James MoruzziObstetrics and infertility, Olympia Women's Health
- Olympia Women's Health
- United States of America
An inexpensive, internet-based, electronic health record (EHR) for use by all fertility clinics could accumulate big data on treatments used and outcomes. It could solicit patient enrollment in randomized protocols. It could be a "smart" EHR, and recommend an timely intervention based on published data.
James Moruzzi, MD
The Silber article with data from the Kato Clinic (Tokyo) is historic. It documents the inherent fertility of individual oocytes from natural cycle for a spectrum of maternal ages.
There are a few technical details that may help me in duplicating these results.
- What suction pressure was used on the 21 G Kitazato aspiration needles?
- The clinic monitored cycles with daily ultrasounds, serum estradiol (E2), progesterone (P4) and luteinizing hormone (LH). But it only recommends using follicular size > or = 18 mm, and E2 > or = 250 pg / ml. Were P4 and LH non-predictive of egg maturity?
- Follicular aspiration was scheduled 32 - 35 hours after buserelin inhalation, having met the 18 mm size and E2 criteria. Was the buserelin given that evening? Was urinary LH monitored between the blood draw and administration of buserelin?
- What percentage of these monitored cycles resulted in retrieval of a mature oocyte? What percentage of oocytes were immature or post-mature (atretic)?