Papers by Jocelyn Mitchell-Williams
Medical science educator, Mar 5, 2024
PubMed, 2013
Purpose: To determine if the addition of luteinizing hormone (LH) to follicle stimulating hormone... more Purpose: To determine if the addition of luteinizing hormone (LH) to follicle stimulating hormone (FSH) stimulation for controlled ovarian hyperstimulation (COH) protocols using gonadotropin releasing hormone (GnRH) antagonists improves pregnancy rates following in vitro fertilization-embryo transfer (IVF-ET). Materials and methods: All IVF-ET cycles using a GnRH antagonist were evaluated according to whether FSH was used exclusively or if LH was added. The cycles were further stratified according to age (< or = 39 and 40-42 years) and according to good responders (> or = five oocytes retrieved) or poor responders (< or = four oocytes). Results: Combining all data, a significantly higher clinical and live delivered pregnancy rates were found in those adding LH (34.7% and 32.3%) vs those taking all FSH (33.4% and 25.8%). The only subgroup not showing this effect was the women aged 40-42 years with diminished oocyte reserve. Conclusions: LH should be added not only to COH protocols using GnRH agonists but also those using GnRH antagonists.
PubMed, 2013
Purpose: To determine if defective oocytes or sperm may be a common etiologic factor in unexplain... more Purpose: To determine if defective oocytes or sperm may be a common etiologic factor in unexplained infertility. Materials and methods: A retrospective comparison of fertilization rates and pregnancy rates from infertile donors with unexplained infertility trying to conceive with in vitro fertilization-embryo transfer (IVF-ET) and their respective recipients, who shared the other half of the oocytes with the recipient's male partner for financial compensation was performed. Pregnancy rates from donors and recipients were also compared to other donor recipient pairs sharing oocytes from infertile donors with tubal or male factor or financially-compensated donors providing oocytes to two recipients. Results: Pregnancy rates from infertile donors with unexplained infertility were comparable not only to their respective recipients but to other donor/recipient pairs that received oocytes from donors with tubal or male factor or financially-compensated donors. Fertilization rates were somewhat reduced in the infertile donors. Conclusions: Abnormal embryos resulting from an oocyte or sperm defect do not appear to be a common cause of unexplained infertility. The possibility does exist that sperm may be an etiologic factor in reduced fertilization potential, which not only could be obviated by conventional oocyte insemination, but could be further improved by intracytoplasmic sperm injection (ICSI).
Clinical and Experimental Obstetrics & Gynecology, Jun 10, 2014
Fertility and Sterility, Sep 1, 2011
TABLE 1. Results Mini-IVF (n ¼ 60 patients) COS (n ¼ 89 patients) p-Value # cycles 155 255 Mean n... more TABLE 1. Results Mini-IVF (n ¼ 60 patients) COS (n ¼ 89 patients) p-Value # cycles 155 255 Mean number of cycles/patient 2.58 AE 1.78 2.87 AE 1.08 0.23 Cancelation rate % 14.8(23/155) 10.19(26/255) 0.16 Mean MII / patient 5.15 AE 2.23 5.75 AE 2.55 0.13 Mean good quality embryos / patient 2.69 AE 2.15 2.51 AE 2.41 0.63 Mean gonadotropins per cycle(IU) 704.56 AE 304.54 2990.37 AE 1826.88 < 0.01 Mean gonadotropins/ MII(IU) 395.94 AE 404.50 1984.09 AE 2960.63 < 0.01 OPR/patient % 30.00(18/60) 24.71(22/89) 0.48 CONCLUSION: ACCU-VIT cycle outcomes of the mini-IVF stimulation in poor responders were comparable to those obtained with classical COS protocols, although a great advantage resided in the significantly lower amount of gonadotropins used, representing an important reduction in terms of costs and number of daily drug injections for the patient.
Fertility and Sterility, Mar 1, 2012
Education Sciences, Jun 23, 2022
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Fertility and Sterility, Mar 1, 2012
Cooper Rowan medical journal, Dec 28, 2022
Introduction: Despite improvement initiatives, patient non-adherence remains an issue in healthca... more Introduction: Despite improvement initiatives, patient non-adherence remains an issue in healthcare. Patients with high-risk pregnancies require more frequent monitoring to reduce complications. This study aims to better understand visit non-adherence with high-risk prenatal appointments. We hypothesized that patients' perceived logistic barriers would be the most prominent determinant of visit non-adherence. Methods: This study included adult, English speaking patients of the high-risk prenatal clinic at Cooper University Hospital that missed at least one appointment. We completed three, one hour focus groups with seven participants. Constant comparison analysis was used to determine common themes discussed by participants. Axial coding and basic unit descriptors were defined by both facilitators to determine common themes discussed during the focus group sessions. Results: We identified two main themes in regards to patient visit non-adherence in our population: logistic issues and perceived relationship issues between the patient and the care team. Logistic issues included issues with rescheduling, seeing different providers, parking, wait time and office hours. In regards to patient-care team relationships, subjects frequently brought up issues with respect, feeling heard by providers, communication and professionalism. All seven patients identified at least one of the five domains of logistic barriers as a concern. Five of the seven participants identified an issue across the four domains of relationship issues. Discussion: The focus group analysis illustrated recurrent themes of logistic barriers and deficiencies in patient-care team relationships that contributed to high-risk prenatal visit non-adherence. A follow-up survey study is necessary to quantitatively assess the most prominent reasons for visit non-adherence based on the themes identified in our study.
Journal of Managed Care & Specialty Pharmacy
Fertility and Sterility, 2010
IGI Global eBooks, Jan 13, 2023
Clinical and Experimental Obstetrics & Gynecology, 2015
To describe an unusual case of Müllerian agenesis associated with gonadal agenesis and thus sexua... more To describe an unusual case of Müllerian agenesis associated with gonadal agenesis and thus sexual infantilism. Materials and Methods: Pelvic magnetic resonance imaging (MRI) and sonography were performed and MRI of the kidneys. Pelvic sonography and serum follicle stimulating hormone (FSH) were also obtained. Results: The only pelvic organ that this 15-year-old girl had was the distal portion of the vaginal canal. The kidneys were normal. Conclusions: This case suggests that at least in some cases some possible viral damaging process may lead to damage to both the ovaries and the Müllerian system. If there was a problem with the anti-Müllerian hormone (AMH), the kidney may be affected. Furthermore, AMH has nothing to do with the ovaries and a chance association of these two entities though possible, seems less likely than a common factor causing both problems.
Clinical and Experimental Obstetrics & Gynecology, 2014
Clinical and experimental obstetrics & gynecology, 2009
PURPOSE To evaluate a case of a normal estrogenic woman with amenorrhea and polycystic ovarian sy... more PURPOSE To evaluate a case of a normal estrogenic woman with amenorrhea and polycystic ovarian syndrome who fails to get menses after progesterone withdrawal but who menstruates with oral contraceptives. METHODS The following sera assays were obtained: total testosterone (T), free T, weakly bound T, dehydroepiandrosterone sulfate, 17 hydroxyprogesterone, estradiol, free thyroxin, thyroid stimulating hormone, prolactin, evening cortisol, LH and FSH. RESULTS The total testosterone was markedly elevated but the free testosterone was normal and the free and weakly bound testosterone was the high end of normal. The LH/FSH ratio was markedly increased consistent with the ultrasound findings of polycystic ovarian syndrome. Vaginal cytology showed a mixed high estrogen/high androgen effect and the endometrial thickness was only 5 mm. Twice she failed to have menses following progesterone withdrawal. CONCLUSIONS One hypothesized mechanism is that the high testosterone levels even though most...
Fertility and Sterility, 2011
TABLE 1. Results Mini-IVF (n ¼ 60 patients) COS (n ¼ 89 patients) p-Value # cycles 155 255 Mean n... more TABLE 1. Results Mini-IVF (n ¼ 60 patients) COS (n ¼ 89 patients) p-Value # cycles 155 255 Mean number of cycles/patient 2.58 AE 1.78 2.87 AE 1.08 0.23 Cancelation rate % 14.8(23/155) 10.19(26/255) 0.16 Mean MII / patient 5.15 AE 2.23 5.75 AE 2.55 0.13 Mean good quality embryos / patient 2.69 AE 2.15 2.51 AE 2.41 0.63 Mean gonadotropins per cycle(IU) 704.56 AE 304.54 2990.37 AE 1826.88 < 0.01 Mean gonadotropins/ MII(IU) 395.94 AE 404.50 1984.09 AE 2960.63 < 0.01 OPR/patient % 30.00(18/60) 24.71(22/89) 0.48 CONCLUSION: ACCU-VIT cycle outcomes of the mini-IVF stimulation in poor responders were comparable to those obtained with classical COS protocols, although a great advantage resided in the significantly lower amount of gonadotropins used, representing an important reduction in terms of costs and number of daily drug injections for the patient.
The Cooper Rowan Medical Journal
Methods: This study included adult, English speaking patients of the high-risk prenatal clinic at... more Methods: This study included adult, English speaking patients of the high-risk prenatal clinic at Cooper University Hospital that missed at least one appointment. We completed three, one hour focus groups with seven participants. Constant comparison analysis was used to determine common themes discussed by participants. Axial coding and basic unit descriptors were defined by both facilitators to determine common themes discussed during the focus group sessions. Results: We identified two main themes in regards to patient visit non-adherence in our population: logistic issues and perceived relationship issues between the patient and the care team. Logistic issues included issues with rescheduling, seeing different providers, parking, wait time and office hours. In regards to patient-care team relationships, subjects frequently brought up issues with respect, feeling heard by providers, communication and professionalism. All seven patients identified at least one of the five domains o...
Education Sciences
Challenging the notion of “teaching by telling,” active learning utilizes a student-oriented appr... more Challenging the notion of “teaching by telling,” active learning utilizes a student-oriented approach by emphasizing the concept of knowledge retention through peer interaction. To further examine the potential of active learning, we created a workshop based on didactic education and student collaboration. Participants included undergraduate students from traditionally underrepresented and disadvantaged backgrounds. The workshop was part of our summer academic enrichment program run in an urban, medically underserved community. The workshop focused on clinical and biochemical nutrition, wherein students synthesized information by discussing dietary choices and the socioeconomic aspects of nutrition. Student reception of the workshop was adjudged by anonymous surveys. The survey questions were designed to gauge how the workshop objectives were achieved. Cronbach alpha (0.276) confirmed that there was more than a single theme contained in the questions. The majority of students (97%) ...
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Papers by Jocelyn Mitchell-Williams