Short Menstrual Cycles Research Articles

P-624 Description of antral follicle count in a population of healthy French women based on age, ultrasound technique, and clinical factors

Abstract Study question How is the age-specific reference range for antral follicle count in healthy French women correlated with clinical markers ? Summary answer AFC declines linearly with age is correlated with weight, hormonal contraception, cycles duration, but not BMI, smoking or infertility history. What is known already AFC is related to the number of primordial follicles within the ovaries and is a widely used marker for baseline assessment of ovarian reserve, but there are no standardized norms for AFC, and major differences between the nomograms published in recent years notably due to the improvement of ultrasound techniques. Moreover, most published data are based on infertile women. Several factors are postulated to have influence on AFC of which ethnic origin, yet the largest cohorts published recently are Asian and therefore do not apply to a Caucasian population. Study design, size, duration In this retrospective study we used data from 640 women who had undergone a Fertility Check Up in our center, from 2018 to 2023. This concept, unique in France, offers all women of reproductive age who wish to undergo a complete ultrasound examination to check for infertility risk factors, whatever their parental plans. Participants/materials, setting, methods 640 healthy French women undergoing a Fertility Check Up were recruited. All participants completed a questionnaire about demographics, medical and surgical history, obstetrical records, familial medical history and any usage of hormonal contraception. AFC was conducted via transvaginal ultrasound using a three-dimensional acquisition, by one of three trained operators, utilizing a Voluson E10 ultrasound machine (GE Healthcare). Operators employed either the sonoAVC option (semi-automatic technique) or a manual two-dimensional counting of the acquired 3D-dimensional volume. Main results and the role of chance The distribution of AFC by age were modelized by a numerical and a graphic nomograms. AFC demonstrated a linear decline with a decrease of 1.11 follicle (IC95% 0.98 - 1.24) per year of age. Age accounted for 12.5% of the variation (R2) in AFC. Linear regression analysis showed a significant negative correlation between AFC and women’s weight (p = 0.02), but not with BMI (p = 0.23), and a significant impact of hormonal contraception (p = 0.001), with an overall reduction of 6.6 follicles in AFC compared with the women without any hormonal contraception (IC95% 4.6 - 8.6). Short menstrual cycles were associated with lower AFC (p < 0.001), when long cycles and amenorrhea were significantly associated with higher AFC (p < 0.01). There was no impact of age of menarche, smoking, family history of POI, or of a history of infertility of more than one year. Multivariate analysis showed that AFC was significantly higher with 3D-manual versus automated-3D follicular counting, the difference averaged 3.59 follicles, reducing as AFCs became smaller. Limitations, reasons for caution We present data from Caucasian women using our ultrasound machines, but in practice, each sonographer must familiarize himself with the capabilities of his own machine. Furthermore, our study does not answer the question of AFC evolution over time, for a given patient. Wider implications of the findings Some questions remain unanswered, including the longitudinal trajectory of AFC within an individual and the impact of ethnic origin. Future longitudinal studies reporting the evolution of AFC with age and involving women of diverse ethnic backgrounds are needed. Ultimately, this study highlights the impact of ultrasound equipment and technique. Trial registration number Not applicable

Uterine artery embolization in the treatment of uterine fibroids and the preservation of reproductive health in women 40 years of age and older: A retrospective study

Aim. To evaluate the effect of uterine artery embolization (UAE) on reproductive health in women 40 years and older. Materials and methods. A retrospective study was conducted at the perinatal center of the District Clinical Hospital of Khanty-Mansiysk. Patients were divided into two groups: the main group (group 1; n=57) included women with uterine fibroids after UAE, and the control group (group 2; n=42) included women without a history of uterine fibroids. Results. Women with uterine fibroids were statistically more likely to have grade 1 obesity (χ2=4.39; p=0.04) and less likely to have normal body weight (χ2=8.73; p=0.00) compared to women without fibroids. Smoking increased the risk of uterine fibroids twofold (χ2=4.49; p=0.03; odds ratio 1.97; confidence interval 0.64-6.11). More women with uterine fibroids had a history of abortions (n=42; 73.7%) than those without uterine fibroids (n=19; 45.2%; χ2=8.27; p=0.01). The most common gynecological comorbidities in women with uterine fibroids included inflammatory disease of the uterus (N71), endometrial polyp (N84), and endometriosis (N80); p0.05. The most common extragenital diseases in patients with uterine fibroids included thyroid disease, hypertension, and iron deficiency anemia (p0.05). Contour SE embolization agent with spherical particles was more often associated with pain (χ2=0.18; p=0.67) and less often with fever (χ2=4.47; p=0.03). There was a decrease in the number of short menstrual cycles (less than 24 days) from the moment before surgical treatment and after 24 months (χ2=34.580; p0.001) and an increase in the number of cycles of 24–38 days (χ2=14.887; p=0.005). At 24 months after UAE, there were more women with a menstrual period of less than 3 days (χ2=10.385; p=0.035) and fewer with a menstrual period of more than 8 days (χ2=34.573; p0.001). Ultrasound showed a decreased ovarian reserve at 6, 12 and 24 months after UAE (p0.05). Conclusion. When assessing the reproductive health of women 40 years and older after embolization of the uterine arteries, it was found that this method of treatment of symptomatic uterine fibroids leads to a decrease in the duration and heaviness of menstruation but increases the risk of an ovarian reserve decrease.

Risk factors associated with changes in serum anti-Müllerian hormone levels before and after laparoscopic cystectomy for endometrioma.

The objective of our study was to investigate the risk factors for a decrease in ovarian reserve in patients with endometriomas after standardized laparoscopic procedures and evaluation to provide corresponding clinical guidance for patients with fertility requirements. Anti-Müllerian hormone (AMH) levels and other clinical data from 233 patients with endometriomas and 57 patients with non-endometrioma ovarian cysts admitted to the Peking Union Medical College Hospital between January 2018 and September 2023 were prospectively analysed. The pretreatment AMH levels of the study groups were compared to assess the impact of endometrioma on ovarian reserve, and the decrease in AMH after treatment was analysed to determine potential risk factors contributing to this change. Pretreatment AMH levels did not significantly differ between patients with endometriomas and those with non-endometrioma ovarian cysts. Within the endometrioma group, older age, higher body mass index (BMI), and shorter menstrual cycles were found to be associated with decreased AMH levels prior to treatment (p<0.05). Participants presenting with bilateral cysts, advanced surgical staging, or a completely enclosed Douglas pouch demonstrated significantly lower levels of AMH prior to treatment compared to those without these conditions (p<0.05). Furthermore, their AMH levels further declined within one year after undergoing laparoscopic cystectomy (p<0.05). However, there was no difference in AMH levels after surgery between patients who successfully became pregnant and those who did not (p>0.05). Laparoscopic removal of endometriomas can adversely affect ovarian reserve, especially during bilateral cysts removal and when patients are diagnosed as having a higher stage of endometriosis, further impacting ovarian function. It should be noted that a decrease in AMH levels may not necessarily indicate an absolute decline in fertility. Therefore, it is crucial to conduct thorough patient evaluations and provide comprehensive patient education to offer appropriate guidance for fertility preservation.

Prevalence of Menstrual Cycle Disorders in Injectable Contraceptive Acceptors: Study at Mulya Mekar Health Center, Purwakarta Regency, Indonesia

Injection contraception is a hormonal contraceptive method that is widely used by women in Indonesia. This method has the advantages of high effectiveness and ease of use. However, contraceptive injections can also cause side effects, one of which is menstrual cycle disorders. This study aims to determine the prevalence of injection contraceptive acceptors on the menstrual cycle at the Mulya Mekar Health Center, Purwakarta Regency, Indonesia. This research uses a descriptive observational research design with accidental sampling. The research sample was 50 contraceptive injection acceptors aged 15-49 years. Data was collected using a questionnaire. The research results show that the prevalence of injection contraceptive acceptors who experience menstrual cycle disorders is 60%. The most frequently experienced menstrual cycle disorders are longer menstrual cycles (26%), followed by shorter menstrual cycles (24%), and irregular menstrual cycles (10%). This study concludes that the prevalence of menstrual cycle disorders in recipients of contraceptive injections is quite high. Therefore, it is important for acceptors to know the risks and benefits of this contraceptive method.

Language deficit in boys with autism spectrum disorder in relation to maternal reproductive health, endocrine disruptors, and delivery method.

The presented research aimed to identify prenatal factors involved in abnormal neurodevelopment and postnatal manifestation of an autistic phenotype in 107 boys (average age 4.31 ± 2.24 years). Their biological mothers were asked to fill out a comprehensive questionnaire about their reproductive health, infections during pregnancy, oral contraceptive intake before conception, and potential substance abuse before and during pregnancy as well as delivery and newborn information. The boys were subsequently diagnosed with autism spectrum disorder (ASD) using the combination of Autism Diagnostic Observation Schedule (ADOS-2) and Autism Diagnostic Interview - Revised (ADI-R). Based on the ADOS-2 module chosen during diagnosis, boys diagnosed with Module 1 can be classified as nonverbal or minimally verbal (N = 68), while those diagnosed using Module 3 are fully verbal (N = 39). According to our results, reproductive health related to the length of the menstrual cycle before pregnancy with the autistic child seems to play a role with regards to the severity of the disorder (P = 0.017) as well as the number of previous pregnancies (P = 0.026). Mothers of nonverbal children reported to have had a much shorter menstrual cycle (27.35 ± 6.60 days) than those with verbal children (30.14 ± 4.44 days) and reported more previous pregnancies (0.93 ± 1.07 vs. 0.51 ± 0.91), while not reporting the number of live births before they had the autistic child. Children who were later diagnosed as non-verbal had a longer delivery time (from 2 to 48 hours; on average 11.13 hours, SD = 9.49) than verbal ones (between 1 and 27 hours, which was on average 7.09 hours, SD = 8.91), P = 0.0182. Delivery method didn't play a role in this context, and neither did the type of conception (natural, insemination, etc.). Studying the involvement of prenatal factors in the etiology of autism based on the speech of the child seems to be a promising approach.

#369 : A Case of Luteal Phase Deficiency (LPD) and Polycystic Ovarian Syndrome (PCOS). When Routine is not Enough

Background and Aims: Luteal phase deficiency (LPD) is a consequence of the inability of the corpus luteum (CL) to produce an adequate level of progesterone. This manifests clinically as a short menstrual cycle and infertility. Abnormal follicular development and inadequate steroidogenesis in lutein cells of the CL have been implicated in CL dysfunction and LPD. LPD and PCOS are independent disorders sharing a common pathophysiology. The aim of this case report is to highlight the importance of additional luteal phase support for patients with PCOS. Case report: A 34-year-old Indian lady with anovulation secondary to PCOS failed to get pregnant after 7 years of marriage. Her menses were irregular, and she had hirsutism. She was also overweight. (BMI 26.4 kg/m2) Her hormonal profile showed a reversal of the FSH/LH ratio of 2:1, and serum progesterone was low. (&lt;1.6 IU/L). A transvaginal scan showed a classic pearl string sign, which was typical for patients with PCOS. She underwent laparoscopic dye insufflation and ovarian drilling, during which four puncture points were made on each ovary at 4 watts for 4 seconds. Later, she underwent a round of timed sexual intercourse and intrauterine insemination. (IUI) Dydrogesterone (10 mg, 8 hourly) was started for luteal phase support as per unit protocol. However, she complained of per vaginal spotting starting on day 7 after human chorionic gonadotropin (hcg) trigger, and both times, treatment was unsuccessful. Then, she had another round of ovarian stimulation with clomiphene citrate 50 mg daily and had IUI. She was given micronized progesterone 100 mg 12 hours a day in addition to the dydrogesterone. The urine pregnancy test was positive, and she is having a healthy, on-going pregnancy. Conclusion: Patients with PCOS may suffer from a defective luteal phase. Hence, it is important to supplement PCOS patients with additional support during the luteal phase, as this can lead to a successful pregnancy.

Associations of Menstrual Cycle Regularity and Length With Cardiovascular Diseases: A Prospective Study From UK Biobank.

Background The association between menstrual cycle characteristics and cardiovascular outcomes remains unclear. This study was undertaken to evaluate whether menstrual cycle regularity and length throughout the life course are associated with cardiovascular outcomes. Methods and Results This cohort study included 58 056 women who had no cardiovascular disease (CVD) at baseline and reported their menstrual cycle regularity and length. Hazard ratios (HRs) and 95% CIs for CVD events were estimated using Cox proportional hazards models. During the median 11.8 years of follow-up, 1623 incident CVD cases were documented, including 827 incident cases of coronary heart disease, 199 myocardial infarctions, 271 strokes, 174 cases of heart failure, and 393 cases of atrial fibrillations. Compared with women with regular menstrual cycles, the HRs for women with irregular menstrual cycles were 1.19 (95% CI, 1.07-1.31) for CVD events and 1.40 (95% CI, 1.14-1.72) for atrial fibrillation. The multivariable-adjusted HRs for short (≤21 days) or long (35 days) menstrual cycles during follow-up were 1.29 (95% CI, 1.11-1.50) and 1.11 (95% CI, 0.98-1.56) for CVD events, respectively. Similarly, long or short cycle length were more likely to be associated with increased risk of atrial fibrillation (HR, 1.30 [95% CI, 1.01-1.66]; and HR, 1.38 [95% CI, 1.02-1.87]), and short cycle length was more likely to be associated with increased risk of coronary heart disease and myocardial infarction. However, these associations for stroke and heart failure were not significant. Conclusions Long or short menstrual cycle length was associated with increased risks of CVD and atrial fibrillation but not myocardial infarction, heart failure, or stroke. Short cycle length was associated with a greater risk of coronary heart disease and myocardial infarction.

Adherence to the Mediterranean Diet in Women and Reproductive Health across the Lifespan: A Narrative Review

The Mediterranean diet (MD) has been previously proven to have various health-related benefits; however, its effect on women’s reproductive health over a lifespan is yet to be summarized. This study aimed to summarize the evidence-based knowledge regarding the association between the MD and selected reproductive health outcomes. By searching PubMed, ScienceDirect, and Google Scholar databases, as well as reference lists, 21 studies were included in this narrative review. The available evidence was very limited; however, there is some suggestion that higher adherence to the MD may be positively associated with a lower risk of early age menarche (1 study) and shorter menstrual cycles (1 study), but is unrelated to dysmenorrhea (1 study). Moreover, no study to date has examined the relationship between the MD and the onset age of natural menopause. Considering reproductive health diseases, there was limited evidence that a higher adherence to the MD was associated with a lower risk of premenstrual syndrome (1 study), an improvement in sexual health and a lower prevalence of sexual dysfunction (3 studies), and an improvement in the general condition of with endometriosis and the pain they can experience (1 study). The largest number of studies were found for polycystic ovarian syndrome (PCOS; 7 studies) and infertility (6 studies). Results showed that a higher adherence to the MD was associated with a lower risk of infertility, while results for PCOS were unclear, but mostly indicated a beneficial trend. Further investigations are necessary to establish the role of adherence to the MD in reproductive health maintenance and its possible role in the prevention and treatment of reproductive health diseases in women.

The Relationship Between the Use of Contraceptives and Menstrual Cycle Disorders in Couples of Childbearing Age (PUS) at Puskesmas Piyungan Bantul Yogyakarta Year 2021

Menstrual cycle disorders are often become a problem for couples of childbearing age who use contraceptives, especially hormonal contraceptives namely injectable contraceptives.The problem itself can be in the form of a long cycle or more than 35 days (oligomenorrhea), a short menstrual cycle of less than 21 days (polymenorrhea) and a menstrual absence in 3 months in a row (amenorrhea). This study aims to determine the relationship between the use of contraceptives and menstrual cycle disorders in couples of childbearing age at Puskesmas Piyungan Sub-district, Bantul Yogyakarta in the year of 2021. This study is quantitative analytical study with Cross Sectional approach which was conducted retrospectively. The sampling technique used was Proportional Random Sampling with the total sample of 96 respondents. The analysis used were univariate and bivariate analysis. The results showed that from 58 respondents who used hormonal contraception, 44 respondents (75,9%) experienced abnormal menstrual cycle. Meanwhile, 38 respondents who used non-hormonal contraception at least experienced an abnormal menstrual cycle as many as 6 respondents (15,8%). The Chi-Square test showed that there was a significant relationship between the use of contraceptives and menstrual cycle disorders in couples of childbearing age, namely p = 0,000 &lt; α = 0,05 with OR value of 16,762. There is a significant relationship between the use of contraceptives and menstrual cycle disorders at Puskesmas Piyungan Sub-district, Bantul Yogyakarta.

MEDICAL STUDENT'S MENSTRUAL CYCLE: THE UNKNOWN UNKNOWNS

Background: The menstrual cycle is a health indicator in women. The change in health makes female students feel less confident in communicating, studying, and living. Therefore, the study on the characteristics of the menstrual cycle in female medical students brings many practical meanings by figuring conclusions and solutions to improve both physiological and mental discomforts for women during menstruation. Objectives: Can Tho University of Medicine and Pharmacy (CTUMP) 3rd year medical students were studied for the characteristics, the abnormalities of the menstrual cycle, and the premenstrual syndrome. Materials and methods: The design of a cross-sectional descriptive study with analysis by direct interview method was conducted on 126 female 3rd year medical students at CTUMP. Results: Long menstrual cycle time accounted for 38.1% of subjects, while short menstrual cycle time accounted for 0.8%. The study also found that the average menstrual period was 5.00±1.34 days. The premenstrual syndrome was observed in 47.3% of students, with abdominal pain and low back pain accounted for the highest rate (63.5%), and headache accounted for the lowest rate (9.5%). Menorrhagia had a low prevalence (7.1%), whereas menstrual cramp was much more common (60.3%). Conclusions: Long menstrual cycles occurred at a high rate among medical students. Abdominal pain and low back pain were the most common symptoms before menstruation. Menstrual cramp was the most common abnormality of the menstrual cycle among CTUMP female medical students.

Uterine Artery Doppler Indices in the Various Causes of Abnormal Uterine Bleeding Confirmed with Histopathology

Background: All disturbed pattern of bleeding which arises due to different reasons such as anovulation, pregnancy, uterine abnormalities and coagulopathies is termed as abnormal uterine bleeding (AUB). Abnormal uterine bleeding is present in many forms such as heavy bleeding, short menstrual cycle, excessive and heavy menstruation, uterine bleeding at irregular period, excessive and prolonged uterine bleeding. Abnormal uterine bleeding is mostly caused by benign findings such as endometrial hyperplasia or atrophy or benign polyps. Around 5–12% of Abnormal uterine bleeding results from Endometrial Cancer. Objective: Uterine artery Doppler indices in various causes of abnormal uterine bleeding confirmed with histopathology. Methodology: A Cross-sectional Analytical study was conducted at Shireen Ultrasound Clinic Peshawar, Pakistan. This study enrolled a purposive sample of 162 patients presenting with abnormal uterine bleeding with the age between 18 to 80 years. The examination was performed with Toshiba Nemio 20(Xario Prime with TVS Probe frequency range 7-14MHz) .The Resistive index(RI), Pulsatility index(PI), mean and standard deviation were calculated for the continuous variables. Results: A total of 162 patients were enrolled in our study. The mean age of patients was recorded 38±5 years. In this study, the histopathological findings were as follow, 8.6% adenomyosis,12.3% endometrial hyperplasia, 43.3% leiomyoma’s, 17.3% polyp, 2.5% endometrial carcinoma and 16% non-specific findings so the most common cause of abnormal uterine bleeding was leiomyoma’s with mean of Right Uterine artery (U-A) PI and RI was 3.33±1.23 and 0.83±0.03 respectively and left U-A PI and RI was 2.95±1.17 and 0.84±0.03 respectively while the least common cause was endometrial carcinoma with mean of Right U-A PI and RI was 2.54±1.08 and 0.52±0.01 respectively and of Left U-A PI and RI was 1.62±0.00 and 0.52±0.00 respectively. Conclusion: From our study we concluded that the uterine artery RI in endometrial carcinoma causing abnormal uterine bleeding is low and in benign condition like polyp, hyperplasia and fibroids is high. Keywords: Uterine bleeding, Carcinoma, Fibroids, Hyperplasia, Trans-vaginal ultrasound

Self-reported menstrual cycle length during reproductive years in relation to menopausal symptoms at midlife in Project Viva.

The aim of this study was to investigate the extent to which self-reported menstrual cycle length during reproductive years is associated with menopausal symptoms and age at natural menopause at midlife. This analysis includes 634 women who enrolled in Project Viva during pregnancy (1999-2002) and completed the midlife visit approximately 18 years later. Women self-reported menstrual cycle length at enrollment (early pregnancy) and at midlife reported total and specific menopausal symptoms using the Menopause Rating Scale as well as age at natural menopause. We used linear and regression models to evaluate associations of cycle length with total and specific menopausal symptoms. We also applied a time-to-event Cox proportional hazards model to investigate the relationship between menstrual cycle length and onset of natural menopause. We adjusted models for age at midlife visit, prepregnancy body mass index, race/ethnicity, education, and parity. At enrollment (median age, 33.3 years), 90 (14%) women reported having short (≤25 days) and 39 (6%) reported long (≥35 days) menstrual cycles. Compared with women with a normal menstrual cycle length of 26 to 34 days, women whose cycles were short had a higher total Menopause Rating Scale at midlife ( β = 2.05; 95% confidence interval [CI], 0.73-3.38). Specifically, women with short menstrual cycles during their reproductive years had higher odds of midlife sleep problems (odds ratio [OR], 1.92; 95% CI, 1.10-3.37), heart discomfort (OR, 1.68; 95% CI, 1.03-2.73), and depressive symptoms (OR, 1.85; 95% CI, 1.16-2.96). In addition, compared with women with a normal cycle length of 26 to 34 days, women reporting short cycles had an earlier onset of natural menopause (hazard ratio, 1.67; 95% CI, 1.11-2.51). Compared with women with normal menstrual cycle length, those with short menstrual cycles during their reproductive years had a higher frequency of total and certain menopausal symptoms at midlife and reached menopause earlier.

Importance and Surgical Methods of Induction of Endometriosis and Osteoporosis Following Menopause in Rats: an Overview Study

Introduction: Endometriosis is one of the main causes of pelvic pain and subfertility, which is characterized by endometrial-like tissues outside the uterus and primarily is created in the pelvic peritoneum, ovaries, walls between the rectum and vagina and in rare cases in the diaphragm, pleura and pericardium. Some risk factors for endometriosis are obstruction in menstrual hemorrhage, an increase in the duration of endogenous estrogen, short menstrual cycles and childbirth at an early age. On the other hand, osteoporosis is a metabolic disease that is determined by bone mineral density and the destruction of the bone microstructure that increases the risk of bone fracture. About 200 million people worldwide are suffering from osteoporosis, that 34% of them are women over 50 years old. The first and most commonly used model for the induction of this disease is the ovariectomy model in rats, which gives a model of the relationship between osteoporosis and menopause. Conclusion: Endometriosis animal models are highly contributing to the development of new non-invasive diagnostic tools and improve therapeutic methods for treatment of endometriosis in women. Although no animal models are absolutely ideal and excellent, but the presence of many similarities in the response of the human skeletal system and rats to reduce estrogen levels and therapeutic compounds caused by the ovariectomy model of the rat, a suitable model for osteoporosis research. The response of rat bones to ovariectomy depends on the type of bone (trabecular against cortical), bone sites (femur, proximal Tibia, and lumbar vertebrae) and it depends on the time elapsed after ovariectomy (the time required to reduce the amount of estrogen levels).

A study on body mass index and menstrual cycle length in reproductive age women

Background: Menstrual cycle length is an indicator of reproductive health of a woman. Duration of menstrual cycle in a woman is affected by a number of factors including BMI. The effect of BMI on menstrual cycle length has been studied less extensively. Not many studies have been conducted on Indian populations. This study was conducted to study the relation of body mass index and menstrual cycle length in reproductive age women.Methods: The study included 225 women of age 15-45 years. Women with average menstrual cycle length of 24-38 were regarded as regularly menstruating women. Menstrual cycle length was defined as short (&lt;24 days), normal (24-38 days), long (&gt;38 days). During the menstrual phase of the cycle BMI of each participant was recorded.Results: A significant (p=0.0008) increase in mean BMI was found with increased in length of menstrual cycle. The majority of the women with long menstrual cycle were obese compared to women having normal and short length of menstrual cycle.Conclusions: The results of present study indicates that women with long menstrual cycle have increased body mass index compared to women having normal or short menstrual cycle length.

Comparisons of the Prevalence, Severity, and Risk Factors of Dysmenorrhea between Japanese Female Athletes and Non-Athletes in Universities.

This study aimed to investigate the difference in the prevalence, severity, and risk factors of dysmenorrhea between Japanese female athletes and non-athletes in universities. The participants were 18 to 30 years old with no history of a previous pregnancy and/or childbirth. After application of the exclusion criteria, the cohort comprised 605 athletes and 295 non-athletes. An anonymous questionnaire, which included self-reported information on age, height, weight, age at menarche, menstrual cycle days, menstrual duration, dysmenorrhea severity, sleeping hours, dietary habits, exercise habits, training hours, and competition level was administered. Compared with athletes, non-athletes had a higher prevalence of dysmenorrhea (85.6% in athletes, 90.5% in non-athletes, p < 0.05); non-athletes also demonstrated increased severity (none/mild 27.8%, moderate 19.3%, and severe 52.9% in athletes; none/mild 21.2%, moderate 17.2%, and severe 61.6% in non-athletes; p < 0.05). Factors related to severe dysmenorrhea in athletes included long training hours, early menarche, and prolonged menstrual periods. In non-athletes, short menstrual cycle days and extended menstrual periods were related to severe dysmenorrhea. The prevalence and severity of dysmenorrhea were higher among non-athletes than among athletes; different factors were related to severe dysmenorrhea in these two groups. Thus, different strategies are necessary to manage dysmenorrhea for athletes and non-athletes in universities.

O-112 Outcomes of random-start ovarian stimulation protocols as a possible evidence of the theory of antral follicles continuous recruitment

Abstract Study question We tried to validate the possibility and efficiency of ovarian stimulation (OS) started on any day of the menstrual cycle, based on a theory of continuous recruitment of antral follicles. Summary answer Formation of a pool of follicles with higher sensitivity to gonadotropic stimulation occurs several times during the menstrual cycle (MC). What is known already According to classical concepts and fundamental positions formulated in the middle of the last century, follicular recruitment occurs only once during the menstrual cycle - in the early follicular phase. Nowadays there is increasing evidence to suggest that there are multiple (two or three) antral follicular waves of recruitment during the MC. Also some researchers state that the process of follicle recruitment is continuous. Study design, size, duration This prospective clinical study was conducted at the V.I. Kulakov NMRC for OG&amp;Pof Russia. The study included female cancer patients seeking retrieval and cryopreservation of oocytes and/or embryos before cancer treatment. 240 patients were selected for the study. The patients were divided into 5 groups depending on the cycle day on the moment when ovarian stimulation was initiated. All patients signed an informed consent form approved by the Ethics Committee. Participants/materials, setting, methods The 1st group consisted of patients who started standart OS from 1 to 5 days of the cycle (n = 65); the 2nd - from 6 to 10 (n = 36), the 3rd - from 11 to 15 (n = 45), the 4th - from 16 to 22 (n = 44), the 5th - from 23 to 28 (n = 50). In the late follicular and luteal phase we performed OS without a pituitary modulator. The comparative analysis included features of oo-, embryogenesis and steroidogenesis. Main results and the role of chance The mean age, BMI and AMH were not different among groups. There were no LH rise or OHSS signs noticed in any groups, despite that OS in late follicular and luteal phase of the MC was performed with no GnRH antagonist addition.There was no statistically significant difference in the duration of stimulation, starting doses, total dose of FSH and HMG. The largest number of oocyte cumulus complexes was obtained in the 5th group (11 (9–21) vs 7 (3,5–15,5) in the 1st group, p = 0,030). The greatest number of mature oocytes was obtained in the 4th and 1st groups. In the 2nd group the largest number of immature oocytes was obtained (37 (9.1%)). A smaller number of mature oocytes (165 (61.8%) vs 492 (72.9%) and 314 (77.5%), p = 0.001) was obtained in group 2 (compared with the 1st and the 4th groups), when stimulation was started in the presence of a dominant follicle . These periods coincided with higher estradiol and lower FSH serum levels. Based on our data the optimal moment for effective OS initiation starts with the decrease in serum estradiol which is approximately 48 hours before the menstrual bleeding. Limitations, reasons for caution The presented results could be applied mainly to young patients with high and normal ovarian reserve, who were in the main study group. In patients with low ovarian reserve, short menstrual cycle and early ovulation an issue of favorable time points for the initiation of OS should be resolved individually. Wider implications of the findings The data collected during our research could possibly contribute to future personification of OS protocols. Tailoring the ovarian stimulation protocols to the needs of the patients could decrease time needed for completing the protocol without affecting oocyte yield or their maturity. Trial registration number none

A Systematic Two-Sample Mendelian Randomization Analysis Identifies Shared Genetic Origin of Endometriosis and Associated Phenotypes.

Endometriosis, one of the most common gynecological disorders, is a complex disease characterized by the growth of endometrial-like tissue in extra-uterine locations and is a cause of pelvic pain and infertility. Evidence from observational studies indicate that endometriosis usually appears together with several other phenotypes. These include a list of autoimmune diseases, most of them more prevalent in women, anthropometric traits associated with leanness in the adulthood, as well as female reproductive traits, including altered hormone levels and those associated with a prolonged exposure to menstruation. However, the biological mechanisms underlying their co-morbidity remains unknown. To explore whether those phenotypes and endometriosis share a common genetic origin, we performed a systematic Two-Sample Mendelian Randomization (2SMR) analysis using public GWAS data. Our results suggest potential common genetic roots between endometriosis and female anthropometric and reproductive traits. Particularly, our data suggests that reduced weight and BMI might be mediating the genetic susceptibility to suffer endometriosis. Furthermore, data on female reproductive traits strongly suggest that genetic variants that predispose to a more frequent exposure to menstruation, through earlier age at menarche and shorter menstrual cycles, might also increase the risk to suffer from endometriosis.

HUBUNGAN TINGKAT STRES DENGAN SIKLUS MENSTRUASI PADA REMAJA PUTRI DI SMAN 5 PEKANBARU TAHUN 2019

ABSTRACT&#x0D; &#x0D; menstrual cycle are a series of events that are complexly affecting each other and occur simultaneously. Menstrual cycle can be influenced by stress factors. Stress is a perception of a threat or from a shadow of displeaseru that moves, alerts or activates an organism. Based on data obtained from the department of education the city of pekanbaru, it is known that schools which have the highest number of girls at SMAN 5 pekanbaru with the highest number of 639 people, while classes X and XI total 395 people and obtain information 8 people claimed to experince menstrual cycles that are not normal and as many as 6 of them experienced symptoms of stress. The purpose of this study was to determine the relationship between stress levels and menstrual cycle in young women at SMAN 5 pekanbaru. This type of research is quantitative with cross sectional design. The population is all young women and a sample of 80 people, taken by stratified random sampling technique. Data analysis was performed univariately and bivariately. The results obtained bye the majority of respondents had a moderate stress level of 31 people (38.8%) and for the menstrual cycle variable obtained the majority of respondents had a short menstrual cycle of 33 people (41.2%). Chi sqaure test results obtained p.value=0.012 &lt;0.05, which means there is a relationship between the level of stress with the menstrual cycle in girls in SMAN 5 pekanbaru in 2019. being input and learning materials that add insight and increase knowledge for students at SMAN 5 cities pekanbaru.&#x0D; &#x0D; Keywords: Stress, Menstrual Cycle&#x0D; Reference: 19 (2004-2017)

The Impact of Endocrine-Disrupting Chemicals on Female Fertility

Nowadays, infertility is a prevalent problem among couples. Exposure to endocrine-disrupting chemicals (EDCs) may influence the female reproductive outcomes through multiple mechanisms, being one of the important causes of infertility. These compounds may interfere with some fertility and fecundity markers, leading to increased time to pregnancy, increased risk of spontaneous abortion, shorter menstrual cycles, early age at menopause, anovulation or delayed ovulation, smaller preovulatory follicles, increased serum FSH, decreased synthesis of estradiol and progesterone, low plasma levels of anti-Mullerian hormone and decreased antral follicle count. Endocrine-disrupting chemicals may also impair in vitro fertilization outcomes, being responsible for: a lower probability of implantation, reduced fertilization rates, diminished probability of clinical pregnancy, and near term pregnancies after in vitro fertilization. Another mechanism of altering the female reproductive function is through the disorders induced by EDCs, such as polycystic ovary syndrome, uterine fibroids, and endometriosis. Those conditions may finally lead to infertility.

Socioeconomic factors and lifestyle affecting the variability of menstrual cycle characteristics in women from Central Poland

Regularity, length of the cycle and duration of menstrual flow are a reflection of women health. The purpose of the research was to assess the relationships between socioeconomic status, cycle length, duration of menses, regularity and dysmenorrhea. A survey was conducted among 896 healthy women from Łódź and Warsaw (Poland), aged 15.71–26.98. Women who were menarche at least 3 years ago were asked to complete the survey. Women were asked about cycle length (number of days), duration of menstrual flow, regularity of the cycle, dysmenorrhea, birth place, parental education level, attendance at physical education classes, participation in additional sports activities, self-assessment of stress levels at home and at school/university, and smoking. For data analysis, t-test, analysis of variance, and chi-square were used, and p&lt;0.05 was considered to be statistically significant. There were no significant relationships between the mean cycle length, regularity and the environmental factors, except for differences in the average length of the menstrual cycle in women from Łódź who attend additional sports activities. Women who are more physically active are characterized by a shorter menstrual cycle. In terms of the length of the menstrual flow, daughters of better educated fathers were characterized by longer menses. In contrast, dysmenorrhea was associated with longer menstrual periods and longer menstrual bleeding, as well as with higher levels of stress, both at home and at school. Environmental factors affected the features of menstruation cycles in women from Central Poland.