Kelly Pagidas

Body mass index and intercourse compliance

OBJECTIVE To investigate the relationship between body mass index and intercourse compliance in the Reproductive Medicine Networks Pregnancy in Polycystic Ovary Syndrome (RMN PPCOS) Trial. DESIGN Post hoc data analysis of subjects in the RMN PPCOS Trial. SETTING Academic medical centers. INTERVENTION(S) None. PATIENT(S) Six hundred twenty-six infertile women with polycystic ovary syndrome (PCOS) with a mean age of 28.1+/-4 years and mean body mass index (BMI) of 35.2+/-8.7 kg/m2. MAIN OUTCOME MEASURE(S) Intercourse compliance and BMI. RESULT(S) Overall, body mass index was not associated with increased intercourse compliance. However, although patients with BMI>or=35 were less likely to ovulate than patients with BMI<35, they tend to be more compliant with intercourse frequency in ovulatory cycles than patients with BMI<35. CONCLUSION(S) BMI was not associated with intercourse compliance or noncompliance. An elevated BMI in infertile women with PCOS is not associated with poor intercourse compliance.

Intercourse compliance, ovulation, and treatment success in the National Institute of Child Health and Human Development–Reproductive Medicine Network's Pregnancy in Polycystic Ovary Syndrome (PPCOS) Trial

OBJECTIVE To investigate the relationship among intercourse compliance, ovulation, and the occurrence of pregnancy in the Reproductive Medicine Networks Pregnancy in Polycystic Ovary Syndrome (RMNPPCOS) Trial. DESIGN Post hoc data analysis of subjects in the Reproductive Medicine Network PPCOS Trial. SETTING Academic medical centers. INTERVENTION(S) None. PATIENT(S) Six hundred twenty-six infertile women with polycystic ovary syndrome with a mean age of 28.1+/-4 years and mean body mass index of 35.2+/-8.7 kg/m2. MAIN OUTCOME MEASURE(S) Intercourse compliance, ovulation, and pregnancy. RESULT(S) Data on 2925 cycles were included in the analysis, of which 1340 were ovulatory cycles and 1585 were nonovulatory cycles. The rates of intercourse compliance in the PPCOS trial were similar across all treatment groups at all cycles except cycle 4. Among cycles with known ovulation status, 81.2% of patients were compliant with intercourse instructions. Patients were more intercourse compliant in those cycles during which ovulation occurred (83.2% vs. 79.4%). With regard to ovulatory cycles, there was no difference in the occurrence of pregnancy when comparing intercourse compliant versus intercourse noncompliant cycles. CONCLUSION(S) Intercourse compliance was not associated with the occurrence of pregnancy in ovulatory cycles in the PPCOS Trial. The occurrence of ovulation still remains a critical predictor for the occurrence of pregnancy.

Perfect Timing [26F]

INTRODUCTION: The outpatient clinic visit is a complicated balance of relationship building, information sharing, and care coordination. To date, video media has not been used in outpatient OB-GYN offices as a mode of patient education. Our objective was to pilot an informational video for new patients presenting for infertility workup and treatment, to increase patient knowledge and satisfaction while shortening visit time. METHODS: We designed a randomized trial in an outpatient clinic at a large, academic medical center. All new patients presenting to one provider for infertility workup/treatment from February–July 2015 were randomized to receive the ten-minute informational video or standard education. Outcomes included knowledge, satisfaction, and visit length. RESULTS: Of the 20 patients were reached and eligible for the study, 17 (85%) participated. 10 received the video, and 7 received standard care. Average age and length of infertility were similar (33.5 vs 31.9, P=.51; 1.4 vs 1.3, P=.84). The intervention group had significantly increased knowledge (32% vs 0%). All participants were “very satisfied,” with their visit. The intervention groups visit length was shorter, but was not statistically significant (16.3 vs 17.2, P=.77). CONCLUSION: Video education is acceptable to patients, and results in improved patient knowledge, consistent satisfaction, and potentially decreased visit time. Video media may be an effective method of seeing patients more efficiently, allowing the provider to focus on more personalized aspects of care. In the modern provision of medicine, time is money. We believe our study can help providers to spend it better: with their patients.