Carolien Koks - Academia.edu (original) (raw)

Papers by Carolien Koks

Journal of Gynecologic Surgery, 1994

ABSTRACT This is the 85th reported case of a fallopian tube prolapse since the first was describe... more ABSTRACT This is the 85th reported case of a fallopian tube prolapse since the first was described in 1902 by Pozzi.1 Eight months after vaginal hysterectomy, the patient was discovered to have a purple-red, infarcted, irregular tumor with a length of 15 cm and a diameter of 5 cm, with 5 cm prolapsing through the vaginal introitus. At laparotomy, fallopian tube prolapse was diagnosed and a left salpingo-oophorectomy was performed. All cases of fallopian tube prolapse reported from 1973 to 1993 were compared with all cases before this period, as reviewed by Sapan and Solberg.2 During both investigation periods, most cases were preceded by vaginal or abdominal hysterectomy, and such symptoms as discharge, abdominal pain, and dyspareunia were observed. Before 1973, however, postoperative complications were more common than in the later period. Correct diagnoses of fallopian tube prolapse were made more frequently after 1973 than before this date. Treatment of fallopian tube prolapse gradually changed over th...

Gynecologic and Obstetric Investigation, 2014

Fertility and Sterility, Dec 1, 2012

Human Reproduction, Jun 1, 1999

The New England Journal of Medicine, Jun 28, 2018

Human Reproduction, Jul 13, 2015

Human Reproduction, Jun 1, 1997

Human Reproduction, Jun 1, 1999

graphy (HSG), an examination which is essential in the routine evaluation of infertile couples, i... more graphy (HSG), an examination which is essential in the routine evaluation of infertile couples, is considered painful. Hysterosonosalpingography (HSS) is a new method for evaluation of the tubal factor which may be used as a less painful alternative in the investigation of infertility. Our objective was to compare the pain intensity of patients submitted to HSG and to HSS as part of the routine evaluation of infertility. Materials and methods: Patients were submitted to HSG with iodine solution, and to HSS with Ecovist'" to evaluate tubal permeability. The exams were performed during the first phase of the cycle. The intensity of the pain experienced by the patients was measured after each exam using a visual analogue scale (VAS). The patients did not receive medication during the performance of the exams. P values of 0.05 (Wilcoxon-Mann-Whitney) were considered as statistically significant. Results: The sample consisted of 24 patients. The average age was 30 years; 22 (91.7%) patients had not had previous pelvic surgery and 20 (83.3%) patients had primary infertility. In terms of schooling, 13 (54.2%) patients had finished primary school; seven (29.2%) had finished high school; and four (16.7%) patients had university degrees. The median VAS score for HSS was 3.75 mm (0-9.9) and the median VAS score for HSG was 4.70 mm (0.3-10). There was a statistically significant difference between the two exams in terms of pain scores (P == 0.046, Wilcoxon-Mann-Whitney). Conclusion: In this study, HSG was more painful than HSS. This should be taken into consideration in the choice of the best method to evaluate the tubal factor.

Fertility and Sterility, Sep 1, 2019

OBJECTIVE: Previous studies suggest an endometrial receptivity analysis (ERA) may improve implant... more OBJECTIVE: Previous studies suggest an endometrial receptivity analysis (ERA) may improve implantation and live birth rates for patients with previous frozen embryo transfer (FET) failure. The purpose of this study is to evaluate whether performing an ERA prior to first time FET with a euploid blastocyst improves the live birth rate. DESIGN: This is a single institution retrospective cohort study. MATERIALS AND METHODS: A retrospective review was performed including all patients in 2017 who underwent first time FET with a euploid blastocyst(s) (n¼220). All patients in this study underwent PGT-A by Nex-Gen sequencing. The embryos were then vitrified. Patients were stratified by ERA status (n¼46) vs. no ERA (n¼174) prior to undergoing FET. The primary outcome was to measure the live birth rate. Secondarily, we measured the implantation rate and the clinical pregnancy rate. A two-sample t-test was used to compare continuous outcomes between groups, and Chi-square testing was used to compare proportions between the two groups. RESULTS: The implantation rate for patients that underwent ERA vs. no ERA prior to FET was 64.6% vs. 60.5% (p¼0.71). The clinical pregnancy rate for ERA vs. no ERA prior to FET was 56.5% vs. 52.8% (0.56). The live birth rate for ERA vs. no ERA prior to FET was 52.2% vs. 51.1% (p¼0.9). The single embryo transfer rate was 96% for the ERA group vs. 98% for the non-ERA group. CONCLUSIONS: Performing an ERA prior to first time FET with a euploid blastocyst did not increase the live birth rate compared to patients who did not have an ERA before their first FET. The differences in implantation and clinical pregnancy rates between the two groups were also not statistically significant. Our findings warrant an adequately powered randomized controlled trial to determine the efficacy of ERA prior to the transfer of a euploid blastocyst.

Human Reproduction Update, Feb 22, 2017

We included 37 studies that investigated a total of 10 689 women. No randomized controlled trials... more We included 37 studies that investigated a total of 10 689 women. No randomized controlled trials were found. Most studies were retrospective cohort studies of a moderate quality. The pooled pregnancy rate after sterilization reversal was 42-69%, with heterogeneity seen from the different methods utilized. The reported ectopic pregnancy rate was 4-8%. The only prognostic factor affecting the chance of conception was female age. The surgical approach (i.e. laparotomy [microscopic], laparoscopy or robotic) had no impact on the outcome, with the exception of the macroscopic laparotomic technique, which had inferior results and is not currently utilized. For older women, IVF could be a more cost-effective alternative for the reversal of sterilization. However, direct comparative data are lacking and a cutoff age cannot be stated. WIDER IMPLICATIONS: In sterilized women who suffer regret, surgical tubal re-anastomosis is an effective treatment, especially in younger women. However, there is a need for randomized controlled trials comparing the success rates and costs of surgical reversal with IVF.

Fertility and Sterility, Sep 1, 1997

To evaluate whether a menstrual cup is a suitable instrument to collect antegradely shed endometr... more To evaluate whether a menstrual cup is a suitable instrument to collect antegradely shed endometrium for in vitro studies. A prospective, descriptive, cell biological and immunohistochemical study. Tertiary care university medical center. Nine female volunteers with regular cycles. Menstrual effluent was collected with a menstrual cup. Experience with the menstrual cup was described. Cytospin specimens, frozen sections, and cultures were prepared from the obtained menstrual tissue. The acceptability of the menstrual cup. The presence and viability of endometrial tissue was evaluated using immunohistochemical staining and culture outcome. All women except one described the menstrual cup as acceptable. Menstrual effluent contained single cells, clumps of cells, and glandlike structures. After 5 days of culture, the endometrial tissue appeared to be viable. Immunohistochemistry showed positive staining for vimentin in most cytospin specimens, in all cryostat specimens, and in 10 of 17 cultures. Cytokeratin 18 stained most cytospin specimens, all cryostat specimens, and 10 of 17 cultures. Positive staining for BW495/36 was observed in most cytospin specimens, all cryostat specimens, and 11 of 17 cultures. A menstrual cup in an acceptable instrument to collect antegradely shed menstrual tissue. Menstruum contains viable endometrial tissue that can be used for in vitro studies of endometrium and endometriosis.

Obstetrical & Gynecological Survey, May 1, 2018

Background In many countries, clomifene citrate is the treatment of first choice in women with no... more Background In many countries, clomifene citrate is the treatment of first choice in women with normogonadotropic anovulation (ie, absent or irregular ovulation). If these women ovulate but do not conceive after several cycles with clomifene citrate, medication is usually switched to gonadotrophins, with or without intrauterine insemination. We aimed to assess whether switching to gonadotrophins is more effective than continuing clomifene citrate, and whether intrauterine insemination is more effective than intercourse. Methods In this two-by-two factorial multicentre randomised clinical trial, we recruited women aged 18 years and older with normogonadotropic anovulation not pregnant after six ovulatory cycles of clomifene citrate (maximum of 150 mg daily for 5 days) from 48 Dutch hospitals. Women were randomly assigned using a central passwordprotected internet-based randomisation programme to receive six cycles with gonadotrophins plus intrauterine insemination, six cycles with gonadotrophins plus intercourse, six cycles with clomifene citrate plus intrauterine insemination, or six cycles with clomifene citrate plus intercourse. Clomifene citrate dosages varied from 50 to 150 mg daily orally and gonadotrophin starting dose was 50 or 75 IU daily subcutaneously. The primary outcome was conception leading to livebirth within 8 months after randomisation defined as any baby born alive after a gestational age beyond 24 weeks. Primary analysis was by intention to treat. We made two comparisons, one in which gonadotrophins were compared with clomifene citrate and one in which intrauterine insemination was compared with intercourse. This completed study is registered with the Netherlands Trial Register, number NTR1449.

Obstetrical & Gynecological Survey, Sep 1, 2016

Obesity is a prevalent health condition that affects 14% to 20% of women of reproductive age. Som... more Obesity is a prevalent health condition that affects 14% to 20% of women of reproductive age. Some of the adverse affects of obesity on reproductive health include increased risks of menstrual dysfunction, anovulation, and infertility, especially resulting in failure of assisted reproductive techniques. There are various guidelines that advocate lifestyle intervention programs aimed at weight loss of 5% to 10% of body weight as the first step in caring for obese infertile women. There is, however, a dearth of randomized controlled trials assessing the effectiveness of lifestyle intervention programs. The objective of this study was to assess the effectiveness of a lifestyle intervention preceding infertility treatment. A multicenter randomized trial was conducted at 6 university medical centers and 17 general hospitals in the Netherlands. Infertile women with a body

Human Reproduction, Jun 23, 2016

What is the feasibility of performing transvaginal hydrolaparoscopy (THL) in an outpatient settin... more 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.

58th Annual ESPE Meeting (ESPE 2019), 2019

SSRN Electronic Journal, 2022

American Journal of Medical Case Reports, 2021

Chorionic villus sampling (CVS) is a procedure in which biopsies of placental tissue are obtained... more Chorionic villus sampling (CVS) is a procedure in which biopsies of placental tissue are obtained for prenatal genetic diagnosis. Risk of infection after CVS is low and only sporadic cases of postprocedural sepsis have been reported. Clostridium perfrigens and Escherichia coli are the most commonly described pathogens in cases of sepsis after prenatal invasive diagnostic procedures. However, this report describes a case of sepsis with fetal loss after CVS caused by Atopobium vaginae.

European journal of nutrition, Jan 3, 2018

To identify demographic, (bio)physical, behavioral, and psychological determinants of successful ... more 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. 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/m), 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. 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 les...

Journal of Gynecologic Surgery, 1994

ABSTRACT This is the 85th reported case of a fallopian tube prolapse since the first was describe... more ABSTRACT This is the 85th reported case of a fallopian tube prolapse since the first was described in 1902 by Pozzi.1 Eight months after vaginal hysterectomy, the patient was discovered to have a purple-red, infarcted, irregular tumor with a length of 15 cm and a diameter of 5 cm, with 5 cm prolapsing through the vaginal introitus. At laparotomy, fallopian tube prolapse was diagnosed and a left salpingo-oophorectomy was performed. All cases of fallopian tube prolapse reported from 1973 to 1993 were compared with all cases before this period, as reviewed by Sapan and Solberg.2 During both investigation periods, most cases were preceded by vaginal or abdominal hysterectomy, and such symptoms as discharge, abdominal pain, and dyspareunia were observed. Before 1973, however, postoperative complications were more common than in the later period. Correct diagnoses of fallopian tube prolapse were made more frequently after 1973 than before this date. Treatment of fallopian tube prolapse gradually changed over th...

Gynecologic and Obstetric Investigation, 2014

Fertility and Sterility, Dec 1, 2012

Human Reproduction, Jun 1, 1999

The New England Journal of Medicine, Jun 28, 2018

Human Reproduction, Jul 13, 2015

Human Reproduction, Jun 1, 1997

Human Reproduction, Jun 1, 1999

graphy (HSG), an examination which is essential in the routine evaluation of infertile couples, i... more graphy (HSG), an examination which is essential in the routine evaluation of infertile couples, is considered painful. Hysterosonosalpingography (HSS) is a new method for evaluation of the tubal factor which may be used as a less painful alternative in the investigation of infertility. Our objective was to compare the pain intensity of patients submitted to HSG and to HSS as part of the routine evaluation of infertility. Materials and methods: Patients were submitted to HSG with iodine solution, and to HSS with Ecovist'" to evaluate tubal permeability. The exams were performed during the first phase of the cycle. The intensity of the pain experienced by the patients was measured after each exam using a visual analogue scale (VAS). The patients did not receive medication during the performance of the exams. P values of 0.05 (Wilcoxon-Mann-Whitney) were considered as statistically significant. Results: The sample consisted of 24 patients. The average age was 30 years; 22 (91.7%) patients had not had previous pelvic surgery and 20 (83.3%) patients had primary infertility. In terms of schooling, 13 (54.2%) patients had finished primary school; seven (29.2%) had finished high school; and four (16.7%) patients had university degrees. The median VAS score for HSS was 3.75 mm (0-9.9) and the median VAS score for HSG was 4.70 mm (0.3-10). There was a statistically significant difference between the two exams in terms of pain scores (P == 0.046, Wilcoxon-Mann-Whitney). Conclusion: In this study, HSG was more painful than HSS. This should be taken into consideration in the choice of the best method to evaluate the tubal factor.

Fertility and Sterility, Sep 1, 2019

OBJECTIVE: Previous studies suggest an endometrial receptivity analysis (ERA) may improve implant... more OBJECTIVE: Previous studies suggest an endometrial receptivity analysis (ERA) may improve implantation and live birth rates for patients with previous frozen embryo transfer (FET) failure. The purpose of this study is to evaluate whether performing an ERA prior to first time FET with a euploid blastocyst improves the live birth rate. DESIGN: This is a single institution retrospective cohort study. MATERIALS AND METHODS: A retrospective review was performed including all patients in 2017 who underwent first time FET with a euploid blastocyst(s) (n¼220). All patients in this study underwent PGT-A by Nex-Gen sequencing. The embryos were then vitrified. Patients were stratified by ERA status (n¼46) vs. no ERA (n¼174) prior to undergoing FET. The primary outcome was to measure the live birth rate. Secondarily, we measured the implantation rate and the clinical pregnancy rate. A two-sample t-test was used to compare continuous outcomes between groups, and Chi-square testing was used to compare proportions between the two groups. RESULTS: The implantation rate for patients that underwent ERA vs. no ERA prior to FET was 64.6% vs. 60.5% (p¼0.71). The clinical pregnancy rate for ERA vs. no ERA prior to FET was 56.5% vs. 52.8% (0.56). The live birth rate for ERA vs. no ERA prior to FET was 52.2% vs. 51.1% (p¼0.9). The single embryo transfer rate was 96% for the ERA group vs. 98% for the non-ERA group. CONCLUSIONS: Performing an ERA prior to first time FET with a euploid blastocyst did not increase the live birth rate compared to patients who did not have an ERA before their first FET. The differences in implantation and clinical pregnancy rates between the two groups were also not statistically significant. Our findings warrant an adequately powered randomized controlled trial to determine the efficacy of ERA prior to the transfer of a euploid blastocyst.

Human Reproduction Update, Feb 22, 2017

We included 37 studies that investigated a total of 10 689 women. No randomized controlled trials... more We included 37 studies that investigated a total of 10 689 women. No randomized controlled trials were found. Most studies were retrospective cohort studies of a moderate quality. The pooled pregnancy rate after sterilization reversal was 42-69%, with heterogeneity seen from the different methods utilized. The reported ectopic pregnancy rate was 4-8%. The only prognostic factor affecting the chance of conception was female age. The surgical approach (i.e. laparotomy [microscopic], laparoscopy or robotic) had no impact on the outcome, with the exception of the macroscopic laparotomic technique, which had inferior results and is not currently utilized. For older women, IVF could be a more cost-effective alternative for the reversal of sterilization. However, direct comparative data are lacking and a cutoff age cannot be stated. WIDER IMPLICATIONS: In sterilized women who suffer regret, surgical tubal re-anastomosis is an effective treatment, especially in younger women. However, there is a need for randomized controlled trials comparing the success rates and costs of surgical reversal with IVF.

Fertility and Sterility, Sep 1, 1997

To evaluate whether a menstrual cup is a suitable instrument to collect antegradely shed endometr... more To evaluate whether a menstrual cup is a suitable instrument to collect antegradely shed endometrium for in vitro studies. A prospective, descriptive, cell biological and immunohistochemical study. Tertiary care university medical center. Nine female volunteers with regular cycles. Menstrual effluent was collected with a menstrual cup. Experience with the menstrual cup was described. Cytospin specimens, frozen sections, and cultures were prepared from the obtained menstrual tissue. The acceptability of the menstrual cup. The presence and viability of endometrial tissue was evaluated using immunohistochemical staining and culture outcome. All women except one described the menstrual cup as acceptable. Menstrual effluent contained single cells, clumps of cells, and glandlike structures. After 5 days of culture, the endometrial tissue appeared to be viable. Immunohistochemistry showed positive staining for vimentin in most cytospin specimens, in all cryostat specimens, and in 10 of 17 cultures. Cytokeratin 18 stained most cytospin specimens, all cryostat specimens, and 10 of 17 cultures. Positive staining for BW495/36 was observed in most cytospin specimens, all cryostat specimens, and 11 of 17 cultures. A menstrual cup in an acceptable instrument to collect antegradely shed menstrual tissue. Menstruum contains viable endometrial tissue that can be used for in vitro studies of endometrium and endometriosis.

Obstetrical & Gynecological Survey, May 1, 2018

Background In many countries, clomifene citrate is the treatment of first choice in women with no... more Background In many countries, clomifene citrate is the treatment of first choice in women with normogonadotropic anovulation (ie, absent or irregular ovulation). If these women ovulate but do not conceive after several cycles with clomifene citrate, medication is usually switched to gonadotrophins, with or without intrauterine insemination. We aimed to assess whether switching to gonadotrophins is more effective than continuing clomifene citrate, and whether intrauterine insemination is more effective than intercourse. Methods In this two-by-two factorial multicentre randomised clinical trial, we recruited women aged 18 years and older with normogonadotropic anovulation not pregnant after six ovulatory cycles of clomifene citrate (maximum of 150 mg daily for 5 days) from 48 Dutch hospitals. Women were randomly assigned using a central passwordprotected internet-based randomisation programme to receive six cycles with gonadotrophins plus intrauterine insemination, six cycles with gonadotrophins plus intercourse, six cycles with clomifene citrate plus intrauterine insemination, or six cycles with clomifene citrate plus intercourse. Clomifene citrate dosages varied from 50 to 150 mg daily orally and gonadotrophin starting dose was 50 or 75 IU daily subcutaneously. The primary outcome was conception leading to livebirth within 8 months after randomisation defined as any baby born alive after a gestational age beyond 24 weeks. Primary analysis was by intention to treat. We made two comparisons, one in which gonadotrophins were compared with clomifene citrate and one in which intrauterine insemination was compared with intercourse. This completed study is registered with the Netherlands Trial Register, number NTR1449.

Obstetrical & Gynecological Survey, Sep 1, 2016

Obesity is a prevalent health condition that affects 14% to 20% of women of reproductive age. Som... more Obesity is a prevalent health condition that affects 14% to 20% of women of reproductive age. Some of the adverse affects of obesity on reproductive health include increased risks of menstrual dysfunction, anovulation, and infertility, especially resulting in failure of assisted reproductive techniques. There are various guidelines that advocate lifestyle intervention programs aimed at weight loss of 5% to 10% of body weight as the first step in caring for obese infertile women. There is, however, a dearth of randomized controlled trials assessing the effectiveness of lifestyle intervention programs. The objective of this study was to assess the effectiveness of a lifestyle intervention preceding infertility treatment. A multicenter randomized trial was conducted at 6 university medical centers and 17 general hospitals in the Netherlands. Infertile women with a body

Human Reproduction, Jun 23, 2016

What is the feasibility of performing transvaginal hydrolaparoscopy (THL) in an outpatient settin... more 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.

58th Annual ESPE Meeting (ESPE 2019), 2019

SSRN Electronic Journal, 2022

American Journal of Medical Case Reports, 2021

Chorionic villus sampling (CVS) is a procedure in which biopsies of placental tissue are obtained... more Chorionic villus sampling (CVS) is a procedure in which biopsies of placental tissue are obtained for prenatal genetic diagnosis. Risk of infection after CVS is low and only sporadic cases of postprocedural sepsis have been reported. Clostridium perfrigens and Escherichia coli are the most commonly described pathogens in cases of sepsis after prenatal invasive diagnostic procedures. However, this report describes a case of sepsis with fetal loss after CVS caused by Atopobium vaginae.

European journal of nutrition, Jan 3, 2018

To identify demographic, (bio)physical, behavioral, and psychological determinants of successful ... more 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. 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/m), 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. 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 les...