Hormone Agonist Treatment Research Articles

Maintenance dienogest therapy following adjuvant gonadotropin-releasing hormone agonist treatment after uterus-sparing surgery in adenomyosis: A retrospective cohort study.

To investigate the safety and efficacy of adjuvant gonadotropin-releasing hormone agonist (GnRH-a) treatment followed by maintenance dienogest (DNG) therapy after uterus-sparing surgery. Retrospective cohort study. A total of 190 patients with severe adenomyosis underwent uterus-sparing surgery between January 2010 and June 2020. Of these patients, 90 were analyzed. Forty-six patients (control group) received adjuvant 6-month GnRH-a therapy alone after uterus-sparing surgery, and 44 patients (maintenance group) received postoperative 6-month GnRH-a treatment followed by maintenance DNG therapy (2mg/day orally). The median follow-up period was 18 months. The study was analyzed using generalized estimating equations. At baseline, the characteristics of patients in each group were comparable. Compared with the control group, the maintenance group had a significant improvement in the visual analog scale score of dysmenorrhea (P< 0.001), hemoglobin level (P= 0.004), and uterine volume (P= 0.004) from baseline to 18 months after uterus-sparing surgery. The symptom recurrence rate was significantly lower in the maintenance group than in the control group (4.6% vs. 37.0%, P< 0.001). The findings of this study suggest that combinatorial treatment with GnRH-a (adjuvant treatment) and DNG (maintenance therapy) represents a safe and effective short-term therapy after uterus-sparing surgery for adenomyosis.

Abstract P4-09-03: Factors affecting the parentingstressand depressioninyoung women with breast cancer

Abstract Background: According to the statistics from 2013 to 2017 at the national cancer institute, more than 30% of breast cancer patients are under the age of 54, and their children are mostly minors. Diagnosis and treatment of breast cancer have a substantial impact on the patients themselves and as caregivers, resulting in both depression and parenting stress. Although there are previous studies investigating the parenting stress in patients with cancer, the factors affecting the parenting stress and depression in young women with breast cancer still remain inconclusive. Herein, we aimed to determine the parenting stress and depression of women diagnosed with breast cancer, and to identify the risk factors. Methods: A cross-sectional survey was conducted among ​​700 patients with breast cancer who visited the breast surgery outpatient clinic in a tertiary hospital from June 2020 to April2021. The study subjects were between 20 and 45 years old at the time of cancer diagnosis. Two-hundred patients without children were included for comparison regarding depression. The center for epidemiologic studies depression scale (CES-D) was used for evaluating depression in all subjects. Five-hundred patients with children also fill out the questionnaires including parenting stress index/short Form (PSI-SF), Child behavior checklist (CBCL), Junior temperament and character inventory (JTCI), and Children’s sleep habits questionnaire(CSHQ).Results: The risk of depression was significantly higher in patients having children (odds ratio [OR], 2.261; 95% confidential interval [CI],1.009-5.063; p=0.047) and who received gonadotropin-releasing hormone agonist (GnRH)treatment (OR 1.667; 95% CI, 1.142-2.433 p=0.008). Meanwhile, longer disease duration was associated with lower risk of depression (OR 0.852; 95% CI, 0.756-0.959 p=0.008). In regards to parenting stress, clinical factors related to breast cancer such as stage and type of treatment did not show significant association. However, children factors including the age (≥ 6 years old), specific behavioral patterns, temperature, and sleep habits reported significant impact on parenting stress. The significant correlation was noted between depression score and parenting stress score (β coefficient =0.557; p&amp;lt;0.0001).Conclusion: In patients with breast cancer, having children, shorter duration from the diagnosis, and treatment with GnRH was associated with higher risk of depression. Among the patients having children, the factors related to children had a significant impact on parenting stress, whereas no association was noted among clinical factors related to breast cancer. Citation Format: Yungil Shin, Harin Kim, Seonok Kim, Sae Byul Lee, Jisun Kim, Il Yong Chung, Beom Seok Ko, Jong Won Lee, Byung Ho Son, Sei Hyun Ahn, Hyo-won Kim, Hee Jeong Kim. Factors affecting the parentingstressand depressioninyoung women with breast cancer [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P4-09-03.

Adult height after gonadotropin-releasing hormone agonist treatment in girls with early puberty: A meta-analysis.

This analysis of previously published reports was performed to examine the effects of gonadotropin-releasing hormone (GnRH) agonist treatment on adult height and the factors associated with adult height outcomes. GnRH agonists are first-line agents in the treatment of precocious puberty. However, studies regarding the treatment effect on subjects with early puberty have reported inconsistent results. A total of 14 studies identified from a search of electronic databases (AMED, EMBASE, MEDLINE and RISS) were included. Controlled studies with girls who developed puberty before 10years of age and measurements of the adult heights of the subjects were selected. Studies using only long-acting GnRH agonists to suppress puberty were included. Adult height, duration of the treatment, age at the start of treatment and bone age advancement were analysed. The mean age of the subjects ranged from 6.3 to 9.0years. The meta-analysis showed a pooled mean difference in adult height of 3.2cm and a 95% confidence interval of 1.3-5.1cm. The height difference between the treated subjects and controls was significantly associated with the duration of treatment (P=.005) rather than the age at the start of treatment (P=.084) or the difference between bone age and chronological age (P=.427). Administration of GnRH agonists in girls who develop early puberty and demonstrate advanced bone age may be effective for increasing adult height, especially if a sufficiently long treatment duration can be achieved.

Androgen deprivation therapy for prostate cancer and risk of dementia.

ObjectivesTo study whether androgen deprivation therapy (ADT), the mainstay treatment for advanced and disseminated prostate cancer, is associated with risk of dementia.MethodsRisk of dementia in men with prostate cancer primarily managed with ADT or watchful waiting (WW) in the Prostate Cancer Database Sweden, PCBaSe, was compared with that in prostate cancer‐free men, matched on birth year and county of residency. We used Cox regression to calculate the hazard ratios (HRs) for Alzheimer's and non‐Alzheimer's dementia (vascular dementia, dementia secondary to other diseases or unspecified dementias) for different types and duration of ADT and oral antiandrogens (AAs) as well as for men managed with WW.ResultsA total of 25 967 men with prostate cancer and 121 018 prostate cancer‐free men were followed for a median of 4 years. In both groups 6% of the men were diagnosed with dementia. In men with prostate cancer, gonadotropin‐releasing hormone agonist treatment ( HR 1.15, 95% confidence interval [CI] 1.07–1.23) and orchiectomy (HR 1.60, 95% CI 1.32–1.93) were associated with an increased risk of dementia, as compared to no treatment in prostate cancer‐free men; however, this increase in risk was only observed for non‐Alzheimer's dementia and occurred from year 1–4 after start of ADT. No increase in risk for any type of dementia was observed for men treated with AAs or for men on WW.ConclusionThis population‐based cohort study does not support previous observations of an increased risk of Alzheimer's dementia for men on ADT; however, there was a small increase in risk of non‐Alzheimer's dementia.

Evolution of quality of life of partners of patients suffering from prostate cancer (PCa) receiving gonadotropin-releasing hormone (GnRH) agonist treatment

Evolution of quality of life of partners of patients suffering from prostate cancer (PCa) receiving gonadotropin-releasing hormone (GnRH) agonist treatment

Chinese medicine improves postoperative quality of life in endometriosis patients: A randomized controlled trial

To investigate the effect of Chinese medicine (CM) and Western medicine (WM) on quality of life (QOL) after conservative surgery for endometriosis. A total of 320 patients with endometriosis were randomized into two groups by using random block design, CM group (160 cases, activating blood circulation and removing blood stasis treatment based on syndrome differentiation) and WM group (160 cases, gonadotropin-releasing hormone agonist or gestrinone treatment) after conservative surgery. Treatment was given for 3-6 months (according to the revised American Fertility Society scoring system stage), and the World Health Organization QOL-BREF (WHOQOL-BREF) was applied to patients before and after treatment to assess QOL. There were 136 cases in the CM group and 141 cases in the WM group completing therapy. In the CM group, the use of the WHOQOL-BREF showed that the physical, psychological and environmental scores posttreatment were significantly higher than those at pre-treatment (P < 0.05), and for 12 items (pain and discomfort, energy and fatigue, sleep and rest, mobility, activities of daily living, work capacity, negative feelings, health and social care: accessibility and quality, participation in and opportunities for recreation/leisure activities, appetite, QOL score, overall health status and QOL), the difference in scores was significant (P < 0.05). In the WM group, 4 items (pain and discomfort, opportunities for acquiring new information and skills, QOL score, overall health status and QOL) had significantly different scores post-treatment compared with those at pre-treatment (P < 0.05). Before treatment, the QOL in the two groups of patients showed no significant difference (P > 0.05). After treatment, the scores for physical health in the CM group were significantly higher than those of the WM group (P < 0.05) and the scores of 4 items (mobility, activities of daily living, sexual activity, QOL score) in the CM group were significantly higher than those in the WM group (P < 0.05). CM and WM treatment could improve the QOL of patients with endometriosis after conservative surgery. CM treatment is more effective than WM.

The effect of gonadotrophin‐releasing hormone agonist treatment over 3 years on bone mineral density and body composition in girls with central precocious puberty

Puberty is a period characterized by growth spurt and rapid change in body composition. The effect of GnRH agonist therapy for central precocious puberty on bone mineral density is unclear. We demonstrated changes in bone mineral density in subjects with central precocious puberty, who were treated with GnRH agonist for more than 3 years. The changes in bone mineral density and body compositions were tested with analysis of variance with repeated measures to identify statistical significance over the treatment period. One hundred ninety-five Korean girls with central precocious puberty were treated with GnRH agonist, and among these subjects, 39 patients were treated for more than 3 years. Dual-energy X-ray absorptiometry was performed on the subjects at the initial evaluation and once yearly thereafter while on the treatment. The bone mineral density parameters for chronological age tended to decrease near the mean for the treatment period; however, they increased significantly for bone age excluding bone mineral apparent density. An increment of the BMI was not significant for the chronological age. Three-year treatment with GnRH agonist in central precocious puberty patients did not impair bone maturation. GnRH agonist could be effectively commenced in girls with precocious puberty from an early age.

Expressions and roles of TGFβ/Smad signal pathway in peritoneum of endometriosis

To investigate the expression of transforming growth factor (TGF)-β and Smad pathway expressed in adhesion peritoneums in patients with endometriosis (EM). From Dec. 2009 to Mar. 2010, 11 patients with EM [including 3 patients treated by gonadotropin releasing hormone agonist (GnRH-a) treatment] underwent laparoscopy surgery in Peking Union Medical College Hospital. In the mean time, 9 patients with benign ovarian tumor without EM and peritoneum adhesion were chosen as control. Peritoneum from lateral peritoneal cavity, adjacent from lesion and grossly normal was obtained during surgery. Microstructure of peritoneums was observed by HE staining and Masson staining. The expression of TGF-β1, TGF-β3, Smad 3 and Smad 7 in peritoneums were measured by immunohistochemistry staining and real-time PCR. The effect of GnRH-a on expressions of these markers were also analyzed. (1) Microstructures of peritoneum: enlargement of nucleus of peritoneal mesothelial cells, thickening of connective tissue, distributive disorder of fiber, increasing numbers of fibroblast and inflammatory cells in EM were significantly different from those in control group. (2) The expression of TGF-β1 and 3 in peritoneum were 0.170 ± 0.020 and 0.110 ± 0.010 in EM group, which were significantly higher than 0.070 ± 0.010 and 0.050 ± 0.020 in control group. TGF-β1 was downregulated to 0.130 ± 0.030 and TGF-β3 was upregulated to 0.490 ± 0.090 by GnRH-a. (3) The expression of Smad 3 and 7 were 0.140 ± 0.020 and 0.110 ± 0.020 in peritoneum in EM group, which were significantly higher than 0.024 ± 0.004 and 0.014 ± 0.007 in control group. GnRH-a could upregualted the expression of smad 7 (0.040 ± 0.020), however, but no significant effect was observed on regulating Smad3 expression. The changes of microstructure and the alteration of TGF-β/Smad expression in peritoneum of endometriosis were observed. GnRH-a could regulate the expression of TGF-β and Smad.

A Complicated Hematometra and Fallopian Tubal Occlusion in Uterine Didelphys With Unilateral Cervical Atresia

Uterine anomalies are uncommon Mullerian malformations without known etiology. Many hypotheses have been put forward to explain these anomalies such as the involvement of genetic, environmental, and pharmacological issues [1]. The incidence is reported to be between 0.5–5.0% of all women [2]. However, a congenital uterine anomaly involving cervical atresia is extremely rare. We report a patient, diagnosed with a uterine anomaly, who underwent a primary laparotomy for unilateral endometrioma without resectioning of the rudimentary horn. Postoperatively, the patient received 6 months of gonadotropin-releasing hormone agonist (GnRHa) treatment as a conservative therapy. After completion of the GnRHa therapy, endometriosis recurred and a hematometra developed. This occurred after her menstrual cycle had resumed for 3 months post GnRHa treatment. The patient underwent a second laparotomy and the rudimentary horn was resectioned. Recovery after the operation was uneventful. The final diagnosis of the uterine anomaly in this patient was uterine didelphys with unilateral cervical atresia. A 23-year-old nulligravid woman had complained of dysmenorrhea since menarche at the age of 14 years in 1999 and this had been partially relieved with medical management. At the age of 22 years during April 2007, the patient presented with acute abdominal pain in the left lower quadrant, in which an abdominal mass was palpable. Pelvic ultrasonography by a primary gynecologist revealed a 10 × 10 × 10 cm complex mass of the left adnexa with multiple cysts and septa. A bimanual pelvic examination showed a single vagina and single cervix. Computed tomography (CT) revealed a multicystic mass associated with the left ovary, possibly endometrioma, and two uterine horns indicating the possibility of a bicornuate uterus (Figures A and B). The right kidney was enlarged and the left kidney was absent. An elevated serum CA-125 level of 8,640 U/mL was noted. The patient underwent exploratory laparotomy by the primary gynecologist. The findings included a 10 cm left ovarian endometrioma, severe endometriosis involving the cul-de-sac and the pelvis, as well as layering of hemosiderin throughout the uterine horns, the pelvis and the omentum. Fibrous adhesions involving the sigmoid colon, small intestine and pelvic sidewall were also noted. The right uterine horn and the right fallopian tube were normal in appearance; a right ovary could also be identified. The uterine anomaly was thought to be a bicornuate uterus. Left partial oophorectomy and lysis of the adhesions were performed. The pathological findings revealed ovarian endometrioma and endometriotic cysts that had endometrial epithelium and hemosiderin-laden macrophages. Postoperatively, the patient recovered quickly and was prescribed 6 months of GnRHa therapy.

Expert opinion on 6‐monthly luteinizing hormone‐releasing hormone agonist treatment with a novel depot delivery system for prostate cancer

Expert opinion on 6‐monthly luteinizing hormone‐releasing hormone agonist treatment with a novel depot delivery system for prostate cancer

Oxandrolone added to gonadotropin-releasing hormone agonist (GnRHa) treatment improves final height in girls

Oxandrolone added to gonadotropin-releasing hormone agonist (GnRHa) treatment improves final height in girls

The comparison of predicted adult height change and height gain after gonadotropin-releasing hormone agonist and combined growth hormone treatment in girls with idiopathic central precocious puberty

Purpose:GnRH analogues(GnRHa) are used to treat central precocious puberty(CPP). However, in some patients, the GV decrease is so remarkable that it impairs predicted adult height(PAH); and there fore, the addition of growth hormone(GH) is suggested. We analysed the growth changes during two years and final adult height(FAH) in girls with idiopathic CPP treated with combined therapy, compared with those of girls treated with GnRHa alone. Methods:For the analysis, we classified the patients, who was treated for longer than two years, into three groups depending on the initial PAH and combination of GH; PAH_L, treated with GnRHa and PAH less than midparental height(MPH) - 5 cm. PAH_H, treated with GnRHa and PAH greater than MPH - 5 cm. GnRHa＋GH, combined GH treatment, regardless of PAH before treatment. We analysed the GV and PAH change during the first two years and FAH. Results:In PAH_L, the PAH(SDS) at first year of therapy was significantly increased to 153.5±6.5 cm(-1.4±1.3) from 149.7±6.4 cm(-2.1±1.3) before treatment(P=0.004). In PAH_H, there was no significant increase in PAH during the two years of treatment. During the first year of combination of GH and GnRHa, GV and PAH increased significantly. We observed significant increases in FAH, comparing to the initial PAH in the PAH_L and GnRHa＋GH groups. The height gains(FAH - initial PAH) were significantly higher in the PAH_L and GnRHa＋GH groups than that in the PAH_H group. Conclusion:This study suggests the FAH and height gains are improved in patients, whose predicted adult height before treatment was shorter than those with higher predicted adult height, with the treatment of GnRHa alone or in combination with GH. GH could not improve the final adult height, but compensated the growth in patients whose growth velocity was decelerated by GnRHa alone.

Time course of serum testosterone and luteinizing hormone levels after cessation of long‐term luteinizing hormone‐releasing hormone agonist treatment in patients with prostate cancer

In order to elucidate the influence of hormone-releasing hormone (LH-RH) agonist therapy cessation on pituitary/testicular function and its clinical implications, we investigated prospectively hormonal (luteinizing hormone: LH; testosterone: T) responses in patients with prostate cancer who received long-term LH-RH 10 agonist therapy. A consecutive 32 patients who had received LH-RH agonist therapy over 24 months were enrolled. As a baseline, T and LH were measured at the time of LH-RH agonist therapy cessation, monthly for 3 months, and subsequently, every 3 months. The median duration of LH-RH agonist therapy was 30 months (24-87 months) with median follow-up duration of 24 months following cessation. All patients had castrated T levels and suppressed LH levels at baseline. Median duration of castrated T levels following cessation was 6 months. Median time to normalization of T levels was 24 months. LH levels returned to normal within 3 months in all cases. Patients who received androgen deprivation therapy for 30 months or longer required a longer time for recovery of T levels. Patients over 65 years of age showed a statistically significant longer time for recovery of T levels (P=0.0167). Long-term LH-RH agonist therapy has remarkable effects on serum T level that last for a significant time after cessation, a fact that should be applied to the interpretation of both PSA and serum T levels after cessation of androgen deprivation therapy.

Low dose gonadotropin-releasing hormone agonist treatments with early discontinuation for controlled ovarian hyperstimulation in an in vitro fertilization program.

Aim: The purpose of the present study was to investigate the applicability of a protocol for controlled ovarian hyperstimulation (COH) featuring early discontinuation of low dose gonadotropin-releasing hormone agonist (GnRHa) for ovulation induction for in vitro fertilization (IVF). Methods: Four hundred and eighty-seven women undergoing 555 IVF cycles were recruited into the study. Controlled ovarian hyperstimulation was achieved by using either a short protocol of low dose GnRHa (for 5days only; groups 1 and 2) or a modified long protocol with early discontinuation of GnRHa (groups 3 and 4). Groups 1 and 3 received urinary follicle-stimulating hormone (FSH) and groups 2 and 4 received recombinant FSH. Oocyte retrieval was performed 34 to 36h after human chorionic gonadotropin (hCG) injection, followed by embryo transfer 3days later. Results: Luteinizing hormone (LH) levels on the hCG injection day were lower with the modified long protocol (groups 3 and 4) than with the short 5-day treatment (groups 1 and 2). There were higher LH levels in group 1 than in groups 2, 3 and 4, resulting in a worse fertilization rate and clinical pregnancy rate. There were no statistically significant differences between groups 2, 3 and 4 in the rates of fertilization, clinical pregnancy and delivery. A higher estradiol (E2) level in group 3 than in groups 1, 2 and 4 resulted in a worse implantation rate. Conclusion: Early cessation of GnRHa may not induce a premature LH surge in controlled ovarian hyperstimulation, while a low dose also offers a useful alternative to a long protocol of IVF. Ovarian stimulation with recombinant follicle-stimulating hormone (rFSH) is considered to be favorable in this low dose GnRHa treatment. (Reprod Med Biol 2003; 2: 25-30).

Differential efficacy of gonadotropin-releasing hormone (GnRH) agonist treatment on pedunculated and degenerated myomas: a retrospective study of 630 women

This study was designed to compare the anatomical location of myomas (submucous, intramural, subserous, or cervical), whether pedunculated or non-pedunculated if degenerated or undegenerated and relating these findings to myoma volume reduction in women treated with gonadotropin-releasing hormone agonist (GnRHa). Our retrospective study group included 630 patients with symptoms attributed to fibroids. They were treated with a single GnRH agonist for 20 weeks and the size of the myoma was monitored by magnetic resonance imaging and/or ultrasonographic scan. During a 20 week-treatment, submucous, intramural, or subserous fibroids showed an overall reduction of 63% ( P <0.01) with little variation between these types. No reduction in size was seen in cases of pedunculated, degenerated, or cervical myomas. These data suggest that GnRH agonist therapy might be used primarily for non-pedunculated and undegenerated myomas.

Alterations in follicular maturation associated with within-breed variation in ovulation rate in Chios sheep.

Within-breed comparisons may be helpful to identify, in a given genetic background (Chios sheep), ovarian strategies and control mechanisms associated with altered ovulation rate. High and low ewes were identified from two large groups (n = 27 and n = 33 in Exp. 1 and Exp. 2 respectively) of Chios ewes submitted to repeated laparoscopies (24 times in Exp. 1 and six times in Exp. 2). High ovulatory ewes (n = 6 and n = 7 in Exp. 1 and Exp. 2 respectively) had mean ovulation rates of 4.3 (Exp. 1) and 4.2 (Exp. 2) while low ovulatory ewes (n = 6 and n = 7 in Exp. 1 and Exp. 2 respectively) had mean ovulation rates of 2.5 (Exp. 1) and 1.9 (Exp. 2). In Exp. 1, follicular function was compared in these two groups of ewes using follicles obtained at 30 h following luteolysis in the same ewes before and after unilateral ovariectomy (ULO). In Exp. 2, circulating follicle stimulating hormone (FSH) concentrations were measured from the end of the luteal phase up to the preovulatory surge in high and low ewes. Thereafter, to demonstrate a causal link between high FSH and high ovulation rate, pituitary downregulation was achieved by a 17-day gonadotrophin releasing hormone (GnRH) agonist treatment and the ovarian response to similar amounts of exogenous gonadotrophins compared between high and low ewes. Numbers of oestrogenic (in vitro oestradiol > 250 pg ml-1 h-1) follicles on the first ovary removed (Exp. 1) were 2.16 +/- 0.5 vs. 1.33 +/- 0.17 in high and low ewes (P = 0.1). Following ULO, these numbers were 3.33 +/- 0.33 and 2.5 +/- 0.18 (P < 0.05 between high and low ewes). There were no significant differences between the first and second ovaries for any of the parameters studied. Follicles from high ovulatory ewes (n = 33) differed from those of low ovulatory ewes (n = 23) by a smaller size (P < 0.01), a reduced number of granulosa cells (P < 0.01) together with decreased oestradiol (P < 0.05) and testosterone (P < 0.01) production in vitro. However, steroid production per cell (oestradiol per granulosa cell, testosterone per thecal cell) was similar in the two groups of sheep. FSH concentrations (Exp. 2) in high ovulatory ewes were significantly higher than those of low ovulatory ewes during the late luteal phase, and the decrease in FSH concentrations was steeper (1.4 ng) during the early follicular phase for high ovulatory ewes than low ovulatory ewes. Chemical hypophysectomy achieved by a 17-day treatment with a GnRH agonist demonstrated that these high FSH concentrations may be important to generate the high ovulation rate of the 'high' ewes as ovulation rate of high and low ewes was similar following chemical hypophysectomy followed by administration of similar amounts of exogenous gonadotropins to both groups of ewes. It is concluded that, despite different genetic control of their high ovulation rate (Chios-polygenic; Booroola-major gene), alterations in follicular function and its control are very similar in high ovulatory Chios and in FecB carriers.

Final height in girls with central precocious puberty: comparison of two different luteinizing hormone‐releasing hormone agonist treatments

In order to evaluate the effects of two long-acting luteinizing hormone-releasing hormone agonists on growth, bone maturation and final height in girls with central precocious puberty, we analyzed growth data from 40 girls (15 treated with buserelin intranasal spray (group A), 15 treated with triptorelin depot im every 28 days (group B) and 10 untreated (group C)). Patients in group A started treatment when chronological age (CA) was 7.7 +/- 0.9 years, bone age (BA) was 10.2 +/- 1.1 years and height was 131.9 +/- 5.0 cm. Patients in group B started therapy when CA was 7.6 +/- 0.5 years, BA 9.8 +/- 1.0 years and height 133.2 +/- 7.6 cm. The diagnosis of untreated patients (group C) was made when CA was 7.2 +/- 0.9 years, BA 9.6 +/- 2.2 years and height 130.2 +/- 8.6 cm. Both luteinizing hormone-releasing hormone agonists appeared to control precocious puberty. Final height in group B (160.6 +/- 5.7 cm) was significantly higher than that of group A (153.2 +/- 5.0 cm: p < 0.05) and group C (149.6 +/- 6.3; p < 0.01), whereas the difference between groups A and C was not statistically significant. In group B a positive difference was observed between final height (160.6 +/- 5.7 cm) and target height (157.6 +/- 5.9 cm) (ns); on the contrary, in groups A and C, final height was lower than target height (155.5 +/- 5.3 and 156.4 +/- 1.3 cm, respectively), but only in group C the difference was statistically significant (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Advanced endoscopic techniques used in dysfunctional bleeding, fibroids and endometriosis, and the role of gonadotrophin-releasing hormone agonist treatment.

Advanced endoscopic techniques used in dysfunctional bleeding, fibroids and endometriosis, and the role of gonadotrophin-releasing hormone agonist treatment.

Effect of deslorelin-induced pubertal delay on the growth of adolescents with short stature and normally timed puberty: preliminary results.

LH-releasing hormone agonist (LHRHa) treatment slows bone maturation and improves adult height in children with LHRH-dependent precocious puberty. To determine whether pubertal delay induced by LHRHa can enhance final height in patients with short stature and a normally timed puberty, we enrolled 43 short children (28 girls and 15 boys) in a double blind, placebo-controlled trial. Patients were assigned randomly to receive either placebo or LHRHa (deslorelin), administered sc at a dose of 4 micrograms/kg.day for a period of 4 yr. This report describes the preliminary results in 16 children who have completed 4 yr of treatment (9 patients in the deslorelin group and 7 patients in the placebo group). Predicted adult height increased significantly in the deslorelin-treated patients, by 7.6 cm compared to the pretreatment baseline and by 10.3 cm compared to that in the placebo-treated patients (P < 0.005). Four of the 16 patients received concurrent GH treatment (3 among the deslorelin-treated patients and 1 among the placebo-treated patients). Omitting these patients from the analysis did not materially affect the results: predicted adult height in the deslorelin-treated patients increased by 7.2 cm compared to the pretreatment baseline and by 10.9 cm compared to that in the placebo-treated patients (P < 0.005). We conclude that pubertal delay induced by deslorelin significantly increases predicted adult height in adolescents with short stature and a normally timed puberty. Whether deslorelin treatment will increase the final height of these patients cannot be determined until they have stopped growing.

Differing responses of plasma bioactive and immunoreactive follicle- stimulating hormone and luteinizing hormone to gonadotropin-releasing hormone antagonist and agonist treatments in postmenopausal women

Differing responses of plasma bioactive and immunoreactive follicle- stimulating hormone and luteinizing hormone to gonadotropin-releasing hormone antagonist and agonist treatments in postmenopausal women