Gestational trophoblastic neoplasia coexisting with cervical carcinoma: A case report / Philippine Journal of Obstetrics and Gynecology

@#Gestational trophoblastic neoplasia (GTN) with a concurrent cervical malignancy is very rare, making the case both a diagnostic dilemma and a therapeutic challenge. Currently, there has only been one reported case worldwide. We present a case of GTN Stage I:11 with non‑keratinizing squamous cell carcinoma of the cervix Stage II‑B. Initial treatment, in the form of chemotherapy, was directed toward the GTN, as this appeared to be the more aggressive disease. Surgery was not feasible during diagnosis due to the cervical carcinoma. However, the GTN proved resistant to chemotherapy due to the increasing beta human chorionic gonadotropin titers. An attempt to decrease the size of the cervix for surgery to be possible through chemoradiation was instituted, but due to complications and tumor progression to the lungs, she succumbed to the malignancy.

Case report -Cesarean scar ectopic pregnancy

Cesarean scar ectopic pregnancy is one of the rarest of all ectopic pregnancy increase in number of cesarean section leads to increase in number of cesarean scar ectopic pregnancy. Early diagnosis and prompt management help in reducing mortality and morbidity occuring due to scar ectopic pregnancy. We are reporting a rare case of cesarean scar ectopic pregnancy G5P3L3D1 with period of gestation 7 weeks 3 days with previous all 4 deliveries by cesarean section. Cesarean scar ectopic pregnancy are life threatening as they pose a great risk of maternal hemorrhage as the patient vital are the stable patient managed medically with injection Methotrexate

Effect of eCG on the follicular dynamics and vascularization of crossbred cows with different circulating progesterone concentrations during synchronization of ovulation in an FTAI protocol / Efeito do eCG na dinâmica e na vascularização folicular de vacas mestiças com diferentes concentrações circulantes de progesterona durante a sincronização de ovulação em um protocolo IATF

This study aimed to evaluate the effect of treatment with equine chorionic gonadotrophin (eCG) on the follicular dynamics and function of crossbred cows with different circulating progesterone (P4) concentrations during synchronization of ovulation in a fixed-time artificial insemination (FTAI) protocol. To this end, 30 crossbred cows were submitted to a pre-synchronization protocol to ensure that all of them presented corpus luteum (CL) at the beginning of the protocol, and were evaluated by transrectal ultrasonography (TRUS) to verify the presence of CL. After that, the animals underwent an ovulation synchronization protocol and evaluation of follicular dynamics and vascularization by B-mode and power-Doppler ultrasound (US). High plasma P4 concentrations at the time of ovulation synchronization negatively influenced follicle diameter on day 10 (D10), preovulatory follicle diameter, and preovulatory follicle wall vascularization area (p<0.05). Cows with high P4 concentration at the time of ovulation synchronization that were treated with eCG showed follicle diameter on D10 and preovulatory follicle diameter and wall vascularization area (p>0.05) similar to those of animals with low P4 concentration at the time of ovulation synchronization. Therefore, high P4 concentrations at the time of ovulation synchronization negatively influence follicular diameter and vascularization, and eCG can be used as a strategy to favor better follicular and luteal response in crossbred cows with high P4 concentrations submitted to an FTAI protocol.(AU)

Objetivou-se neste estudo avaliar o efeito do tratamento com gonadotrofina coriônica equina (eCG) sobre a dinâmica e função folicular em fêmeas mestiças com diferentes concentrações circulantes de P4 durante a sincronização da ovulação em um protocolo de IATF. Para tanto, foram utilizadas 30 fêmeas mestiças e submetidas a um protocolo de pré-sincronização para garantir que todos os animais apresentassem corpo lúteo (CL) no início do protocolo, sendo avaliadas por ultrassonografia (US) transretal para a verificação da presença ou não de CL. Em seguida foram submetidas a um protocolo de sincronização da ovulação e avaliação da dinâmica e vascularização folicular por ultrassonografia (US) em modo B e Doppler colorido. Altas concentrações de P4 no momento da sincronização da ovulação impactaram negativamente no diâmetro do folículo no D10, o diâmetro do folículo pré-ovulatório e na área de vascularização da parede do folículo pré-ovulatório (P<0,05). As vacas com alta concentração de P4 no momento da sincronização da ovulação e que foram tratadas com eCG apresentaram diâmetro do folículo no D10 e no diâmetro e a área de vascularização da parede do folículo pré-ovulatório (P>0,05), semelhantes às vacas que com baixa concentração de P4 no momento da sincronização da ovulação. Conclui-se que elevadas concentrações de P4 no momento da sincronização da ovulação impactam negativamente no diâmetro e vascularização folicular e que o eCG pode ser utilizado como uma estratégia para favorecer uma melhor resposta folicular e luteal em fêmeas mestiças com altas concentrações de P4 submetidas a um protocolo de IATF.(AU)

Quality control of human chorionic gonadotrophin subunit dissociation / 药学学报

Human chorionic gonadotrophin (hCG), a glycohormone widely used in treatment of infertility, is a heterodimer composed of an alpha-and a beta-subunit. The heterodimer could be dissociated during production and storage with an impact on its bioactivity. A CE-SDS method for quantitative analysis of hCG subunit dissociation was established in this study by optimization of a variety of method conditions including sample preparation buffer compositions, incubation temperature, separation voltage, and capillary temperature. This method was validated for good sensitivity, linearity, precision, and accuracy for both α-and β-subunit. CE-SDS also showed much better precision and accuracy than SDS-PAGE. The method was successfully used in both recombinant hCG (r-hCG) produced by cell culture and hCG (u-hCG) derived from urine. The CE-SDS method was used in the study of hCG development and stability. Therefore, it is an useful tool for the quality control of hCG.

ICSI cycle oocytes maturation ratio and different dosage of gonadotropin choices affecting embryo quality and clinical outcome / 实用医学杂志

Objective To explore ICSI treatment process in the different proportion of oocytes maturation and dosage of gonadotropin affecting embryo quality and clinical outcome. Methods From Jan. to Dec. 2015,we retrospectively analyzed the patients from the center line of ICSI cycle ,divided them into three groups according to the maturity of oocytes. The 3 groups were due to maturity rate of oocytes in 50% in group A(n = 19),50% 0.05). Group A had the best egg rate,high quality embryo rate,clinical pregnancy rate than the other two groups (P < 0.05). In pregnancy and non-pregnancy groups ,the dosage of gonadotropin in the non-pregnancy group was obviously higher than that in the pregnancy group in oocyte maturation in the same proportion interval(P<0.05). Conclusion In ICSI treatment process,the high dose of gonadotropin and rising rates of oocytes maturation are not conducive to the development potential of the egg and clinical outcome,so the dose of gonadotropin and oocyte maturation ratio should be controlled in a certain range to collect and protect the best dominant egg which matches to the state of the patient.

Association between adverse obstetric outcomes and abnormal maternal serum markers in the second trimester screening / 上海交通大学学报（医学版）

Objective · To evaluate the association between the abnormal maternal serum markers of alpha fetoprotein (AFP), human chorionic gonadotrophin (hCG) and unconjugated estriol (uE3) in the second trimester screening and the adverse obstetric outcomes other than trisomy 21 (T21),trisomy 18 (T18) and open neural tube defects (ONTD), and to provide local data for supporting evidence based clinical managements. Methods · A retrospective cohort study was performed in the women who received second trimester maternal serum screening in the International Peace Maternal and Child Health Hospital between 2012 and 2014, with naturally conceived singleton pregnancies. Obstetric outcomes were followed up by searching electronic medical records within the hospital. Abnormal level of marker was defined as a MOM value ≥ 99th (P99) or ≤ 1st percentile (P1) of the overall screened population. Incidence of an adverse obstetric outcome was compared between the groups with abnormal markers and the control with all markers in normal. Results · ① A total of 25616 pregnancies were included in this study, in which 4526 were identified as having various adverse obstetric outcomes. Among them 4143 pregnancies were with isolated and 383 pregnancies were with co-occurring two or more adverse outcomes. ② When compared to pregnancies with normal levels of all three serum markers, pregnancies with decreased AFP or decreased hCG did not show associations with any adverse obstetric outcomes. However, pregnancies with increased AFP, increased hCG or decreased uE3 were at increased risk for a variety of abnormal pregnancy outcome. In 18 pregnancies with an outcome of fetal chromosomal abnormalities other than T21 and T18, 9 presented with either increased AFP, increased hCG or decreased uE3, with relative risk ratios of 13.33、35.00 and 59.00, respectively. ③ The performance of those markers tended to be improved in a subset of adverse obstetric outcomes, including low birth weight

Pituitary suppression before frozen embryo transfer is beneficial for patients suffering from idiopathic repeated implantation failure / 华中科技大学学报（医学）（英德文版）

Long-term gonadotropin-releasing hormone agonist (GnRHa) administration before in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) in infertile women with endometriosis or adenomyosis significantly enhanced the chances of pregnancy in both fresh and frozen embryo transfer cycles. We hypothesized that long-term GnRHa treatment might also be beneficial for the idiopathic repeated implantation failure (RIF) patients. In the 21 patients receiving GnRHa and hormone replacement therapy (G-HRT) protocols for frozen embryo transfer, their data were compared with those of the 56 of frozen/fresh cycles they had previously undergone (previous protocols). Comparison showed that the finial results were significantly better with G-HRT protocols than with their previous protocols, with pregnancy rate, clinical pregnancy rate, implantation rate and on-going pregnancy rate being 70%, 60%, 40% and 38% respectively with G-HRT protocols, against 17%, 11%, 6.3% and 5% with previous protocols. The results showed that hormonally controlled endometrial preparation with prior GnRHa suppression could be used for patients who had experienced repeated failures of IVF treatment despite having morphologically optimal embryos, and the treatment may help increase the receptivity of the endometrium in these patients.

Secondary male hypogonadism induced by sellar space-occupying lesion: Clinical analysis of 22 cases / 中华男科学杂志

<p><b>Objective</b>To analyze the clinical characteristics of secondary male hypogonadism induced by sellar space-occupying lesion, explore its pathogenesis, and improve its diagnosis and treatment.</p><p><b>METHODS</b>We retrospectively analyzed the clinical data about 22 cases of secondary male hypogonadism induced by sellar space-occupying lesion, reviewed related literature, and investigated the clinical manifestation, etiological factors, and treatment methods of the disease. Hypogonadism developed in 10 of the patients before surgery and radiotherapy (group A) and in the other 12 after it (group B). The patients received endocrine therapy with Andriol (n=7) or hCG (n=15).</p><p><b>RESULTS</b>The average diameter of the sellar space-occupying lesions was significantly longer in group A than in B (［2.35±0.71］ vs ［1.83±0.36］ cm, P<0.05) and the incidence rate of prolactinomas was markedly higher in the former than in the latter group (60% vs 0, P<0.01). The levels of lutein hormone (LH), follicle stimulating hormone (FSH) and testosterone (T) were remarkably decreased in group B after surgery and radiotherapy (P<0.01). Compared with the parameters obtained before endocrine therapy, all the patients showed significant increases after intervention with Andriol or hCG in the T level (［0.78±0.40］ vs ［2.71±0.70］ ng/ml with Andriol; ［0.93±0.44］ vs ［3.07±0.67］ ng/ml with hCG) and IIEF-5 score (5.00±2.61 vs 14.50±3.62 with Andriol; 5.36±1.82 vs 15.07±3.27 with hCG) (all P<0.01). The testis volume increased and pubic hair began to grow in those with hypoevolutism. The patients treated with hCG showed a significantly increased testis volume (P<0.01) and sperm was detected in 7 of them, whose baseline testis volume was markedly larger than those that failed to produce sperm (［11.5±2.3］ vs ［7.5±2.3］ ml, P<0.01). Those treated with Andriol exhibited no significant difference in the testis volume before and after intervention and produced no sperm, either.</p><p><b>CONCLUSIONS</b>Hypothyroidism might be attributed to surgery- or radiotherapy-induced damage to the pituitary tissue, space-occupying effect of sellar lesion, and hyperprolactinemia. Both Andriol and hCG can improve the T level and erectile function, but the former does not help spermatogenesis.</p>

Cerebral Venous Sinus Thrombosis Developed during Infertility Treatment in a Male Patient

No abstract available.

The effect of aromatase inhibitor letrozole incorporated in gonadotrophin-releasing hormone antagonist multiple dose protocol in poor responders undergoing in vitro fertilization

OBJECTIVE: To evaluate whether letrozole incorporated in a gonadotrophin-releasing hormone (GnRH) antagonist multiple dose protocol (MDP) improved controlled ovarian stimulation (COS) and in vitro fertilization (IVF) results in poor responders who underwent IVF treatment. METHODS: In this retrospective cohort study, a total of 103 consecutive IVF cycles that were performed during either the letrozole/GnRH antagonist MDP cycles (letrozole group, n=46) or the standard GnRH antagonist MDP cycles (control group, n=57) were included in 103 poor responders. COS results and IVF outcomes were compared between the two groups. RESULTS: Total dose and days of recombinant human follicle stimulating hormone (rhFSH) administered were significantly fewer in the letrozole group than in the control group. Duration of GnRH antagonist administered was also shorter in the letrozole group. The number of oocytes retrieved was significantly higher in the letrozole group. However, clinical pregnancy rate per cycle initiated, clinical pregnancy rate per embryo transfer, embryo implantation rate and miscarriage rate were similar in the two groups. CONCLUSION: The letrozole incorporated in GnRH antagonist MDP may be more effective because it results comparable pregnancy outcomes with shorter duration and smaller dose of rhFSH, when compared with the standard GnRH antagonist MDP.

Induction of ovulation in quarter horse mares through the use of deslorelin acetate and human chorionic gonadotrophin (hCG)

The aim this study was to compare two protocols of induction for ovulation by desloreline acetate and hCG in Quarter Horse mares. The choice of the animals was based on the observations by the estrus, by rectal palpation of the ovaries and by ultrassonography of the follicular dynamics. After estrus detection and follicle control, the measurement of the follicles and the classification of uterus were carried out. The animals that had dominant follicle (diameter more than 35 mm) and swollen uterus were used. In these conditions, the mares received hCG or desloreline acetate. Once ovulation occurred, the artificial insemination was carried. Two groups were performed: G1 (20 animals) received 1.5 mg desloreline acetate and G2 (20 animals) received 1700 IU of hCG. Following 6h intervals, the control follicular was performed by ultrasonography. The follicular average diameter was 42.6 cm for the groups and set up a score of 0 to 3 of uterine edema displayed by the device as well as the time of ovulation. In conclusion, the desloreline acetate showed better performance than hCG, because the ovulation was induced in less time (nine hours than hCG) (p<0.05).The pregnancy rate was 80 and 75 percent, respectively in G1 and G2.

A Case of Trophoblastic Tumor Associated with Papillary Thyroid Cancer / 대한내과학회지

Thyroid cancer is one of the most common endocrine malignancies. It is known that thyroid cancer can develop during reproductive periods, possibly due to the effects of sex hormones and growth factors such human chorionic gonadotrophin (HCG). Some data suggest that elevated HCG levels during pregnancy or gestational trophoblastic disease can stimulate thyroid cellular proliferation and promote cancer formation; however, a case of papillary thyroid cancer accompanied by a gestational trophoblastic tumor has not been reported. Here, we report the case of a 44-year-old woman with papillary thyroid cancer during treatment for a gestational trophoblastic tumor.

Analysis of prophylactic chemotherapy outcome and clinical characteristics in patients of high-risk hydatidiform mole / 中华妇产科杂志

Objective To analyze prophylactic chemotherapy outcome and clinical characteristics in patients of high-risk hydatidiform mole. Methods Twenty-three patients who were diagnosed as high-risk hydatidiform mole and undergone prophylactic chemotherapy in our hospital were retrospectively analyzed.After prophylactic chemotherapy, 11 patients didn't develop to gestational trophoblastic neoplasia (GTN),while the other 12 patients developed to GTN and needed a regimen change to combination chemotherapy.The clinical characteristics of these patients and outcome of prophylactic chemotherapy were compared between two groups. Results There was no significant difference between the two groups on patients' age,weeks of delayed menses, enlarged uterine size excessive for gestational age, and incidence of theca-lutein cysts of ovaries. However,the median levels of pre-evacuation serum β-hCG in two groups were 469 144 U/L and 768 044 U/L respectively, and median days needed for β-hCG declining to normal(≤2U/L) at the first time were 71 and 120 days respectively, which were both significantly different between two groups.Analyzed with receiver operating charactristic(ROC), the level of serum β-hCG could be a predictor for prognosis. Choosing 750 000 U/L as the cut-off value, we could expect the serum β-hCG to have a specificity of 91% and a sensitivity of 58% to predict whether prophylactic chemotherapy will be successful.Conclusions For those patients who have to receive prophylactic chemotherapy because of risk factors and unavailable hCG assessments for follow-up, it's better to use double-agent or combination chemotherapy if the level of serum β-hCG reached 750 000 U/L so as to reduce therapy duration and prevent relevant chemoresistance.

Preparation and purification of monoclonal antibodies against human chorionic gonadotrophin / 中国生化药物杂志

Purpose To prepare monoclonal antibody against hCG. Methods Balb/c mice were immunized with hCG, and spleen cells from the mice were fused with myeloma cells SP2/0 at ratio of 5:1. Positive clones were screened by indirect enzyme-linked-immunoadsorbent assay (ELISA) ,then the clones were subcloned by limiting dilution and amplified further. After intraperitoneal injection of hybridoma cells, mouse ascites antibody was prepared. Titres and specificity of the ascites antibody were identified and determined by indirect ELISA. The ascites were purified by protein A affinity chromatography. Results Two strains of hybridoma cell lines obtained could secrete MAb stably. The titre of MAb of cell culture supernate is more than 10~(-3), and the titre of prepared ascites MAb is more than 10~(-7).The purity of the obtained monoclonal antibody was more than 98% and recovery reached 75 % after purification. Conclusion The obtained two strains of hybridoma cell lines can secrete MAb stably. The monoclonal antibodies can be used in the research of early pregnancy and tumor diagnosis .

Association of GnRH1 Polymorphisms with Rheumatoid Arthritis in a Korean Female / 대한정형외과학회잡지

PURPOSE: Rheumatoid arthritis (RA) is a common, chronic inflammatory arthritis that develops most often in women. Gonadal hormones may account for the sexual dimorphism in the immune response and for the greater incidence of autoimmune disease in females. Gonadotrophin-releasing hormone (GnRH), one of the gonadal hormones, plays an important role in immune system modulation. This study examined the effects of single nucleotide polymorphisms (SNP) in GnRH on gender differences in the pathophysiology of RA. MATERIALS AND METHODS: The presence of SNPs rs2659590, rs2321248, rs6186, rs6185, and rs2321049 in the human GnRH1 gene was confirmed in Korean RA patients by Taqman(R) SNP genotyping assays. A total of 153 unrelated female, Korean RA patients and 96 female Korean controls participated. RESULTS: There were no significant associations between GnRH1 polymorphisms and RA. However, we found that the rs2659590, rs6185 and rs2321248 polymorphism might be associated with a susceptibility to aberrantly high erythrocyte sedimentation rates in female RA patients. CONCLUSION: Additional studies, with a larger number of patients and in different populations will be required to assess whether GnRH1 polymorphisms and these haplotypes could be used as susceptibility or resistance markers in RA. To our knowledge, this study is the first to analyze associations between SNPs of GnRH1 and RA.

Expression of kisspeptin in hypothalamus and the relationship between kisspeptin and puberty / 国际儿科学杂志

The priming of puberty is date from the increase of the secretion of hypothalamic gonadotropin-releasing hormone (GnRH). Recently,Kisspeptins/ GPR54 signaling were found critical to promote the secretion of GnRH and the onset of puberty. KISSI expresses in special area of hypothalamus and is regulated by sex steroids in the estrous cycle.Kisspeptins transitive steroid feedback signals to GnRH cells, especially the positive feedback signal which causes preovulatory GnRH / LH secretion. Kisspeptins bind KISS1R in the hypothalamic GnRH neurons and evoke the release of GnRH and the onset of puberty.

Adjusting effect of human chorionic gonadotrophin in the vascular endothelial growth factor in rabbit phallus with hypospadias / 中华泌尿外科杂志

Objective To study the function of human chorionie gonadotrophin(HCG) in adjus-ting the vascular endothelial growth factor(VEGF) in rabbit phallus with hypospadias. Methods Rabbit hypospadias mode was made by Finasteride. After the spontaneous delivery, 35 rabbits were divided into 5 groups with 7 in each group. Four groups accepted HCG intramuscular injection for 7 consecutive days with dosages of 100,200,400 and 600 U, respectively. The control group accepted the same dosage of saline injection. Another 7 normal rabbits were used as normal controls without in-tervention. After 3 weeks, the rabbit phallus tissue was collected and the VEGF levels were detected by ELISA. Results Rabbits with hypospadias accepted HCG 100, 200, 400, 600 U injection had the phallus tissue VEGF level of 5.00±2.37,5.63±1.73, 10.35±2.34 and 16.91±2.34 pg/ml, respectively. While the rabbits accepted saline injection had VEGF levels of 3.99±1.19 pg/ml. The normal rabbit phallus tissue contained VEGF level of 14.82±3.32 pg/ml. There were significant differences between normal group and the rabbits accepted HCG 100, 200, 400 U injection (P＜ 0.05), but there was no difference with the rabbits accepted HCG 600 U injection (P＞0.05). The VEGF level in rabbits accepted 400 U HCG injection had significant difference with rabbits accepted 100, 200, 600 U HCG (P＜0.05). The VEGF levels in rabbits accepted 100, 200 U HCG injection had no difference with rabbits accepted saline injection(P＞0.05). Conclusions The VEGF in rabbit phallus with hypospadias is decreased. HCG of certain dosage could increase VEGF level in rabbit phallus with hypospadias.

Second trimester maternal serum screening for Down's syndrome in mainland China :a multi-center prospective study / 中华妇产科杂志

Objective To evaluate the performance characteristics of the second trimester double-marker test for the detection of fetal Down's syndrome in mainland China. Methods This prospective national multi-centered study used alpha-fetoprotein (AFP) and free β-subunit of human chorionic gonadotrophin( free β-hCG)as the serum markers. From May 2004 to September 2006, 11 centers participated in the collection and analysis of maternal serum AFP and free β-hCG between 14 and 20+6 weeks of pregnancy. The screening results were calculated using the standard algorithm based on the standard database provided with the analytic software. Patients with an increased risk of Down's syndrome pregnancy (≥1/270) were offered genetic anmiocentesis. Outcomes of all pregnancies were obtained.Results A total of 66 132 singleton pregnancies were included in the study. The median maternal age was 27 years. At a cut-eft of 1 in 270, the detection rate (DR) based on a Caucasian database was 72% corresponding to a false positive rate (FPR) of 5%, and the DR based on the Chinese database was raised to 76% corresponding to an FPR of 5%. Conclusion The double-marker test using AFP and free β-hCG is an effective screen strategy for second-trimester detection of fetal Down's syndrome in mainland China. Ethnic variance exists between the Caucasian and Chinese populations. The accuracy of screening is increased by the use of race-specific medians.

Efeitos da pioglitazona em mulheres com obesidade e síndrome dos ovários policísticos / Pioglitazone effects in women with obesity and polycystic ovary syndrome

Introdução. A resistência à insulina é considerada a principal causa da síndrome dos ovários policísticos. A pioglitazona, droga sensibilizadora da insulina, da família das tiazolidinedionas, pode ser boa opção na abordagem medicamentosa da resistência à insulina em pacientes com a síndrome. Objetivo. Avaliar o efeito da pioglitazona em mulheres portadoras da doença sobre parâmetros clínicos e laboratoriais e a resistência à insulina. Métodos. Foram avaliadas nove mulheres com sobrepeso ou obesas, com a síndrome e resistência à insulina (HOMA-IR > 2,7), tratadas com 30 mg/dia de pioglitazona, durante três meses, em relação a critérios clínicos (freqüência dos ciclos menstruais, hiperandrogenismo, acantosis nigricans, relação cintura-quadris e índice de massa corporal) e laboratoriais (glicemia e insulina de jejum, teste de tolerância à glicose oral (TTGO) com dosagem de insulina, FSH, LH, estradiol, TSH, prolactina, TGO, TGP, gama-GT, fosfatase alcalina, uréia, creatinina e testosterona total. Resultados. As pacientes tratadas apresentaram regularização dos ciclos menstruais, melhoraram da acantosis nigricans e aumento não significativo do peso corporal, índice de massa corporal, circunferência do abdome e dos quadris e relação cintura-quadris. Os níveis séricos de glicose e insulina diminuíram significativamente em todos os tempos do teste de tolerância, bem como o HOMA-IR (p < 0,05), mas não o HOMA-b. As gonadotrofinas, os esteróides sexuais e a prolactina não tiveram modificações significativas, mas o TSH teve elevação significativa. TGO, TGP, γ-GT e fosfatase alcalina tiveram teor significativamente diminuído, mas a uréia ficou elevada sem alterar os níveis de creatinina. Conclusão. A pioglitazona tem efeitos favoráveis em parâmetros clínicos e laboratoriais relacionados à resistência à insulina em pacientes com a doença, e é boa alternativa no tratamento dessas pacientes.

Introduction. Insulin resistance is considered the main cause in the pathogenesis of the polycystic ovary syndrome. Pioglitazone, an insulin sensitizer drug of the thiazolidinediones family, may be a good alternative in the medical approach of these patients. Objective. To evaluate the pioglitazone’s effects in women with the syndrome on clinical and laboratorial parameters and insulin resistance. Methods. We evaluate nine obese or overweight women with this ovary disorder, with insulin resistance (HOMAIR > 2.7), treated with 30 mg/day of pioglitazone in relation clinical parameters (menstrual cycles frequency, hyperandrogenism, acantosis nigricans, waist-hip ratio and body mass index) and fast glucose, fast insulin, oral glucose tolerance test with insulin dosages, FSH, LH, estradiol, TSH, prolactin, OGT, PGT, γ-GT, alkaline phosphatase, urea, creatinine, total testosterone. Results. The patients had menstrual cycles regularization, acantosis nigricans improvement, and a no significant increase in weight, body mass index, waist and hip circumference and waist-hip ratio. Serum insulin and glucose levels significantly decreased in all times of the glucose tolerance test, as well as HOMA-IR (p < 0,05), but not HOMA-b. Gonadotropins, sexual steroids and prolactin did not have significant modifications, but TSH significantly increased. OGT, PGT, γ-GT and alkaline phosphatase levels decreased significantly, but urea increase without change creatinine level. Emotional memory modulation. Conclusion. Pioglitazone has favorable effects on clinical parameters and insulin resistance in patients with polycystic ovary syndrome, and it is a good alternative to treatment of these patients.