The ability of several endocrine tests to distinguish between women with and without polycystic ovaries (PCO) has been studied prospectively in a series of 65 patients with functional oligo-amenorrhoea using ultrasonography as a reference test. In terms of overall diagnostic accuracy, the free androgen index (FAI) (94%) and the progestogen challenge (89%) gave similar results (Cl = -5 to 15%) but both were significantly better than all the other tests including measurement of serum LH (69%), total testosterone (71%) and androstenedione (74%) (minimum Cl = 6 to 23%). The FAI together with LH measurement was the most accurate of the combinations (97%) but this was not significantly better than the best of the combinations incorporating the progestogen challenge (92%; Cl = -3% to 13%). Given the limited availability of the assay for SHBG, these results show that assessment of oestrogen state is a useful method for categorizing patients with functional oligo-amenorrhoea.
Purpose : To predict the ongoing likelihood of natural conception, when a couple has ceased to try to conceive by assisted conception. Methods : A postal questionnaire survey obtained information on further attempts to conceive and have a baby, either without treatment or by treatment elsewhere. Results : From a response rate of 44%, there were 116 couples who fulfilled the study criteria. The data presented are based on this group. The overall likelihood of conception was 18%. Cumulative results were analysed up to 3 years following treatment. Univariate analysis showed that likelihood of conception was affected by infertility diagnosis (p = 0.024), woman's age (>38 years; p < 0.005) (negatively) and duration of infertility (<3 years; p < 0.005) (positively), while primary infertility did not. Effects of diagnosis and infertility duration were confirmed by multivariable analysis, controlling for age and primary infertility. These latter variables had no independent effect. Conclusion : The likelihood of natural conception following IVF treatment was determined by duration of infertility and diagnosis; tubal disease in particular was associated with a very poor likelihood of natural conception.
SummaryThe status of nose bleeding as a symptom of high blood pressure has been studied in patients admitted because of epistaxis. Twenty-six patients with a factor predisposing to nasal bleeding had age-and sexadjusted systolic and diastolic scores similar to those of the general population. One hundred and sixty-eight patients with no such factor formed a different population with significantly higher age-and sex-adjusted systolic and diastolic scores. It is concluded that epistaxis is a true symptom of hypertension.
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