Bryan Hecht - Academia.edu (original) (raw)

Papers by Bryan Hecht

Human Reproduction, Oct 1, 1995

... CL, Karande, V., Rao, R., Balin, M. and Pratt, D. (1995) The desire for multiple births in co... more ... CL, Karande, V., Rao, R., Balin, M. and Pratt, D. (1995) The desire for multiple births in couples with infertility problems contradicts present practice patterns. Hum. Reprod., 10, 1079-1084. Hecht, BR (1993) Iatrogenic multifetal pregnancy. Assist. Reprod. Rev., 3, 75-87. Bryan R ...

Obstetrics & Gynecology, Oct 1, 2010

To assess the efficacy and safety of an oral formulation of tranexamic acid for the treatment of ... more To assess the efficacy and safety of an oral formulation of tranexamic acid for the treatment of heavy menstrual bleeding. METHODS: Adult women with heavy menstrual bleeding (mean menstrual blood loss 80 mL or more per cycle) were enrolled in a double-blind, placebo-controlled study. After two pretreatment menstrual cycles, women were randomized to receive tranexamic acid 3.9 g/d or placebo for up to 5 days per menstrual cycle through six cycles. To meet the prespecified three-component primary efficacy end point, mean reduction in menstrual blood loss from baseline with tranexamic acid treatment needed to be 1) significantly greater than placebo, 2) greater than 50 mL, and 3) greater than a predetermined meaningful threshold (36 mL or higher). Health-related quality of life was measured using a validated patientreported outcome instrument. RESULTS: Women who received tranexamic acid (n‫)511؍‬ met all three primary efficacy end points: first, a significantly greater reduction in menstrual blood loss of ؊69.6 mL (40.4%) compared with ؊12.6 mL (8.2%) in the 72 women who received placebo (P<.001); reduction of menstrual blood loss exceeding a prespecified 50 mL; and last, reduction of menstrual blood loss considered meaningful to women. Compared with women receiving placebo, women treated with tranexamic acid experienced significant improvements in limitations in social or leisure and physical activities, work inside and outside the home, and self-perceived menstrual blood loss (P<.01). The majority of adverse events were mild to

Fertility and Sterility, 2012

The aim of the present study was to describe hatching of human embryos and investigate difference... more The aim of the present study was to describe hatching of human embryos and investigate differences in hatching between IVF and ICSI fertilized embryos using time-lapse monitoring. DESIGN: Prospective, observational, cohort study. MATERIALS AND METHODS: From February 2011 till April 2012, 138 women consented to embryo culture in a time-lapse incubator till day 6 after oocyte retrieval. Automated image recording was performed of * P<0.05.

Archives of Andrology, 1999

Semen assessments were performed on ejaculates from 25 men with proven fertility requesting vasec... more Semen assessments were performed on ejaculates from 25 men with proven fertility requesting vasectomy. Multiple cytological slides were made simultaneously from each ejaculate and analyzed by a single technician. The morphology data obtained were analyzed for repeatability. The mean ± SD for normal sperm morphology was 30.6 ± 7.3, and the within-subject repeatability was £ 1 SD of the mean for 17 of 25 ejaculates. Technician and laboratory specific criteria for the percent normal sperm morphology component of a semen analysis report (that are clinically meaningful) can be developed using the approach described herein.

The Journal of Emergency Medicine, 2011

American family physician, 1995

Women often express concern about what they consider to be excess body or facial hair. This surpl... more Women often express concern about what they consider to be excess body or facial hair. This surplus of hair may be normal or it may signal hypertrichosis or hirsutism. Hirsutism may be idiopathic, secondary to increased responsiveness of hair follicles to normal circulating levels of androgens, or it may result from an excess of androgens, which may be exogenous, or of ovarian or adrenal origin. The evaluation of hirsutism must include the identification, or exclusion, of androgen-producing tumors, but other extensive evaluation is controversial. Treatment includes local measures, antiandrogenic therapy and treatment focused on the underlying source of excess androgen.

Obstetrics and gynecology, 1992

In an interesting experiment of nature, we observed the discordant onset of fetal cardiac activit... more In an interesting experiment of nature, we observed the discordant onset of fetal cardiac activity between the two gestations of a heterotopic pregnancy. After initially detecting cardiac activity only in the tubal gestational sac, we later observed cardiac activity in the intrauterine sac 6 days after laparoscopic salpingectomy. This case illustrates the variable onset of cardiac activity. We advise expectant management of the intrauterine pregnancy in a heterotopic gestation when cardiac activity is not detected initially in the intrauterine sac.

Andrologia, 2001

A prospectively controlled in vitro study was performed to compare sperm concentration, sperm mot... more A prospectively controlled in vitro study was performed to compare sperm concentration, sperm motility and progressive sperm motility recovered following the standard swimup procedure and a new CentriSwim procedure. The CentriSwim procedure involves creating a centrifugal force to counteract the force of gravity during sperm swim-up procedure. Two aliquots of semen from 12 normozoospermic ejaculates and 12 laboratory-induced oligoasthenozoospermic specimens were diluted, centrifuged, and 1.0 ml of media layered over the sperm pellet. One aliquant was processed by standard swim-up technique. The other aliquant was processed by CentriSwim procedure involving centrifugation at 200 rpm on a 2-cm radius upward-directing arm, at an angle of 60u for 10 min, creating roughly 0.8 g centrifugal force at room temperature (22±24uC) to counteract the force of gravity. The numbers of spermatozoa recovered from the upper 0.5 ml of the medium following CentriSwim from the normozoospermic ejaculates and laboratory-induced oligoasthenozoospermic specimens were signi®cantly higher than following standard swim-up procedure. No statistical differences in the recovery of percentage sperm motility and progressive sperm motility between the two techniques were observed. In conclusion, the CentriSwim procedure yields higher numbers of motile spermatozoa than the standard swim-up technique.

International journal of fertility and menopausal studies

To determine how the screening practices of commercial semen banks vary from published guidelines... more To determine how the screening practices of commercial semen banks vary from published guidelines, which factors influence cryobanks to exclude prospective semen donors for genetic reasons, and the current role of clinical geneticists/genetic counselors in evaluating prospective semen donors. The genetic screening of prospective donors by commercial semen banks was evaluated using written questionnaires completed by bank directors. Responses were analyzed to determine exclusion criteria, adherence to published guidelines, and contribution of genetic professionals. Semen banks were selected on the basis of membership in the American Association of Tissue Banks and commercial use of semen for artificial insemination by donor. Semen bank practices as reported by commercial semen bank directors. Of 37 eligible banks, 16 responded. All screen prospective donors by medical/family history and physical examination, 94% have upper age limits; 63% examine for minor physical defects; 56% routi...

Archives of Women's Mental Health, 2021

The purpose of this systematic review is to evaluate the prevalence of disordered eating and eati... more The purpose of this systematic review is to evaluate the prevalence of disordered eating and eating disorders among women seeking fertility treatment. Observational studies were searched in Ovid MEDLINE, Web of Science, Embase, and PsycInfo. Studies published prior to September 2020 when the search was conducted were considered. Inclusion criteria included (1) original and empirical research, (2) published in a peer-reviewed journal, and (3) reported on disordered eating among women seeking fertility treatment in the sample or reported on prevalence of eating disorders among women seeking fertility treatment in the sample. Independent screening of abstracts was conducted by two authors (LH and AH). Ten studies met the inclusion criteria. Sample size, study location, measures, and results for each study in this review were reported. Among women pursuing fertility treatment, rates of current eating disorders ranged from 0.5 to 16.7%, while past eating disorder prevalence rates ranged from 1.4 to 27.5%. Current anorexia nervosa or bulimia nervosa was reported by up to 2% and 10.3% of women, respectively, while history of anorexia nervosa or bulimia nervosa was reported by up to 8.5% and 3.3% of women, respectively. Binge eating disorder or other eating disorders were reported by up to 18.5% and 9.1% of women, respectively. Disordered eating pathology was endorsed by 1.6 to 48% of women seeking fertility treatment. Endorsement of pathological eating attitudes was generally higher among women seeking fertility treatment with current or past eating disorders as compared to community samples, with the exception of dietary restraint. Rates of current and past eating disorders are higher among women seeking fertility treatment than in the general population. Providers treating women with infertility should be cognizant of these prevalence rates and consider screening for eating pathology in their patients as this may contribute to their likelihood of successful conception and/or subsequent pregnancy outcomes.

Human Reproduction, 1995

International Journal of Gynecology & Obstetrics, 1994

We describe a normal pregnancy that was conceived less than 3 weeks following curettage for a bli... more We describe a normal pregnancy that was conceived less than 3 weeks following curettage for a blighted ovum. A delay between curettage and subsequent pregnancy is often recommended. Evidence supporting such a delay is examined.

Fertility and Sterility, 2000

Fertility and Sterility, 2002

Clinical Obstetrics and Gynecology, 1989

Clinical Obstetrics and Gynecology, 1998

Obstetrics & Gynecology, 2002

To investigate whether specimens obtained from the perianal area have a Group B streptococcal cul... more To investigate whether specimens obtained from the perianal area have a Group B streptococcal culture detection rate similar to anorectal specimens. METHODS: This is a prospective cohort study at a tertiary care university-affiliated teaching hospital. A total of 136 pregnant women between 33 and 40 weeks' gestation were recruited. Three samples for Group B streptococcal culture detection were obtained from each subject in the following order: perianal sample, vaginoperianal sample, and an anorectal sample. The women were asked to rank their pain or discomfort with obtaining the anorectal sample. The vaginoperianal specimen is the standard sample obtained from antepartum patients in this clinic, and, therefore, it serves as the control. RESULTS: Of the 136 subjects, 26.5% of the control, vaginoperianal samples were positive for Group B streptococcal culture. In comparison, 27.2% of the anorectal specimens and 28.7% of the perianal specimens were positive for Group B streptococcal culture. There was no statistically significant difference in the detection of Group B streptococcal culture among the three sample sites. Evaluation of the pain experienced with an anorectal sampling showed that 68% of subjects ranked their pain between mild to moderate, and 5% noted severe pain. CONCLUSION: The Group B streptococcal detection rate was not different among the three sampling sites. Therefore, pregnant women do not need to be subjected to the additional pain of anorectal sampling to detect Group B Streptococcus.

Primary Care Update for OB/GYNS, 2000

Recent trends in international travel and emigration have brought the practice of female circumci... more Recent trends in international travel and emigration have brought the practice of female circumcision, also known as female genital mutilation, to the awareness of an increasing number of physicians and public policy agencies in developed countries. The main reason for the continuation of this practice is deeply held tradition. The high incidence of complications attending the procedure leads to a poor quality of life and potential life-threatening problems. Female circumcision serves no biologically useful purpose and perpetuates the subjugation and social deprivation of females. Suggestions for the eradication of this custom include universal education of females and public enlightenment campaigns; legislation tends to send the practice underground. This review is aimed at providing objective background information on female circumcision to residents in obstetrics and gynecology. An effective solution to this problem requires not just knowledge but also wisdom in order to offer a compassionate approach to the management of these women. The American women's health care specialist should be well informed on this issue because of the increasing likelihood of contact with these women. It is also hoped that health care providers will become sensitized to the point of designing and participating actively in effective schemes for the worldwide eradi-cation of this practice.

Primary Care Update for OB/GYNS, 2002

ABSTRACT Presently available information on the causation and management of infertility disorders... more ABSTRACT Presently available information on the causation and management of infertility disorders is sufficient for the formulation of some tentative proposals for the provision of preventive reproductive health care to females. This should be aimed at preventing the initiation of the infertility-associated disorder in the first place (primary prevention), at detecting and preventing overt manifestations of disease (secondary prevention) and/or halting or slowing disease progression, and at reducing long-term morbidity and preventing mortality (tertiary prevention). This review will suggest ways to implement such preventive strategies with respect to the care of women with endometriosis, polycystic ovary syndrome, tubal pathology, and hypoestrogenism. We will also discuss the prevention of iatrogenic problems encountered during infertility management such as multiple pregnancy, ovarian hyperstimulation syndrome, postoperative pelvic adhesions, and delayed referral for subspecialist care. These primary care issues should be considered by all physicians who care for females from infancy, through adolescence, to the reproductive and postreproductive age periods. We hope that dialogue and future developments will lead to further refinement of our present proposals.