Follicular Stimulating Hormone Levels Research Articles

The Effects of Myo-Inositol and D-Chiro-Inositol in a Ratio 40:1 on Hormonal and Metabolic Profile in Women with Polycystic Ovary Syndrome Classified as Phenotype A by the Rotterdam Criteria and EMS-Type 1 by the EGOI Criteria

Setting: Insulin resistance (IR) and compensatory hyperinsulinemia are considered contributing factors toward polycystic ovary syndrome (PCOS). Objectives: This study evaluates the frequency of metabolic abnormalities in PCOS patients and the effects of myo-inositol (MI) and D-chiro-inositol (DCI), in a 40:1 ratio on hormonal and metabolic parameters. Participants: Thirty-four women with PCOS phenotype A (endocrine-metabolic syndrome [EMS-type 1]) between the ages of 20–40. Design: Open prospective study with phenotype A (EMS-type I, n = 34) supplemented with 2,255 mg/day of inositol (MI and DCI in a 40:1 ratio) for 3 months. Methods: The following were measured before and after treatment: serum levels of follicular stimulating hormone, luteinizing hormone (LH), estradiol, total and free testosterone, sex hormone-binding globulin (SHBG), free androgen index (FAI), anti-Müllerian hormone, glucose, insulin, HOMA-IR, and body mass index (BMI). Results: 55.9% of the enrolled patients were overweight or obese, 50% affected by IR, 17.6% with a history of gestational diabetes mellitus, and 61.8% had familial diabetes mellitus. At the conclusion of the study, BMI (p = 0.0029), HOMA-IR (p p p p p p p Limitations: The present analysis was limited to a 12-week follow-up, which precluded a long-term evaluation of the effects of MI and DCI combination. Also, this period was insufficient to achieve and analyze clinical changes such as restoration of the menstrual cycle, restoration of reproductive function, and clinical manifestations of hyperandrogenism. Conclusions: Supplementation improved metabolic and hormonal profile in PCOS phenotype A (EMS-type I) patients. This builds upon previous work that demonstrated that combined inositol treatment may be effective in PCOS. The study presented herein, used a reduced concentration than in prior literature; however, a significant change in hormonal and metabolic parameters was still observed.

Influence of ovarian cysts on ovarian reserve and fertility: Acase-control study.

The aim of this study was to evaluate the impact of having an ovarian cyst and undergoing cystectomy on the expression of ovarian reserve markers among adolescent females who live in Armenia. We conducted a prospective case-control study. Cases were arranged into two groups. The postoperative group (POG) included those who underwent unilateral ovarian cystectomy, and those in the benign ovarian cyst group (BOCG) had complex ovarian cysts with a diameter of 5 cm or more. Adolescents without ovarian pathologies were included in the reference group (RFG). Levels of anti-Mullerian hormone (AMH) and follicular stimulating hormone (FSH) were measured, and an ultrasound investigation of antral follicular count (AFC) was also done. Mean differences between baseline and 6-month follow-up levels of AMH, AFC significantly decreased in both the POG and BOCG compared to the RFG. However, the decrease was more significant in the POG: a decrease of 0.86 ng/mL for AMH and 3.11 ng/mL for AFC versus decreasing by 0.61 ng/mL for AMH and 1.68 ng/mL for AFC. Meanwhile, in the BOCG, 6-month FSH levels did not show any significant changes compared to the baseline measurement. In comparison with the reference group, there was a significant decrease in the levels of AMH and AFC among participants who had endometriomas and cystadenomas. Benign ovarian cysts 5 cm or more in diameter, as well as cystectomy, statistically affect OR after 6 months. Therefore, adolescents with ovarian cyst or cystectomy need individualized support to maintain reproductive age fertility.

Mechanisms and predictors of menses resumption once normal weight is reached in anorexia nervosa

BackgroundIn cases of Anorexia Nervosa (AN), achieving weight gain recovery beyond the lower limits set by the World Health Organization and normalizing classical nutritional markers appears to be essential for most patients. However, this is not always adequate to restore menstrual cycles. This discrepancy can cause concern for both patients and healthcare providers, and can impact the medical management of these individuals. Thus, the purpose of this study was to assess the ability of anthropometric and hormonal factors to predict the resumption of menstrual cycles in individuals with anorexia nervosa upon reaching a normal body weight.MethodPatients with AN who had achieved a normal Body Mass Index but had not yet resumed their menstrual cycles (referred to as ANRec) were evaluated on two occasions: first at visit 1 and then again 6 months later, provided their body weight remained stable over this period (visit 2). Among the 46 ANRec patients who reached visit 2, they were categorized into two groups: 20 with persistent amenorrhea (PA-ANRec) and 26 who had regained their menstrual cycles (RM-ANRec). Anthropometric measurements, several hormone levels, Luteinizing Hormone (LH) pulsatility over a 4-h period, and LH response to gonadotropin-releasing hormone injection (LH/GnRH) were then compared between the two groups at visit 1.ResultsPatients in the RM-ANRec group exhibited higher levels of follicular stimulating hormone, estradiol, inhibin B, LH/GnRH, and lower levels of ghrelin compared to those in the PA-ANRec group. Analysis of Receiver Operating Characteristic curves indicated that having ≥ 2 LH pulses over a 4-h period, LH/GnRH levels ≥ 33 IU/l, and inhibin B levels > 63 pg/ml predicted the resumption of menstrual cycles with a high degree of specificity (87%, 100%, and 100%, respectively) and sensitivity (82%, 80%, and 79%, respectively).ConclusionsThese three hormonal tests, of which two are straightforward to perform, demonstrated a high predictive accuracy for the resumption of menstrual cycles. They could offer valuable support for the management of individuals with AN upon achieving normalized weight. Negative results from these tests could assist clinicians and patients in maintaining their efforts to attain individualized metabolic targets.Trial registrationIORG0004981.

The importance of gynecological examination in adolescent girls and adult women with Prader-Willi syndrome.

Current published guidelines for routine care of women with Prader-Willi syndrome (PWS) do not include recommendations for gynecologic examinations. We describe our experience with gynecological examinations in women with PWS and offer recommendations for routine health care for these patients. Data were collected on all 41 PWS females ages ≥12 year, followed in our national Israeli multidisciplinary clinic between the years 2011 and 2022. Menstrual data and findings on external gynecological examination, including evaluation of the vulva and hymen were recorded at yearly visits. During the gynecological evaluation the topic of sexual education was discussed. Pelvic ultrasound, specifically for antral follicular count, was performed for those visiting the clinic during 2020-2022. Blood samples for luteinizing hormone (LH), follicular stimulating hormone (FSH), and estradiol were obtained routinely and DEXA scans for bone density were done when indicated. Of the 41 women, (median age at start of follow-up 17 years, range [12.3-39], BMI 30.4 kg/m2 [IQR 23.5-37.1]), 39 women agreed to external gynecological examination. Eleven women (27%) had spontaneous menses, with menarche at the age of 14 to as late as 31 years. The hymen was intact in all except one. Poor hygiene was observed in eight women, three women with vulvovaginitis, and five with irritated vulva related to poor hygiene. Gynecological ultrasound was performed in 27 women. In 22, endometrial thickness was less than 5 mm. The median antral follicular count (AFC) was 6 (<10th percentile for age). No correlation between AFC and menstruation or BMI was found. Mean FSH level was 5.7 ± 3.6 IU, LH was 2.29 ± 2.23, and estradiol was 128 ± 76 pmol/L. Data on DEXA measurements were available in 25 women aged 16-39. Median spine T score was -1.3 (range between 0.5 and -3.7), and hip T score was -1.2 (range between 0.8 and -3.3). A negative correlation was found between endometrial thickness and the presence of osteopenia or osteoporosis (r = -0.5, p = 0.013). Despite our recommendations, only eight of 14 women agreed to hormonal treatment or contraception. One woman who received treatment had a thromboembolic event. Routine health care for women with PWS should include gynecological examinations. The gynecological evaluation should include external genital examination, assessment of hygiene, obtaining a blood sample for hormone levels, and documenting a history of sexual experience or sexual abuse. Hormonal treatment or contraception should be offered when appropriate.

Metformin Effects on Blood Levels of Myonectin in Polycystic Ovarian Women

Background: Polycystic ovary syndrome (PCOS) is a most prevalent endocrine diseases for females of childbearing age, and lead to an ovulatory infertility. It was shown that myonectin may be positively associated with insulin resistance parameters. Objectives: To evaluate serum myonectin levels and to determine the effects of metformin treatment on myonectin levels in patients with polycystic ovary syndrome. Patients and Methods: The Cross-Sectional Study carried out in the Department of Obstetrics and Gynecology Salahdeen general hospital in Tikrit city from 1st November 2022-30th January 2023. Patients diagnosed with PCOs depending based on the Rotterdam criteria. Participants were enrolled after all eligibility criteria were confirmed and informed consent completed. Sixty PCOS patients were selected as the PCOS group, while 30 healthy women matched for age with the PCOS patients were selected as the control group. Only 30 patients of them complete the follow up study and they agree to continue on metformin treatment during three months, the duration of the follow up. They take metformin 850 mg twice daily for three months and provide fasting blood samples on the second day of menstruation before and after treatment. The data collection done through: a designed closed and open-ended questionnaire, by using direct interviewing and Ultrasound examination, Laboratory examination. Myonectin, Luteinizing hormone (LH), Follicular Stimulating Hormone (FSH), and insulin were analysed by enzyme-linked immunosorbent assay (ELIZA) technique from Biomeriuex. Data were analyzed using SPSS for Windows 7. Results: The level of myonectin decreased significantly in PCOS patients compare to control group. The level of blood glucose, Insulin, and HOMA-IR, were increased significantly compared to the control. Serum LH levels were significantly higher, while the level of FSH were lowerin in women with PCOS than in controls. After metformin intake, all patients showed significant in decrease in gremlin concentration at p-values 0.05, but no significant difference (P&gt;0.05) in myonectin level when compared to pre-treatment. Treatment resulted a significant decrease in in body mass index, Blood glucose, Insulin, HOMA-IR, testosterone and LH at p-values 0.05. However, the study found no significant difference (p &gt; 0.05) in myonectin level between both groups in treated group with metformin compared with pre-treatment. Conclusion: Metformin testosterone and insulin resistance but can’t induce changes of myonectin level in patients with polycystic ovary syndrome.

Effects of radioiodine therapy on fertility indicators among men with differentiated thyroid cancer: A cohort study.

Following thyroidectomy, radioiodine therapy is the standard management of differentiated thyroid cancer. The effects of such treatment on testicular function remained a concern for cases and clinicians. We aimed to observe changes in fertility indicators in men treated with ablation. In this prospective cohort study, 18 men with differentiated thyroid cancer from June to December 2020 underwent thyroidectomy plus radioiodine therapy. Participants were grouped based on iodine dose (8 men with 30 mCi vs. 10 men with 150 mCi). Baseline values (V) of the follicular stimulating hormone, luteinizing hormone, testosterone, and sperm analyses were measured 3 wk before iodine ablation and repeated 3 (V) and 12 (V) months later. They were analyzed once as a whole and once based on their groups via ANOVA and Friedman's tests where appropriate. The mean age of participants was 35.61 9.74 yr. Follicular stimulating hormone levels showed a significant trend among all participants (V: 12.51 1.72, V: 13.54 1.41, and V: 13.10 1.67 IU/mL; p 0.001). Luteinizing hormone showed a similar pattern (V: 4.98 1.27, V: 5.65 1.29, and V: 5.21 0.95 IU/mL; p 0.001). Testosterone levels did not differ significantly from baseline. Sperm count decreased at the first checkpoint and returned to normal after 12 months (V: 38.22 19.40, V: 32.05 17.96, and V: 36.66 18.81 million/mL; p 0.001). Sperm motility and morphology did not change significantly. Our research showed that even less than 5 GBq irradiation could induce a transient testicular dysfunction in the first 3 months of therapy, but it was mostly reversible after 12 months.

Influence of different types of tobacco smoking on seminal fluid parameters and sex hormones among males from the Gaza Strip

Background: Smoking is a global problem that negatively affects human health and fertility and the endocrine functions of the male reproductive system. Objectives: The present study aims to investigate the influence of the different types of tobacco smoking (cigarette, hookah, and electronic) on semen parameters and sex hormones in males from the Gaza Strip. Methods and Materials: A total of 206 samples were classified into 156 cases and 50 controls. The cases have been classified into three groups depending on the type of tobacco smoking (cigarette smoking "n=52", hookah "n=55", and electronic "n=49"). Semen samples were collected to investigate the semen parameters in smokers compared to non-smokers. Additionally, blood samples were also collected to assess the level of sex hormones (testosterone, follicular stimulating hormone (FSH), and luteinizing hormone (LH)). Results: A significant increase in FSH and LH levels has been found in smokers compared to non-smokers (P &lt; 0.001), while a significant decrease in testosterone level has been observed in smokers’ men compared to non-smokers (P &lt; 0.001). Significant variations have been shown in the sperm concentration (P &lt; 0.001) and the percentages of sperm total motility (P &lt; 0.001), active progressive motility (P &lt; 0.001), slow progressive motility (P = 0.004), and immotile spermatozoa (P &lt; 0.001) among the different tobacco smoking groups. Furthermore, significant variations have been found in the levels of testosterone, FSH, and LH among the different tobacco smoking groups (P &lt; 0.001). The results showed significant positive correlations between sperm concentration, total motility, active progressive motility, slow progressive motility, and testosterone level (P &lt; 0.001) in smokers. Conclusions: The different types of tobacco smoking have negative influences on semen parameters and the levels of testosterone, FSH, and LH of smokers in the Gaza Strip.

Correlation of serum anti-müllerian hormone levels with serum follicular stimulating hormone, luteinizing hormone and testosterone levels in male patients of depression.

To determine the correlation of serum anti-müllerian hormone with follicular stimulating hormone, luteinizing hormone and testosterone levels in male patients of depression. The cross-sectional analytical study was conducted at the Islamic International Medical College and the Armed Forces Institute of Mental Health, Military Hospital, Rawalpindi, Pakistan, from March 4, 2017, to March 29, 2018, and comprised male patients aged 18-60 years suffering from depression diagnosed on the basis of Siddiqui Shah Depression Scale. Serum anti-müllerian hormone, follicular stimulating hormone, luteinizing hormone and testosterone levels of all patients were measured using enzyme-linked immunosorbent assay kits. Correlation of anti-müllerian hormone with the rest was explored. Data was analysed using SPSS 21. There were 72 male subjects with mean age 35.19±9.97 years. A significant negative correlation was observed between serum anti-müllerian hormone levels and serum follicular stimulating hormone levels (p=0.001), but the correlation was not significant with serum luteinizing hormone and serum testosterone levels (p>0.05). Anti-Müllerian Hormone was found to be significantly correlated with follicular stimulating hormone, but not with luteinizing hormone and testosterone.

Relationship between serum Prostate Specific Antigen (PSA) in women with polycystic ovary syndrome and some reproductive hormones in Kirkuk city

PCOS is one of the most common endocrine disorders among women between 12 and 45 years of age, affecting 5-10% of women. The patients were included in the current study based on the criteria of Rotterdam in the diagnosis of polycystic ovarian syndrome with at least two of the following three criteria: menstrual cycle disorder, chemical criteria for high levels of androgen, detection of polycystic ovary using ultrasound (10 or more cysts of 2-10 mm in diameter). Sixty (60) patients were diagnosed with the syndrome and 30 healthy women were considered as control groups aged between 16 and 46 years.A number of criteria have been adopted to exclude patients who have had previous ovarian surgery as well as women taking contraceptives, steroids and herbal medicines that affect ovarian function for at least two months. The study was conducted at the Azadi Teaching Hospital in the city of Kirkuk for the period from October 2016 to February 2017.&#x0D; Blood collected for all participants on the second or third day of the menstrual cycle. Body mass index (BMI) was calculated and prostate specific antigen (PSA) level and the level of sex hormones such as Anti-mullarian hormone(AMH),Luteinizing hormone(LH),Follicular stimulating hormone(FSH),Testosterone hormone(T) as well as Luteinizing hormone/Follicular stimulating hormone(LH / FSH) ratio were determined. The relationship between PSA and all studied variables was investigated after dividing the study sample into three age groups A (16-25), B (26-35), and C (36-45) years. Each age group included 30 patients with PCOS and 10 women as a control group).The results showed a significant increase (p &lt;0.05) in the level of the PSA, AMH, LH, T and LH / FSH ratio, conversely the level of FSH was significantly reduced (p &lt;0.05) when comparing women patientswith the control group. Correlation results showed a positive correlation between the PSA level and the values of all the studied variables except for FSH, which was inversely correlated with serum PSA in PCOS patients and for most age groups except for category C where AMH showed a negative correlation with PSA. The results also indicated a significant correlation between PSA and T, LH, and LH / FSH ratio for all ages groups. PSA can therefore be considered as a biochemical marker for androgen activity changes in patients with PCOS

Gonadal Function in Female Adolescent and Young Adult Survivors of Childhood Cancer.

Childhood cancer survivors (CCSs) are at risk for premature ovarian insufficiency (POI). The aim of this study is to evaluate ovarian function and associated health outcomes in female adolescent and young adult survivors of childhood cancer. Sixty-nine female CCSs were enrolled. Medical records of CCSs were retrospectively reviewed. The subjects were categorized into three groups according to follicular stimulating hormone (FSH) levels (cutoff, 12, 40 IU/L). Anti-müllerian hormone (AMH) level less than 1 ng/mL was considered low AMH level. Of 69 subjects, 14 (20.3%) had POI and 14 (20.3%) had FSH levels between 12 and 40 IU/L. Forty-one of 69 (59.4%) had normal FSH levels. Pelvic irradiation and stem cell transplantation (SCT) were more frequently performed in subjects with POI (p=0.001 and p < 0.001). AMH levels were remarkably low when FSH levels were over 12 IU/L (p < 0.001). In multivariate analysis, cyclophosphamide equivalent dose and SCT were significant treatment factors for developing low AMH levels (p=0.005 and p=0.002, respectively). Total, low-density lipoprotein cholesterol and triglyceride were significantly different in three groups according to FSH levels (p=0.047, p=0.030, and p=0.045). Z-score of femur neck bone mineral density was significantly reduced when FSH levels were increased (p=0.011). Gonadal dysfunction is common in CCSs. Gonadal function was associated with a few treatment factors known to increase the risk of POI. Regular monitoring of gonadal function is needed for better health outcomes.

Effect of Depression on Serum Levels of Follicular Stimulating Hormone and Luteinizing Hormone in Male Population of Military Hospital, Rawalpindi

Background: Depression is a psychiatric illness that affects the overall life quality of an individual. In depression along with other symptoms, one of the features affecting the personal life of individuals is loss of libido which is influenced by the hypothalamic-pituitary-testicular axis. This study was aimed to determine the serum levels of Follicular stimulating hormone (FSH) and Luteinizing hormone (LH) in depressed male patients.&#x0D; Methodology: This comparative cross sectional study was done at Islamic International Medical College and Armed Forces Institute of Mental Health, Military Hospital Rawalpindi after being approved by ethical review committee. After informed consent, 96 male individuals having 18 – 60 years of age participated in the current study. Participants were segregated into groups A and B. Gender and age-matched healthy subjects in a quantity of 24 were taken in group A whereas group B consisted of 72 male depressed patients. Serum gonadotropins levels of both groups were compared by using an independent student t-test in SPSS 21.&#x0D; Results: Serum FSH (2.66 ± 0.34 mIU/ml) and LH (2.67 ±0.18 mIU/ml) levels of Group A have shown no significant difference as compared to serum FSH (3.32 ± 0.43 mIU/ml) and LH (3.12 ± 0.19 mIU/ml) levels of Group B.&#x0D; Conclusion: It is concluded from the study that serum FSH and LH levels were not significantly decreased in individuals with depression.&#x0D; Keywords: Depression, Follicle stimulating hormone, Luteinizing hormone&#x0D;  

Pituitary imaging findings in pediatric patients with idiopathic hypogonadotropic hypogonadism.

Objective. Idiopathic hypogonadotropic hypogonadism in children is a disease leading to a puberty absence. Some hypothalamic and pituitary defects cause hypogonadotropic hypogonadism. Pituitary magnetic resonance imaging is routinely performed in these patients. In our study, we provide an information about pituitary pathologies associated with an idiopathic hypogonado-tropic hypogonadism in childhood. Methods. Twenty-two patients, who were admitted to the pediatric endocrine outpatient clinic of our hospital because of their undeveloped secondary sex characteristics during adolescence, were included in our study. Age, gender, history, physical examination findings, and laboratory tests were recorded in patients. Pituitary magnetic resonance imaging results were examined. The criteria for the diagnosis of hypogonadism were: absence of puberty or delayed puberty, clinical signs or symptoms of hypogonadism, and presence of low or normal gonadotropin levels. Results. In the present study, 22 patients were diagnosed with hypogonadotropic hypogonadism. The mean age of the patients was 15.90±1.09 years. Basal and stimulated luteinizing hormone and follicular stimulating hormone levels of the patients were found to be low. Prolactin, cortisol, adrenocorticotropic hormone, free thyroxine, and thyroid stimulating hormone levels were within normal limits in all patients. The pituitary magnetic resonance imaging revealed six patients with pituitary adenoma, one with empty sella turcica, and five with pituitary hypoplasia. Conclusions. The present data showed that in the presence of hypogonadotropic hypogonadism, the hypothalamic-pituitary abnormalities are more likely to be present in the children compared to the adult population. Thus, it can be strongly emphasized the importance of the pituitary imaging examination, especially in the idiopathic hypogonadotropic hypogonadism cases.

Role of glandular hormones in estimating time passed since death: histological and biochemical examination (an experimental study)

ABSTRACT One of the most common and difficult questions that a forensic practitioner faces is the estimation of time since death. The goal of this study is to investigate the post-mortem interval in relation to degenerative histological alterations and biochemical hormonal analysis of follicular stimulating hormone (FSH), dihydrotestosterone (DHT), testosterone (T) and dehydroepiandrosterone (DHEA) in pituitary, testicular and adrenal glands respectively. One hundred adult male albino rats were divided into five groups (0, 1, 5, 10 and 15 days post-mortem groups). The glands showed normal histological structure at time of death. Autolysis started in the glands within 1 day post-mortem (PM) and became marked with increase post-mortem interval. FSH level in pituitary gland, T hormone and DHT levels in testicular gland and DHEA level in adrenal gland revealed statistically significant reductions by ELISA (enzyme-linked immunosorbent assay) with increased post-mortem interval. Glandular hormones proved to be a useful parameter consistent with the histopathological changes for the estimation of post-mortem interval from the pituitary, adrenal and testicular glands. New equations for estimation of the post-mortem interval (PMI) were performed and appeared to be useful in estimating the post-mortem interval.

Physiological Efficiency of Sage Tea (salvia officinalis L.)Administration on Fertility in Adult Female Rats

Salvia officinalis L. (common name sage) is one of this which has been used since ancient Egyptian times for increasing women's fertility;it has been used traditionally to increase fertility have been rather poorly understood.The present work was aimed to investigate the physiological role of sage tea drinking in fertility capacity by some female reproductive parameters of rat during the experiment for 28 day to includes reproductive hormones (follicular stimulating hormone (FSH), luteinizing hormone (LH), estrogen and progesterone hormones) and reproductive indexes (fertility, gestation, post-natal viability and weaning viability indexes). Thirty six female rats were divided at random into three main groups'one control group and two treatment groups as first experiment (received orally by gavage single (0.057 g/kg B.W.) and double (0.114 g/kg B.W.) traditional doses/daily of sage tea drinking for 28 day respectively). The second experiment was done to evaluate the reproductive indexes for female fertility. The results showed a higher significantly increase in serum FSH, LH, estrogen and progesterone hormones levels non dose dependent orally administration of sage tea. But, the reproductive indexes showed a single dose related orally administration of sage tea.Concludes from this present finding that sage tea drinking may be improves female fertility via of the hypothalamic-pituitary-ovarian axis in adult rats.

Precocious puberty or growth hormone deficiency as initial presentation in Mayer-Rokitansky-kuster-Hauser syndrome: a clinical report of 5 cases

BackgroundWe report five patients with Mayer-Rokitansky-Küster-Hauser syndrome (MRKHS), four of whom presented with precocious puberty and one with growth hormone deficiency (GHD. Our five children add to the growing endocrine data base of MRKHS.Case presentationWe retrospectively reviewed clinical data of 5 MRKHS patients from 2017 to 2020. The clinical features, hormonal profiles, radiological imaging and genetic analyses were collated. The age range of the 5 patients at diagnosis was 6.7–9.1 years. Four presented with premature thelarche, and one presented with short stature. External genitalia were normal in all patients. Gonadotropin-releasing hormone stimulation tests for the 5 patients revealed peak luteinizing hormone and follicular stimulating hormone levels of 3.57, 6.24, 11.5, 4.44 and 4.97 IU/L and 9.41, 16.7, 13.8, 14.2 and 10.3 mIU/mL, respectively. Growth hormone stimulation for one patient with short stature was consistent with GHD with a peak level of GH was 7.30 ng/mL. Imaging disclosed advanced bone age in four patients and no skeletal abnormalities in any of the patients. Ultrasonography of the abdomen revealed bilateral polycystic kidneys in one patient. Pelvic magnetic resonance imaging confirmed no uterus in five patients. All of the patients had a normal karyotype (46, XX). In one patient, whole-exome sequencing detected a deletion of 17q12(chr17:36,046,434–36,105,050, hg19) encompassing the HNF1B gene.ConclusionsWe report the unusual co-occurrence of precocious puberty and GHD in patients with MRKHS, highlighting that abnormal puberty and growth development may represent initial unexplained manifestations. Whether the deletion of 17q 22 begat GHD is unclear.

Factors predicting successful sperm retrieval in men with nonobstructive Azoospermia: A single center perspective.

Predicting successful sperm retrieval is essential in counseling infertile men with Azoospermia.ObjectivesTo assess the predictors of successful sperm extraction in men with nonobstructive Azoospermia.Patients and MethodsA retrospective study included all patients with nonobstructive Azoospermia from January 2018 to May 2019. Subdivided into two groups, group I (negative sperm retrieval) and group II (positive sperm retrieval).ResultsA total of 108 patients with a mean age of 36.8 ± 10 years were included. The rate of successful sperm retrieval was 47.2%. Group I included 57 patients (52.8%) with a mean age of 33.98 ± 6.18, and group II included 51 patients (47.2%) with a mean age of 40.04 ± 12.22 (p = 0.008). Follicular stimulating hormone (FSH) levels were significantly higher in group I (18.55 ± 13 vs. 7.97 ± 7.11; p < 0.004). Similarly, in group I, luteinizing hormone was significantly higher (11.4 ± 7.45 vs. 5.9 ± 4.4; p < 0.001). Age and FSH were the independent predictors of successful micro‐TESE. Additionally, successful pregnancies were 13.7% of patients, 28.6% of which gave rise to living birth.ConclusionPatients' age and serum FSH are independent predictors of successful sperm retrieval for infertile men with nonobstructive Azoospermia; young patients with high FSH levels could have little chance of sperm retrieval.

P-574 Ovarian Revitalisation using Platelet Rich Plasma

Abstract Study question Can we rejuvinate ovaries (with low ovarian reserve) by injecting fresh platelet rich plasma ? Summary answer With ovarian PRP injections, Ovarian reserve will increase and number of follicles increases in treated ovaries . What is known already Till date no definitive treatment is available to restore function of ovaries. Few drugs e.g. granulocyte colony stimulating factor etc tried for the same but no satisfactory result was achieved. Oral ovulogens and gonadotropins cannot produce satisfactory number of ova in these patients. So they were forced to go for donar ova. By using ovarian PRP injections couple can have a chance of their own biological child. Study design, size, duration we conducted the pilot study involving injection of autologous fresh platelet rich plasma injection into the ovaries of subfertile females by comparison of their fertility parameters viz. hormonal profile involving measurements of blood levels of follicular stimulating hormone (FSH), luteinizing hormone (LH), anti-Mullerian hormone (AMH), prostaglandin E2 levels (PGE2); antral follicular count (AFC); number of mature follicles (NMF) and number of retrieved oocytes (NRO) in both pre-PRP and post-PRP states. Participants/materials, setting, methods Forty-five subfertile females of more than 20 years were included in our study . All the patients underwent fresh autologous PRP injection under transvaginal ultrasonographic guidance. Besides the demographic data, each patient’s hormonal profile (including blood levels of AMH, FSH, LH, PGE2), AFC, NMF and NRO in both pre-PRP and post-PRP state were recorded in a predesigned proforma. Statistical evaluation of the recorded data was done using appropriate methods and tools. Main results and the role of chance Mean age, weight, height, body mass index and years of subfertility of the patients in our study was 31.27yrs, 58.38kg, 154.84cm, 24.37kg/m2 and 8.44years respectively. The mean blood levels of AMH increased significantly in post-PRP state (1.6 vs 2.4pg/ml) in contrast to significant decrease in blood level of FSH (21.4 vs 12.5mIU/ml), LH (15.1 vs 5.9mIU/ml) &amp; PGE2 (162.7 vs 66pg/ml). The AFC, NMF &amp; NRO also increased in post-PRP state relative to pre-PRP state. The differences in above levels and numbers were statistically significant. Limitations, reasons for caution Autologous PRP injection into ovaries improves hormonal profile, AFC and number of mature follicles as well as retrieved oocytes. Furthur followup is needed to know weather our patients concieve spontaneously or they will need some kind of assisted tecniques to concieve a pregnency. Wider implications of the findings Autologous PRP injection into ovaries improves hormonal profile, AFC and number of mature follicles as well as retrieved oocytes, it can be utilized as a revitalisation tool to boost fertility. Our study results reinforce the above concept. However, outcome-based studies are needed to further validate the results of our study. Trial registration number TMU/IEC/19-20/0113

Serum Mannose Level and Its Association in Women with Polycystic Ovarian Syndrome: a Case Control Study of Al-Najaf City / 2020

Background: Polycystic ovarian syndrome is a common public health issue around the world. Insulin resistance and glucose intolerance play important role in the etiology of polycystic ovarian syndrome and the serum mannose is incorporated in metabolism of glucose. Aim of study: Determination of the association between serum mannose level and polycystic ovarian syndrome. Patients and Methods: A case control study enrolled eighty eight women were divided as forty four women with polycystic ovarian syndrome and forty four women without polycystic ovarian syndrome presented to outpatient clinic at Fertility Center/Al Sader Medical City and outpatient clinic of Al- Zahraa Teaching Hospital in Najaf city-Iraq during the period from 1st of February till 31st of December, 2020. Results: The mean Serum Mannose level of women with polycystic ovarian syndrome 7.37 was   significantly higher than mean serum mannose of controls 1.32 (p&lt;0.001). Cutoff serum mannose level of 1.98 had acceptable validity results (90.9% sensitivity, 90.9% specificity, 94% PPV, 90.5% NPV and 90% accuracy). The means of serum level testosterone and luteinizing hormones were significantly higher among women with polycystic ovarian syndrome, while mean follicular stimulating hormone level was significantly lower among women with polycystic ovarian syndrome. Conclusions: The serum mannose level is significantly increased in women with polycystic ovarian syndrome which may indicate its possible role in the pathophysiology of polycystic ovarian syndrome.

Predicting the testicular function in non-obstructive azoospermia via targeted gene panel

BackgroundMen with non-obstructive azoospermia constitute a challenging subgroup of male infertility patients in whom a genetic cause of defective spermatogenesis may be a contributing factor. The aim of this prospective observational cohort study was to determine whether assessment of meiotic nuclear division 1 (MND1) and glyceraldehyde-3-phosphate dehydrogenase (GAPDH) gene expression (MND1/GAPDH) in testicular tissue could be a prognostic indicator for sperm retrieval and ICSI outcome in patients with non-obstructive azoospermia. The study participants underwent clinical evaluation, conventional semen analysis, serum follicular stimulating hormone (FSH), testosterone assay, scrotal ultrasound examination, microsurgical testicular sperm extraction (mTESE), and assessment of MND1/GAPDH gene expression levels in testicular tissue via quantitative polymerase chain reaction (qPCR) techniques.ResultsThe MND1/GAPDH level was associated with the likelihood of identifying sperm in testicular biopsies (odds ratio (OR) 1.25, 95% confidence intervals (CI) 1.14 to 1.34, p < 0.0001), which was confirmed by the pairwise comparison of high vs. low levels of MND1/GAPDH (OR 5.34, 95% CI 1.97 to 13.16, p = 0.0006). The level of FSH was inversely associated with a lower chance of finding sperm (OR 0.37, 95% CI 0.20 to 0.65, p = 0.001). Compared with small testicular volume, normal volume was inversely associated with the chance of sperm presence (OR 0.16, 95% CI 0.06 to 0.47, p = 0.0002). However, there was no correlation between MND1/GAPDH levels and ICSI outcome.ConclusionGene expression analysis to predict the likelihood of sperm retrieval following mTESE in patients with non-obstructive azoospermia provides a new avenue for future research, diagnosis and treatment of male factor infertility. Before its wider clinical application, however, this proof-of-concept should be tested in a large multinational, multicenter observational study.

P–640 High physical activity and ovarian reserve: A prospective study of normo-ovulatory professional athletes

Abstract Study question Is high physical activity (HPA) associated with low ovarian reserve in normo-ovulatory, reproductive-age women? Summary answer HPA does not affect ovarian reserve negatively. What is known already HPA is associated with menstrual irregularities and subsequent potential infertility, probably through hypothalamic neuroendocrine pathways. However, it is not yet known whether HPA influences the ovarian reserves of normo-ovulatory, reproductive-age women. Study design, size, duration This observational, cross-sectional study compared 30 professional female athletes who were engaged in HPA for at least 3 years prior to study recruitment, with high International Physical Activity Questionnaire (IPAQ) scores and 30 women who did not engage in physical activity. The study was conducted at a tertiary medical center from 2017–2020. Participants/materials, setting, methods Physically active, normo-ovulatory women (n = 30), ages 20–35 years were recruited from The Wingate Institute, the Israeli National Institute for Sport Excellence. Non-physically active women (n = 30), matched by age and BMI to the HPA group, were recruited from the hospital staff. Both groups were evaluated for ovarian reserve markers on day 2–5 of the menstrual cycle, including follicular stimulating hormone (FSH), antral follicle count (AFC), anti-Mullerian hormone (AMH) and Inhibin B. Main results and the role of chance The average age of the athletes (HPA group) was 30.1±2.1 years and of the nonactive (control) group 31.6±3.8 years (p = 0.071). BMI of the 2 groups was similar (22.6±2.4 vs. 21.3±2.6; p = 0.075) for the HPA and control groups, respectively. Regarding ovarian reserve, no significant differences were observed between the HPA group and the control group with respect to FSH (p = 0.304), AFC (p = 0.27), AMH (0.507) or Inhibin B (p = 0.074). For the HPA group, older age at menarche was positively associated with AFC (p = 0.008) and AMH (p = 0.009) and not with FSH levels (p = 0.313). For the nonactive group, no significant association between age at menarche and FSH levels, AFC or AMH was found (p = 0.433, p = 0.274 and p = 0.163, respectively). Additionally, for the HPA group, duration of physical activity per week (hours) was not significantly associated with FSH levels, AFC or AMH (p = 0.619, p = 0.608 or p = 0.997, respectively). Limitations, reasons for caution Although we investigated the ovarian reserves of 30 women engaged in HPA, a larger cohort would provide more information. Information on diet and sleep habits was not evaluated and may result in some confounding. Moreover, it would be more informative if we also followed these women regarding fecundability and fertility. Wider implications of the findings: This study demonstrated that HPA may not negatively affect ovarian reserve markers. These findings may provide reassurance for women who are engaged in HPA and attempting pregnancy. Further research needs s to be confuted. Trial registration number 0247–16