Elevated Luteinizing Hormone Levels Research Articles

Uncovering ovarian reserve: Insights into hormones, lipids, and essential metals

: Polycystic Ovary Syndrome (PCOS) is an endocrine disorder prevalent in women of reproductive age group. The intricate nature of PCOS development is highlighted by fluctuations in various sex hormones, such as luteinizing hormone(LH), follicle-stimulating hormone and prolactin. This study aims to assess the lipid profile levels, vital metals and sex hormones in the serum of patients with PCOS and contrast these findings with normal controls.The study analyzed health metrics between 57 women with PCOS and 57 normal controls. The lipid profile was assessed using Beckman Coulter AU480. Sex hormones were estimated using Roche Diagnostics Cobas 6000. Inductively coupled plasma mass spectrometry (ICPMS) was used to measure the essential trace metals, including magnesium (Mg), copper (Cu) Selenium (Se) and zinc (Zn).: The PCOS patients exhibited significantly elevated levels of LH (9.52 vs 3.48, p<0.0001), FSH (9.91 vs. 6.12, p<0.0001) and prolactin (24.71 vs. 16.41, p=0.03) mIU/ml. The correlation study showed a significant positive correlation between AMH and Se levels (R=0.27, p=0.045) and between LH and HDL (R=0.76, p=0.030).: In patients with PCOS, LH, FSH, and prolactin levels were found to be increased. A correlation was observed between Se and AMH, and a relationship was noted between LH and HDL. Selenium appears to have a significant influence on the ovarian reserve.

Evaluation of the anti‐PCOS Potential of Ethanolic Extract of Ocimum Gratissimum (Linn.) Leaf in Letrozole‐Induced Polycystic Ovarian Syndrome in Wistar Rats

AbstractThis study investigated the effect of ethanolic extract of Ocimum gratissimum leaves (EEOGL) on letrozole‐induced polycystic ovarian syndrome (PCOS) and determine the possible binding effects of compounds identified in EEOGL using molecular docking method. After the induction using letrozole (1 mg/kg), normal (n=4) and PCOS (n=16; 4 groups of 4 animals/group) were treated for 14 days orally with distilled water (1 ml/kg), metformin (500 mg/kg), clomiphene‐citrate (2 mg/kg), and EEOGL (50 and 100 mg/kg). 47 compounds were docked to androgen receptor (AR), estrogen receptor (ER), fructose‐1,6‐bisphosphate (FBP), and phosphoenolpyruvate‐carboxykinase (PEPCK) using Vina. The result obtained revealed that letrozole‐induced PCOS rats exhibited altered oestrous cycle and administration of the EEOGL at 50 mg/kg significantly (p<0.05) decreased the serum insulin, testosterone, luteinizing hormone (LH), Low Density Lipoprotein (LDL), total cholesterol (TC), triglyceride while serum concentration of Follicle stimulating hormone (FSH), estradiol, and High‐Density Lipoprotein (HDL) were significantly (p<0.05) increased compared to the control. However, administration of 100 mg/kg of the EEOGL did not reverse elevated insulin and LH levels. Molecular docking revealed four compounds with at high binding affinity for at least one of the proteins studied compared to standard drugs. Ethanolic extracts of O. gratissimum has the potential to regulate the reproductive‐induced alterations in PCOS rats.

Adult-type granulosa cell tumor associated with elevated luteinizing hormone: Two rare case reports.

Adult-type granulosa cell tumors (AGCTs), which account for 2% to 5% of all malignant ovarian tumors, are rare sex cord-stromal tumors that usually secrete excess estrogens, but they can also secrete androgens. We report 2 patients of childbearing age with AGCT who presented with the complaint of abnormal menstruation and elevated luteinizing hormone (LH), and mildly elevated testosterone. The ovarian tumors had hormonal activity. The 2 patients underwent laparoscopic left adnexectomy. The second patient underwent 4 cycles of chemotherapy with paclitaxel and carboplatin as adjuvant treatments. Their postoperative pathology confirmed AGCTs. Also, their menstrual cycle returned to normal, with normal serum LH and testosterone levels. There was no sign of recurrence. The cases suggest that elevated serum LH levels may be a sign of unknown tumors in cases of oligomenorrhea or secondary amenorrhea. It is useful to evaluate the serum levels of inhibin B and anti-Müllerian hormone to improve the early recognition of ovarian granulosa cell tumors.

Social isolation and aggression training lead to escalated aggression and hypothalamus-pituitary-gonad axis hyperfunction in mice

AbstractAlthough the participation of sex hormones and sex hormone-responsive neurons in aggressive behavior has been extensively studied, the role of other systems within the hypothalamus-pituitary-gonadal (HPG) axis remains elusive. Here we assessed how the gonadotropin-releasing hormone (GnRH) and kisspeptin systems are impacted by escalated aggression in male mice. We used a combination of social isolation and aggression training (IST) to exacerbate mice’s aggressive behavior. Next, low-aggressive (group-housed, GH) and highly aggressive (IST) mice were compared regarding neuronal activity in the target populations and hormonal levels, using immunohistochemistry and ELISA, respectively. Finally, we used pharmacological and viral approaches to manipulate neuropeptide signaling and expression, subsequently evaluating its effects on behavior. IST mice exhibited enhanced aggressive behavior compared to GH controls, which was accompanied by elevated neuronal activity in GnRH neurons and arcuate nucleus kisspeptin neurons. Remarkably, IST mice presented an increased number of kisspeptin neurons in the anteroventral periventricular nucleus (AVPV). In addition, IST mice exhibited elevated levels of luteinizing hormone (LH) in serum. Accordingly, activation and blockade of GnRH receptors (GnRHR) exacerbated and reduced aggression, respectively. Surprisingly, kisspeptin had intricate effects on aggression, i.e., viral ablation of AVPV-kisspeptin neurons impaired the training-induced rise in aggressive behavior whereas kisspeptin itself strongly reduced aggression in IST mice. Our results indicate that IST enhances aggressive behavior in male mice by exacerbating HPG-axis activity. Particularly, increased GnRH neuron activity and GnRHR signaling were found to underlie aggression whereas the relationship with kisspeptin remains puzzling.

Heme oxygenase 2 genetic variants alter hormonal and metabolic traits in polycystic ovary syndrome.

Oxidative stress and metabolic disorders are involved in the pathogenesis of polycystic ovary syndrome (PCOS). Heme oxygenase 2 (HMOX2) plays a critical role in preserving heme metabolism as well as in modulating glycolipid metabolism, oxidative stress, and inflammation. This study examined the correlation between HMOX2 G554A (rs1051308) and A-42G (rs2270363) genetic variants with the risk of PCOS and assessed the effects of these genotypes on clinical, hormonal, metabolic, and oxidative stress indices using a case-control design that included 1014 patients with PCOS and 806 control participants. We found that the allelic and genotypic frequencies of the HMOX2 G554A and A-42G polymorphisms were comparable between the PCOS and control groups in Chinese women (P > 0.05). Nevertheless, it was discovered that patients with the AA or AG genotype of A-42G polymorphism had notably elevated levels of estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), LH/FSH ratio, high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), apolipoprotein (apo)B, and/or apoB/apoA1 ratio than those with the GG genotypes (P < 0.05). Patients with the GG or AG genotype of G554A polymorphism had elevated serum levels of LH, FSH, E2, LH/FSH ratio, TC, HDL-C, LDL-C, apoB, and/or apoB/apoA1 ratio and lower 2-h glucose concentration compared with those with the AA genotype (P < 0.05). Our findings indicate a potential association between the genetic variants and endocrine abnormalities in the reproductive system and metabolic irregularities in glycolipid levels in patients, thus suggesting their potential role in the pathogenesis of PCOS.

Effect of Aqueous Extract of Unripe Musa Paradisiaca Linn on Parameters Affecting Reproduction in Rats.

Aqueous extract of unripe Musa paradisiaca fruit is commonly used for the treatment of ulcers in eastern Nigeria. This study aimed to assess the acute and subacute effects of an aqueous extract of unripe fruit on male and female fertility in rats. Aqueous extracts obtained by maceration were analyzed for acute and subacute toxicity and for the presence of phytochemical constituents using standard procedures. The extract (100, 500, and 1000 mg/kg) was administered daily to rats of both sexes for 28 d. Blood samples collected on days 0 and 28 were assessed for follicle-stimulating hormone (FSH), luteinizing hormone (LH), catalase (CAT), superoxide dismutase (SOD), and malondialdehyde (MDA). Testes and ovaries were harvested for histopathological analysis. Sperm were also collected to determine the sperm count and motility. Phytochemical screening revealed the presence of saponins, tannins, alkaloids, and resins. After an oral dose of up to 5000 mg/kg, there were no deaths in the acute toxicity test. The extract (500 mg/kg) significantly (P < .05) enhanced sperm count and motility relative to the untreated control; significantly (P < .05) reduced SOD, CAT, and glutathione levels, while significantly (P < .05) elevated LH, FSH, and MDA levels in male and female rats. Histological examination revealed significant structural damage to the ovaries. Unripe Musa paradisiaca fruit exhibited an adverse toxicological profile following prolonged administration and caused oxidative stress in rodents.

Rejuvenation of Ovarian Function after Autologous Platelet Lysate Injection: Promising Evidence from Confirmed Cases

Intraovarian injection of autologous Platelet Lysate (PL) can be considered a potential therapeutic strategy for ovarian function rejuvenation. Especially, in women diagnosed with Poor Ovarian Response (POR) or Primary Ovarian Insufficiency (POI), the exogenous administration of the autologous platelet-derived growth factors, influence positively the regulation of the serum Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH), and Anti-Mullerian Hormone (AMH) and Estradiol (E2). Therefore, the evaluation of the serum levels of the aforementioned hormones was performed on 10 participants with a mean age of 43 ± 4 years diagnosed with POR or POI, who received intraovarian PL injection monotherapy. The monitoring of the serum hormone levels was performed for 3 months. The results of this study clearly showed that all participants were characterized by elevated levels of FSH and LH and reduced levels of E2 and AMH, prior to the PL injection. However, the levels of all hormones started to change after the 1st month of follow-up monitoring. Moreover, 40% of the participants conceived successfully either by natural way or after in vitro Fertilization (IVF). Considering these, the intraovarian injection of autologous PL exhibited promising evidence regarding the altering of hormone levels at physiological values. Moreover, the contained PL growth factors were implicated in angiogenesis promotion and also in toleration of the inflammatory microenvironment, regulating positively ovarian function. In conclusion, the intraovarian autologous PL injection is considered a safe, effective, and tolerable therapeutic strategy in women with POR or POI. Moreover, the results of this study were very encouraging, especially for the women with infertility issues, who want their genetic offspring.

Reformed Hormonal Status in Hyperandrogenism through Ayurvedic Management with &lt;i&gt;Yoga&lt;/i&gt; and &lt;i&gt;Prānāyāma&lt;/i&gt; in a Known Case of Polycystic Ovarian Syndrome - A Case Report

Polycystic Ovarian Syndrome is the commonest endocrinological disorder of women in the reproductive age group. It is characterized by oligo/anovulation, hyperandrogenism, and raised Luteinizing Hormone: Follicle Stimulating Hormone ratio. Elevated levels of Luteinizing Hormone, contribute to hyperandrogenism and the altered ratio between Luteinizing Hormone and Follicle Stimulating Hormone. The present case report discusses the Ayurvedic management of altered Luteinizing Hormone - Follicle Stimulating Hormone ratio in a diagnosed case of Polycystic Ovarian Syndrome. The patient was diagnosed as having Ārtava Kṣaya with Mukhadūṣikā and was subjected to Ayurvedic management for 6 months commencing with Śodhana followed by Śamana. A remarkable improvement was obtained after the course of treatment.

Immune checkpoint inhibitor effects on male reproduction.

e16528 Background: Immune checkpoint inhibitors (ICI) have been shown to improve overall survival (OS) in patients with metastatic renal cell carcinoma (RCC) as compared to previous therapy with multi-kinase inhibitors (MKI). However, little is known about the effects of these drugs on male reproductive capacity and the current data regarding effects of MKI and ICI therapies on gonadal function and fertility are both limited and conflicting. We sought to evaluate effects of MKI and ICI on male reproductive function in patients with RCC. Methods: Male patients with RCC receiving MKI or ICI for a period of at least 3 months were identified. Inclusion criteria included age ≤ 50 years, no prior history of chemotherapy, and no prior history of medical or surgical conditions that would affect spermatogenesis such as hypogonadism, Klinefelter syndrome, or vasectomies. Patients were instructed to abstain from ejaculation 2 to 7 days prior to study collection. Follicle-stimulating hormone (FSH), luteinizing hormone (LH), morning testosterone, and a semen analysis was obtained for each patient and analyzed. Results: Of 10 patients, 5 (50%) were on ICI and 5 (50%) were on MKI. Of the patients on ICI, 2 (40%) exhibited abnormal semen morphology, motility, and sperm concentration. Of the patients on ICI, one exhibited elevated LH and FSH levels and one exhibited elevated LH levels only. Of the patients on MKI, 2 (40%) exhibited abnormal semen morphology, motility, and sperm concentration. One patient on MKI exhibited elevated LH and FSH levels. All patients had normal testosterone levels. Conclusions: Our preliminary descriptive data analysis suggests that both ICI and MKI may affect semen morphology and motility, sperm concentration, and LH and FSH levels, but does not affect testosterone levels. Due to the currently limited sample size, abnormal semen analysis and hormone levels may be attributable to confounding factors, such as performance status, the metastatic disease itself, comorbidities, etc. Study recruitment and analysis are ongoing.

Effect of methylphenidate on the onset of puberty and reproductive organ development in rats

Methylphenidate (MPH) is the first-line therapy for attention deficit hyperactivity disorder (ADHD) in children and adolescents. The aim of this study was to investigate the effects chronic MPH administration on reproductive parameters in both male and female pre-pubertal rats and reversibility of these effects. Sprague-Dawley rats were administered with 5 mg/kg MPH or saline orally from postnatal day (PND) 21 to PND60 and from PND21 to PND90. In addition, recovery groups from both sexes, in which MPH administration was stopped from PND60 to PND90 were included. Puberty onset, serum luteinizing hormone (LH), follicle stimulating hormone (FSH), testosterone and estradiol levels were determined. Histopathology of male and female reproductive organs was examined. Puberty onset was significantly early in the males (p<0.01), but late in females (p<0.05). In males, serum LH and FSH levels were similar. Testosterone levels tended to decrease in MPH-treated animals. Morphology of testes, epididymis and vas deferens was disrupted in MPH-treated animals, while it was improved in the recovery group. In females, estradiol levels decreased in MPH-treated group compared to controls, and elevated LH levels were detected in recovery group. Similar to the males, disruption in the reproductive organ histology was seen with morphological deterioration in basement membrane of the ovaries of MPH-treated groups. These adverse effects of MPH were recovered after drug cessation for 30 days. The present results demonstrate that MPH could affect the reproductive functions in both male and female rats. However, our findings also suggest that those effects are transient.

Identifying risk factors for polycystic ovary syndrome in women with epilepsy: A comprehensive analysis of 248 patients.

To assess the risk factors for polycystic ovary syndrome (PCOS) in women with epilepsy (WWE) and develop a practical approach for PCOS screening based on clinical characteristic, blood indicator, and anti-seizure medication (ASM) profiles. This cross-sectional study was conducted with 248 WWE who were consecutively enrolled from the Epilepsy Center of West China Hospital between April 2021 and March 2022. The epilepsy characteristics, blood indicators, and use of ASMs were compared between WWE with and without PCOS. Multivariate logistic regression was used to identify the factors independently associated with PCOS. The differential analysis showed that younger age at onset of epilepsy (<13 years), a history of birth hypoxia, obesity (BMI ≥25 kg/m2 ), use of levetiracetam (LEV) (≥1 year), higher levels of cholesterol, luteinizing hormone (LH) and anti-Müllerian hormone (AMH), and lower levels of sex hormone-binding globulin were associated with PCOS (p < .05). Multivariate logistic regression identified that obesity (BMI ≥25 kg/m2 ), use of LEV (≥1year), and higher levels of AMH and LH were independently associated with PCOS in WWE (p < .05). Obesity (BMI ≥25 kg/m2 ), LEV use (≥1year), and elevated AMH and LH levels suggest an increased in the probability of occurrence of PCOS in WWE. The combination of these profiles provides a practical approach for screening PCOS in WWE.

A study of hormonal and anthropometric parameters in polycystic ovarian syndrome.

Polycystic Ovarian Syndrome (PCOS) is an endocrinopathy with a complex metabolic disorder. PCOS is characterized by reproductive hormonal imbalances leading to the clinical presentation of hyperandrogenism and infertility. PCOS is also showing an increased prevalence of several other conditions such as obesity, dyslipidemia, hypertension, metabolic syndrome and type 2 diabetes mellitus (DM2) when compared with women without PCOS. The principal symptoms in patients with PCOS are irregular menstruation, acne, and excessive amounts of androgenic hormones. The Rotterdam PCOS consensus workshop has given specific criteria to establish PCOS diagnosis only after exclusion of other known disorders. Obesity is a common finding of women with PCOS, but it is not part of the diagnostic criteria. PCOS has metabolic characteristics that include prominent defects in insulin action and beta-cell function, defects that confer a substantially increased risk for obesity and type 2 diabetes mellitus. PCOS women have an increased level of luteinizing hormone (LH) and a decreased level of follicle-stimulating hormone (FSH), which leads to disorders in the regulation of the menstrual cycle. The values of LH and FSH are dependent on the day of the menstrual cycle in which the hormones are measured. Obesity also has an influence on these values. The objective of this study was to compare the hormonal and anthropometric parameters in women with PCOS and healthy control group. This study was carried out in the Department of Pathology, Dr. D Y Patil Medical College and Research Centre, Pune, Maharashtra. Fifty female patients aged 16-40 years diagnosed with PCOS by known criteria were included in the study and compared with 50 healthy control group females. Elevated levels of thyroid-stimulating hormone, LH, FSH, and prolactin along with increased body mass index and waist-to-hip ratio were predictors of PCOS and the early metabolic abnormalities.

Ultrasonographic Evaluation and Clinicobiochemical Association in Patients with Polycystic Ovarian Disease in a Tertiary Care Hospital: A Cross-sectional Study

Introduction: Polycystic Ovarian Syndrome (PCOS) is an endocrinological disorder characterised by a combination of polycystic ovarian morphology, diverse clinical features, and abnormal biochemical indices that affects women of reproductive age. Aim: To assess the sonographic appearance of ovaries and endometrium in clinically suspected cases of PCOS and to determine the association between the sonographic appearance of ovaries and endometrium with the clinical and hormonal profile of the patient. Materials and Methods: This cross-sectional study included 53 female patients in the reproductive age group (18-35 years) who were referred to the Department of Radiology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India for pelvic ultrasonography in clinical suspicion of PCOS from September 2020 to September 2022. All patients underwent transabdominal sonography, only married individuals with abdominal obesity underwent transvaginal ultrasonography. Complete biochemical hormonal analysis was performed. Association between volume, size of the ovary, number of follicles, and stromal thickness with hormones like Follicle Stimulating Hormone (FSH), Luteinising Hormone (LH), testosterone, prolactin, Thyroid Stimulating Hormone (TSH) was analysed. All continuous variables were expressed as mean±standard deviation and categorical variables as percentages. Chi-square test was used for statistical analysis. Results: The mean age was 25.60±4.09 years and the majority 26 (49.1%) were between 18 to 25 years and presented with menstrual abnormalities. Volume of ovary was ≥10 cc in 41 (93.18%) patients with LH &gt;6.7 IU/mL which was statistically significant (p=0.03) and LH/FSH ratio was &gt;2:1 in 30 patients of which 28 (93.3%) had ovarian volume ≥10 cc which was statistically significant (p=0.03). A number of follicles &gt;12 showed a significant association with LH (p=0.04), LH/FSH (p=0.01), testosterone (p=0.002). Stromal thickness also showed significant association with LH (p=0.018), LH/FSH (p=0.001), testosterone (p=0.04). Conclusion: Predominant patients with PCOS had enlarged ovaries with multiple (&gt;12), small-sized (&lt;9 mm) peripherally arranged follicles and low FSH and elevated LH, LH/FSH ratio, testosterone, TSH, and prolactin levels.

Associations of Serum Follicle-Stimulating Hormone and Luteinizing Hormone Levels with Fat and Lean Mass during Menopausal Transition

Introduction: The association of serum follicle-stimulating hormone (FSH) levels with body fat mass remains inconclusive. Furthermore, little was known about the association of luteinizing hormone (LH) with body fat. This study aimed to investigate the associations of serum FSH and LH levels with fat and lean mass in women during menopausal transition. Methods: The data analyzed in this study were derived from the National Health and Nutrition Examination Survey from 1999 to 2002. Women aged from 35 to 60 years were eligible. Serum FSH and LH levels were assayed using the microparticle enzyme immunoassay technology. A dual energy X-ray absorptiometry was used to measure body fat mass and lean mass. Fat mass index (FMI) and fat-free mass index (FFMI) were respectively used to assess fat and lean mass. General linear regression was employed to examine the associations of serum FSH and LH levels with FMI and FFMI. Results: This study included 1,329 women. For the total participants, elevated serum FSH and LH levels were associated with an increased FMI (β = 0.004 and 0.007; 95% CI: 0.002, 0.006 and 0.004, 0.010, respectively) and a decreased FFMI (β = −0.004 and −0.007; 95% CI: −0.006, −0.002 and −0.010, −0.004, respectively). Furthermore, the significant associations of serum FSH and LH levels with FMI and FFMI were fully observed in postmenopausal women, especially in a certain range of higher serum FSH and LH quartiles. Conclusion: Elevated serum FSH and LH levels were associated with increased body fat mass but decreased lean mass in postmenopausal women but not in premenopausal women. Furthermore, only higher serum FSH and LH percentiles were associated with fat and lean mass in postmenopausal women.

P-607 Basal serum luteinizing hormone and total testosterone levels do not impact the outcomes of in-vitro fertilization in women with polycystic ovarian syndrome (PCOS)

Abstract Study question Do basal serum luteinizing hormone (LH) and total testosterone (TT) levels affect the outcomes of patients with PCOS undergoing in vitro fertilization? Summary answer LH and TT does not impact number of mature oocytes, fertilization rates, and high-quality blastocysts frozen, in PCOS with GnRH-antagonist protocol IVF with hyper-responses. What is known already The impact of basal serum LH and TT levels on IVF outcomes is debatable. Worldwide, there are many clinics that will postpone ovarian stimulation until a lower basal LH or TT is obtained in women with PCOS based on the assumption that outcomes will subsequently be more successful. However, hormones are released in a pulsatile fashion and single levels are unlikely to reflect patient status. There is a paucity of research addressing this concern. Study design, size, duration We completed a single university-centre retrospective cohort study comparing the outcomes of PCOS patients undergoing freeze-all GnRH antagonist IVF cycles divided into 50% groupings for basal serum LH and TT levels between the dates of January, 2013 and December, 2019. There were 76 women identified and confirmed on chart review to have a diagnosis of PCOS per the 2003 Rotterdam criteria. Participants/materials, setting, methods Patients were divided into the 50% with the lowest LH levels(1.0-7.0 IU/L) and highest LH(7.1-29.0 IU/L). The same was done for TT(0.30-1.50 vs. 1.6-5.6 nmol/L). These two groups were compared using chi-square test and t-test as indicated. Demographics included: serum estradiol, follicle stimulating hormone, thyroid stimulating hormone, prolactin, TT, free testosterone, gravida, parity, female age, male age, semen analysis parameters, antral follicle count, and duration of infertility. IRB approval was obtained(2020-5971). Data is X±SD. Main results and the role of chance When assessing based on LH, there were no differences in demographics(P &amp;gt; 0.05 in all cases) except for TT(1.4±1.0 vs. 1.9±0.9 nmol/L-p=0.02) and free-testosterone(0.6±0.5 vs. 0.9±0.5 nmol/L-p=0.03). The number of oocytes collected(26.8±7.4 vs. 27.3±9.6-p=0.82), mature oocytes(19.9± 6.8 vs. 20.2±7.8-p=0.88), and frozen high-quality blastocysts(7.0±4.4 vs. 8.2±5.1-p=0.25) were similar. The percent of MII that fertilized(75%±16 vs. 74%±19-p=0.78), the percent of 2PN that grew to blastocysts(47%±23 vs. 55%±27-p=0.18) and the percent of MII that grew to blastocyst(35%±18 vs. 40%±19-p=0.25) were similar. Among subjects who underwent embryo transfer, clinical pregnancy rates(33% vs. 45%-p=0.36) and live birth rates(22% vs 32%-p=0.39) were similar when comparing lowest vs. highest percentile, respectively. When comparing demographics by TT grouping, differences were previous pregnancies(0.9±1.2 vs. 0.3±0.7-p=0.02), serum TSH(1.66±0.96 vs. 2.43±1.90 nmol/L-p=0.04), and duration of infertility(2.3±2.0 vs 3.7±2.7years-p=0.04). The number of oocytes collected(27.5±7.5 vs. 28.3±9.7-p=0.73), MII oocytes(20.5±6.9 vs. 20.4±8.3-p=0.98), and frozen high-quality blastocysts(6.9±4.0 vs. 8.1±5.7-p=0.32) were similar. The percent of MII that fertilized(73%±19 vs. 74%±17-p=0.96), the percent of 2PN that grew into blastocysts(48%±23 vs. 53%±28-p=0.50) and the percent of MII that grew to blastocyst(34%±17 vs. 38%±19-p=0.36) were similar. Among subjects undergoing embryo transfer, clinical pregnancy rates(46% vs. 44%-p=0.90) and live birth rates(38% vs 26%-p=0.33) were similar when comparing lowest vs. highest percentile respectively. Limitations, reasons for caution Our study was limited to GnRH-antagonist cycles with freeze all embryos. Thus, findings may not be applicable to IVF cycles with fresh embryo transfer. It is a retrospective study and therefore is at risk for inherent biases. Wider implications of the findings Our findings provide reassurance that elevated basal serum LH and TT levels do not impact IVF outcomes in hyper-responding patients and therefore should not result in cycle cancellation or delay in those with PCOS undergoing GnRH-antagonist cycles with anticipated hyper-responses. Trial registration number N/A

Quantitative Changes in White Blood Cells: Correlation with the Hallmarks of Polycystic Ovary Syndrome.

Background and Objectives: In women of reproductive age, leukocytosis is a risk factor that bridges low-grade chronic inflammation (metabolic inflammation), metabolic changes, and polycystic ovary syndrome (PCOS) and is a potential early predictor of PCOS. This study aims to explore the predictive role of quantitative changes in white blood cells (WBCs) and neutrophils in PCOS-associated metabolic changes. Materials and Methods: A total number of 176 blood samples were obtained from age-matched women of the reproductive period, comprising 88 PCOS cases and 88 healthy controls. Hematological, metabolic, and anthropometric indices and ultrasonic assessment were recorded. Results: Elevated levels of luteinizing hormone, testosterone, and lipid parameters except HDL-C levels, and the prevalence of metabolic syndrome in PCOS were statistically significant (p < 0.001). The neutrophil count and neutrophil–lymphocyte ratio (NLR) in PCOS patients were significantly higher (p < 0.001) than their counterparts. The predictive ability of the neutrophil count and neutrophil–lymphocyte ratio (NLR) for PCOS, and possibly its associating subclinical inflammation at optimum cut-off values for the neutrophil count and NLR of >46.62% (sensitivity 94.32% and specificity 74.42%) and >1.23 (sensitivity 71.59% and specificity 100%), respectively. With regard to the areas under the curve (AUC) and Youden indices, they constituted 0.922 and 0.697 for neutrophil count and 0.926 and 0.716 for NLR, respectively. The comparative ROC z-statistic value was 2.222 and a p = 0.026. The multiple linear regression analysis revealed no significant influence for hormonal and metabolic independent variables on the neutrophil count in PCOS cases, but, as can be expected, revealed a significant negative relationship with the other components of WBCs. Conclusion: In conclusion, relative neutrophilia and elevated NLR are potential cost-effective, sensitive, and specific predictors of PCOS that may also shed light on the mechanism of chronic low-grade inflammation that is characteristic of the disease.

The role of histamine in anterior pituitary secretion

Objectives: The aim of the present study was to determine the effects of histamine on the anterior pituitary secretion in rats. Materials and Methods: In the first experiments rats were injected with histamine 5 mg/kg i.p., and blood samples were collected to determine the effect of histamine on serum level of adrenocorticotropic hormone (ACTH), follicle-stimulating hormone (FSH), prolactin, FSH, and luteinizing hormone (LH) after 10, 20, and 30 min of histamine injection. In the second experiments, rats were treated with (H 1 blocker), chlorphenramine 10 mg/kg, i.p. or (H 2 blocker), cimetidine 80 mg/kg, i.p. respectively, and after 30 min they were injected with histamine and blood samples were taken 30 min after the injection of histamine to determine the same hormones. Results: Histamine significantly elevated serum ACTH and LH level, and these stimulatory effects were inhibited by both H1 and H2 receptor blockers. However, histamine significantly inhibited the serum level of thyroid-stimulating hormone and this inhibitory effect was blocked by H2 receptor blocker, while it showed no effect on the secretion of both prolactin and FSH, although H2 blocker significantly decreased prolactin level and H1 blocker significantly elevated FSH level. Conclusion: The results clearly indicated that histaminergic pathways were involved in the anterior pituitary secretion.

Does elevated luteinizing hormone level before trigger mean premature luteinizing hormone surge in advanced-aged women undergoing mild ovarian stimulation?

Objective To explore whether elevated luteinizing hormone (LH) level before trigger means premature LH surge in advanced aged women undergoing mild ovarian stimulation. Methods To retrospectively analyze 235 in vitro fertilization/intracytoplasmic sperm injection cycles in women >35 years old with the poor ovarian response (POR) from January 2012 to March 2016. Cycles are named Group 1, Group 2, and Group 3, being treated with gonadotropin-releasing hormone antagonist protocol (76 cycles), mild stimulation protocol using clomiphene citrate (73 cycles), and tamoxifen (86 cycles), respectively. Main outcome measure(s) The dynamic change of LH level during stimulation; the proportion of an elevated LH level defined as >10 IU/L on trigger day; the proportion of premature ovulation in each group. Results Serum LH level increased early in Group 2 and Group 3 and remained significantly higher than that in Group 1 during stimulation. In a sequence of three groups, the proportion of elevated LH levels before the trigger was 11.84, 43.8, and 37.21% (p＜.001) respectively. And the proportion of premature ovulation in patients with elevated LH levels was 11.11, 18.75, and 25% (p = .11) respectively. Conclusion Elevated LH level before trigger does not mean premature LH surge in women more than 35 years old with POR undergoing mild ovarian stimulation with clomiphene or tamoxifen.

An Ancient Practice but a New Paradigm: Personal Choice for the Age to Spay or Neuter a Dog.

Extensive practice and knowledge of the methods and effects of castration of male livestock and even humans has been widespread since ancient times, but only a few decades ago did neutering (including spaying) become a routine part of canine husbandry. In the US, the 6-month neuter became standard practice. Only recently, however, have some of the consequences of this major physiological alteration become evident. As the data-based study on 35 breeds reveals, there are major breed differences associated with effects of neutering, especially with early neutering, including increased risks of joint disorders and some cancers. The study of mixed-breed dogs reveals that the risk of joint disorders is increased in the large dogs. Implications of breed-specific and sex-specific effects for age of neutering have prompted the consideration of a new paradigm with regard to this practice. This involves focusing on each individual dog when deciding upon the appropriate age of neutering to avoid increasing the risk of a joint disorder or cancer above that inherent for the breed. For many breeds, particularly the smaller dogs, no effects were found for the age of neutering on joint disorders and the cancers followed. In these cases, the caregiver has a wide range of choice for neutering without increasing the dog's risk for these diseases. In the future, additional research may reveal more about other increased risks for age-related cognitive dysfunction or elevated levels of luteinizing hormone caused by gonad removal, and lead to revised guidelines.

The patterns and occupational distribution of hormonal abnormalities among men investigated for infertility in some centers in the southwest, Nigeria

Male factor infertility results from dysfunction at various levels of spermatogenesis, sex hormone abnormalities, and occupation or workplace exposure to toxins are involved. This study was designed to determine the frequency of occupational distribution of men who were evaluated for infertility, the patterns of hormonal abnormalities, and to associate hormonal abnormalities with occupational categories in some centers in Osun State, Nigeria. Semen and 5 mL of whole blood were collected from the infertile men (n=319) who were referred to the laboratories for fertility investigation after physical and medical examination. Semen analysis was performed microscopically according to the World Health Organization manual while serum gonadotrophin-releasing hormone (GnRH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone, and prolactin were determined by Enzyme-linked Immunosorbent assay technique using reagents supplied by Biorex Diagnostics Limited, Antrim, United Kingdom. The subjects were grouped based on semen characteristics. More than half 164 (51.4%) of the subjects were within the age group of 31-40 years, followed by 70 (21.9%) in the age group of 21-30 years, while 67 (21.0%) was in the age group of 41-50 years. Some 133/319 (41.7%) of the subjects had normal sex hormone levels while 186/319 (58.3%) had abnormal hormone levels. The patterns of hormonal abnormalities observed were 96/186 (51.6%) normogonadotrophin-hypogonadism, 49/186 (26.3%) normogonadotrophin-hypergonadism, 14/186 (7.5%) elevated FSH levels, 15/186 (8.1%) elevated LH levels, 07/186 (3.8%) hypergonadotropic-hypergonadism, and 05/186 (2.7%) hyperprolactinemia. Artisans (OR 1.2252 95%CI 0.367-2.472), workers in chemical related industries (OR 1.667, 95%CI 0.594-4.676), and businessmen (OR 1.200, 95%CI 0.110-3.49) are more likely to be predisposed to hormonal abnormalities. The patterns of hormone abnormalities as well as their relative proportions are slightly different from those reported previously. Some occupations may predispose workers to hormonal disorder than the others. This is a cross-sectional study of males investigated for infertility; the contribution and patterns of hormonal abnormalities were evaluated. The possible association between workplace and infertility that may assist in the management of patients with male infertility was evaluated.