Serum LH Concentrations Research Articles

Stężenia gonadotropin i α podjednostki w surowicy krwi u pacjentów z gruczolakami gonadotropowymi przysadki w zależności od immunoreaktywności guza

Although active gonadotropin-secreting pituitary adenomas are considered very rare, the vast majority of pituitary tumours diagnosed as "non-functioning" express gonadotropins or their free β or α subunits. However, systemic investigations comparing the serum concentrations of follitropin (FSH), lutropin (LH), and α-subunit (αSU) before surgery with the immunoreactivity of the respective substances in the excised tumours are still lacking. Immunostaining of FSH, LH, and αSU was compared in 43 surgically removed gonadotropin - expressing pitu-itary adenomas with serum concentrations of the above-mentioned substances before surgery in the same patients. The serum concentrations of FSH were elevated (> 11.6 mU/mL) in 8/12 (66.7%) cases of FSH-positive adenomas. By contrast, in FSH-negative tumours the elevation of FSH is absent. Moreover, only 1/25 (4%) patients with LH-positive adenoma had the elevated serum concentration of LH (51.5 mU/mL). The overproduction of LH was not observed in adenomas expressing free β LH or in LH-negative tumours. In patients with αSU-positive adenomas elevated serum levels of αSU were observed in 3/15 (20%) cases. No αSU elevations were observed in patients with αSU-negative adenomas. The mean serum FSH, LH, and αSU concentrations were higher in patients with FSH, LH, and/or αSU immunopositive tumours in comparison with immunonegative. However, the differences are not statistically significant. Although "silent" gonadotropinomas constitute a frequent subtype of pituitary adenomas, the "active" subtype (i.e. manifesting by gonadotropin excess) are rare (approx. 4% of all pituitary adenomas). Gonadotropinomas are difficult to diagnose before surgery. The measurement of gonadotropins including αSU is needed but often not sufficient for presurgical diagnosis.

Relationship among thyroid stimulating hormone level and sex hormones, blood lipids and insulin resistance in patients with polycystic ovary syndrome

Objective To explore the relationship among thyroid stimulating hormone level and sex hormone level, blood lipid level and insulin resistance in patients with polycystic ovary syndrome. Methods From February 2014 to February 2017, eighty cases with polycystic ovary treated in the People's Hospital of Longhua, Shenzhen were selected as the research object.The clinical data of all patients were collected to check the indexes of thyroid function, lipid metabolism, glucose metabolism, and sex hormone related indexes, and the insulin resistance index (HOMA-IR) was calculated according to the related indexes of glucose metabolism.The patients were divided into group according to the level of thyrotropin, group A (thyrotropin 4.0mIU / L). According to the patient's insulin resistance index, the patients were divided into IR group and non IR group.According to the blood lipid metabolism index, the patients were divided into abnormal blood lipid group and non lipid abnormality group.The levels of thyrotropin and sex hormone related indexes were compared in different groups, and the correlation between thyrotropin level and various indexes was analyzed. Results The differences in body mass index ((23.3±4.2) kg/m2 vs.(23.8±3.5) kg/m2 vs.(25.6±5.2) kg/m2), luteinizing hormone((11.9±1.1)U/L vs.(11.7±1.2)U/L vs.(9.5±1.0)U/L), low density lipoprotein cholesterol ((2.4±0.9) mmol/L vs.(2.7±0.7) mmol/L vs.(2.9±0.8) mmol/L), high-density lipoprotein cholesterol ((1.5±0.4) mmol/L vs.(1.5±0.5) mmol/L vs.(1.3±0.2) mmol/L), triglyceride ((1.1±0.8) mmol/L vs.(1.5±0.9) mmol/L vs.(1.8±0.7) mmol/L), and apolipoprotein A ((1.8±0.5) mg/L vs.(1.7±0.4) mg/L vs.(1.5±0.3) mg/L) among group A, B and C were statistically significant (F=8.456, 9.587, 11.245, 10.784, 10.847, 10.214, P<0.05). The serum TSH concentration in group IR was significantly higher than that in non IR group ((3.1±1.1) mU/L vs.(2.3±0.8) mU/L) (t=3.551, P<0.05). The serum LH concentration in group IR was significantly lower than that in non IR group((9.4±1.1)U/L vs.(11.2±2.1)U/L) (t=3.739, P<0.05). The level of TSH in dyslipidemia group was significantly higher than that of non dyslipidemia group((3.2±1.3) mU/L vs.(2.4±1.1) mU/L) (t=3.551, P<0.05), and the level of LH in dyslipidemia group was significantly lower than that of non dyslipidemia group((9.3±1.6)U/L vs.(11.6±2.4)U/L) (t=4.709, P<0.05). The TSH level in patients with polycystic ovary syndrome was positively correlated with body mass index, three acylglycerol, low density lipoprotein cholesterol and insulin resistance index(r=0.272, 0.317, 0.364, 0.227)( P=0.015, 0.004, 0.003, 0.043), and there was a negative correlation with luteinizing hormone and high-density lipoprotein cholesterol(r=-0.616, -0.254) (P=0.000, 0.034). Conclusion Hyperthyroidism in patients with polycystic ovary syndrome is associated with abnormal blood lipid, abnormal sex hormone levels, and insulin resistance. Key words: Polycystic ovary syndrome; thyroid stimulating hormone; sex hormones; blood lipids; insulin resistance

GnRH antagonist treatment of malignant adrenocortical tumors.

Aberrantly expressed G protein-coupled receptors in tumors are considered as potential therapeutic targets. We analyzed the expressions of receptors of gonadotropin-releasing hormone (GNRHR), luteinizing hormone/chorionic gonadotropin (LHCGR) and follicle-stimulating hormone (FSHR) in human adrenocortical carcinomas and assessed their response to GnRH antagonist therapy. We further studied the effects of the GnRH antagonist cetrorelix acetate (CTX) on cultured adrenocortical tumor (ACT) cells (mouse Cα1 and Y-1, and human H295R), and in vivo in transgenic mice (SV40 T-antigen expression under inhibin α promoter) bearing Lhcgr and Gnrhr in ACT. Both models were treated with control (CT), CTX, human chorionic gonadotropin (hCG) or CTX+hCG, and their growth and transcriptional changes were analyzed. In situ hybridization and qPCR analysis of human adrenocortical carcinomas (n = 11–13) showed expression of GNRHR in 54/73%, LHCGR in 77/100% and FSHR in 0%, respectively. CTX treatment in vitro decreased cell viability and proliferation, and increased caspase 3/7 activity in all treated cells. In vivo, CTX and CTX+hCG (but not hCG alone) decreased ACT weights and serum LH and progesterone concentrations. CTX treatment downregulated the tumor markers Lhcgr and Gata4. Upregulated genes included Grb10, Rerg, Nfatc and Gnas, all recently found to be abundantly expressed in healthy adrenal vs ACT. Our data suggest that CTX treatment may improve the therapy of human adrenocortical carcinomas by direct action on GNRHR-positive cancer cells inducing apoptosis and/or reducing gonadotropin release, directing tumor cells towards a healthy adrenal gene expression profile.

L-Carnitine improves endocrine function and folliculogenesis by reducing inflammation, oxidative stress and apoptosis in mice following induction of polycystic ovary syndrome.

Polycystic ovary syndrome (PCOS) is related to low levels of serum l-carnitine, which has antioxidant, anti-inflammatory and antiapoptotic properties. The aim of this study was to investigate the effect of l-carnitine on folliculogenesis in mice following induction of PCOS. PCOS was induced by daily injections of testosterone enanthate (1mg per 100g, s.c., for 35 days). NMRI mice (21 days old) were divided into four groups (n=6 per group): Control, Control+l-carnitine, PCOS and PCOS+l-carnitine. Mice were treated with 500mgkg-1, i.p., l-carnitine every second day for 28 days. Ovaries were studied stereologically and serum concentrations of FSH, LH, testosterone, interleukin (IL)-6 and tumour necrosis factor (TNF)-α were determined using ELISA kits. Serum concentrations of malondialdehyde (MDA) and the ferric ion reducing antioxidant power (FRAP) were also analysed. Apoptosis of follicles was evaluated by terminal deoxyribonucleotidyl transferase-mediated dUTP-digoxigenin nick end-labelling (TUNEL). CD31 was assessed immunohistochemically. Data were analysed using one-way analysis of variance (ANOVA) and Tukey's test, differences considered significant at P<0.05.The total volume of the ovary, cortex volume, oocyte volume, zona pellucida thickness and the number of antral follicles increased significantly, whereas the number of primary and preantral follicles decreased significantly, in the PCOS+l-carnitine versus PCOS group. In the PCOS+l-carnitine group, serum concentrations of FSH and FRAP increased significantly, whereas there were significant decreases in serum concentrations of testosterone, LH, MDA, IL-6 and TNF-α, as well as in the percentage of TUNEL-positive apoptotic cells, compared with the PCOS group. l-Carnitine improves folliculogenesis and is therefore suggested as a therapeutic supplement in the treatment of PCOS.

Quinine inhibits ovulation and produces oxidative stress in the ovary of cyclic Sprague-Dawley rats.

Quinine has been reported to possess anti-spermatogenic activities. This study was carried out to determine the effect of quinine on ovarian function in Sprague-Dawley rats. Twenty rats with regular 4-days oestrous cycle divided into 4 groups (N=5) were used. Group I received quinine at 30 mg/kg body weight by gavage for 28 days after which they were sacrificed. The ovaries were excised for biochemical oxidation of glutathione peroxidase (GSH), superoxide dismutase (SOD), catalase and malondialdehyde (MDA). Group II received single dose quinine at 30 mg/kg body weight at 0900 hrs on day of proestrus. Blood was obtained at 1800 hrs for hormonal assay of FSH and LH. The animals were sacrificed the next morning on estrus: oviducts were examined for ova count. Groups III and IV served as controls. Quinine treated rats recorded zero number of ova compared to control. Serum concentration of LH reduced significantly in the quinine treated group compared to the control. Furthermore, quinine significantly decreased the oxidant status of GSH, SOD and catalase and significantly increased MDA levels in the ovary compared to the control group. Quinine completely blocks ovulation, suppresses LH surge, and produces oxidative stress in the ovary.

Follicle growth and endocrine dynamics in women with spontaneous luteinized unruptured follicles versus ovulation.

Do growth patterns and endocrine profiles differ between ovulatory follicles (OvFs) and luteinized unruptured follicles (LUFs) in women? Growth rates, diameters and associated endocrine profiles differed between OvFs and LUFs in unstimulated cycles. Two-three waves of antral follicles develop during the menstrual cycle in ovulatory women of reproductive age, with the second or third wave terminating in ovulation. In contrast, some women can develop LUFs, where a preovulatory follicle fails to rupture and there is subsequent luteinization of the follicle wall. However, no study has compared OvFs and LUFs in unstimulated cycles. This retrospective observational study was conducted in 56 healthy women of reproductive age (range: 19-41 years) and with a history of regular menstrual cycles. Participants who met inclusion criteria were enrolled, as previously reported. Daily transvaginal ultrasonography was performed for one interovulatory interval (IOI) to measure the diameters of all follicles >2 mm. Blood samples were collected every 3 days during the IOI to measure serum concentrations of FSH, LH, estradiol and progesterone. The interval from emergence to deviation (i.e. follicle selection) was shorter (P < 0.05) for LUFs compared to OvFs. However, the intervals from emergence to maximum diameter and deviation to maximum diameter were longer (P < 0.05) for LUFs compared to OvFs. Follicle deviation in LUFs occurred at a larger diameter (P < 0.05) compared to OvFs, and LUFs grew to larger (P < 0.0001) diameters compared to OvFs. Moreover, LUFs grew faster (P < 0.05) from emergence to deviation and from deviation to maximum diameter, compared to OvFs. LUFs were associated with low (P < 0.05) systemic LH levels at emergence and maximum diameter compared to OvFs. LUFs were also associated with low (P < 0.05) systemic FSH and high (P < 0.05) systemic progesterone at deviation and maximum diameter, respectively. Estradiol was higher (P < 0.05) at deviation and lower (P < 0.05) at maximum diameter for LUFs compared to OvFs. A 3-day interval of blood sampling for hormonal analyses was conducted, as a more frequent sampling interval was not considered acceptable by the study volunteers. A 3-day sampling interval did not allow characterization of acute changes in hormone production during the IOI. In addition, study visits were less frequent when LUFs persisted long after the expected day of the second ovulation of the IOI. Information about the growth and endocrine dynamics of OvFs and LUFs developing in unstimulated cycles in women may be applied to the early detection of LUF-associated anovulatory infertility and clinical management of women with this condition. No external funding sources were used for this study. The authors have no conflicts of interest in publishing this manuscript. ClinicalTrials.gov Identifier: NCT01389141.

Serum sex hormones concentrations in young women in the early period after successful kidney transplantation.

Hormonal disorders are frequently present in hemodialysed patients with chronic kidney disease (CKD). In women with CKD sex hormones abnormalities may lead to irregular, often anovulatory cycles, sexual dysfunction and infertility. Kidney transplantation done in young women tends to ameliorate most of the aforementioned disorders and improve fertility. The aim of this study was to assess the changes of serum sex hormones concentration in young women before, and after the first 6 months after successful KTx Material and methods: Fourteen chronic hemodialysis women with CKD undergoing kidney transplantation and 46 apparently healthy women in similar age (control group) were enrolled into the study. In all women serum concentration of: FSH, LH, PRL and estradiol determined. Measurements in the transplanted group were done four times: immediately before surgery, in the 14th - and 30th - day and 6 months after the transplantation. The results are presented as means and 95% CI. All of the women that have finished the study presented an excellent function of the transplanted kidney - mean serum creatinine concentration was 92.54 (74.85 - 110.23) µmol/l. After successful KTx a significant decrease in the serum concentrations of FSH and LH was observed. Decrease of serum PRL concentration after KTx did not reach statistical significance in the multiple comparisons analyses, but returned to the values observed in healthy controls. KTx did not significantly influence serum estradiol concentration. Successful kidney transplantation leads to the normalization of serum concentrations of hormones linked to fertility disorders in women with chronic kidney disease. < p > < /p >.

Does improving hematological iron status restore the menstrual cycle in female athletes?

Summary Objectives The aim of this study was to assess whether a 12-week nonpharmalogical nutritional intervention NI aimed at improving iron status in female athletes can mitigate disorders in the menstrual cycle. Equipment and methods Forty-one female athletes with menstrual disorders and iron deficiency or anemia were recruited. Energy and nutrient intake, total energy expenditure, energy availability, morphological parameters and serum iron and ferritin level, as well as serum concentrations of LH and FSH were measured at the beginning of the study and after twelve weeks of NI. Results Twelve weeks of NI resulted in an increase in energy and several nutrients (energy: mean 527 kcal/d, protein: 17 g/d, carbohydrate: 98 g/d, calcium: 430 mg/d, vitamin D 2 μg/d, iron 5 mg/d, thiamin 0.5 mg/d, niacin, 3.4 mg, folate 163 μg/d, vitamin C 50 mg/d). After twelve weeks of NI, an improvement in iron status was observed in the athletes (as increases in hemoglobin: mean 0.43 g/dl, MCV: 2 fl, MCH: 1.04 fl, and serum iron level: 46 μg/l). Basis on hemoglobin, serum iron, ferritin and red cell indices (MCV, MCH, MCHC, RDW) results the number of subjects with iron deficiency, anemia declined and latent iron deficiency was observed (iron deficiency from 7 to 5, anemia from 9 to 5, latent iron deficiency from 25 to 15). Significant increases in the level of LH and the LH-to-FSH ratio were also seen (LH means 1.51 mlU/ml and LH-to-FSH ratio means 0.31). Conclusion A NI aimed at improving iron status in female athletes with simultaneous iron deficiency and anemia can also improve the level of the hormones responsible for maintaining a regular menstrual cycle.

Leydig cell dysfunction is associated with post-transcriptional deregulation of CYP17A1 in men with Sertoli cell-only syndrome.

Is the expression of steroidogenic enzyme 17α-Hydroxylase/17,20-Lyase (CYP17A1) down-regulated in Leydig cells (LCs) of men with spermatogenic failure and compensated impairment of LC function, i.e. a low testosterone to LH (T/LH) ratio? Although the transcriptional expression of CYP17A1 is increased, its protein expression is decreased, in isolated LCs of men with spermatogenic failure and reduced serum T/LH. Primary spermatogenic defects have been associated with functional and morphological abnormalities of LCs, characterized by decreased serum testosterone (T) levels, decreased T/LH, increased 17β-estradiol (E2) and E2/T ratio, and larger clusters of LCs (LC hyperplasia). CYP17A1 is a key enzyme in the testosterone pathway and has been implicated in the steroidogenic lesion produced by E2 stimulation. We studied 18 azoospermic patients with Sertoli cell-only syndrome (SCOS) and signs of LC dysfunction (cases) and 10 obstructive azoospermic/oligozoospermic men with normal spermatogenesis (controls). The SCOS patients were sub-grouped into 9 cases with T/LH <2 and 9 cases with T/LH ≥2. All of the men underwent testicular biopsy for sperm retrieval at the Reproductive Unit of a University Hospital. The transcriptional expression of CYP17A1 and SF-1 (steroidogenic factor 1) was quantified by SYBR®Green-based qPCR in LCs isolated by laser capture microdissection (LCM), and relative expression to the control pool was assessed. CYP17A1 protein expression was semi-quantified by indirect immunofluorescence (IFI) using Image-Pro Plus v7.0 (Media Cybernetics) in testicular tissue. FSH and LH serum concentrations, and serum and intratesticular T (ITT) and E2 (ITE2) were measured by IRMA and RIA, respectively. Relative CYP17A1 mRNA expression was increased in cases with T/LH <2 compared to cases with T/LH ≥2, by a mean of 3.3-fold (P = 0.002). No corresponding increase in protein expression was found; in fact, CYP17A1 immunostaining intensity assessed by the Integrated Optical Density (IOD) parameter was lower in the cases with T/LH <2 compared to controls (P = 0.008). Relative SF-1 mRNA expression was similar in both case subgroups. CYP17A1 mRNA expression correlated with ITE2 and intratesticular E2/T (r = 0.536; P = 0.026 and r = 0.542; P = 0.016, respectively), while an inverse association was observed for ITE2 and protein level expression (r = -0.421; P = 0.05). Not applicable. We should interpret the results of the semi-quantification of immunofluorescent staining by Image-Pro Plus software with caution, because it is a semi-quantitative method that may have certain difficulties regarding the disposition of protein in the cells. However, it is not influenced by variations in the number of cells that express the protein, as could be the case of western blot analysis in testicular tissue. Dysfunctional LCs of men with SCOS show post-transcriptional deregulation of CYP17A1, with increased mRNA and decreased protein expression, which may be modulated by increased ITE2 levels. In addition, transcriptional expression of CYP17A1 was not associated with changes in SF-1 mRNA expression. This work was supported by the National Fund for Scientific and Technological Development (FONDECYT) of Chile to A.C. [grant number 1120176]. The authors declare no conflict of interest.

The Influence of Garcinia kola Seed on Sexual Behavior and Testis Physiology in Wistar Rats

Garcina kola seed is believed by some to enhance male sexual performance but existing scientific data show divergent results. In this study, the sexual and reproductive influence of ethanol (70%) seed extract of G. kola was evaluated in Wistar rats. Adult male rats were gavaged with 0, 50, 100, 200 or 300 mg kg-1 day-1 of extract for 30 days and mated with female rats after sexual behavior characteristics were carefully evaluated. Serum concentrations of testosterone, LH and FSH, as well as epididymal sperm indices were analyzed after mating, while pregnancy rate and litter size of female rats were recorded. Extract (50 mg kg-1) treatment produced no effect on sexual activities, but higher doses caused reduction relative to control. Additionally, except at 50 mg kg-1, extract treatment caused reduction in sperm count (p<0.0001), sperm viability (p = 0.0011), testosterone and FSH (p<0.0001). LH was unaltered, while abnormal sperm morphology was elevated (p<0.05). Furthermore, pregnancy rate and litter size in extract (100-300 mg kg-1) treated rats were lower when compared to control. The results suggest that low dose of G. kola seed may not affect sexual activity, whereas high doses may affect fertility by negatively altering sexual behavior, testosterone level and sperm indices.

Fluoxetine treatment of prepubertal male rats uniformly diminishes sex hormone levels and, in a subpopulation of animals, negatively affects sperm quality.

Fluoxetine (Flx) is a selective serotonin reuptake inhibitor that alters the male reproductive system when administered at the adult stage or after maternal exposure. In the present study we evaluated the effects of Flx administration on reproductive parameters during juvenile-peripubertal development when treated male rats reached adulthood. Groups of rats were treated daily with Flx (5mgkg-1, i.p.) or saline (0.9% NaCl), or were left untreated. Rats were treated between 30 and 53 days of age and were killed at 65 days of age. Serotonin concentrations were determined in the hypothalamus, hypophysis and testis. Gonadotrophins, sex steroids and sperm quality (membrane integrity, sperm with functional mitochondria, sperm density, sperm motility and morphological abnormalities) were also evaluated. Flx did not affect bodyweight, but significantly diminished LH, FSH, progesterone and testosterone serum concentrations. After graphical analysis, a subgroup of rats was identified whose sperm quality parameters were greatly affected by Flx. In the present study we show that Flx administered to juvenile rats disrupts the hypothalamic-hypophyseal-testicular axis and its effects on sperm quality are not homogeneous in adults. In contrast, Flx altered concentrations of gonadotrophins and sexual steroids in all treated rats. These results suggest caution should be exercised in the prescription of Flx to prepubertal males.

Ginger attenuated di (n-butyl) phthalate-induced reproductive toxicity in pubertal male rabbits

This study was conducted to investigate the toxic effects of di (n-butyl) phthalate (DBP) on reproductive functions in male rabbits and the probable protective role of ginger. Twenty rabbits were divided equally into 4 groups: control group; DBP group (520 mg/kg body weight [BW] DBP orally), DBP+ginger group (520 mg/kg BW DBP and 400 mg/kg BW ginger) and ginger group (400 mg/kg BW ginger orally). Treatments were given three-times/week. After 7 wk of the experiment, DBP induced significant reduction in testis and prostate weights, serum and intratesticular testosterone concentrations, sperm counts both mass and progressive sperm motility and live sperms percentage as well as significant elevation of testicular malondialdehyde compared to control group. No significant changes were detected in epididymal weights, serum FSH and serum LH concentrations and testicular total superoxide dismutase and glutathione peroxidase activities in all treated groups. DBP induced considerable histopathological alterations in testis and to minimal extent in epididymis and prostates. Ginger treatment attenuated the significant changes to a certain extent induced by DBP intoxication in male rabbits probably due to its potential to scavenge free radicals.

Serum Ghrelin, LH and FSH Concentrations During Menstrual Cycle in Non-Obese PCOS Women Compared to Healthy Women.

Introduction Ghrelin, an acylated 28-amino acid peptide hormone with a unique octanoyle adjustment of hydroxy group on serine at the position three, that is substantial for its role, latterly synthesis by the gastric oxyntic gland human stomach, is the long-searched natural ligand for the GH sec

The levels of adipokines in relation to hormonal changes during the menstrual cycle in young, normal-weight women.

ContextThe aim of this study was to assess the plasma leptin, adiponectin, resistin, visfatin/NAMPT, omentin-1, vaspin, apelin, TNF-α, IL-6 and RBP4 levels in relation to hormonal changes during the menstrual cycle in young, healthy, normal-weight women.MethodsThe study involved 52 young, healthy, normal-weight women. Anthropometric parameters, body composition and levels of plasma leptin, adiponectin, resistin, visfatin/NAMPT, omentin-1, vaspin, apelin, TNF-α, IL-6 and RBP4 in addition to serum FSH, LH, estradiol, progesterone, 17-OH progesterone, androgens, SHBG and insulin concentrations were measured during a morning in fasting state three times: between days 2–4, days 12–14 and days 24–26 of the menstrual cycle.ResultsPlasma adiponectin, omentin-1, resistin and visfatin/NAMPT, apelin, TNF-α, IL-6 and RBP4 concentrations were stable during the menstrual cycle, while leptin and vaspin levels were significantly higher in both the midcycle and the luteal phases than those in the follicular phase. Multivariate regression analyses revealed that changes in leptin and vaspin levels between the follicular and the luteal phase are strongly related to changes in total testosterone levels.ConclusionsOur results revealed stable levels of adipokines during the phases of the physiological menstrual cycle, except for leptin and vaspin, which showed increased levels in both the midcycle and the luteal phases. This effect was significantly associated with changes in the secretion of testosterone, 17-OH progesterone and insulin in the luteal phase.

Serum and follicular fluid testosterone concentrations do not correlate, questioning the impact of androgen supplementation on the follicular endocrine milieu

Basic research into a possible link between serum and follicular fluid androgen concentrations to detemine whether androgen supplementation in low responders affects follicular endocrine milieu is still lacking. Ninety-seven women (aged 28–43 years) undergoing one natural IVF cycle without any hormone stimulation were analysed. Serum and follicular fluid were collected at the time of follicle aspiration, and the concentrations of LH, total testosterone, oestradiol, dehydroepiandrosterone and anti-Mullerian hormone (AMH) were determined. Serum LH (P = 0.003) and AMH (P = 0.026) concentrations, and follicular fluid AMH (P = 0.015) decreased with increasing age. Within follicular fluid, total testosterone was correlated with oestradiol (P < 0.001) and AMH (P = 0.010); LH correlated with AMH (P = 0.005). Correlation analysis of serum and follicular fluid hormone concentrations revealed that LH, oestradiol and AMH correlated (P < 0.001), whereas testosterone did not. Testosterone serum concentrations did not correlate with other follicular fluid hormones, such as dehydroepiandrosterone, oestradiol and AMH, whereas serum LH correlated with follicular flulid AMH (P < 0.008). Follicular fluid hormone concentrations seem to be independent from serum testosterone. Therefore, it is questionable whether an increase in serum testosterone concentration by androgen supplementation could improve the follicular endocrine milieu.

Fertility Assessment in Thalassemic Men

Male infertility in β-thalassemia patients is typically considered to be the consequence of iron deposition in the endocrine glands. Adult male patients with β-thalassemia, on regular blood transfusions, are prone to developing acquired hypogonadism. The aim of this study was to evaluate the fertility indicators in male patients with β-thalassemia major and intermedia. In this study we evaluated testicular volume, semen parameters and serum FSH, LH, and Testosterone concentrations in 62 male patients in reproductive age, with major and intermedia thalassemia, at a tertiary care hospital in Tehran, Iran. The range of serum ferritin level in our patients was from 182 to 11053 ng/mL (mean 2067 ng/mL). The mean concentration of sperm was 61.04 million per milliliter. The mean volume of right and left testes was 11.4 cc and 11.7 cc, respectively. Those patients who had lower testicular volumes significantly had lower sperm concentration, lower percents of motile and also lower percents of normal morphologic sperms (p = 0.04). The frequency of hypogonadism was significantly higher in patients whose testicular volume was lower (p = 0.02). Hypogonadism and hypothyroidism were seen in 22.6% and 17.7% of patients, respectively. Patients with hypogonadism had significantly lower ejaculate volume, lower sperm concentration, lower percents of motile and progressively motile sperms and also lower percents of normal morphologic sperms (p = 0.001). This study suggests that in thalassemic men, concentrations of serum testosterone, LH, FSH has significant correlation with sperm parameters and testicular volume.

Comparison of metformin and N-acetyl cysteine, as an adjuvant to clomiphene citrate, in clomiphene-resistant women with polycystic ovary syndrome

ObjectiveTo evaluate the effects of short- and long-term treatment with metformin and NAC, in an adjuvant to clomiphene citrate (CC), on the improvement of hormonal profile (SHBG, total testosterone, FBS, and fasting insulin) and fertility status in CC-resistant women with PCOS. Materials and methodsOne hundred and eight CC-resistant PCOS patients participated in the study and received either metformin (1500mg/day) or NAC (1800mg/day) with 100mg/day of CC for 8 and 12 weeks. Mean BMI, hirsutism score, LH/FSH ratio, endometrial thickness, mature follicle number, and serum concentrations of LH, FSH, E2, fasting insulin, total testosterone and FBS were evaluated before and after short- and long-term treatment. Furthermore, ovulation and pregnancy rates in the first and second cycles were also determined in treated patients. ResultsThere was no significant difference in all variables before and 8 weeks after treatment with metformin and NAC. The BMI- and insulin-lowering effects of metformin were significantly higher than NAC after long-term treatment. However, the reducing-effect of NAC on hirsutism score and FBS levels was significantly more than metformin after 12 weeks. Treatment with metformin and NAC significantly increased ovulation and pregnancy rates in CC-resistant PCOS patients. In the first and second cycles, ovulation and pregnancy rates in patients treated with NAC were slightly higher than those received metformin. ConclusionsCompared with metformin, administration of NAC in an adjuvant to CC is recommended for improving of hormonal profile and treatment of anovulatory infertility in hyperinsulinemic patients especially women with PCOS who are CC-resistant.

Clinical features and sex hormone parameters analysis in 227 male patients with 47, XXY

Objective To explore clinical characteristics of patients with Klinefelter′s syndrome(KS; 47, XXY). Methods 227 male patients with 47, XXY treated by artificial insemination with donor(AID)were included. Age, education, height, weight, body mass index(BMI), testicular volume, FSH, LH, testosterone(T), prolactin(PRL), estradiol(E2)were analyzed retrospectively. Results Of these patients, their height were(176.4±5.5)cm, weight(74.5±12.7)kg, BMI(23.89±3.66)kg/m2[77 of overweight(33.92%)and 34 of obesity(14.98%)], FSH(38.35±14.33)IU/L, LH(19.40±9.00)IU/L, T(132.00±194.50)ng/dl, E2(23.90±15.00)ng/L, PRL(10.50±8.20)μg/L, E2/T 0.21±0.80. Testicular volume had the positive association with the level of T(r=0.197, P=0.003). BMI had the negative association with the serum concentration of T(r=-0.284, P=0.000), while positive association with the E2(r=0.174, P=0.009)and ratio of E2/T(r=0.323, P=0.000). Age had no association with T, E2,and E2/T(P>0.05), but had negative association with the serum concentration of LH(r=-0.154, P=0.02)and FSH(r=-0.196, P=0.03). The higher education group were older(P<0.01), while the level of T were lower(P<0.01). Conclusion In patients with Klinefelter′s syndrome(KS; 47, XXY), level of T may associate with testicular volume. T, E2,and the ratio of E2/T seem to associate with their height, BMI, and education level. (Chin J Endocrinol Metab, 2017, 33: 398-401) Key words: 47, XXY; Sex hormones; Clinical features

Very low doses of heavy oxygen ion radiation induce premature ovarian failure.

Astronauts are exposed to charged particles during space travel, and charged particles are also used for cancer radiotherapy. Premature ovarian failure is a well-known side effect of conventional, low linear energy transfer (LET) cancer radiotherapy, but little is known about the effects of high LET charged particles on the ovary. We hypothesized that lower LET (16.5 keV/µm) oxygen particles would be less damaging to the ovary than we previously found for iron (LET = 179 keV/µm). Adult female mice were irradiated with 0, 5, 30 or 50 cGy oxygen ions or 50 cGy oxygen plus dietary supplementation with the antioxidant alpha lipoic acid (ALA). Six-hour after irradiation, percentages of ovarian follicles immunopositive for γH2AX, a marker of DNA double strand breaks, 4-HNE, a marker of oxidative lipid damage and BBC3 (PUMA), a proapoptotic BCL-2 family protein, were dose dependently increased in irradiated mice compared to controls. One week after irradiation, numbers of primordial, primary and secondary follicles per ovary were dose dependently decreased, with complete absence of follicles in the 50 cGy groups. The ED50 for primordial follicle destruction was 4.6 cGy for oxygen compared to 27.5 cGy for iron in our previous study. Serum FSH and LH concentrations were significantly elevated in 50 cGy groups at 8 week. Supplementation with ALA mitigated the early effects, but not the ultimate depletion of ovarian follicles. In conclusion, oxygen charged particles are even more potent inducers of ovarian follicle depletion than charged iron particles, raising concern for premature ovarian failure in astronauts exposed to both particles during space travel.

Effects of active immunization against GnRH versus surgical castration on hypothalamic-pituitary function in boars

The objective was to compare effects of anti-GnRH immunization (immunocastration) versus surgical castration on hypothalamic-pituitary function in boars. Thirty-six boars were randomly divided into three groups (n = 12/group): control, surgically castrated, or immunized against GnRH at 10 wk of age (boostered 8 wk later). Compared to intact boars, immunocastration reduced (P < 0.05) serum concentrations of LH, FSH, testosterone and inhibin B and caused severe testicular atrophy, whereas surgical castration increased (P < 0.05) serum concentrations of LH and FSH. Both immunocastration and surgical castration consistently reduced hypothalamic GnRH synthesis, with decreased (P < 0.05) mRNA expressions of GnRH, GnRH up-stream gatekeeper genes kiss1 and its receptor (GPR54), and androgen receptor in the hypothalamic arcuate nucleus (ARC) and anteroventral periventricular nucleus (AVPV), as well as GnRH content in the median eminence. Inconsistently, mRNA expressions of gonadotropin-inhibitory hormone (GnIH) in ARC and AVPV as well as its receptor (GPR147) in pituitary were selectively reduced (P < 0.05), but mRNA expressions of estrogen receptor alpha and aromatase (CPY17A1) in pituitary were selectively increased (P < 0.05) in surgical castrates. In response to selectively attenuated suppressive signaling from GnIH and testosterone, mRNA expressions of GnRH receptor (GnRHR), LH-β and FSH-β in pituitary were increased (P < 0.05) in surgical castrates, whereas these pituitary gene expressions were decreased (P < 0.05) in immunocastrates, due to loss of hypothalamic GnRH signaling. We concluded that immunocastration and surgical castration consistently reduced hypothalamic GnRH synthesis due to a testosterone deficiency disrupting testosterone-Kisspeptin-GPR54-GnRH signaling pathways. Furthermore, selectively attenuated GnIH and testosterone signaling in the pituitary increased gonadotropin production in surgical castrates.