Neil Johnson

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Andrej Dujella

University of Zagreb

Hemin Koyi

Uppsala University

Jana Javornik

University of East London

Armando Marques-Guedes

UNL - New University of Lisbon

Graham Martin

University of Leicester

Gwen Robbins Schug

University of North Carolina at Greensboro

Gabriel Gutierrez-Alonso

University of Salamanca

John Sutton

Macquarie University

Eros Carvalho

Universidade Federal do Rio Grande do Sul

Kevin Arbuckle

Swansea University

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Papers by Neil Johnson

Консенсус по ведению эндометриоза

Reproductive Endocrinology, Aug 17, 2013

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استفاده از بیومارکرهای خون برای تشخیص غیرتهاجمی آندومتریوز

Europe PMC (PubMed Central), Jan 10, 2016

Trusted evidence. Informed decisions. Better health.

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Response to Letter to the Editor From Marin et al.: “The SELFI Study: Iodine Excess and Thyroid Dysfunction in Women Undergoing Oil-Soluble Contrast Hysterosalpingography”

The Journal of Clinical Endocrinology & Metabolism

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The SELFI Study: Iodine Excess and Thyroid Dysfunction in Women Undergoing Oil-Soluble Contrast Hysterosalpingography

The Journal of Clinical Endocrinology & Metabolism

Context Hysterosalpingography (HSG) with oil-soluble contrast medium (OSCM) improves pregnancy ra... more Context Hysterosalpingography (HSG) with oil-soluble contrast medium (OSCM) improves pregnancy rates. However, OSCM has high iodine content and long half-life, leading to potential iodine excess. Objective This work aimed to determine the pattern of iodine excess after OSCM HSG and the effect on thyroid function. Methods A prospective cohort study was conducted of 196 consecutive consenting eligible women without overt hypothyroidism or hyperthyroidism. All completed the study with compliance greater than 95%. Participants underwent OSCM HSG (Auckland, 2019-2021) with serial monitoring of thyrotropin (TSH), free thyroxine (FT4), and urine iodine concentration (UIC) for 24 weeks. The main outcome measure was the development of subclinical hypothyroidism (SCH), defined as a nonpregnant TSH greater than 4 mIU/L with normal FT4 (11-22 pmol/L) in those with normal baseline thyroid function. Results Iodine excess (UIC ≥ 300 μg/L) was almost universal (98%) with UIC peaking usually by 4 we...

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Effect of Acupuncture vs Sham Acupuncture on Live Births Among Women Undergoing In Vitro Fertilization: A Randomized Clinical Trial

JAMA, May 15, 2018

Acupuncture is widely used by women undergoing in vitro fertilization (IVF), although the evidenc... more Acupuncture is widely used by women undergoing in vitro fertilization (IVF), although the evidence for efficacy is conflicting. To determine the efficacy of acupuncture compared with a sham acupuncture control performed during IVF on live births. A single-blind, parallel-group randomized clinical trial including 848 women undergoing a fresh IVF cycle was conducted at 16 IVF centers in Australia and New Zealand between June 29, 2011, and October 23, 2015, with 10 months of pregnancy follow-up until August 2016. Women received either acupuncture (n = 424) or a sham acupuncture control (n = 424). The first treatment was administered between days 6 to 8 of follicle stimulation, and 2 treatments were administered prior to and following embryo transfer. The sham control used a noninvasive needle placed away from the true acupuncture points. The primary outcome was live birth, defined as the delivery of 1 or more living infants at greater than 20 weeks' gestation or birth weight of at ...

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EPHect - the Endometriosis Phenome (and Biobanking) Harmonisation Project - may be very helpful for clinicians and the women they are treating

F1000Research, 2017

This article acts as a summary of the recently published papers by the World Endometriosis Resear... more This article acts as a summary of the recently published papers by the World Endometriosis Research Foundation aiming to set up the Endometriosis Phenome and Biobanking Harmonisation Project. The objective of this project is to standardise recording of patient history and characteristics, recording of surgical procedure and extent of disease as well as collection, processing and storage of specimens and consequently create a reliable resource for research into endometriosis.

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Treatment strategies for women with WHO group II anovulation: systematic review and network meta-analysis

BMJ (Clinical research ed.), Jan 31, 2017

To compare the effectiveness of alternative first line treatment options for women with WHO grou... more To compare the effectiveness of alternative first line treatment options for women with WHO group II anovulation wishing to conceive. Systematic review and network meta-analysis. Cochrane Central Register of Controlled Trials, Medline, and Embase, up to 11 April 2016. Randomised controlled trials comparing eight ovulation induction treatments in women with WHO group II anovulation: clomiphene, letrozole, metformin, clomiphene and metformin combined, tamoxifen, gonadotropins, laparoscopic ovarian drilling, and placebo or no treatment. Study quality was measured on the basis of the methodology and categories described in the Cochrane Collaboration Handbook. Pregnancy, defined preferably as clinical pregnancy, was the primary outcome; live birth, ovulation, miscarriage, and multiple pregnancy were secondary outcomes. Of 2631 titles and abstracts initially identified, 57 trials reporting on 8082 women were included. All pharmacological treatments were superior to placebo or no inte...

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World Endometriosis Society consensus on the classification of endometriosis

Human reproduction (Oxford, England), Feb 5, 2016

What is the global consensus on the classification of endometriosis that considers the views of w... more What is the global consensus on the classification of endometriosis that considers the views of women with endometriosis? We have produced an international consensus statement on the classification of endometriosis through systematic appraisal of evidence and a consensus process that included representatives of national and international, medical and non-medical societies, patient organizations, and companies with an interest in endometriosis. Classification systems of endometriosis, developed by several professional organizations, traditionally have been based on lesion appearance, pelvic adhesions, and anatomic location of disease. One system predicts fertility outcome and none predicts pelvic pain, response to medications, disease recurrence, risks for associated disorders, quality of life measures, and other endpoints important to women and health care providers for guiding appropriate therapeutic options and prognosis. A consensus meeting, in conjunction with pre- and post-meet...

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Combination of the non-invasive tests for the diagnosis of endometriosis

Cochrane Database of Systematic Reviews, 2016

Trusted evidence. Informed decisions. Better health.

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Endometrial biomarkers for the non-invasive diagnosis of endometriosis

The Cochrane database of systematic reviews, Jan 20, 2016

About 10% of reproductive-aged women suffer from endometriosis, which is a costly, chronic diseas... more About 10% of reproductive-aged women suffer from endometriosis, which is a costly, chronic disease that causes pelvic pain and subfertility. Laparoscopy is the gold standard diagnostic test for endometriosis, but it is expensive and carries surgical risks. Currently, there are no non-invasive tests available in clinical practice that accurately diagnose endometriosis. This is the first diagnostic test accuracy review of endometrial biomarkers for endometriosis that utilises Cochrane methodologies, providing an update on the rapidly expanding literature in this field. To determine the diagnostic accuracy of the endometrial biomarkers for pelvic endometriosis, using a surgical diagnosis as the reference standard. We evaluated the tests as replacement tests for diagnostic surgery and as triage tests to inform decisions to undertake surgery for endometriosis. We did not restrict the searches to particular study designs, language or publication dates. To identify trials, we searched the ...

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Surgical pelvic neuroablation for chronic pelvic pain: a systematic review

Gynaecological Endoscopy, 2000

Objective To determine, from the best available evidence, the effectiveness of surgical pelvic ne... more Objective To determine, from the best available evidence, the effectiveness of surgical pelvic neuroablative techniques as treatment for primary and secondary dysmenorrhoea. Systematic review of randomized controlled trials (RCTs). Women with primary or secondary dysmenorrhoea. Surgical neuroablative techniques including uterine nerve ablation and presacral neurectomy. Pain relief (both short-and long-term) and adverse effects. Laparoscopic uterine nerve ablation (LUNA) has been shown by one small study to be effective for primary dysmenorrhoea up to 12 months. A larger study showed no significant difference between LUNA and laparoscopic presacral neurectomy (LPSN) in pain relief for primary dysmenorrhoea up to 6 months, but LPSN was significantly more effective beyond 6 months. For dysmenorrhoea secondary to endometriosis, two trials found no significant difference in pain relief afforded by LUNA plus conservative laparoscopic surgery for endometriosis vs. conservative laparoscopic surgery alone. Presacral neurectomy (PSN) plus conservative surgery for endometriosis at laparotomy vs. conservative surgery for endometriosis at laparotomy showed no significant difference in overall pain relief, although there was a significant difference in relief of midline abdominal pain. Adverse events overall were significantly more common following PSN; these included constipation, urinary urgency, painless labour and one case necessitating a laparotomy for presacral haematoma 2 days after PSN. There is insufficient evidence to recommend the use of surgical pelvic neuroablation in the management of dysmenorrhoea, regardless of cause. Further scientifically rigorous RCTs should be undertaken.

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Adherence compounds in embryo transfer media for assisted reproductive technologies

Cochrane Database of Systematic Reviews, 2014

Analysis 1.3. Comparison 1 High versus low or no hyaluronic acid, Outcome 3 Live birth rate (grou... more

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Evidence-based research and practice: attitudes of reproduction nurses, counsellors and doctors

Reproductive BioMedicine Online, 2014

is an experienced clinical research and acupuncture practitioner. She brings expertise in relatio... more is an experienced clinical research and acupuncture practitioner. She brings expertise in relation to acupuncture research and clinical skills in relation to women's health and reproductive health. She has a background in evidence based research in relation to acupuncture and other complementary therapies and the integration of Chinese medicine and biomedical research protocols, predominately in the areas of women's health. She has extensive experience in evidence based research including the design, conduct of randomised controlled trials and systematic reviews.

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Metformin versus oral contraceptive pill in polycystic ovary syndrome: a Cochrane review

Human Reproduction, 2007

BACKGROUND: The object of this review was to compare metformin versus oral contraceptive pill (OC... more BACKGROUND: The object of this review was to compare metformin versus oral contraceptive pill (OCP) treatment in polycystic ovary syndrome. METHODS: A systematic review and meta-analysis employing the principles of the Cochrane Menstrual Disorders and Subfertility Group was undertaken. RESULTS: Four randomized controlled trials (RCTs) (104 subjects) were included. Limited data demonstrated no evidence of a difference in effect between metformin and the OCP on hirsutism, acne or development of type 2 diabetes mellitus. There were no trials assessing diagnosis of cardiovascular disease or endometrial cancer. Metformin, in comparison with the OCP, was less effective in improving menstrual pattern [Peto odds ratio (OR) 0.08, 95% confidence interval (CI) 0.01-0.45) and in reducing the serum total testosterone level weighted mean difference (WMD) 0.54, 95% CI 0.22-0.86] but more effective in reducing fasting insulin (WMD 23.46, 95% CI25.39 to 21.52) and not increasing fasting triglyceride (WMD 20.48, 95% CI20.86 to 20.09) levels. Limited data demonstrated no evidence of a difference in effect between the two therapies on reducing fasting glucose or total cholesterol levels and severe adverse events. CONCLUSIONS: The limited RCT evidence to date does not show adverse metabolic risk with the use of the OCP compared with metformin. Further long-term RCTs are required.

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A randomized controlled trial of laparoscopic ovarian diathermy versus gonadotropin therapy for women with clomiphene citrate-resistant polycystic ovary syndrome

Fertility and Sterility, 2002

Objective: To compare the effectiveness of laparoscopic ovarian diathermy with gonadotropin ovula... more Objective: To compare the effectiveness of laparoscopic ovarian diathermy with gonadotropin ovulation induction for women with clomiphene citrate-resistant polycystic ovary syndrome. Design: Randomized controlled trial. Setting: A tertiary referral fertility clinic. Patient(s): Women with anovulatory infertility secondary to clomiphene-resistant polycystic ovary syndrome. Inclusion criteria were age of Ͻ39 years, body mass index of Ͻ35 kg/m 2 , failure to ovulate with 150 mg of clomiphene citrate for 5 days in the early follicular phase, Ͼ12 months of infertility, and no other causes of infertility. Intervention(s): Laparoscopic ovarian diathermy versus three cycles of urinary or recombinant gonadotropins. Main Outcome Measure(s): Cumulative pregnancy and miscarriage rates. Result(s): Cumulative pregnancy rates were 28% at 6 months for laparoscopic ovarian diathermy and 33% for three cycles of ovulation induction with gonadotropins. There were three miscarriages in each group. Women in the laparoscopic ovarian diathermy arm of the study had four additional spontaneous pregnancies 6 to 12 months after surgery. There was no statistically significant difference in pregnancy or miscarriage rates during the 6-month follow-up period or the three cycles. Laparoscopic ovarian diathermy is a safe and effective alternative to ovulation induction with gonadotropins. (Fertil Steril 2002;78:404 -11.

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Endometriosis

BMJ, 2007

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Individual patient data meta-analysis of diagnostic and prognostic studies in obstetrics, gynaecology and reproductive medicine

BMC Medical Research Methodology, 2009

In clinical practice a diagnosis is based on a combination of clinical history, physical examinat... more In clinical practice a diagnosis is based on a combination of clinical history, physical examination and additional diagnostic tests. At present, studies on diagnostic research often report the accuracy of tests without taking into account the information already known from history and examination. Due to this lack of information, together with variations in design and quality of studies, conventional meta-analyses based on these studies will not show the accuracy of the tests in real practice. By using individual patient data (IPD) to perform meta-analyses, the accuracy of tests can be assessed in relation to other patient characteristics and allows the development or evaluation of diagnostic algorithms for individual patients. In this study we will examine these potential benefits in four clinical diagnostic problems in the field of gynaecology, obstetrics and reproductive medicine. Methods/design: Based on earlier systematic reviews for each of the four clinical problems, studies are considered for inclusion. The first authors of the included studies will be invited to participate and share their original data. After assessment of validity and completeness the acquired datasets are merged. Based on these data, a series of analyses will be performed, including a systematic comparison of the results of the IPD meta-analysis with those of a conventional metaanalysis, development of multivariable models for clinical history alone and for the combination of history, physical examination and relevant diagnostic tests and development of clinical prediction rules for the individual patients. These will be made accessible for clinicians.

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Meta‐analysis using individual patient data from randomised trials to assess the effectiveness of laparoscopic uterosacral nerve ablation in the treatment of chronic pelvic pain: a proposed protocol

BJOG: An International Journal of Obstetrics & Gynaecology, 2007

Background Currently, there are a number of clinical trials, but no international collaboration ... more Background Currently, there are a number of clinical trials, but no international collaboration for collating research on effectiveness of laparoscopic uterosacral nerve ablation (LUNA) for alleviating chronic pelvic pain.Objective Meta‐analysis was used by collecting individual patient data (IPD) from the existing trials, to provide a comprehensive assessment of the effectiveness of LUNA that will be generalisable in various clinical contexts.Methods IPD will be sought and collected from all relevant (both already finished and continuing) randomised trials identified through previous systematic reviews. After obtaining raw data and cleaning the database, analysis will be of all patients ever randomised based on the intention‐to‐treat principle using endpoints measured at 12 months following randomisation.Proposal We will update searches, contact all authors, obtain data in whatever form it can be provided, build a single database, produce results for individual studies, have th...

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A double‐blind randomised controlled trial of laparoscopic uterine nerve ablation for women with chronic pelvic pain

BJOG: An International Journal of Obstetrics & Gynaecology, 2004

Objective To determine the effectiveness of laparoscopic uterine nerve ablation (LUNA) for chron... more Objective To determine the effectiveness of laparoscopic uterine nerve ablation (LUNA) for chronic pelvic pain in women with endometriosis and women with no laparoscopic evidence of endometriosis.Design A prospective double‐blind randomised controlled trial (RCT).Setting Single‐centre, secondary‐level gynaecology outpatient service and tertiary‐level pelvic pain and endometriosis outpatient service in Auckland, New Zealand.Population One hundred and twenty‐three women undergoing laparoscopy for investigation and management of chronic pelvic pain, 56 with no laparoscopic evidence of endometriosis and 67 with endometriosis.Methods Women were randomised from the two populations, firstly those with no evidence of endometriosis and secondly those undergoing laparoscopic surgical treatment for endometriosis, to receive LUNA or no LUNA. Participant and assessor blinding was employed. Follow up for pain outcomes was undertaken at 24 hours, 3 months and 12 months.Main outcome measures ...

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Surgical interruption of pelvic nerve pathways in dysmenorrhea: a systematic review of effectiveness

Acta Obstetricia et Gynecologica Scandinavica, 2007

Objectives. To assess the effectiveness of surgical interruption of pelvic nerve pathways in prim... more Objectives. To assess the effectiveness of surgical interruption of pelvic nerve pathways in primary and secondary dysmenorrhea. Data sources. The Cochrane Menstrual Disorders and Subfertility Group Trials Register (9 June 2004), CENTRAL (The Cochrane Library, Issue 2, 2004), MEDLINE (1966 to Nov. 2003), EMBASE (1980 to Nov. 2003), CINAHL (1982 to Oct. 2003), MetaRegister of Controlled Trials, the citation lists of review articles and included trials, and contact with the corresponding author of each included trial. Review methods. The inclusion criteria were randomized controlled trials of uterosacral nerve ablation or presacral neurectomy (both open and laparoscopic procedures) for the treatment of dysmenorrhea. The main outcome measures were pain relief and adverse effects. Two reviewers extracted data on characteristics of the study quality and the population, intervention, and outcome independently. Results. Nine randomized controlled trials were included in the systematic revi...

Консенсус по ведению эндометриоза

Reproductive Endocrinology, Aug 17, 2013

Download

استفاده از بیومارکرهای خون برای تشخیص غیرتهاجمی آندومتریوز

Europe PMC (PubMed Central), Jan 10, 2016

Trusted evidence. Informed decisions. Better health.

Download

Response to Letter to the Editor From Marin et al.: “The SELFI Study: Iodine Excess and Thyroid Dysfunction in Women Undergoing Oil-Soluble Contrast Hysterosalpingography”

The Journal of Clinical Endocrinology & Metabolism

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The SELFI Study: Iodine Excess and Thyroid Dysfunction in Women Undergoing Oil-Soluble Contrast Hysterosalpingography

The Journal of Clinical Endocrinology & Metabolism