Adrian Lower

Mr Adrian Lower is one of the founding consultants at Nuada Gynaecology and lead consultant for gynaecology and infertility.  He was formerly a consultant gynaecologist at St Bartholomew’s Hospital in London,  before leaving the NHS to establish centres of excellence in the private sector.   

He specialises in Reproductive Medicine and Surgery.   There is a strong research base to his practice and he has contributed to research in the fields of pelvic adhesions, IVF, reproductive endocrinology and ultrasound.  He was the first author and editor of one of the early textbooks of Gynaecological Endoscopic Surgery.

He is a highly regarded as an expert in the management of a number of key gynaecological conditions and many patients are referred to him by other Consultants and specialist clinicians.

He is recommended for treatment of the following conditions:

 

Further reading

Surgery and Anatomy

Lower AM, Sutton CJG & Grudzinskas JG. Introduction to Gynaecological Endoscopy. ISIS Medical Media, Oxford. 1996.

Lower AM and Trew G.  Laparoscopic techniques for tubal pregnancy and tubal reconstructive surgery.  In:  Laparoscopic Surgery for Benign Gynaecology.  Eds Cutner A and Vyas S.  2011

Lower AM Surgical Anatomy.  In Gynaecology (4th Edition).  Eds Shaw RW, Luesley D and Monga A.  2011

Lower AM  Postoperative adhesions: the extent and impact of the problem.  In: RCOG Yearbook 10 Ed Dunlop W. 2002

Lower AM  Laparoscopic Myomectomy.  In: Progress in Obstetrics & Gynaecology 15.  Ed Studd J.  2002

Lower AM.  Reproductive Endoscopic Surgery.  Fertility 2000.  Ed Balen AH.

Shepherd JH, Lower AM, Jarvis GJ.  Gynaecological Conditions Relevant to the Colorectal Surgeon.  In: Surgery of the Anus Rectum and Colon. 2nd Edition.  Eds Keighley MRB and Williams NS. 1999

Lower AM, Richardson PA, Jequier AM.  Intrauterine surgery using electrocautery.  Aust N Z J Obstet Gynaecol. 1991 May;31(2):192.

Lower AM, Maguiness S, Djahanbakhch O, Grudzinskas JG. Transcervical tubal endoscopy (falloposcopy) – a clinically useful tool? Gynaecological Endoscopy 1992. 1, 155-8.

Surgical Adhesions

Trew G, Pistofidis G, Pados G, Lower A, Mettler L, Wallwiener D, Korell M, Pouly JL, Coccia ME, Audebert A, Nappi C, Schmidt E, McVeigh E, Landi S, Degueldre M, Konincxk P, Rimbach S, Chapron C, Dallay D, Röemer T, McConnachie A, Ford I, Crowe A, Knight A, Dizerega G, Dewilde R. Gynaecological endoscopic evaluation of 4% icodextrin solution: a European, multicentre, double-blind, randomized study of the efficacy and safety in the reduction of de novo adhesions after laparoscopic gynaecological surgery. Hum Reprod. 2011 Aug;26(8):2015-27.

Lower AM, Hawthorn RJ, Clark D, Boyd JH, Finlayson AR, Knight AD, Crowe AM. Adhesion-related readmissions following gynaecological laparoscopy or laparotomy in Scotland: an epidemiological study of 24 046 patients.  Hum Reprod. 2004 Aug;19(8):1877-85.

Lower AM, Hawthorn RJ, Ellis H, O’Brien F, Buchan S, Crowe AM.  The impact of adhesions on hospital readmissions over ten years after 8849 open gynaecological operations: an assessment from the Surgical and Clinical Adhesions Research Study.  BJOG. 2000 Jul;107(7):855-62.

Ellis H, Moran BJ, Thompson JN, Parker MC, Wilson MS, Menzies D, McGuire A, Lower AM, Hawthorn RJ, O’Brien F, Buchan S, Crowe AM.   Adhesion-related hospital readmissions after abdominal and pelvic surgery: a retrospective cohort study.  Lancet. 1999 May 1;353(9163):1476-80.

Parker MC, Ellis H, Moran BJ, Thompson JN, Wilson MS, Menzies D, McGuire A, Lower AM,  Hawthorn RJ, O’Briena F, Buchan S, Crowe AM.  Postoperative adhesions: ten-year follow-up of 12,584 patients undergoing lower abdominal surgery.  Dis Colon Rectum. 2001 Jun;44(6):822-29; discussion 829-30.

Diagnostic Imaging

Hamilton JA, Larson AJ, Lower AM, Hasnain S, Grudzinskas JG.   Routine use of saline hysterosonography in 500 consecutive, unselected, infertile women.  Hum Reprod. 1998 Sep;13(9):2463-73.

Hamilton JA, Larson AJ, Lower AM, Hasnain S, Grudzinskas JG.  Evaluation of the performance of hysterosalpingo contrast sonography in 500 consecutive, unselected, infertile women.  Hum Reprod. 1998 Jun;13(6):1519-26.

Hamilton J, Latarche E, Gillott C, Lower A, Grudzinskas JG.  Intrauterine insemination results are not affected if Hysterosalpingo Contrast Sonography is used as the sole test of tubal patency.  Fertil Steril. 2003 Jul;80(1):165-71.

Ovarian Hyperstimulation Syndrome

Tozer AJ, Al-Shawaf T, Zosmer A, Hussain S, Wilson C, Lower AM, Grudzinskas JG.  Does laparoscopic ovarian diathermy affect the outcome of IVF-embryo transfer in women with polycystic ovarian syndrome? A retrospective comparative study.  Hum Reprod. 2001 Jan;16(1):91-95.

Al-Shawaf T, Zosmer A, Hussain S, Tozer A, Panay N, Wilson C, Lower AM, Grudzinskas JG.  Prevention of severe ovarian hyperstimulation syndrome in IVF with or without ICSI and embryo transfer: a modified ‘coasting’ strategy based on ultrasound for identification of high-risk patients.  Hum Reprod. 2001 Jan;16(1):24-30.

Al-Mizyen E, Sabatini L, Lower AM, Wilson CM, al-Shawaf T, Grudzinskas JG.   Does pretreatment with progestogen or oral contraceptive pills in low responders followed by the GnRHa flare protocol improve the outcome of IVF-ET? J Assist Reprod Genet. 2000 Mar;17(3):140-6.

Basic Science

Hamilton JA, Iles RK, Gunn LK, Wilson CM, Lower AM, Chard T, Grudzinskas JG.  Concentrations of placental protein 14 in uterine flushings from infertile women: validation of the collection technique and method of expression of results.  Hum Reprod. 1998 Dec;13(12):3357-62.

El-Nemr A, Al-Shawaf T, Sabatini L, Wilson C, Lower AM, Grudzinskas JG.  Effect of smoking on ovarian reserve and ovarian stimulation in in-vitro fertilization and embryo transfer.  Hum Reprod. 1998 Aug;13(8):2192-8.

Balet R, Lower AM, Wilson C, Anderson J, Grudzinskas JG.  Attitudes towards routine human immunodeficiency virus (HIV) screening and fertility treatment in HIV positive patients–a UK survey.  Hum Reprod. 1998 Apr;13(4):1085-7.

El-Nemr A, Sabatini L, Wilson C, Lower AM, Al-Shawaf T, Grudzinskas JG.   Vitamin B12 deficiency and IVF.  J Obstet Gynaecol. 1998 Mar;18(2):192-3.

Sabatini L, Wilson C, al Shawaf T, Lower A, Grudzinskas JG.  Efficacy of serum albumin to prevent ovarian hyperstimulation syndrome? Fertil Steril. 1997 Mar; 67(3):587-9.

Jacobs I, Davies AP, Bridges J, Stabile I, Fay T, Lower A, Grudzinskas JG, Oram D.  Prevalence screening for ovarian cancer in postmenopausal women by CA 125 measurement and ultrasonography.  BMJ. 1993 Apr 17;306(6884):1030-4.

Lower AM, Yovich JL, Hancock C, Grudzinskas JG.  Is luteal function maintained by factors other than chorionic gonadotrophin in early pregnancy? Hum Reprod. 1993 Apr;8(4):645-8.

Lower AM, Yovich JL.  The value of serum levels of oestradiol, progesterone and beta-human chorionic gonadotrophin in the prediction of early pregnancy loss.  Hum Reprod. 1992 May;7(5):711-7.

Lower AM, Mulcahy MT, Yovich JL.  Chromosome abnormalities detected in chorionic villus biopsies of failing pregnancies in a subfertile population. Br J Obstet Gynaecol. 1991 Dec;98(12):1228-33.

White TEK, Miller RK, Grudzinskas JG, Lower AM, Fay TN. Human endometrial cells grown on extracellular matrix (ECM) form an in vivo type morphology and produce the endometrial protein PP14 (alpha 2-PEG) Placenta 1989. 10, 520.