Follicular Stimulating Hormone Research Articles

Testes and Testicular Disorders

The testes begin to function in utero and continue to function into senescence, with the major roles of testosterone secretion and sperm production. This review discusses how testicular function can be affected by diseases of the hypothalamus and pituitary, as well as by diseases of the testes themselves. These diseases may be either congenital or acquired. The clinical manifestation, history and physical examination, laboratory studies, diagnoses, and treatment of these diseases, as well as other conditions, including gynecomastia and erectile dysfunction, are discussed. Specific therapies, such as the off-label use of tamoxifen (gynecomastia) and the various oral phosphodiesterase inhibitors (for erectile dysfunction), are also covered. This review contains 2 figures, 21 tables, and 51 references. Keywords: Testes, hypogonadism, erectile dysfunction, gynecomastia, dihydrotestosterone, gonadotropine, luteinizing hormone, follicular-stimulating hormone

Application of element-tagged immunoassay combined with inductively coupled plasma mass spectrometry in HCG detection

Objective To establish an inductively coupled plasma mass spectrometry (ICP-MS) based immunoassay method for the quantitative detection of human chorionic gonadotropin (HCG), and evaluate the clinical applicability of this method. Methods Sm was selected as element tags, and the HCG quantitative detection system was established by double antibody sandwich method. The dosage of biotinylated antibody and reaction time were optimized. According to EP documents of Clinical and Laboratory Standards Institute (CLSI) and related standards, the analytical performance was evaluated after the establishment of the assay, including the limit of blank (LOB), linearity, precision, recovery, cross reactivity and interference test. And 88 clinical samples were measured using the new method compared to the electrochemical immunoassay (ECLIA) method. Results Total process completed within 30 min after optimization, and the optimal biotinylated antibody dosage was 0.5 μl. The LOB was 0.29 mIU/ml. The linearity was good within the range of 1.16-8 365.62 mIU/ml with the linear correlation coefficient greater than 0.995 (R2=0.998 0), the recovery was 97.53%-102.01%. Both intra-and inter-assay coefficients of variation of the high-value sample and the low-value sample were less than 10%. And there was no significant cross-reaction with Luteinizing hormone (LH), follicular stimulating hormone (FSH), and thyroid-stimulating hormone (TSH). The interference bias caused by different concentrations of interference substances was less than 10%. When compared with the ECLIA method for clinical sample detection, the proposed method showed a significant correlation(R2=0.960 0). Conclusion The proposed ICP-MS base immunoassay for HCG detection has good accuracy, high sensitivity and specificity, and the results of analytical performance verification meet the clinical requirements, which provides experimental basis for the clinical application of this method. Key words: Chorionic gonadotropin; Immunoassay; Spectrophotometry, atomic; Mass spectrometry

Reproductive management of the transitional mare

The mare is a seasonally polyoestrous long-day breeder with a physiological breeding season lasting from April–October in the Northern Hemisphere. The hypothalamic-pituitary-gonadal axis in the mare is subject to a circannual endogenous rhythm that is primarily regulated by day length. Increasing ambient photoperiod in the spring alters the pattern of melatonin secretion. The resulting stimulation of hypothalamic gonadotropin-releasing hormone secretion triggers pituitary follicular stimulating hormone release and follicular growth. Exposure of mares in deep anoestrus to a stimulatory photoperiod remains the most successful method of advancing the first ovulation of the season. The most commonly used lighting regimen is providing a fixed length of 15–16 hours of light exposure and 8–9 hours of dark, with a minimum light intensity in a stable of 100-lux (100–200 watt incandescent bulb). Other methods include using an additional 2.5 hours of light beginning at sunset and a pulse lighting system, providing 1 hour of light, 9.5–10.5 hours after the onset of darkness, during the photosensitive phase. Alternatively, the EquilumeTMlight masks provide a unilateral LED light source emitting 50 lux of blue-light directly to the eye during the hours after dusk (until 11 pm). Mares that have not been maintained under lights, or that have been exposed to ineffective light therapy, may require therapeutic hormonal intervention to advance the onset of the first ovulation of the season. Many hormone protocols involving progestins, GnRH, dopamine agonists and recombinant luteinising hormone/follicle stimulating hormone have been studied with variable results. Therapy is typically more effective when started either in late transitional mares or following a period of stimulatory artificial photoperiod.

Reproductive management of the transitional mare

The mare is a seasonally polyoestrous long-day breeder with a physiological breeding season lasting from April–October in the Northern Hemisphere. The hypothalamic-pituitary-gonadal axis in the mare is subject to a circannual endogenous rhythm that is primarily regulated by day length. Increasing ambient photoperiod in the spring alters the pattern of melatonin secretion. The resulting stimulation of hypothalamic gonadotropin-releasing hormone secretion triggers pituitary follicular stimulating hormone release and follicular growth. Exposure of mares in deep anoestrus to a stimulatory photoperiod remains the most successful method of advancing the first ovulation of the season. The most commonly used lighting regimen is providing a fixed length of 15–16 hours of light exposure and 8–9 hours of dark, with a minimum light intensity in a stable of 100-lux (100–200 watt incandescent bulb). Other methods include using an additional 2.5 hours of light beginning at sunset and a pulse lighting system, providing 1 hour of light, 9.5–10.5 hours after the onset of darkness, during the photosensitive phase. Alternatively, the EquilumeTM light masks provide a unilateral LED light source emitting 50 lux of blue-light directly to the eye during the hours after dusk (until 11 pm). Mares that have not been maintained under lights, or that have been exposed to ineffective light therapy, may require therapeutic hormonal intervention to advance the onset of the first ovulation of the season. Many hormone protocols involving progestins, GnRH, dopamine agonists and recombinant luteinising hormone/follicle stimulating hormone have been studied with variable results. Therapy is typically more effective when started either in late transitional mares or following a period of stimulatory artificial photoperiod.

Effectiveness and safety assessment of drospirenone/ethinyl estradiol tablet in treatment of PCOS patients: a single center, prospective, observational study

BackgroundTo investigate the effectiveness and safety of 3 mg drospirenone and 20 μg ethinyl estradiol tablet (3 mg DRSP/20 μg EE) in the treatment of polycystic ovary syndrome (PCOS).MethodsThis single center, prospective observational study was conducted in 140 patients with PCOS. They were prescribed 3 mg DRSP/20 μg EE in a 24/4/ regimen for 3 months. Patients were instructed to take oral DRSP/EE tablets (once daily) on the 2nd day of menstruation, for 28 consecutive days for 1 cycle. After 3 months of treatment, anthropometric assessments along with variations in sex hormones related index, glucolipid metabolic index, changes in bilateral ovarian volume, as well as adverse effect of the combination were evaluated.ResultsWhen compared to baseline, body mass index (BMI, 22.07 ± 4.09 vs. 21.35 ± 3.22, p < 0.001) and waist hip ratio (WHR, 0.86 ± 0.07 vs. 0.854 ± 0.06, p = 0.026) decreased significantly after treatment. Sex-hormones such as luteinizing hormone (LH) (10.88 vs. 5.81 U/L), testosterone (T) (1.85 vs. 1.51 nmol/L) and free androgen index (FAI) (5.37 vs. 1.50) decreased significantly after treatment (p < 0.001). Follicular stimulating hormone (FSH) increased significantly at 3 months as compared to before treatment (5.13 vs. 5.42 U/L, p = 0.009). Plasma insulin (11.03 vs. 11.10 pmol/L), fasting (4.97 vs. 4.93 mmol/L) and 2 h-blood glucose levels (7.18 vs. 7.04 mmol/L) did not change when compared to baseline. Plasma triglycerides (TG, 1.32 vs. 1.65 mmol/L) significantly increased 3 months after treatment when compared to before treatment (p < 0.001). However, high density lipoprotein-cholesterol (HDL-C) levels increased significantly after treatment (1.41 vs. 1.57 mmol/L, p < 0.001). It was seen that, when compared to baseline, bilateral ovarian volume (left and right) was significantly lower after treatment (p < 0.05). It was seen that 81 patients reported no adverse reactions. Of the common discomforts reported, breast swelling and pain, gastrointestinal disorder and dizziness and headache were most frequent.ConclusionsTreatment of PCOS patients with3 mg DRSP/20 μg EE has shown beneficial hormonal and lipid profile along with considerable safety profile.Trial registrationChinese Clinical Trial Registry ChiCTR1900022001, March 2019, retrospectively registered.

Inonotus obliquus polysaccharide ameliorates impaired reproductive function caused by Toxoplasma gondii infection in male mice via regulating Nrf2-PI3K/AKT pathway

This study was carried out to investigate the effects of Inonotus obliquus polysaccharide (IOP) on impaired reproductive function and its mechanisms in Toxoplasma gondii (T. gondii)-infected male mice. Results showed that IOP significantly improved the spermatogenic capacity and ameliorated pathological damage of testis, increased serum testosterone (T), luteinizing hormone (LH) and follicular-stimulating hormone (FSH) levels in T. gondii-infected male mice. IOP effectively up-regulated testicular steroidogenic acute regulatory protein (StAR), P450scc and 17β-HSD expressions. IOP also significantly decreased the levels of malondialdehyde (MDA) and nitric oxide (NO), but increased the activities of antioxidant enzyme superoxide dismutase (SOD) and glutathione (GSH). Furthermore, IOP up-regulated the expressions of nuclear factor erythroid 2-related factor 2 (Nrf2), heme oxygenase-1 (HO-1) and NADPH quinoneoxidoreductase-1 (NQO-1), and suppressed the apoptosis of testicular cells by decreasing Bcl-2 associated x protein (Bax) and cleaved caspase-3 expressions. IOP further enhanced testicular phosphatidylinositol 3-kinase (PI3K), phospho-protein kinase B (p-AKT) and phospho-mammalian target of rapamycin (p-mTOR) expression levels. It demonstrates the beneficial effects of IOP on impaired reproductive function in T. gondii-infected male mice due to its anti-oxidative stress and anti-apoptosis via regulating Nrf2-PI3K/AKT signaling pathway.

Influence of Gonadotropin Hormone Releasing Hormone Agonists on Interhemispheric Functional Connectivity in Girls With Idiopathic Central Precocious Puberty.

Purpose: The pubertal growth suppressive effects of gonadotropin hormone releasing hormone agonists (GnRHa) are well-known, although it remains unclear if long-term GnRHa treatment influences the brain function of treated children. The present study investigated the differences in the homotopic resting-state functional connectivity patterns in girls with idiopathic central precocious puberty (ICPP) with and without GnRHa treatment using voxel-mirrored homotopic connectivity (VMHC).Methods: Eighteen girls with ICPP who underwent 12 months of GnRHa treatment, 40 treatment-naïve girls with ICPP, and 19 age-matched girls with premature thelarche underwent resting-state functional magnetic resonance imaging using a 3T MRI. VMHC method was performed to explore the differences in the resting-state interhemispheric functional connectivity. The levels of serum pubertal hormones, including luteinizing hormone (LH), follicular-stimulating hormone, and estradiol, were assessed. Correlation analyses among the results of clinical laboratory examinations, neuropsychological scales, and VMHC values of different brain regions were performed with the data of the GnRHa treated group.Results: Significant decreases in VMHC of the lingual, calcarine, superior temporal, and middle frontal gyri were identified in the untreated group, compared with the control group. Medicated patients showed decreased VMHC in the superior temporal gyrus, when compared with the controls. Compared to the unmedicated group, the medicated group showed a significant increase in VMHC in the calcarine and middle occipital gyrus. Moreover, a positive correlation was observed between basal LH levels and VMHC of the middle occipital gyrus in medicated patients.Conclusions: These findings indicate that long-term treatment with GnRHa was associated with increased interhemispheric functional connectivity within several areas responsible for memory and visual process in patients with ICPP. Higher interhemispheric functional connectivity in the middle occipital gyrus was related to higher basal LH production in the girls who underwent treatment. The present study adds to the growing body of research associated with the effects of GnRHa on brain function.

Hormonal and molecular alterations induced by sub-lethal toxicity of zinc oxide nanoparticles on Oreochromis niloticus.

This study was carried out to determine the biochemical and molecular potential effects of Zn-ONPs sub-lethal toxicity on the hormonal profile of Oreochromis niloticus (O. niloticus). One hundred and fifty O. niloticus juvenile female were used in this experiment; Ninety for determination of LC50 and other 60 fish were divided into 3 groups with 20 fish each (two replicate in each group). Group I used as control group whereas other groups treated with 1/20 and 1/30 of LC50 respectively for 4 days. Serum, pituitary gland, hepatic, pancreatic and muscular tissues were obtained for hormonal and molecular evaluation. Serum growth hormone (GH), thyroid stimulating hormone (TSH), triiodothyronine (T3), tetraiodothyronine (T4), follicular stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), testosterone and insulin hormones were significantly decreased with a significant increase in both Adrenocorticosteroid hormone (ACTH) and cortisol levels with no change in serum glucagon levels. On molecular levels there were a significant down regulation in transcriptional levels of GH, Insulin like growth factor I (IGF-I), insulin and Insulin receptor-A (IRA genes. These results suggested that, hormonal and molecular alterations can be used as an early biomarkers for Zn-ONPs toxicity in fish.

Effect of Gonadotropin Releasing Hormone Injection on Physiological Changes and Reproductive Hormones in Clarias gariepinus

Evaluation of gonadotropin releasing hormone (GnRH) to physiological changes, spawning and reproductive parameters of African catfish, Clarias gariepinus in the current study has been conducted to determine the effectiveness of GnRH in stimulation the maturation and ovulation of African catfish. GnRH at 4, 8 and 12 μg/kg body weight dissolved in 0.6% NaCl under a natural temperature regime. The fish from Abbasa farm were fed with 30 % protein diet during experiment. Fish550 - 600 g body weight were injected with a doses of (4, 8 and 12 μg/kg body weight) three times a week. Result showed multiple ovulations and spawns within a period of approximately 30 days. Levels of 17β- estradiol (E2), testosterone (T) and follicular stimulating hormone (FSH) were elevated at 30 days’ post treatment, preceding the spawns with the highest fecundity. These results show that administration of GnRH induces multiple spawns in fishwhere, approximately 100% increase in red blood cells (RBCs), white blood cells (WBCs), hematocrit value (Hc) and hemoglobin content (Hb) respectively. Also, there are increased in plasma glucose level, total protein, aspartate and alanine amino transferase activities (AST and ALT) and increased in plasma creatinine and uric acid concentration after administration of GnRH. These data suggest that fish respond to administration of GnRH by increasing their hematology, enzymes of liver functions and kidneyfunctions. Injection of GnRH at 4, 8 and 12 µg/kg was found to be effective to induce ovulation in African catfish. 100% ovulation was also observed for the fish treated with GnRH. Also, plasma level of E2, FSH and T increased significantly with the association of ovulation. The present study indicates that administration of GnRH is effective for sexual maturation and ovulation in African catfish.

Postprandial glycaemic responses in women co-ingesting green leafy vegetables with a carbohydrate meal: interactions with the sirtuin system

AbstractThe addition of vegetable to carbohydrate-based meals has been shown to improve postprandial glucose homeostasis. Inter-individual variation in responses preclude conclusive evidence, particularly in women. The sirtuins and associated genes involved in producing the chemical, nicotinamide adenine dinucleotide (NAD), are emerging as key players in blood glucose control and may contribute to variable responses. This study aimed to investigate effects of co-ingesting green leafy vegetables (GLV) on postprandial glucose regulation following a carbohydrate meal and factors affecting inter-individual variation particularly around the sirtuin system.Twenty-five women (BMI 24.8–30.5 kg/m2) were recruited to ‘The impact of Vegetables’ (VegGI) study on acute glycaemia and Glycaemia induced CVD risk in women: metabolic effects and Inter-individual variations. Postprandial glycaemic responses (GR) following rice (75 g of available carbohydrate), rice with bok choy (150g) or spinach (150g) were measured every 5 minutes for 4 hours using a Continuous Glucose Monitoring system (Medtronic Ltd). Anthropometric, cholesterol (Cholestech LDX, Alere), HbA1c (Afinion AS100, Alere) and insulin (Mercodia AB) measures were made in a fasted state. Oestradiol, progesterone, follicular stimulating hormone and testosterone were measured (ADVIA Centaur). Total RNA was extracted from postprandial blood collected at 0 h, 30 min, 1 h and 2 h in PAXgene blood RNA tubes (PreAnalytiX GmbH) using a Blood RNA Kit (Qiagen, Crawley, UK) and quality assessed by Agilent Bioanalyser (Agilent Technologies, Bracknell, UK). Gene expression was measured using the GenomeLab System and a custom designed multiplex assay, the hSIRTNADPlex (25 targets involved in the sirtuin signalling).Linear mixed models (ver.24.0; SPSS Inc) revealed no effect of GLV consumption on postprandial GR. Principal component analysis (SIMCA-P + 12.0 software, MKS Instruments UK Ltd.) of postprandial GR indicated inter-individual variation in the responses associated with the test meals. Partial Least Square (PLS) stratified the cohort into two subgroups based on sirtuin system gene expression profiles. Postprandial GR was a contributing factor in the stratification observed, together with BMI, plasma lipid, insulin and glucose levels, but not menopausal status.Preliminary evidence indicates that co-ingesting GLV with a carbohydrate meal does not reduce postprandial GR in women (BMI 24.8–30.5 kg/m2) and that significant inter-individual variation in postprandial GR may be linked to the sirtuin system, BMI, plasma lipid, insulin, and glucose levels but not menopausal status. Recruitment and data analysis are ongoing to increase group size and further assess contributing factors.This work was supported by Scottish Government's Rural and Environment Science and Analytical Services Division

The effect of correction of serum level of vitamin D on hyperandrogenism in women with polycystic ovary syndrome and hypovitaminosis D

Background: Polycystic ovary syndrome (PCOS) is a common condition among female of reproductive age. Vitamin D may involve in the pathogenesis of PCOS. Vitamin D deficiency may exacerbate the symptom of PCOS through precipitating insulin resistance, menstrual irregularities, subfertility, hyperandrogenism, and cardiovascular dysfunction. Aim: The aim of the study is to determine whether normalization of vitamin D level in women with PCOS and hyperandrogenism (clinical and/or biochemical) would result in improvement in the parameters of hyperandrogenism. Materials and Methods: One hundred one women with PCOS and vitamin D deficiency were involved in the study, BMI, and Gallwey-Ferriman score were estimated, 25 (OH) vitamin D, total testosterone, sex hormone binding globulin (SHBG), follicular stimulating hormone (FSH), and luteinizing hormone (LH) were measured and pelvic ultrasound was performed. Forty-nine of these women received weight reduction and lifestyle modification advice and metformin only, while the remaining 52 women received vitamin D in addition, after six months all parameters were re-examined. Results: Adding vitamin D did not result in significant reduction in the Ferriman-Gallwey score or in total testosterone level, also normalization of vitamin D had insignificant effect on the level of sex hormone binding globulin and ovarian polycystic morphology, however it was associated with significant reduction in LH level. Conclusion: Despite the fact that correction of vitamin D deficiency is important for general health, however it is of limited beneficial effect on the biochemical and clinical parameters of hyperandrogenism in women with PCOS.

How can we improve embryo production and pregnancy outcomes of Holstein embryos produced in vitro? (12 years of practical results at a California dairy farm).

Genomic evaluations have revolutionized dairy cattle breeding, and the demand for embryos produced from very young heifers with high genetic merit has increased over time. The combination of low oocyte recovery, young age of donors, and milk production status can make the in vitro embryo production (IVP) of Holstein cattle incredibly challenging. Several factors need to be coordinated to obtain a live calf from an IVP embryo, but the quality of the oocyte at the start of the process is one of the key factors. Aspects related to oocyte quality, laboratory quality control, embryo quality and recipient selection are addressed here, based on the measures that the RuAnn Genetics Laboratory (Riverdale, California, USA) adopted in the last 12 years, with the goal of improving production of live, healthy calves from Holstein embryos. Follicular wave synchronization and stimulation with follicular stimulating hormone (FSH) is necessary to improve oocyte quality and consequently embryo production. Laboratory quality control and the use of high-quality supplies are essential to reduce variability in production and facilitate identification of other factors that might interfere with embryo production. High pregnancy rates can be achieved with good quality embryos selected at optimal time and stage of development, transferred by an experienced embryo transfer (ET) technician, to well managed recipients 7 or 8 days after estrus. Attention to detail at every step of the process is crucial to success.

044 Short-acting Exogenous Testosterone Appears to have a Lesser Effect on Gonadotropins Compared to Long-acting Testosterone: A Pilot Study Using Mouse Models

Low testosterone affects up to 12% of men worldwide, and various testosterone replacement therapies (TRT) have been offered to healthcare consumers over the years. Although exogenous testosterone is considered to be a contraceptive, based on emerging data, we hypothesized that short-acting testosterone will have lesser impact on hypothalamic-pituitary-gonadal (HPG) axis as compared to long-acting testosterone. To investigate the effect of short acting testosterone versus long acting testosterone on gonadotropins. Wild type male C57/B6 mice (n=10) of similar ages were administered either long-acting testosterone pellets (150mg one-time) or short acting testosterone propionate (0.2 mg/kg every other day). Another 5 age-matched mice were used as wild-type controls. After 3 months testicular weight, luteinizing hormone (LH) levels, follicular stimulating hormone (FSH) levels, serum testosterone and 17-OHP (17 hydroxy-progesterone – serum marker of intratesticular testosterone) were measured and compared. Statistical analysis for non-parametric data was performed using Mann-Whitney U test and ANOVA for multiple group comparisons. P-values below 0.05 were considered significant.

The effect of three-month topical testosterone gel application on semen quality in men with oligozoospermia and low serum testosterone levels

Objective: The effects of daily topical application of testosterone gel on semen characteristics in infertile men with oligozoospermia and hypogonadism were assessed. Methods: Sixteen infertile men were included in this prospective study. A daily morning application of 25 mg transdermal testosterone (T) gel was used for 3 months. Semen parameters, serum follicular stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E) and T levels, and seminal plasma E and T levels were measured before treatment and once monthly for three months during the therapy. Results: The baseline median sperm concentration was 5.5 × 106/mL. Median sperm concentrations at the first, second and third months were 9 × 106, 8 × 10 6, and 4 × 106/mL, respectively. The sperm concentrations at the first and second months after starting therapy significantly (p &lt; 0.001) increased compared with the baseline. However, sperm volume, pH, motility, viability and morphology were similar to baseline. Serum T significantly (p &lt; 0.001) increased, while serum FSH significantly (p &lt; 0.001) decreased from baseline. Seminal T and T/E ratios were raised significantly (p = 0.008 and p = 0.004, respectively) after gel application, whereas the seminal E level was not affected. Conclusions: Daily 25 mg T gel applications for oligospermic infertile men with hypogonadism increased the sperm concentration at the first and second months and raised the serum T level to the normal adult male range. Nevertheless, the sperm concentration had a decreasing trend after the third month.

Sex hormone levels in drug-naïve, first-episode patients with psychosis

Aim: Sex differences have long been reported in schizophrenia leading to the hypothesis that sex hormones may be implicated in the pathophysiology of the disorder. We assessed gonadal hormones during the fasted state in drug-naïve patients with psychosis.Method: Fasting serum concentrations of follicular-stimulating hormone (FSH) and luteinizing hormone (LH), testosterone, free-testosterone, Sex Hormone Binding Globulin (SHBG) and oestradiol (E2) were compared between a group of 55 newly diagnosed, drug-naïve, first-episode men with psychosis and a group of 55 healthy controls, matched for age, smoking status and BMI. Testosterone, free-testosterone and SHBG were compared between a group of 32 drug-naïve, first-episode females with psychosis and a group of 32 healthy controls matched for age, smoking status and BMI.Results: Testosterone and free-testosterone levels were significantly lower in the patients’ group and SHBG levels significantly higher in the patients’ group compared to those in healthy controls. The two female groups had similar values in the hormones which were measured.Conclusion: Our findings provide evidence of lower testosterone and free-testosterone levels and increased SHBG levels in drug-naïve, first-episode males with psychosis.KEY POINTSReduced testosterone and free-testosterone levels in drug-naive, first-episode males with psychosis.Increased SHBG levels in drug-naive first-episode males with psychosis.No difference in FSH, LH and E2 levels between drug-naive first episode males with psychosis and controls.No difference in testosterone, free-testosterone and SHBG levels between drug-naive, first-episode women with psychosis and controls.

The influence of different intensity of treatment on hormonal markers of gonadal function in acute lymphoblastic leukemia survivors.

Anti-cancer treatment in children can deteriorate gonadal function and affect future fertility. We analyzed the hormonal markers of gonadal function in adolescent leukemia survivors, treated in childhood with different levels of aggressiveness. We analyzed hormone levels in 69 adolescents and young adults, leukemia survivors stratified into standard (SR), intermediate (IR), and high (HR) risk groups, and in 80 healthy controls (38 men) at a similar age. We assessed follicular stimulating hormone (FSH), luteinizing hormone (LH), and inhibin B in the whole group, testosterone in males, and E2 and anti-Müllerian hormone (AMH) in females. Males classified into HR group presented, in comparison to control, higher levels of FSH, LH, lower inhibin B, and normal testosterone, whereas in SR and IR group, the hormonal values were comparable to the control. In females, in all risk groups, the levels of FSH, LH, E2, and inhibin B were comparable with the control, but the mean AMH levels were slightly lowered. We did not observe the effect of prophylactic cranial irradiation (12 or 18 Gy) or the time of treatment (before vs. during puberty) on hormone levels. In females, a positive correlation was found between the time interval after the end of treatment and AMH levels. Male leukemia survivors having undergone more intensive chemotherapy show the symptoms of disturbed spermatogenesis and need to be followed-up in the future. Women, irrespective of the risk group, can develop the signs of preterm ovarian insufficiency. They should be informed about the impact of the treatment on gonadal function.

Impact of Hormonal Contraceptives on Cervical T-helper 17 Phenotype and Function in Adolescents: Results from a Randomized, Crossover Study Comparing Long-acting Injectable Norethisterone Oenanthate (NET-EN), Combined Oral Contraceptive Pills, and Combined Contraceptive Vaginal Rings.

BackgroundAdolescents in sub-Saharan Africa are at risk for human immunodeficiency virus (HIV) infection and unintended pregnancies. Observational studies suggest that injectable hormonal contraceptives (HCs) increase the HIV risk, although their effects on genital inflammation, particularly HIV-susceptible T-helper 17 (Th17) cells, are unknown. In a randomized crossover study, the effect of injectable norethisterone oenanthate (NET-EN), combined contraceptive vaginal rings (CCVR; NuvaRing), and combined oral contraceptive pills (COCPs) on cervical Th17 cells and cytokines were compared.MethodsAdolescents (n = 130; 15–19 years) were randomly assigned 1:1:1 to NET-EN, CCVR, or COCPs for 16 weeks, then subsequently crossed over to another HC for 16 weeks. Estrogen, follicular stimulating hormone (FSH), and luteinizing hormone (LH) levels were measured. Chemokine receptor 5 (CCR5), human leukocyte antigen (HLA) DR isotope, and cluster of differentiation 38 (CD38) expression by cervical cytobrush-derived CD4+ T cells was assessed by fluorescence-activated cell sorting. Th17 cells were defined as CCR6+ and CCR10-. Cervicovaginal Th17-related cytokines were measured by Luminex.ResultsCCVR use for the first 16 weeks was associated with reduced Th17 frequencies and lower FSH and LH concentrations, as compared to NET-EN and COCPs, with FSH concentrations and Th17 frequencies correlating significantly. However, Th17-related cytokine concentrations (interleukin [IL]-21, IL-1β, tumor necrosis factor–α, interferon-γ) and CCR5, HLA-DR, CD38, and Th17 frequencies were significantly higher in CCVR than NET-EN and COCP. At crossover, CCVR users changing to COCPs or NET-EN did not resolve activation or cytokines, although switching from COCP to CCVRs increased cytokine concentrations.ConclusionsCCVR use altered endogenous hormone levels and associated cervical Th17 cell frequencies to a greater extent than use of NET-EN or COCPs, although Th17 cells were more activated and Th17-related cytokine concentrations were elevated. While CCVRs may impact the HIV risk by regulating Th17 numbers, increased activation and inflammation may balance any risk gains.

Reproductive endocrine functions in women with epilepsy

Women with epilepsy (WWE) have higher incidence of hormonal disturbance in comparison to the general female population. We analyzed the reproductive endocrine functions in patients with idiopathic generalized epilepsy and compared with controls. The study was conducted in the outpatient department of Neurology at a superspeciality hospital from south India. Women of reproductive age with epilepsy were recruited for the study. Patients in post menopausal state, pregnancy, who have undergone oophorectomy, use of oral contraceptive pills, patients with systemic illness, long term medication for other diseases or progressive or degenerative diseases were excluded. Five ml of venous blood was collected from 3rd day of follicular phase in fasting condition from the women study subjects. Free T3(fT3), Free T4(fT4) and Thyroid Stimulating Hormone(TSH), Follicular Stimulating Hormone(FSH). Luteinizing Hormone(LH), Prolactin, Testosterone and Estrodiol were measured. Hormones like serum Androstenedione, dehyroepiandrosterone(DHEA) and serum17-OH Progesterone were measured. Mean age of patients (N = 100) 22.78 + 7.08 and controls (N = 75) was 24.45+ 4.52. BMI was higher in patients (23.87 + 5.18) than in controls (21.87 + 2.11) p = .05. There was no significant difference in thyroid hormone levels and prolactin. There was a lower level of progesterone(0.54 + 0.27) vs. 1.01 + 0.34 ng/ml), p = .00; higher levels of dehydroepiandrostenedione (0.69 + 0.25vs. 0.54 + 0.38μg/mL), p = .05 and luteinizing hormone-LH (6.01 + 3.90mIU/mL vs. 2.85 + 1.36mIU/mL), p = .00, higher LH/FSH ration (0.87 + 0.50 vs 0.32 + 0.16, p = .00). AED'S were Phenytoin (70%), Carbamazepine(26%), Valproate (4%). There was no significant difference between individual AED's. This study demonstrates that WWE have reproductive endocrine abnormalities. The role of epilepsy versus EIAEDS needs further evaluation.

Effect on clinical symptoms and mechanism of chloasma in premenopausal women with liver qi stagnation treated with acupoint catgut embedding

To explore the therapeutic effect and mechanism of acupoint catgut embedding for chloasma in premenopausal women with liver qi stagnation. A total of 92 patients of chloasma in premenopausal women with liver qi stagnation were randomized into an observation group and a control group, 46 cases in each one.In the observation group, acupoint catgut embedding was applied at Ganshu (BL 18), Pishu (BL 20), Sanyinjiao (SP 6), also the surrounding acupuncture was performed at facial part, once a week. In the control group, vitamin C (200 mg per time, 3 times a day) and vitamin E (100 mg per time, once a day) were prescribed for oral administration. Both of the two groups were given treatment for 12 weeks. The score of chloasma area and severity index (MASI), the serum levels of follicular stimulating hormone (FSH), leuteinizing hormone (LH) and estradiol (E2) before and after treatment were observed in the two groups, and the clinical effect of the two groups were compared after 3 months of treatment. Finally, 44 cases in the observation group and 43 cases in the control group completed the study. The effective rate in the observation group was 88.6% (39/44), which was higher than 55.8% (24/43) in the control group (P<0.01). Compared before treatment, the MASI scores after treatment were reduced in the two groups (P<0.01, P<0.05), the MASI score in follow-up in the observation group was reduced as compared with after treatment (P<0.01), and the MASI scores after treatment and in follow-up in the observation group were lower than the control group (P<0.01). Compared before treatment, the levels of FSH and LH in follow-up were reduced (P<0.01), there was no significant difference between before treatment and in follow-up in the level of E2 in the observation group (P>0.05). There was no significant difference between before treatment and in follow-up in the levels of FSH, LH and E2 in the control group (P>0.05). In follow-up, the levels of FSH and LH in the observation group were lower than the control group (P<0.01, P<0.05), there was no significant difference in the level of E2 between the two groups (P>0.05). Acupoint catgut embedding can improve the clinical symptoms of chloasma in premenopausal women with liver qi stagnation, the mechanism may be related to regulate the serum level of sex hormone to reduce high sensitivity of melanocytes to estrogen.

Elevated Random Luteinizing Hormone is an Unreliable Indicator for Pubertal Suppression in Girls Treated with Monthly Leuprolide for Idiopathic Central Precocious Puberty

Objective:Longitudinal data regarding random luteinizing hormone (LH) concentrations in patients with idiopathic central precocious puberty (ICPP) during treatment are limited. Therefore, we sought to evaluate random LH and estradiol concentrations during monthly leuprolide injection and their associations with pubertal progression and final adult height (FAH) in girls with ICPP.Methods:Medical records of 27 girls with ICPP who had attained FAH were reviewed. Patients’ height, weight, Tanner stage, growth rate (GR), bone age, random LH measured by both immunoradiometric and immunochemiluminescent methods, follicular-stimulating hormone (FSH) and estradiol levels were monitored until FAH.Results:Treatment was started at a mean (±standard deviation) age of 8.1±0.6 years with mean duration of 3.9±0.2 years. At six months of follow-up, random LH (p=0.048), FSH (p<0.001) and estradiol (p=0.023) concentrations were decreased compared with baseline. Thereafter, random LHs were well suppressed. GRs gradually decreased to prepubertal norm by month 12. Seventeen patients (63%) exhibited pubertal LH concentrations at least once during treatment visits. Furthermore, 43 of a total 116 (37%) LH measurements were found elevated. However, those patients with elevated random LH did not show signs of pubertal progression. After treatment, mean FAH was greater than predicted adult height (p<0.0001) and target height (p=0.03). At no time points of treatment did random LH, FSH and estradiol correlate with GRs or FAH.Conclusion:Elevated random LH is commonly found in ICPP girls during monthly leuprolide treatment. However, these elevations were not associated with clinical progression of puberty or decreased FAH, suggesting that it is not a reliable method for CPP monitoring.