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PubMed2000

Overall self-confidence, self-confidence in mathematics, and sex-role stereotyping in relation to salivary free testosterone in university women.

This study investigated in 40 young university women the possible relationships between levels of testosterone and specific measures of overall self-confidence and self-confidence in approaching mathematics. Correlations of -.43 and -.49 with each measure of self-confidence, respectively, and level of testosterone were found in the portion of the sample displaying normal ovulatory function. There was no correlation (r=.02) between the measures of mathematics and overall self-confidence. 19 women did not display normal ovulatory function. The only significant result for the full sample was a significant correlation of -.73 between scores on the Bem Sex Role Inventory Masculinity and overall self-confidence. The reasons for the high anovulatory percentage are not clear, nor are the associations which anovulation might have with either hormonal levels or the personality characteristics in question.

Adolescent↗
PubMed1996

Morphological action of tamoxifen in the endometrium of persistent estrous rats.

BACKGROUND: The aim of this study was to evaluate the action of tamoxifen on the endometrium in states of chronic anovulation. METHODS: Thirty-eight rats inducted to persistent estrous (testosterone propionate) confirmed by hormonal colpocytology were divided into a control and an experimental group; the latter received tamoxifen and had fragments of the uterine horns processed for morphological and morphometrical analysis. Data were analysed statistically by the Mann-Whitney and Student's t tests. RESULTS: Our findings revealed minor uterine weight, epithelial thickness; number of endometrial glands and low eosinophil counts in the group that received tamoxifen. These results were statistically significant. We often observed areas of metaplasic stratified squamous epithelium between cylindrical epithelial cells in both groups. CONCLUSIONS: Our results indicate that antiestrogenic effect of tamoxifen was only partial in persistent estrous, since there was no blocking against the squamous metaplasia of the endometrium.

Animals↗
PubMed1989

A prospective study on corpus luteum function and breast cancer risk.

A case-control study incorporated within a cohort study was undertaken to test the hypothesis that anovulation or decreased luteal function is associated with increased risk of breast cancer. A large population (n = 12,000) of apparently healthy women aged 40-49 collected a specimen of urine on day 22 of 3 consecutive menstrual cycles, or, in cases of amenorrhea, on 3 arbitrarily chosen days. These samples were stored at -20 degrees C. Subsequent screening of the women by mammography revealed 34 cases of breast cancer, and over the next 4 years a further 34 cases were reported to the cancer registry. Urine samples from 53 of these cases were assayed for pregnanediol and creatinine, and the results were compared with those for an equal number of matched controls. No differences between these groups were found in the pregnanediol/creatinine ratio. We conclude that our results do not support the hypothesis that women with luteal insufficiency are at increased risk for breast cancer. However, since breast cancer patients tend to have a later menopause than controls, the possibility cannot be excluded that breast cancer patients continue to have ovulatory cycles for a longer period during reproductive life. Such a finding--opposite to the working hypothesis--would complicate the interpretation of the results.

Adult↗
PubMed1990

Pituitary-adrenal responses to ovine corticotropin-releasing factor in polycystic ovary syndrome and in other hyperandrogenic patients.

This study was carried out to further characterize the pituitary-adrenal androgen responses of hyperandrogenic patients with 'classic' polycystic ovary syndrome (PCO) and others who were less distinctive and have been called 'PCO-like'. PCO-like patients differed from PCO only in that serum luteinizing hormone (LH) levels were normal and anovulation was not consistent. Ovine corticotropin-releasing factor (CRF) resulted in normal responses of adrenocorticotropic hormone and cortisol in the two groups when compared to controls, while androstenedione (delta 4A) and dehydroepiandrosterone (DHEA) responses were significantly elevated. There were no differences in the responses of PCO and PCO-like patients. Although basal DHEA levels correlated with DHEA responses of CRF, basal levels of DHEA sulfate (S) could not be used to predict CRF responses. These data further confirm that there is heightened adrenal androgen activity in PCO whether the patients are 'classic' or PCO-like. Serum DHEA-S does not appear to be a good marker for this adrenal hyperactivity and might in turn also be under the control of other factors.

Adolescent↗
PubMed1999

Follow-up of 32 hypothalamo-hypopituitary patients treated with pulsatile gonadotropin-releasing hormone or human menopausal gonadotropin.

In a clinical retrospective study, a follow-up of hypothalamo-amenorrheic patients treated firstly with gonadotropin-releasing hormone (GnRH) pump stimulation and secondly with human menopausal gonadotropin (hMG) was performed. Thirty-two hypothalamo-amenorrheic patients, 24-38 years old, were submitted to 103 GnRH stimulation cycles. Seven, with polycystic ovaries (PCO) on ultrasound, were stimulated with hMG after one or several unsuccessful pump cycles. Ovulation was confirmed by a luteinizing hormone (LH) surge or triggered by human chorionic gonadotropin in 80 out of 103 cycles (77.7%/cycle) leading to 62 timed sexual intercourses and 17 intrauterine inseminations (IUI). Twenty-one pregnancies (26.3%/cycle) terminated in eight abortions (38.1%/pregnancy) and 13 deliveries (40.6%/patient). hMG stimulation, in the seven PCO patients (six IVF, one IUI), led to four additional deliveries in three patients. Five patients became pregnant spontaneously after pump failure (n = 2) or unsuccessful IVF (n = 3). Combining all cycles, 17 deliveries were obtained in 16 patients. No case of ovarian hyperstimulation syndrome (OHSS) was observed. GnRH is an efficient and safe treatment of hypothalamo-amenorrheic-induced anovulation. Following GnRH or hMG ovarian stimulation, spontaneous ovulation and conception may be restored in certain hypothalamo-amenorrheic patients.

Adult↗
PubMed1991

Relationship between blood radioimmunoreactive beta-endorphin and hand skin temperature during the electro-acupuncture induction of ovulation.

Thirteen cycles of anovulation menstruation in 11 cases were treated with Electro-Acupuncture (EA) ovulation induction. In 6 of these cycles which showed ovulation, the hand skin temperature (HST) of these patients was increased after EA treatment. In the other 7 cycles ovulation was not induced. There were no regular changes in HST of 5 normal subjects. The level of radioimmunoreactive beta-endorphin (r beta-E) fluctuated, and returned to the preacupunctural level in 30 min. after withdrawal of needles in normal subjects. After EA, the level of blood r beta-E in cycles with ovulation declined or maintained the range of normal subjects. But the level of blood r beta-E in cycles in which the induction failed to cause ovulation was kept higher that that of normal. (P less than 0.05). There was a negative correlation in the decrease of blood r beta-E and increase of HST after EA (r = 0.677, P less than 0.01). EA is able to regulate the function of the hypothalamic-pituitary-ovarian axis. Since a good response is usually accompanied with the increase of HST, monitoring HST may provide a rough but simple method for predicting the curative effect of EA. The role of r beta-E in the mechanism of EA ovulation induction was discussed.

Anovulation↗
PubMed1990

Gynecologic problems of androgen excess.

The patient with androgen excess may present with amenorrhea, oligomenorrhea, painless metromenorrhagia, or infertility. Adrenal and ovarian tumors, though uncommon, must be excluded in the workup. The long-term sequelae of untreated anovulation includes adenomatous hyperplasia and cancer of the endometrium. Treatment can range from uncomplicated follow-up with cosmetic advice to the use of potent drugs that induce ovulation.

Adolescent↗
PubMedDate not supplied

Use of insulin-sensitizing agents in patients with polycystic ovary syndrome.

OBJECTIVE: To review the subject of polycystic ovary syndrome and the therapeutic use of insulin-sensitizing agents in patients with this endocrinopathy. METHODS: We present background information on this disorder and summarize the pertinent published literature. RESULTS: Polycystic ovary syndrome affects approximately 7.5% of reproductive-age women in the United States. Although specific diagnostic criteria for this condition have not been established, the presence of three major factors-chronic anovulation, hyperandrogenemia, and clinical signs of hyperandrogenism-has been proposed as essential for consideration of the diagnosis. A high ratio of serum luteinizing hormone to follicle-stimulating hormone is found in 60 to 75% of women with this syndrome. Treatment with metformin may yield heterogeneous responses in differing populations with polycystic ovary syndrome, but most studies have shown evidence of restoration of ovulatory cycling. In addition, weight loss and decreases in free and total testosterone levels have been reported. Troglitazone therapy proved somewhat less efficacious than metformin for restoring menstrual cycles and similar to metformin in producing hormonal responses. Because troglitazone is no longer available for clinical use, studies will need to be extended to other thiazolidinediones. Patients treated with another insulin sensitizer, D-chiro-inositol, have demonstrated improved insulin sensitivity, ovulatory rates, and biochemical findings. CONCLUSION: Current evidence suggests that the use of insulin-sensitizing agents in patients with polycystic ovary syndrome not only improves their sensitivity to the effects of insulin on glucose and lipid metabolism but also ameliorates clinical and biochemical manifestations of hyperandrogenism and increases rates of ovulation. Multicenter studies with larger numbers of patients are needed.

Androgens↗
PubMed2026

Personalized approach to infertility treatment in a patient with polyendocrine metabolic ovarian syndrome and chronic pancreatitis.

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in fertile women, with an estimated prevalence of 10-15%. It is a heterogeneous disease characterized by a complex pathogenesis. Genetic predisposition, neuroendocrine regulation disorders, and environmental influences play a key role. Dysregulation of the hypothalamic-pituitary-ovarian axis occurs with subsequent chronic anovulation, hyperandrogenemia, and metabolic abnormalities. Phenotypic variability reflects different pathophysiological mechanisms - based on genomic association studies, three subtypes of PCOS can be distinguished: reproductive, metabolic, and indeterminate. PCOS is one of the main causes of female infertility and a risk factor for the development of cardiometabolic diseases. Objective: The aim of the article is to summarize current recommendations of the European Society of Human Reproduction and Embryology (ESHRE 2023) regarding the diagnosis and treatment of polyendocrine metabolic ovarian syndrome (PMOS) in patients with fertility disorders and to demonstrate their practical application through a selected clinical case.

Humans↗
PubMed1998

Induction of ovulation in thalassemic patients.

The authors studied 19 thalassemic patients: 14 patients with secondary amenorrhea (group A), 5 patients with primary amenorrhea (group B) and 1 patient with anovulation (group C). All the patients underwent three cycles of induction of ovulation with FSH. The level of 17 beta-estradiol and the diameter of follicles were evaluated every three days. Normal gonadal function was maintained in three patients with positive response at Step 1 of the treatment.

Amenorrhea↗
PubMed1999

[Effect of weight reduction on the clinical and hormonal condition of obese anovulatory women].

Obesity is associated to a variety of endocrine abnormalities that might lead to chronic anovulation in women. Weight loss may improve the hormonal profile and then restore ovulation in some of them. The aim of the current study was to evaluate the effect of a weight loss program on the clinical and hormonal characteristics of anovulatory obese women attending our reproductive clinic. We studied a group of 30 anovulatory obese patients between 18 and 35 years old without any thyroid disease. Before and after a weight loss of at least 5% of initial body weight we analyzed LH, FSH, estradiol, prolactine, testosterone, dehydroepiandrosterone sulfate, oral glucose tolerance test and progesterone, weight, BMI, waist/hip ratio and total body fat percentage. The mean weight loss was 9.5 +/- 4.3 kg. which represents a weight loss of 10.96% from initial body weight, with 26 patients (86.6%) resuming spontaneous ovulation. The women's mean plasma testosterone, LH, estradiol and DHEA-S decreased significantly and there was significantly increased on progesterone. At the beginning a total of 12 patients showed an impaired oral glucose tolerance test and after weight loss 9 of them improved it. The results shown in this study demonstrate that even a small weight reduction and a decrease in total body fat percentage improve the hormonal profile and restore ovulation in anovulatory obese women. Thus weight loss should be considered before starting with ovulation induction therapy.

Adipose Tissue↗
PubMed1999

Management of hyperprolactinemia in infertility.

Hyperprolactinemia is a frequent cause of anovulatory sterility, although spontaneous pregnancy may occur occasionally. Dopaminergic treatment is highly effective for both idiopathic and tumoral hyperprolactinemia. If the only cause of infertility is chronic anovulation due to hyperprolactinemia, a 60-80% pregnancy rate can be achieved. These results mean that surgical treatment is still needed only rarely. Either spontaneous or drug-induced pregnancy is usually uneventful for the mother and is not associated with any increase in abortion, twins or malformations. Pregnancy-related tumor growth occurs rarely and can be treated successfully with dopaminergic drugs. Pregnancy frequently leads to some improvement in the biochemical and clinical disorders associated with hyperprolactinemia.

Anovulation↗
PubMed1999

Assessing the status of intrauterine insemination before forming a medically assisted conception unit.

A survey in 1996 of our female patients suggest that the three commonest causes of infertility were endometriosis, anovulation and idiopathic which comprises of about 70% of all the patients. In the male patients, sperm morphology evaluation by critical criteria showed that abnormal morphology was present in 71% while 87% of all the semen analysis were abnormal. The objective of this study was to assess the status of IUI before proceeding to formulate patient protocols for IVF in a tertiary infertility referral unit. A retrospective study of patients data was done from Jan 1995 to Dec 1996. Ovarian stimulation by clomiphene for anovulatory and idiopathic patients was performed on couples with at least one patent fallopian tube. Ovulation induction was by an intramuscular injection of 5000 i.u of HCG after follicular maturation. IUI was performed approximately 36-40 hours later. A total of 74 couples received 114 treatment cycles producing a total of 9 conceptions. The conception rate of IUI was therefore 7.89% per cycle and 12.16% per couple with the cumulative pregnancy rate of 28.21%. Associated success features of IUI found in this study were the age of the woman and the semen parameters of the husband.

Anovulation↗
PubMed2000

[Treatment options of clomiphene-resistant polycystic ovary syndrome related infertility].

OBJECTIVE: To investigate the treatment options of clomiphene(CC)-resistant polycystic ovary syndrome (PCOS) related infertility. METHODS: Fifty-nine PCOS patients with CC resistant-anovulation were accepted and treated by the following three protcols: (1) follicle-stimulating hormone (FSH) group, 49 cycles; (2) FSH + pulsatile gonadotropin-releasing hormone(GnRH) group, 13 cycles; (3) conventional in vitro fertilization (IVF)-embryo transfer (ET) group, 19 cycles. Suppressive treatment on serum luteinising hormone (LH) and testosterone (T) levels was given in the first and second groups in advance. Serum estradiol level; pregnancy rate; miscarriage rate, ovarian hyperstimulation syndrome (OHSS) and multiple pregnancy rate were compared among the three groups. RESULTS: The pregnancy rate in FSH group, FSH + GnRH group and IVF-ET group were 37%, 54% and 22% respectively. The highest rate and multiple pregnancy rate was found in IVF-ET group. CONCLUSION: The rationale treatment options for CC-resistant PCOS related infertility was the addition pre-suppressive treatment, low-dose FSH stimulated regimen subsequent pulsatile GnRH infusion. IVF were only accepted after failure with gonadotropin therapy.

Adult↗
PubMed2002

Polycystic ovary syndrome in adolescents.

Recent findings suggest substantial metabolic sequelae to polycystic ovary syndrome (PCOS), including risk of diabetes and cardiovascular disease. Primary treatment of the metabolic sequelae should be the focus of the clinician. The definition of PCOS has been expanded from a disorder that presents at menarche and ends at menopause to a disorder that may be present from birth to senescence. The earliest recognized PCOS phenotype to date is premature pubarche characterized by excessively elevated levels of dehydroepiandosterone sulfate and hyperinsulinemia. Such girls are at high risk to develop the full PCOS phenotype, including ovarian hyperandrogenism and chronic anovulation. A fasting glucose-to-insulin ratio of < 7 is a useful index of insulin resistance in adolescents. However, each patient should be evaluated for glucose intolerance and lipid abnormalities on a regular basis by completing a 2-hour oral glucose tolerance test and a fasting lipid profile. Primary prevention of diabetes and cardiovascular disease by lifestyle modifications, regular exercise, and a balanced diet are of utmost importance, especially in adolescents who have the opportunity to establish healthy habits before entering adulthood. The role of insulin-sensitizing medications is still under study. Although no clinical trials over 6 months in duration have assessed the long-term efficacy of metformin use in adolescents, short-term trials have shown promising effects in lowering insulin secretion, improving insulin sensitivity, restoring normal menstrual cycles, and correcting lipid abnormalities.

Adolescent↗
PubMed2002

[Role of LH in ovarian stimulation: present and future].

Contribution of LH to ovarian stimulation, distinguishing treatment of anovulation and ovarian stimulation with the objective of IVF. LH and ovarian dysfunction LH furnishes the androgen substrate necessary for FSH for estrogen synthesis, but excess LH is a less reliable index than free androgen level to predict the absence of response to ovarian stimulation. LH and ovarian stimulation

Anovulation↗
PubMed2002

Advances in polycystic ovary syndrome treatment: metformin and ovarian diathermy.

Polycystic ovary syndrome (PCOS) affects approximately 6% of women in their reproductive years. The symptoms of the syndrome are chronic anovulation and androgen excess. Infertility due to ovulatory dysfunction is a common problem for women with PCOS. Metformin, an antihyperglycemic agent, can correct the metabolic dysfunction that occurs with PCOS, and also stimulate folliculogenesis. The drug is effective alone and in combination with clomiphene citrate. An alternative option, ovarian diathermy, also promotes ovulation through changes in the intraovarian hormonal environment. Both techniques provide promising and effective alternatives for women with PCOS who do not respond to traditional oral ovulation induction agents.

Algorithms↗
PubMed1986

Steroids and the risk of breast cancer.

The search for major abnormalities as causes for breast cancer have not been successful, whether they have been directed to patients with this disease, different groups, or populations at risk. Anovulation or progesterone deficiency are not characteristic for those at risk for breast cancer or those patients with early breast cancer. In contrast, early-onset long-lasting ovulatory cycle function seems to be prevalent in different risk categories. Women with early menarche are additionally characterized by having higher serum estradiol and lower sex hormone-binding globulin concentrations than women with later menarche, at least during the early years of their fertile life. Estradiol is a central agent in the process of breast cancer appearance, and progesterone does not seem to have an opposing action. A decrease in the number of ovulatory cycles may exert a protective effect against breast cancer. If the decrease is affected by endocrine mechanisms maintaining breast ethelial stimulation comparable to that during the normal menstrual cycle, the protective effect would be nullified.

Age Factors↗