Gynaecology 2

Technology assessment of reproductive medicine

Principal investigators

Prof.Dr F.M.Helmerhorst

Aim and focus

I      Reproductive endocrinology and vascular medicine

Pathophysiology of processes leading to and during  implantation.

Development and evaluation of methods for  understanding of physiology (eg endocrinology, hemstatas, (epi)genetics) and pathophysiology of implantation. Target of research on these processes is the endothelial cell in relation to endo- para and autocrinological signalling systems as steroids, eicosanoids, cytokines and metalloproteinases, leading to angiogenesis of maternal vessels on the implantation site. Different stressors of the implanation processes  are under research in relation with the Barker hypothesis, that may explain fetal origin of  late onset disease as cardiovascular diseases.

Contraception.

Effect of ovarian steroids (as eg in hormonal contraception) on the endothelial cell and the clotting system, leading to trombosis.

II      Evaluation of diagnostics and therapy in reproductive medicine

Effectivennes and adverse efffects of the routine work-up in the examination of the subfertile couple is investigated. The detection of antibodies against spermatozoa, the postcoital test and hysterosalpingography have been evaluated. Implementation of the results into the daily work is underway.  Technology in the assisted reproductive technology (ART) laboratory is continuously under investigation as well as the development of   ART  children  n our laboratory.

Another part of reproductive medicine is the inhibition of fertility: contraception. Systematic reviews on effective care in Fertility Regulation (contraception and abortion) within the international Cochrane Collaboration (see www.lumc.nl/1060/cochrane) have been and are currently developed. 

Position in international context

Publications in high ranked scientific journals

Chief editor or coordinating editor of Fertility Regulation of the Cochrane Collaboration (www.lumc.nl/1060/cochrane/), in cooperation with WHO ( www.WHO.int) FHI (www.FHI.int) and more than 100 specialists on fertility regulation in high and low income countries.

Member of the internationally recognized department of Clinical Epidemiology of Leiden University Medical Center ( www.lumc.nl/4060/)  

Contents / highlights / achievements

Three interlinked research projects covering basic science, evidence based medicine on reproductive medicine at large. Each part of the research is internationally recognized and appreciated.

Achievements: 1 millimetre further?

Cohesion within LUMC

Establishment of research cooperation connections (apart from the Cochrane Collaboration and department of Clinical Epidemiology) with LUMC departments: Haemostasis, Geriatrics & Gerontology, Rheumatology, Neonatology, Obstetrics, Endocrinology.

Key publications

Westendorp RGJ, van Dunné FM, Kirkwood TBL, Helmerhorst FM, Huizinga TWJ. (2001) Optimizing human fertility and survival. Nature Medicine 1;7:1.         
IF 29

Tanis BC, Van den Bosch MAAJ, Kemmeren JM, Manger Cats V, Helmerhorst FM, Algra A, van der Graaf Y, Rosendaal FR. (2001) Oral contraceptives and the risk of acute myocardial infarction. NEJM 345:1787-93.
IF 51

Helmerhorst FM, Perquin DAM, Donker D, Keirse MJNC. (2004) Perinatal outcome of singletons and twins after assisted conception: a systematic review of controlled studies. BMJ 328:261-5.      
IF 9

Van Dunné FM, Lard LR, Rook D, Helmerhorst FM, Huizinga TW. (2004) Miscarriage but not fecundity is associated with progression of joint destruction in rheumatoid arthritis. Ann Rheum Dis 63:956-60.     
IF 6

van Vliet HA, Frolich M, L G D Thomassen MC, Doggen CJ, Rosendaal FR, Rosing J, Helmerhorst FM. (2005) Association between sex hormone-binding globulin levels and activated protein C resistance in explaining the risk of thrombosis in users of oral contraceptives containing different progestogens. Hum Reprod. 20:563-8.
IF 4

Van Dunné FM, Doggen CJ, Heemskerk M, Rosendaal FR, Helmerhorst FM. (2005) Factor V Leiden mutation in relation to fecundity and miscarriage in women with venous thrombosis. Hum Reprod. 20:802-6.
IF 4

 Perquin DA,  Dorr PJ,  Craen AJ,  Helmerhorst FM. (2006) Routine use of hysterosalpingography prior to laparoscopy in the fertility workup: a multicentre randomized controlled trial. Hum Reprod. 21:1227-31.
IF 4

Plaisier M, Rodrigues S, Willems F, Koolwijk P, van Hinsbergh VW, Helmerhorst FM. (2007) Different degrees of vascularization and their relationship to the expression of vascular endothelial growth factor, placental growth factor, angiopoietins, and their receptors in first-trimester decidual tissues. Fertil Steril. 88:176-87.
IF 3

Knoester M, Vandenbroucke JP, Helmerhorst FM, van der Westerlaken LA, Walther FJ, Veen S. (2007) Matched follow-up study of 5-8 year old ICSI-singletons: comparison of their neuromotor development to IVF and naturally conceived singletons. Hum Reprod. 22:1638-46.
IF 4

Sibug RM, Datson N, Tijssen AM, Morsink M, de Koning J, de Kloet ER, Helmerhorst FM. (2007) Effects of urinary and recombinant gonadotrophins on gene expression profiles during the murine peri-implantation period. Hum Reprod. 22:75-82.
IF 4