Siladitya Bhattacharya

University of Aberdeen, Aberdeen, Scotland, United Kingdom

Are you Siladitya Bhattacharya?

Claim your profile

Publications (98)444.1 Total impact

  • Natalie Whitelaw, Siladitya Bhattacharya, David McLernon, Mairead Black
    [Show abstract] [Hide abstract]
    ABSTRACT: Repeat caesarean sections make a substantial contribution to the overall caesarean section rate. It is important to understand what influences women to choose this option when the alternative of attempting vaginal birth after caesarean section is available. As many such women use the internet while seeking information on their options, the aim of this study was to assess content of websites on birth after previous caesarean and identify website characteristics which predict content.
    BMC Pregnancy and Childbirth 10/2014; 14(1):361. · 2.52 Impact Factor
  • Shilpi Pandey, Maureen Porter, Siladitya Bhattacharya
    [Show abstract] [Hide abstract]
    ABSTRACT: Background Researchers are being urged to involve patients in the design and conduct of studies in health care with limited insight at present into their needs, abilities or interests. This is particularly true in the field of reproductive health care where many conditions such as pregnancy, menopause and fertility problems involve women who are otherwise healthy.Objective To ascertain the feasibility of involving patients and members of the public in research on women's reproductive health care (WRH).SettingUniversity and tertiary care hospital in north-east Scotland; 37 women aged 18–57.Method Four focus groups and one individual interview were audio-recorded and verbatim transcripts analysed thematically by two researchers using a grounded theory approach.Results and discussionMost participants were interested in WRH, but some participated to promote a health issue of special concern to them. Priorities for research reflected women's personal concerns: endometriosis, polycystic ovary syndrome, menopause, fertility risks of delaying parenthood and early post-natal discharge from hospital. Women were initially enthusiastic about getting involved in research on WRH at the design or delivery stage, but after discussion in focus groups, some questioned their ability to do so or the time available to commit to research. None of the respondents expected payment for any involvement, believing that the experience would be rewarding enough in itself.Conclusions Involving patients and public in research would include different perspectives and priorities; however, recruiting for this purpose would be challenging.
    Health expectations: an international journal of public participation in health care and health policy 09/2014; · 1.80 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: What is the impact of different age and BMI groups on total investigation and treatment costs in women attending a secondary/tertiary care fertility clinic?
    Human reproduction (Oxford, England). 07/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Increasing numbers of children are being conceived by assisted reproductive technology (ART). A number of studies have highlighted an altered epigenetic status in gametes from infertile couples and the possibility of an increased risk of imprinting defects and somatic epigenetic changes in ART conceived children, but the results have been heterogeneous. We performed a systematic review of existing studies to compare the incidence of imprinting disorders and levels of DNA methylation in key imprinted genes in children conceived through in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) with those in children conceived spontaneously.
    Human reproduction update. 06/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: One in five women in the United Kingdom is obese at antenatal booking. We aimed to determine whether maternal obesity during pregnancy is associated with increased mortality from cardiovascular events in later life.
    Heart (British Cardiac Society) 06/2014; 100(Suppl 3):A65-A66. · 5.01 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: How does maternal cigarette smoking disturb development of the human fetal ovary?
    Human reproduction (Oxford, England). 05/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Is DNA methylation in buccal cell DNA from children born following IVF (in vitro fertilization) and ICSI (intra-cytoplasmic sperm injection) different from that of spontaneously conceived children? DNA methylation in the imprinted gene, small nuclear ribonucleoprotein polypeptide N (SNRPN), was higher in children conceived by ICSI and in those born to women with the longest duration of infertility regardless of the method of conception. Fertility treatment is associated with a small but significant increase in the risk of a range of adverse obstetric outcomes, birth defects and longer term sequelae, but the biological basis for this is unknown. A growing evidence base suggests that epigenetics may play a role in subfertility and the link between fertility and health. In this retrospective cohort study of children born between 2002 and 2008, we measured DNA methylation in paternally expressed gene 3 (PEG3), insulin-like growth factor II (IGF2), SNRPN, long interspersed nuclear element 1 (LINE1) and the insulin gene (INS) in buccal cell DNA from children born following IVF (n = 49) and ICSI (n = 20) and compared them with a matched spontaneous conception group (n = 86). Participants were identified from the Aberdeen Maternity and Neonatal Databank and IVF and ICSI pregnancies were matched to spontaneous conception pregnancies on year of birth and maternal age at delivery. Only singleton pregnancies following fresh embryo transfer were included. DNA methylation was determined by pyrosequencing. Regression with adjustment for covariates was used to determine the effect of infertility on offspring DNA methylation. SNRPN methylation in the offspring was linked to fertility treatment in the parents. This effect was specific to children conceived using ICSI and was apparent in the comparison of ICSI versus spontaneous conception (1.03%; 95% CI 0.10, 1.97; P = 0.031), ICSI versus standard IVF (1.13%; 95% CI 0.04, 2.23; P = 0.043) and ICSI versus standard IVF and spontaneous conception (1.05; 95% CI 0.15, 1.94; P = 0.023). In all comparisons, the use of ICSI was associated with a higher level of SNRPN methylation in the offspring. A higher level of SNRPN methylation in the offspring was also associated with a longer duration of infertility in the parents. This was observed in all cases of infertility (0.18% per year of infertility; 95% CI 0.02, 0.33; P = 0.026) and after excluding ICSI cases (0.21% per year of infertility; 95% CI 0.04, 0.37; P = 0.017). There was a significant increase in the level of LINE1 methylation with age between birth and 7 years (0.77% per year; 95% CI 0.49, 1.05; P < 0.001). Methylation in the INS gene decreased significantly over the same period (-0.46% per year; 95% CI -0.89, -0.03; P = 0.035). There was no evidence from this cross-sectional data that methylation within the imprinted genes changed over the first 7 years of life. The ICSI sample size was limited but the groups were carefully selected and well matched and the SNRPN findings were consistent across different outcomes. The results of this study provide support for a role for epigenetics, and imprinting in particular, in fertility. The specific changes point to possible long-term consequences of fertility treatment for the health and fertility of future generations. The authors report no conflict of interest in relation to this work. Funding was provided by the University of Aberdeen and the Scottish Government. Not applicable.
    Human Reproduction 05/2014; · 4.67 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The expression and regulation of endometrial proteins are crucial for conceptus implantation and development. However, little is known about site-specific proteome profiles of the mammalian endometrium during the peri-implantation period. We utilized two-dimensional gel electrophoresis/mass spectrometry-based proteomics approach to compare and identify differentially expressed proteins in sheep endometrium. Caruncular and intercaruncular endometrium were collected on days 12 and 16 of the oestrous cycle and at three stages of pregnancy corresponding to conceptus pre-attachment (day 12), implantation (day 16) and post-implantation (day 20). Abundance and localisation changes in differentially expressed proteins were determined by Western blot and immunohistochemistry. In caruncular endometrium, 45 protein spots (5% of total spots) altered between days 12 and 16 of pregnancy while 85 protein spots (10% of total spots) were differentially expressed between day 16 of pregnancy and day 16 of the oestrous cycle. In intercaruncular endometrium, 31 protein spots (2% of total spots) were different between days 12 and 16 of pregnancy while 44 protein spots (4% of total spots) showed differential expression between days 12 and 16 of the oestrous cycle. The pattern of protein changes between caruncle and intercaruncle sites were markedly different. Among the protein spots with implantation related changes in volume, 11 proteins in the caruncular endometrium and 6 proteins in the intercaruncular endometrium, with different functions such as protein synthesis and degradation, antioxidant defence, cell structural integrity, adhesion and signal transduction, were identified. Our findings highlight the different but important roles of the caruncular and intercaruncular proteins during early pregnancy.
    Reproduction 01/2014; · 3.56 Impact Factor
  • Siladitya Bhattacharya, Mohan S Kamath
    [Show abstract] [Hide abstract]
    ABSTRACT: Multiple pregnancy, a complication of assisted reproduction technology, is associated with poorer maternal and perinatal outcomes. The primary reason behind this is the strategy of replacing more than one embryo during an assisted reproduction technology cycle to maximise pregnancy rates. The solution to this problem is to reduce the number of embryos transferred during in-vitro fertilisation. The transition from triple- to double-embryo transfer, which decreased the risk of triplets without compromising pregnancy rates, was easily implemented. The adoption of a single embryo transfer policy has been slow because of concerns about impaired pregnancy rates in a fresh assisted reproduction technology cycle. Widespread availability of effective cryopreservation programmes means that elective single embryo transfer, along with subsequent frozen embryo transfers, could provide a way forward. Any such strategy will need to consider couples' preferences and existing funding policies, both of which have a profound influence on decision making around embryo transfer.
    Best practice & research. Clinical obstetrics & gynaecology 12/2013; · 1.87 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Guidelines issued by a number of bodies highlight the importance of providing information on fertility for young adults receiving a cancer diagnosis. However, previous research has established that provision is uneven and even when information is available, counselling may not be offered. This paper draws on interviews with 15 professionals and 30 younger adults (17-39 years) following a diagnosis of cancer at one tertiary referral centre. Sociological insights highlight the disruption to biographies, plans, identities and personal values involved in acknowledging and responding to the impact of cancer on fertility. Patients and professionals are involved in making difficult decisions in a rapidly evolving situation, in terms of both progression of cancer and advances in treatments for cancer and fertility preservation. It is argued that the constellation of knowledge and skills required does not readily map onto existing professional roles and we suggest that it may be appropriate to provide further training or even to draw on the services of specialist 'oncofertility' counsellors.
    Human Fertility 03/2013; · 1.60 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To determine whether maternal obesity during pregnancy is associated with increased mortality from cardiovascular events in adult offspring. Record linkage cohort analysis. Birth records from the Aberdeen Maternity and Neonatal databank linked to the General Register of Deaths, Scotland, and the Scottish Morbidity Record systems. 37 709 people with birth records from 1950 to present day. Death and hospital admissions for cardiovascular events up to 1 January 2012 in offspring aged 34-61. Maternal body mass index (BMI) was calculated from height and weight measured at the first antenatal visit. The effect of maternal obesity on outcomes in offspring was tested with time to event analysis with Cox proportional hazard regression to compare outcomes in offspring of mothers in underweight, overweight, or obese categories of BMI compared with offspring of women with normal BMI. All cause mortality was increased in offspring of obese mothers (BMI >30) compared with mothers with normal BMI after adjustment for maternal age at delivery, socioeconomic status, sex of offspring, current age, birth weight, gestation at delivery, and gestation at measurement of BMI (hazard ratio 1.35, 95% confidence interval 1.17 to 1.55). In adjusted models, offspring of obese mothers also had an increased risk of hospital admission for a cardiovascular event (1.29, 1.06 to 1.57) compared with offspring of mothers with normal BMI. The offspring of overweight mothers also had a higher risk of adverse outcomes. Maternal obesity is associated with an increased risk of premature death in adult offspring. As one in five women in the United Kingdom is obese at antenatal booking, strategies to optimise weight before pregnancy are urgently required.
    BMJ (online) 01/2013; 347:f4539. · 17.22 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Tubal ectopic pregnancy (tEP) is the most common life-threatening condition in gynaecology. tEPs with pretreatment serum human chorionic gonadotrophin (hCG) levels <1000 IU/L respond well to outpatient medical treatment with intramuscular methotrexate (MTX). TEPs with hCG >1000 IU/L take a significant time to resolve with MTX and require multiple outpatient monitoring visits. Gefitinib is an orally active epidermal growth factor receptor (EGFR) antagonist. In preclinical studies, we found that EP implantation sites express high levels of EGFR and that gefitinib augments MTX-induced regression of pregnancy-like tissue. We performed a phase I toxicity study administering oral gefitinib and intramuscular MTX to 12 women with tEPs. The combination therapy did not cause significant toxicities and was well tolerated. We noted that combination therapy resolved the tEPs faster than MTX alone. We now describe the protocol of a larger single arm trial to estimate the efficacy and side effects of combination gefitinib and MTX to treat stable tEPs with hCG 1000-10 000 IU/L METHODS AND ANALYSIS: We propose to undertake a single-arm multicentre open label trial (in Edinburgh and Melbourne) and recruit 28 women with tEPs (pretreatment serum hCG 1000-10 000 IU/L). We intend to give a single dose of intramuscular MTX (50 mg/m(2)) and oral gefitinib (250 mg) daily for 7 days. Our primary outcome is the resolution of EP to non-pregnant hCG levels <15 IU/L without requirement of surgery. Our secondary outcomes are comparison of time to resolution against historical controls given MTX only, and safety and tolerability as determined by clinical/biochemical assessment. Ethical approval has been obtained from Scotland A Research Ethics Committee (MREC 11/AL/0350), Southern Health Human Research Ethics Committee B (HREC 11180B) and the Mercy Health Human Research Ethics Committee (R12/25). Data will be presented at international conferences and published in peer-reviewed journals. ACTRN12611001056987.
    BMJ Open 01/2013; 3(7). · 1.58 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective To perform a systematic review and meta-analysis of obstetric and perinatal complications in singleton pregnancies after the transfer of blastocyst-stage and cleavage-stage embryos generated through IVF. Design Systematic review. Setting University hospital. Patient(s) Singleton pregnancies resulting from ET at the blastocyst stage versus those at the cleavage stage. Intervention(s) Medline, EMBASE, Cochrane Central Register of Clinical Trials DARE, and CINAHL (1980–2013) were searched. Two independent reviewers extracted data and assessed the methodological quality of the relevant studies using CASP scoring. Risk ratios and risk differences were calculated in Rev Man 5.1. Main Outcome Measure(s) Very preterm birth, preterm birth, small for gestational age, low birth weight, very low birth weight, congenital anomalies, perinatal mortality, preeclampsia, and placenta previa. Result(s) In vitro fertilization pregnancies occurring as a result of ET at the blastocyst stage were associated with a higher relative risk (RR; 95% confidence interval [CI]) of preterm (RR 1.27; 95% CI 1.22–1.31) and very preterm delivery (RR 1.22; 95% CI 1.10–1.35) in comparison with those resulting from the transfer of cleavage-stage embryos. The risk of growth restriction was lower in babies conceived through blastocyst transfer (RR 0.82; 95% CI 0.77–0.88). Conclusion(s) Data from observational studies show that ET at the blastocyst stage is associated with a higher risk of very preterm delivery. However, we were not able to adjust for confounders. Perinatal outcome data from existing randomized trials are needed to determine the safety of ET at the blastocyst stage compared with the cleavage stage.
    Fertility and Sterility. 01/2013; 100(6):1615–1621.e10.
  • Source
    Siladitya Bhattacharya, Abha Maheshwari, Jill Mollison
    [Show abstract] [Hide abstract]
    ABSTRACT: In-vitro fertilization (IVF) is the treatment of choice for unresolved infertility. It comprises a number of key steps, each of which has to be negotiated before the next is attempted, but the factors which are associated with failure at each stage have not been reported. We analyzed anonymised national data on women undergoing their first fresh autologous IVF and intracytoplasmic sperm injection (ICSI) cycle in the United Kingdom between 2000 and 2007 to predict factors associated with overall lack of livebirth as well as the chance of non-progress at different stages of an IVF cycle. A total of 121,744 women were included in this analysis. Multivariable models underlined the importance of increased female age and duration of infertility, lack of previous pregnancy, and a diagnosis of tubal or male factor infertility in predicting the risk of not having a live birth in an IVF treatment. At each stage, a woman's chance of proceeding to the next stage of IVF treatment is affected by increased age and duration of infertility. The intention to use intra-cytoplasmic sperm injection (ICSI) is associated with a decreased risk of treatment failure in women starting an IVF cycle (RR 0.93, 99% CI 0.92, 0.94) but this association is reversed at a later stage once fertilisation has been confirmed (RR=1.01, 99%CI 1.00, 1.03). Female age is a key predictor of failure to have a livebirth following IVF as well as the risk of poor performance at each stage of treatment. While increased duration of infertility is also associated with worse outcomes at every stage, its impact appears to be less influential. Women embarking on ICSI treatment for male factor infertility have a lower chance of treatment failure but this does not appear to be due to increased chances of implantation of ICSI embryos.
    PLoS ONE 01/2013; 8(12):e82249. · 3.53 Impact Factor
  • Source
  • Mohan S Kamath, Siladitya Bhattacharya
    [Show abstract] [Hide abstract]
    ABSTRACT: The cause of infertility is unexplained in about 22-28% of all infertile couples. The prognosis for spontaneous pregnancy in such couples is better than in those with diagnosed causes of infertility. Traditional treatment options in this group have included expectant management, clomifene citrate, intrauterine insemination with (super ovulation plus intrauterine insemination) or without (intrauterine insemination) super ovulation and in-vitro fertilisation. Despite being more expensive, empirical clomifene and intrauterine insemination in an unstimulated cycle do not improve the chances of live birth compared with expectant management. Although unlikely to be more effective than no treatment in couples with a reasonably good prognosis, super ovulation plus intrauterine insemination has been shown to be more effective than intrauterine insemination. Any potential advantage of super ovulation plus intrauterine insemination has to be balanced against the relatively high risk of iatrogenic multiple pregnancy. In-vitro fertilisation remains the treatment of choice in longstanding unresolved infertility and, when coupled with the use of elective single embryo transfer, can minimise the risk of multiple pregnancies. Data from randomised trials confirming the superiority of in-vitro fertilisation over expectant management is limited.
    Best practice & research. Clinical obstetrics & gynaecology 08/2012; 26(6):729-38. · 1.87 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To perform a systematic review and meta-analysis of obstetric and perinatal complications in singleton pregnancies after the transfer of frozen thawed and fresh embryos generated through IVF. Systematic review. Observational studies, comparing obstetric and perinatal outcomes in singleton pregnancies subsequent to frozen thawed ET versus fresh embryo transfer, were included from Medline, EMBASE, Cochrane Central Register of Clinical Trials, DARE, and CINAHL (1984-2012). Women undergoing IVF/intracytoplasmic sperm injection (ICSI). Two independent reviewers extracted data and assessed the methodological quality of the relevant studies using critical appraisal skills program scoring. Risk ratios and risk differences were calculated in Rev Man 5.1. Subgroup analysis was performed on matched cohort studies. Antepartum hemorrhage, very preterm birth, preterm birth, small for gestational age, low birth weight, very low birth weight, cesarean section, congenital anomalies, perinatal mortality, and admission to neonatal intensive care unit. Eleven studies met the inclusion criteria. Singleton pregnancies after the transfer of frozen thawed embryos were associated with better perinatal outcomes compared with those after fresh IVF embryos. The relative risks (RR) and 95% confidence intervals (CI) of antepartum hemorrhage (RR = 0.67, 95% CI 0.55-0.81), preterm birth (RR = 0.84, 95% CI 0.78-0.90), small for gestational age (RR = 0.45, 95% CI 0.30-0.66), low birth weight (RR = 0.69, 95% CI 0.62-0.76), and perinatal mortality (RR = 0.68, 95% CI 0.48-0.96) were lower in women who received frozen embryos. Although fresh ET is the norm in IVF, results of this systematic review of observational studies suggest that pregnancies arising from the transfer of frozen thawed IVF embryos seem to have better obstetric and perinatal outcomes.
    Fertility and sterility 06/2012; 98(2):368-77.e1-9. · 3.97 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: We aimed to compare reproductive outcomes following ectopic pregnancy (EP) versus livebirth, miscarriage, or termination in a first pregnancy. A retrospective cohort study design was used. Scottish national data on all women whose first pregnancy occurred between 1981 and 2000 were linked to records of a subsequent pregnancy. The exposed cohort comprised women with an EP in their first pregnancy. There were three unexposed cohorts: women with livebirth, miscarriage, and termination of their first pregnancies. Any differences in rates of second pregnancy, livebirth, EP, miscarriage, or terminations and complications of a second ongoing pregnancy and delivery were assessed among the different exposure groups. A total of 2,969 women had an initial EP; 667,299 had a livebirth, 39,705 women miscarried, and 78,697 terminated their first pregnancies. Women with an initial EP had an increased chance of another pregnancy within 2 years (adjusted hazard ratio (AHR) 2.76 [95% CI 2.58-2.95]) or after 6 years (AHR 1.57 [95% CI 1.29-1.91]) compared to women with a livebirth. In comparison with women with an initial miscarriage, women who had an EP had a lower chance of a second pregnancy (AHR 0.53 [95% CI 0.50-0.56]). Compared to women with an initial termination, women with an EP had an increased chance of a second pregnancy (AHR 2.38 [95% CI 2.23-2.55]) within 2 years. Women with an initial EP suffered an increased risk of another EP compared to women with a livebirth (AHR 13.0 [95% CI 11.63-16.86]), miscarriage (AHR 6.07 [95% CI 4.83-7.62]), or termination (AHR 12.84 [95% CI 10.07-16.37]). Perinatal complications in a pregnancy following EP were not significantly higher than those in primigravidae or in women with a previous miscarriage or termination. Women with an initial EP have a lower chance of conception than those who miscarry but an increased risk of a repeat EP in comparison with all three comparison groups. A major limitation of this study was the inability to separate women using contraception from those who were intending to conceive.
    PLoS Medicine 06/2012; 9(6):e1001243. · 15.25 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Earlier reviews have suggested that IVF/ICSI pregnancies are associated with higher risks. However, there have been recent advances in the way IVF/ICSI is done, leading to some controversy as to whether IVF/ICSI singletons are associated with higher perinatal risks. The objective of this systematic review was to provide an up-to-date comparison of obstetric and perinatal outcomes of the singletons born after IVF/ICSI and compare them with those of spontaneous conceptions. Extensive searches were done by two authors. The protocol was agreed a priori. PRISMA guidance was followed. The data were extracted in 2 × 2 tables. Risk ratio and risk difference were calculated on pooled data using Rev Man 5.1. Quality assessment of studies was performed using Critical Appraisal Skills programme. Sensitivity analysis was performed when the heterogeneity was high (I(2) > 50%). There were 20 matched cohort studies and 10 unmatched cohort studies included in this review. IVF/ICSI singleton pregnancies were associated with a higher risk (95% confidence interval) of ante-partum haemorrhage (2.49, 2.30-2.69), congenital anomalies (1.67, 1.33-2.09), hypertensive disorders of pregnancy (1.49, 1.39-1.59), preterm rupture of membranes (1.16, 1.07-1.26), Caesarean section (1.56, 1.51-1.60), low birthweight (1.65, 1.56-1.75), perinatal mortality (1.87, 1.48-2.37), preterm delivery (1.54, 1.47-1.62), gestational diabetes (1.48, 1.33-1.66), induction of labour (1.18, 1.10-1.28) and small for gestational age (1.39, 1.27-1.53). Singletons pregnancies after IVF/ICSI are associated with higher risks of obstetric and perinatal complications when compared with spontaneous conception. Further research is needed to determine which aspect of assisted reproduction technology poses most risk and how this risk can be minimized.
    Human Reproduction Update 05/2012; 18(5):485-503. · 9.23 Impact Factor
  • Abha Maheshwari, Sumana Gurunath, Farah Fatima, Siladitya Bhattacharya
    [Show abstract] [Hide abstract]
    ABSTRACT: Uterine adenomyosis was initially thought to be found only in parous women, and final diagnosis was made at histology after hysterectomy. With better imaging techniques and with women attending clinics at older ages, adenomyosis is diagnosed with increasing frequency in women attending infertility clinics. A dozen conservative interventions have been advocated, with variable reports of their impact on fertility. This presents a dilemma for clinicians managing such patients. Hence, this systematic review of adenomyosis was performed to determine (i) the prevalence in a subfertile population, (ii) the accuracy of diagnostic tests, (iii) the efficacy of fertility sparing treatment options and (iv) the reproductive and obstetric/perinatal outcomes in women with adenomyosis. Systematic searches of various databases were performed independently by two reviewers, and data were extracted according to predefined criteria by two reviewers. There is little data on the epidemiology of adenomyosis associated with subfertility. Both magnetic resonance imaging and ultrasound are non-invasive tests with equivalent accuracy in diagnosing adenomyosis (area under curve 0.91 and 0.88, respectively). Most studies on treatments have been uncontrolled and outcomes are usually reported in the form of case series. Hence, the true impact of various treatments on fertility is not known. There are variable reports of the impact of adenomyosis on the success of IVF. Increased incidence of preterm labour and premature rupture of membranes has been reported in women with adenomyosis. Further studies are needed to determine the natural history of adenomyosis and implications for fertility and reproductive outcomes, with and without treatment. Currently, there is no evidence that we should find and treat adenomyosis in patients who wish to conceive.
    Human Reproduction Update 03/2012; 18(4):374-92. · 9.23 Impact Factor

Publication Stats

1k Citations
444.10 Total Impact Points

Institutions

  • 2001–2014
    • University of Aberdeen
      • • Division of Applied Health Sciences
      • • Division of Applied Medicine
      • • Obstetrics and Gynaecology
      Aberdeen, Scotland, United Kingdom
  • 2012
    • Christian Medical College Vellore
      Velluru, Tamil Nādu, India
    • Mansoura University
      • Department of Obstetrics and Gynecology
      Ṭalkha, Muhafazat ad Daqahliyah, Egypt
    • The University of Edinburgh
      • MRC Centre for Reproductive Health
      Edinburgh, SCT, United Kingdom
    • King's College London
      Londinium, England, United Kingdom
  • 2011
    • University of Glasgow
      • College of Medical, Veterinary and Life Sciences
      Glasgow, SCT, United Kingdom
  • 2009
    • Deenanath Mangeshkar Hospital
      Dattāpur, Mahārāshtra, India