RESUMO
OBJECTIVE: To determine the frequency of phenotypes of polycystic ovarian syndrome (PCOS) in patients presenting with sub-fertility, and to compare the clinical and hormonal characteristics among them. STUDY DESIGN: Descriptive cross-sectional study. Place and Duration of the Study: Department of Obstetrics and Gynaecology, Forest View Specialist Clinic, Peshawar, Pakistan, from August 2022 to January 2023. METHODOLOGY: The study included 662 female patients presenting with menstrual irregularities, hyperandrogenism, and infertility to the clinic. PCOS was diagnosed on the basis of the Rotterdam criterion and clinical features and classified into different phenotypes on the basis of the National Institute of Health (NIH) panel criteria. Data were entered and analysed by IBM SPSS VERSION 23.0. The frequency of four phenotypes was calculated and phenotypes were compared for age, weight, hormonal profiles, and history of miscarriages. A p <0.05 was considered statistically significant. RESULTS: Frequency of PCOS in patients with infertility was 59.76%. Phenotype A was seen in 58.2%, phenotype D in 23.3%, phenotype C in 16.9%, and phenotype B in 1.7% of cases. The LH/FSH ratio was statistically significant in phenotype A as compared to other phenotypes, while other parameters were non-significant. CONCLUSION: The frequency of PCOS is high in patients with infertility. Phenotype A is the most common variant and is associated with significant impairment of the LH/FSH ratio. KEY WORDS: Polycystic ovarian syndrome, Subfertility, Phenotypes of PCOS, Hyperandrogenism, Anovulation, R-C1.
Assuntos
Hiperandrogenismo , Fenótipo , Síndrome do Ovário Policístico , Humanos , Síndrome do Ovário Policístico/sangue , Síndrome do Ovário Policístico/epidemiologia , Feminino , Adulto , Estudos Transversais , Paquistão/epidemiologia , Hiperandrogenismo/sangue , Infertilidade Feminina/sangue , Infertilidade Feminina/etiologia , Hormônio Foliculoestimulante/sangue , Hormônio Luteinizante/sangue , Adulto Jovem , Distúrbios Menstruais/epidemiologia , Distúrbios Menstruais/sangueRESUMO
Premature ovarian insufficiency (POI) is a cause of infertility and endocrine dysfunction in women, defined by loss of normal, predictable ovarian activity before the age of 40 years. POI is clinically characterized by amenorrhoea (primary or secondary) with raised circulating levels of follicle-stimulating hormone. This condition can occur due to medical interventions such as ovarian surgery or cytotoxic cancer therapy, metabolic and lysosomal storage diseases, infections, chromosomal anomalies and autoimmune diseases. At least 1 in 100 women is affected by POI, including 1 in 1,000 before the age of 30 years. Substantial evidence suggests a genetic basis to POI. However, the cause of idiopathic POI remains unknown in most patients, indicating that gene variants associated with this condition remain to be discovered. Over the past 10 years, tremendous progress has been made in our knowledge of genes involved in POI. Genetic approaches in diagnosis are important as they enable patients with familial POI to be identified, with the opportunity for oocyte preservation. Moreover, genetic approaches could provide a better understanding of disease mechanisms, which will ultimately aid the development of improved treatments.
Assuntos
Insuficiência Ovariana Primária , Humanos , Insuficiência Ovariana Primária/fisiopatologia , Insuficiência Ovariana Primária/etiologia , Insuficiência Ovariana Primária/genética , Insuficiência Ovariana Primária/diagnóstico , Feminino , Hormônio Foliculoestimulante/sangue , AdultoRESUMO
This study hypothesized that SCFA, acetate impacts positively on hypothalamic pyroptosis and its related abnormalities in experimentally induced PCOS rat model, possibly through NrF2/HIF1-α modulation. Eight-week-old female Wister rats were divided into groups (n = 5), namely control, PCOS, acetate and PCOS + acetate groups. Induction of PCOS was performed by administering 1 mg/kg body weight of letrozole for 21 days. After PCOS confirmation, the animals were treated with 200 mg/kg of acetate for 6 weeks. Rats with PCOS were characterized with insulin resistance, leptin resistance, increased plasma testosterone as well as degenerated ovarian follicles. There was also a significant increase in hypothalamic triglyceride level, triglyceride-glucose index, inflammatory biomarkers (SDF-1 and NF-kB) and caspase-6 as well as plasma LH and triglyceride. A decrease was observed in plasma adiponectin, GnRH, FSH, and hypothalamic GABA with severe inflammasome expression in PCOS rats. These were accompanied by decreased level of NrF2/HIF1-α, and the alterations were reversed when treated with acetate. Collectively, the present results suggest the therapeutic impact of acetate on hypothalamic pyroptosis and its related comorbidity in PCOS, a beneficial effect that is accompanied by modulation of NrF2/HIF1-α.
Assuntos
Hipotálamo , Subunidade alfa do Fator 1 Induzível por Hipóxia , Síndrome do Ovário Policístico , Piroptose , Ratos Wistar , Síndrome do Ovário Policístico/induzido quimicamente , Síndrome do Ovário Policístico/metabolismo , Síndrome do Ovário Policístico/tratamento farmacológico , Síndrome do Ovário Policístico/patologia , Feminino , Animais , Hipotálamo/metabolismo , Hipotálamo/efeitos dos fármacos , Hipotálamo/patologia , Piroptose/efeitos dos fármacos , Ratos , Subunidade alfa do Fator 1 Induzível por Hipóxia/metabolismo , Resistência à Insulina , Fator 2 Relacionado a NF-E2/metabolismo , Modelos Animais de Doenças , Letrozol/farmacologia , Triglicerídeos/sangue , Triglicerídeos/metabolismo , Hormônio Luteinizante/sangue , Hormônio Foliculoestimulante/sangue , Adiponectina/metabolismo , Adiponectina/sangue , Testosterona/sangue , Leptina/sangue , Leptina/metabolismo , Hormônio Liberador de Gonadotropina/metabolismo , Ácido gama-Aminobutírico/metabolismoRESUMO
The practice of hormone therapy is crucial in aligning secondary sex characteristics with the gender identity of transgender adults. This study examines the effects of a commonly used injectable hormone combination, specifically estradiol enanthate with dihydroxyprogesterone acetophenide (EEn/DHPA), on serum hormonal levels and self-reported satisfaction with breast development in transwomen. Our research focused on a retrospective longitudinal study involving a large cohort of transwomen evaluated between 2020 and 2022, comprising 101 participants. We assessed serum levels of estradiol (E2), testosterone (T), luteinizing hormone (LH), and follicle-stimulating hormone (FSH), comparing the EEn/DHPA hormonal regimen with other combined estrogen-progestogen (CEP) therapies. Additionally, a subset of 43 transwomen completed a 5-question survey to evaluate self-reported satisfaction with breast development using Tanner scales. Our findings indicated that participants using the EEn/DHPA regimen exhibited significantly higher serum E2 levels (mean: 186 pg/mL ± 32 pg/mL) than those using other therapies (62 ± 7 pg/mL), along with lower FSH levels, but no significant differences in T and LH levels. Concerning satisfaction with breast development, 76% reported increased fulfillment with breast augmentation while using EEn/DHPA. These results suggest that an injectable, low-cost EEn/DHPA administered every three weeks could serve as an alternative feminizing regimen, particularly considering the extensive long-term experience of the local transgender community. Further longitudinal studies on the efficacy of feminizing-body effects and endovascular risks of various parenteral CEP types are warranted to improve primary healthcare provision for transgender persons.
Assuntos
Estradiol , Pessoas Transgênero , Humanos , Feminino , Estradiol/administração & dosagem , Estradiol/sangue , Adulto , Estudos Retrospectivos , Masculino , Estudos Longitudinais , Mama/efeitos dos fármacos , Satisfação do Paciente , Serviços de Saúde Comunitária , Testosterona/administração & dosagem , Testosterona/sangue , Hormônio Luteinizante/sangue , Hormônio Foliculoestimulante/administração & dosagem , Hormônio Foliculoestimulante/sangue , Pessoa de Meia-Idade , Adulto JovemRESUMO
According to numerous studies, the most common pituitary tumors are prolactinomas, reaching 60% of all clinically significant adenomas, the next in order are non-functional pituitary adenomas, somatotropinomas, corticotropinomas and thyrotropinomas. Plurigormonal tumors occur in less than 1% of all pituitary adenomas. The most common form of mixed secretion adenoma in this patient population, derived from the Pit-1 cell line, produces various combinations of hormones: growth hormone (GH), prolactin (PRL), thyroid-stimulating hormone (TSH). This article presents a patient with a plurihormonal two-component pituitary macroadenoma with a rare and exceptional combination of secreted hormones - GH / adrenocorticotropic hormone (ACTH) / TSH / follicle-stimulating hormone (FSH) / luteinizing hormone (LH) with minimal nonspecific clinical manifestations such as diabetes mellitus and poorly controlled arterial hypertension.
Assuntos
Adenoma , Neoplasias Hipofisárias , Tireotropina , Humanos , Neoplasias Hipofisárias/diagnóstico , Neoplasias Hipofisárias/patologia , Neoplasias Hipofisárias/metabolismo , Adenoma/diagnóstico , Adenoma/patologia , Adenoma/metabolismo , Tireotropina/sangue , Tireotropina/metabolismo , Hormônio Luteinizante/sangue , Hormônio Foliculoestimulante/sangue , Hormônio Adrenocorticotrópico/sangue , Hormônio Adrenocorticotrópico/metabolismo , Masculino , Adulto , Feminino , Pessoa de Meia-Idade , Diagnóstico DiferencialRESUMO
Highly purified human menopausal gonadotropin (HP-hMG [Menopur®, Ferring Pharmaceuticals, Saint-Prex, Switzerland]) contains a 1:1 ratio of follicle-stimulating hormone (FSH) and luteinizing hormone (LH). This analysis aimed to assess gonadotropin (FSH, LH and hCG) abundance in HP-hMG and clarify the source of hCG by assessing the presence of sulfated glycans, which are diagnostic for pituitary hCG forms due to their distinct glycosylation patterns. Additionally, the purity of each sample, their specific components, and their oxidation levels were assessed. HP-hMG samples (three of Menopur® and two of Menogon® Ferring Pharmaceuticals, Saint-Prex, Switzerland) were included in the current analyses. Brevactid® (urinary hCG; Ferring Pharmaceuticals, Saint-Prex, Switzerland) and Ovidrel® (recombinant hCG; Merck KGaA, Darmstadt, Germany) were used as control samples. Glycopeptide mapping and analysis of impurities were carried out by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Oxidation was assessed through reducing peptide mapping using LC-MS/MS. The FSH and LH in the HP-hMG samples showed sulfated glycans, while no signals of sulfated glycopeptides were detected on any site of the beta subunit of hCG. HP-hMG test samples presented the same hCG glycan distribution as the control sample (placental hCG, Brevactid®) extracted from the urine of pregnant women, suggesting a non-pituitary source of hCG. Protein impurities were estimated to constitute approximately 20-30% of the entire HP-hMG protein content in the test samples. More than 200 non-gonadotropin proteins were identified in the HP-hMG test samples, of which several were involved in embryonic development or pregnancy. The alpha subunit of the tested samples was strongly oxidized, with a relative abundance of 20% of the total gonadotropin content. Without taking into account all the protein impurities, the beta subunit of LH was detected only in traces (0.9-1.2%) in all tested HP-HMG samples, confirming the data obtained by intact molecule analysis, while high levels of beta hCG (18-47%) were observed. Advanced molecular analysis of HP-hMG indicates a primarily placental origin of hCG, as evidenced by the absence of hCG sulfated glycans and the predominance of placental non-sulfated hCG in LH activity. The analysis revealed 20-30% of protein impurities and a significant presence of oxidized forms in the HP-hMG samples. These findings are critical for understanding the quality, safety, and clinical profile of HP-hMG.
Assuntos
Gonadotropina Coriônica , Menotropinas , Feminino , Humanos , Gonadotropina Coriônica/análise , Gonadotropina Coriônica/isolamento & purificação , Gonadotropina Coriônica/urina , Cromatografia Líquida/métodos , Hormônio Foliculoestimulante/urina , Hormônio Foliculoestimulante/análise , Glicopeptídeos/análise , Glicopeptídeos/química , Glicopeptídeos/urina , Glicosilação , Hormônio Luteinizante/urina , Hormônio Luteinizante/análise , Menotropinas/urina , Menotropinas/análise , Oxirredução , Polissacarídeos/análise , Polissacarídeos/química , Polissacarídeos/urina , Espectrometria de Massas em Tandem/métodos , Menopausa , Pós-MenopausaRESUMO
Infertility rates have risen significantly, one of which is due to monosodium glutamate (MSG) consumption. Recent studies have shown that flavonoids in black garlic (Allium sativum) act as antioxidants. The aim of this study was to assess the effect of black garlic extract (BGE) on gonadosomatic index, follicle-stimulating hormone (FSH) levels, and spermatozoa quality in rats exposed to MSG. Twenty-five healthy rats, aged ten to twelve weeks, were divided equally into five experimental groups: (1) negative control (NC), no intervention; (2) positive control (PC), fed with MSG 8 mg/kg; and (3) fed with MSG + BGE 200 mg/kg; (4) fed with MSG + BGE 400 mg/kg; and (5) fed with MSG + BGE 600 mg/kg. Oral MSG was administered once a day for two weeks before BGE administration was started for two weeks. The measured endpoints were gonadosomatic index, FSH levels, and spermatozoa concentration and quality (spermatozoa motility and abnormality). Analysis of variance (ANOVA) followed by Duncan's post hoc analysis was used to assess the measurement differences. The result suggested that the administration of BGE did not significantly affect the gonadosomatic index (p=0.513). Significant decreases in FSH levels (p=0.005) and spermatozoa concentration were observed in the PC group compared to other groups (p<0.001). Additionally, spermatozoa motility was significantly lower in the PC group compared to NC, BGE200, BGE400, and BGE600 (p<0.001), with higher motility noted in BGE200, BGE400, and BGE600 compared to PC (p<0.001). Furthermore, PC had significantly higher spermatozoa abnormalities compared to NC, BGE200, BGE400, and BGE600 (p<0.001). In conclusion, administration of BGE had a significant effect on the improvement of FSH levels and the quality of spermatozoa in rats exposed to MSG.
Assuntos
Hormônio Foliculoestimulante , Alho , Extratos Vegetais , Glutamato de Sódio , Espermatozoides , Animais , Masculino , Alho/química , Glutamato de Sódio/farmacologia , Hormônio Foliculoestimulante/sangue , Ratos , Extratos Vegetais/farmacologia , Extratos Vegetais/administração & dosagem , Espermatozoides/efeitos dos fármacos , Motilidade dos Espermatozoides/efeitos dos fármacos , Ratos Wistar , Antioxidantes/farmacologiaRESUMO
BACKGROUND: Valproic acid (VPA) is a widely used antiepileptic drug (AED) often prescribed as a first-line treatment for many idiopathic and symptomatic generalized epilepsies. Several studies have highlighted the side effects of VPA on male fertility and reproductive factors in males, although the specific underlying etiology of these abnormalities is not clear. The present systematic review and meta-analysis aimed to assess the preclinical and clinical evidence concerning the impact of VPA on male fertility and reproductive factors. METHODS: The scientific literature was reviewed for eligibility using PubMed, Web of Science, and PsycINFO, encompassing preclinical and clinical studies. Factors related to male fertility and reproduction, such as differences in sperm count, sperm motility, and the percentage of abnormal sperm, were compared between the experimental groups treated with VPA (in both preclinical and clinical) and the control groups using the Standardized Mean Difference (SMD) with 95% confidence intervals (CIs). Additionally, differences in follicle-stimulating hormone (FSH) and luteinizing hormone (LH) were explicitly assessed in clinical studies. RESULTS: Male fertility data were extracted from 7 preclinical studies (112 animals) and 5 clinical studies (274 male individuals). The results of animal studies found that the sperm count (SMD = -2.28, 95% CI: -3.39 to -1.18, P = 0.335) and sperm motility (SMD = -2.32, 95% CI: -3.34 to -1.30, P = 0.368) were decreased in the treated groups compared to the control groups. The percentage of abnormal sperm (SMD = 3.27, 95% CI: 1.98 to 4.56, P = 0.019) was significantly increased, while a non-significant reduction was revealed in the weight of the testis (SMD = -2.73, 95% CI: -4.23 to -1.23, P = 0.673) in treated groups. The outcomes of clinical studies indicated a non-significant decrease in sperm count (SMD = -0.78, 95% CI: -1.58 to 0.03, P = 0.286) among patients with epilepsy treated with VPA compared to control subjects. However, a significant reduction in sperm motility (SMD = -1.62, 95% CI: -2.81 to -0.43, P = 0.033 was observed. The percentage of abnormal sperm showed a non-significant increase (SMD = 0.93, 95% CI: -0.97 to 2.84, P = 0.616) after being treated with VPA. Furthermore, there was a non-significant reduction in the levels of FSH (SMD = -1.32, 95% CI: -2.93 to 0.29, P = 0.198) and LH (SMD = -0.96, 95% CI: -1.95 to 0.04, P = 0.211) observed in clinical participants. CONCLUSION: This meta-analysis of both preclinical and clinical studies revealed that VPA causes a significant reduction in male fertility and reproductive factors among male patients with epilepsy. Clinical neurologists should be more cautious when prescribing VPA, especially to young male adult patients with epilepsy.
Assuntos
Anticonvulsivantes , Fertilidade , Contagem de Espermatozoides , Motilidade dos Espermatozoides , Ácido Valproico , Ácido Valproico/efeitos adversos , Masculino , Humanos , Anticonvulsivantes/efeitos adversos , Fertilidade/efeitos dos fármacos , Animais , Motilidade dos Espermatozoides/efeitos dos fármacos , Infertilidade Masculina/induzido quimicamente , Hormônio Foliculoestimulante/sangueRESUMO
Objective: To investigate the possible pathogenesis and possible risk factors of tinnitus related to female menopause. Methods: From April 2016 to October 2016, 59 female patients with menopausal syndrome were diagnosed in the menopause comprehensive management clinic. Tinnitus and menopause questionnaires were conducted, based on whether having tinnitus, those patients were divided into two groups: tinnitus group and no tinnitus group. Age, body mass index (BMI), Kupperman menopausal index (KMI) score, follicle-stimulating hormone (FSH) level of patients in the two groups were analyzed. Menopausal symptoms, related medical history and possible related factors of tinnitus were statistically analyzed. Results: A total of 59 cases were collected, 22 of which were accompanied by tinnitus. The incidence of idiopathic tinnitus was 35.1% (20/57) because 2 cases of thyroid related tinnitus with clear etiology were removed. Complete data were obtained from 17 of 20 patients with idiopathic tinnitus and 26 of 37 patients without tinnitus. Age, BMI, menopause KMI score, hormone level, menopause symptoms and possible factors related to tinnitus were statistically analyzed between the two groups, and the incidence of headache was statistically different between the two groups (χ2=9.098, P=0.003), but no other factors were statistically significant(P>0.05). The severity of insomnia and tinnitus were further analyzed (χ2=2.841, P=0.417), and there was no significant difference between the two groups. Conclusion: Headache history may be one of the high risk factors for the occurrence of menopausal tinnitus.
Assuntos
Menopausa , Zumbido , Humanos , Feminino , Zumbido/epidemiologia , Zumbido/etiologia , Fatores de Risco , Inquéritos e Questionários , Cefaleia/etiologia , Cefaleia/epidemiologia , Índice de Massa Corporal , Pessoa de Meia-Idade , Hormônio Foliculoestimulante/sangue , IncidênciaRESUMO
Oogenesis involves two phases: initial volumetric growth driven by nutrient accumulation and subsequent nuclear maturation. While melatonin (MLT) has been employed as a supplement to enhance the quality of fully grown oocytes during nuclear maturation phase, its impact on oocyte growth remains poorly studied. Here, we provide in vivo evidence demonstrating that follicle-stimulating hormone increases MLT content in ovary. Administration of MLT improves oocyte growth and quality in mice and goats by enhancing nutrient reserves and mitochondrial function. Conversely, MLT-deficient mice have smaller oocytes and dysfunctional mitochondria. Exploring the clinical implications of MLT in promoting oocyte growth, we observe that a brief 2-day MLT treatment enhances oocyte quality and reproductive performance in older mice. These findings highlight the role of MLT in regulating oocyte growth and provide a specific treatment window for optimizing oocyte quality and reproductive performance in female animals.
Assuntos
Cabras , Melatonina , Mitocôndrias , Oócitos , Animais , Melatonina/farmacologia , Melatonina/metabolismo , Oócitos/metabolismo , Oócitos/efeitos dos fármacos , Oócitos/crescimento & desenvolvimento , Camundongos , Feminino , Mitocôndrias/metabolismo , Mitocôndrias/efeitos dos fármacos , Oogênese/efeitos dos fármacos , Oogênese/fisiologia , Hormônio Foliculoestimulante/metabolismo , Nutrientes/metabolismo , Camundongos Endogâmicos C57BLRESUMO
Thyroid hormone regulates the rate of testis maturation in mammals. Manipulations of thyroid hormone levels in neonatal animals affect various aspects of testis biology. However, there have been no studies examining the effects of thyroid hormone on the rete testis (RT). Here, we used animal models of neonatal hyperthyroidism (injections of triiodothyronine, or T3) and hypothyroidism (goitrogen 6-propyl-2-thiouracil [PTU] treatment) and found that higher levels of thyroid hormone accelerate RT development, while lower levels of thyroid hormone delay it. T3 and PTU treatments influence RT size, proliferation of RT cells, and expression of DMRT1 and androgen receptor in the RT. T3 supplementation accelerates RT development in an organ testicular culture, which indicates the local action of thyroid hormone. Additionally, it was found that follicle-stimulating hormone could be involved in the regulation both of RT proliferation and RT size. The fact that RT cells in a cell culture do not respond to T3 suggests indirect action of thyroid hormone on the RT in vivo or the loss of the responsiveness to the hormone in vitro.
Assuntos
Animais Recém-Nascidos , Testículo , Hormônios Tireóideos , Tri-Iodotironina , Animais , Masculino , Camundongos , Testículo/efeitos dos fármacos , Testículo/metabolismo , Testículo/crescimento & desenvolvimento , Tri-Iodotironina/farmacologia , Hormônios Tireóideos/metabolismo , Hormônios Tireóideos/farmacologia , Propiltiouracila/farmacologia , Proliferação de Células/efeitos dos fármacos , Hipertireoidismo/induzido quimicamente , Hipertireoidismo/metabolismo , Hipotireoidismo/metabolismo , Hipotireoidismo/induzido quimicamente , Hormônio Foliculoestimulante/farmacologia , Receptores Androgênicos/metabolismoRESUMO
Herbal remedies are used for managing different ailments including male sexual abnormalities. Mucuna pruriens, Cinnamomum zeylanicum and Myristica fragrans, are some of the important herbs of these remedies for male sexual disorders. This study has been conducted to evaluate the effects of these drugs, individually and in combination on fertility parameters in mice. The study was carried out on male and female albino mice of BALB/c strain bearing weight of 20-25 g and age 12 to 13 weeks. Animals were divided into control and test batches (n=10). Drugs were given to the male mice test groups daily for 52 days by oral route and on 53rd day the fertility parameters were measured. Afterwards, histopathological analysis was also done. One-way analysis of variance (ANOVA) followed by post hoc was applied for statistical analysis. Important contrast was found in fertility parameters, including pregnancy outcome, serum testosterone, luteinizing hormone, follicle stimulating hormone and histological examination of tested batches as compared to control. The fertility enhancing effect of the drugs were found in the tested doses used in this study in male albino mice of BALB/c strain. However further preclinical and clinical studies are necessary to determine the safety of these drugs.
Assuntos
Cinnamomum zeylanicum , Fertilidade , Camundongos Endogâmicos BALB C , Mucuna , Myristica , Extratos Vegetais , Testosterona , Animais , Masculino , Myristica/química , Feminino , Fertilidade/efeitos dos fármacos , Cinnamomum zeylanicum/química , Extratos Vegetais/farmacologia , Camundongos , Mucuna/química , Testosterona/sangue , Gravidez , Hormônio Luteinizante/sangue , Hormônio Foliculoestimulante/sangue , Testículo/efeitos dos fármacos , Testículo/patologiaRESUMO
Rationale: Azoospermia is a significant reproductive challenge. Differentiating between non-obstructive azoospermia (NOA) and obstructive azoospermia (OA) is crucial as each type requires distinct management strategies. Testicular microcirculation plays a profound role in spermatogenic functions. However, current diagnostic methods are limited in their ability to effectively elucidate this crucial connection. Methods: We employed ultrasound localization microscopy (ULM) to visualize testicular microcirculation in NOA and OA patients and quantified the testicular hemodynamic parameters. Pearson correlation analysis was conducted to investigate the inner connection between parameters of testicular microcirculation and clinical spermatogenic functions. We conducted multiple logistic regression analysis to establish a new diagnostic model that integrates follicle-stimulating hormone (FSH) and mean vascular diameter to distinguish NOA from OA. Results: Our findings demonstrated significant differences in vascular parameters between NOA and OA, with NOA characterized by lower mean vascular diameter (p < 0.001), vessel density (p < 0.001), and fractal number (p < 0.001). Testicular volume showed a moderate positive correlation with mean vascular diameter (r = 0.419, p < 0.01) and vessel density (r = 0.415, p < 0.01); Mean vascular diameter exhibited negative correlations with both FSH (r = -0.214, p < 0.05) and age (r = -0.240, p < 0.05); FSH (r = -0.202, p < 0.05) and luteinizing hormone (LH) (r = -0.235, p < 0.05) were negatively correlated with mean blood flow velocity. The diagnostic model demonstrated an area under the curve (AUC) of 0.968. We also reported a method to map the vascular pressure distribution derived from the blood flow velocity generated by ULM. Conclusions: ULM provides a non-invasive and detailed assessment of testicular microvascular dynamics. The ULM-derived vascular parameters are able to connect testicular microcirculation to spermatogenic functions. The combination of FSH and mean vascular diameter enhances diagnostic precision and holds potential for distinguishing NOA from OA.
Assuntos
Azoospermia , Hormônio Foliculoestimulante , Microcirculação , Espermatogênese , Testículo , Masculino , Humanos , Testículo/irrigação sanguínea , Testículo/diagnóstico por imagem , Azoospermia/diagnóstico por imagem , Azoospermia/fisiopatologia , Adulto , Hormônio Foliculoestimulante/sangue , Ultrassonografia/métodos , Pessoa de Meia-Idade , Microscopia/métodosRESUMO
OBJECTIVE: Aim: To establish the peculiarities of the hormonal background in women with abnormal uterine bleeding and extragenital disorders. PATIENTS AND METHODS: Materials and Methods: The study involved examination of 100 women of reproductive age with concomitant ED and AUB (MG). CG included 50 healthy women. MG women were additionally divided into subgroups depending on the detected pathological changes in the uterine cavity. When examining the hormonal status, concentrations of FSH, LH, estradiol, progesterone, and leptin in BS were determined. Additionally, the level of 25-hydroxyvitamin D ((25-OH) D) was determined. RESULTS: Results: The decrease in FSH level in subgroups of GP, PSL, EH, EHL was 1.8-2.4 times (KWT, p<0.01). LH in BS of MG patients was statistically lower than that of CG patients (MWT, p=0.0083). The lowest level of LH was registered in patients with EHL, which was 2 times lower than this indicator in CG. A statistically significant increase in the level of estradiol was registered in 73% of MG patients (MWT, p=0.044). The lowest level of progesterone was registered in patients with EHL - 8.40, which is 4.7 times lower than in CG (MWT, p=0.0021). A statistically significant increase in the level of leptin in BS was observed in MG patients (KWT, p=0.0021). The highest level of leptin was found in women with AFP, 2.3 times higher than CG indicators. A statistically significant correlation between the level of leptin and BMI (r=0.86, p=0.011) and a statistically significant (p=0.023) correlation between the level of leptin and estradiol in BS of patients of the examined groups (r=0.42) were revealed. In 87% of MG women, vitamin D deficiency was observed in BS (KWT, p=0.03). A statistically significant (p=0.01) negative correlation between the level of estradiol and vitamin D in the BS of female patients was revealed (r=-0.61, p=0.01). CONCLUSION: Conclusions: Women of reproductive age with AUB and ED were found to have disorders in the hypothalamic-pituitary-ovarian system. Most patients are characterized by an elevated level of leptin, the concentration of which is closely correlated with BMI, and an elevated level of estradiol is correlated with the level of vitamin D.
Assuntos
Estradiol , Hormônio Foliculoestimulante , Leptina , Hormônio Luteinizante , Progesterona , Hemorragia Uterina , Humanos , Feminino , Adulto , Estradiol/sangue , Progesterona/sangue , Hormônio Luteinizante/sangue , Leptina/sangue , Hormônio Foliculoestimulante/sangue , Hemorragia Uterina/sangue , Vitamina D/sangue , Vitamina D/análogos & derivados , Adulto Jovem , Pessoa de Meia-IdadeRESUMO
Objective: To exlplore the association between the baseline luteinizing hormone/follicle stimulating hormone (LH/FSH) ratio of polycystic ovary syndrome (PCOS) and in vitro fertilisation-embryo transfer outcomes. Methods: This was a retrospective cohort study. A total of 2 868 PCOS patients were enrolled, all of the participants were patients in The First Affiliated Hospital of Anhui Medical University Hospital from October 2015 to October 2021. Propensity score matching (1â¶2.5) was conducted to regulate the non-random allocation of patients. Data were extracted from the hospital's medical records. Patients with baseline LH/FSH ratio>2 were deemed as study group, patients with baseline LH/FSH ratio≤2 were deemed as control group. Single factor analysis was applied to compare the differences of pregnancy outcomes between two groups. Results: After propensity score matching (1â¶2.5), there were no statistically significant differences in baseline data between the two groups (all P>0.05), indicating that the data were comparable. In the study group, the total dose of gonadotropin (Gn) and duration of Gn were lower than those of the control group (t=4.989, P<0.001; t=3.267, P=0.001), the rate of in vitro maturation was higher than that of the control group (χ2=4.938, P=0.026), the number of retrieved oocytes and cleavage were higher than those of the control group (t=-2.305, P=0.021; t=-2.816, P=0.005), but there were no differences in the number and rate of high-quality embryos between the two groups (t=-1.636, P=0.102; t=-0.123, P=0.902). The incidence of moderate to severe ovarian hyperstimulation syndrome in the study group was significantly higher than that in the control group (χ2=17.277, P<0.001). Regardless of fresh embryo transfer or frozen-thawed embryo transfer cycles, the incidences of gestational diabetes mellitus in the study group were higher than those in the control group (χ2=9.174, P=0.002; χ2=4.204, P=0.040) of singleton pregnancy. In the fresh embryo transfer cycle, the clinical pregnancy rate [30.30% (20/66) vs 47.75% (53/111)] and delivery rate [30.30% (20/66) vs 46.85% (52/111)] in the study group were lower than those in the control group (χ2=5.198, P=0.023; χ2=4.695, P=0.030). In the frozen-thawed embryo transfer cycle, the delivery rate in the study group was higer than that in the control group [59.41% (423/712) vs 55.04% (1 053/1 913); χ2=7.526, P=0.023]. The clinical pregnancy rate and delivery rate of fresh embryo transfer cycle in the study group were significantly lower than those of frozen-thawed embryo transfer cycle (χ2=21.308, P<0.001; χ2=20.871, P<0.001), but there were no significant differences in the control group (all P>0.05). Conclusions: PCOS patients with a higher basal LH/FSH ratio are more likely to develop moderate to severe ovarian hyperstimulation syndrome after controlled ovarian stimulation and have a higher incidence of gestational diabetes mellitus. Better pregnancy outcome could be obtained by frozen-thawed embryo transfer.
Assuntos
Transferência Embrionária , Fertilização in vitro , Síndrome do Ovário Policístico , Taxa de Gravidez , Adulto , Feminino , Humanos , Gravidez , Transferência Embrionária/métodos , Fertilização in vitro/métodos , Hormônio Foliculoestimulante/sangue , Infertilidade Feminina/terapia , Infertilidade Feminina/etiologia , Hormônio Luteinizante/sangue , Síndrome de Hiperestimulação Ovariana/etiologia , Síndrome de Hiperestimulação Ovariana/epidemiologia , Indução da Ovulação/métodos , Síndrome do Ovário Policístico/terapia , Resultado da Gravidez , Pontuação de Propensão , Estudos Retrospectivos , Resultado do TratamentoRESUMO
The possible vulnerability of the male reproductive system to environmental pollutants such as air pollution necessitates a thorough investigation of the underlying mechanisms involved in the dysregulation of male reproductive function. The present study was designed to investigate the influence of the filtered fraction of diesel exhaust (predominantly comprising gases) on male reproductive function in Wistar rat model. Adult male rats were randomly assigned into three groups (n=8/group): Control (unexposed) group (CG-A), the Clean air group in WBE chamber (CAG-A), and Filtered diesel exhaust group in WBE chamber (FDG-A). The exposure protocol for CAG-A and FDG-A was 6â¯h/day x 5d/week x 6 weeks,evaluation of sperm parameters, testicular histopathology, quantification of hormones (testosterone, LH, FSH, 17ß-Estradiol, and prolactin), and GST levels were performed. Results showed that WBE to FDE leads to a significant decline in sperm concentration (p=0.008, CG-A vs FDG-A; p=0.014, CAG-A vs FDG-A), motility (p=0.008, CG-A vs FDG-A; p=0.029, CAG-A vs FDG-A), serum testosterone (p=0.024, CG-A vs FDG-A; p=0.007, CAG-A vs FDG-A), testicular testosterone (p=0.008, CG-A vs FDG-A; p=0.028, CAG-A vs FDG-A), 17ß-Estradiol (p=0.007, CG-A vs FDG-A), and GST levels (p=0.0002, CG-A vs FDG-A; p=0.0019, CAG-A vs FDG-A). These findings demonstrate the disruption of testosterone-estradiol balance in the intratesticular milieu without significant alterations in other principal pituitary hormones in adult rats exposed to FDE. The predominant presence of gaseous components in FDE can cause testicular damage due to oxidative imbalance. This underscores the causality of FDE exposure and impaired male reproductive outcomes.
Assuntos
Poluentes Atmosféricos , Glutationa Transferase , Ratos Wistar , Espermatozoides , Testículo , Emissões de Veículos , Animais , Masculino , Emissões de Veículos/toxicidade , Testículo/efeitos dos fármacos , Testículo/patologia , Testículo/metabolismo , Glutationa Transferase/metabolismo , Espermatozoides/efeitos dos fármacos , Poluentes Atmosféricos/toxicidade , Motilidade dos Espermatozoides/efeitos dos fármacos , Testosterona/sangue , Contagem de Espermatozoides , Estradiol/sangue , Ratos , Hormônio Foliculoestimulante/sangue , Hormônio Luteinizante/sangueRESUMO
In brief: FSH leads to glutamine dependence, which is required for mTORC1 activation and in consequence Sertoli cell proliferation. Abstract: The spermatogenic capacity of adult individuals depends on, among other factors, the number of Sertoli cells (SCs) that result from the proliferative waves during development. FSH upregulates SC proliferation at least partly, through the activation of the PI3K/Akt/mTORC1 pathway, among other mechanisms. It is widely known that mTORC1 is a sensor of amino acids. Among amino acids, glutamine acquires relevance since it might contribute to cell cycle progression through the modulation of mTORC1 activity. It has not been studied yet whether glutamine intervenes in FSH-mediated regulation of SC proliferation and cell cycle progression, or if FSH has any effect on glutamine metabolism. Eight-day-old rat SCs were incubated in culture media without glutamine or with glutamine in the absence or presence of a glutamine transporter inhibitor or a glutaminase activity inhibitor under basal conditions or stimulated with FSH. The results obtained show that FSH does not promote SC proliferation and mTORC1 activation in the absence of glutamine. Also, FSH modulates glutamine metabolism increasing glutaminase isoform 2 and reducing glutamine synthetaseexpression. FSH did not promote SC proliferation and mTORC1 activation when glutaminase activity was inhibited. The results suggest that glutamine or its metabolites might cooperate with FSH in the upregulation of SC proliferation through mTORC1. In addition, as FSH modulates glutamine metabolism through the induction of glutaminase isoform 2, the hormonal control of glutamine metabolism might be part of the intricate signaling network triggered by FSH, which is crucial to establish the population of mature SCs that supports the reproductive function.