Bruce R Carr

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

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Publications (294)1275.92 Total impact

  • Mohammad Ezzati, Bruce R Carr
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    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 (London, England). 01/2015; 11(1):19-28.
  • Bruce R Carr
    Seminars in Reproductive Medicine 11/2014; 32(6):415-416. · 3.21 Impact Factor
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    ABSTRACT: Do women with polycystic ovary syndrome (PCOS) seeking fertility treatment report smoking accurately and does participation in infertility treatment alter smoking?
    Human reproduction (Oxford, England). 10/2014;
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    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; · 2.18 Impact Factor
  • Bruce R Carr
    Seminars in Reproductive Medicine 09/2014; 32(5):331-332. · 3.21 Impact Factor
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    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; · 1.82 Impact Factor
  • Bruce R Carr
    Seminars in Reproductive Medicine 07/2014; 32(4):241-242. · 3.21 Impact Factor
  • Source
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    ABSTRACT: 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.
    Molecular and Cellular Endocrinology 06/2014; · 4.24 Impact Factor
  • Bruce R Carr
    Seminars in Reproductive Medicine 11/2013; 31(6):387-388. · 3.21 Impact Factor
  • Bruce R Carr
    Seminars in Reproductive Medicine 09/2013; 31(5):311-2. · 3.21 Impact Factor
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    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; · 2.18 Impact Factor
  • Bruce R Carr
    Seminars in Reproductive Medicine 07/2013; 31(4):231-2. · 3.21 Impact Factor
  • Bruce R Carr
    Seminars in Reproductive Medicine 05/2013; 31(3):183-4. · 3.21 Impact Factor
  • Bruce R Carr
    Seminars in Reproductive Medicine 03/2013; 31(2):95-96. · 3.21 Impact Factor
  • Bruce R Carr
    Seminars in Reproductive Medicine 01/2013; 31(1):1-2. · 3.21 Impact Factor
  • Jeffrey T Jensen, Bruce R Carr
    Seminars in Reproductive Medicine 12/2012; 30(6):457-458. · 3.21 Impact Factor
  • Orkun Tan, Bruce R Carr
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    ABSTRACT: Obesity-related infertility is one of the most common problems of reproductive-age obese women who desire childbearing. The various types of bariatric surgeries have proved effective in controlling excessive weight gain, improving fertility, and preventing certain maternal and fetal complications in these women. This article summarizes the current evidence regarding the impact of bariatric surgery on obesity-related infertility and in vitro fertilization (IVF) outcomes. We have also attempted to draw conclusions about maternal and fetal risks and the benefits of bariatric surgery. Laparoscopic adjustable gastric banding and Roux-en-Y procedures are the two most commonly performed bariatric surgeries. Bariatric surgery was believed to improve menstrual irregularity and increase ovulation rate in anovulatory obese women, which lead to increased pregnancy rates. Although there are data in the literature suggesting the improvement of both the ovulatory function and the spontaneous pregnancy rates in obese women who lost weight after bariatric surgery, most of these are case-control studies with a small number of patients. The data are insufficient to determine an ideal time interval for pregnancy after bariatric surgery; however, the general consensus is that pregnancy should be delayed 12 to 18 months after bariatric surgery to avoid nutritional deficiencies. Few data exist regarding IVF success rates in women who have undergone bariatric surgery. One pairwise study discussed five patients who underwent bariatric surgery followed by IVF that resulted in three term pregnancies in three patients after the first IVF cycle. Many studies reported reductions in obesity-related pregnancy complications such as gestational diabetes and hypertensive disorders after bariatric surgery. Although data are inconsistent, some studies reported increased rate of preterm delivery and small for gestational age infants after bariatric surgery. Pregnancies after bariatric surgery may be considered high risk due to the concerns for vitamin deficiencies and gastrointestinal symptoms related to the surgery. Therefore the follow-up of these pregnancies might require a team approach including a maternal fetal medicine specialist, bariatric surgeon, and nutritionist.
    Seminars in Reproductive Medicine 12/2012; 30(6):517-28. · 3.21 Impact Factor
  • Bruce R Carr
    Seminars in Reproductive Medicine 12/2012; 30(6):455-456. · 3.21 Impact Factor
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    ABSTRACT: Potential roles of gonadotropin-releasing hormone (GnRH) antagonists on GnRH/GnRH receptor systems and their effects on the extrapituitary tissues are largely elusive. In this narrated review, we summarized the systemic effects of GnRH antagonists on ovary, endometrium, embryo implantation, placental development, fetal teratogenicity, reproductive tissue cancer cells, and heart while briefly reviewing the GnRH and GnRH receptor system. GnRH antagonists may have direct effects on ovarian granulosa cells. Data are conflicting regarding their effects on endometrial receptivity. The GnRH antagonists may potentially have detrimental effect on early placentation by decreasing the invasive ability of cytotrophoblasts if the exposure to them occurs during early pregnancy. The GnRH antagonists were not found to increase the rates of congenital malformations. Comparative clinical data are required to explore their systemic effects on various extrapituitary tissues such as on cardiac function in the long term as well as their potential use in other human cancers that express GnRH receptors.
    Reproductive sciences (Thousand Oaks, Calif.) 09/2012; · 2.18 Impact Factor
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    ABSTRACT: Ovarian pathology, including nonfunctional tumors and massive edema of the ovary, has been associated with stromal luteinization and clinical endocrinopathies. An adolescent girl presented with primary amenorrhea, clitoromegaly, and large abdominopelvic mass. Laboratory evaluation revealed an elevated serum total testosterone level of 241 ng/dL. Magnetic resonance imaging confirmed three cystic adnexal structures, with the largest measuring 16 × 8 × 18 cm. Surgery with pelvic washings, bilateral ovarian cystectomies, unilateral paratubal cystectomy, and bilateral ovarian biopsies were performed. Pathology confirmed bilateral mucinous cystadenomas and massive edema of the ovaries. Postoperatively, the serum total testosterone level normalized. Nonfunctional ovarian tumors and massive edema of the ovaries should be considered in the differential diagnosis for a patient presenting with signs of hyperandrogenism.
    Obstetrics and Gynecology 08/2012; 120(2 Pt 2):473-6. · 4.37 Impact Factor

Publication Stats

5k Citations
1,275.92 Total Impact Points

Institutions

  • 1979–2014
    • 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
    • Oregon Health and Science University
      • Department of Obstetrics & Gynecology
      Portland, OR, United States
  • 2011
    • St George's, University of London
      Londinium, England, United Kingdom
    • University of Miami Miller School of Medicine
      • Department of Obstetrics and Gynecology
      Miami, FL, United States
  • 2003–2010
    • Università della Calabria
      • Department of Pharmaco-Biology
      Rende, Calabria, Italy
  • 2009
    • University of Florida
      • Department of Obstetrics and Gynecology
      Gainesville, FL, United States
    • Alpert Medical School - Brown University
      • Department of Obstetrics and Gynecology
      Providence, RI, United States
  • 2008
    • Georgia Health Sciences University
      • Department of Physiology
      Augusta, GA, United States
    • Stanford Medicine
      Stanford, California, United States
  • 2007–2008
    • Rutgers New Jersey Medical School
      • Department of Obstetrics, Gynecology and Women's Health
      Newark, NJ, United States
  • 2006–2008
    • Center for Assisted Reproduction
      Bedford, Texas, United States
  • 2005
    • University of Adelaide
      Tarndarnya, South Australia, Australia
  • 2001
    • Tohoku University
      • Department of Pathology
      Sendai-shi, Miyagi-ken, Japan
  • 1995
    • Carolinas Medical Center University
      Charlotte, North Carolina, United States
  • 1982–1993
    • University of Texas at Dallas
      Richardson, Texas, United States
  • 1986–1987
    • University of Texas Health Science Center at Tyler
      Tyler, Texas, United States