.Y., Spinder T., Kuchenbecker W., van der Steeg J.W., Janssen C.A.H., Kapiteijn K., Schols W.A., Torrenga B., Torrance H.L., Verhoeve H.R., Huirne J.A.F., Hoek A., Nieboer T.E., van Rooij I.A.J., Clark T.J., Robinson L., Stephenson M.D., Mol B.W.J., van der Veen F., van Wely M., Goddijn M., Jansen F.W., Rikken J.F.W., Verhorstert K.W.J., Emanuel M.H., Bongers M.Y., Spinder T., Kuchenbecker W., van der Steeg J.W., Janssen C.A.H., Kapiteijn K., Schols W.A., Torrenga B., Torrance H.L., Verhoeve H.R., Huirne J.A.F., Hoek A., Nieboer T.E., van Rooij I.A.J., Clark T.J., Robinson L., Stephenson M.D., Mol B.W.J., van der Veen F., van Wely M., and Goddijn M.

Abstract

The authors of the above article would like to apologise for an error in one of the authors' names. W. Kuchenbecker should be W.K.H. Kuchenbecker, as above. The electronic version of this article has been updated at https:// doi.org/10.1093/humrep/dez284. The print version is correct. The Authors would like to assure readers that this does not affect any other content of the article.Copyright © The Author(s) 2020.

Published
2020

17. Transvaginal hydrolaparoscopy and laparoscopy.

Author

Bongers M., Mol B.W., Koks C., Tros R., van Kessel M., Oosterhuis J., Kuchenbecker W., Bongers M., Mol B.W., Koks C., Tros R., van Kessel M., Oosterhuis J., and Kuchenbecker W.

Abstract

Research question: To evaluate the findings of outpatient transvaginal hydrolaparoscopy (THL) in comparison with diagnostic laparoscopy combined with chromopertubation in subfertile women. Design(s): In a retrospective study in four large teaching hospitals, all subfertile women who underwent a THL and a conventional laparoscopy as part of their fertility work-up in the period between 2000 and 2011 were studied. Findings at THL were compared with findings at diagnostic and therapeutic laparoscopies. Tubal occlusion, endometriosis and adhesions were defined as abnormalities. Result(s): Out of 1119 women, 1103 women underwent THL. A complete evaluation or incomplete but diagnostic procedure could be performed in 989 (89.7%) and 28 (2.5%), respectively. An incomplete non-diagnostic procedure was performed in 11 (1.0%) women. Failure of THL occurred in 75 women (6.8%) and 40 of these women (3.6%) subsequently underwent laparoscopy. Laparoscopy was performed in a total of 126 patients with a median time interval of 7 weeks (interquartile range [IQR] 3-13 weeks). Of 64 patients who successfully underwent both THL and laparoscopy, concordant findings were found in 53 women and discordant results in 11 women, 6 of which were caused by tubal spasm. Sensitivity of THL in detecting abnormalities was 100% and specificity was 22.2%, with a likelihood ratio of 1.29. Conclusion(s): THL in an outpatient setting can detect anatomical abnormalities comparable to the more invasive reference standard diagnostic laparoscopy. If THL succeeds, there is no need to add a diagnostic laparoscopy in the work-up.Copyright © 2019 Reproductive Healthcare Ltd.

Published
2020

18. Septum resection in women with a septate uterus: a cohort study

Author

MS VPG/Gynaecologie, Child Health, Arts-assistenten Kinderen, Anatomie, Fertiliteitartsen, Rikken, J F W, Verhorstert, K W J, Emanuel, M H, Bongers, M Y, Spinder, T, Kuchenbecker, W, Jansen, F W, van der Steeg, J W, Janssen, C A H, Kapiteijn, K, Schols, W A, Torrenga, B, Torrance, H L, Verhoeve, H R, Huirne, J A F, Hoek, A, Nieboer, T E, van Rooij, I A J, Clark, T J, Robinson, L, Stephenson, M D, Mol, B W J, van der Veen, F, van Wely, M, Goddijn, M, MS VPG/Gynaecologie, Child Health, Arts-assistenten Kinderen, Anatomie, Fertiliteitartsen, Rikken, J F W, Verhorstert, K W J, Emanuel, M H, Bongers, M Y, Spinder, T, Kuchenbecker, W, Jansen, F W, van der Steeg, J W, Janssen, C A H, Kapiteijn, K, Schols, W A, Torrenga, B, Torrance, H L, Verhoeve, H R, Huirne, J A F, Hoek, A, Nieboer, T E, van Rooij, I A J, Clark, T J, Robinson, L, Stephenson, M D, Mol, B W J, van der Veen, F, van Wely, M, and Goddijn, M

Published
2020

19. Septum Resection in Women With a Septate Uterus: A Cohort Study

Author

Rikken, J. F. W., primary, Verhorstert, K. W. J., additional, Emanuel, M. H., additional, Bongers, M. Y., additional, Spinder, T., additional, Kuchenbecker, W., additional, Jansen, F. W., additional, van der Steeg, J. W., additional, Janssen, C. A. H., additional, Kapiteijn, K., additional, Schols, W. A., additional, Torrenga, B., additional, Torrance, H. L., additional, Verhoeve, H. R., additional, Huirne, J. A. F., additional, Hoek, A., additional, Nieboer, T. E., additional, van Rooij, I. A. J., additional, Clark, T. J., additional, Robinson, L., additional, Stephenson, M. D., additional, Mol, B. W. J., additional, van der Veen, F., additional, van Wely, M., additional, and Goddijn, M., additional

Published
2021
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20. Corrigendum. Septum resection in women with a septate uterus: a cohort study

Author

Rikken, J F W, primary, Verhorstert, K W J, additional, Emanuel, M H, additional, Bongers, M Y, additional, Spinder, T, additional, Kuchenbecker, W K H, additional, Jansen, F W, additional, van der Steeg, J W, additional, Janssen, C A H, additional, Kapiteijn, K, additional, Schols, W A, additional, Torrenga, B, additional, Torrance, H L, additional, Verhoeve, H R, additional, Huirne, J A F, additional, Hoek, A, additional, Nieboer, T E, additional, van Rooij, I A J, additional, Clark, T J, additional, Robinson, L, additional, Stephenson, M D, additional, Mol, B W J, additional, van der Veen, F, additional, van Wely, M, additional, and Goddijn, M, additional

Published
2020
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21. Septum resection in women with a septate uterus: a cohort study

Author

Rikken, J F W, primary, Verhorstert, K W J, additional, Emanuel, M H, additional, Bongers, M Y, additional, Spinder, T, additional, Kuchenbecker, W, additional, Jansen, F W, additional, van der Steeg, J W, additional, Janssen, C A H, additional, Kapiteijn, K, additional, Schols, W A, additional, Torrenga, B, additional, Torrance, H L, additional, Verhoeve, H R, additional, Huirne, J A F, additional, Hoek, A, additional, Nieboer, T E, additional, van Rooij, I A J, additional, Clark, T J, additional, Robinson, L, additional, Stephenson, M D, additional, Mol, B W J, additional, van der Veen, F, additional, van Wely, M, additional, and Goddijn, M, additional

Published
2020
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23. A systematic review and secondary analysis of two studies identifying demographic and medical characteristics determining patient-centeredness in endometriosis care as experienced by patients

Author

Schreurs, A M F, primary, Dancet, E A F, additional, Apers, S, additional, van Hoefen Wijsard, M, additional, Kuchenbecker, W K H, additional, van de Ven, P M, additional, Lambalk, C B, additional, Nelen, W L D M, additional, van der Houwen, L E E, additional, and Mijatovic, V, additional

Published
2020
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24. Uterine bathing with sonography gel prior to IVF/ICSI-treatment in patients with endometriosis, a multicentre randomised controlled trial

Author

Lier, M C I, primary, Özcan, H, additional, Schreurs, A M F, additional, van de Ven, P M, additional, Dreyer, K, additional, van der Houwen, L E E, additional, Johnson, N P, additional, Vandekerckhove, F, additional, Verhoeve, H R, additional, Kuchenbecker, W, additional, Mol, B W, additional, Lambalk, C B, additional, and Mijatovic, V, additional

Published
2020
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25. Determinants of successful lifestyle change during a 6-month preconception lifestyle intervention in women with obesity and infertility

Author

MS Verloskunde, MS VPG/Gynaecologie, UMC Utrecht, Child Health, Circulatory Health, Karsten, Matty D.A., van Oers, Anne M., Groen, Henk, Mutsaerts, Meike A.Q., van Poppel, Mireille N.M., Geelen, Anouk, van de Beek, Cornelieke, Painter, Rebecca C., Mol, Ben W.J., Roseboom, Tessa J., Hoek, Annemieke, Burggraaff, J. M., Kuchenbecker, W. K.H., Perquin, D. A.M., Koks, C. A.M., van Golde, R., Kaaijk, E. M., Schierbeek, J. M., Oosterhuis, G. J.E., Broekmans, F. J., Vogel, N. E.A., Lambalk, C. B., van der Veen, F., Klijn, N. F., Mercelina, P. E.A.M., van Kasteren, Y. M., Nap, A. W., Mulder, R. J.A.B., Gondrie, E. T.C.M., de Bruin, J. P., the LIFEstyle study group, MS Verloskunde, MS VPG/Gynaecologie, UMC Utrecht, Child Health, Circulatory Health, Karsten, Matty D.A., van Oers, Anne M., Groen, Henk, Mutsaerts, Meike A.Q., van Poppel, Mireille N.M., Geelen, Anouk, van de Beek, Cornelieke, Painter, Rebecca C., Mol, Ben W.J., Roseboom, Tessa J., Hoek, Annemieke, Burggraaff, J. M., Kuchenbecker, W. K.H., Perquin, D. A.M., Koks, C. A.M., van Golde, R., Kaaijk, E. M., Schierbeek, J. M., Oosterhuis, G. J.E., Broekmans, F. J., Vogel, N. E.A., Lambalk, C. B., van der Veen, F., Klijn, N. F., Mercelina, P. E.A.M., van Kasteren, Y. M., Nap, A. W., Mulder, R. J.A.B., Gondrie, E. T.C.M., de Bruin, J. P., and the LIFEstyle study group

Published
2019

26. Determinants of patients' experiences with patientcenteredness in endometriosis care

Author

Schreurs, A, Nelen, W, Kuchenbecker, W, Van De Ven, P, Van Der Houwen, L, Dancet, E, Apers, S, Lambalk, C, Mijatovic, V, Obstetrics and gynaecology, CCA - Imaging and biomarkers, Amsterdam Reproduction & Development (AR&D), APH - Methodology, ACS - Heart failure & arrhythmias, Epidemiology and Data Science, CCA - Cancer Treatment and quality of life, ACS - Atherosclerosis & ischemic syndromes, Amsterdam Neuroscience - Cellular & Molecular Mechanisms, and CCA - Cancer biology and immunology

Abstract

Study question: Which demographic and medical characteristics of woman are associated with their assessment of patient-centeredness in endometriosis care? Summary answer: A lower educational level, dyspareunia and membership of a patient-organization were found to be independently associated with patient-centeredness as experienced by women in endometriosis care. What is known already: Patient-centered care (PCC) is one of the six dimensions of quality of care. Indeed, focusing on improving patients' experiences with patient-centered care is necessary to improve quality of care. The patientcenteredness of endometriosis care can be measured with the validated and reliable Endocare Questionnaire (ECQ), generating patient-centeredness scores (PCS). Those PCS can subsequently facilitate the development of care improvement projects. A previous study found that a lower educational level was correlated with a higher overall PCS in patients from solely two tertiary clinics. Study design, size, duration: A cross-sectional study was conducted in surgically diagnosed patients with endometriosis. A total of 401 patients were eligible and received the ECQ in 2015 and 2016 and, if needed, two reminders were sent. Participants/materials, setting, methods: All patients were selected from a Dutch tertiary and a Dutch secondary clinic. All 401 patients underwent endometriosis surgery between 2013 and 2014. Univariate and multivariate regression analyses with a forward elimination procedure were conducted to identify variables associated with PCC. Main results and the role of chance: The overall response rate was 56.9%. In total, data from 209 patients was eligible for analysis. Univariate analyses showed 'educational level', 'membership of a patient organization', 'child wish in the future', 'subfertility', 'dysmenorrhea', 'dyspareunia', 'chronic pelvic pain' and 'the degree of which disease is suppressed' as potential determinants of PCC (all p

Published
2017

27. The tap test- an accurate First-line test for fetal lung maturity testing

Author

Kuchenbecker, W K H, Pistorius, L R, and Pattinson, R C

Abstract

Objective. To determine the accuracy of near-patient and laboratory- based fetal lung maturity tests in predicting the need for neonatal ventilation.Design. A prospective descriptive study. Subjects. One hundred high-risk obstetric patients where confirmation of fetal lung maturity would initiate delivery.Methods. Fetal weight estimation, placental maturity grading, and amniocentesis were performed. The investigators examined the amniotic fluid visually, and performed the tap test and shake test. Laboratory technicians estimated the lecithin-sphingomyelin (L/S) ratio, determined the presence of a phosphatidyl glycerol (PG) band on gel electrophoresis, and the optical density at 650 nm. Neonates delivered within 1 week of amniocentesis were included in the analysis. The primary end-point was the ability of the lung maturity tests to predict the need for neonatal ventilation.Results. Twelve of 100 neonates required ventilation. The tap test and optical density (OD) shift at 650 nm predicted the need for neonatal ventilation with the greatest accuracy.Conclusion. The tap test is a rapid, easy and accurate predictor of the need for neonatal ventilation. The OD shift at 650 nm is the laboratory-based test with the greatest accuracy in our setting.

Published
2016

28. Effectiveness of lifestyle intervention in subgroups of obese infertile women : a subgroup analysis of a RCT

Author

Oers, A. M., Henk Groen, Mutsaerts, M. A. Q., Burggraaff, J. M., Kuchenbecker, W. K. H., Perquin, D. A. M., Koks, C. A. M., Golde, R., Kaaijk, E. M., Schierbeek, J. M., Oosterhuis, G. J. E., Broekmans, F. J., Vogel, N. E. A., Land, J. A., Mol, B. W. J., Hoek, A., and LIFEstyle study group

Subjects
Journal Article
Abstract

STUDY QUESTION: Do age, ovulatory status, severity of obesity and body fat distribution affect the effectiveness of lifestyle intervention in obese infertile women? SUMMARY ANSWER: We did not identify a subgroup in which lifestyle intervention increased the healthy live birth rate however it did increase the natural conception rate in anovulatory obese infertile women. WHAT IS KNOWN ALREADY: Obese women are at increased risk of infertility and are less likely to conceive after infertility treatment. We previously demonstrated that a 6-month lifestyle intervention preceding infertility treatment did not increase the rate of healthy live births (vaginal live birth of a healthy singleton at term) within 24 months of follow-up as compared to prompt infertility treatment in obese infertile women. Natural conceptions occurred more frequently in women who received a 6-month lifestyle intervention preceding infertility treatment. STUDY DESIGN, SIZE, DURATION: This is a secondary analysis of a multicentre RCT (randomized controlled trial), the LIFEstyle study. Between 2009 and 2012, 577 obese infertile women were randomly assigned to a 6-month lifestyle intervention followed by infertility treatment (intervention group) or to prompt infertility treatment (control group). Subgroups were predefined in the study protocol, based on frequently used cut-off values in the literature: age (≥36 or

Published
2016

29. Hysteroscopic resection of a uterine caesarean scar defect (niche) in women with postmenstrual spotting: a randomised controlled trial

Author

Vervoort, AJMW, primary, van der Voet, LF, additional, Hehenkamp, WJK, additional, Thurkow, AL, additional, van Kesteren, PJM, additional, Quartero, H, additional, Kuchenbecker, W, additional, Bongers, M, additional, Geomini, P, additional, de Vleeschouwer, LHM, additional, van Hooff, MHA, additional, van Vliet, H, additional, Veersema, S, additional, Renes, WB, additional, Oude Rengerink, K, additional, Zwolsman, SE, additional, Brölmann, HAM, additional, Mol, BWJ, additional, and Huirne, JAF, additional

Published
2017
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30. Effectiveness of lifestyle intervention in subgroups of obese infertile women : a subgroup analysis of a RCT

Author

van Oers, A M, Groen, H, Mutsaerts, M A Q, Burggraaff, J M, Kuchenbecker, W K H, Perquin, D A M, Koks, C A M, van Golde, R, Kaaijk, E M, Schierbeek, J M, Oosterhuis, G J E, Broekmans, F J, Vogel, N E A, Land, J A, Mol, B W J, Hoek, A, LIFEstyle study group, van Oers, A M, Groen, H, Mutsaerts, M A Q, Burggraaff, J M, Kuchenbecker, W K H, Perquin, D A M, Koks, C A M, van Golde, R, Kaaijk, E M, Schierbeek, J M, Oosterhuis, G J E, Broekmans, F J, Vogel, N E A, Land, J A, Mol, B W J, Hoek, A, and LIFEstyle study group

Published
2016

31. Effectiveness of lifestyle intervention in subgroups of obese infertile women: a subgroup analysis of a RCT

Author

MS VPG/Gynaecologie, Circulatory Health, Child Health, van Oers, A M, Groen, H, Mutsaerts, M A Q, Burggraaff, J M, Kuchenbecker, W K H, Perquin, D A M, Koks, C A M, van Golde, R, Kaaijk, E M, Schierbeek, J M, Oosterhuis, G J E, Broekmans, F J, Vogel, N E A, Land, J A, Mol, B W J, Hoek, A, LIFEstyle study group, MS VPG/Gynaecologie, Circulatory Health, Child Health, van Oers, A M, Groen, H, Mutsaerts, M A Q, Burggraaff, J M, Kuchenbecker, W K H, Perquin, D A M, Koks, C A M, van Golde, R, Kaaijk, E M, Schierbeek, J M, Oosterhuis, G J E, Broekmans, F J, Vogel, N E A, Land, J A, Mol, B W J, Hoek, A, and LIFEstyle study group

Published
2016

32. Cost-effectiveness of a structured lifestyle program in overweight and obese subfertile women. Preliminary data from a randomised controlled trial - the LIFEstyle study

Author

van Oers, A. M., Mutsaerts, M. A. Q., Burggraaff, J. M., Kuchenbecker, W. K. H., Perquin, D. A. M., Koks, C. A. M., Van Golde, R., Kaaijk, E. M., Schierbeek, J. M., Oosterhuis, G. J. E., Broekmans, F. J., Land, J. A., Mol, B. W., Hoek, A., Groen, H., Reproductive Origins of Adult Health and Disease (ROAHD), and Methods in Medicines evaluation & Outcomes research (M2O)

Published
2014

33. The effectiveness of a structured lifestyle program in overweight and obese subfertile women. Preliminary data from a randomised controlled trial (LIFEstyle study)

Author

Mutsaerts, M. A. Q., Van Oers, A. M., Groen, H., Burggraaff, J. M., Kuchenbecker, W. K. H., Perquin, D. A. M., Koks, C. A. M., Van Golde, R., Kaaijk, E. M., Schierbeek, J. M., Oosterhuis, G. J. E., Broekmans, F. J., Land, J. A., Mol, B. W., Hoek, A., Methods in Medicines evaluation & Outcomes research (M2O), and Reproductive Origins of Adult Health and Disease (ROAHD)

Published
2014

34. ALIFE2 study: low-molecular-weight heparin for women with recurrent miscarriage and inherited thrombophilia - study protocol for a randomized controlled trial

Author

Jong, P.G. de, Quenby, S., Bloemenkamp, K.W., Braams-Lisman, B.A., Bruin, J.P. de, Coomarasamy, A., David, M., DeSancho, M.T., Heijden, O.W.H. van der, Hoek, A., Hutten, B.A., Jochmans, K., Koks, C.A., Kuchenbecker, W., Mol, B.W., Torrance, H.L., Scheepers, H.C., Stephenson, M.D., Verhoeve, H.R., Visser, J., Vries, J.I. de, Goddijn, M., Middeldorp, S., Jong, P.G. de, Quenby, S., Bloemenkamp, K.W., Braams-Lisman, B.A., Bruin, J.P. de, Coomarasamy, A., David, M., DeSancho, M.T., Heijden, O.W.H. van der, Hoek, A., Hutten, B.A., Jochmans, K., Koks, C.A., Kuchenbecker, W., Mol, B.W., Torrance, H.L., Scheepers, H.C., Stephenson, M.D., Verhoeve, H.R., Visser, J., Vries, J.I. de, Goddijn, M., and Middeldorp, S.

Abstract

Contains fulltext : 153200.pdf (publisher's version ) (Open Access), BACKGROUND: A large number of studies have shown an association between inherited thrombophilia and recurrent miscarriage. It has been hypothesized that anticoagulant therapy might reduce the number of miscarriages and stillbirth in these women. In the absence of randomized controlled trials evaluating the efficacy of anticoagulant therapy in women with inherited thrombophilia and recurrent miscarriage, a randomized trial with adequate power that addresses this question is needed. The objective of the ALIFE2 study is therefore to evaluate the efficacy of low-molecular-weight heparin (LMWH) in women with inherited thrombophilia and recurrent miscarriage, with live birth as the primary outcome. METHODS/DESIGN: Randomized study of LMWH plus standard pregnancy surveillance versus standard pregnancy surveillance alone. STUDY POPULATION: pregnant women of less than 7 weeks' gestation, and confirmed inherited thrombophilia with a history of 2 or more miscarriages or intra-uterine fetal deaths, or both. SETTING: multi-center study in centers from the Dutch Consortium of Fertility studies; centers outside the Netherlands are currently preparing to participate. INTERVENTION: LMWH enoxaparin 40 mg subcutaneously once daily started prior to 7 weeks gestational age plus standard pregnancy surveillance or standard pregnancy surveillance alone. Main study parameters/endpoints: the primary efficacy outcome is live birth. Secondary efficacy outcomes include adverse pregnancy outcomes, such as miscarriage, pre-eclampsia, syndrome of hemolysis, elevated liver enzymes and low platelets (HELLP syndrome), fetal growth restriction, placental abruption, premature delivery and congenital malformations. Safety outcomes include bleeding episodes, thrombocytopenia and skin reactions. DISCUSSION: After an initial period of slow recruitment, the recruitment rate for the study has increased. Improved awareness of the study and acknowledgement of the need for evidence are thought to be contributin

Published
2015

35. Effect of levothyroxine on live birth rate in euthyroid women with recurrent miscarriage and TPO antibodies (T4-LIFE study)

Author

Vissenberg, R., van Dijk, M. M., Fliers, E., van der Post, J. A M, van Wely, M., Bloemenkamp, K. W M, Hoek, A., Kuchenbecker, W. K., Verhoeve, H. R., Scheepers, H. C J, Rombout-de Weerd, S., Koks, C., Zwart, J. J., Broekmans, F., Verpoest, W., Christiansen, O. B., Post, M., Papatsonis, D. N M, Verberg, M. F G, Sikkema, J., Mol, B. W., Bisschop, P. H., Goddijn, M., Vissenberg, R., van Dijk, M. M., Fliers, E., van der Post, J. A M, van Wely, M., Bloemenkamp, K. W M, Hoek, A., Kuchenbecker, W. K., Verhoeve, H. R., Scheepers, H. C J, Rombout-de Weerd, S., Koks, C., Zwart, J. J., Broekmans, F., Verpoest, W., Christiansen, O. B., Post, M., Papatsonis, D. N M, Verberg, M. F G, Sikkema, J., Mol, B. W., Bisschop, P. H., and Goddijn, M.

Published
2015

36. The HysNiche trial : hysteroscopic resection of uterine caesarean scar defect (niche) in patients with abnormal bleeding, a randomised controlled trial

Author

Vervoort, A J M W, Van der Voet, L F, Witmer, M, Thurkow, A L, Radder, C M, van Kesteren, P J M, Quartero, H W P, Kuchenbecker, W K H, Bongers, M Y, Geomini, P M A J, de Vleeschouwer, L H M, van Hooff, M H A, van Vliet, H A A M, Veersema, S, Renes, W B, van Meurs, H S, Bosmans, J, Oude Rengerink, K, Brölmann, H A M, Mol, B W J, Huirne, J A F, Vervoort, A J M W, Van der Voet, L F, Witmer, M, Thurkow, A L, Radder, C M, van Kesteren, P J M, Quartero, H W P, Kuchenbecker, W K H, Bongers, M Y, Geomini, P M A J, de Vleeschouwer, L H M, van Hooff, M H A, van Vliet, H A A M, Veersema, S, Renes, W B, van Meurs, H S, Bosmans, J, Oude Rengerink, K, Brölmann, H A M, Mol, B W J, and Huirne, J A F

Published
2015

37. Effect of levothyroxine on live birth rate in euthyroid women with recurrent miscarriage and TPO antibodies (T4-LIFE study)

Author

Project Ondersteuning, Geboortecentrum voorzitterschap, MS VPG/Gynaecologie, Circulatory Health, Child Health, Cardiologie, Vissenberg, R., van Dijk, M. M., Fliers, E., van der Post, J. A M, van Wely, M., Bloemenkamp, K. W M, Hoek, A., Kuchenbecker, W. K., Verhoeve, H. R., Scheepers, H. C J, Rombout-de Weerd, S., Koks, C., Zwart, J. J., Broekmans, F., Verpoest, W., Christiansen, O. B., Post, M., Papatsonis, D. N M, Verberg, M. F G, Sikkema, J., Mol, B. W., Bisschop, P. H., Goddijn, M., Project Ondersteuning, Geboortecentrum voorzitterschap, MS VPG/Gynaecologie, Circulatory Health, Child Health, Cardiologie, Vissenberg, R., van Dijk, M. M., Fliers, E., van der Post, J. A M, van Wely, M., Bloemenkamp, K. W M, Hoek, A., Kuchenbecker, W. K., Verhoeve, H. R., Scheepers, H. C J, Rombout-de Weerd, S., Koks, C., Zwart, J. J., Broekmans, F., Verpoest, W., Christiansen, O. B., Post, M., Papatsonis, D. N M, Verberg, M. F G, Sikkema, J., Mol, B. W., Bisschop, P. H., and Goddijn, M.

Published
2015

38. The HysNiche trial: hysteroscopic resection of uterine caesarean scar defect (niche) in patients with abnormal bleeding, a randomised controlled trial

Author

Arts-assistenten Kinderen, Epi Methoden Team 1, Vervoort, A J M W, Van der Voet, L F, Witmer, M, Thurkow, A L, Radder, C M, van Kesteren, P J M, Quartero, H W P, Kuchenbecker, W K H, Bongers, M Y, Geomini, P M A J, de Vleeschouwer, L H M, van Hooff, M H A, van Vliet, H A A M, Veersema, S, Renes, W B, van Meurs, H S, Bosmans, J, Oude Rengerink, K, Brölmann, H A M, Mol, B W J, Huirne, J A F, Arts-assistenten Kinderen, Epi Methoden Team 1, Vervoort, A J M W, Van der Voet, L F, Witmer, M, Thurkow, A L, Radder, C M, van Kesteren, P J M, Quartero, H W P, Kuchenbecker, W K H, Bongers, M Y, Geomini, P M A J, de Vleeschouwer, L H M, van Hooff, M H A, van Vliet, H A A M, Veersema, S, Renes, W B, van Meurs, H S, Bosmans, J, Oude Rengerink, K, Brölmann, H A M, Mol, B W J, and Huirne, J A F

Published
2015

40. The HysNiche trial: hysteroscopic resection of uterine caesarean scar defect (niche) in patients with abnormal bleeding, a randomised controlled trial

Author

Vervoort, A. J. M. W., primary, Van der Voet, L. F., additional, Witmer, M., additional, Thurkow, A. L., additional, Radder, C. M., additional, van Kesteren, P. J. M., additional, Quartero, H. W. P., additional, Kuchenbecker, W. K. H., additional, Bongers, M. Y., additional, Geomini, P. M. A. J., additional, de Vleeschouwer, L. H. M., additional, van Hooff, M. H. A., additional, van Vliet, H. A. A. M., additional, Veersema, S., additional, Renes, W. B., additional, van Meurs, H. S., additional, Bosmans, J., additional, Rengerink, K. Oude, additional, Brölmann, H. A. M., additional, Mol, B. W. J., additional, and Huirne, J. A. F., additional

Published
2015
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41. The subcutaneous abdominal fat and not the intra-abdominal fat compartment is associated with anovulation in women with obesity and infertility (editorial comment)

Author

Kuchenbecker, W. K. H., Groen, Harry J. M., Zijlstra, T. M., Bolster, J. H. T., Riemer Slart, eric van der jagt, Anneke Muller Kobold, Bhr, Wolffenbuttel, Land, J. A., Hoek, A., Science in Healthy Ageing & healthcaRE (SHARE), Damage and Repair in Cancer Development and Cancer Treatment (DARE), Life Course Epidemiology (LCE), Reproductive Origins of Adult Health and Disease (ROAHD), Guided Treatment in Optimal Selected Cancer Patients (GUTS), Lifestyle Medicine (LM), Vascular Ageing Programme (VAP), Cardiovascular Centre (CVC), Translational Immunology Groningen (TRIGR), and Center for Liver, Digestive and Metabolic Diseases (CLDM)

Published
2010

42. Subfertiliteit bij vrouwen met overgewicht

Author

Kuchenbecker, W. K. H., Ruifrok, A. E., Bolster, J. H. T., Heineman, M. J., Hoek, A., and Obstetrics and Gynaecology

Subjects
nutritional and metabolic diseases
Abstract

The prevalence of overweight individuals in The Netherlands is increasing sharply as has also been observed in populations worldwide. In addition to the long-term health risks of being overweight, overweight women of reproductive age are more commonly faced with reproductive disorders. Women who are overweight are less fertile than women of normal weight. The chances of both spontaneous conception and conception after ovulation induction and assisted reproduction are lower in women who are overweight. The chance of a live birth is also decreased due to an increased risk of miscarriage. Furthermore pregnancy outcome is compromised by obesity-related complications of pregnancy. Weight loss of 5-15% in subfertile women who are overweight increases the chance of spontaneous conception and conception after fertility treatment and can be achieved through a low-calorie diet, increased exercise and behaviour modification

Published
2006

43. Cost-effectiveness analysis of lifestyle intervention in obese infertile women.

Author

van Oers, A. M., Mutsaerts, M. A. Q., Burggraaff, J. M., Kuchenbecker, W. K. H., Perquin, D. A. M., Koks, C. A. M., van Golde, R., Kaaijk, E. M., Schierbeek, J. M., Klijn, N. F., van Kasteren, Y. M., Land, J. A., Mol, B. W. J., Hoek, A., Groen, H., and LIFEstyle study group

Subjects
COST effectiveness, LIFESTYLES, INFERTILITY treatment, OVERWEIGHT women, OBESITY, HEALTH promotion, OBESITY treatment, CRYOPRESERVATION of organs, tissues, etc., FERTILIZATION in vitro, OBESITY complications, BIRTH rate, EMBRYO transfer, FAMILIES, LONGITUDINAL method, INFERTILITY, EVALUATION of medical care, MEDICAL care costs, INDUCED ovulation, PREGNANCY, WEIGHT loss, BODY mass index, HUMAN research subjects, PATIENT dropouts, DISEASE complications, ECONOMICS
Abstract

Study Question: What is the cost-effectiveness of lifestyle intervention preceding infertility treatment in obese infertile women?Summary Answer: Lifestyle intervention preceding infertility treatment as compared to prompt infertility treatment in obese infertile women is not a cost-effective strategy in terms of healthy live birth rate within 24 months after randomization, but is more likely to be cost-effective using a longer follow-up period and live birth rate as endpoint.What Is Known Already: In infertile couples, obesity decreases conception chances. We previously showed that lifestyle intervention prior to infertility treatment in obese infertile women did not increase the healthy singleton vaginal live birth rate at term, but increased natural conceptions, especially in anovulatory women. Cost-effectiveness analyses could provide relevant additional information to guide decisions regarding offering a lifestyle intervention to obese infertile women.Study Design, Size, Duration: The cost-effectiveness of lifestyle intervention preceding infertility treatment compared to prompt infertility treatment was evaluated based on data of a previous RCT, the LIFEstyle study. The primary outcome for effectiveness was the vaginal birth of a healthy singleton at term within 24 months after randomization (the healthy live birth rate). The economic evaluation was performed from a hospital perspective and included direct medical costs of the lifestyle intervention, infertility treatments, medication and pregnancy in the intervention and control group. In addition, we performed exploratory cost-effectiveness analyses of scenarios with additional effectiveness outcomes (overall live birth within 24 months and overall live birth conceived within 24 months) and of subgroups, i.e. of ovulatory and anovulatory women, women <36 years and ≥36 years of age and of completers of the lifestyle intervention. Bootstrap analyses were performed to assess the uncertainty surrounding cost-effectiveness.Participants/materials, Settings, Methods: Infertile women with a BMI of ≥29 kg/m2 (no upper limit) were allocated to a 6-month lifestyle intervention programme preceding infertility treatment (intervention group, n = 290) or to prompt infertility treatment (control group, n = 287). After excluding women who withdrew informed consent or who were lost to follow-up we included 280 women in the intervention group and 284 women in the control group in the analysis.Main Results and the Role Of Chance: Total mean costs per woman in the intervention group within 24 months after randomization were €4324 (SD €4276) versus €5603 (SD €4632) in the control group (cost difference of -€1278, P < 0.05). Healthy live birth rates were 27 and 35% in the intervention group and the control group, respectively (effect difference of -8.1%, P < 0.05), resulting in an incremental cost-effectiveness ratio of €15 845 per additional percentage increase of the healthy live birth rate. Mean costs per healthy live birth event were €15 932 in the intervention group and €15 912 in the control group. Exploratory scenario analyses showed that after changing the effectiveness outcome to all live births conceived within 24 months, irrespective of delivery within or after 24 months, cost-effectiveness of the lifestyle intervention improved. Using this effectiveness outcome, the probability that lifestyle intervention preceding infertility treatment was cost-effective in anovulatory women was 40%, in completers of the lifestyle intervention 39%, and in women ≥36 years 29%.Limitations, Reasons For Caution: In contrast to the study protocol, we were not able to perform the analysis from a societal perspective. Besides the primary outcome of the LIFEstyle study, we performed exploratory analyses using outcomes observed at longer follow-up times and we evaluated subgroups of women; the trial was not powered on these additional outcomes or subgroup analyses.Wider Implications Of the Findings: Cost-effectiveness of a lifestyle intervention is more likely for longer follow-up times, and with live births conceived within 24 months as the effectiveness outcome. This effect was most profound in anovulatory women, in completers of the lifestyle intervention and in women ≥36 years old. This result indicates that the follow-up period of lifestyle interventions in obese infertile women is important. The scenario analyses performed in this study suggest that offering and reimbursing lifestyle intervention programmes in certain patient categories may be cost-effective and it provides directions for future research in this field.Study Funding/competing Interest(s): The study was supported by a grant from ZonMw, the Dutch Organization for Health Research and Development (50-50110-96-518). The department of obstetrics and gynaecology of the UMCG received an unrestricted educational grant from Ferring pharmaceuticals BV, The Netherlands. B.W.J.M. is a consultant for ObsEva, Geneva.Trial Registration Number: The LIFEstyle RCT was registered at the Dutch trial registry (NTR 1530). http://www.trialregister.nl/trialreg/admin/rctview.asp?TC = 1530. [ABSTRACT FROM AUTHOR]

Published
2017
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44. The OPTIMIST study: optimisation of cost effectiveness through individualised FSH stimulation dosages for IVF treatment. A randomised controlled trial

Author

van Tilborg, T.C., Eijkemans, M.J., Laven, J.S.E., Koks, C.A., de Bruin, J.P., Scheffer, G.J., van Golde, R.J., Fleischer, K., Hoek, A., Nap, A.W., Kuchenbecker, W., Manger, P.A., Brinkhuis, E.A., van Heusden, A.M., Sluijmer, A.V., Verhoeff, A., van Hooff, M.H., Friederich, J., Smeenk, J.M.J., Kwee, J., Verhoeve, H.R., Lambalk, C.B., Helmerhorst, F.M., van der Veen, F., Mol, B.W., Torrance, H.L., Broekmans, F.J., van Tilborg, T.C., Eijkemans, M.J., Laven, J.S.E., Koks, C.A., de Bruin, J.P., Scheffer, G.J., van Golde, R.J., Fleischer, K., Hoek, A., Nap, A.W., Kuchenbecker, W., Manger, P.A., Brinkhuis, E.A., van Heusden, A.M., Sluijmer, A.V., Verhoeff, A., van Hooff, M.H., Friederich, J., Smeenk, J.M.J., Kwee, J., Verhoeve, H.R., Lambalk, C.B., Helmerhorst, F.M., van der Veen, F., Mol, B.W., Torrance, H.L., and Broekmans, F.J.

Abstract

Contains fulltext : 109739.pdf (publisher's version ) (Open Access), BACKGROUND: Costs of in vitro fertilisation (IVF) are high, which is partly due to the use of follicle stimulating hormone (FSH). FSH is usually administered in a standard dose. However, due to differences in ovarian reserve between women, ovarian response also differs with potential negative consequences on pregnancy rates. A Markov decision-analytic model showed that FSH dose individualisation according to ovarian reserve is likely to be cost-effective in women who are eligible for IVF. However, this has never been confirmed in a large randomised controlled trial (RCT). The aim of the present study is to assess whether an individualised FSH dose regime based on an ovarian reserve test (ORT) is more cost-effective than a standard dose regime. METHODS/DESIGN: Multicentre RCT in subfertile women indicated for a first IVF or intracytoplasmic sperm injection cycle, who are aged < 44 years, have a regular menstrual cycle and no major abnormalities at transvaginal sonography. Women with polycystic ovary syndrome, endocrine or metabolic abnormalities and women undergoing IVF with oocyte donation, will not be included. Ovarian reserve will be assessed by measuring the antral follicle count. Women with a predicted poor response or hyperresponse will be randomised for a standard versus an individualised FSH regime (150 IU/day, 225-450 IU/day and 100 IU/day, respectively). Participants will undergo a maximum of three stimulation cycles during maximally 18 months. The primary study outcome is the cumulative ongoing pregnancy rate resulting in live birth achieved within 18 months after randomisation. Secondary outcomes are parameters for ovarian response, multiple pregnancies, number of cycles needed per live birth, total IU of FSH per stimulation cycle, and costs. All data will be analysed according to the intention-to-treat principle. Cost-effectiveness analysis will be performed to assess whether the health and associated economic benefits of individualised treatme

Published
2012

45. Recombinant LH supplementation to a standard GnRH antagonist protocol in women of 35 years or older undergoing IVF/ICSI: a randomized controlled multicentre study

Author

Konig, T. E., primary, van der Houwen, L. E. E., additional, Overbeek, A., additional, Hendriks, M. L., additional, Beutler-Beemsterboer, S. N., additional, Kuchenbecker, W. K. H., additional, Renckens, C. N. M., additional, Bernardus, R. E., additional, Schats, R., additional, Homburg, R., additional, Hompes, P. G. A., additional, and Lambalk, C. B., additional

Published
2013
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46. Reproductive surgery

Author

Simsek, E., primary, Kilicdag, E. B., additional, Haydardedeoglu, B., additional, Coban, G., additional, Iskender, C., additional, Simsek, S. Y., additional, Zeyneloglu, H. B., additional, Glazebrook, J. E., additional, Stocker, L. J., additional, Cheong, Y., additional, Di Florio, C., additional, Immediata, V., additional, Gagliano, D., additional, Zumpano, A., additional, Tartaglia, C., additional, Selvaggi, L., additional, Lanzone, A., additional, Guido, M., additional, Kanmaz, G., additional, Kahraman, A., additional, Varli, B., additional, Cetinkaya, E., additional, Taskin, S., additional, Ozmen, B., additional, Vij, P., additional, Cherian, T. K., additional, Simsek, M., additional, Atilgan, R., additional, Ozkan, Z. S., additional, Kavak, B., additional, Deveci, D., additional, Demirel, I., additional, Sapmaz, E., additional, Ashraf, M., additional, Ghourab, G., additional, Abuzeid, O., additional, Mitwally, M. F., additional, Diamond, M. P., additional, Abuzeid, M., additional, Coenders-Tros, R., additional, Van Kessel, M. A., additional, Oosterhuis, G. J. E., additional, Vernooy, E., additional, Kuchenbecker, W. K. H., additional, Mol, B. W. J., additional, Koks, C., additional, Al Rabiah, H., additional, Karins, M., additional, Faghih, M., additional, Choussein, S., additional, Bailey, A. P., additional, Srouji, S. S., additional, Gargiulo, A. R., additional, Bosteels, J., additional, Pelckmans, S., additional, Weyers, S., additional, D'Hooghe, T., additional, Jayakrishnan, K. D. K., additional, Baheti, B. D. S., additional, Lee, J. H., additional, Lee, J. R., additional, Lee, J. Y., additional, Jee, B. C., additional, Suh, C. S., additional, Kim, S. H., additional, Aboeighait, S., additional, Youssef, M. A. F., additional, Hosny, A. N., additional, Yassin, M. S., additional, Shokry, M. A., additional, Gemei, S., additional, Sanad, A., additional, Esin, S., additional, Baser, E., additional, Okuyan, E., additional, and Kucukozkan, T., additional

Published
2013
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47. Performance of outpatient transvaginal hydrolaparoscopy.

Author

Coenders-Tros, R., van Kessel, M. A., Vernooij, M. M. A., Oosterhuis, G. J. E., Kuchenbecker, W. K. H., Mol, B. W. J., and Koks, C. A. M.

Subjects
OUTPATIENT medical care, TRANSVAGINAL surgery, LAPAROSCOPY, FEASIBILITY studies, PATIENT satisfaction, INFERTILITY, RETROSPECTIVE studies, FALLOPIAN tube patency tests, DIAGNOSIS
Abstract

Study Question: What is the feasibility of performing transvaginal hydrolaparoscopy (THL) in an outpatient setting?Summary Answer: It is feasible to perform THL in an outpatient setting, reflected by a low complication and failure rate and a high patients' satisfaction.What Is Known Already: THL is a safe method to investigate tubal patency and exploring the pelvis in subfertile women.Study Design, Size, Duration: Retrospective cohort study of 1127 subfertile women who underwent THL as primary diagnostic method for testing tubal patency in an outpatient setting.Participants/materials, Setting, Methods: We studied all THL procedures performed as a primary diagnostic tubal patency test in an outpatient setting in subfertile women starting from the initial THL in four large hospitals. Baseline characteristics were obtained, as well as the outcome of the procedures in terms of success, complications and findings by examining medical records. We used a uniform visual analogue scale (VAS) score document to collect data on pain and acceptability prospectively and compared two methods of pain relief.Main Results and the Role Of Chance: We studied a total of 1103 women who underwent THL. Successful access to the pouch of Douglas was achieved in 1028 women (93.2%), and 1017 women had a complete evaluation (92.2%). Double-sided tubal patency was found in 844 women (83%), unilateral tubal patency in 127 women (12.5%), while in 46 women (4.5%) bilateral occluded tubes were diagnosed. Endometriosis alone was seen in 64 women (6.3%), adhesions alone in 87 women (8.6%) and both endometriosis and adhesions in 42 women (4.1%).Complications occurred in 29 (2.6%) women, including 10 perforations of the rectum (0.9%), 8 perforations of the posterior uterine wall (0.7%) and 5 infections/pelvic inflammatory diseases (PIDs) (0.5%). Bleeding of the vaginal wall requiring intervention and hospital admissions due to pain was seen in 4 (0.4%) and 2 women, respectively (0.2%). The average pain score was rated 4.0 (±2.4 SD) on a VAS from 0 to 10 with 0 meaning no pain at all with no difference in different types of pain relief. Acceptability was rated 1.5 (±2.1 SD).Limitations, Reasons For Caution: The main limitation of the study is its retrospective character and the fact that only a fourth of the women were asked for pain and acceptability scores.Wider Implications Of the Findings: THL can be used as a primary method for tubal assessment in an outpatient setting. Further randomized studies are needed to assess whether THL is superior to other methods and strategies for tubal assessment in terms of prognostic capacity and cost-effectiveness.Study Funding/competing Interest: No external funding was either sought or obtained for this study. The authors have no competing interests to declare. [ABSTRACT FROM AUTHOR]

Published
2016
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48. Tailored expectant management in couples with unexplained infertility does not influence their experiences with the quality of fertility care.

Author

Kersten, F. A. M., Hermens, R. P. G. M., Braat, D. D. M., Tepe, E., Sluijmer, A., Kuchenbecker, W. K., Van den Boogaard, N., Mol, B. W. J., Goddijn, M., Nelen, W. L. D. M., and Improvement study Group

Subjects
WATCHFUL waiting, INFERTILITY treatment, MEDICAL quality control, CONCEPTION, MEMORY bias, PUBLIC health research, MEDICAL protocols, PATIENT satisfaction, PROGNOSIS, TIME, CROSS-sectional method, PATIENT-centered care
Abstract

Study Question: Do couples who were eligible for tailored expectant management (TEM) and did not start treatment within 6 months after the fertility work-up, have different experiences with the quality of care than couples that were also eligible for TEM but started treatment right after the fertility work-up?Summary Answer: Tailored expectant management of at least 6 months in couples with unexplained infertility is not associated with the experiences with quality of care or trust in their physician.What Is Known Already: In couples with unexplained infertility and a good prognosis of natural conception within 1 year, expectant management for 6-12 months does not compromise ongoing birth rates and is equally as effective as starting medically assisted reproduction immediately. Therefore, TEM is recommended by various international clinical guidelines. Implementation of TEM is still not optimal because of existing barriers on both patient and professional level. An important barrier is the hesitance of professionals to counsel their patients for TEM because they fear that patients will be dissatisfied with care. However, if and how adherence to TEM actually affects the couples' experience with care is unknown. Experiences with the quality care can be measured by evaluating the patient-centredness of care and the patients' trust in their physician.Study Design, Size, Duration: This is a retrospective cross-sectional study. A survey with written questionnaires was performed among all couples who participated in the retrospective audit of guideline adherence on TEM in 25 Dutch clinics.Participants/materials, Setting, Methods: Couples were eligible to participate if they were diagnosed with unexplained infertility and had a good prognosis (>30%) of natural conception within 1 year based on the Hunault prediction model. We used patient's questionnaires to collect data on the couples' experience with the quality of care and possible confounders for their experiences other than having undergone TEM or not. Multilevel regression analyses were performed to investigate case-mix adjusted association of TEM with the patient-centredness of care (PCQ-Infertility) and the patients' trust in their physician (Wake Forest Trust Scale).Main Results and the Role Of Chance: Couples who adhered to TEM experienced the quality of care on the same level as couples who were exposed to early treatment, i.e. started fertility treatment within 6 months after fertility work-up. There were no associations between adherence to TEM and the patient-centredness of care or the patients' trust in their physician.Limitations, Reasons For Caution: Because this study is retrospective, recall bias might occur. Furthermore, we were unable to measure the difference in experience with care over time. Therefore, our results have to be interpreted carefully.Wider Implications Of the Findings: Prospective research on couples undergoing TEM have to be performed to provide more detailed insight in the patients' experiences with the decision making process and subsequently the expectant period. Tackling the barriers surrounding TEM, i.e. better counselling and more patient information material, could further improve patient experiences with the quality of care for couples who are advised TEM.Study Funding/competing Interests: Supported by Netherlands Organisation for Health Research and Development (ZonMW). ZonMW had no role in designing the study, data collection, analysis and interpretation of data or writing of the report. Competing interests: none.Trial Registration Number: www.trialregister.nl NTR3405. [ABSTRACT FROM AUTHOR]

Published
2016
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49. REPRODUCTIVE EPIDEMIOLOGY AND HEALTH ECONOMY

Author

Nyman Iliadou, A., primary, Ekberg, S., additional, Cnattingius, S., additional, Johansson, A. L. V., additional, Mutsaerts, M. A. Q., additional, Groen, H., additional, Buiter-Van der Meer, A., additional, Sijtsma, A., additional, Kuchenbecker, W. K. H., additional, Mol, B. W., additional, Sauer, P. J. J., additional, Land, J. A., additional, Corpeleijn, E., additional, Hoek, A., additional, Bhattacharya, S., additional, Kurinczuk, J., additional, Lee, A., additional, Raja, E. A., additional, Porter, M., additional, Hamilton, M., additional, Templeton, A., additional, Mollison, J., additional, Moore, V. M., additional, Marino, J. L., additional, Willson, K. J., additional, Davies, M. J., additional, Chambers, G. M., additional, Zhu, R., additional, and Hoang, V. P., additional

Published
2012
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