Analysis of relative factors affecting the pregnancy outcome of frozen-thawed embryo transfer in patients with endometriosis / 上海交通大学学报（医学版）

Objective:To explore the factors affecting the pregnancy outcome of frozen-thawed embryo transfer (FET) in endometriosis (EMT) patients in order to provide reference for the clinical selection of FET strategies. Methods:A total of 329 EMT patients who received blastocyst FET at the Reproductive Medicine Center, Department of Obstetrics & Gynecology, The 900th Hospital of the Joint Logistics Support Force, PLA, from Jan. 2015 to Dec. 2017 were analyzed retrospectively. The patients were divided into three groups according to endometrial preparation protocols, ages, and endometrial thickness on the day of progesterone conversion, respectively. By endometrial preparation protocols, the three groups included gonadotropin-releasing hormone agonist (GnRH-a) down-regulation+ hormone replacement therapy (HRT) group (GnRH-a+HRT group, A1 group, n=138), HRT group (B1 group, n=52), and natural cycle (NC) group (C1 group, n=139). By ages, the three groups included 35 years old group (C2 group, n=59). By endometrial thickness on the day of progesterone conversion, the three groups included 12 mm group (C3 group, n=37). The differences in pregnancy outcomes among EMT patients with blastocyst FET were compared under different grouping factors. Results:The endometrium of A1 group was significantly thicker than that of B1 group (P=0.041), the implantation rate and clinical pregnancy rate of B1 group were significantly higher than those of C1 group (P=0.000, P=0.003). Compared with A1 group, the implantation rate of B1 group was significantly higher (P=0.023), while it was significantly lower in group C1 (P=0.027). The abortion rate of A2 group was significantly higher than that of B2 group (P=0.007). Compared with A3 group, the implantation rate of B3 group was significantly higher (P=0.041), while it was significantly lower in C3 group (P=0.026). Conclusion:HRT endometrial preparation protocol for EMT patients with blastocyst FET can improve the implantation rate and clinical pregnancy rate, and reduce the abortion rate and ectopic pregnancy rate, which may be an economical and efficient endometrial preparation protocol in clinical.

Impact of Hormone Replacement Therapy on the Quality of Life in Climacteric Women / 中国药学杂志

OBJECTIVE: To evaluate the effects of hormone replacement therapy(HRT) on the quality of life in climacteric women. METHODS: The 202 patients were collected and divided into three groups according to whether or not they were treated with HRT: group 1 (not HRT), group 2 (HRT for the first time), group 3 (HRT for more than one year). All patients received follow-up visiting once per three months for one year. They were evaluated by the professionals through Kupperman index(KI), menopause-specific quality of life questionnaire(MENQOL), self-rating anxiety scale(SAS), self-rating depression scale(SDS). All patients were guided to improve the way of life. RESULTS: After a year, KI, MENQOL and SAS in the three groups were improved significantly (P=0.003, 0.007, 0.014). KI and MENQOL were improved earlier than SAS. SDS was improved but not significantly(P=0.109). KI, MENQOL, SAS and SDS of patients in group 1 were improved significantly, but improved more weakly than those in group 2 and group 3. There is negative correlation between HRT and the values of every scale, and there is positive correlation between culture degree and SAS, SDS score values. CONCLUSION: HRT canim prove the quality of life in climacteric women. The improvement in physical symptoms is earlier than that in mental symptoms. Anxiety and depression are more likely to occur in menopausal patients with high degree of education. Traditional Chinese medicine, exercise therapy and physical rehabilitation can be used as an auxiliary treatment for patients who are unable or unwilling to accept the HRT.

Ovarian Cancer among Women of Lahore Metropolitan; a Survey.

The symptoms, causes and different risk factors related to ovarian cancer (OC) in Lahore Metropolitan are studied. Information was collected from 52 patients (having mean age 45±10 years) referred to the Institute of Nuclear Medicine and Oncology Lahore (INMOL), Pakistan. The risk was found relevant in the patients having positive family history of any cancer other than OC and that’s why 21.1% patients faced this dilemma. Marital status was not found a cause of OC as unmarried and married patients both were affected. Birth control pills were not a cause of OC as 96.6% patients in Lahore did not used them. High parity and Brest feeding were the cause of OC as 59.6% patients have high parity and 78.8% have breast fed their children for more than one year. Fallopian tube tide (94.2%), hysterectomy (86.5%) and smoking (98.1%) were not the cause of OC. Irregularity in menstrual cycle (30.8%), eating disorders (38.5%), abdominal pain or bloating (90.4%) and natural menopause (50%) were the symptoms of OC. Hormone replacement therapy (HRT) is not found a cause of OC in Lahore as all the selected patients under study never used HRT.

Pulmonary Thromboembolism after Post-menopause Hormonal Replacement Therapy / 결핵및호흡기질환

Hormonal replacement therapy (HRT) has been proven for treatment of postmenopausal symptoms such as hot flushes, night sweats and urologic symptoms. HRT became very popular in the 1990's, when there were several reports showing that it also helped with other menopausal complications such as osteoporosis and cardiovascular disease. Recent studies report that the incidence of breast cancer, endometrial cancer, cerebral infarction, coronary artery diseases, deep vein thrombosis and pulmonary thrombembolism could rise after HRT. Among these side effects of HRT, the risk of pulmonary thromboembolism increases 2 to 4 fold after HRT, but can vary with the use of different doses and preparations. Here, we summarize the risk factors and clinical courses for 5 patients who developed pulmonary thromboembolism after postmenopausal HRT.

Menopausia: tiempo para pensarla / Menopause: time to rethink it

Se hace un recuento histórico de cómo la cultura médica occidental ha percibido la menopausia, su transformación de condición fisiológica en una enfermedad y cómo a consecuencia de nuevas publicaciones relacionadas con las terapias de reemplazo hormonal se hace necesario reconsiderar muchas actitudes y prácticas médicas que se desarrollaron en los últimos años.

This article presents a historic review about the recent ways in which medicine conceives menopause, the implications of the Women's Health Initiative Studies and the need to develop a critic attitude before adopting foreign doctrines, technologies and drug therapies

Estrogen Receptor Gene PvuII and XbaI Polymorphisms and Ultrasonographic Findings of Uterine Endometrium in Postmenopausal Women with Hormone Replacement Therapy / 대한산부인과학회지

OBJECTIVE: To explore the association of estrogen receptor (ER) alpha gene PvuII and XbaI polymorphisms and ultrasonographic findings of uterine endometrium. METHODS: Forty-five postmenopausal women undergoing hormone replacement therapy (HRT) were included in this study. Women were evaluated for PvuII and XbaI polymorphisms for ER alpha gene after extracting DNA from peripheral blood. The thickness and appearance of uterine endometrium was measured by transvaginal ultrasonography. The association of estrogen receptor gene PvuII and XbaI polymorphisms and ultrasonographic endometrial findings were analyzed. RESULTS: No statistically significant difference was found in endometrial thickness (pp 3.6 +/- 1.5 mm, Pp 4.2 +/- 1.6 mm, PP 3.5 +/- 1.3 mm) or endometrial appearance among the three different groups by PvuII polymorphism. No significant difference was also observed in endometrial thickness (xx 3.6 +/- 1.5 mm, Xx 4.2 +/- 1.4 mm) or endometrial appearance between the two groups of different XbaI genotypes. CONCLUSION: These results suggest that neither PvuII nor XbaI polymorphism of the estrogen receptor alpha gene may be associated with the ultrasonographic findings of uterine endometrium in postmenopausal women undergoing HRT. Further studies with a larger scale are necessary to confirm these data.

Comparative Study on Treatment of Postmenopausal Symptoms with Black Cohosh Root Extract and Hormone Replacement Therapy / 대한산부인과학회잡지

OBJECTIVE: The fears and side effects of a prolonged hormone replacement therapy on the postmenopausal symptoms reinforce a growing interest about alternatives. The present study was performed to investigate whether black cohosh root extract (BCRE) can be used or not as an alternative to hormone replacement therapy (HRT) in order to relieve postmenopausal symptoms. MATERIAL & METHODS: Randomized, double-blind prospective clinical trial examined the effects of BCRE and HRT on Kupperman index, biochemical bone markers, lipid profiles, and side effects in 74 women with postmenopausal symptoms. Treatments included placebo (Festal(R)) (n=12), BCRE (Feramin(R)) (n=32) and HRT (Premarin(R)) (n=30) for 3 months. Kupperman index, biochemical bone markers (osteocalcin and deoxypyridinoline), and lipid profiles (total cholesterol, triglyceride and HDL-cholesterol) were measured at 0, 1 and 3 months. Side effects were checked at 3 months. RESULTS: BCRE was significantly effective in lowering of Kupperman index as much as HRT at two control times (1 month: p<0.05, 3 months: p<0.001). It also showed slightly favorable effects on biochemical bone markers and lipid profiles but not statistically significant. Fewer side effects were seen in BCRE than HRT. CONCLUSION: BCRE appears to be a safe and effective alternative to HRT for early postmenopausal symptoms and may be especially useful in women with intolerances or contraindications to traditional HRT.

Comparative Study on Treatment of Postmenopausal Symptoms with Black Cohosh Root Extract and Hormone Replacement Therapy / 대한산부인과학회잡지

OBJECTIVE: The fears and side effects of a prolonged hormone replacement therapy on the postmenopausal symptoms reinforce a growing interest about alternatives. The present study was performed to investigate whether black cohosh root extract (BCRE) can be used or not as an alternative to hormone replacement therapy (HRT) in order to relieve postmenopausal symptoms. MATERIAL & METHODS: Randomized, double-blind prospective clinical trial examined the effects of BCRE and HRT on Kupperman index, biochemical bone markers, lipid profiles, and side effects in 74 women with postmenopausal symptoms. Treatments included placebo (Festal(R)) (n=12), BCRE (Feramin(R)) (n=32) and HRT (Premarin(R)) (n=30) for 3 months. Kupperman index, biochemical bone markers (osteocalcin and deoxypyridinoline), and lipid profiles (total cholesterol, triglyceride and HDL-cholesterol) were measured at 0, 1 and 3 months. Side effects were checked at 3 months. RESULTS: BCRE was significantly effective in lowering of Kupperman index as much as HRT at two control times (1 month: p<0.05, 3 months: p<0.001). It also showed slightly favorable effects on biochemical bone markers and lipid profiles but not statistically significant. Fewer side effects were seen in BCRE than HRT. CONCLUSION: BCRE appears to be a safe and effective alternative to HRT for early postmenopausal symptoms and may be especially useful in women with intolerances or contraindications to traditional HRT.

Clinical Analysis of 53 Cases of Postmenopausal Vaginal Bleeding Caused by Hormone Replacement Therapy / 中国医师杂志

Objective To investigate the effects of HRT on endometrium of postmenopausal women.Methods 53 cases of postmenopausal vaginal bleeding(PMB),from Jan,1995 to Dec.1999 treated by HRT were selected to make a comparison with the other 60 cases of PMB without HRT during the corresponding period.Both groups had integrated ultrasonic and pathological data and getting information from succedent inspection.Results The rates of the endometrial carcinorma incidences that happen in the HRT group were non-HRT group were 5 66% and 8 33% respectively,which had little significant.While the occurring rates of inflammation were 1 89% and 16 67% respectively,a significant difference between the both existed here.Conclusions With HRT,the various symptoms of post menopause women can be efficiently improved.It is safe and effective in short term.But a close monitoring is absolutely necessary for its long term effect(5 years or more).

Biochemical Bone Markers in Postmenopausal Women with Hormone Replacement Therapy / 대한산부인과학회잡지

OBJECTIVES: To investigate the patterns of biochemical bone markers, such as urinary deoxypyridinoline (DPD), N-telopeptide of type I collagen (NTX), and serum osteocalcin (OC), bone-specific alkaline pbosphatase (BSAP) in postmenopansal women with hormone replacement therapy (HRT). Materials and METHOD: From July 1997 to January 1998, total 239 postmenopausal women were emolled in the present study, and 198 healthy premenopausal women with regular menstruation were served as control. The postmenopausal women were pouped into the HRT group and the non-HRT group. The women in the HRT poup have received estrogen with continuous or cyclic progestin therapy far more tban 6 months. The biochemical bone markers of all women were assayed. Results were analysed with Students t-test. RESULTS: The urinary DPD of the non-HRT group was sigaificantly higher than both the HRT poup and the premenopausal group(5.51 +/- 2.47 vs. 3.36 +/- 1.02 and 4.01 +/- 3.86 nM/mM, p < 0.05, repectively). The urinary NTX of the non-HRT group was also higher in comparison to the HRT group and the premenopausal group(48.71 +/- 11.54 vs. 33.70 +/- 17.43 and 33.70 +/- 17.43 nM BCE/mmol, p < 0.05, repectively). However, there were no significant differences in the concentrations of serum BSAP and OC among the three poups. CONCLUSION: The urinary DPD and NTX were more sensitive indicators of bone metabolism tban serum BSAP and OC in postmenopausal women undergoing HRT.