Follicle-stimulating Hormone Ratio Research Articles

A comprehensive investigation on female Wistar rats examining the therapeutic potential of Pueraria tuberosa on letrozole-induced Polycystic ovarian syndrome

Background Polycystic ovarian syndrome (PCOS) stands out as the most prevalent endocrine disorder affecting women of reproductive age with 5–10% of women experiencing its effects. Historically known as Stein-Leventhal syndrome, its pathology involves various irregularities including heightened androgen levels, insulin resistance, diminished estrogen and progesterone levels, and irregular gonadotropin levels. However, the drugs commonly used to treat PCOS come with multiple side effects and limited efficacy in targeting the disorder’s underlying pathology. Indian kudzu tubers, specifically Pueraria tuberosa (Willd.) DC. tubers are a valuable source of phytoestrogens such as puerarin, daidzein, biochanin-A, and formononetin. Phytoestrogens are natural compounds derived from plants that stimulate estrogenic activity through estrogen receptors (ERα and ERβ), thereby increasing estrogen levels. Hence, the objective of this research was to assess the impact of the ethanolic extract obtained from Pueraria tuberosa (Willd.) DC. on the ovarian steroidogenesis pathway in a rat model with induced PCOS using letrozole. Objective To determine the hormonal parameters i.e. estrogen, testosterone, progesterone, follicle-stimulating hormone and luteinizing hormone level, as well as to evaluate body weight, ovarian weight, and histopathology of the ovary in female rats, we investigated a comprehensive investigation on female Wistar rats examining the therapeutic potential of Pueraria tuberosa on letrozole-induced PCOS. Materials and methods For this aim, animals were divided into six groups (n=6). Control group, untreated letrozole-induced PCOS group (1 mg/kg bwt) for 21 days, PCOS group treated with tuber extract of Pueraria tuberosa (Willd.) DC (100 200 and 400 mg/kg bwt) for 14 days, and PCOS group treated with clomiphene citrate (1 mg/kg bwt) for 14 days. Finally, body and ovarian weight, and hormonal assays (estrogen, testosterone, progesterone, follicle-stimulating hormone, and luteinizing hormone levels) were conducted. Histomorphometric ovarian evaluation of cystic follicles was determined. Results and conclusion The ethanolic extract of Pueraria tuberosa (Willd.) DC. tuber exhibited a significant enhancement in both body weight and ovarian weight when compared with the PCOS-induced group. It positively influenced hormonal levels by increasing estrogen and progesterone while decreasing testosterone levels. In addition, the extract normalized the ratio of follicle-stimulating hormone and luteinizing hormone levels and assessed histomorphometric changes, leading to a reduction in cystic follicles. In summary, the ethanolic extract derived from the tuber of Pueraria tuberosa (Willd.) DC. demonstrates the potential to alleviate certain symptoms associated with polycystic ovary syndrome. This positive impact is attributed to its components, including puerarin, daidzein, biochanin-A, and formononetin, which exhibit estrogenic and antiandrogenic effects. Notably, in this study, doses of 200–400 mg/kg of the extract were identified as the most effective, suggesting their promise as a potential therapeutic intervention for PCOS.

The state of erectile and reproductive functions in young men who have undergone COVID-19

Introduction. The negative consequences of the pandemic caused by the COVID-19 virus are being actively studied nowadays. It is known that the new coronavirus infection aggressively affects not only the organs of the respiratory system, but also the male reproductive system through binding to the ACE-2 receptor on the surface of cells of reproductive organs.The purpose of the study: to identify the impact of the virus on erectile and reproductive functions in young men of childbearing age 20–45 years who have undergone a new coronavirus infection.Material and methods. The study included 75 men of reproductive age 20–45 years who had undergone COVID-19. During the period of COVID-19 disease and 12 weeks after recovery, the study participants completed a questionnaire to assess erectile function "International Index of Erectile Function" (ICEF-5). The men underwent a blood test for hormones: luteinizing hormone (LH), follicle-stimulating hormone (FSH), the ratio of FSH to LH (FSH/ LH), testosterone total, prolactin, thyroid-stimulating hormone (TSH), T4 free, prostate specific antigen total (PSA total). The analysis of the ejaculate of 29 study participants was also carried out during the illness and 12 weeks after the recovery from COVID-19.Results. When processing the ICEF-5 questionnaire data, erectile dysfunction was detected in 81% of cases, p < 0,01 during the illness, after coronavirus infection, sexual disorders persisted in 44% of cases, p < 0,01. A study of the hormonal status in 80% of men during the COVID-19 disease revealed a significant decrease in the level of total testosterone, p < 0,01, which remained reduced in 64% of men 12 weeks after recovery, p < 0,01. According to the results of 29 spermograms, 42% of the study participants during the COVID-19 disease had oligospermia, p < 0,01, in 44% of cases oligozoospermia was noted, p<0,01. After recovery, there was a decrease in the volume of ejaculate, the concentration of spermatozoa remained in 17% of cases, p < 0,01.Conclusion. A new coronavirus infection negatively affects the erectile and reproductive functions in men who have undergone COVID-19.

Exploring Serum Vitamin D, Sex Hormones, and Lipid Profile Disparities in Women With and Without Polycystic Ovarian Syndrome: A Case-Control Study.

Background Polycystic ovarian syndrome (PCOS) is a common endocrine disorder affecting women of reproductive age. It is characterized by dyslipidemia, hormonal imbalances, and metabolic dysfunctions.Vitamin D deficiency may be implicated in the pathogenesis of PCOS, potentially exacerbating its metabolic syndrome. However, the exact interplay between these factors remains underexplored. Aim This study aimed to evaluate serum levels of vitamin D and its association with modalities of PCOS among women with PCOS and healthy controls. Methods This was a hospital-based case-control study where 60 women newly diagnosed with PCOS and 56 non-PCOS controls were consecutively recruited within a 10-month period. The women aged 20-40 were recruited at the gynecology clinics of Lagos State University Teaching Hospital and Lagos Island Maternity Hospital. PCOS was diagnosed using the Rotterdam's criteria. The biodata, anthropometry, clinical features, serum vitamin D, cortisol, progesterone, testosterone, estradiol, prolactin, anti-Mullerian hormone (AMH), thyroid-stimulating hormone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), insulin, fasting blood glucose (FBG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), and very-low-density lipoprotein cholesterol (VLDL-C) levels of PCOS-diagnosed women were assessed and compared with those of women without PCOS. The exclusion criteria comprised known diabetics, women with gynecological pathologies such as fibroids, and womenon medications affecting the study analytes or hormones. Statistical analyses included chi-square or Fisher's exact tests for categorical variables, student t-test for continuous variables, and Pearson's correlation for assessing relationships between continuous variables. The significance level was set at p<0.05 and a confidence interval of 95%. Results Individuals with PCOS exhibited a younger mean age (26.90±3.73 versus 29.95±5.00 years, p=0.001) and a higher prevalence of irregular menstrual patterns (46.7% versus 14.3%, p=0.0001) and acne (58.3% versus 37.5%, p=0.025). Moreover, PCOS was associated with elevated levels of TC (p = 0.03), TG (p = 0.03), LDL-C (p = 0.014), FBG (p = 0.001), LH:FSH ratio (p = 0.002), AMH (p = 0.0001), and testosterone (p = 0.003), but low progesterone (p = 0.001) and vitamin D (p = 0.033), alongside a higher incidence of vitamin D deficiency (33.3% versus 26.1%) and insufficiency (66.7% versus 56.5%). Additionally, significant but weak correlations were observed between serum vitamin D levels and waist-hip ratio (r = 0.4, p = 0.016) and FBG (r = -0.4, p = 0.036) in the PCOS group, suggesting potential metabolic implications. Conclusion The PCOS subjects in this study had decreased vitamin D and progesterone levels, with elevated concentrations of testosterone, AMH, lipid profile (TC, LDL, and TG), FBG, and LH:FSHratio. Studies on the therapeutic effect of vitamin D administration in managing PCOS will need to be further evaluated.

Predictive Analysis and Discerning of Polycystic Ovary Syndrome in Women using Machine Learning Computations

This paper focuses on the data-driven diagnosis of polycystic ovary syndrome (PCOS) in women. For this, machine learning algorithms are applied to a dataset freely available in Kaggle repository. This dataset has 43 attributes of 541 women, among which 177 are patients of PCOS disease. Firstly, univariate feature selection algorithm is applied to find the best features that can predict PCOS. The ranking of the attributes is computed and it is found that the most important attribute is the ratio of Follicle stimulating hormone (FSH) and Luteinizing hormone (LH), Next, holdout and cross validation methods are applied to the dataset to separate the training and testing data. A number of classifiers such as gradient boosting, random forest, logistic regression, and hybrid random forest and logistic regression (RFLR) are applied to the attributed are good enough to predict the PCOS disease

Irisin combined index to diagnose central precocious puberty in girls: a cross-sectional study

BackgroundTo investigate serum irisin levels in girls at different developmental status and explore the significance of irisin for the diagnosis of central precocious puberty (CPP) in girls.MethodsIn this cross-sectional study 111 girls were enrolled, including 43 cases of CPP, 44 cases of peripheral precocious puberty (PPP) and 24 cases of girls with normal sexual development as controls. The data on age, weight and height, measured blood levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol, and irisin were collected. Pelvic Doppler ultrasound was performed to evaluate uterine length, transverse diameter, anteroposterior diameter. The girls were divided into non-CPP group and CPP group according to gonadotropin-releasing hormone (GnRH) stimulation test.ResultsSerum irisin levels were significantly higher in CPP group than in PPP group and normal control group. Serum irisin level was positively correlated with basal LH level, basal FSH level, peak LH level, peak LH /FSH ratio, uterine volume, bone age, and bone age index. The area under the curve, cut-off value, sensitivity and specificity of serum irisin were 0.958, 219.255 pg/ml, 100% and 80.6%. The combined diagnosis of CPP in girls by serum irisin and serum basal LH combined with uterine volume had an AUC, sensitivity, and specificity of 0.994, 97.6%, and 100%, superior to that of the single index.ConclusionsSerum irisin level in girls with CPP is significantly increased. An irisin combined index could help the diagnosis of CPP in girls.

Dehydroepiandrosterone with a high-fat diet treatment at inducing polycystic ovary syndrome in rat model

ObjectiveThis study aimed to evaluate the effects of dehydroepiandrosterone (DHEA) and DHEA combined with a high-fat diet (HFD) treatment of reproductive and endocrine metabolism in rats and then identify an ideal model of polycystic ovary syndrome (PCOS). MethodsThree-week-old female Sprague–Dawley rats were injected subcutaneously with DHEA or oil, fed with or without a HFD, for 21 days, during which body weight, feed intake, and estrous cycle monitoring were carried out. Fasting blood glucose was measured, and serum fasting insulin, testosterone, dihydrotestosterone (DHT), estradiol, progesterone, luteinizing hormone (LH), anti-Müllerian hormone (AMH), and follicle-stimulating hormone (FSH) were estimated by ELISA. Serum total cholesterol (TC), total triglycerides (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were measured by colorimetric assay. Whereas, histologic changes in rat ovaries were evaluated by H&E staining. Ovarian steroid hormone synthases and their protein levels (StAR, 3β-HSD2, 17β-HSD1, CYP11A1, CYP17A1, and CYP19A1) were examined by Western blotting. ResultsBoth DHEA and DHEA + HFD-treated rats lost a regular estrous cycle; had polycystic ovarian changes, significantly higher serum fasting insulin and testosterone levels; and increased ovarian StAR, 3β-HSD2, and CYP11A1 protein levels. Additionally, rats in the DHEA + HFD-treated group were obese; had elevated fasting blood glucose, TG, DHT, AMH levels and LH:FSH ratios; increased ovarian 17β-HSD1 protein levels. ConclusionDHEA combined with HFD treatment is more effective at inducing PCOS than DHEA alone. The reproductive and endocrine metabolic aspects of this method are more consistent with the clinical characteristics of PCOS patients.

SAT385 Pituitary Immune Cells Regulate Gonadotrope Hormone Secretion

Abstract Disclosure: Z. Del Mundo: None. T. Nguyen: None. N. Ujagar: None. D. Nicholas: None. Polycystic ovary syndrome (PCOS) is one of the most common causes of female infertility in the US and is associated with a combination of reproductive neuroendocrine physiological changes. Previous studies have shown that PCOS patients have elevated serum C reactive peptide and lipopolysaccharide (LPS), which indicates chronic low-grade inflammation. However, it is unknown how inflammation or immune cells impact reproductive outcomes. In this project, I study how inflammation affects gonadotrope regulation of sex hormone secretion. I show that in vitro depletion of immune cells from dispersed primary mouse pituitary increases the luteinizing hormone (LH) to follicle-stimulating hormone (FSH) ratio. In contrast, immune activation through chronic LPS exposure in mice results in decreased serum LH to FSH ratio. Using single-cell RNA sequencing data from immune cell-enriched mouse pituitaries, I identified specific resident immune cell populations. These cell populations include macrophages with higher RNA expression of heat shock proteins in male mice compared to female mice suggesting inflammatory protection in males. Ongoing experiments include chronic LPS exposure in mice, where pituitary cells are immunophenotyped, sex hormone serum levels measured, and ovulation monitored. Ultimately this work will allow us to understand the contribution of inflammation to PCOS, with the hope of designing immunotherapy for PCOS. Presentation Date: Saturday, June 17, 2023

Diagnostic Role of Anti-Mullerian hormone in Polycystic Ovarian Syndrome

Objective: To evaluate if the elevated levels of Anti-Mullerian hormone (AMH) could serve as an indicator of polycystic ovarian syndrome (PCOS) in patients presenting with infertility. Method: The present study was conducted at Institute of Molecular Biology and Biotechnology, The University ofLahore andAustralianConceptInfertilityMedicalCenter(ACIMC),Lahore. It was a case control study. Atotal of 101 females aged between 20-40 years presenting with infertility were included in this study. Among study participants, 51 infertile females had PCOS and 50 were non-PCOS infertile subjects. After taking informed consent, medical history and anthropometric indices were recorded on standardized proforma.Transvaginal ultrasound was done to assess ovarian morphology. Serum AMH, follicle stimulating hormone (FSH), luteinizing hormone (LH), thyroid stimulating hormone (TSH) and prolactin levels were measured by commercially available ELISAkits. Serum AMH levels were measured in 10 healthy, fertile females having normal menstrual cycle as normal reference values in our population. Results: Mean AMH levels were significantly higher (9.9±1.1ng/ml) in females with polycystic ovarian syndrome as compared to subjects without this syndrome (1.0± 0.3ng/ml). Mean FSH levels were significantly lower in females with PCOS (p value 0.001) but LH: FSH ratio, serum luteinizing hormone and prolactin level were not significantly different in two groups. Conclusion: The study provides evidence that raised serum levels of AMH are associated with the presence of PCOS and therefore can serve as useful marker in diagnosis of PCOS

Follicle-stimulating hormone is negatively associated with nonalcoholic fatty liver disease in a Chinese elderly population: a retrospective observational study

BackgroundSeveral studies have explored the connection between follicle-stimulating hormone (FSH) and nonalcoholic fatty liver disease (NAFLD). However, the impact of FSH elevation on NAFLD remains a topic of debate. Hence, this investigation aimed to evaluate the potential correlation between FSH levels and NAFLD in the aging population.MethodsThis was a retrospective observational cross-sectional study between July 2017 and August 2018 in our hospital. We used data obtained from 455 patients over 60 years old. Anthropometrics and laboratory tests were performed for each patient. NAFLD was diagnosed by sonographic features and the fatty liver index (LFI).ResultsOf the 455 patients, 200 (43.96%) had NAFLD on their ultrasound and 169 (37.14%) had NAFLD according to the LFI. An intraclass correlation coefficient of the two methods was 80.4% (P < 0.001). People with NAFLD on their ultrasound showed lower FSH levels (52.68 vs. 61.39 IU/L) and more unfavorable metabolic profiles. FSH was negatively correlated with age, alanine aminotransferase, estradiol, testosterone, systolic blood pressure, waist, body mass index, fasting blood glucose, postload plasma glucose and positive associated with total cholesterol, high-density lipoprotein-cholesterol and low-density lipoprotein-cholesterol by Spearman correlation analysis (all P < 0.05). By controlling for all confounding factors, the odds ratios (OR) of FSH for NAFLD were determined in elderly individuals, both men and women, aged 60–70 years and over 70 years. These ORs were found to be 0.937, 0.982, 0.983, and 0.973, respectively, with corresponding 95% confidence intervals (CI) of 0.892–0.984 (P = 0.009), 0.971–0.993 (P = 0.002), 0.967–0.999 (P = 0.033), and 0.958–0.989 (P = 0.001). In addition, our findings demonstrated no significant correlation between FSH and advanced fibrosis when adjusting for potential covariates. The OR for advanced fibrosis was 0.979 (95% CI, 0.938–1.022, P = 0.339). Additionally, ROC curve analysis showed an optimal cut-off value of 66.91 for women and 15.25 for men for NAFLD diagnosis.ConclusionsThere was an inverse relationship observed between levels of FSH in the blood serum and NAFLD in the elderly population. These findings suggest that reduced FSH levels might serve as a potential risk factor or biomarker for NAFLD in the elderly.

The utilization of basal luteinizing hormone in combination with the basal luteinizing hormone and follicle-stimulating hormone ratio as a diagnostic tool for central precocious puberty in girls.

Intravenous gonadotropin-releasing hormone (IV GnRH) testing is the gold standard for confirming a central precocious puberty (CPP) diagnosis. However, this test is not widely available commercially. Therefore, our study aim was to establish cutoff values for basal gonadotropin level and gonadotrophin responses to a 100-μg subcutaneous IV GnRH test that can distinguish between CPP and premature thelarche (PT) to discover a simple method to detect CPP. Girls between the ages of 6 and 8 years who attended the pediatric endocrinology outpatient clinic at our tertiary hospital between 2019 and 2022 were included in this study. They were evaluated for breast development, and a subcutaneous 100-μg GnRH test was administered by measuring the luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels in blood samples at baseline and then 30, 60, 90, and 120 minutes after injection. CPP is characterized by increased height velocity, advanced bone age, and progression of breast development. The cutoff value for diagnosis of CPP was determined using a receiver operating characteristic (ROC) analysis. In 86 Thai girls (56 with CPP and 30 with PT), the ROC analysis showed 71.4% and 100% sensitivity and specificity, respectively, for basal LH (cutoff ≥ 0.2 IU/L) plus the basal LH/FSH ratio (cutoff ≥ 0.1). The optimal cutoff values for peak LH (cutoff ≥ 7 IU/L) demonstrated a sensitivity of 94.6% and a specificity of 100%, whereas the LH value at 30 and 60 minutes after injection (cutoff ≥ 6 IU/L) demonstrated sensitivities of 92.9% and 94.6% and a specificity of 100%, respectively. Combining the basal LH (cutoff: 0.2 IU/L) and the basal LH/FSH ratio (cutoff: 0.1) can easily and cost-effectively diagnose CPP in a girl in breast Tanner stage II.

Effect of vitamin D supplementation on hormones and menstrual cycle regularization in polycystic ovary syndrome women: A systemic review and meta-analysis.

Polycystic ovary syndrome (PCOS) is a prevalent endocrine disease among women of childbearing age. Women with PCOS frequently experience reproductive complications, which are closely associated with the concentration of vitamin D. This systemic review and meta-analysis were conducted to elucidate the possible effect of vitamin D supplementation in PCOS women on hormones, including Luteinizing hormone (LH), follicle-stimulating hormone (FSH), the ratio of LH and FSH (LH/FSH), and the menstrual cycle regularization. We searched PubMed, Web of Science, Ovid MEDLINE, Cochrane Library, and EMBASE for the relevant articles published up to January 2022. The pooled estimates were calculated using RevMan 5.4 software. Twelve studies involving 849 PCOS patients were included. Our study indicated that vitamin D supplementation could reduce serum LH (standard mean difference [SMD]: -0.41; 95% confidence interval [CI]: -0.54, -0.28; p < 0.01). Subgroup analysis identified that the supplementation of vitamin D ≤4000 IU/day (SMD: -0.69; 95% CI: -1.15, -0.23; p < 0.01), treatment time ≤8 weeks (SMD: -0.61; 95% CI: -0.95, -0.26; p < 0.01), and vitamin D co-supplementation (SMD: -0.37; 95% CI: -0.65, -0.10; p < 0.01) were related to reduce serum LH level. In addition, vitamin D supplementation improved the regularity of menstrual cycle significantly (risk ratio [RR]: 1.35; 95% CI: 1.18, 1.54; p < 0.01). In stratified analysis, the significant effects only existed in dosage of vitamin D >4000 IU (RR: 1.62; 95% CI: 1.02, 2.57; p < 0.01), treatment time >8 weeks (RR: 1.41; 95% CI: 1.06, 1.87; p = 0.02) and vitamin D co-supplementation (RR: 1.18; 95% CI: 1.03, 1.35; p = 0.02). However, vitamin D might have no effects on serum FSH (SMD: -0.05; 95% CI: -0.42, 0.32; p = 0.79) and LH/FSH (SMD: -0.24; 95% CI: -0.55, 0.08; p = 0.14) in PCOS patients. Evidence from the existing randomized controlled trials indicated that vitamin D supplementation might improve the LH level and the menstrual cycle regularization but did not have any effect on FSH and LH/FSH levels in PCOS patients.

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.

Pituitary immune cells regulate gonadotrope hormone secretion

Abstract Polycystic ovary syndrome (PCOS) is one of the most common causes of female infertility in the US and is associated with a combination of reproductive neuroendocrine physiological changes. Previous studies have shown that PCOS patients have elevated serum C reactive peptide and lipopolysaccharide (LPS), which indicates chronic low-grade inflammation. However, it is unknown how inflammation or immune cells impact reproductive outcomes. In this project, I study how inflammation affects gonadotrope regulation of sex hormone secretion. I show that in vitro depletion of CD45+ cells from dispersed primary mouse pituitary increases the luteinizing hormone (LH) to follicle-stimulating hormone (FSH) ratio. In contrast, immune activation through chronic LPS exposure in mice results in decreased serum LH to FSH ratio. Using single-cell RNA sequencing data from CD45+ enriched cells from mouse pituitaries, I identified specific resident immune cells. These cell populations include macrophages with higher RNA expression of heat shock proteins in male mice compared to female mice suggesting inflammatory protection in males. Ongoing experiments include chronic LPS exposure in mice, where pituitary cells are immunophenotyped, sex hormone serum levels measured, and ovulation monitored. Ultimately this work will allow us to understand the contribution of inflammation to PCOS, with the hope of designing immunotherapy for PCOS. NICHD R00 HD098330-03

Diagnostic Performance of Anti-Müllerian Hormone, Luteinizing Hormone to Follicle-Stimulating Hormone Ratio, Testosterone, and Prolactin to Predict Polycystic Ovary Syndrome Among Sudanese Women.

Polycystic ovary syndrome (PCOS) is one of the most important contributing factors to infertility. The diagnosis of PCOS is not an easy procedure, as the signs and symptoms are heterogeneous and of undefined etiology. There are only a few published studies that address the diagnostic performance of anti-Müllerian hormone in diagnosis of PCOS in sub-Saharan Africa including Sudan. This study aims to assess anti-Müllerian hormone (AMH), luteinizing to follicle-stimulating hormone ratio (LH: FSH), total testosterone (TT), and prolactin (PRL) levels among PCOS. In addition, we determine if AMH can be used as a predictor of PCOS among Sudanese women. There were 600 women enrolled in this observational cross-sectional study, 300 of whom had PCOS, and 300 of whom healthy women; PCOS was diagnosed using the Rotterdam criteria. On days 2-4 of the menstrual cycle, serum LH, FSH, AMH, TT, and PRL levels were measured for all participants. Diagnostic performance of these parameters for PCOS was determined by receiver operating characteristic (ROC) curve. Significantly higher means among PCOS regarding their BMI, AMH; LH: FSH ratio; TT; PRL, whereas significantly inverse in FSH compared with normal ovulatory women. On ROC analysis, AMH had the largest operating characteristic curve at cut-off >3.95 ng/mL; AUC = 0.999 with Youden's index 0.99%, followed by LH: FSH ratio at cut-off 0.749; AUC=0.932; Youden's index 0.813%, TT cut-off 0.82 mIU/L, AUC=0.852 with Youden's index 0.58, while PRL showed the lowest AUC=0.627 with cut-off 15.3 ng/mL, Youden's index was 0.18%, P. value<0.001. Sudanese women with PCOS had higher serum AMH level, LH:FSH ratio, and TT level. Moreover, AMH level has better discriminative power and good diagnostic potency for the diagnosis of PCOS among Sudanese.

Observing the Use of Insulin Sensitizers for Ovulation Induction among PCOS Women

Introduction: In women of reproductive age, PCOS is a prevalent endocrine illness characterized by irregular menstrual cycles, many tiny ovarian cysts, and high levels of androgens. Insulin resistance is one of the leading causes of PCOS. Insulin sensitizers can help increase cells' sensitivity to insulin, allowing them to respond more effectively to insulin and transport glucose into the cells. Aim of the Study: The study's objective was to evaluate how PCOS women used insulin sensitizer as an ovulation inducer. Methods: This was a prospective, observational, cross-sectional research at the Manikganj 250 Bedded Sadar hospital, Dhaka, Bangladesh. The study duration was 1 year, from January 2022 to December 2022. During this period, 100 patients with PCOS were selected following the inclusion and exclusion criteria for their participation in this study. Result: The study population consisted of young individuals with a mean age of 24.91 years, a moderate-to-high body mass index of 26.79 kg/m2, a moderate waist-to-hip ratio of 0.82, high fasting insulin level of 21.00 µIU/mL, high insulin area under the curve (AUC) of 308.32, moderate luteinizing hormone (LH) level of 10.90 mIU/mL, moderate follicle-stimulating hormone (FSH) level of 5.43 mIU/mL, a high LH:FSH ratio of 2.02, and moderate free testosterone level of 2.72 pg/mL. After 4 months of treatment with metformin, 80% of the participants had ovulation induction, with 33% having at least one ovulation, 25% having 2 ovulations, and 6% having 4 ovulations. After continuous treatment with metformin for 16 weeks, the study population had a mean body mass index of 26.22 kg/m2, a moderate waist-to-hip ratio of 0.81, low fasting insulin level of 10.55 µIU/mL, low insulin area under the curve (AUC) of 183.00, low to moderate luteinizing hormone (LH) level of 5.32 mIU/mL, moderate follicle- stimulating hormone (FSH) level of 4.80 mIU/mL, a low LH:FSH ratio of 1.10, and low free testosterone level of 1.33 pg/mL. .....

The predictive value of preoperative luteinizing hormone to follicle stimulating hormone ratio for ovulation abnormalities recovery after laparoscopic sleeve gastrectomy: A prospective cohort study.

Obesity-related ovulation abnormalities (OA) affect fertility. LSG is the most frequent bariatric operation. However, no research has identified a reliable indicator for predicting OA recovery after LSG. The purpose of this research was to examine the prognostic usefulness of preoperative the luteinizing hormone (LH) to follicle-stimulating hormone (FSH) ratio (LFR). Our department conducted a prospective study from 2016 to 2021. Venous blood was typically tested 3 days before surgery to get the preoperative LFR. Descriptive data, preoperative and postoperative variables were also collected. Binary logistic regression related preoperative LFR with OA recovery. The receiver operating characteristic (ROC) curve evulated preoperative LFR's predictive capability. A total of 157 women with a complete follow-up of one year were included. LFR was the only factor linked with OA (P < 0.001). AUC (area under the ROC curve) = 0.915, cutoff = 1.782, sensitivity = 0.93, and specificity = 0.82. Overall, LSG has a favorable surgical result, with a %TWL of 66.082 ± 12.012 at 12 months postoperatively. Preoperative sexual hormone levels, as expressed by LFR, has the potential to predict the fate of OA following LSG at one year post-operatively.

Прогнозування перебігу гіпоандрогенії в хлопців-підлітків

The most pathological conditions that adversely affect the reproductive function in men of mature age is formed precisely in adolescence as a result from hypoandrogenism (HA), - a decrease in the production of male sex hormones (androgens) below the age norm. Therefore, the ability to predict the course of HA in adolescent boys allows to prevent serious health problems in the future. Purpose - to determine significant prognostic criteria for adverse course of HA in adolescent boys with delayed sexual development. Materials and methods. Were examined 157 boys 14-17 years old with signs of androgen deficiency, the degree of which was based on the assessment of total testosterone (TT). The levels of gonadotropic hormones, estradiol, their ratios were studied by enzyme-linked immunosorbent assay, and the content of thyroid-stimulating hormone and free thyroxine, their ratio was determined. The lipid spectrum of blood was studied. On the basis of X-rays of the non-dominant hand and wrist determined bone age and ossification deficiency. Сonditionally unfavorable course of HA was formed in adolescent boys with severe androgen deficiency (HA 3 degree) at the level of total testosterone &lt;4 nmol/l. Favorable course of HA was considered to be the presence of clinical signs of hypoandrogenism in adolescents with normal TT, levels more than 12 nmol/l (HA 0 degree). Results. Based on the study was identified the most informative features and calculated their prognostic coefficient. It is proved that significant informative signs of HA in adolescent boys are such as body mass index abnormalities, bone age deficit, levels and ratios of gonadotropic hormones, estradiol values and testosterone / estradiol, testosterone / luteinizing hormone ratios, thyroid stimulating hormone / free thyroxine, changes in lipid profile. To the most prognostically significant negative prognostic criteria for adverse HA in adolescent boys are excess body weight by body mass index level, significant deficit of bone age (more than 3 years), decreased luteinizing hormone levels, decreased luteinizing hormone / follicle stimulating hormone ratio, hyperestrogenism, pronounced androgenic-estrogenic disbalance, the presence of minimal thyroid dysfunction, disorders of the lipid profile. Conclusions. The developed prognostic criteria for adolescent boys with HA will make it possible to predict the further course of the disease (in the early stages of its formation pathology), what will carry out timely treatment and rehabilitation measures in adolescent boys, and this will help to improve their health. Teens with HA, who show prognostically unfavorable signs, need more careful dispensary observation of an endocrinologist. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

Efficacy of a Proprietary Fenugreek Seed Extract (Trigonella foenum-graecum, Furocyst®) in Women with Polycystic Ovary Syndrome (PCOS): a Randomized, Double-Blind, Placebo-Controlled Study

Introduction Polycystic ovary syndrome (PCOS) is characterized by hyperandrogenemia, a quite common heterogenous endocrine/hormonal disorder, and accompanied by elevated androgen level, menstrual irregularity, and hirsutism. The consequences include infertility or miscarriage. It is a challenging problem to the physicians. In a one-arm, non-randomized preliminary investigation in fifty premenopausal women, we demonstrated the efficacy of Furocyst®, a patented, standardized Trigonella foenum-graecum extract, in ameliorating the symptoms of PCOS over a period of 90 consecutive days. Objective In the present study, a double-blind, two-arm, single-center, randomized, comparative study was conducted to assess the efficacy of Furocyst® (2 capsules of 500 mg/day) in 208 pre-menopausal women diagnosed with PCOS. Methods Ethical committee approval was obtained. A total of 208 subjects (placebo = 95; Furocyst® = 113; age:18-45 years, BMI < 42 kg/m2) completed the investigation. The comparative efficacy of placebo and Furocyst® was assessed on the number of cysts, ovarian volume, hirsutism, LH:FSH ratio, titer of TSH, SHBG, prolactin and free testosterone. Key clinical parameters such as fasting blood glucose levels, HOMA Index, cholesterol, LDL, and triglyceride levels, as well as total blood chemistry were also investigated Results Furocyst® supplementation significantly reduced the number of cysts, ovarian volume, and hirsutism levels, as well as normalized the menstrual cycle in Furocyst®-treated subjects as compared to placebo group. Furocyst® significantly reduced luteinizing hormone (LH) and follicle stimulating hormone (FSH) levels, and thyroid stimulating hormone (TSH) levels, and reduced the prolactin and SHBG levels. Furocyst® significantly reduced the fasting blood glucose levels, HOMA Index, cholesterol, LDL, and triglyceride levels as compared to the placebo group, while the free testosterone levels were significantly decreased in the Furocyst® group. Conclusion The studies collectively demonstrated the efficacy of Furocyst® as a safe, natural phytochemical-based formulation to alleviate the symptoms of PCOS. No significant adverse events were observed.

Polycystic Ovary Syndrome Phenotype D Versus Functional Hypothalamic Amenorrhea With Polycystic Ovarian Morphology: A Retrospective Study About a Frequent Differential Diagnosis

The two most frequent causes of secondary amenorrhea are polycystic ovary syndrome (PCOS) and functional hypothalamic amenorrhea (FHA). Despite several studies showing differences in hormonal profile between these groups, the differential diagnosis remains challenging, in particular between FHA women with polycystic ovarian morphology (FHA-PCOM) and PCOS patients without hyperandrogenism (phenotype D, PCOS-D). In a retrospective case-control study, 58 clearly defined patients with FHA-PCOM were compared to 58 PCOS-D patients, matched 1:1 for age and BMI. Significantly higher levels of LH, estradiol, testosterone, and a higher luteinizing hormone (LH): follicle stimulating hormone (FSH) ratio as well as lower sexual hormone binding globulin (SHBG) levels were found in PCOS-D patients (p< 0.05). Optimized cut-off values for the prediction of FHA-PCOM were calculated by the Youden index. The highest sensitivity was found for an estradiol serum level <37.5 pg/mL (84.5%, 95% confidence interval, CI: 72.6-92.6), whereas a LH : FSH ratio <0.96 had the highest specificity (94.8, 95% CI: 85.6-98.9). A linear discriminant analysis including testosterone, SHBG and LH was able to correctly classify 87.9% of FHA-PCOM patients (bootstrap 95% CI: 80.2 - 94.0%). In conclusion, this model including serological parameters could be an easy and reliable tool to distinguish between FHA-PCOM and PCOS-D patients, especially in situations where the clinical profile is not obvious.

Testosterone level correlates significantly with luteinizing hormone to follicle-stimulating hormone ratio among women with polycystic ovary syndrome: A cross sectional study

Background: Polycystic ovary syndrome (PCOS), an endocrinological problem among women in the reproductive age, is characterized by chronic ovulatory dysfunction, hyperandrogenism, and elevated luteinizing hormone: follicle stimulating hormone (LH-FSH) ratio. The goal of this study was to examine if the blood LH-FSH ratio and total testosterone (TT) levels in Sudanese women with PCOS were linked. Methods: This cross-sectional study included 300 women with confirmed PCOS based on Rotterdam criteria. PCOS women mean (standard deviation): age 29.1(5.8) years; body mass index (BMI) 27.9±4.6 kg/m2. Each participant underwent a clinical history, physical examination, and ovaries ultrasonogram. ASYS Expert Plus Microplate was used to quantify serum LH, FSH, and TT levels in fasting blood specimen drawn during the follicular phase of the menstrual cycle of women with PCOS. Results: More than two-thirds of the participants (71.0%) had an aberrant LH-FSH ratio (cut-off&gt;1.0), and 58.3% had hyperandrogenemia (TT&gt;109.5 ng/dL). Hyperandrogenemic women had significantly increased LH-FSH ratio (P= 0.000). The LH-FSH ratio and serum TT were significantly positive correlated (r= 0.329, P= 0.000). Overall, 52.0% of women with PCOS exhibited menstrual cycle irregularity, and 59.0 % had a positive family history of PCOS. On logistic regression analysis, the LH-FSH ratio (odds ratio (OR) (95% confidence interval (CI)): 2.308 (1.698- 3.139, P= 0.000) was found to be positively related to hyperandrogenemia independently. Furthermore, when the LH-FSH ratio is greater than one, hyperandrogenemia can be distinguished from normoandrogenemia, area under the curve (AUC) = 0.726, P= 0.000, 95% CI: (0.668-0.785) with a serum TT threshold of 109.5 ng/dL (sensitivity 70.0%, specificity 77.1%). Conclusions: In Sudanese women with PCOS, the serum LH-FSH ratio and TT have a strong relationship. Furthermore, LH-FSH ratio of greater than one can be used to distinguish between hyperandrogenic and non-hyperandrogenic PCOS women.