Bruce R Carr

University of Texas Southwestern Medical Center, Dallas, Texas, United States

Are you Bruce R Carr?

Claim your profile

Publications (308)1379.04 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Heterozygous gene mutations in fumarate hydratase can result in a syndrome characterized by hereditary (cutaneous and uterine) leiomyomatosis and renal cell cancer. This disorder has been described in more than 200 families, but the prevalence of the disease is unknown. A 22 year-old woman of Bangladeshi lineage presented with menorrhagia and pelvic pain secondary to uterine leiomyomas and underwent an abdominal myomectomy. Because of a family history of renal cell cancer, she was tested for fumarate hydratase mutations and found to be a carrier. As a result of the risk of renal cell cancer associated with this mutation, an annual surveillance plan was initiated. Fumarate hydratase gene mutations should be considered in women presenting with leiomyomas and a family history of renal cancer.
    Obstetrics and Gynecology 04/2015; 126(1). DOI:10.1097/AOG.0000000000000702 · 5.18 Impact Factor
  • Mohammad Ezzati · Bruce R Carr
    [Show abstract] [Hide abstract]
    ABSTRACT: Suppression of estrogen production and reduction of menstrual blood flow are the mainstays of medical treatment of endometriosis-related pain and have been traditionally achieved by methods such as combined hormonal contraception, progestins and GnRH analogs, all with comparable efficacies, though different side-effect profiles. Elagolix is the frontrunner among an emerging class of GnRH antagonists, which unlike their peptide predecessors has a nonpeptide structure resulting in its oral bioavailability. Phase I and II clinical trials have demonstrated safety of elagolix and its efficacy in partial and reversible suppression of ovarian estrogen production resulting in improvements in endometriosis-related pain. Phase III clinical trials are currently underway and elagolix may become a valuable addition to the armamentarium of pharmacological agents to treat endometriosis-related pain.
    Women s Health 01/2015; 11(1):19-28. DOI:10.2217/whe.14.68
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: Treatment of menopausal symptoms by compounds with tissue-selective estrogen agonist/antagonist effects, often called selective estrogen receptor modulators, has been researched as an alternative to the use of estrogen therapy. These structurally diverse molecules elicit tissue-dependent responses in hormone-responsive tissues and organs, exhibiting variations in estrogenic activity in preclinical models of postmenopausal reproductive tissues that may improve postmenopausal women's health (eg, prevention and treatment of breast cancer, osteoporosis, and vulvar and vaginal atrophy). Methods: This literature review investigates whether preclinical data predicted the clinical effects of ospemifene on female reproductive and urinary tract tissues and compares these findings with the specific vaginal effects of other estrogen receptor agonists/antagonists (tamoxifen, raloxifene, and bazedoxifene) in preclinical and clinical studies. Lasofoxifene, although not currently available, is included because of its unique effects on vaginal tissue. Results: The response of endometrial and vaginal tissues to estrogen receptor agonists/antagonists can be differentiated using transvaginal ultrasound, endometrial histopathology, cytologic examination of vaginal smears, assessment of physical changes in the vagina, and relief of symptoms associated with vulvar and vaginal atrophy (such as dyspareunia). Conclusions: Available evidence indicates that ospemifene has unique effects on tissue, leading to a favorable long-term profile for the relief of vulvar and vaginal atrophy compared with other estrogen receptor agonists/antagonists (eg, tamoxifen, raloxifene, and bazedoxifene) with no short-term concerns about endometrial safety (based on endometrial hyperplasia, carcinoma, endometrial spotting, and endometrial bleeding).
    Menopause (New York, N.Y.) 11/2014; 22(7). DOI:10.1097/GME.0000000000000365 · 3.36 Impact Factor
  • Bruce R Carr
    Seminars in Reproductive Medicine 11/2014; 32(6):415-416. DOI:10.1055/s-0034-1384686 · 2.35 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: STUDY QUESTION Do women with polycystic ovary syndrome (PCOS) seeking fertility treatment report smoking accurately and does participation in infertility treatment alter smoking?
    Human Reproduction 10/2014; 29(12). DOI:10.1093/humrep/deu239 · 4.57 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: This randomized double-blind study, with 24-week treatment and 24-week posttreatment periods, evaluated the effects of elagolix (150 mg every day, 75 mg twice a day) versus subcutaneous depot medroxyprogesterone acetate (DMPA-SC) on bone mineral density (BMD), in women with endometriosis-associated pain (n = 252). All treatments induced minimal mean changes from baseline in BMD at week 24 (elagolix 150 mg: -0.11%/-0.47%, elagolix 75 mg: -1.29%/-1.2%, and DMPA-SC: 0.99%/-1.29% in the spine and total hip, respectively), with similar or less changes at week 48 (posttreatment). Elagolix was associated with improvements in endometriosis-associated pain, assessed with composite pelvic signs and symptoms score (CPSSS) and visual analogue scale, including statistical noninferiority to DMPA-SC in dysmenorrhea and nonmenstrual pelvic pain components of the CPSSS. The most common adverse events (AEs) in elagolix groups were headache, nausea, and nasopharyngitis, whereas the most common AEs in the DMPA-SC group were headache, nausea, upper respiratory tract infection, and mood swings. This study showed that similar to DMPA-SC, elagolix treatment had minimal impact on BMD over a 24-week period and demonstrated similar efficacy on endometriosis-associated pain.
    Reproductive sciences (Thousand Oaks, Calif.) 09/2014; 21(11). DOI:10.1177/1933719114549848 · 2.23 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Purpose To determine whether postwashed total progressively motile sperm count (TPMSC) obtained by CASA estimates could predict positive pregnancy test result in non-donor IUI cycles. Methods Six thousand eight hundred and seventy one (6,871) IUI cycles with non-donor semen were retrospectively analyzed. Patient, cycle characteristics and prewashed and postwashed semen parameters were included in analysis. The main outcome measure was the positive pregnancy test result. Results The pregnancy rate per cycle (PR/cycle) when postwashed TPMSC is between 0–0.5 million, 0.51–1 million, 1.01–5 million, 5.01–10 million and greater than 10 million were 8.1 % (42/520), 14.4 % (41/285), 16.1 % (237/1,469), 18.4 % (193/1,046) and 18.8 % (668/3,551) respectively. The predicted odd of positive pregnancy result is statistically significantly higher when TPMSC is >0.51 million compared to the TPMSC of
    Journal of Assisted Reproduction and Genetics 09/2014; 31(9):1147-1153. DOI:10.1007/s10815-014-0306-0 · 1.72 Impact Factor
  • Bruce R Carr
    Seminars in Reproductive Medicine 09/2014; 32(5):331-332. DOI:10.1055/s-0034-1381230 · 2.35 Impact Factor
  • S.N. Babayev · O. Bukulmez · B.R. Carr · R.A. Word
    Fertility and Sterility 09/2014; 102(3):e238. DOI:10.1016/j.fertnstert.2014.07.808 · 4.59 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: With the advent of assisted reproductive technology in the past three decades, the clinical importance of fallopian tubes has been relatively overlooked. However, successful spontaneous conception requires normal function of the tube to provide not only a conduit for the gametes to convene and embryo to reach the uterine cavity, but also a physiologically optimized environment for fertilization and early embryonic development. In this review, after a brief description of normal human tubal anatomy and histology, we will discuss tubal transport and its principal effectors, including ciliary motion, muscular contractility and tubal fluid. Furthermore, we will discuss the ciliary ultrastructure and regulation of ciliary beat frequency by ovarian steroids, follicular fluid, angiotensin system, autonomic nervous system and other factors such as adrenomedullin and prostaglandins. In the last section, we describe the adverse impact of various pathological conditions, such as endometriosis, infection and smoking on tubal function and ciliary motility.
    Journal of Assisted Reproduction and Genetics 08/2014; 31(10). DOI:10.1007/s10815-014-0309-x · 1.72 Impact Factor
  • Bruce R Carr
    Seminars in Reproductive Medicine 07/2014; 32(4):241-242. DOI:10.1055/s-0034-1375174 · 2.35 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: 46,XY sex reversal is a rare disorder and familial cases are even more rare. The purpose of the present study was to determine the molecular basis for a family with three affected siblings who had 46,XY sex reversal. Methods: DNA was extracted from three females with 46,XY sex reversal, two normal sisters, and both unaffected parents. All protein coding exons of the SRY and NR5A1 genes were subjected to PCR-based DNA sequencing. In addition, array comparative genomic hybridization was performed on DNA from all seven family members. A deletion was confirmed using quantitative polymerase chain reaction. Expression of SOX9 gene was quantified using reverse transcriptase polymerase chain reaction. Results: A 349kb heterozygous deletion located 353kb upstream of the SOX9 gene on the long arm of chromosome 17 was discovered in the father and three affected siblings, but not in the mother. The expression of SOX9 was significantly decreased in the affected siblings. Two of three affected sisters had gonadoblastomas. Conclusion: This is the first report of 46,XY sex reversal in three siblings who have a paternally inherited deletion upstream of SOX9 associated with reduced SOX9 mRNA expression.
    Molecular and Cellular Endocrinology 06/2014; 393(1-2). DOI:10.1016/j.mce.2014.05.006 · 4.41 Impact Factor
  • Bruce R Carr
    Seminars in Reproductive Medicine 01/2014; 32(1):1-2. DOI:10.1055/s-0033-1361815 · 2.35 Impact Factor
  • Bruce R Carr
    Seminars in Reproductive Medicine 11/2013; 31(6):387-388. DOI:10.1055/s-0033-1356472 · 2.35 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Our study compares the efficacy of the combined contraceptive vaginal ring to oral contraceptive pills (OCPs) for hypothalamic-pituitary-ovarian (HPO) axis suppression in egg donor in vitro fertilization (IVF) cycles. Our retrospective cohort study includes patients from the Center for Assisted Reproduction (CARE) in Bedford, Texas undergoing IVF cycles as egg donors from January 2003 through December 2009. Twenty-five and thirty-nine women were treated with OCPs and the combined contraceptive vaginal ring, respectively. Statistical analyses were performed using the SigmaStat Software package (Systat, Chicago, IL). Data were analyzed by t or Mann-whitney test and Chi-square of Fisher exact test. Statistical significance was set at p<0.05. Prior to gonadotropin initiation, endometrial thickness and serum estradiol were 5.6±2.6 mm and 33.6±19.9 pg/ml in the OCP group and 6.0±2.4 mm and 36.6±24.3 pg/ml in the combined contraceptive vaginal ring group, respectively (p=0.49 and p=0.33). Average serum FSH and LH were 1.7±1.9 and 1.7±2.5 mIU/ml in the OCP group and 1.7±1.6 and 1.2±1.4 mIU/ml in the combined contraceptive vaginal ring group, respectively (p=0.45 and p=0.95). No significant differences were found for gonadotropin requirement, peak estradiol, maximal endometrial thickness, number of oocytes retrieved, number of normally fertilized embryos, number of cryopreserved embryos, or live birth rates. The combined contraceptive vaginal ring is effective for HPO axis suppression in egg donor IVF cycles and associated with cycle characteristics similar to those observed with OCP treatment. The combined contraceptive vaginal ring may provide an important advantage over OCPs due to improved patient compliance.
    Journal of Reproduction and Infertility 10/2013; 14(4):207-13.
  • Bruce R Carr
    Seminars in Reproductive Medicine 09/2013; 31(5):311-2. DOI:10.1055/s-0033-1348887 · 2.35 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: This Phase 2 study evaluated the safety and efficacy of elagolix for treating endometriosis-associated pain. A total of 155 women with laparoscopically confirmed endometriosis were randomized to placebo, elagolix 150 mg, or elagolix 250 mg once daily for 12 weeks. Placebo patients were rerandomized to elagolix and elagolix patients continued their dosing assignment for 12 additional weeks; the primary efficacy measure was changed from baseline in the monthly mean numerical rating scale for pain at week 12. Monthly mean (standard error of the mean) reductions were greater with elagolix versus placebo (-1.19 ± 0.18, -1.25 ± 0.18, and -0.88 ± 0.18 for elagolix 150 mg, 250 mg, and placebo, respectively); differences were not statistically significant. Monthly mean dysmenorrhea and nonmenstrual pelvic pain scores were reduced with elagolix, with significant differences for dysmenorrhea at weeks 8 and 12 versus placebo (P < .05). Minimal bone mineral density changes were observed with elagolix treatment. In women with endometriosis-associated pain, elagolix demonstrated an acceptable efficacy and safety profile in this Phase 2 study.
    Reproductive sciences (Thousand Oaks, Calif.) 07/2013; 21(3). DOI:10.1177/1933719113497292 · 2.23 Impact Factor
  • Bruce R Carr
    Seminars in Reproductive Medicine 07/2013; 31(4):231-2. DOI:10.1055/s-0033-1345267 · 2.35 Impact Factor
  • Bruce R Carr
    Seminars in Reproductive Medicine 05/2013; 31(3):183-4. DOI:10.1055/s-0033-1336596 · 2.35 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The Foxos are key effectors of the PI3K/Akt signaling pathway and regulate diverse physiologic processes. Two of these factors, Foxo1 and Foxo3, serve specific roles in reproduction in the mouse. Foxo3 is required for suppression of primordial follicle activation in females while Foxo1 regulates spermatogonial stem cell maintenance in males. In the mouse ovary, Foxo1 is highly expressed in somatic cells (but not in oocytes), suggesting an important functional role for Foxo1 in these cells. Given that invertebrate model species such as C. elegans and D. melanogaster harbor a single ancestral Foxo homolog, these observations suggest that gene duplication conferred a selective advantage by permitting the Foxos to adopt distinct roles in oogenesis and spermatogenesis. Our objective was to determine if the remarkably specific expression patterns of Foxo1 and Foxo3 in mouse gonads (and by inference, Foxo function) are conserved in diverse mammalian species. Western blotting was used to validate isoform-specific antibodies in rodents, companion animals, farm animals, nonhuman primates, and humans. Following validation of each antibody, immunohistochemistry (IHC) was performed to ascertain Foxo1 and Foxo3 gonadal expression patterns. While Foxo1 expression in spermatogonia and granulosa cells was conserved in each species evaluated, Foxo3 expression in oocytes was not. Our findings suggest that Foxo3 is not uniquely required for primordial follicle maintenance in nonrodent species, and that other Foxos, particularly Foxo1, may contribute to oocyte maintenance in a functionally-redundant manner.
    Biology of Reproduction 03/2013; 88(4). DOI:10.1095/biolreprod.112.105791 · 3.32 Impact Factor

Publication Stats

7k Citations
1,379.04 Total Impact Points


  • 1987–2014
    • University of Texas Southwestern Medical Center
      • • Division of Reproductive Endocrinology and Infertility
      • • Department of Obstetrics and Gynecology
      • • Green Center for Reproductive Biology Sciences
      Dallas, Texas, United States
  • 2012
    • Alpert Medical School - Brown University
      • Department of Obstetrics and Gynecology
      Providence, Rhode Island, United States
    • University of Pittsburgh
      • Division of General Obstetrics and Gynecology
      Pittsburgh, Pennsylvania, United States
  • 1980–2012
    • University of Texas at Dallas
      • Biochemistry
      Richardson, Texas, United States
  • 2006
    • Children's Medical Center Dallas
      Dallas, Texas, United States
  • 2005
    • University of Adelaide
      Tarndarnya, South Australia, Australia
  • 2001
    • Tohoku University
      • Department of Pathology
      Sendai-shi, Miyagi-ken, Japan
  • 1998
    • University of Dallas
      Irving, Texas, United States
  • 1995
    • Carolinas Medical Center University
      Charlotte, North Carolina, United States
  • 1993
    • University of North Carolina at Chapel Hill
      • Department of Obstetrics and Gynecology
      North Carolina, United States
  • 1986–1988
    • University of Texas Health Science Center at Tyler
      Tyler, Texas, United States
  • 1979–1981
    • University of Texas Medical School
      Houston, Texas, United States