A practical method for ultrasonographically monitoring the day-to-day growth of individual ovarian follicles in women undergoing assisted reproduction.

The objective of this study was to validate the use of the nonidentity (NonID) method compared with the identity (ID) method for tracking the day-to-day growth of individual follicles in women undergoing ovarian stimulation for assisted reproduction. A retrospective observational study was conducted in 20 women during ovarian stimulation. Conventional 2-D transvaginal ultrasonography was used to monitor follicle growth every 2-3 days throughout stimulation. Video clips of both ovaries were obtained in sagittal and coronal planes at each visit. Standardized diameter measurements of all follicles ≥4 mm were made retrospectively from video clips. The growth profiles of all follicles that developed to ≥10 mm were determined using the ID and NonID methods. Using Lin's concordance statistics, we documented that agreement between methods was 91% for follicles <10 mm, 96% for follicles 10-15 mm and 99% for follicles >15 mm. Lin's concordance correlation coefficient between the two methods was 0.96 (standard error = 0.003). We concluded that the NonID method is a practical, effective tool for monitoring the day-to-day growth of individual ovarian follicles in women undergoing assisted reproduction.

Outpatient total laparoscopic hysterectomy.

STUDY OBJECTIVE: To assess the safety of and patient satisfaction with total laparoscopic hysterectomy as an outpatient procedure. DESIGN: Retrospective case study (Canadian Task Force classification III). SETTING: Tertiary care hospital. PATIENTS: Sixty-six consecutive women. INTERVENTION: Outpatient total laparoscopic hysterectomy. MEASUREMENTS AND MAIN RESULTS: Of 66 procedures completed, 6 patients (7.5%) required overnight hospitalization, with 4 of them discharged the next day. Seven (11%) minor postoperative complications occurred. One patient required hospitalization to receive intravenous antibiotics and one for drainage of a cuff hematoma. There were three (4.5%) minor intraoperative complications. One woman developed Clostridium difficile diarrhea as well as deep vein thrombosis and pulmonary embolus. Sixty-three women (95%) were satisfied with the procedure and would recommend it to others. CONCLUSION: Outpatient total laparoscopic hysterectomy is well tolerated, safe, and cost effective.