Normal Regular Menses Research Articles

P-665 Fertility in female patients treated for Hodgkin’s lymphoma

Abstract Study question we aimed to determine factors which could possibly predict future ability to conceive in patients that are to be treated for Hodgkin's lymphoma. Summary answer we identified the key characteristics for high probability to achieve a spontaneous pregnancy: younger age, high ovarian reserve and GnrH-a or COC during chemotherapy. What is known already Hodgkin's lymphoma is considered one of the most aggressive yet successfully treatable oncological diseases. Prevalence among younger patients and highly gonadotoxic chemotherapy regimens bring up a question of fertility preservation. The issue of predicting the future fertility potential of patients who will have undergone chemotherapy treatment is unresolved to this day. Determining the influence of different factors would allow the creation of personalized fertility preservation treatment plans for each patient. Study design, size, duration This observational study was conducted at the V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology. It included 149 patients of reproductive age diagnosed with Hodgkin's lymphoma who had indications to chemotherapy. All of the patients signed an informed consent form prior to participation. Participants/materials, setting, methods The study included 149 participants with a mean age of 23 ± 6.08 years. All of the participants underwent chemotherapy either without (68.09%) or with ovarian protection (OP) (31.91%). The prevalent chemotherapeutic agents were Adriamycin, Oncovin and Bleomycin. The median number of cycles was 6 ± 2.62. Main results and the role of chance Out of all patients 18 had a recurrence and only one died. One patient had three recurrences but after treatment she resumed her menstrual function, achieved one spontaneous pregnancy and live birth. This patient was only 21 years old with very high antral follicular count and had a very short period between recurrences, that way her treatment was performed with continuous GnRH-a protection. Out of patients without OP, 44.8% lost their menstrual function and later had to undergo assisted reproduction treatment, including oocyte donation. Menstrual function recovery rate was higher in both groups with GnRH-a and COC - 80% and 84%, respectively – but not high enough to be statistically significant. Time to recovery was 2 ± 2.57 months, with no significant difference between groups with COC, GnRH-a or without any protection. Patients aged 30 and older had a lower menstruation recovery rate (33.33%) compared to 71.08% and 75% for those younger than 30 and 20, respectively. Two more patients were prepubescent and therefore were not included in the statistical analysis but showed normal regular menses after menarche and achieved spontaneous pregnancies. Limitations, reasons for caution Despite aforementioned results the quantity of factors does not let us draw compelling conclusions about their degree of influence; this way multifactorial analysis with more participants would be more preferable. A higher rate of pregnancies in OP group could also correlate with higher alertness and therefore earlier attempts to conceive. Wider implications of the findings our findings demonstrate the need for and possibility of predictive model development. This would provide an opportunity not only to establish fertility preservation treatment options but also help in reproductive planning for those who have completed their main treatment, taking the risk of POI into consideration. Trial registration number not applicable

Premature Menarche: A Follow-up Study

Follow-up information was obtained from 12 women aged 16-34 years who had been seen previously because of premature isolated menstrual bleeding (premature menarche) starting between ages 9 months and 9 years. All the women reported normal regular menses and fertility was normal in the 6 women who had married.

Daily fluctuation of the serum protein-bound iodine level.

DETERMINATIONS of the concentration of protein-bound iodine (PBI) in serum are being widely used as a measure of thyroid activity. Although the normal range is generally accepted as 4–8 micrograms per 100 ml. of serum, no information is available as to the normal fluctuation of the PBI is one individual from day to day. If great reliance is to be placed on a single PBI result, then it is of importance that the circulating level of the PBI remain fairly constant. Danowski et al. (1) studied the PBI in 4 females and 2 males at about weekly intervals for one and a half to two months. Variations in the females ranged from 0.5 to 0.8 microgram per 100 ml. and in the males from 0.3 to 1.1 microgram per 100 ml. The authors concluded that the PBI level appeared to be relatively constant over a period of weeks in healthy young adults. MATERIALS AND METHODS The subjects were 2 males and 3 females. All the females were in the reproductive period, had normal regular menses, and were studied for slightly more than one...