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PubMed1994

Growth hormone therapy in adults: rationales, results, and perspectives.

This review outlines the present knowledge of the rationales, clinical aspects, and perspectives of a therapy with recombinant human growth hormone (rhGH) in adults. In patients with hypopituitarism the effects of rhGH replacement have been extensively studied. Recent clinical trials show that rhGH treatment improves most alterations of body composition and psychological performance, but many of the metabolic actions of GH remain equivocal. Although side effects after short-term administration are usually mild, the risks of severe long-term adverse effects are still uncertain. A supplementation with rhGH is also suggestive in advanced age and obesity, but the clinical results are controversial so far. The anabolic actions of rhGH were exploited in several recent trials including patients who were severely ill, malnourished, on chronic haemodialysis, or on total parenteral nutrition. Although nitrogen-sparing effects of GH have been demonstrated in most cases, the data do not indicate a clinical benefit in terms of reduced mortality, improved outcome, or accelerated recovery. Therefore, recommendations for the use of rhGH do not have any rationale in these patients yet. The efficacy of rhGH in the treatment of reproductive or immunological disorders remains elusive and needs further investigation. In conclusion, the application of rhGH is still an experimental therapy which should be performed under close observation in well-controlled clinical studies.

Aging↗
PubMedDate not supplied

Role of estrogen in the treatment of depression.

The role of estrogen in the treatment of depression is reviewed. The relation is examined in studies of perimenopausal and postmenopausal women with depressed mood, in studies of depressive disorders, and in studies of estrogen as an adjunct to antidepressant medication. The literature has many methodologic shortcomings, including combining women of various ages, failure to confirm life stage, the use of different types of estrogens, the inclusion of women with a range of mood disturbances, and the enrollment of women with concurrent psychiatric illness. There are few controlled evaluations of the use of estrogen to supplement ongoing antidepressant treatment. Estrogen alone seems to be beneficial for improving mood in perimenopausal and postmenopausal women. Estrogen is superior to placebo for reproductive-related mood disorders, including postpartum depression and mild depressive disorders during perimenopause. Replication is necessary, especially in moderate to severe levels of major depression. Estrogen may augment antidepressant treatment. Assessment and treatment implications are discussed.

Climacteric↗
PubMed1998

Modulating mechanisms of neuroendocrine cell activity: the LHRH pulse generator.

1. Luteinizing hormone-releasing hormone (LHRH), synthesized in specialized neurons in the hypothalamus, is the prime regulator of reproduction. In its absence, reproductive development is arrested and disorders of LHRH secretion result in several reproductive dysfunctions. 2. The LHRH neuronal network plays a paramount role in the regulatory loop controlling gonadal homeostasis. LHRH input to the pituitary gland maintains gonadotropin secretion, which, in turn, is responsible for gonadal trophism. Steroidal and peptidergic hormones from the gonad close the regulatory system by establishing negative (male and females) and positive (females) feedback loops. 3. Interestingly, LHRH input to the pituitary is intermittent rather than continuous. In fact, continuous exposure to LHRH results in paradoxical hypogonadism. Several studies in animals have provided direct evidence for episodic secretion of LHRH into the hypophyseal portal system. However, the nature of the system(s) responsible for the generation of the LHRH pulsatile profile is not currently known. The recent observation that immortalized LHRH neurons secrete LHRH in a pulsatile manner suggests that the pulse generating mechanism resides within the LHRH neuronal network. 4. In this overview, we compile several lines of evidence supporting this notion and put this characteristic of LHRH neurons in perspective with gonadal influences both internal and external to the LHRH neuronal network. Some recent data regarding the site of action of gonadal steroids on the LHRH neuronal system, the functional significance of galanin colocalization with LHRH, and the role of nitric oxide in the pulse generating mechanism are also discussed.

Animals↗
PubMed2006

[Clinical, hormonal and histological features in ovarian stromal hyperthecosis].

The aim of our study was to investigate clinical, hormonal and histological features of ovarian stromal hyperthecosis We have studied 104 patients with a histological diagnosis of ovarian stromal hyperthecosis and hyperplasia. Analyzing the results we can conclude that clinical features of ovarian stromal hyperthecosis and hyperplasia with polycystic ovarian disease and without it were identical and characterised by virilization syndrome, disorders of menstrual cycle and reproductive function; metabolic and vegeto-vascular disorders; breast and endometrial hyperplasias, high blood level of testosterone . The histological study of ovarian stromal hyperthecosis has showed that superficial part of ovarian cortex is hypocellular and fibrotic, contains scattered follicles with few granulosa cells, luteinized internal theca cells, hyperplasia of deep cortex and medulla, corpus luteus is absent.

Adult↗
PubMed2001

Altered structure and function of reproductive organs in transgenic male mice overexpressing human aromatase.

Aromatization of androgens is a key step in estrogen production, and it regulates the delicate balance between estrogens and androgens in the gonads and sex steroid target tissues. In the present study, we generated transgenic mice (AROM(+)) bearing the human ubiquitin C promoter/human P450 aromatase fusion gene. AROM(+) male mice are characterized by an imbalance in sex hormone metabolism, resulting in elevated serum E(2) concentrations, combined with significantly reduced testosterone and FSH levels, and elevated levels of PRL and corticosterone. AROM(+) males present a multitude of severe structural and functional alterations in the reproductive organs, such as cryptorchidism associated with Leydig cell hyperplasia, dysmorphic seminiferous tubules, and disrupted spermatogenesis. The males also have small or rudimentary accessory sex glands with abnormal morphology; a prominent prostatic utricle with squamous epithelial metaplasia, and edema in the ejaculatory ducts and vas deferens. In addition, the abdominal muscle wall is thin, and the adrenal glands are enlarged, with cortical hyperplasia. Some of the abnormalities, such as undescended testes and undeveloped prostate, resemble those observed in animals exposed perinatally to high levels of exogenous estrogen, indicating that the elevated aromatase activity results in excessive estrogen exposure during early phases of development. Some of the disorders in the reproductive organs, furthermore, can be explained by the fact that AROM(+) males are hypoandrogenic, and have elevated levels of serum PRL and corticosterone. Thus, the AROM(+) mouse model provides a novel tool to investigate the consequences of a prolonged increase in conversion of androgens to estrogens which results in complex hormonal disturbances altering the structure and function of various male reproductive organs.

Abdominal Muscles↗
PubMed1999

Occupational health survey on workers exposed to 2-bromopropane at low concentrations.

BACKGROUND: Recent case studies in Korea and animal studies revealed the reproductive and hematopoietic toxicity of 2-bromopropane introduced into workplaces as an alternative to ozone-layer depleting chlorofluorocarbons. We aimed to clarify the dose-effect relationship of 2-bromopropane in workers. METHOD: The exposure concentration of 2-bromopropane and hematological indices, hormonal levels, menstruation status, and sperm indices were examined in 25 workers (11 males, 14 females) at a 2-bromopropane factory. Regression analyses of the examined indices against time-weighted average (TWA) of exposure concentration were conducted. RESULTS: Amenorrhea or polymenorrhea was observed only in older females. Hematological indices had a significant relation with TWA of exposure concentration in females with normal menstruation. However, no other indices showed any significant relation with TWA of 2-bromopropane. CONCLUSIONS: No severe cases of reproductive or hematopoietic disorders were found at less than 10 ppm (TWA), but a possible adverse effect of 2-bromopropane on hematopoiesis could not be disproved.

Adult↗
PubMed2004

Characterization of two SNPs (single nucleotide polymorphisms) in the porcine INSL3 gene and their exclusion as a common genetic basis of hernia inguinalis in pigs.

The INSL3 gene encoding Leydig cell insulin-like hormone is an important candidate gene for congenital disorders of the reproductive tract in pigs. Comparative sequencing using phenotypically hernia inguinalis affected and unaffected animals showed that the porcine gene is remarkably conserved. No polymorphisms were found in the two exons or in the intron. Two single-nucleotide polymorphisms (SNPs) were detected in the promoter region (G-224A and A-164C) of the sequenced pigs and fast screening methods were developed for large scale studies. Some significant breed differences exist for allele frequencies at both SNPs in the INSL3 gene. Screening of the two SNPs in a population of hernia inguinalis affected full and half sib piglets (n = 223) revealed that the SNPs can be excluded as a common genetic basis for this congenital disorder in this pedigree.

Animals↗
PubMed1999

[Not Available].

Endometriosis is one of the most frequent gynecological disorders in the reproductive age. Discrepancies between clinical findings and subjective Symptoms cause the question of the determing factors for the subjective experience. In the present study an hermeneutic, sense-orientated approach was employed by using qualitative methods of research. Eleven interviews with endometriosis patients were recorded on tape and transcribed, followed by an individual-case and a comparative analysis in partly deductively and inductively defined categories. The psychosexual development has been found as negatively influenced. Endometriosis patients show conflicting concepts of their sex-specific role. A found aggression conflict manifests itself in the pain Sensation, at an intrapsychic land an interpersonnel level: it influences the relations with other persons, in particular, the doctor-patient relationship. Changes of sense in the doctor-patient-relationship and recent concepts of psychosomatic disorders are discussed.

Endometriosis↗
PubMed1978

[Conception of female rats and litter mortality due to Mn-deficiency].

Sexually mature, female rats were fed an Mn-deficient (1.0 ppm) diet on saccharose/casein basis and studied for their reproductive behaviour. Cycle disorders as sometimes described of females depleted over a longer period, were not observed in any case. Although the experimental animals showed a normal estrus, only 50% of the rats conceived. The rats that had become pregnant produced litters of 2 to 11 animals born alive. However, their mortality was 80%. They died either immediately after birth or during the first days post partum.

Animal Nutritional Physiological Phenomena↗
PubMedDate not supplied

A review of ten years experience of ICSI.

This review summarizes the introduction of ICSI in the early 1990s as an assisted fertilization procedure in couples with severe male factor infertility, who could not be helped by conventional IVF. As for current practice, the indications for ICSI using fresh or frozen-thawed ejaculated, epididymal or testicular sperm are reviewed as well as some reports on the use of ICSI in non-male infertility. The main steps in an ICSI cycle are well standardized by now; it is rare that ICSI cannot be carried out and the results in terms of fertilization, embryo transfer and clinical pregnancy rate have been consistent for many years, indicating that a substantial number of couples can now have their own genetic child instead of having to use artificial insemination with donor sperm. This review also emphasizes the importance of assessing the risk of ICSI for the children: there is a slight increase in de novo chromosomal abnormalities, the major congenital malformation rate is similar for IVF and ICSI (between 3 and 4%), and at approximately 2 years of age the developmental outcome as assessed by the Bayley scale is similar for IVF and ICSI. Recent publications mention that a few children are affected by diseases caused by imprinting disorders. Future studies are needed to assess the association between assisted reproductive technologies and imprinting disorders. ICSI is frequently used in couples undergoing preimplantation genetic diagnosis. PGD stricto sensu as well as PGD for aneuploidy screening and for Klinefelter patients are reviewed using the ESHRE PGD Consortium data.

Embryo Implantation↗
PubMed1986

Pathology of the canine and feline uterine tube.

Lesions of the uterine tube were described in 37 dogs and nine cats. Of the 52 lesions noted, 18 were developmental abnormalities; four paramesonephric remnants, and 14 mesonephric remnants. Uterine tube cysts were seen in 16 animals, and seven animals had salpingitis. One dog had hyperplastic changes of the infundibular mucosa, and one cat and one dog demonstrated adenomyosis. There were three primary benign uterine tube neoplasms, one adenocarcinoma, two metastatic neoplasms in the uterine tube, and two bursal lipomas, all in dogs. With the exception of neoplasia of the uterine tube, most lesions were unlikely to affect the reproductive performance of these animals and/or were incidental or secondary to disorders elsewhere in the reproductive tract.

Animals↗
PubMed1990

Ketoconazole use in the treatment of ovarian hyperandrogenism.

Ovarian hyperandrogenism is a common disorder of women of reproductive age. The therapies that are presently available to treat this disorder are not uniformly effective or free of adverse effects. We conducted a prospective study of eight women receiving ketoconazole for a mean duration of 44 +/- 15 (SEM) weeks, as therapy of ovarian hyperandrogenism. Serum testosterone and hair growth rate declined in patients while on 600 to 1,000 mg ketoconazole daily. Menses normalized in seven of eight subjects during treatment. Ketoconazole therapy was not associated with a change in basal or postgonadotropin-releasing hormone stimulation gonadotropin levels. Basal cortisol levels were also unchanged on ketoconazole though responsiveness of cortisol to adrenocorticotropic hormone stimulation tended to be reduced. We conclude that ketoconazole can effectively reverse the biochemical and clinical abnormalities of ovarian hyperandrogenism. Until the issue of its safety is resolved, ketoconazole therapy is best limited to select individuals who agree to careful monitoring and the use of reliable birth control methods during treatment.

17-alpha-Hydroxyprogesterone↗
PubMed2005

Amino thiols, detoxification and oxidative stress in pre-eclampsia and other disorders of pregnancy.

New knowledge of placental development and function suggests that several common complications of pregnancy could share a similar origin. It is suggested that impaired placental development in early pregnancy may lead to placental oxidative stress and subsequently to the maternal syndromes such as recurrent early pregnancy loss and pre-eclampsia. Oxidative stress has been most extensively investigated in pre-eclampsia, resulting in hundreds of publications and many reviews. In general the literature points to the presence of placental and maternal oxidative stress. However, conformity amongst the relevant data is not absolute, most probably the result of the diversity of biomarkers investigated and the methods employed to assess oxidative stress, which generally depend on the assessment of end products of oxidative stress. Recently, new techniques have been developed that use different approaches based on the "real-time" measurement of oxidative stress by the redox status of thiols or the assessment of superoxide generation, whereas the role of Phase I/Phase II biotransformation pathways in oxidative stress was recognised. This review focuses on this biotransformation system, the thiol redox status and the involvement of these systems in oxidative stress associated with reproduction and pregnancy disorders, with the emphasis being laid on the syndrome of pre-eclampsia.

Adult↗
PubMed1996

Luteinizing hormone pulsatility and computer-assisted analysis of sperm features in patients with Hodgkin's disease.

The aim of this work was to characterize further the impairment of the reproductive function reported in untreated male patients with Hodgkin's disease. We evaluated the pattern of luteinizing hormone pulsatility and unconventional sperm features by computer-assisted sperm analysis (CASA) in 20 adult patients affected by biopsy-proven Hodgkin's disease before they were submitted to any therapeutic approach. Changes of luteinizing hormone pulsatility were documented and consisted mainly in an increase in pulse number in comparison with control subjects (P < 0.05). On CASA, 1/3 of the patients showed a reduction in the sperm number but, when motility, velocity and linearity of progression were evaluated, the number of patients with seminal alterations rose to 2/3. Sperm velocity and linearity were already impaired in stages I and II, whereas sperm number was reduced only in stage III. Symptomatic patients, regardless of the stage, showed a significant deterioration of all parameters. Our study supports the view that in Hodgkin's disease, before any treatment, a disorder of the reproductive system is present, both at hypothalamic/hypophysial and the gonadal level, having a pathogenesis that deserves to be elucidated by further study.

Adult↗
PubMedDate not supplied

[Remission of polycystic ovary syndrome associated with valproic acid in an epileptic female].

INTRODUCTION: In the epileptic female there is an increase in the number of disorders affecting the reproductive function, which on some occasions can be related to a polycystic ovary syndrome (PCOS). The Finnish school showed an increase in the number of cases of PCOS among females receiving antiepileptic therapy with valproic acid over a long period of time, which can affect up to 43% of the patients being treated. Such a high incidence has not been confirmed in other European series and it is likely that specific ethnic characteristics exert an influence on the results. We examine the possibility that PCOS constitutes a secondary chronic side effect of using valproic acid (VPA) and, as such, is reversible if the antiepileptic therapy is modified following its detection. CASE REPORT: Female, aged 21, who developed PCOS during the course of therapy with VPA, which remitted after changing the treatment to lamotrigine. The clinical signs that have to act as a warning of the possible presence of PCOS in epileptic patients are the appearance of menstrual disorders or signs of virilisation, such as hirsutism and android obesity.

Adolescent↗
PubMedDate not supplied

Polycystic ovary syndrome.

Polycystic ovary syndrome (PCOS) is a common endocrine disorder, affecting between 4% and 8% of reproductive aged women. This syndrome, a complex disorder with multiple components, including reproductive, metabolic, and cardiovascular manifestations, has long-term health concerns that cross the life span. The diagnostic criteria for PCOS are ovarian dysfunction evidenced by oligomenorrhea or amenorrhea and clinical evidence of androgen excess (e.g., hirsutism and acne) in the absence of other conditions that can cause these same symptoms. This article reviews current knowledge about the pathophysiology, clinical manifestations, diagnosis, and management of this disorder.

Amenorrhea↗
PubMed1996

Sexuality, pregnancy, and childrearing among women with schizophrenia-spectrum disorders.

OBJECTIVE: This study compared sexuality, reproduction, and childrearing characteristics of women with schizophrenia-spectrum disorders with those of women without serious mental illness. METHODS: A semistructured interview was given to 46 women meeting Research Diagnostic Criteria for schizophrenia or schizoaffective disorder and to 50 control subjects without major mental illness who were matched for age, race, education, employment status, and religion. RESULTS: Compared with the control subjects, the women with schizophrenic disorders had more lifetime sexual partners, were less likely to have a current partner, and were more likely to have been raped and to have engaged in prostitution. Despite being at high risk for HIV infection, as a group they were less likely to have been tested for HIV. They reported wanting sex less often than did control subjects and rated their physical and emotional satisfaction with sex lower. They had fewer planned pregnancies, more unwanted pregnancies, and more abortions and were more often victims of violence during pregnancy. They were more likely to have lost custody of children and to report that they were unable to meet their children's basic needs and less likely to have another caregiver helping them raise their children. Both groups reported high rates of substance abuse during pregnancy. CONCLUSIONS: Health care delivery systems could better meet the needs of women with severe mental illness by providing social skills training, family planning, and more consistent screening for pregnancy, HIV, and battering. In addition, barriers to care for pregnant women with severe mental illness and substance abuse should be reduced, and parenting training should be incorporated into psychosocial rehabilitation programs for mentally ill parents.

Adolescent↗
PubMed1998

[Long-term ecological and genetic consequences of use of dioxin-containing environmental agents].

The long-term consequences of the use of dioxine-containing ecotoxic agents in the USA in 1961-1972 are ecologically and genetically characterized. There were increases in the incidence of pathological reproductive events in the contaminated region. It is concluded that there will be higher probability of abnormalities in the families of individuals born at war or just thereof. An association of impaired reproduction with functional disorders and women's poorer health, with higher incidence of somatic and gynecological diseases (chronic ones in particular) is shown. Cytogenetic changes in the lymphocytes were found in individuals from exposure risk groups. The contribution of chromosomal alterations observed in the contaminated area to immunodeficiency is appreciated. The systemic pattern of the action of biologically active properties of dioxine was demonstrated from the morphofunctional changes of different cell types. Cluster analysis revealed associations of cytogenetic parameters with the integrated index of health status in individuals from different contaminated areas. The ecological and genetic consequences may be regarded as part of homeostatic changes at many levels, as suggested by a correlation between the genetic instability and the changes occurring in other tissues, organs, and systems.

Adolescent↗