Serum FSH Levels Research Articles

MON-272 Clinical Relevance of Serum Prolactin Levels to Inflammatory Reaction in Male Patients

PRL is a polypeptide hormone that is, in phylogeny, well conserved but elicits various species-dependent functions. PRL is related to the regulation of osmotic pressure in fish and amphibians, fat retention in reptiles and birds, and glucose-lipid metabolism, bone homeostasis and development of the mammary gland in mammals. In humans, PRL secretion is regulated in an inhibitory manner by dopaminergic neurons that project from the hypothalamus to PRL-producing cells in the anterior pituitary gland. Since dopaminergic actions are mainly mediated by D2R, various agents that bind D2R can affect serum PRL levels. In the clinical aspect, hyperprolactinemia is considered in cases with galactorrhea, infertility and sexual dysfunction. Other causes of hyperprolactinemia include hypothyroidism, chronic kidney disease and pregnancy. Also, PRL receptors have been considered as therapeutic targets for some cancers and autoimmune diseases. Given that several pathophysiological functions related to PRL have been recently uncovered, the utility of measuring serum PRL levels could be more widely applicable for a clinical setting. We therefore attempted to reveal the relevance of PRL levels to various clinical parameters in patients who visited a general medicine department. We reviewed medical records of 353 patients whose serum PRL levels were measured in our department during the period from 2016 to 2018. Patients lacking detailed clinical records (n=194) and patients taking medications that affect D2R (n=19) were excluded from this study. Data were analyzed for 140 patients (42 males, aged 49 ± 18 years; 98 females, 45 ± 19 years) in whom various pain and general fatigue were major symptoms at the first visit and in whom hypertension and dyslipidemia were frequently seen in past histories. Average PRL levels were significantly lower in males than in females. The median PRL level in males was 6.5 ng/ml (IQR: 4.2–10.3) ng/ml and that in females was 8.1 ng/ml (5.9–12.9). Patients were divided into two groups depending on whether PRL levels were higher than 10 ng/ml. The group of males with relatively high PRL levels (≥10 ng/ml) had significantly lower levels of serum albumin and higher levels of serum LDH. Of note, there were significant correlations of male PRL levels to erythrocyte sedimentation rate (ESR) (r=0.6), serum LDH (r=0.4) and albumin level (r=-0.5), and TSH/FT4 ratio (r=0.5). On the other hand, female PRL levels were negatively correlated to age (r=-0.2) and serum levels of FSH (r=-0.3) and positively correlated to serum levels of GH (r=0.3). Collectively, the results revealed that PRL levels had gender-specific relevance to various clinical factors. It is notable that PRL levels in males were related to inflammatory status shown by high ESR and low serum albumin and were also associated with a hypothyroid condition.

SUN-241 Adult Exposure to Iodoacetic Acid Leads to Abnormal Expression of Key Genes Related to Hypothalamic and Pituitary Control of Reproductive Function

Water disinfection byproducts (DBPs) are formed when chemicals used to decontaminate water come into contact with natural or synthetic organic material. DBPs have been linked to a range of health concerns including reproductive disfunction. One such DBP, the monohalogenated iodoacetic acid (IAA), is formed when iodide reacts with a disinfectant, for example, chlorine. IAA is of particular health concern; not only is iodide widely present in the water supply, especially in coastal communities and those near fracking sites, but IAA has been found to be one of the most cyto- and genotoxic DBPs. Further, a previous study has indicated that in vitro IAA exposure significantly inhibits antral follicle growth and reduces estradiol levels in ovaries. However, little is known about how IAA affects the other major components of the reproductive axis: the hypothalamus and pituitary. The reproductive axis relies on homeostatic release of hormones to communicate from one organ to another and alterations at any level may impact reproduction. So, we set out to test the hypothesis that exposure to IAA would lead to disrupted expression of key hypothalamic and pituitary genes related to reproductive function. We continually exposed female adult CD1 mice to 0.5, 10, 100, or 500 mg/L IAA in their drinking water for approximately 35 days (postnatal day 40 (P40) to their first day in diestrus following P75.) Whole pituitaries and hypothalamic punches containing the arcuate nucleus (ARC), anteroventral periventricular zone (AVPV), and medial preoptic nucleus (mPOA) were collected and processed for qPCR analysis. We find that while kisspeptin (Kiss1) expression in the AVPV - the population responsible for generating the LH surge - is unchanged, 0.5 mg/L IAA exposure significantly increases Kiss1 in the ARC, which controls pulsatile GnRH release, and there is a trending increase (p=.056) at 10mg/L. We also measured ARC expression of Neurokinin B (NKB; Tac2), a neuropeptide secreted by kisspeptin co-expressing neurons to autosynaptically stimulate Kiss1 release. We found no change in mRNA levels of Tac2. We also saw no significant changes in GnRH (Gnrh1) mRNA expression. At the level of the pituitary, there is no change in Lhb mRNA levels. Exposure to 10 mg/L IAA leads to significantly reduced Fshb expression, however FSH serum levels are not significantly changed. These data, taken together with previous findings in the ovary, indicate that IAA has the potential to disrupt each major level of the reproductive axis: ovarian follicle development and steroid synthesis, hypothalamic arcuate Kiss1 synthesis, and Fshb synthesis from the pituitary. Further research is necessary to elucidate at which levels IAA acts directly and at which it acts through action on another component of the axis. Additionally, future studies can clarify the mechanism through which IAA has these effects.

SAT-043 Utility of Ultrasensitive Inhibin B Measurement for the Management of Men with Non-Obstructive Azoospermia

Inhibin B measurement by conventional assay(s) may be useful in the assessment of spermatogenesis in infertile male patients, especially in cases of azoospermia. Indeed, numerous previous studies have shown that Inhibin B could be helpful to predict a positive testicular sperm extraction (TESE). However, an undetectable Inhibin B concentration (<10pg/mL) does not predict a TESE failure in all cases. These findings explained that most medical centers have precluded the use of Inhibin B assay in the pre-operative hormonal assessment of azoospermic men. Recently, an ultrasensitive Inhibin B assay has been developed allowing the measurement of concentrations below 10pg/mL. The current study aims to assess the clinical relevance of this new assay in men with azoospermia with undetectable Inhibin B levels by conventional assay(s).Methods: This retrospective study included 71 non-obstructive azoospermic men who had undetectable Inhibin B levels (i.e. <10pg/mL by Gen II ELISA from Beckman Coulter, USA) and who underwent a TESE procedure between 2013 and 2019 in the Lille University Hospital. Serum LH, FSH and testosterone levels were systematically measured by routine immunoassays. Cryopreserved serum samples were used to perform ultrasensitive Inhibin B assay (Ultrasensitive Inhibin B, AL-195, Ansh Labs, USA). Additional hormonal assays including Inhibin A, Activin B and Activin A were performed on available subset of samples.Results: The TESE was successful, allowing sperm cryopreservation in 32.5 % (25/71) of the cases. No significant statistical difference was found in FSH, LH, or testosterone levels between patients with positive or negative TESE. By contrast, men with positive TESE had more than twice higher serum ultrasensitive Inhibin B levels (median 5.03pg/mL [1.93-8.5] vs. 2.19pg/mL [0.2-4.72], p=0.006). An ultrasensitive Inhibin B serum level >3.67 pg/mL (determined by ROC analysis) was associated with increased odds ratio (OR= 4.82; 95% CI: 1.647-12.93) for positive TESE. Inhibin A, Activin B and Activin A serum concentrations did not differ significantly between the two groups.Conclusion: FSH measurement which is routinely performed in men with azoospermia was not predictive of successful TESE whereas, Inhibin B was found to be a valuable marker in predicting TESE success in this population using ultrasensitive Inhibin B assay.

The protective effect of recombinant globular adiponectin on testis by modulating autophagy, endoplasmic reticulum stress and oxidative stress in streptozotocin-induced diabetic mice

This study was to investigate whether recombinant globular adiponectin produced its protective effect on the testis of diabetic mice by modulating autophagy, endoplasmic reticulum stress and oxidative stress. Male mice were randomly divided into control, diabetic, diabetic treated with low and high dose of adiponectin. Mice were killed at the termination after 4 weeks and 8 weeks of adiponectin treatment. Serum levels of glucose, lipids, testosterone, insulin, LH and FSH were measured. The protein expression of glucose-regulated protein 78 (GRP78), C/EBP homologous protein (CHOP), Caspase12, Beclin1, microtubule-associated protein light chain 3 (LC3) and p62 was determined by western blotting. The mRNA expression of adiponectin receptor 1 (AdipoR1), p22phox, p47phox, nuclear factor erythroid2-related factor 2 (Nrf2), NAD(P)H-quinone oxidoreductase 1(NQO1), heme oxygenase-1 (HO-1) and superoxide dismutase (SOD) were determined by real-time fluorescence quantitative PCR. The testicular weight, the sperm number and motility, and the serum levels of testosterone and insulin were significantly decreased in diabetic mice (P < 0.05). The expression of Beclin1, LC3, Nrf2, NQO1, HO-1, SOD and AdipoR1 were significantly decreased (P < 0.05), while the expression of GRP78, CHOP, Caspase12, p62, p22phox and p47phox were notably increased in the testes of diabetic mice (P < 0.05). Adiponectin treatment significantly reversed the above-mentioned changes in the testes of diabetic mice, some of which were dose- and time-dependent (P < 0.05). These data suggested that recombinant globular adiponectin may produce the protective effect on the testes of diabetic mice by inducing autophagy and inhibiting ER stress and oxidative stress.

Tandem mass tag-based proteomic analysis reveals the treatment mechanism of Bushen Huoxue Formula on psychological stress-induced premature ovarian insufficiency

Ethnopharmacological relevanceBushen Huoxue formula (BSHXF) is a Chinese herbal prescription composed of eleven herbs widely used to treat psychological stress-induced premature ovarian insufficiency (POI) in clinical. However, the underlying mechanism is still unclear. Aim of the studyThe purpose of this study was to clarify the underlying molecular mechanisms of BSHXF in the treatment of psychological stress-induced POI. Materials and MethodsThe rat model was induced by corticosterone (CORT, 40mg/kg). Drugs were administered to rats once daily for 21 days. The serum E2, FSH and AMH levels were examined by enzyme-linked immunosorbent assays. Tandem mass tag-based proteomic analysis was used to identify differentially expressed proteins. Western blot was used to verify the results of proteomic. ResultsOur results indicate that BSHXF can improve ovarian disfunction. The levels of serum FSH were signally enhanced in model group compared to control group. As respected, BSHXF treatment for 3 weeks led to the decreased FSH levels than the model group. The concentrations of AMH showed an obvious decrease in the model group and were increased by BSHXF treatment. Moreover, the size and number of follicles in the BSHXF groups were similar to those in the control group. The proteomic screened out that Np4 and Angptl4 were simultaneously enriched by GO and KEGG, thus these two proteins were chosen for further study. ConclusionsThese findings revealed that BSHXF might regulate the expression of Np4 and Angptl4 to improve psychological stress-induced POI.

Evaluation of Reproductive Hormones in Patients with ?-Thalassemia Major in Misan Province, Iraq

Assessment of serum ferritin, FSH, LH, estradiol, testosterone levels in ?-thalassemia major patients. A total50 (30 male and 20 female) children with ?- thalassemia major patients with ages range 11- 16 years and 50age and sex matched healthy adolescents as control group were included in this study. The study subjectsdivided into 2 more subgroups: 11-13 years, and 14-16 years to measure mean serum ferritin, FSH, LH,testosterone, estradiol hormones. There was significant increase (P &lt;0.05) in serum ferritin level in maleand female patients as compared to control groups. Male patients have significant decreased (P&lt;0.05)serumlevels of FSH, LH, testosterone and estradiol, while female patients have non-significant (P &gt;0.05) highserum FSH and testosterone levels, but LH, estradiol levels were non-significant (P&gt;0.05) lowas comparedto control. In age subgroup 11–13 years, male patients have significant (P&lt;0.05) decreased reproductivehormones levels as compared to control, however in 14 – 16 years subgroups serum FSH,LH and estradiollevels in male patients were significantly decreased as compared to control (P&lt;0.05), whereas,hormoneslevels in female patients didn’t show significant differences in comparison to female control in both agesubgroups (P&gt;0.05). Serum ferritin had an inverse correlation with serum FSH, LH, testosterone, estradiolhormones levels. Patients with ?- thalassemia major have iron overload with inverse correlation betweengonadal hormones and serum ferritin.

Murine FSH Production Depends on the Activin Type II Receptors ACVR2A and ACVR2B.

Activins are selective regulators of FSH production by pituitary gonadotrope cells. In a gonadotrope-like cell line, LβT2, activins stimulate FSH via the activin type IIA receptor (ACVR2A) and/or bone morphogenetic protein type II receptor (BMPR2). Consistent with these observations, FSH is greatly reduced, though still present, in global Acvr2a knockout mice. In contrast, FSH production is unaltered in gonadotrope-specific Bmpr2 knockout mice. In light of these results, we questioned whether an additional type II receptor might mediate the actions of activins or related TGF-β ligands in gonadotropes. We focused on the activin type IIB receptor (ACVR2B), even though it does not mediate activin actions in LβT2 cells. Using a Cre-lox strategy, we ablated Acvr2a and/or Acvr2b in murine gonadotropes. The resulting conditional knockout (cKO) animals were compared with littermate controls. Acvr2a cKO (cKO-A) females were subfertile (~70% reduced litter size), cKO-A males were hypogonadal, and both sexes showed marked decreases in serum FSH levels compared with controls. Acvr2b cKO (cKO-B) females were subfertile (~20% reduced litter size), cKO-B males had a moderate decrease in testicular weight, but only males showed a significant decrease in serum FSH levels relative to controls. Simultaneous deletion of both Acvr2a and Acvr2b in gonadotropes led to profound hypogonadism and FSH deficiency in both sexes; females were acyclic and sterile. Collectively, these data demonstrate that ACVR2A and ACVR2B are the critical type II receptors through which activins or related TGF-β ligands induce FSH production in mice in vivo.

The impact of L-carnitine Supplement on Semen Variables and the Levels of Sexual Hormones (Serum LH, FSH, Testosterone, and Inhibin) in Males with Infertility

Background: It had been estimated that tenth of partners had infertility, and in approximately half of these cases, the imperfection can be ascribed to male related causes. Fecundity in men necessitate regular functioning hypothalamus, pituitary gland, and testes axis. aberrant spermatogenesis is habitually incorporated to permuted serum gonadotropins and testosterone. L-carnitine is an supreme antioxidant existing in a lofty concentration in epididymal excretions. It affords liveliness for sperms to earn their dynamism in the epididymis.Aim: The study proposed to explore the effect of L-carnitine supplement on semen parameters, and sex hormones milieu in patients with primary or secondary infertility.Patients and Methods: A clinical trial conducted on a 58 patients(mean age± SD: 30.6 ± 6.07) treated with 2gm of L carnitine, which prescribed orally at a daily dose of 2gm a day in divided doses for 3 months. Before, and after the end of the L-carnitine treatment, semen analysis and serum levels of LH, FSH, Testosterone, and inhibin were performed.Results: The mean values of sperm count, total motility and normal morphology of and oligo-astheno-teratospermic were found notably changed (p<0.05) with 3 months carnitine supplement. The outcome of this trial exhibited that L-carnitine supplement can improve sperm concentration, and count, as well active motility. Additionally it has been noticed that the serum gonadotropin (FSH and LH) levels were noteworthy declined, while serum testosterone and inhibin levels were upraised in infertile males when compared with the levels before, the 3 months course of L-carnitine treatment.

The Level of Serum Progesterone on the day of HCG Administration in Assisted Reproduction Cycles

Introduction: During stimulated IVF- ET cycle spontaneous LH surge occur in about 20 – 50 % of cycle stimulated with gonadotropin without the pituitary suppression of GnRH agonist. This has been related to maturation and recovery of oocyte together decrease fertilization and implantation rate, this spontaneous LH surge is associated with increase in serum progesterone , so without pituitary suppression with GnRH , the rise of serum progesterone in the per ovulatory period may indicate the occurrence of spontaneous of LH surge, the aim of study is to indicate cutoff point of progesterone in the day of HCG administration. Method: This was a retrospective, non-interventional cohort study of patients undergoing ICSI at Tiba infertility center in Babylon, from period 2015 - 2019, all patient age from 20 – 45 years old under long protocol, had at least one grade I embryo transferred, total amount of patients was 1457. At second day of menstrual cycle we stimulate by used recombinant FSH, measured on second day of menstruation serum FSH, LH and estrogen levels, transvaginal ultrasound used to monitored the follicles. when follicle became 14 mm in size we used antagonist. 3 or more follicles gotten 18 mm in diameter. Activation gave either hCG alone or mixture of hCG and agonist. After 14 days from embryo transfer we checked HCG and after that after 10 days transvaginal ultrasound was done. Results: In our study showed the significant association between positive pregnancy outcome and progesterone level at day of HCG trigger were 79.2 % of female with positive pregnancy at progesterone level 2.5, There is a significant differences of LH at day of HCG activate rendering to progesterone level day of HCG activate, progesterone level ( < 1.5) had more chief level at day of HCG activate with mean and SD (5.38 ± 2.52), and reduction when the level progesterone rise. Conclusion: pregnancy cannot depend on progesterone level at day when HCG administration for assisted reproduction cycles treated with GnRH agonists and gonadotrophins. So cutoff point of progesterone can reach to above 1.5 ng/ ml and expected of pregnancy at this level.

The Level of Serum Progesterone on the day of HCG Administration in Assisted Reproduction Cycles

Introduction: During stimulated IVF- ET cycle spontaneous LH surge occur in about 20 – 50 % of cycle stimulated with gonadotropin without the pituitary suppression of GnRH agonist. This has been related to maturation and recovery of oocyte together decrease fertilization and implantation rate, this spontaneous LH surge is associated with increase in serum progesterone , so without pituitary suppression with GnRH , the rise of serum progesterone in the per ovulatory period may indicate the occurrence of spontaneous of LH surge, the aim of study is to indicate cutoff point of progesterone in the day of HCG administration. Method: This was a retrospective, non-interventional cohort study of patients undergoing ICSI at Tiba infertility center in Babylon, from period 2015 - 2019, all patient age from 20 – 45 years old under long protocol, had at least one grade I embryo transferred, total amount of patients was 1457. At second day of menstrual cycle we stimulate by used recombinant FSH, measured on second day of menstruation serum FSH, LH and estrogen levels, transvaginal ultrasound used to monitored the follicles. when follicle became 14 mm in size we used antagonist. 3 or more follicles gotten 18 mm in diameter. Activation gave either hCG alone or mixture of hCG and agonist. After 14 days from embryo transfer we checked HCG and after that after 10 days transvaginal ultrasound was done. Results: In our study showed the significant association between positive pregnancy outcome and progesterone level at day of HCG trigger were 79.2 % of female with positive pregnancy at progesterone level 2.5, There is a significant differences of LH at day of HCG activate rendering to progesterone level day of HCG activate, progesterone level ( < 1.5) had more chief level at day of HCG activate with mean and SD (5.38 ± 2.52), and reduction when the level progesterone rise. Conclusion: pregnancy cannot depend on progesterone level at day when HCG administration for assisted reproduction cycles treated with GnRH agonists and gonadotrophins. So cutoff point of progesterone can reach to above 1.5 ng/ ml and expected of pregnancy at this level.

Factors influencing sperm retrieval rate by Microdissection Testicular Sperm Extraction (mTESE) in non-obstructive azoospermia cases: a literature review

Background:Â Non-Obstructive Azoospermia (NOA) had dominating 60% of all azoospermia cases. Sperm Retrieval Techniques (SRT) continued with Intra-Cytoplasmic Sperm Injection (ICSI) are therapy modalities helping infertile azoospermia to be fertile. There are some options of SRT such as PESA, MESA, TESE, TESA and microdissection-TESE (mTESE) to collect sperm from azoospermia cases. This study aims to evaluate some factors influencing sperm retrieval rate by mTESE in non-obstructive azoospermia cases.Method:Â The data collection for eligible articles were conducted from 2011 to 2019. Different database and manual search methods were used to find the topic-related articles, particularly in some factors influencing the sperm retrieval rate of mTESE in NOA cases. A total of 21 relevant kinds of literature were studied regarding some factors that might be increasing or decreasing of sperm retrieval rate by mTESE procedure. However, four literature were elaborated further due to a similar approach to get the results.Results:Â A previous study from Saudi Arabia with 264 patients samples found significant different on testosterone level who had successful Sperm Retrieval Rate (SRR) 57.25%. SRR was related by several factors of testosterone, FSH, bilateral testis retrieval and seminiferous tubules diameter taken as the earliest study from India. Besides, taking bilateral testis sperm retrieval also had low SRR 14.4%, but serum FSH level was not influenced by increasing SRR. The previous study found a very weak correlation between FSH and SRR. A different study was conducted in Italy found that all NOA patient who undergone mTESE procedure found the Maturation Arrest (MA) has the significant higher success SRR until 67% after Sertoli Cell Only (SCO) syndrome and sclera-hyalinosis histology.Conclusion:Â SRR depends on some factors those influencing by hormonal baseline preoperative such as testosterone level and FSH serum level, technique and how mTESE done by the operator in mTESE procedure.

Comparison effects of olive leaf extract and oleuropein compounds on male reproductive function in cyclophosphamide exposed mice

Spermatogenesis is a complicated process in which sperm is susceptible to various chemotherapy drugs such as cyclophosphamide (CP). As olive leaf extract (OLE) and its active ingredient, oleuropein, have variousantioxidant, anti-apoptotic, and anti-inflammatory properties the aim of the present study was to investigate the effects of OLE and oleuropein on male reproductive function focusing antioxidative effects and histological modifications in the testes of CP-exposed mice.In order to do this, 80 NMRI male mice were divided into eight groups including control group, group received CP, group received OLE, group received oleuropein, group received OLE following CP exposure, group received oleuropein following CP exposure, group received OLE plus oleuropein and group received OLE plus oleuropein following CP exposure. In all groups CP (single dose of 100 mg/kg (, OLE (100 mg/kg for consequence 28 days) and oleuropein (100 mg/kg for consequence 28 days) were injected intraperitoneally. Moreover, testis histology, sperm parameters and serum levels of LH, FSH, MDA and antioxidant capacity were investigated. Results showed that CP caused oxidative state and abnormal changes in sperms and testes. Besides, treatments with oleuropein and OLE led to mitigate the harmful effects of CP on the male reproductive system. In conclusion, our findings showed that olive's compounds can diminish the hazardous effects of CP on spermatogenesis in mice.

Effect of Carbonated Drinks on Uterine Development-An Experimental Study

&lt;p&gt;&lt;strong&gt;ABSTRACT&lt;/strong&gt;&lt;br /&gt;&lt;strong&gt;Background and Objective&lt;/strong&gt;: Consumption of Coca-cola and Pepsi-cola has harmful impact on human health. Currently, scant data is available regarding effects of carbonated beverages on female reproductive system. This study was aimed to investigate the effects of carbonated beverages on uterine development and expression of follicle stimulating hormone receptor in mice model.&amp;nbsp;&lt;br /&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A total of 150 female Kunming mice weighing 20.36 &amp;plusmn; 2.28 gm. were divided into five groups with&amp;nbsp; 30 mice in each group. Groups COC-1 and COC-2 mice were given 50% and 100% Coca-cola per oral respectively for 25 days. Groups PEP-1 and PEP-2 mice were given 50% and 100% Pepsi-cola per oral respectively. Control group (CG) mice were given tap-water per oral. Western blotting was done to&amp;nbsp; ascertain the levels of Follicle Stimulating Hormone Receptor (FSHR) protein in ovaries. Follicle&amp;nbsp; Stimulating Hormone (FSH) levels were measured by ELISA kit.&lt;br /&gt;&lt;strong&gt;Results&lt;/strong&gt;: The weight of uterus in the groups COC-2 and PEP-2 was lower than that of CG. Uterine wall and&amp;nbsp; uterine cavities were slightly decreased in Coca-cola and Pepsi-cola groups compared to CG. Uterine mucus was ruffled. Uterus wall thicknesses (UWT) were reduced. In comparison with CG, FSHR protein levels in&amp;nbsp; COC-2 and PEP-2 groups were reduced by 21.14% and 22.80%. Serum FSH levels of COC-1, COC-2 and&amp;nbsp; PEP-1 were less than that of CG. Body weights of the one-week-old mice from COC-2, PEP-1 and PEP-2&amp;nbsp; groups were increased in COC-2 and PEP-2 groups in comparison with CG (P &amp;lt; 0.05).&lt;br /&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Oral ingestion of Coca-cola and Pepsi-cola for a longer duration reduces uterine weight, affects the uterine histology and inhibits the uterine development. reduced expression of FSHR protein may be&amp;nbsp; linked with reduced growth and development of new born mice.&lt;/p&gt;

EFFECT OF NUTRACEUTICAL FORMULATION OVAJAL ON DHT AND FRUCTOSE INDUCED PCOS IN RODENT MODEL.

Polycystic ovary syndrome is a most common female reproductive disorder, involving endocrine and metabolic disorders with unclear etiology. It may clinically be manifested in young women of reproductive age as oligo-ovulation, abnormal levels of reproductive hormones, clinical hyperandrogenism, hirsutism, male pattern baldness, acne, acanthosis nigricans, and polycystic ovaries, additionally having a long prodroma with detectable abnormalities that present as the metabolic syndrome like Insulin resistance, hyperinsulinemia, obesity, and dyslipidemia. Current treatment options are unable to manage PCOS and suffer from unwanted effects. The present study aimed to investigate the effect of nutraceutical formulation ovajal on dihydrotestosterone (DHT)-fructose-induced polycystic ovary syndrome (PCOS) in Sprague Dawley (S.D.) female rats. Prepubertal rats in the experimental group (except control) received coadministration of DHT (s.c.) and fructose(p.o.). Along with DHT+F other groups were treated with OV100 and OV200, clomiphene, and metformin, at a dose of 100 mg/kg p.o., 200 mg/kg p.o., 100 mg/kg p.o., and 200 mg/kg p.o., respectively for 90 days. Estrus cyclicity, OGTT, luteinizing hormone, follicle-stimulating hormone, insulin, testosterone, and estradiol serum levels were assessed. Ovary, uterus, abdominal fat, and subcutaneous fat were collected, weighed and an ovary histomorphology examination was done. Results showed that OV100 and OV200 reversed the DHT-fructose induced changes by significantly (p is less than 0.05) increasing serum FSH level, estradiol level and decreasing their body weight, ovary weight, uterine weight, serum luteinizing hormone level, testosterone level, oral glucose tolerance, irregular estrous cyclicity and no. of cystic follicles. However, the OV200 notably ameliorated the abnormalities of experimental PCOS. Our study findings demonstrate that ovajal formulation exerted preventive benefits in an experimental model of PCOS. Hence can be suggested in the management of PCOS.

FSH signaling is involved in affective disorders

Affective disorders are a set of mental disorders and particularly disrupt the mental health of susceptible women during puberty, pregnancy, parturition and menopause transition, which are characterized by dramatic changes in reproductive hormone profiles. The serum FSH level changes significantly during these periods; yet, the role of FSH in mood regulation is poorly understood. In the current study, FSHR knockout (Fshr−/−) mice displayed enhanced affective disorder behaviors in an open field test and a forced swim test, accompanied by altered gene expression profiles. The differentially expressed genes between Fshr−/− mice and Fshr+/+ mice were enriched in multiple neuroendocrine metabolic pathways. FSHR deletion significantly increased/decreased the mRNA and/or protein expression levels of AOX1, RDH12, HTR3a and HTR4 in mood-mediating brain regions, including the hippocampus and prefrontal cortex. These results reveal that FSH signaling is involved in the development of affective disorders.

Association between Letrozole Dose and Pregnancy Rate in Clomiphene-Resistant Women with Polycystic Ovary Syndrome Randomized Controlled Trial

Abstract Background Among couples experiencing difficulty conceiving, unexplained infertility is a fairly common diagnosis, occurring in approximately 10–20% of cases. One of the options available to women with unexplained infertility is ovulation induction, which is most commonly achieved using clomiphene citrate. Aim of the Work To evaluate the effect of high dose letrozole protocol (7.5 mg, 10 mg for 5 days compared with standard letrozole protocol 5 mg for 5 days) in the management of clomiphene-resistant women with polycystic ovary syndrome. Patients and Methods Randomized controlled clinical trial. The current study was conducted in Ain Shams University Maternity Hospital. The study included a total of 120 women. The study population was randomized using a Computer generated randomization system into 3 groups: Group A: standard letrozole regimen (5mg /day starting from day 2 to for 5 days). Group B received letrozole (7.5 mg/day from day 2 for 5 days). Group C received letrozole (10 mg/day from day 2for 5 days). Results We found that there were insignificant differences between study groups as regard age, BMI and Duration of infertility p-value 0.997,0.873,0.927 respectively, there was insignificant differences between study groups as regard parity and Ovulation status p-value 0.575,0.897 respectively, there was insignificant differences between study groups as regard serum level of FSH,LH, E2 and Testosterone p-value 0.911, 0.821, 0.811, 0.954 respectively. Conclusion It seems that the use of higher doses of letrozole improve endometrial thickness and follicle number but it offers no advantage in terms of pregnancy rates over the lower (2.5 mg) dose.

Increased Gonadotropins and prolactin are linked to infertility in males.

Infertility has become a significant issue among married couples worldwide. The association of variations in reproductive hormones with infertility is evaluated at a tertiary care hospital in North India. A total of 220 infertile males having infertility longer than one year (cases) and 220 age-matched fertile males with confirmed paternity in past two to three years (controls) were enrolled for the study. Serum levels of LH, FSH, testosterone and PRL were measured by Roche e411 autoanalyzer using electrochemiluminescense immunoassay technique. Significant higher levels of serum hormone (mean±SD) were found in cases vs. controls; LH (9.02±7.81 vs. 5.22±1.45 mIU/ml), FSH (11.45±14.02 vs. 4.09±1.62 mIU/ml) and PRL (199.08±80.79 vs. 127.23±81.64 µIU/ml). However, the serum testosterone level was significantly low in cases associated with male infertility (4.62±2.03 vs. 6.82±2.79 ng/ml). LH, FSH and PRL levels were significantly increased in azoospermic, oligozoospermic and asthenozoospermic infertile males while FSH and PRL were significantly elevated in normozoospermic infertile group. Conversely, mean serum testosterone levels were significantly low in all infertile subgroups in comparison to fertile controls. PRL showed a significant prediction of Normozoospermia (AUC=0.836, Z=4.916, p<0.001) in ROC analysis. Data presented here is interesting, requiring further confirmation using larger samples of multiple cohorts.

Estrogens in Human Male Gonadotropin Secretion and Testicular Physiology From Infancy to Late Puberty.

Several reports in humans as well as transgenic mouse models have shown that estrogens play an important role in male reproduction and fertility. Estrogen receptor alpha (ERα) and beta (ERβ) are expressed in different male tissues including the brain. The estradiol-binding protein GPER1 also mediates estrogen action in target tissues. In human testes a minimal ERα expression during prepuberty along with a marked pubertal up-regulation in germ cells has been reported. ERβ expression was detected mostly in spermatogonia, primary spermatocytes, and immature spermatids. In Sertoli cells ERβ expression increases with age. The aromatase enzyme (cP450arom), which converts androgens to estrogens, is widely expressed in human tissues (including gonads and hypothalamus), even during fetal life, suggesting that estrogens are also involved in human fetal physiology. Moreover, cP450arom is expressed in the early postnatal testicular Leydig cells and spermatogonia. Even though the aromatase complex is required for estrogen synthesis, its biological relevance is also related to the regulation of the balance between androgens and estrogens in different tissues. Knockout mouse models of aromatase (ArKO) and estrogen receptors (ERKOα, ERKOβ, and ERKOαβ) provide an important tool to study the effects of estrogens on the male reproductive physiology including the gonadal axis. High basal serum FSH levels were reported in adult aromatase-deficient men, suggesting that estrogens are involved in the negative regulatory gonadotropin feedback. However, normal serum gonadotropin levels were observed in an aromatase-deficient boy, suggesting a maturational pattern role of estrogen in the regulation of gonadotropin secretion. Nevertheless, the role of estrogens in primate testis development and function is controversial and poorly understood. This review addresses the role of estrogens in gonadotropin secretion and testicular physiology in male humans especially during childhood and puberty.

Impact of Bariatric Surgery on Clinical, Biochemical, and Hormonal Parameters in Women with Polycystic Ovary Syndrome (PCOS).

To study the impact of bariatric surgery in women with PCOS in terms of clinical, hormonal, and radiological aspects of polycystic ovarian syndrome. A prospective observational study of 50 women who underwent bariatric surgery at our tertiary care center. Evaluation of anthropometric data and menstrual cyclicity as well as markers of hyperandrogenism was done preoperatively and at 3- and 6-month and 1-year follow-up. Eighteen (36%) women were diagnosed to have PCOS. % EWL at 3-months (n = 14), 6-month (n = 14), and 1-year (n = 11) follow-up was 31%, 49%, and 63% respectively among women with PCOS. All females regained their normal menstrual cycle at 3months of follow-up. Hirsutism resolved completely among 44% (5/11) with a decline in median hirsutism score from 11 to 9 at 1-year follow-up. Mean serum testosterone decreased from 0.83 ± 0.38ng/ml preoperatively to 0.421 ± 0.25ng/ml at 1-year follow-up (p˂0.01), whereas changes in levels of serum LH and FSH were not significant. Seventy-seven percent of females (14/18) had polycystic ovaries preoperatively on USG; out of which, 55% (i.e., 4/7) showed complete resolution at 1-year follow-up. Metabolic syndrome resolved completely at 1-year follow-up in both PCOS and non PCOS group. Bariatric surgery results in an effective and sustained weight loss with improvement in clinical, hormonal, and radiological parameters associated with PCOS.

Sperm retrieval rates in non-mosaic Klinefelter patients undergoing testicular sperm extraction: What expectations do we have in the real-life setting?

A recent meta-analysis (Human Reproduction Update 23, 2017 and 265) reported positive sperm retrieval rates (SRR) in 50% of patients with Klinefelter syndrome (KS) undergoing testicular sperm extraction (TESE). However, these results do not reflect the rates of SR that we observe in clinical practice. We assessed the rate and potential predictors of SR in Klinefelter patients in the real-life setting. We reviewed clinical data of 103 KS men who underwent TESE between 08/2008 and 03/2019 at five tertiary referral Andrology centers. Patients underwent testis ultrasound, hormonal evaluation, and genetic testing. All patients were azoospermic based on the 2010 WHO reference criteria. Conventional TESE (cTESE) or microsurgical TESE (mTESE) was performed based on the surgeon's preference. We used descriptive statistics and logistic regression models to describe the whole cohort. Median (IQR) patient's age was 32 (24-37) years. Baseline serum FSH and total testosterone levels were 29.5 (19.9-40.9) mUI/mL and 3.8 (2.5-11.0) ng/mL, respectively. Conventional TESE and mTESE were performed in 38 (36.5%) and 65 (63.5%) men, respectively. The sperm retrieval rate was 21.4% (22/103 men). Fifteen patients used spermatozoa for ICSI and five ended in live birth children. Patients with positive SR were similar to those with a negative TESE in terms of clinical, hormonal, and procedural parameters (all P>.05). Logistic regression analyses confirmed the lack of association between clinical, hormonal, and procedural parameters with SR outcome. Given the conflicting results in the literature regarding SRR in KS, patients should be carefully counseled regarding TESE outcomes based on data from published literature and local results. In the real-life setting, we observed a lower SRR (21.4%) than that reported in meta-analyses in our cohort of KS patients. No associations between clinical, hormonal, and procedural variables with TESE success were found.