Serum Progesterone Concentrations Research Articles

Функционирование АВСВ1-белка при беременности

Objective. To study the functioning of ABCB1 protein in pregnancy, namely, to evaluate its amount in the organs that play a significant role in pharmacokinetics and its functional activity at the whole organism level. Materials and methods. The study was performed on 52 female rabbits divided into two groups. Serum concentrations of progesterone, estradiol, testosterone, and prolactin were determined in animals before the experiment and on days 7, 14, 21, and 28 of pregnancy by the radioimmunoassay method. In group 1, the amount of ABCB1 protein was assessed in the jejunum, liver, kidneys, and cerebral cortex at the indicated gestational ages by enzyme immunoassay. In group 2, the functional activity of ABCB1 protein was studied during the same periods by evaluating the pharmacokinetics of its marker substrate fexofenadine. Results. Elevated serum concentrations of progesterone were detected at all gestational ages. There was an increase in the amount of ABCB1 protein compared to non-pregnant animals in the jejunum on days 7, 14, 21, and 28, in the liver – on day 7 with a tendency to increase on day 14, in kidneys and large cerebral cortex – on day 28. Pharmacokinetic parameters of fexofenadine did not differ significantly from those of intact animals, except for elevated T1/2 values on day 14. The results indicate an increase in the amount of ABCB1 protein in the studied organs, which is leveled by a decrease in its activity, which is probably due to the effect of progesterone. Conclusion. The functioning of ABCB1 protein does not change throughout the gestational period; therefore, pharmacotherapy with ABCB1 protein substrates during pregnancy does not require dose adjustments. Key words: ABCB1 protein (P-glycoprotein, Pgp), activity, amount, pharmacotherapy during pregnancy, function

Combined thickness of uterus and placenta, foetal heart rate oscillations and progesterone concentration in last week of canine gestation

This study aimed to evaluate the combined thickness of uterus and placenta, foetal heart rate and serum progesterone concentration in prepartum bitches. Eighteen pregnant female dogs in the last week of gestation were subjected to ultrasonographic examination and progesterone assay to evaluate changes prior to impending whelping. No significant difference was found in the combined thickness of uterus and placenta measurements in the last week of gestation. However, foetal heart rate showed oscillations and progesterone declined 12h prior to whelping.

A possible function of Nik-related kinase in the labyrinth layer of delayed delivery mouse placentas.

In mice and humans, Nik-related protein kinase (Nrk) is an X-linked gene that encodes a serine/threonine kinase belonging to GCK group 4. Nrk knockout (Nrk KO) mice exhibit delayed delivery, possibly due to defective communication between the Nrk KO conceptus and its mother. However, the mechanism of delayed labor remains largely unknown. Here, we found that in pregnant mothers with the Nrk KO conceptus, the serum progesterone (P4) and placental lactogen (PL-2) concentrations in late pregnancy were higher than those in the wild type. Moreover, we demonstrated that Nrk is expressed in trophoblast giant cells (TGCs) and syncytiotrophoblast-2 (SynT-2) in the labyrinth layer of the mouse placenta. In the human placenta, NRK is also expressed in Syn-T in villi. Both human Syn-T and mouse TGCs of the labyrinth layer are present within fetal tissues that are in direct contact with the maternal blood. The labyrinth layer of the Nrk KO conceptus was gigantic, with enlarged cytoplasm and Golgi bodies in the TGCs. To investigate the function of Nrk in the labyrinth layer, a differentially expressed gene (DEG) analysis was performed. The DEG analysis revealed that labor-promoting factors, such as prostaglandins, were decreased, and pregnancy-maintaining factors, such as the prolactin family and P4 receptor, were increased. These findings suggest that the Nrk KO mice exhibit delayed delivery owing to high P4 concentrations caused by the hypersecretion of pregnancy-maintaining factors, such as PL-2, from the placenta.

Correlational analysis of anuclear cell index and serum progesterone concentration for predicting the optimum time of breeding in subfertile bitches

Twenty bitches with previous history of subfertility presented for breeding management at University Veterinary Hospital, Kokkalai were selected for the study. The stage of oestrous cycle was determined and breeding scheduled based predominantly on anuclear cell index (ACI) and serum progesterone assay, after giving due weightage to behaviour and clinical signs. First mating was considered as day 0 and the second as day 3. The mean ACI of the bitches under study was 56.4 ± 1.53 per cent and the mean serum progesterone levels was recorded as 2.82± 0.16 ng/mL three days prior to breeding (day 3). Since, ACI had highly positive correlation with serum progesterone level (Pearson’s correlation coefficient being 0.880) in subfertile bitches three days prior to first breeding, it could be inferred that, when the mean ACI reached more than 55 per cent, serum progesterone levels reach values corresponding to presumably the day of LH surge and by considering both the variables, the day of ovulation could be predicted. Hence, the correlation analysis of ACI and progesterone assay can be considered as reliable method to schedule optimum breeding time in subfertile bitches.

Early diagnosis of pseudopregnancy in goats by ultrasonography and response to treatment using cloprostenol sodium

Pseudopregnancy is a state of temporary infertility in goats characterised by the accumulation of sterile fluid in the uterus in the absence of a foetus with persistent corpus luteum. B-mode ultrasonographic examination of goats on day 60 post-breeding was conducted for differential diagnosis of pregnancy, non-pregnancy and pseudopregnancy. Pseudopregnant does diagnosed on day 60 (day 0) post-breeding (Group I, n=8) were treated with three doses of 125μg of cloprostenol sodium (i/m) 10 days apart and were bred by natural service on induced oestrus after the third dose of treatment. The response to treatment was evaluated and compared with normal cycling does (Group II, n=8) which were mated on spontaneous oestrus. The uterine wall thickness measured ultrasonographically on day 0 in group I and on day 60 post-breeding in pregnant does of group II were 0.63 ± 0.02 and 0.66±0.03 cm, respectively (P >0.05). Serum progesterone concentration estimated on day 0, day of the evacuation of uterine fluid, days 10 and 20 in group I and on day 60 post-breeding in group II were 2.73 ± 0.19, 0.78± 0.19, 1.67 ± 0.10, 1.72 ± 0.19 and 3.64± 0.16 ng/mL, respectively. A statistically significant difference was observed between day 0 in group I and day 60 in group II; within group I, between day 0 and the day of evacuation and between the day of evacuation and day 10. Pregnancy diagnosis on day 60 post-breeding revealed a conception rate of 50 and 75 per cent in groups I and II, respectively (P>0.05).

Serum Progesterone Concentration and Ongoing Pregnancy Rate in Frozen-Thawed Embryo Transfers with Intramuscular Plus Vaginal Progesterone Administration for Endometrial Preparation

Background: Insufficient serum progesterone level in the implantation phase may reduce the rate of pregnancy during freeze embryo transfer (FET) cycles. The present study aimed to evaluate the impact of FET day serum progesterone level on pregnancy outcomes in patients receiving intramuscular plus vaginal progesterone administration for endometrial preparation. Methods: Based on serum progesterone level on FET day, patients were divided into four quartiles: first (<25%), second (26–50%), third (51%–75%), and fourth (>75%). There was no significant difference among groups in basal characteristics. Results: No statistically significant difference was seen among groups concerning the mean number of retrieved and mature oocytes, embryos transferred, and endometrial thickness (EnT). The rate of implantation (P=0.5), biochemical (P=0.75), clinical (P=0.54), and ongoing pregnancy (P=0.5) were not associated with serum progesterone level on embryo transfer day. Conclusion: We found that there is no association between serum progesterone level on ET day and pregnancy outcome during FET cycles. It seems that combination therapy using intramuscular and vaginal progesterone, keeps the serum progesterone on ET day high enough that eliminates the need for serum progesterone measurement.

Structural and Functional Dynamics of the Ovary and Uterus during the Estrous Cycle in Donkeys in the Eastern Caribbean.

Eight non-bred, non-pregnant, regularly cycling Caribbean jennies were examined daily via transrectal ultrasound to define the ovarian and uterine dynamics during four consecutive estrous cycles. Blood samples were collected every other day for progesterone analysis. The mean (±SD) overall inter-ovulatory interval across all donkeys and cycles was 22.93 ± 1.99 days. The maximum follicular diameter was 34.6 ± 2.9 mm. A two-wave pattern was evident in 97% (30/31) of the cycles. The emergence of the future dominant follicle and the largest subordinate follicle of the major primary wave coincided on Day 5.7 ± 3.6 post-ovulation, whereas the secondary wave emerged on Day 19.8 ± 2.9 during estrus of the previous cycle or early diestrus. The secondary wave was often minor (93%, 28/30 cycles). Follicular deviation occurred 8.2 ± 1.4 days before the subsequent ovulation. Luteal volume increased for the first four days after ovulation and reached a maximum volume of 8.5 ± 2.7 mm3 at Day 5.4 ± 0.4, before gradually regressing after Day 15. Serum progesterone concentration increased from Day 1 after ovulation, peaking at 27.0 ± 9.6 ng/mL between 7 and 10 days after ovulation. Progesterone concentration dropped precipitously around Day 15 after ovulation and was below 2 ng/mL around Day 17 ± 2. A day effect (p < 0.0001) was observed for corpus luteum’s volume, progesterone concentration, and uterine tone, but not for endometrial edema (p > 0.05). This study helps to clarify and define normal estrous characteristics of jennies in the Eastern Caribbean.

Growth, maturity, reproduction, and life expectancy in ex-situ pacific walruses (Odobenus rosmarus divergens)

BackgroundPacific walruses are found in Arctic regions of the Chukchi and Bering Sea where rapid changes in environmental conditions resulting in loss of sea ice are occurring. Therefore, accurate life history data are crucial for species management plans and longitudinal data collected over the lives of individual walruses housed in zoos and aquaria provide otherwise difficult to obtain biological information.ResultsWhile similar at birth, Gompertz regression curves indicated that males grew faster than females (p < 0.0001) in weight (99 kg vs 57.6 kg/y) and length (26.9 cm vs 26.3 cm/y) with physical differences being detected by age 3 for weight and age 7 for length. Males reached adult weight at 13.5 ± 3.3 y and females by age 12.3 ± 2.3 y. The mean age at first ovulation and at first conception occurred at 8.8 y and 9.6 y. Greater than 75% of all conceptions and calving occurred between February and March and from May to June, respectively. Mean gestation lasted 423 d and false pregnancies lasted at least 169 d with a decrease (p < 0.05) in serum progesterone concentration between false pregnancy and pregnancy occurring within 6 months after ovulation. Based on these results, we estimated embryonic diapause to last from 120 to 139 days, and fetal growth last ~ 284 days. All males older than 8 y had an increase in serum testosterone and body weight that was highest in February and lowest in July. Overall, no differences were observed between male and female survival, with a mean (± SEM) life expectancy of 19.5 ± 1.5 y, respectively. Currently, the oldest male and female captive walruses are 40 and 43 y, respectively.ConclusionsData provided herein include details of life history characteristics of zoo and aquaria housed walruses that are useful for wild population recovery models. In particular, results on survivorship and the identification of the most vulnerable period for calf survival can help with model development and suggests that for recovery to occur birthing locations for this species must be protected.

Individualized luteal phase support based on serum progesterone levels in frozen-thawed embryo transfer cycles maximizes reproductive outcomes in a cohort undergoing preimplantation genetic testing.

Low serum progesterone concentration on frozen embryo transfer (FET) day in hormone replacement therapy (HRT) cycles results in lower reproductive outcomes. Recent studies showed the efficiency of a "rescue protocol'' to restore reproductive outcomes in these patients. Here, we compared reproductive outcomes in HRT FET cycles in women with low serum progesterone levels who received individualized luteal phase support (iLPS) and in women with adequate serum progesterone levels who underwent in vitro fertilization for pre-implantation genetic testing for structural rearrangements or monogenic disorders. This retrospective cohort study included women (18-43 years of age) undergoing HRT FET cycles with pre-implantation genetic testing at Montpellier University Hospital between June 2020 and May 2022.A standard HRT was used: vaginal micronized estradiol (6mg/day) followed by vaginal micronized progesterone (VMP; 800 mg/day). Serum progesterone was measured after four doses of VMP: if <11ng/ml, 25mg/day subcutaneous progesterone or 30mg/day oral dydrogesterone was introduced. 125 HRT FET cycles were performed in 111 patients. Oral/subcutaneous progesterone supplementation concerned 39 cycles (n=20 with subcutaneous progesterone and n=19 with oral dydrogesterone). Clinical and laboratory parameters of the cycles were comparable between groups. The ongoing pregnancy rate (OPR) was 41.03% in the supplemented group and 18.60% in the non-supplemented group (p= 0.008). The biochemical pregnancy rate and miscarriages rate tended to be higher in the non-supplemented group versus the supplemented group: 13.95% versus 5.13% and 38.46% versus 15.79% (p=0.147 and 0.182 respectively). Multivariate logistic regression analysis found that progesterone supplementation was significantly associated with higher OPR ​​ (adjusted OR = 3.25, 95% CI [1.38 - 7.68], p=0.007). In HRT FET cycles, progesterone supplementation in patients with serum progesterone concentration <11 ng/mL after four doses of VMP significantly increases the OPR.

Ovarian remnant syndrome in small animals: case series

Our objective was to report the utility of various diagnostic tests in identifying ovarian remnant syndrome (ORS) in dogs and cats. Medical records from 2 referral teaching hospitals (Health Sciences Centre at the Ontario Veterinary College and Cornell University Hospital for Animals) were examined and 48 animals (31 dogs and 17 cats) were chosen. Data included were based on sufficient clinical or diagnostic evidence of ORS. Histopathology was used as the confirmatory test for ORS. There was no difference between the proportions of dogs versus cats diagnosed with ORS. Similarly, there was no difference in the proportions of ovarian remnants (OR) between large, medium, or small dogs, or the side (right, left, or bilateral) in which OR was diagnosed. Vaginal cytology and transabdominal ultrasonography findings, and serum progesterone concentrations had the highest chance of correctly identifying an OR prior to exploratory surgery. Transabdominal ultrasonography had strong agreement with OR location identified at surgery. Presumptive intraoperative diagnosis of OR was possible in 39/41 cases (95.1%). Auxiliary diagnostic testing should be recommended to confirm functional ovarian tissue before surgery to reduce unnecessary surgery. Additionally, transabdominal ultrasonography examination may reduce surgical time since ovarian remnant location has strong agreement with surgical findings.

Do serum biochemistry parameters affect the embryo yield in goats?

The aim of this study was to investigate the effects of serum biochemistry parameters on superovulation response, embryo yield and quality on the onset of synchronization and superovulation protocols in goats. Twelve Angora Goats aged 3–5 years, who gave birth at least once and did not have any reproductive problems were used in the study. For synchronization, progesterone source was placed intravaginally for 11 days (Day 0) and FSH was administered at 12-hour intervals in 6 decreasing doses starting from the 9th day. On the 11th day, the progesterone source was removed from the vagina, and 24 h later, the donors were mated with bucks of known fertility. Embryos were collected surgically 156 h following mating. To evaluate serum biochemistry parameters and progesterone concentrations in the study, blood samples were taken on the days of inserting the progesterone source (day 0) and uterine flushing (day 19). A positive correlation was determined between total protein, glucose and progesterone level on the day the progesterone source was inserted (P < 0.05). However, a negative correlation was found between zinc and progesterone level on the day of uterine flushing (P < 0.05). A positive correlation was determined between the triglyceride, total protein, glucose and potassium levels on the day of inserting the progesterone source and the number of transferable embryos (P < 0.05). A negative correlation was found between the blood urea level and the number of Code I embryos (P < 0.05). There was a positive correlation between calcium level and total CL and total cell number, and a negative correlation between the number of degenerated embryos (P < 0.05). However, a negative correlation was found between triglyceride and oocyte count (P < 0.05). In addition, a positive correlation was found between potassium and the number of Code I embryos (P < 0.05). As a result, it was concluded that there may be a relationship between some serum biochemistry parameters (total protein, glucose, triglyceride, potassium, calcium, urea) and embryo yield and quality on the onset of synchronization and superovulation protocols in goats. In addition, it is thought that it would be useful to evaluate the serum biochemistry parameters of donors before starting the synchronization and superovulation protocols as an additional clinical parameter to select animals that can respond better to superovulation treatments.

Seasonal changes of gonadal activity of invasive vermiculated sailfin catfish (Pterygoplichthys disjunctivus) from Polgolla reservoir in Sri Lanka

The present study elucidates the pattern of the reproductive activity of the invasivePterygoplichthys disjunctivusmale (n = 113) and female (n = 124) fish in Polgolla Reservoir, Sri Lanka. The reproductive activity was studied based on the gonadosomatic index (GSI), macroscopic and microscopic features of the testes and ovaries, and the serum testosterone and progesterone level during a 12-month study period. The monthly GSI of male fish (P = 0.0001) was the highest (0.333 ± 0.08%) in October and the lowest (0.044 ± 0.01%) in January whereas in the female fish, the GSI was not changed significantly (P = 0.1780) during the 12-month period of sampling. The mean monthly serum testosterone concentration (P = 0.0244) was the highest (0.396 ± 0.332 ng/ml) in March and the lowest (0.085 ± 0.156 ng/ml) in August, while the mean serum progesterone concentration of female fish showed no significant difference (P = 0.4798). Histological examination revealed that the testes with seminiferous tubules filled with sperm and the ovaries with mature oocytes were present throughout the year. Therefore, based on the results of histology and reproductive characteristics, we concluded that both male and femaleP. disjunctivusin Polgolla Reservoir are breeding throughout the year.

Follicular Dynamics and Endocrine Profile during Normal Estrous Cycle and Early Pregnancy in Surti Buffaloes

The study was conducted on Surti buffaloes for follicular dynamics and endocrine profile during normal estrous cycle (n=6) and early pregnancy (n=6). In cyclic and early pregnant buffaloes, one-wave (33.33% vs. 50.00%) and two-waves (66.66% vs. 50.00%) follicular development was recorded, without three-wave pattern. In cyclic buffalo, the length of estrous cycle and duration of inter-ovulatory interval were little shorter in one wave cycles than in two wave cycles (22.50±0.50 and 23.25±0.25 days). The number of follicles differed non-significantly within and between cyclic and early pregnant buffaloes. The mean maximum diameter of dominant follicle of second wave was significantly larger in cyclic than early pregnant animals for two wave pattern (1.09±0.02 vs 0.73±0.02 cm). In cyclic buffaloes, the mean maximum CL size recorded was 1.21±0.02 and 1.52±0.05 cm (P&lt;0.05) in one- and two-wave cycles, respectively, whereas in early pregnant buffaloes, the corresponding CL size was 1.50±0.04 and 1.55±0.07 cm without significant difference. Thus the mean maximum CL size of early pregnant buffaloes was significantly larger than the cyclic buffaloes with one-wave cycle (1.50±0.04 vs. 1.21±0.02 cm). In the normal cyclic animals, the CL size increased gradually up to day 8 (1.30±0.04 cm) and then remained stable up to day 18 (1.26±0.15 cm), followed by regression and display of next estrus between day 19 and 21, whereas in early pregnant animals the CL size gradually increased up to day 10 (1.48±0.07 cm) and then it was maintained till day 22 (1.46±0.04 cm) of monitoring. The mean diameter of largest follicle recorded was on the day of estrus (0.98±0.07 cm) with variable development of follicles during metestrus to diestrus phase with a new follicles developed during proestrus to estrus phase reaching maximum diameter of ovulatory size (0.99±0.09 cm) between days 19 and 21, whereas in early pregnant animals, the diameter of larger follicle (0.76±0.05 cm) was not recorded up to ovulatory size. The mean concentrations of serum progesterone were lowest during peri-estrus phase, increased through early-luteal phase to a maximum concentration during mid-luteal phase (4.50±0.88 to 4.67±0.95 ng/ml) and then gradually declined through late-luteal phase of diestrus in normal cyclic animals with inverse trend in estradiol profile. However, in early pregnant animals the progesterone levels gradually increased initially and then were maintained higher (6.17±0.32 to 8.13±0.55 ng/ml) with basal estradiol throughout the luteal phase. The serum progesterone/estradiol levels were in harmony with the ovarian dynamics in both cyclic and early pregnant buffaloes. The mean concentrations of serum FSH, LH and kisspeptin in normal cyclic and early pregnant animals did not vary statistically between periods within the status or between reproductive status of animals at any of the periods. The concentration of serum kisspeptin dropped significantly in advanced pregnancy as compared to first and second trimester.

RELATIONSHIP BETWEEN ROUTE OF PROGESTERONE SUPPLEMENTATION, SERUM PROGESTERONE CONCENTRATION, AND LIVE BIRTH FROM VITRIFIED-WARMED BLASTOCYST TRANSFERS: SECONDARY ANALYSES OF A RANDOMIZED CONTROLLED TRIAL (RCT)

Recent RCT data indicate that programmed endometrial preparation regimens inclusive of intramuscular progesterone (IMP) are superior to regimens using vaginal progesterone (VP) only, in terms of live birth (LB) from frozen embryo transfer (FET) (1). Studies suggest inferior FET outcomes with lower serum progesterone concentration (P). A recent meta-analysis suggested P <10ng/mL as a negative prognosticator. However, most published analyses relied upon FET with VP only (2). It remains unclear whether P is associated with lower LB when IMP is used.

Features of the sonographic picture in female veterans of reproductive age who suffered injuries during combat actions

The objective: to study the features of the sonographic picture of the pelvic organs in women of reproductive age who took part in combat operations and suffered a concussion. Materials and methods. Ultrasound examination of the pelvic organs with Doppler study on the 5th and 21st days of the menstrual cycle was performed in 457 women of reproductive age who took part in combat operations and suffered a concussion. 246 patients of theses persons with a history of trauma without post-concussion syndrome were included in the comparison group, 211 women with consequences of concussion in the form of post-concussion syndrome – in the main group. The control group included 30 healthy civilian women of reproductive age. The concentration of progesterone in blood serum was studied in all subjects on the 5th and 21st days of the menstrual cycle. The average age of women was 37.08±4.23 years. The period of stay in the combat zone was 60.26±42.21 months, the time since the traumatic brain injury (concussion) was 18.8±9.2 months. Results. In patients of the main group without hyperplastic processes of the endometrium the M-echo thickness on the 21st day of the menstrual cycle was 1.12 times less (p&lt;0.001) than in the control group, and 1.15 times less in patients in the comparison group (p&lt;0.001). In 20.71 % of women with a contusion during combat operations, there is an inferior secretory transformation of the endometrium with increased echogenicity only in the peripheral parts of the M-echo with a hypoechoic zone in the center, in 13.81 % of patients there are no secretory changes in the endometrium on echograms, which manifested by the preservation on the 21st day of its three-layer construction, typical for the preovulatory period, with a hypoechoic functional layer. Intrauterine synechiae are formed in 10.95 % of women who suffered contusions during combat operationss, hyperplastic endometrial processes – 30.24 % of women, 12.3 8% of which had hyperplasia, 17.86 % –endometrial polyps.In patients who suffered a contusion during combat operations a decrease in the vascularization of the corpus luteum with a significant increase in the resistance index of blood flow in the corpus luteum by 1.27 times and a decrease in the maximum systolic velocity by 1.19 times was, in the subjects of the main group compared to women of the comparison group – 1.07 (p&lt;0.01) and 1.05 (p&lt;0.01) times, respectively. On the 21st day of the menstrual cycle in women who took part in combat operations and had concussion, a correlation between the level of serum progesterone and the index of blood flow resistance in the corpus luteum – r=-0.76, p&lt;0.05, as well as maximum systolic blood flow velocity - r=0.70, p&lt;0.05 was established. Conclusions. According to the ultrasound examination of the pelvic organs for women of reproductive age who took part in combat operations and suffered a concussion, ultrasound changes in the structure of the tissues of the pelvic organs and their vascularization are typical, in particular, the thickening of the M-echo on the 21st day of the menstrual cycle, and in a third of cases – the presence of hyperplastic changes of the endometrium.

Aspects of the rehabilitation of the reproductive function of women after urgent gynecological surgery

The objective: to assess the hormonal homeostasis and ovarian reserve in women of reproductive age after urgent gynecological operations due to the symptom complex of “acute abdomen”.Materials and methods. The studied cohort included 90 women 19–40 years old. The main group included 60 women after emergency surgery for ectopic pregnancy (23 patients), ovarian apoplexy (18 patients), complicated ovarian tumor (19 patients), and at the rehabilitation stage they refused to receive the proposed hormonal therapy; control group – 30 women of reproductive age without somatic and gynecological pathology. A complex study of the reproductive system was carried out: ultrasound (transvaginal) examination of the pelvic organs with the calculation of the number of antral follicles, determination of the levels of estradiol, follicle-stimulating hormone, luteinizing hormone, prolactin, thyroid-stimulating hormone, free testosterone index, anti-Müllerian hormone (AMH), and 25(OH)D level in blood serum. The examinations were carried out 3 and 6 months after surgery. Statistical processing of the results was performed using the Microsoft Excel 7.0 and “Statistica 6.0” standard programs.Results. The average age of the patients was 26.4±3.5 years. Before the current surgical intervention, 21 % of patients in the main group were diagnosed premenstrual syndrome, dysmenorrhea, abnormal uterine bleeding, pelvic inflammatory disease, and ovarian tumors. In the postoperative period, the most often menstrual cycle (MC) disorder was an increase in its duration (56.7 % of patients). 63.3 % of patients after urgent gynecological operations had normogonadotropic dysfunction of the ovaries, which is characterized by anovulation, insufficiency of the luteal phase and the ovarian blood flow disorders. The restoration of normal two phases of MC after 6 months was found in 34.2 % of the patients who did not have the hormonal correction. In 18.3 % of patients with ovulatory MC, the insufficiency of the luteal phase is characterized by a decrease of progesterone concentration in the blood serum on the 18–20th day of MC and a disperancy in the endometrium structure. Transient hyperprolactinemia was found in 15.0 % of patients. The surgical injury of the ovary in some patients leads to a decrease in the ovarian reserve. AMH indicators in 61.1 % of patients with the effect of surgical energies on the affected ovary were significantly reduced (0.67±0.4 ng/ml) compared to controls (2.1±0.3 ng/ml; p&lt;0.01) until the 6th month after the operation. Similar dynamics were absent in patients operated on for a ruptured tubal pregnancy. The recovery of the two phases of MC during a six-month observation was established in only 47.4 % of patients with torsion of an ovarian tumor.As a result of the lack of complex rehabilitation therapy, the repeated operations due to the ruptured tubal pregnancy happened in 13.5 % of patients, recurrence of apoplexy and/or ovarian tumors – in 25.8 % of women.Conclusions. Acute gynecological pathology, which requires immediate surgery, occurs in 21 % of patients with the disorders of the reproductive system. In 63.3 % of women after urgent gynecological operations, normogonadotropic dysfunction of the ovaries was observed, which was characterized by anovulation, insufficiency of the luteal phase and ovarian blood flow disorders. The absence of rehabilitation complex therapy causes recurrence of acute gynecological pathology in 13.5–25.8 % of operated women.

Melatonin efficacy in comparison with PMSG-HCG program for induction of fertile estruc in Iraqi anestrus bitches

This study was conducted to investigate the ability of melatonin as S/C implant in induction of fertile estrus in bitches, evaluation the treatment with PMSG-HCG in induction of estrus, and monitoring serum concentration of Estrogen and Progesterone before and after treatment, during November (2020) to May (2021) at the College of Veterinary Medicine, University of Baghdad, Baghdad, Iraq. Therefore, 21 local female dogs aged 2-4 years and two fertile males aged 2-5 years were used for natural insemination. Animals were divided equally into 3 groups including 1st group were treated with Melatonin implant S/C 18 mg /animals, 2nd group were treated with PMSG I.M 30 IU / animal for 7 days, in day 8 hCG I.M 100 IU / animal were injected and 3rd group were left as control (without treatment). After that, the bitches were subjected for clinical examination and behaviors investigation, vaginal smears sampling and hormonal evaluation (estrogen and progesterone). The findings of vaginal cytology reveled that parabasal and superficial cells were predominant during the estrus phase. Animal response recorded a significant increase between all groups, with high significance at 1st group comparing with 2nd and 3rd groups, in addition to high significant difference between 2nd and 3rd groups. Duration of response was significantly longer in 3rd group but lowered in 1st group. Pregnancy rate was higher in the 1st and 2nd group. The number of offspring in Iraqi bitches treated with melatonin for estrus induction G1 was 43 pups in G2 it was 29 pups and 7 pups for G3, the sex of offspring recorded 49.37% females and 50.63% males in total. In conclusion, the use of melatonin for induction of fertile estrus in anestrus Iraqi bitches was effective and safe.

Ovarian contrast-enhanced ultrasonography and Doppler fluxometry in bitches during the postovulatory estrus and corpora lutea formation

The aim of the present study was to evaluate the vascularization features of canine ovaries during the follicular phase and the formation of the corpora lutea by using Doppler ultrasonography and Contrast-Enhanced Ultrasound (CEUS). Eight healthy bitches were enrolled in the study and were evaluated at five different timepoints (T1 – T5) of the estrous cycle established by vaginal cytology and serum progesterone concentration. Ultrasonographic examinations were performed by a single operator using the ACUSON S2000/SIEMENS machine equipped with a linear multifrequency transducer (9.0 MHz). Color-coded Doppler evaluation of the ovarian parenchyma was performed to investigate the aspects of the signal detection throughout the different timepoints. Pulsed-wave Doppler of the intraovarian arteries was performed to evaluate spectral waveform and doppler velocimetric parameters of Systolic Peak Velocity (SPV cm/s), End Diastolic Velocity (EDV cm/s), Resistivity Index (RI) and Pulsatility Index (PI). CEUS evaluation of the ovaries was performed using a vascular contrast agent (SonoVue®, Bracco, Sao Paulo, Brazil) and the CADENCE™ Contrast Pulse Sequencing (CPS, Siemens) software, in order to perform both qualitative and quantitative analysis. Perfusion parameters of pixel number, peak intensity (PPI in %), time to peak intensity (TTP in s), mean transit time (MTT in s) and area under the curve (AUC in %). Colour-coded Doppler evaluation demonstrated an increase in signal detection as cycle progressed, with blood flow initially detected with few coloured pixels and mainly at the ventral surface of the ovaries. Further on, the number of coloured pixels increased and spreading to the central region, resulting in a circular-like pattern around the corpora hemorrhagica. The spectral waveform was consistent at all timepoints. SPV (cm/s) and EDV (cm/s) presented a numeric trend and a slight statistical difference at all timepoints, whereas no difference was found for RI and PI. CEUS evaluation demonstrated an increase in pixel intensity across all the timepoints. Quantitative CEUS analysis revealed a statistical difference in PPI (%), MTT (s) and AUC (%) at T5. CEUS evaluation of the ovaries was feasible and demonstrated a marked increase in perfusion parameters in the late postovulatory period, demonstrating its applicability in the assessment of canine corpora lutea development.

Relugolix/Estradiol/Norethisterone (Norethindrone) Acetate: A Review in Symptomatic Uterine Fibroids.

An oral fixed-dose combination of relugolix/estradiol/norethisterone (also known as norethindrone) acetate (Ryeqo®; Myfembree®) has been approved for the management of heavy menstrual bleeding associated with uterine fibroids in the USA and management of moderate to severe symptoms of uterine fibroids in the EU. Relugolix is a gonadotropin releasing hormone (GnRH) receptor antagonist that decreases serum estradiol and progesterone concentrations to postmenopausal levels. The addition of estradiol/norethisterone acetate to relugolix ameliorates relugolix-induced bone loss and hot flush. In the two phase 3 LIBERTY trials, relugolix + estradiol/norethisterone substantially decreased menstrual bleeding and improved a range of other uterine fibroid symptoms in women with uterine fibroids-associated heavy menstrual bleeding. The combination was generally well tolerated, with vasomotor symptoms being the most common adverse reaction. Treatment with this combination for over up to 2 years did not induce a clinically meaningful bone loss in the majority of women. Relugolix/estradiol/norethisterone acetate, with its convenient once-daily administration, is a useful addition to current pharmacological treatment options for premenopausal women with symptomatic uterine fibroids.

The Comparison the Impact of Flare-up GnRH Agonist with Delayed-Start GnRH Antagonist Protocols on the IVF Outcome of Poor Responder Patients: A Randomized Controlled Trial

Objectives: The current research was established to make a comparison between the delayed-start GnRH antagonist and flare-up GnRH agonist protocols in poor response patients. Methods: The present study is a randomized, prospective, controlled trial that was performed on 150 women who referred to two distinct in vitro fertilization (IVF) centers in Iran. Patients were randomly assigned to two experimental groups, as one group was treated with the delayed-start GnRH antagonist protocol (delayed-start group), while another group was treated with the flare-up protocol (flare-up group). Results: The serum concentrations of estradiol and progesterone, along with the thickness of endometrial tissue and the number of follicles ≥13 mm was significantly increased in the delayed-start group compared with the flare-up group. Also, the number of total oocytes, retrieved mature oocytes, total embryos, fertilized oocytes, as well as the quality of embryos were markedly higher in the delayed-start group when compared with the flare-up group. No statistically significant difference was found in the rates of fertilization, implantation, and pregnancy between the two experimental groups. Conclusions: According to the above evidence, it seems that the effect of delayed-start protocol on ovarian responsiveness was more pronounced during controlled ovarian stimulation in comparison with the flare-up protocol and the delayed start protocol probably lead to better implantation and pregnancy rates in comparison with the flare up agonist protocol cycle in poor responders.