GnRH Analogue Research Articles

Comparative evaluation of the efficacy of three GnRH analogues in induced breeding of stinging catfish, Heteropneustes fossilis under hatchery conditions

Evaluating the breeding performance of cultivable fish using gonadotropin-releasing hormone (GnRH) analogues is crucial for optimizing reproductive efficiency and enhancing the sustainability of aquaculture practices. However, there is a lack of understanding regarding which GnRH analogue performs best under hatchery conditions for stinging catfish. Therefore, this study was conducted to assess the breeding performance of stinging catfish (Heteropneustes fossilis) using three commercially available GnRH analogs: Wova-FH, Ovaprim, and Easy-spawn. For this purpose, an experiment was set up in a commercial hatchery by dividing the samples into three groups, each treated with one of the analogs: Wova-FH, Ovaprim, or Easy-spawn. In the experiment, a ratio of 1.5:1 male to female was maintained, and 1 mL syringes were used to inject the analogs. The results showed that the spawning induction efficiency differed among the three inducing agents. Compared to Ovaprim and Easy-spawn, Wova-FH-treated H. fossilis exhibited higher breeding success in all measured aspects. Specifically, Wova-FH achieved a latency period of 8 h, an ovulation rate of 87.25%, a fertilization rate of 89.33%, a hatching rate of 88.85%, and an incubation period of 16 h. In comparison, Ovaprim and Easy-spawn had incubation periods of 18 h and 24 h, respectively. In Ovaprim-induced individuals, the latency period was approximately 8.30 h, with an ovulation rate of 82.08%, a fertilization rate of 86.75%, and a hatching rate of 85.97%. In contrast, the Easy-spawn-induced individuals had a latency period of 9 h, an ovulation rate of 27.50%, a fertilization rate of 27.10%, and a hatching rate of 26.15%. Significant differences (p < 0.05) were observed among the treatments in both the ovulation rate, fertilization rate, latency period incubation period, and hatching rate. The findings suggest that Wova-FH is a superior alternative to Ovaprim and Easy-spawn for GnRH analogs in the induced breeding programs of H. fossilis, offering optimal yield.

Progestin-primed ovarian stimulation outcomes in in-vitro fertilization (IVF) – A systematic review of the literature

Background: Progestin-primed ovarian stimulation (PPOS) stimulates ovaries to block the premature surge of luteinizing hormone (LH) by using micronized progesterone or a progestin during the follicular phase instead of the conventional gonadotropin-releasing hormone (GnRH) analogues or GnRH antagonists downregulating LH to obtain multi-follicle engagement. Current work aims to assess the influence of progestogen treatment on ovarian stimulation and the ability to control LH surge, its efficacy and suitability in retrieving oocytes, without affecting the embryo quality and its benefit among infertile women long-term outcomes on children compared to standard stimulation protocols. Materials and Methods: The literature review used the randomized control trials published in the Pubmed database from January 2015 to April 2021. To generate the citation list, the following keywords were used: ‘progestin-primed ovarian stimulation’, ‘PPOS’, ‘micronized progesterone’, ‘medroxyprogesterone’, and/or ‘dydrogesterone’. The selected articles analyzed the cohort, intervention, and scheme of the progestin-primed ovarian stimulation protocol in controlled ovarian stimulation (COS) for in-vitro fertilization (IVF)/intra cytoplasmic sperm injection (ICSI) used in Assisted Reproductive Technologies (ART). Results: Overall we concluded that PPOS for IVF/ICSI in ART results in a higher number of obtained embryos, lower incidence of OHSS, equal duration of stimulation, number of retrieved oocytes, and number of MII oocytes. It is also suggested that long-term safety in children shows no significant difference between the study and control groups. Conclusions: Despite the outcomes of progestin stimulation cycles among all cohorts, we concluded that poor ovarian responders, patients with PCOS, women of advanced age and oocyte donors benefit the most from using PPOS.

Embryonic and larval development of black jewfish, Protonibea diacanthus: A new candidate for aquaculture in northern Australia

Black jewfish Protonibea diacanthus is a large, commercially important fish distributed across the tropical Indo-Pacific. In Australia, there is an established commercial wild fishery for the species but it’s aquaculture potential has not been investigated. This research presents hatchery production of native P. diacanthus in Darwin, Australia and documents ontogeny of early life stages of this species over three trial runs. Wild P. diacanthus were induced to spawn with luteinizing hormone-releasing hormone analog (LHRHa) and eggs were released approximately 25–28 h after injection (0.88 ± 0.01 mm in diameter with oil globule 0.24 ± 0.01 mm). Larvae hatched 12 h after spawning. At one day post hatch (dph) larvae were 2.68 ± 0.01 mm standard length with 0.15 ± 0.01 mm oil globule diameter. Larvae mouths opened at 31 h post hatch (hph) and first feeding was seen at 57 hph. Swim bladder inflation (92 %) occurred between 40 and 62 hph. Larvae were progressively fed rotifers, Artemia and Otohime microdiet, and metamorphosis occurred between 20 and 25 dph, completing as they reached over 13 mm standard length. Tail biting cannibalism began with the onset of metamorphosis and caused significant mortality until approximately 24 dph when metamorphosed juveniles could be handled and moved to low stocking density systems. This study demonstrates that northern Australian P. diacanthus is amenable to hatchery production and provides important foundational knowledge for this emerging aquaculture species.

Revising LH cut-off for the diagnosis of central precocious puberty via triptorelin stimulation assay.

Precocious puberty (PP) in girls is defined by thelarche before age 8. The diagnostic gold standard is an increased LH level following gonadotropin-releasing hormone (GnRH) stimulation. Alternatively, GnRH analogues like triptorelin can be used, though their interpretation varies. Since 2000, we have used a triptorelin-induced LH cut-off of 15 IU/L, 4 h post-stimulus. However, many girls showed LH values below this threshold despite evident pubertal progression. To establish a new LH threshold post-triptorelin stimulation for earlier diagnosis of central precocious puberty (CPP) in girls showing pubertal progression and to evaluate additional parameters for diagnostic accuracy. We enrolled 186 girls with thelarche onset between ages 1-8 and a GnRH analogue assay performed between 2015-2019 without signs of axis activation. Within this cohort, 62 patients repeated the triptorelin test due to rapid pubertal progression. The assay involved administering 100 mcg/m² of triptorelin and measuring LH, FSH, and estradiol levels before and four hours post-injection. Patients with axis activation at the second test had significantly higher post-stimulus LH levels at the first test compared to those below 15 IU/L. They also had higher basal LH levels, elevated LH/FSH ratio, and increased growth velocity. Statistical analysis identified a new post-stimulus LH threshold of 5 IU/L. We propose a LH value of 5 IU/L after triptorelin administration as a new threshold for early CPP diagnosis. While the LH/FSH ratio and growth velocity are associated with axis activation, they did not significantly enhance diagnostic accuracy when combined with the LH value.

6480 Variability in Breast Development in Response to Exogenous Estrogen in Girls

Abstract Disclosure: T.M. Kurman: None. E.A. Eugster: None. Intro: Adolescents requiring treatment with exogenous estrogen (E2) include girls with primary and secondary hypogonadism and transfeminine youth. While 17B-estradiol is standard of care, the starting dose and escalation schedule are individualized. To what degree the response to E2 as assessed by breast Tanner stage is correlated with the dose is unknown. Similarly, whether the response to E2 varies depending on the underlying diagnosis has not been systematically analyzed. We aimed to investigate relationships between diagnosis, E2 dose, and breast Tanner staging in adolescent girls. Methods: We conducted a chart review of girls treated with E2 followed at our Pediatric Endocrine clinic between 2008-2022. Inclusion criteria included girls who were prepubertal at baseline and on a single increment of a 25 mcg E2 patch changed 2X/week from initiation of treatment to the first follow up visit. Only transgender girls being treated with a GnRH analog were included. Within each group of patients on the same starting dose, a Kruskal-Wallis test was conducted to evaluate differences in Tanner stage between diagnostic groups. Spearman’s correlation was used to evaluate the relationship between starting dose and Tanner stage. Finally, we evaluated differences within the Turner syndrome (TS) group for girls with monosomy X vs a mosaic karyotype. Results: Of 1,899 medical records, 70 eligible patients were identified. Of these, 33 (47.2%) had TS, 17 (24.3%) had primary ovarian insufficiency (POI), 15 (21.4%) had hypogonadotropic hypogonadism (HH), and 5 (7.1%) were transgender (TG). Twenty-three (32.9%) started on 1/4 patch (6.25 mcg), 29 (41.4%) on 1/2 patch (12.5 mcg) and 18 (25.7%) on a full patch (25 mcg). Girls on other regimens (e.g., 1/8 patch worn only at night) were excluded from analysis. The first f/u visit occurred at a median of 6 months (range 3-12 months). All TG girls were started on 25 mcg E2, which was significantly different compared to the other groups (p=0.002, p=0.005, and p=0.005 for TS, POI, and HH respectively). Breast Tanner stage at the first f/u visit ranged from 1-4 with no significant difference within each dose group based on diagnosis. However, a significant correlation between E2 dose and breast Tanner stage at f/u was seen in girls with HH (r=0.601, p=0.018). No effect of karyotype (monosomy X vs mosaic) on response to E2 in girls with TS was seen. Conclusion: There was striking variability in the starting dose of E2 in the vast majority of patients, highlighting the lack of standardization in clinical management. Interestingly, we found significant individual variability in terms of breast development in response to the initial dose of E2, regardless of diagnosis. Factors responsible for the unpredictable nature of the response to exogenous E2 are unexplored. Our findings provide important and novel prognostic information for patients and providers. Presentation: 6/1/2024

Evaluation of Synthetic GnRH-Analog Peforelin with Regard to Oocyte Differentiation and Follicular Development in C57BL/6J Mice.

In biomedical research, ovulation induction is a critical step in the reproductive biology of laboratory animals. This study evaluates the efficacy of peforelin, a synthetic gonadotropin-releasing hormone (GnRH) analog, in comparison to pregnant mare serum gonadotropin (PMSG, synonym: eCG), traditionally used for ovulation induction in mice. PMSG is derived from the serum of pregnant horses, and its production is becoming increasingly problematic due to animal welfare concerns and regulatory restrictions. The aim of this study was, therefore, to evaluate an ethically acceptable and less invasive alternative to PMSG. Female C57BL/6J mice, aged 3-4 weeks, were divided into two groups to receive either peforelin at three different concentrations or PMSG, followed by an injection of human chorionic gonadotropin (hCG) to induce ovulation. Key outcomes included the number and quality of oocytes collected, fertilization rates, ovary morphology, and follicular differentiation. Although the number of oocytes was significantly lower in the peforelin cohort, the fertilization rate was high. Ovarian morphology was not significantly altered compared to the PMSG cohort. This study showed that peforelin is suitable for superovulation in mice. These results suggest that peforelin could be an ethically acceptable alternative to PMSG stimulation for inducing superovulation in mice.

Comparison of highly purified human menopausal gonadotropin and recombinant follicle stimulating hormone use in patients undergoing in vitro fertilization with progestin-primed ovarian stimulation protocol: a single center retrospective analysis.

Recently, progesterone has been used to prevent LH surge instead of GnRH analogues during ART treatments, which is known as progesterone-primed ovarian stimulation (PPOS) protocol. During ART treatment, highly purified human menopausal gonadotropin (HP-hMG) and recombinant follicle stimulating hormone (rFSH) are two of the agents used for stimulation of antral follicles. The aim of this study is to compare the efficacy and success of HP-hMG and rFSH agents in the ovarian stimulation step of the PPOS protocol, which has not been previously reported in the literature. This retrospective study was conducted at a university hospital with patients who underwent IVF treatment using PPOS protocols in between January 2019 and July 2021. For ovarian stimulation, rFSH was used in group I and HP-hMG was used in group II. Mature oocyte ratio was the primary outcome, and live birth rate was the secondary outcome. Mann-Whitney and Chi-square tests were used for statistical analysis. All p values below 0.05 were considered significant. Total numbers of follicles, oocytes, MII, and 2PN numbers obtained were similar between the two groups. The fertilization rates were 66.7% in the rFSH group and 64.3% in the HP-hMG group (p > 0.05). The pregnancy rates were 53.5% and 46.7% in the rFSH and HP-hMG groups, respectively. There was no statistically significant difference between pregnancy, abortus, and live birth rates. In this study, it is demonstrated that stimulation of oocytes with either rFSH or hMG in the PPOS protocol, which has been added to IVF treatment protocols in recent years, had no statistical difference regarding mature oocyte numbers and live birth rates between the two groups. These results are consistent with the previous literature which compared rFSH and hMG in GnRH agonist and antagonist protocols.

Progestin-primed ovarian stimulation

The use of progestins for the prevention of premature ovulation during ovarian stimulation is called progestin-primed ovarian stimulation (PPOS). Response to ovarian stimulation with PPOS and gonadotropin-releasing hormone (GnRH) analogs seem to be similar with the clinically insignificant differences being explained by endocrine characteristics as expected. PPOS has the advantage of oral administration and lower medication cost than GnRH analogs, but the mandatory cancellation of an otherwise possible fresh embryo transfer can render PPOS less cost-effective if a fresh transfer would have been possible. Oocytes collected in PPOS cycles have similar developmental potential, including blastocyst euploidy rates. Frozen embryo transfer outcomes of PPOS and GnRH analog cycles seem similar both in terms of ongoing pregnancy/live birth rates and obstetric and perinatal outcomes. While some studies reported lower cumulative live birth rates with PPOS, they suffer from methodological issues, including arbitrary definitions of cumulative live birth rates. PPOS has been used in all patient types with consistent results and seems a patient-friendly and cost-effective choice when a fresh embryo transfer is not intended.

Potency evaluation of different GNRH analogues on ovulation induction and reproductive performance of doe rabbit.

Gonadotropin-releasing hormone (GnRH) -supplemented extenders have emerged as a welfare-orientated method to induce ovulation in the artificial insemination (AI) of rabbits. The main factor that limits the bioavailability of GnRH analogue on intravaginal administration is the proteolytic activity of enzymes present in rabbit seminal plasma. The use of GnRH analogues with higher biological potency would allow us to decrease their concentration in the seminal dose without compromising effectiveness. The current study was designed to assess the efficacy of various GnRH analogues concerning their ability to induce ovulation in rabbit AI. The base solution used for experimental extenders contained an aminopeptidase inhibitor. Four experimental groups were used, females from the Control group were induced to ovulate with an intramuscular administration of 1 μg of buserelin, while in the other three groups females received an intravaginal administration of 3.5 μg of buserelin (BUS), deslorelin (DES) or fertirelin (FER) within the seminal dose. Results showed that the ovulation frequency was similar in all groups studied. A concentration of 3.5 μg of the different GnRH analogues tested in this study showed similar potency in inducing ovulation in non-lactating females, yielding comparable results in terms of pregnancy rate at birth and prolificacy.

Use of puberty-blocking hormones for gender dysphoria in New Zealand: descriptive analysis and international comparisons.

To investigate use of puberty-blocking hormones (gonadotropin-releasing hormone analogues [GnRHa]) for gender dysphoria in New Zealand. Specifically, to describe demographic characteristics and time trends in the prevalence and incidence of prescribing, and to calculate cumulative incidence (proportion) of first prescribing of GnRHa for gender dysphoria in order to make valid international comparisons. The national Pharmaceutical Collection was used to identify all dispensing from 2006 to 2023 to those aged <18, by sex/gender and age. Cumulative incidence of first prescriptions between ages 12 and 17 (which largely excludes prescribing for other indications) was calculated and compared with the Netherlands and England and Wales. In New Zealand, prescription of GnRHa for gender dysphoria started around 2011; prevalence of use increased to 2014, then more steeply to 2022, followed by a decline. Incidence data show the decline started from 2021. New Zealand, compared to the Netherlands (which started prescribing in the 1990s), had 1.7 times the cumulative incidence of first prescriptions by 2018. Compared to England and Wales up to 2020, New Zealand had 3.5-6.9 times the cumulative incidence. The high rate of prescribing for probable gender dysphoria in New Zealand, and the decline after 2021, require further investigation.

Effect of Administering Serially Diluted Suprecur and Motilium (Dopamine Blocker) on the Breeding Performance of Clarias gariepinus

This study was designed to determine the effect of using serially diluted Buserelin acetate (Suprecur), which is a luteinizing hormone-releasing hormone analogue (LHRHa) with dopamine antagonist (Motilium) on the latency period, fecundity, percentage fertilization and percentage hatching of Clarias gariepinus. Treatments administered include 50ug/l, 40ug/l, 20ug/l and 10ug/l of Suprecur in tandem with 5mg/kg of Motilium. Metrics obtained include egg numbers, latency period, fertilization rate, hatching rates, and survival to first feeding. The results obtained demonstrated that the use of Suprecur (LHRHa) together with dopamine antagonist (Motilium) successfully induced ovulation in the experimental Clarias gariepinus broodfish. The highest fecundity was from the treatment T40 There was no significant difference in egg weights stripped from each treated group. The application of 50 µg/kg of Suprecur with 5mg/kg of Motilium resulted in earlier synchronization of ovulation (Latency period; 12 hours). Results of the fertilization percentage indicated that an increase in the dose of LHRHa did not significantly affect the fertilization rate in treated groups of broodfish. Overall superiority of 50 µg/kg of Suprecur plus 5mg/kg of Motilium in spawning induction was proved by significantly high hatchability, 83.56%. Broodstock used for the 40µg/kg dose had the highest fecundity. There was no significant correlation (p&gt;0.05) between the water quality parameters and the breeding parameters. In conclusion, the result obtained clearly indicates an overall superiority of using 50 µg/kg of Suprecur together with 5mg/kg of Motilium to induce spawning with regard to the recorded high hatchability percentage.

Effect of repeated low doses of gonadotropin-releasing hormone on the secretion of luteinizing hormone and follicle-stimulating hormone, and ovarian function in dairy cows suffering from anovulation type I

The aim of the study was to evaluate the effect of repeated low doses of gonadotropin-releasing hormone (GnRH) agonist buserelin once a day for 5 days on follicle-stimulating hormone (FSH) and luteinizing hormone (LH) release, and ovarian function in dairy cows with anovulation type I. The study was conducted on 10 anovulatory Polish Holstein-Friesian cows. Cows in Group 1 (n = 5) received 4 µg of buserelin intramuscularly. once a day for 5 days. Control cows from Group 2 (n = 5) received saline. Concentrations of progesterone, FSH, and LH in the blood were analysed using radioimmunoassay (RIA). Ovarian structures were monitored weekly after the end of treatment by ultrasound for 4 weeks. Injections of buserelin increased FSH and LH concentrations. Release of FSH and LH was largely variable, but there was significant (P < 0.001) interaction between time and treatment during all treatment days. The number of follicles in the treatment group was significantly greater (P = 0.029) than in the control group on day 5, the diameter of follicles on day 12 was also larger (P < 0.01) in treated than in control cows. Ovulation occurred in 4 of the 5 treated cows, but only in 1 of the control cows in the 40 days after treatment. In conclusion, repeated low doses of GnRH analogue buserelin once a day for 5 days may increase the concentration of FSH and LH in dairy cows with anovulation type I.

1652P SAABR: Single arm phase II study of androgen receptor pathway inhibitor (ARPI) + atezolizumab + GnRH analog (ADT) and stereotactic body radiotherapy (SBRT) to the prostate in men with de novo hormone-sensitive metastatic prostate cancer (mHSPC)

1652P SAABR: Single arm phase II study of androgen receptor pathway inhibitor (ARPI) + atezolizumab + GnRH analog (ADT) and stereotactic body radiotherapy (SBRT) to the prostate in men with de novo hormone-sensitive metastatic prostate cancer (mHSPC)

Body composition in recurrent prostate cancer and the role of steroidogenic genotype.

Hormone therapy (HT) to treat prostate cancer is reported to cause adverse changes in body composition. Clinically, interpatient body composition changes are heterogeneous, but the biologic and clinical determinants of body composition toxicity are unknown. Herein, we test the hypothesis that inherited polymorphisms in steroidogenic genes are associated with differential change in body composition after HT. Men with biochemically recurrent prostate cancer (BCR) who received 8 months of LHRH analog (LHRHa) +/- abiraterone acetate (AAP) were eligible if they had: 1) CT imaging of L3 prior to and after treatment, and 2) nucleated cells collected. Cardiometabolic co-morbidities were retrospectively extracted. Body composition was measured using an AI-based segmentation tool. Germline DNA whole exome or genome sequencing was performed. In 162 men treated with 8 months of HT, median skeletal muscle mass (SMMi) loss was 6.6% and subcutaneous adipose gain was 12.3%. Men with type 2 diabetes had higher loss of SMMi after treatment (-11.1% vs. -6.3%, p = 0.003). For the 150 men with germline NGS, SRD5A2 rs523349 genotype was associated with differential loss in skeletal muscle density after HT, (-1.3% vs. -7.1%, p=0.04). In addition, HSD3B1 rs104703 genotype was associated with decreased baseline visceral adipose tissue (63.0 cm2/m2 vs. 77.9, p=0.05). In men with BCR, HT induced notable loss of skeletal muscle and increased subcutaneous adipose tissue. An inherited polymorphism in SRD5A2 and T2DM were associated with differential skeletal muscle toxicity. These findings suggest that inherited polymorphisms may contribute to the body composition toxicity observed with HT.

Andrew Victor Schally: Pioneering Neuroendocrinologist and Architect of Luteinizing Hormone-Releasing Hormone Analogs.

Andrew Victor Schally is a pioneering figure in endocrinology and neuroendocrinology, whose work has fundamentally transformed the understanding and treatment of hormone-related disorders and cancer. His research, particularly in the isolation, characterization, and clinical application of hypothalamic hormones, has been instrumental in advancing medical science. Schally's early life, marked by the adversities of World War II, shaped his resilience and determination, driving him to pursue a career in medical research. His groundbreaking discovery of luteinizing hormone-releasing hormone (LHRH) and its analogs revolutionized the treatment of hormone-dependent cancers, especially advanced prostate cancer, by providing an effective alternative to surgical castration. Beyond LHRH, Schally's contributions to the development of somatostatin analogs have also had a significant impact on the management of acromegaly and neuroendocrine tumors. This article reviews Schally's life and work, emphasizing his contributions to endocrinology, particularly in the context of LHRH and its clinical applications. The review outlines his early life and education, his pioneering research on hypothalamic hormones, and the development of LHRH analogs that have become a cornerstone in the treatment of prostate cancer. Schally's ability to translate basic scientific discoveries into practical therapeutic strategies has earned him numerous accolades, including the Nobel Prize in Physiology or Medicine in 1977. His legacy continues to inspire and guide research in endocrinology and oncology, underscoring the lasting impact of his scientific achievements.

Cytotoxic Activity of Novel GnRH Analogs Conjugated with Mitoxantrone in Ovarian Cancer Cells.

The gonadotropin-releasing hormone (GnRH) receptor (GnRH-R) is highly expressed in ovarian cancer cells (OCC), and it is an important molecular target for cancer therapeutics. To develop a new class of drugs targeting OCC, we designed and synthesized Con-3 and Con-7 which are novel high-affinity GnRH-R agonists, covalently coupled through a disulfide bond to the DNA synthesis inhibitor mitoxantrone. We hypothesized that Con-3 and Con-7 binding to the GnRH-R of OCC would expose the conjugated mitoxantrone to the cellular thioredoxin, which reduces the disulfide bond of Con-3 and Con-7. The subsequent release of mitoxantrone leads to its intracellular accumulation, thus exerting its cytotoxic effects. To test this hypothesis, we determined the cytotoxic effects of Con-3 and Con-7 using the SKOV-3 human OCC. Treatment with Con-3 and Con-7, but not with their unconjugated GnRH counterparts, resulted in the accumulation of mitoxantrone within the SKOV-3 cells, increased their apoptosis, and reduced their proliferation, in a dose- and time-dependent manner, with half-maximal inhibitory concentrations of 0.6-0.9 µM. It is concluded that Con-3 and Con-7 act as cytotoxic "prodrugs" in which mitoxantrone is delivered in a GnRH-R-specific manner and constitute a new class of lead compounds for use as anticancer drugs targeting ovarian tumors.

Effect of dietary with Zhibai dihuang pills and gonadotropin-releasing-hormone-analogue on girls with precocious and rapidly progressive puberty

BACKGROUND At present, the clinical mechanisms underlying precocious puberty remain unclear, making effective intervention for children experiencing this condition and rapidly progressive puberty essential. AIM To explore the effects of Zhibai dihuang pills and gonadotropin-releasing hormone analogue (GnRHa) on growth and ovarian function in girls with precocious puberty. METHODS The clinical data of 84 adolescent girls with precocious puberty and rapidly progressive puberty from February 2017 to August 2023 were retrospectively analyzed. Girls were divided into a control group and an observation group, with 42 cases in each group. The control group received diet intervention combined with GnRHa treatment, while the observation group received diet intervention combined with Zhibai dihuang pills + GnRHa treatment. Outcomes such as clinical efficacy, growth indicators, ovarian function, and adverse reactions were compared between the two groups. RESULTS The observation group showed superior clinical efficacy compared to the control group (P &lt; 0.05). Prior to the intervention, no significant differences were found in growth or ovarian function between the groups (P &gt; 0.05). Post-intervention, the observation group exhibited significantly lower rates in growth, height, and bone age, along with reduced levels of progesterone, testosterone, estradiol, prolactin, luteinizing hormone, and follicle-stimulating hormone compared to the control group (P &lt; 0.05). The incidence of adverse reactions was similar across both groups (P &gt; 0.05). CONCLUSION Combining Zhibai dihuang pills with GnRHa and dietary intervention effectively improves growth, enhances ovarian function, and minimizes adverse reactions in adolescent girls with precocious and rapidly progressive puberty.

Central precocious puberty should be taken seriously in children with Leydig cell tumors of the testis after surgical treatment: a tertiary center experience.

Central precocious puberty secondary to Leydig cell tumors is rare in children. We retrospectively analyzed the mid- to long-term follow-up data of patients with Leydig cell tumors. The clinical data of 12 consecutive patients who were treated at Beijing Children's Hospital, Capital Medical University (Beijing, China), between January 2016 and October 2023 were retrospectively reviewed. Clinical evaluations, including physical examination, hormone examination, serum tumor marker analysis, abdominal and scrotal ultrasound, chest X-ray, and bone age measurement, were conducted before surgery and at follow-up time points. Surgical approaches were selected according to the individual conditions. Patients with an abnormal hormonal status and suspected of having central precocious puberty were referred to endocrinologists to confirm the diagnosis. Subsequently, gonadotropin-releasing hormone analog therapy was proposed. The mean patient age was 81.3 (range: 40-140) months at the time of the operation. Ten patients had peripheral precocious puberty at admission. All patients had elevated preoperative testosterone levels, whereas tumor marker levels were normal. Testis-sparing surgery was performed in eleven patients, and radical orchiectomy was performed in one patient. The follow-up duration (mean ± standard deviation) was 36.2 ± 25.3 months. Five patients had central precocious puberty, with a mean duration of 3.4 (range: 1-6) months postoperatively. Three patients were receiving gonadotropin-releasing hormone analog therapy, and good suppression of puberty was observed. No risk factors were found for secondary central precocious puberty. There was a high prevalence of central precocious puberty secondary to Leydig cell tumors in our study. Gonadotropin-releasing hormone analog therapy has satisfactory treatment effects. Larger sample sizes and long-term follow-up are needed in future studies.

Use of a slow-release GnRH implant in an adult billy goat.

A 9.4 mg deslorelin slow-release implant was inserted into an adult, healthy billy goat to achieve temporary infertility and a reduction in sexual behavior. The implant was inserted in late autumn. No significant change in testis size was observed over the following 6 weeks. The endocrine function of the testis, which was examined by stimulation with human chorionic gonadotropin, was also unchanged after 6 weeks compared to the initial examination. Histological examination revealed a preserved spermatogenesis.In conclusion, the application of a GnRH analogue implant in the adult male goat has no influence on the investigated parameters - and thus probably also on its fertility.

A randomised trial of short- vs long-term androgen deprivation with salvage radiotherapy for biochemical failure following radical prostatectomy: URONCOR 06-24.

Salvage radiotherapy (SRT) and androgen-deprivation therapy (ADT) are widely used in routine clinical practice to treat patients with prostate cancer who develop biochemical recurrence (BCR) after radical prostatectomy (RP). However, there is no standard-of-care consensus on optimal duration ADT. Investigators propose three distinct risk groups in patients with prostate cancer treated with SRT in order to better define the indications and duration of ADT combined with SRT. The URONCOR 06-24 trial (ClinicalTrials.gov identifier NCT05781217) is a prospective, multicentre, randomised, open-label, phase III, clinical trial. The aim of the trial is to determine the impact of short-term (6 months) vs long-term (24 months) ADT in combination with SRT on distant metastasis-free survival (MFS) in patients with prostate cancer with BCR after RP (intermediate and high risk). The primary endpoint is 5-year MFS rates in patients with prostate cancer treated with long- vs short-term ADT in combination with SRT. Secondary objectives are biochemical-relapse free interval, pelvic progression-free survival, time to start of systemic treatment, time to castration resistance, cancer-specific survival, overall survival, acute and late toxicity, and quality of life. Total of 534 patients will be randomised 1:1 to ADT 6 months or ADT 24 months with a luteinizing hormone-releasing hormone analogue in combination with SRT, stratified by risk group and pathological lymph node status. The study is conducted under the guiding principles of the World Medical Association Declaration of Helsinki. The results will be disseminated at research conferences and in peer-reviewed journals. EudraCT number 2021-006975-41.