1.  Peer Reviewed Title: Comparison of GnRH antagonist protocol with or without oral contraceptive pill pretreatment and GnRH agonist low-dose long protocol in low responders undergoing IVF/intracytoplasmic sperm injection. Author: Kim CH; Jeon GH; Cheon YP; Jeon I; Kim SH; Chae HD; Kang BM Source: Fertility and Sterility. 2009 Jun 10; Abstract: This prospective randomized study was performed to compare the efficacy of GnRH antagonist multiple-dose protocol (MDP) with or without oral contraceptive pill (OCP) pretreatment and GnRH agonist low-dose long protocol (LP) in 82 patients undergoing IVF/intracytoplasmic sperm injection (ICSI). GnRH antagonist MDP with OCP pretreatment was at least as effective as GnRH agonist low-dose LP in low responders, and can benefit the low responders by reducing the amount of FSH and the number of days of stimulation required for follicular maturation. Language: English Keywords: REPUBLIC OF KOREA | RESEARCH REPORT | PROSPECTIVE STUDIES | COMPARATIVE STUDIES | CLIENTS | ARTIFICIAL INSEMINATION | HORMONE ANTAGONISTS | ORAL CONTRACEPTIVES | ADMINISTRATION AND DOSAGE | FOLLICLE STIMULATING HORMONE | Asia, Eastern | Asia | Developed Countries | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Reproductive Technologies | Reproduction | Hormones | Endocrine System | Physiology | Biology | Contraceptive Methods | Contraception | Family Planning | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Gonadotropins, Pituitary | Gonadotropins Document Number: 341712 |
| 2. Peer Reviewed Title: Follicular development in a 7-day versus 4-day hormone-free interval with an oral contraceptive containing 20 mcg ethinyl estradiol and 1 mg norethindrone acetate. Author: Rible RD; Taylor D; Wilson ML; Stanczyk FZ; Mishell DR Jr Source: Contraception. 2009 Mar;79(3):182-8. Abstract: BACKGROUND: Combined oral contraceptive (COC) formulations with 20 mcg ethinyl estradiol (EE) have a greater incidence of ovarian hormone production and follicular development, which can be managed by shortening the number of hormone-free days per COC cycle. This study evaluates differences in follicular development during a 7-day versus 4-day hormone-free interval in a COC regimen with 20 mcg EE and 1 mg norethindrone acetate. STUDY DESIGN: Forty-one healthy women were randomized in an open-label fashion to this formulation in either a 24/4 or a 21/7 day regimen for three cycles. Estradiol, progesterone, follicle-stimulating hormone, luteinizing hormone and inhibin B were measured daily from Cycle 2, Day 21 to Cycle 3, Day 3 and on Day 7 of Cycle 3. Follicular diameter and Hoogland score were calculated on Cycle 2, Days 21, 24 and 28 and Cycle 3, Days 3 and 7. RESULTS: Sixty-six percent of subjects in the 21/7 group and 70% of the subjects in the 24/4 group developed a follicle greater than 10 mmdiameter. Ovarian steroid hormone levels, Hoogland scores and bleeding patterns were not statistically significant between the groups. CONCLUSION: In contrast to prior studies, this analysis suggests no difference in follicle development or bleeding patterns among women receiving a 21/7 or 24/4 regimen of a 20-mcg EE/1-mg norethindrone acetate COC. Language: English Keywords: CALIFORNIA | RESEARCH REPORT | CLINICAL RESEARCH | CASE CONTROL STUDIES | COMPARATIVE STUDIES | WOMEN | FOLLICLE STIMULATING HORMONE | ORAL CONTRACEPTIVES, COMBINED | ETHINYL ESTRADIOL | NORETHINDRONE | ADMINISTRATION AND DOSAGE | MENSTRUATION | TIME FACTORS | United States of America | North America | Americas | Developed Countries | Research Methodology | Studies | Demographic Factors | Population | Gonadotropins, Pituitary | Gonadotropins | Hormones | Endocrine System | Physiology | Biology | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Contraceptive Agents, Progestin | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Reproduction | Population Dynamics Document Number: 330059 |
| 3. Peer Reviewed Title: Clinical and biochemical characteristics of polycystic ovary syndrome in Korean women. Author: Chae SJ; Kim JJ; Choi YM; Hwang KR; Jee BC Source: Human Reproduction. 2008;23(8):1924-1931. Abstract: BACKGROUND: We investigated the differences in anthropometrical, hormonal and insulin resistance parameters according to the subtype of polycystic ovary syndrome (PCOS) in Korean women. METHODS: We recruited 166 women with PCOS and retrospectively recruited 277 controls. PCOS was diagnosed by irregular menstruation (IM), polycystic ovary (PCO) and hyperandrogenism (HA). Subjects were divided into four subgroups: the IM/HA/PCO group (n = 87, 52.4%), the IM/PCO group (n = 52, 31.3%), the IM/HA group (n = 23, 13.9%) and the HA/PCO group (n = 4, 2.4%). Clinical and biochemical variables were compared among the PCOS subgroups. RESULTS: The IM/HA/PCO and IM/HA groups showed higher body mass index (P < 0.001) and waist-to-hip ratio (P < 0.001) than the IM/PCO group. The IM/HA group had higher triglyceride levels than the other groups (P < 0.001). Higher fasting insulin (P < 0.001) and postprandial 2 h insulin (P < 0.01) were noted in the IM/HA/PCO group and the IM/HA group, compared with the IM/PCO group. Women with PCOS showed lower sex hormone-binding globulin (P < 0.001) and higher systolic blood pressure (BP) (P = 0.004), diastolic BP (P = 0.001), fasting insulin (P < 0.001), postprandial 2 h insulin (P < 0.001), homeostatic model for insulin resistance (P < 0.001) and clinical and biochemical parameters of metabolic syndrome (P < 0.05) compared with subjects without PCOS. CONCLUSIONS: Women with PCOS without HA are common in Korea and are less likely to have metabolic dysfunction, insulin resistance and elevated BP. PCOS without HA may be a mild phenotype of PCOS. Therefore, women with PCOS in Korea could have a reduced likelihood of having metabolic syndrome compared with women of other ethnicities. Language: English Keywords: KOREA | RESEARCH REPORT | RETROSPECTIVE STUDIES | OVARIAN EFFECTS | BLOOD PRESSURE | FOLLICLE STIMULATING HORMONE | LUTEINIZING HORMONE | MENSTRUATION DISORDERS | METABOLIC EFFECTS | Studies | Research Methodology | Ovary | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Hemic System | Gonadotropins, Pituitary | Gonadotropins | Hormones | Endocrine System | Diseases Document Number: 327760 |
| 4. Peer Reviewed Title: Decreased anti-Mullerian hormone and altered ovarian follicular cohort in infertile patients with mild / minimal endometriosis. Author: Lemos NA; Arbo E; Scalco R; Weiler E; Rosa V Source: Fertility and Sterility. 2008 May;89(5):1064-1068. Abstract: The objective was to evaluate the ovarian reserve and follicular cohort of infertile patients with minimal/mild endometriosis. The design used was a prospective study. The setting was the University hospital. Patients were divided into two groups: group I, minimal/mild endometriosis and group II, tubal obstruction. The following exclusion criteria were established: [1] patients with previous endocrine disorders; and [2] cases in which the cause for infertility was other than endometriosis (except for patients with tubal obstruction, in the control group). Serum FSH and anti-Mullerian hormone were measured on day 3. On the same day all patients were submitted to transvaginal ultrasound to evaluate the antral follicular count and the ovarian follicular cohort. The main outcome measure(s) were serum FSH, anti-Mullerian hormone, and the follicular cohort with the respective antral follicular count. Serum FSH were not different between the groups. However, infertile patients with endometriosis have a decreased serum anti-Mullerian hormone (1.26 plus or minus 0.7 ng/mL) compared to the control group (2.02 plus or minus 0.72 ng/mL). The analysis of follicular cohort showed that the number of selectable follicles were similar, but the follicular diameter was different. Minimal/mild endometriosis is associated with a decrease in the follicular ovarian reserve. In addition, the follicular cohort of these patients is more heterogeneous in comparison to the control group. (author's) Language: English Keywords: BRAZIL | RESEARCH REPORT | PROSPECTIVE STUDIES | WOMEN | ENDOMETRIOSIS | PREVALENCE | FOLLICLE STIMULATING HORMONE | INFERTILITY | OVARIAN EFFECTS | TUBAL EFFECTS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Studies | Research Methodology | Demographic Factors | Population | Diseases | Measurement | Gonadotropins, Pituitary | Gonadotropins | Hormones | Endocrine System | Physiology | Biology | Reproduction | Ovary | Genitalia, Female | Genitalia | Urogenital System | Fallopian Tubes Document Number: 327225 |
| 5. Title: Predictors for partial suppression of spermatogenesis of hormonal male contraception. Author: Li JW; Gu YQ Source: Asian Journal of Andrology. 2008 Sep;10(5):723-30. Abstract: AIM: To analyze factors influencing the efficacy of hormonal suppression of spermatogenesis for male contraception. METHODS: A nested case-control study was conducted, involving 43 subjects, who did not achieve azoospermia or severe oligozoospermia when given monthly injections of 500 mg testosterone undecanoate (TU), defined as partial suppressors compared with 855 subjects who had suppressed spermatogenesis (complete suppressors). Sperm density, serum testosterone, luteinizing hormone (LH) and follicle stimulating hormone (FSH) concentrations at the baseline and the suppression phase were compared between partial and complete suppressors. Polymorphisms of androgen receptor (AR) and three single nucleotide variants and their haplotypes of FSH receptor (FSHR) genes determined by polymerase chain reaction (PCR) and DNA sequencing technique were compared between 29 partial and 34 complete suppressors. RESULTS: Baseline serum LH level was higher and serum LH as well as FSH level during the suppression phase was less suppressed in partial suppressors. Additionally, in a logistic regression analysis larger testis volume, higher serum FSH concentrations alone, or interaction of serum LH, FSH, testosterone and sperm concentrations were associated with degree of suppression. The distribution of polymorphisms of AR or FSH receptor genes did not differ between partial and complete suppressors. In cases with incomplete FSH suppression (FSH 0.2 IU/L), the chances of reaching azoospermia were 1.5 times higher in the subjects with more than 22 CAG triplet repeats. CONCLUSION: Partial suppression of spermatogenesis induced by 500 mg TU monthly injections is weakly influenced by hormonal and clinical features but not polymorphism in AR and FSHR genes. Language: English Keywords: CHINA | RESEARCH REPORT | CASE STUDIES | MALE CONTRACEPTION | ANDROGENS | FOLLICLE STIMULATING HORMONE | SPERM COUNT | Asia, Eastern | Asia | Developing Countries | Studies | Research Methodology | Contraception | Family Planning | Hormones | Endocrine System | Physiology | Biology | Gonadotropins, Pituitary | Gonadotropins | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 328849 |
| 6. Title: Oral contraceptive pretreatment and half dose of ganirelix does not excessively suppress LH and may be an excellent choice for scheduling IUI cycles. Author: Meldrum DR; Cassidenti DL; Rosen GF; Yee B; Wisot AL Source: Journal of Assisted Reproduction and Genetics. 2008 Aug;25(8):417-20. Abstract: PURPOSE: To assess the effects of using a reduced dose of ganirelix with oral contraceptive pretreatment in a pilot study of COH using pure FSH for intrauterine insemination (IUI) METHODS: Patients received oral contraceptive (OC; 30 microg ethinyl estradiol/150 microg desogestrel) for 14-21 days and rFSH (50-225 IU/day SC) was started on day 4 after OC discontinuation. Ganirelix acetate (125 microg/day) was started with a lead follicle diameter of 14 mm. RESULTS: Of the 25 subjects who started oral contraceptives, one was cancelled due to an excessive response, and one subject was not included in the analysis because she did not receive ganirelix until the lead follicle was 18 mm. Median (range) starting FSH dose was 100 (50-225), cumulative rFSH dose was 1000 (675-2175) IU over 10 (9-17) days. Duration of ganirelix acetate treatment was 4.0 (2-5) days. Seven subjects (30.4%) delivered ten babies (three pregnancies were twins). There were no biochemical pregnancies or miscarriages. Of the 16 subjects with measurement of LH on the day of HCG administration, only one was under 0.5 mIU/ml (0.4), and only one was over 10 mIU/ml (17.7), and that subject delivered twins. CONCLUSION: OC pretreatment afforded flexibility in scheduling while a reduced dose of ganirelix avoided excessive suppression of LH. The excellent results in this pilot study for IUI suggest this regimen could be further evaluated for scheduling IUI and IVF cycles. Language: English Keywords: MOZAMBIQUE | RESEARCH REPORT | CLINICAL RESEARCH | PILOT PROJECTS | WOMEN | ORAL CONTRACEPTIVES, COMBINED | ARTIFICIAL INSEMINATION | ORAL CONTRACEPTIVES, LOW-DOSE | ADMINISTRATION AND DOSAGE | ETHINYL ESTRADIOL | FOLLICLE STIMULATING HORMONE | IN VITRO | TIME FACTORS | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Studies | Demographic Factors | Population | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Reproductive Technologies | Reproduction | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Gonadotropins, Pituitary | Gonadotropins | Hormones | Endocrine System | Physiology | Biology | Population Dynamics Document Number: 329209 |
| 7. Peer Reviewed Title: Effects on serum hormone levels of low-dose estrogen in place of placebo during the hormone-free interval of an oral contraceptive. Author: Reape KZ; DiLiberti CE; Hendy CH; Volpe EJ Source: Contraception. 2008 Jan;77(1):34-39. Abstract: The study was conducted to evaluate the effects of low-dose estrogen compared to placebo on ovarian activity during the traditional 7-day hormone-free interval (HFI) of an oral contraceptive (OC). Women were randomized to placebo or low-dose estrogen for 7 days during the HFI. Serum levels of estradiol, follicle-stimulating hormone (FSH), luteinizing hormone and inhibin B were obtained before, during and after treatment. Mean hormone levels remained constant or only increased slightly for the low-dose estrogen group compared to greater more sustained increases observed for the placebo group. Estradiol, FSH and inhibin B levels were substantially higher for those on placebo. Differences were most noticeable by the end of the HFI and persisted into the subsequent cycle. Subjects receiving low-dose estrogen for 7 days during the HFI demonstrated more pronounced ovarian suppression compared to placebo as evidenced by attenuation of increases in serum inhibin B, FSH and estradiol levels. (author's) Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | PROSPECTIVE STUDIES | WOMEN | ORAL CONTRACEPTIVES | ORAL CONTRACEPTIVES, SIDE EFFECTS | ESTROGENS | OVARIAN EFFECTS | ENDOCRINE EFFECTS | ESTRADIOL | FOLLICLE STIMULATING HORMONE | LUTEINIZING HORMONE | Developed Countries | North America | Americas | Studies | Research Methodology | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Contraceptive Safety | Safety | Public Health | Health | Hormones | Endocrine System | Physiology | Biology | Ovary | Genitalia, Female | Genitalia | Urogenital System | Gonadotropins, Pituitary | Gonadotropins Document Number: 323056 |
| 8. Peer Reviewed Title: Continuous oral contraception: Changing times. Author: Sulak PJ Source: Best Practice and Research Clinical Obstetrics and Gynaecology. 2008 Apr;22(2):355-374. Abstract: Oral contraceptives (OCs) remain the most common method of reversible contraception. Despite lowering of oestrogen and progestin content, the same basic design of 21 combination oestrogen plus progestin pills followed by a week of placebo pills has remained. Numerous studies have now documented that the 21/7 regimen needs to be modified. The 7-day hormone-free interval (HFI) in today's low-dose OCs is associated with reduced pituitary-ovarian suppression, allowing for ovarian follicular development, endogenous oestradiol production and possible ovarian cyst formation and ovulation. The 7-day HFI is also associated with hormone withdrawal symptoms that can lead to discontinuation and unintended pregnancy. Modifications in OC regimens are now appearing on the market secondary to the accumulated scientific data on the disadvantages of low-dose 21/7 pills. This article will review the data on problems with standard OC regimens and modifications that can improve the efficacy and side-effect profile. (author's) Language: English Keywords: UNITED STATES OF AMERICA | LITERATURE REVIEW | CLINICAL RESEARCH | WOMEN | ORAL CONTRACEPTIVES, COMBINED | CONTRACEPTIVE AGENTS, ESTROGEN | ORAL CONTRACEPTIVES, LOW-DOSE | PITUITARY GLAND | FOLLICLE STIMULATING HORMONE | ADMINISTRATION AND DOSAGE | Developed Countries | North America | Americas | Research Methodology | Demographic Factors | Population | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Female | Contraceptive Agents | Endocrine System | Physiology | Biology | Gonadotropins, Pituitary | Gonadotropins | Hormones | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 324955 |
| 9. Peer Reviewed Title: Fetal and early postnatal environmental exposures and reproductive health effects in the female. Author: Woodruff TK; Walker CL Source: Fertility and Sterility. 2008 Feb;89(2 Suppl 1):e47-e51. Abstract: The environment influences not only the development of the reproductive system, but also impacts adult reproductive function. Environmental cues such as the light:dark cycle, caloric signals, and pheromones are integrated at the central nervous system and, in combination with endogenous endocrine and paracrine signals, create a permissive or nonpermissive environment for the initiation and maintenance of the normal reproductive cycle. On the other hand, exposure to environmental agents can have profound negative effects on the development and function of the reproductive tract. The developmental programming hypothesis proposes that at critical times during development, exposure of developing tissues to an adverse stimulus or insult can permanently reprogram normal physiologic responses, and so give rise to metabolic and hormonal disorders later in life. The female reproductive tract has been shown to be a target for developmental programming as a result of environmental hormone exposure. This short review presents current research into the role of the environment in normal female reproductive function and pathogenesis, specifically focusing on the ovary and uterus. (excerpt) Language: English Keywords: TEXAS | LITERATURE REVIEW | CLINICAL RESEARCH | FETUS | PREGNANT WOMEN | WOMEN | ENVIRONMENT | TOXICITY | OVARIAN EFFECTS | FOLLICLE STIMULATING HORMONE | ESTROGENS | UTERUS | DIETHYLSTILBESTROL | REPRODUCTIVE HEALTH | POSTPARTUM | United States of America | North America | Americas | Developed Countries | Research Methodology | Pregnancy | Reproduction | Population Characteristics | Demographic Factors | Population | Physiology | Biology | Ovary | Genitalia, Female | Genitalia | Urogenital System | Gonadotropins, Pituitary | Gonadotropins | Hormones | Endocrine System | Health | Puerperium Document Number: 325258 |
| 10. Peer Reviewed Title: Effects of ovarian high response on implantation and pregnancy outcome during controlled ovarian hyperstimulation (with GnRH agonist and rFSH). Author: Chen QJ; Sun XX; Li L; Gao XH; Wu Y Source: Acta Obstetrica et Gynecologica Scandinavica. 2007;88(7):849-854. Abstract: The study was aimed at investigating the effects of ovarian high response during controlled ovarian hyperstimulation (COH) on implantation and pregnancy outcome in fresh IVF/ICSI cycles, and subsequent frozen-thawed embryo transfer (FET) cycles. An analysis of 1,196 cycles using a long protocol with GnRHa and rFSH was performed. A serum oestrial level (peak E2) was obtained on the day of hCG administration, and patients were grouped by peak E2 percentile distribution into 3 groups. Normal responder was set as cut-off concentrations between percentile (P)25 and P75 (Group A: 1,199-3,047 pg/ml, 595 cycles). Moderate high responders were classified as peak E2 between P75-P90 (Group B: 3,048-4,127 pg/ml, 180 cycles). For the high response group, the E2 cut-off concentration was set as P90 and above (Group C: >/= 4,128 pg/ml, 119 cycles). Oocyte/embryo parameters and clinical outcomes were compared among the 3 groups in fresh cycles and subsequent FET cycles. Comparisons between groups revealed no difference in the quality of oocyte retrieved and in fertilisation rates. Group C showed decreased trends in implantation and pregnancy rates compared with Group A, but statistical significance was reached only for the difference in implantation rates. Implantation and pregnancy rates in FET cycles were similar among the 3 groups. High serum estrogen levels were detrimental to implantation, but not to the quality of oocytes, which may be due to an adverse effect on endometrial receptivity in COH cycles. (author's) Language: English Keywords: CHINA | RESEARCH REPORT | WOMEN | OVULATION | GONADOTROPINS | FOLLICLE STIMULATING HORMONE | ADMINISTRATION AND DOSAGE | IN VITRO | FERTILIZATION | IMPLANTATION | PREGNANCY RATE | PREGNANCY OUTCOMES | Developing Countries | Asia, Eastern | Asia | Demographic Factors | Population | Reproduction | Hormones | Endocrine System | Physiology | Biology | Gonadotropins, Pituitary | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Clinical Research | Research Methodology | Pregnancy, First Trimester | Pregnancy | Fertility Measurements | Fertility | Population Dynamics Document Number: 317961 |
11.  Title: [Gonadotropin level changes during the reproductive life] Modificacoes dos niveis de gonadotrofinas durante a vida reprodutiva. Author: de Medeiros SF; de Medeiros MM Source: Revista Brasileira de Ginecologia e Obstetricia. 2007 Jan;29(1):48-55. Abstract: Changes in the levels of gonadotropins throughout the reproductive life depend on a fine tuned functional development of neural pathways and GnRH-neurones, pituitary gonadotrophs and granulosa-theca cells of the follicular wall. Both, LH and FSH levels change according to the day-time, menstrual cycle phase, and gynecological age. Initiating the puberty, changes in LH pulses are remarkable, showing higher frequency and amplitude at night. Later in puberty, the pulses of LH are also maintained during the day, remaining its levels with very little variation within the 24 hours period. During the menstrual cycle, the FSH levels increase at the end of the luteal phase, decrease during the medium and late follicular phase, increase rapidly in the ovulatory phase and remain at low basal levels until the late luteal phase. The levels of LH remain unaltered during the whole follicular phase, increase in the ovulatory surge, and decrease to the basal levels in the luteal phase. At the forth decade of life, the GnRH secretion changes, with hypothalamic loss of sensitivy to the estradiol positive feedback and decrease in frequency and prolongation of the GnRH pulses. The pituitary response is atenuated due to decrease in the density of GnRH receptors on gonadotroph cells, loss of gonadotroph sensitivity, secretion of more basic FSH and LH molecules, decrease in frequency and increase in amplitude of LH and FSH pulses. These modifications result in monotropic increase of the FSH secretion. Current studies show that the selective increase in the FSH levels in the early follicular phase is gradual, beginning as early as the third decade of life. These alterations in FSH are associated with an accelerated follicular depletion in women after 37-38 years old. On the other side, the LH levels remain almost constant up to the end of reproductive life. The different levels of FSH and LH seen throughout the reproductive years may be due to yet unknown regulatory mechanisms in the hypothalamic-pituitary-ovarian axis. Language: Portuguese Keywords: DEVELOPING COUNTRIES | RESEARCH REPORT | PUBERTY | GONADOTROPINS, PITUITARY | FOLLICLE STIMULATING HORMONE | MENSTRUAL CYCLE | Reproduction | Gonadotropins | Hormones | Endocrine System | Physiology | Biology | Menstruation Document Number: 326824 |
| 12. Peer Reviewed Title: Are GnRH antagonists comparable to agonists for use in IVF? Author: Huirne JA; Homburg R; Lambalk CB Source: Human Reproduction. 2007;22(11):2805-2813. Abstract: We believe that appropriate comparison of optimal GnRH agonist and antagonist regimens has not been performed yet. Currently available meta-analyses included all comparative studies between GnRH agonists and antagonists performed so far, including less than optimal GnRH antagonist regimens. After critical appraisal of the various studied GnRH antagonist regimens in terms of follicular development and IVF outcome, we postulate that early suppression of endogenous FSH results in optimal follicular development. Additionally, stable and early suppression of LH and progesterone levels during the entire period of stimulation may be an advantage for implantation and pregnancy outcome. In this respect, single dose and particularly flexible protocols seem to be less advantageous. Early FSH and LH suppression can be achieved by early GnRH antagonist administration (stimulation day 1) or by oral contraceptive (OC) pretreatment. More studies comparing long GnRH agonist protocols with 'long' GnRH antagonist protocols, with enough power to identify differences in pregnancy rates, are required before appropriate comparison can be made. (author's) Language: English Keywords: NETHERLANDS | RESEARCH REPORT | WOMEN | GONADOTROPINS | HORMONE ANTAGONISTS | FOLLICLE STIMULATING HORMONE | LUTEINIZING HORMONE | IN VITRO | FERTILIZATION | ORAL CONTRACEPTIVES | PREGNANCY RATE | Developed Countries | Europe, Western | Europe | Demographic Factors | Population | Hormones | Endocrine System | Physiology | Biology | Gonadotropins, Pituitary | Clinical Research | Research Methodology | Reproduction | Contraceptive Methods | Contraception | Family Planning | Fertility Measurements | Fertility | Population Dynamics Document Number: 321407 |
| 13. Peer Reviewed Title: Usefulness of FSH measurements for determining menopause in long-term users of depot medroxyprogesterone acetate over 40 years of age. Author: Juliato CT; Fernandes A; Marchi NM; Castro S; Olivotti B Source: Contraception. 2007 Oct;76(4):282-286. Abstract: The objective was to assess the usefulness of follicle-stimulating hormone (FSH) measurements for determining menopause in 40-55-year-old users of depot medroxyprogesterone acetate (DMPA). FSH levels were measured in 355 blood samples from 82 amenorrheic women during an 18-month period. Blood was collected every 90 days immediately prior to DMPA administration. Using FSH values >35 mIU/mL as being in the post menopausal range, 32 women (39.0%) presented at least one FSH measurement in the postmenopausal range and 14 of them (43.7%) had more than one elevated FSH measurement and were considered postmenopausal. In five users (15.6%), only the last FSH measurement was within the postmenopausal range, and in 13 women (40.6%), FSH returned to normal values following one measurement that was within the postmenopausal range. The menopausal status in DMPA users in amenorrhea should be determined based on at least two consecutive high FSH evaluations, since, as shown here, 40.6% of the women with high FSH had a low FSH in the subsequent determination. FSH measurements should be done only in women >/=50 years old because there is a greater possibility of being in postmenopause. However, we do not recommend the interruption of DMPA use prior to the quantification of FSH. (author's) Language: English Keywords: BRAZIL | RESEARCH REPORT | STATISTICAL STUDIES | MEASUREMENT | WOMEN | MENOPAUSE | MEDROXYPROGESTERONE ACETATE | FOLLICLE STIMULATING HORMONE | South America, Eastern | South America | Latin America | Americas | Developing Countries | Studies | Research Methodology | Demographic Factors | Population | Reproduction | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Gonadotropins, Pituitary | Gonadotropins | Hormones | Endocrine System | Physiology | Biology Document Number: 320546 |
| 14. Peer Reviewed Title: Effect of octapeptide: FSH binding inhibitor on cyclicity of bonnet monkeys (Macaca radiata). Author: Kulkarni-Chitnis S; Nandedkar T Source: Contraception. 2007 Dec;76(6):467-473. Abstract: The gonadotropins follicle-stimulating hormone (FSH) and luteinizing hormone play an important role in the development of ovarian follicles, and a number of autocrine/paracrine factors secreted by the ovary are known to directly or indirectly regulate gonadotropin action. The objective of the present study was to elucidate the effect of octapeptide (OP) on cyclicity and hormonal profile of bonnet monkeys, the menstruating Old World primates. Our group has purified one such factor from human ovarian follicular fluid, which inhibits the binding of FSH to the granulosa cells. N-terminal eight-amino-acid sequence of this peptide has been deduced, which is referred to as the OP. It has shown an antifertility effect in marmosets, the New World primates. In the present study, the bonnet monkeys were divided into two groups, namely, the treated group (n=5), which was administered with OP (250 mcg/kg body weight/day) intramuscularly during the follicular phase, and the control group (n=6), which was injected with vehicle (saline). Blood was collected every other day, and progesterone levels were estimated by enzyme-linked immunosorbent assay. Animals in the control group demonstrated normal plasma progesterone levels and exhibited normal cyclicity. On the other hand, in the treated group, progesterone levels decreased by 65.8%, as compared with that in pretreatment cycles. This probably disturbed the cyclicity, thus causing amenorrhea (73.0+or-6.7 days). (author's) Language: English Keywords: INDIA | RESEARCH REPORT | LABORATORY ANIMALS | FOLLICLE STIMULATING HORMONE | PROGESTERONE | MENSTRUATION | OVULATION | Developing Countries | Asia, Southern | Asia | Clinical Research | Research Methodology | Gonadotropins, Pituitary | Gonadotropins | Hormones | Endocrine System | Physiology | Biology | Progestational Hormones | Reproduction Document Number: 323342 |
| 15. Title: Suprasellar arachnoid cyst with delayed puberty. Author: Kumar R; Singhal N Source: Indian Pediatrics. 2007 Nov;44(11):858. Abstract: A 15-year-old female presented with primary amenorrhea and delayed onset of secondary sexual characteristics. Earlier she was operated for endoscopic third ventriculostomy (ETV) for a tense suprasellar arachnoid cyst with obstructive hydrocephalus. MRI revealed recurrence of hydrocephalus. Hormonal levels were suggestive of hypogonadism and deficiency of growth hormone. She was operated for fenestration of cyst. In this case, suprasellar arachnoid cyst presented with delayed puberty, which is unusual. (author's) Language: English Keywords: INDIA | RESEARCH REPORT | ADOLESCENTS, FEMALE | AMENORRHEA | PUBERTY | ENDOCRINE EFFECTS | DEFICIENCY DISEASES | PHYSICAL EXAMINATIONS AND DIAGNOSES | FOLLICLE STIMULATING HORMONE | LUTEINIZING HORMONE | EVALUATION | Developing Countries | Asia, Southern | Asia | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Menstruation Disorders | Diseases | Reproduction | Endocrine System | Physiology | Biology | Nutrition Disorders | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Gonadotropins, Pituitary | Gonadotropins | Hormones Document Number: 322831 |
| 16. Peer Reviewed Title: The most frequent hormone dysfunctions in juvenile bleeding. Author: Lazovic G; Radivojevic U; Milicevic S; Milosevic V; Spremovic S Source: International Journal of Fertility. 2007 Jan-Feb;52(1):35-40. Abstract: The main goal of this study was to investigate the precise hormone dysfunction that leads to dysfunctional uterine bleeding (DUB) in adolescent girls so that, with the appropriate therapy, the occurrence of organic dysfunctions of their reproductive function can be prevented. This study included 70 adolescents with DUB aged 14.70 +or- 1.70 and 30 healthy adolescents aged 13.7+or- 1.83. Hormone examinations indicated the presence of three typical endocrinological findings of the adolescents with DUB: the first group with FSH values within the normal range, but low LH values, the lower value of estradiol and absence of hyperandrogenism; the second group with higher LH values and normal FSH values but one third with hyperandrogenism; and the third group with normal FSH and LH values, but with hyperinsulinemia and hyperandrogenism. Comparing the hormone values obtained in the control group and the group with DUB, we have concluded that hyperandrogenism, hyperinsulinemia, lower values of progesterone, and dysfunctions in secretion of gonadotropin are statistically important factors for the origin of juvenile bleeding. (author's) Language: English Keywords: SERBIA AND MONTENEGRO | RESEARCH REPORT | CLINICAL RESEARCH | CASE CONTROL STUDIES | ADOLESCENTS, FEMALE | HORMONES | METRORRHAGIA | FOLLICLE STIMULATING HORMONE | LUTEINIZING HORMONE | ANDROGENS | PROGESTERONE | GONADOTROPINS | Europe, Southeastern | Europe | Developing Countries | Research Methodology | Studies | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Endocrine System | Physiology | Biology | Bleeding | Signs and Symptoms | Diseases | Gonadotropins, Pituitary | Progestational Hormones Document Number: 326061 |
| 17. Title: In the spotlight: Insight into human congenital abnormality. Author: Maduro MR Source: Reproductive Sciences. 2007 May;14(4):295. Abstract: Congenital absence of the uterus and vagina in humans, also known as Rokitansky-Kuster-Hauser (RKH) syndrome, is characterized by utero-vaginal atresia in an otherwise phenotypically normal female with a normal 46,XX karyotype. In this syndrome, anomalies of the genital tract range from upper vagina atresia to total Mullerian agenesis with urinary tract abnormalities. Although a mutation in the wingless type 4 (Wnt4) gene has been identified in 1 isolated patient with a phenotype similar to RKH syndrome, no association between Wnt4 and RKH syndrome has been proven, and the disease etiology still remains to be elucidated. Interestingly, in a research article recently published in Development, Iizuka-Kogo and colleagues report a mouse knockout for the discs large homolog 1, which presents a phenotype that clearly resembles the human congenital absence of the uterus and vagina associated with other variable Mullerian duct abnormalities. (excerpt) Language: English Keywords: PROGRESS REPORT | CLINICAL RESEARCH | MEN | LABORATORY ANIMALS | CONTRACEPTIVE AGENTS, MALE | SPERMATOGENESIS BLOCKING AGENTS | HYPOTHALAMUS | PITUITARY GLAND | TESTIS | FOLLICLE STIMULATING HORMONE | ADMINISTRATION AND DOSAGE | ORAL CONTRACEPTIVES | TIME FACTORS | Research Methodology | Demographic Factors | Population | Contraceptive Agents | Contraception | Family Planning | Central Nervous System | Physiology | Biology | Endocrine System | Genitalia, Male | Genitalia | Urogenital System | Gonadotropins, Pituitary | Gonadotropins | Hormones | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Methods | Population Dynamics Document Number: 322733 |
| 18. Peer Reviewed Title: Does meloxicam increase the incidence of anovulation induced by single administration of levonorgestrel in emergency contraception? A pilot study. Author: Massai MR; Forcelledo ML; Brache V; Tejada AS; Salvatierra AM Source: Human Reproduction. 2007;22(2):434-439. Abstract: Levonorgestrel (LNG) consistently prevents follicular rupture only when it is given before the onset of the ovulatory stimulus. As locally synthesized prostaglandin (PG) plays a crucial role in follicular rupture and cyclooxygenase-2 (cox-2) catalyses the final step of PG synthesis, we reasoned that adding a cox-2 inhibitor to LNG would prevent follicular rupture even after the ovulatory process had been triggered by the gonadotrophin surge. Forty-one women were divided into two groups. One was treated when the size of the leading follicle was 15-17 mm (n = 10) and the other when it was ³18 mm (n = 31). Each woman contributed with one cycle treated with LNG 1.5 mg single dose plus placebo and another treated with LNG + meloxicam (Melox) 15 mg, in a randomized order. Serial blood sampling for the assay of LH and follicular monitoring by transvaginal ultrasound were performed before and after treatment. Follicular rupture failed to occur within the 5-day period that followed treatment in 50 and 70% of cycles treated with LNG + Placebo and LNG + Melox, respectively, in the 15-17 mm group (P = 0.15) and in 16 and 39% of cycles treated with LNG + Placebo and LNG + Melox, respectively, in the = 18 mm group (P < 0.052). The overall proportion of cycles with no follicular rupture or ovulatory dysfunction increased significantly by the addition of Melox to LNG (66 versus 88%, P < 0.012; n = 41-matched pairs). The trend towards increased incidence of no follicular rupture when Melox was combined with LNG suggests that the addition of a cox-2 inhibitor has the potential to improve the contraceptive efficacy of LNG by a pre-fertilization effect. (author's) Language: English Keywords: VIRGINIA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | PILOT PROJECTS | CASE CONTROL STUDIES | WOMEN | ANOVULATION | LEVONORGESTREL | EMERGENCY CONTRACEPTION | ADMINISTRATION AND DOSAGE | INCIDENCE | FOLLICLE STIMULATING HORMONE | Developed Countries | United States of America | North America | Americas | Research Methodology | Studies | Demographic Factors | Population | Ovarian Effects | Ovary | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement | Gonadotropins, Pituitary | Gonadotropins | Hormones | Endocrine System Document Number: 312200 |
| 19. Title: Intratesticular androgens and spermatogenesis during severe gonadotropin suppression induced by male hormonal contraceptive treatment. Author: Page ST; Kalhorn TF; Bremner WJ; Anawalt BD; Matsumoto AM Source: Journal of Andrology. 2007 Sep-Oct;28(5):734-741. Abstract: Male hormonal contraceptive regimens function by suppressing gonadotropin secretion, resulting in a dramatic decrease in testicular androgen biosynthesis and spermatogenesis. Animal studies suggest that persistent intratesticular (iT)-androgen production has a stimulatory effect on spermatogenesis in the setting of gonadotropin suppression. We hypothesized that men with incompletely suppressed spermatogenesis (> 1 000 000 sperm/mL) during male hormonal contraceptive treatment would have higher iTandrogen concentrations than men who achieved severe oligospermia (Language: English Keywords: WASHINGTON | RESEARCH REPORT | CLINICAL RESEARCH | MEN | ANDROGENS | TESTIS | SPERMATOGENESIS BLOCKING AGENTS | CONTRACEPTIVE AGENTS, MALE | GONADOTROPINS | FOLLICLE STIMULATING HORMONE | Developed Countries | United States of America | North America | Americas | Research Methodology | Demographic Factors | Population | Hormones | Endocrine System | Physiology | Biology | Genitalia, Male | Genitalia | Urogenital System | Contraceptive Agents | Contraception | Family Planning | Gonadotropins, Pituitary Document Number: 319476 |
| 20. Title: The salivary ferning test and ovulation in clomiphene citrate-stimulated cycles. Author: Pattanasuttinont S; Sereepapong W; Suwajanakorn S Source: Journal of the Medical Association of Thailand. 2007 May;90(5):876-883. Abstract: The objective was to determine the day of ovulation by the salivary ferning test in clomiphene citrate-treated women. A descriptive study was the design used. The setting used was the Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. Seventy-five infertile women with regular menstrual cycles were studied. Infertile women were given 100 mg of clomiphene citrate for five days and collected their saliva samples daily until seven days after ovulation. Transvaginal ultrasound was performed daily to detect ovulation. The salivary ferning formation was examined by a normal light microscope and graded from 1-3, according to its extent and intensity. The salivary ferning score, the peak salivary ferning day, and the day of ovulation detected by ultrasound. The patients' age and cycle length (mean ± SD) were 32.9 ± 3.7 years and 28.4 ± 1.3 days. The peak salivary ferning day corresponded with the ultrasound ovulation day in only 7.1%. There were two peaks of median salivary ferning scores; one was two days prior ovulation and the other was five days post ovulation. There was no correlation between the peak salivary ferning day and day of ovulation detected by ultrasound (r = 0.102, p > 0.05). In clomiphene citrate-stimulated cycles, the saliva ferning test does not seem to associate with ovulation. (author's) Language: English Keywords: THAILAND | RESEARCH REPORT | QUALITATIVE RESEARCH | WOMEN | INFERTILITY | CLOMIPHENE | OVULATION | MENSTRUAL CYCLE | FOLLICLE STIMULATING HORMONE | LUTEINIZING HORMONE | GONADOTROPINS, PITUITARY | Asia, Southeastern | Asia | Developing Countries | Research Methodology | Demographic Factors | Population | Reproduction | Fertility Agents | Reproductive Control Agents | Family Planning | Menstruation | Gonadotropins | Hormones | Endocrine System | Physiology | Biology Document Number: 317807 |
| 21. Title: Assessment of insulin resistance in the idiopathic hirsutism. Author: Sarac F; Saygili F; Ozgen G; Tuzun M; Yilmaz C; Kabalak T Source: Gynecologic and Obstetric Investigation. 2007 Apr;63(3):126-131. Abstract: Idiopathic hirsutism (IH) is the second most common cause of hirsutism, after polycystic ovary syndrome and occurs in about 15% of hirsute women. There are not many studies showing whether patients with IH also have insulin resistance. In the present study, we aimed to investigate the insulin sensivity in IH with non-obese and changing hormone levels during the hyperinsulinemic-euglycemic clamp. Twenty (20) non-obese women with IH (Group I) ranging in age from 20 to 30 (mean 25 ± 5) years were studied. Hirsutism in women with normal testosterone (T) levels and regular menstrual cycles is as defined IH. Twenty (20) healthy women (mean age 23 ± 2 years) (Group II) were included in this study as the control group. Insulin sensitivity was assessed with modified euglycemic insulin clamp technique. Samples of prolactin, luteinizing hormone (LH), follicle-stimulating hormone, adrenocorticotropic hormone (ACTH), dehydroepiandrosterone sulfate, cortisol, estradiol, progesterone, 17-OH progesterone (17-OHP), total T, and free T (FT) were obtained at baseline and at 2nd hour during clamp. Steady-state (120 min) glucose disposal rates were higher in Group II than Group I (7.51 ± 0.83 vs. 5.76 ± 1.89 mg/kg/min). Mean FT, ACTH, cortisol, LH, prolactin and 17-OHP levels were found to have decreased statistically significantly (p < 0.05) in Group I. Mean FT, ACTH, and prolactin levels were found to have decreased statistically significantly (p < 0.05) in Group II during the clamp. Mean baseline levels of FT, LH and prolactin were greater in women with hirsutism than in the control subjects (p < 0.05). Insulin mediated glucose disposal was lower in the normal weight women with IH than in those without hirsutism. Mean FT, 17-OHP and dehydroepiandrosterone sulfate levels decreased during euglcemic-hyperinsulinemic clamp in IH. (author's) Language: English Keywords: TURKEY | RESEARCH REPORT | WOMEN | HIRSUTISM | TESTOSTERONE | MENSTRUAL CYCLE | PROLACTIN | FOLLICLE STIMULATING HORMONE | LUTEINIZING HORMONE | MEASUREMENT | EXAMINATIONS AND DIAGNOSES | GLUCOSE METABOLISM EFFECTS | Developing Countries | Europe, Southeastern | Europe | Demographic Factors | Population | Signs and Symptoms | Diseases | Androgens | Hormones | Endocrine System | Physiology | Biology | Menstruation | Reproduction | Pituitary Hormones | Gonadotropins, Pituitary | Gonadotropins | Research Methodology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Carbohydrate Metabolic Effects | Metabolic Effects Document Number: 315877 |
| 22. Title: Total salpingectomy during abdominal hysterectomy: Effects on ovarian reserve and ovarian stromal blood flow. Author: Sezik M; Ozkaya O; Demir F; Sezik HT; Kaya H Source: Journal of Obstetrics and Gynaecology Research. 2007 Dec;33(6):863-869. Abstract: The aim was to investigate the short- and medium-term consequences of performing total salpingectomy during abdominal hysterectomy (without oophorectomy) on certain ovarian reserve parameters and blood flow velocity measurements through the ovarian stroma. Twenty-four patients were recruited and randomized into two groups. Group 1 patients (n = 12) underwent total hysterectomy and complete excision of the fallopian tubes bilaterally. In group 2 (classical approach), fallopian tubes were removed partially leaving behind the neighboring paraovarian tissue. Pre- and postoperative (at 1 and 6 months) serum follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol values, ovarian volume estimation by transvaginal ultrasound, and ovarian stromal blood flow Doppler velocimetry were assessed during the early follicular phase. Mann-Whitney U-test, Student's t-test and Freidman's test were used for comparisons. Baseline data were similar across the groups (P > 0.05). Mean FSH, LH, estradiol values, and ovarian volume were unchanged after both of the techniques. However, mean pulsatility index, resistance index, and systole/diastole (S/D) ratio were significantly decreased in both groups compared to baseline values (group 1, P = 0.027, P = 0.018, and P = 0.013, respectively; group 2, P = 0.01, P = 0.002, and P = 0.0001, respectively). Postoperative decline in the mean pulsatility index was more pronounced (P = 0.02) in group 2 (partial removal). It appears that complete removal of fallopian tubes during hysterectomy has no advantageous effect on ovarian blood supply. It might be important to protect the ovarian blood supply as much as possible while performing hysterectomy in the reproductive period. (author's) Language: English Keywords: TURKEY | RESEARCH REPORT | CLINICAL RESEARCH | CASE CONTROL STUDIES | WOMEN IN DEVELOPMENT | HYSTERECTOMY | OVARIAN EFFECTS | FOLLICLE STIMULATING HORMONE | LUTEINIZING HORMONE | ESTRADIOL | ULTRASONICS | BLOOD PRESSURE | TUBAL EXCISION | Europe, Southeastern | Europe | Developing Countries | Research Methodology | Studies | Economic Development | Economic Factors | Gynecologic Surgery | Urogenital Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Ovary | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Gonadotropins, Pituitary | Gonadotropins | Hormones | Endocrine System | Estrogens | Hemic System | Tubal Occlusion | Female Sterilization | Sterilization, Sexual | Family Planning Document Number: 322693 |
| 23. Title: Ovarian reserve and reproductive age. Author: Zaidi S; Usmani A; Shokh IS Source: Pakistan Journal of Medical Sciences Quarterly. 2007 Apr-Jun;23(3):449-453. Abstract: Ovarian reserve is an estimate of the primordial follicle pool in the ovaries and is indicative of the reproductive age of a woman. This estimate helps in assessing a woman's reproductive potential, in predicting her possible response in assisted conception, and in screening women for "early ovarian ageing" as a possible cause for subfertility. Over the years, several methods have been used for its determination. These include biochemical parameters such as estradiol, FSH/LH levels and ratio, inhibin-B and anti-mullerian hormone levels, sonographic measurement of ovarian volume, antral follicle count and follicular volume, dynamic tests of ovarian function, and ovarian biopsy. In this paper these methods are briefly described, and their advantages and disadvantantages are discussed with a view to finding accurate, available and easily reproducible methods for assessing ovarian reserve. (author's) Language: English Keywords: PAKISTAN | LITERATURE REVIEW | WOMEN | REPRODUCTIVE AGE | OVARIAN EFFECTS | REPRODUCTIVE TECHNOLOGIES | FOLLICLE STIMULATING HORMONE | LABORATORY EXAMINATIONS AND DIAGNOSES | INFERTILITY | Developing Countries | Asia, Southern | Asia | Demographic Factors | Population | Reproduction | Ovary | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Gonadotropins, Pituitary | Gonadotropins | Hormones | Endocrine System | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 319189 |
| 24. Title: Assessment of hormonal and metabolic effects of dietary fiber in young Thai women. Author: Chearskul S; Supingklud N; Nitithamyong A; Sirichakwal P Source: Journal of the Medical Association of Thailand. 2006;89(7):997-1003. Abstract: The objective was to investigate whether daily dietary fiber intake at the reference level has any impact on studied hormones in a population of Thai women. Twenty-eight healthy Thai women (aged 18-20 years, BMI 18.5-25 kg/m2) with a history of regular menstrual cycles committed themselves to prepared food without changing the usual ratio of three major macronutrients. Dietary fiber from natural source at the amount of 8-10 g/day equal to their regular consumption was added to their daily diet for one menstrual cycle, then, increased to be 25-30 g/day for another 2 successive cycles. A single blood sample on midluteal day (day 18-23) was obtained in all three cycles. Plasma luteinizing hormone, follicle stimulating hormone, prolactin, estradiol, progesterone, cortisol, and insulin together with total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides were analyzed. The measured hormones and lipids did not change significantly when compared between a control and two experimental cycles (p > 0.05). Short-term consumption of 25-30 g/day fiber diet as recommended by the Reference Daily Intake (RDI) in a Thai population did not alter the studied hormones and lipids thus did not create any health problems. (author's) Language: English Keywords: THAILAND | WOMEN | DIET | MENSTRUAL CYCLE | HORMONES | CHOLESTEROL | LUTEINIZING HORMONE | FOLLICLE STIMULATING HORMONE | ESTROGENS | NUTRITION | Developing Countries | Asia, Southeastern | Asia | Demographic Factors | Population | Health | Menstruation | Reproduction | Endocrine System | Physiology | Biology | Lipids | Gonadotropins, Pituitary | Gonadotropins Document Number: 304359 |
| 25. Title: Regulation of female fertility and identification of future contraceptive targets. Author: Chengalvala MV; Meade EH Jr; Cottom JE; Hoffman WH; Shanno LK Source: Current Pharmaceutical Design. 2006;12(30):3915-3928. Abstract: Mammalian reproduction is a complex physiological process involving a tightly regulated hypothalamic-pituitary-gonadal axis and the integration of a diverse array of molecular signals. Oral contraceptives (OCs) were introduced over 40 years ago and have evolved over the years through the discovery of new estrogens and progestins, the development of progestin-only pills and the reduction of the estrogen content in combined OCs. Despite the developments that improved the safety profile of current OCs, adverse metabolic and vascular effects caused by the estrogen component and possible neoplastic effects of OCs remain and, thus, necessitate efforts to develop newer, possibly non-steroidal and non-hormonal, contraceptives. Recent advances in our understanding of ovarian endocrinology, coupled with molecular biology and transgenic technology, have enabled identification of several factors that are functionally critical in the regulation of female fertility. Progress in the area of female reproduction is showing great promise for identifying new contraceptive drug targets. In this article, the authors review the field of female contraception with emphasis on novel targets involved in reproductive function and identified through genomics and proteomics. In addition, the usefulness of these targets for contraception purposes will be discussed. (author's) Language: English Keywords: UNITED STATES OF AMERICA | LITERATURE REVIEW | CLINICAL RESEARCH | GENETIC TECHNIQUES | WOMEN | CONTRACEPTIVE SAFETY | LOW-DOSE PROGESTINS | ORAL CONTRACEPTIVES, SIDE EFFECTS | METABOLIC EFFECTS | VASCULAR DISEASES | CONTRACEPTIVE AGENTS, ESTROGEN | PROTEINS | FOLLICLE STIMULATING HORMONE | North America | Americas | Developed Countries | Research Methodology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Demographic Factors | Population | Safety | Public Health | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Physiology | Biology | Diseases | Gonadotropins, Pituitary | Gonadotropins | Hormones | Endocrine System Document Number: 310300 |
| 26. Peer Reviewed Title: Feasibility study of Nestorone - ethinylestradiol vaginal contraceptive ring for emergency contraception. [Estudio de factibilidad sobre el uso de nestorona: anillo anticonceptivo vaginal de etinilestradiol para anticoncepción de emergencia] Author: Croxatto HB; Brache V; Massai R; Alvarez F; Forcelledo ML Source: Contraception. 2006;73:46-52. Abstract: Objective: The Nestorone®/ethinylestradiol (NES/EE) vaginal ring is being developed as a regular contraceptive method by the Population Council. This ring is designed to release NES 150 µg/day and EE 15 µg/day during 1 year. Here, we report a Phase I clinical trial to determine the usefulness of this ring for emergency contraception. To that end, we tested the ability of this ring to interfere with ovulation when it is inserted during the follicular phase. Method: Forty-eight women protected from the risk of pregnancy by nonhormonal methods were divided into three groups, which differed by the size of the dominant follicle at the time of ring insertion: 12-14 mm (n =16), 15-17 mm (n =18) and =18 mm (n =14) diameter. The NES/EE ring was left in the vagina for 7 consecutive days, after which it was removed. The growth of the leading follicle and plasma levels of estradiol, progesterone (P), luteinizing hormone (LH) and follicle stimulating hormone (FSH) in the ensuing 5 days after ring insertion were determined. Afterwards, steroid hormones were measured twice a week, until menses took place. All women had a control cycle before the ring cycle, and the range of maximum follicular diameter assigned to each volunteer was the same for the control and the ring cycle at the time when placebo was ingested or the ring inserted. Results: During the 5-day period after ring insertion with follicles 12-17 mm, ovulation was absent in 25 of 34 cycles (p<.01 vs. control), and ovulatory dysfunction (absent, blunted or mistimed LH peak) occurred in 8 of the 9 remaining cycles (33/34 ovulatory processes altered; pb.005 vs. control). After ring insertion with follicles =18 mm in diameter, ovulation did not occur in 2 of 14 cycles or was dysfunctional in 7 of the 12 remaining cycles (9/14 ovulatory processes altered; p<.025 vs. control). Altogether, 87.5% of ring cycles (42/48) had either no ovulation or ovulatory dysfunction in the 5-day study period, in contrast to 39.6% (19/48 cycles) in control cycles (p<.001). Among follicles that failed to rupture within the 5-day study period, none ruptured later on in the ring-treated cycles, while 9 of 16 did so in control cycles. Sixty-two percent of ring-treated cycles were shorter than 24 days. Nausea, vaginal discharge and abdominal pain were the most frequently reported adverse events during ring use. Conclusion: Interference with 87.5% of ovulatory processes, without ovulation occurring later in the cycle and shortening of cycle length, suggests the NES/EE ring may be used as an emergency contraceptive method, with the potential advantage of providing continuing contraception after it has performed its emergency function. (author's) Spanish Abstract: Objetivo: El Consejo de Población está desarrollando el anillo anticonceptivo vaginal de etinilestradiol Nestorone(r) (NES/EE) como método anticonceptivo corriente. Este dispositivo está diseñado para liberar 150 mg diarios de nestorona durante 1 año. Este trabajo presenta un ensayo clínico en fase I que se llevó a cabo para determinar la utilidad del anillo como anticonceptivo de emergencia. A tal fin, se evaluó la capacidad del anillo para interferir con la ovulación al insertarse durante la fase folicular. Método: Se asignaron cuarenta y ocho mujeres protegidas del riesgo de embarazo con métodos no hormonales a uno de tres grupos que diferían por el tamaño del folículo dominante al momento de la inserción del anillo: 12-14 mm (n = 16), 15-17 mm (n = 18) y = 18 mm (n = 14) de diámetro. El anillo anticonceptivo vaginal de etinilestradiol Nestorone(r) se dejó en la vagina durante 7 días, al cabo de los cuales se lo retiró. Se determinaron el crecimiento del folículo dominante y los niveles plasmáticos de estradiol, progesterona (P), hormona luteinizante (LH, luteinizing hormone) y hormona folículo estimulante (FSH, follicle-stimulating hormone) en los 5 días siguientes a la inserción. Posteriormente se midieron las hormonas esteroides dos veces por semana, hasta el momento de la menstruación. Todas las mujeres tuvieron un ciclo control antes del ciclo del anillo, asignándose a cada voluntaria el mismo rango de diámetro folicular máximo para ambos ciclos en el momento de ingerir el placebo o insertarse el anillo. Resultados: Durante el período de 5 días posterior a la inserción del anillo, con folículos de 12 a 17 mm, la ovulación estuvo ausente en 25 de los 34 ciclos (p < 0,01 versus control), y fue disfuncional (sin pico de hormona luteinizante, o bien, con pico más leve o en un momento inadecuado) en 8 de los 9 ciclos restantes (33/34 procesos ovulatorios alterados; pb. 0,005 versus control). Luego de insertar el anillo con folículos de 18 mm, la ovulación estuvo ausente en 2 de los 14 ciclos o fue disfuncional en 7 de los 12 ciclos restantes (9/14 procesos ovulatorios alterados; p < 0,025 versus control). En total, el 87,5% de los ciclos del anillo (42/48) se caracterizaron por falta de ovulación o disfunción ovulatoria en el período de 5 días del estudio, en comparación con el 39,6% (19/48 ciclos) en los ciclos control (p < 0,001). Ninguno de los folículos que no se rompieron en el período de 5 días del estudio se rompió posteriormente en los ciclos tratados con el anillo, mientras que 9 de 16 lo hicieron durante los ciclos control. El sesenta y dos por ciento de los ciclos tratados con el anillo duró menos de 24 días. Los eventos adversos referidos con mayor frecuencia incluyeron náuseas, flujo vaginal y dolor abdominal. Conclusión: La interferencia con el 87,5% de los procesos ovulatorios, sin ovulación posterior en el ciclo ni reducción de la duración de este último, sugiere que el anillo anticonceptivo vaginal de etinilestradiol Nestorone(r) puede utilizarse como método anticonceptivo de emergencia, con la posible ventaja de continuar brindando protección anticonceptiva luego de haber cumplido con su función de emergencia. (del autor) Language: English Keywords: LATIN AMERICA | RESEARCH REPORT | CLINICAL TRIALS | WOMEN IN DEVELOPMENT | ETHINYL ESTRADIOL | EMERGENCY CONTRACEPTION | VAGINAL RING | IUD, HORMONE RELEASING | FOLLICLE STIMULATING HORMONE | ADMINISTRATION AND DOSAGE | CONTRACEPTIVE AGENTS, SIDE EFFECTS | OVULATION | Americas | Developing Countries | Clinical Research | Research Methodology | Economic Development | Economic Factors | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Contraceptive Methods | IUD | Gonadotropins, Pituitary | Gonadotropins | Hormones | Endocrine System | Physiology | Biology | Drugs | Treatment | Reproduction Document Number: 293359 |
| 27. Peer Reviewed Title: Simvastatin improves biochemical parameters in women with polycystic ovary syndrome: results of a prospective, randomized trial. Author: Duleba AJ; Banaszewska B; Spaczynski RZ; Pawelczyk L Source: Fertility and Sterility. 2006 Apr;85(4):996-1001. Abstract: Objective: To test the hypothesis that statins improve hyperandrogenemia in women with polycystic ovary syndrome (PCOS). Design: Prospective, randomized trial. Setting Academic medical center. Patient(s): Forty-eight women with PCOS. Interventions(s): Subject were randomized to a statin group (simvastatin, 20 mg daily plus oral contraceptive pill [OCP]; n = 24) or an OCP group (OCP alone; n=24). Main Outcome Measure(s; Serum T. Result(s): Baseline parameters of both groups were comparable. After 12 weeks of treatment, serum T levels declined by 41% in the statin group and by 14% in the OCP group. In the statin group, there was a greater decrease of LH (43% decrease vs. 9% in the OCP group) and a greater decline of LH/FSH ratio (44% vs.12%). In the statin group, total cholesterol declined by 10% and low-density lipoprotein (LDL) by 24%. In the OCP group, total cholesterol increased by 8%, and LDL was unchanged. Conclusion(s): This is the first study demonstrating that statin decreases T levels and normalizes gonadotropin levels in women with PCOS. Statin therapy might offer a novel approach, providing endocrine and cardiovascular benefits. (author's) Language: English Keywords: POLAND | RESEARCH REPORT | CLINICAL TRIALS | PROSPECTIVE STUDIES | WOMEN | OVARIAN CYSTS | ORAL CONTRACEPTIVES | ADMINISTRATION AND DOSAGE | LIPIDS | LUTEINIZING HORMONE | FOLLICLE STIMULATING HORMONE | Developing Countries | Europe, Central | Europe | Clinical Research | Research Methodology | Studies | Demographic Factors | Population | Diseases | Contraceptive Methods | Contraception | Family Planning | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Physiology | Biology | Gonadotropins, Pituitary | Gonadotropins | Hormones | Endocrine System Document Number: 298572 |
| 28. Peer Reviewed Title: Ovarian cysts in users of Implanon and Jadelle subdermal contraceptive implants. [Quiste ovárico en usuarias de implantes anticonceptivos subdérmicos Implanon y Jadelle] Author: Hidalgo MM; Lisondo C; Juliato CT; Espejo-Arce X; Monteiro I Source: Contraception. 2006 May;73(5):532-536. Abstract: Objective: To evaluate the prevalence of ovarian cysts in users of two contraceptive implants compared to users of intrauterine contraceptive (IUC). Materials and Methods: A total of 344 women were enrolled at 3 months of use of the etonogestrel-releasing implant (Implanon®), the levonorgestrel-releasing implant (Jadelle®) or the TCu380A IUC. Bimanual pelvic examination and vaginal ultrasound were performed during routine 3-, 6- and 12-month visits of asymptomatic women. Women with ovarian cysts (or enlarged ovarian follicles = 25 mm) were assessed weekly until disappearance or reduction of the image [including estradiol (E(-2)) and progesterone (P) measurement], and women with no ovarian enlargement underwent the same evaluation for the same period of time. Results: Ovarian cysts were detected in 5.2%, 13.0% and 1.9% of users of Implanon®, Jadelle® and IUC, respectively, at 3 months. At 6 months of use, prevalence was 7.2%, 8.0% and 2.1%, whereas 12-month rates were 26.7%, 14.6% and 1.2% in the three groups, respectively. E(-2) levels were significantly higher among users with ovarian cysts than controls. The time until disappearance of the ovarian cyst was similar in all three groups. There were more cases of menorrhagia in users of implants who had ovarian cysts than in those with no ovarian enlargement. Conclusions: The finding of ovarian cyst or enlarged ovarian follicles during the first year of use of Implanon® and Jadelle® implants is common and transient and should not be interpreted as a pathologic ovarian cyst. No further medical interventions are necessary. (author's) Spanish Abstract: Objetivo: Evaluar la prevalencia de quistes ováricos en usuarias de dos implantes anticonceptivos en comparación con las usuarias de anticonceptivos intrauterinos (DIU). Materiales y métodos: Se incluyó en el estudio un total de 344 mujeres a los 3 meses de uso de un implante de liberación de etonogestrel (Implanon®), de levonorgestrel (Jadelle®) o el DIU Tcu380A. Se realizaron exámenes pélvicos bimanuales y ecografías vaginales durante las visitas de rutina a los 3, 6 y 12 meses de las mujeres asintomáticas. Se realizó una revisación semanal a las mujeres con quiste ovárico (o aumento del tamaño de los folículos ováricos = 25 mm) hasta su desaparición o hasta la reducción de la imagen [incluidas las determinaciones de estradiol (E (-2)) y progesterona (P)] y a las que no presentaban aumento del ovario durante el mismo período. Resultados: A los tres meses, se detectó quiste ovárico en el 5,2%, 13,0% y 1,9% de las usuarias de Implanon®, Jadelle® y DIU, respectivamente. A los 6 meses de uso, la prevalencia fue del 7,2%, 8,0% y 2,1%, mientras que a los 12 meses los porcentajes fueron 26,7%, 14,6% y 1,2% en los tres grupos, respectivamente. Las concentraciones de E(-2) fueron significativamente más altas entre las usuarias con quiste ovárico que en las del grupo control. El intervalo hasta la desaparición del quiste ovárico fue similar en los tres grupos. Se registraron más casos de menorragia en usuarias de implantes que tenían quiste ovárico que en las que no presentaban aumento del tamaño del ovario. Conclusiones: La presencia de quiste ovárico o de aumento de los folículos ováricos durante el primer año de uso de implantes de Implanon® y Jadelle® es frecuente y transitoria y no se debe interpretar como un quiste ovárico patológico. No se requieren intervenciones médicas adicionales. (del autor) Language: English Keywords: BRAZIL | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | WOMEN IN DEVELOPMENT | OVARIAN CYSTS | CONTRACEPTIVE IMPLANTS | PELVIC EXAM | ULTRASONICS | ESTRADIOL | PROGESTERONE | PREVALENCE | FOLLICLE STIMULATING HORMONE | MENORRHAGIA | CONTRACEPTIVE SAFETY | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Economic Development | Economic Factors | Diseases | Contraceptive Methods | Contraception | Family Planning | Physical Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Estrogens | Hormones | Endocrine System | Physiology | Biology | Progestational Hormones | Measurement | Gonadotropins, Pituitary | Gonadotropins | Menstruation Disorders | Safety | Public Health Document Number: 299444 |
| 29. Peer Reviewed Title: The dilemma of future family planning and the role of female fertility tests. Author: Horne A; Warner P Source: Journal of Family Planning and Reproductive Health Care. 2006 Jul;32(3):195-196. Abstract: There has been a huge amount of media interest in the development of new home fertility tests for couples trying to conceive. The female fertility tests are marketed as devices that measure the quantity of healthy eggs women have left (ovarian reserve). Ovarian reserve is measured by determining the level of follicle-stimulating hormone (FSH) in the urine. High levels of FSH suggest that the ovaries are not responding to the hormone and that the woman's ability to conceive may be decreased. The tests show whether the FSH level is above healthy cut-off levels. One test is being marketed particularly to help women decide how long they can delay trying for a baby. In addition to FSH, it also measures inhibin B and anti-Müllerian hormone levels, which decline as the menopause approaches. (excerpt) Language: English Keywords: UNITED KINGDOM | PHILOSOPHICAL OVERVIEW | PROVIDERS WITH CLIENTS | WOMEN | PANEL DISCUSSION | FOLLICLE STIMULATING HORMONE | FERTILITY | TESTING | VALUE ORIENTATION | PHYSICIAN-PATIENT RELATIONS | Developed Countries | Europe, Western | Europe | Health Services | Delivery of Health Care | Health | Demographic Factors | Population | Group Meeting | Communication | Gonadotropins, Pituitary | Gonadotropins | Hormones | Endocrine Syste |