Diagnostic value of urinary luteinizing hormone levels in the monitoring of precocious puberty treatment

ABSTRACT Objective To determine whether first-voided urinary LH (FV-ULH) - level measurement can adequately assess pubertal suppression as much as standard tests can. Subjects and methods The study group included patients with central precocious puberty and rapidly progressing early puberty who received up to 3 - 4 doses of GnRHa therapy monthly and did not have adequate hormonal suppression after GnRH stimulation (90-minute LH level > 4 IU/L). Design: All of the participants underwent an LHRH test just after admission to the study. According to the stimulated peak LH levels, the patients were divided into 2 groups and followed until the end of the first year of treatment. The concordance between FV-ULH and stimulated LH levels was assessed. Results The FV-ULH levels in patients with inadequate hormonal suppression were significantly high compared to patients with adequate hormonal suppression. FV-ULH levels were very strongly correlated with stimulated LH levels (r = 0.91). Its correlation with basal LH levels was significant (r = 0.65). However, this positive correlation was modestly weakened after the first year of treatment. The cutoff value for FV-ULH of 1.01 mIU/mL had the highest sensitivity (92.3%) and specificity (100%). Conclusion FV-ULH levels, using more reliable and sensitive assay methods, can be used to monitor the adequacy of GnRHa therapy.

Use of a GnRH synthetic analog (buserelin) for estrous induction in female dogs / Utilização de análogo sintético de GnRH (buserelina) na indução do estro em cadelas

The aim of this study was to evaluate the effectiveness of a GnRH synthetic analog, as an estrous inducer in female dogs when administered during the anestrous phase, and to evaluate the pregnancy rate achieved through natural copulation. For this purpose, ten female dogs of different breeds were used. The subjects received buserelin by intramuscular injections at a dose of 2,1mcg when female dogs weighed up to 10kg (Group 1) and of 4,2mcg when the dogs weighed above 10kg (Group 2). Of the ten subjects, only three presented estrus after a single injection of buserelin: two dogs from Group 1 and one dog from Group 2 on average 7±1.29 days. The remaining seven dogs were given a second dose of buserelin, equal to the first administration. Of these, three belonged to Group 1 and four to Group 2. Four of these dogs exhibited clinical signs of estrus within, on average 9±7.3 days from the second injection. The seven female dogs that did enter estrus were fertilized successfully through natural copulation. The administration of buserelin was effective in inducing estrus in female dogs during the anestrous phase, with a maximum of two administrations.(AU)

Objetivou-se avaliar a eficácia de um análogo sintético ao GnRH como indutor de estro em cadelas em anestro e a taxa de prenhez por meio de cópula natural. Para isso, foram utilizadas 10 fêmeas caninas de diferentes raças. Cadelas de até 10kg de peso (grupo 1) foram submetidas à administração de buserelina por via intramuscular, na dose de 2,1mcg, e cadelas acima de 10kg (grupo 2) foram submetidas à mesma medicação, porém na dose de 4,2mcg. Das fêmeas em anestro, apenas três apresentaram estro com apenas uma aplicação, sendo duas do grupo 1 e uma do grupo 2, em 7±1,29 dias, em média. Em sete cadelas foi administrada mais uma dose de buserelina; destas, quatro eram pertencentes ao grupo 2 e três eram do grupo 1. Os sinais de estro ocorreram, em média, após 9±2,73 dias da segunda aplicação. As sete cadelas que manifestaram estro foram fertilizadas por meio de cópula natural. A administração de buserelina é eficiente para a indução de estro, em cadelas em anestro, em, no máximo, duas aplicações.(AU)

Survival Outcomes of Concurrent Treatment with Docetaxel and Androgen Deprivation Therapy in Metastatic Castration-Resistant Prostate Cancer

PURPOSE: Docetaxel-based chemotherapy (DTX) improves overall survival (OS) of men with metastatic castration-resistant prostate cancer (mCRPC). Considering the potential existence of androgen receptors that remain active at this stage, we aimed to assess the impact of the combined use of androgen deprivation therapy (ADT) with DTX for mCRPC. MATERIALS AND METHODS: We performed a single-institutional retrospective analysis of patients with mCRPC who received either DTX alone (DTX group, n=21) or concurrent DTX and ADT (DTX+ADT group, n=26) between August 2006 and February 2014. All patients received DTX doses of 75 mg/m2 every three weeks for at least three cycles. In the DTX+ADT group, all patients used luteinizing hormone releasing hormone agonist continuously as a concurrent ADT. RESULTS: The median follow-up period was 24.0 months (interquartile range 12.0-37.0) for the entire cohort. The median radiographic progression-free survival (rPFS) was 9.0 months and 6.0 months in the DTX+ADT and DTX groups, respectively (log-rank p=0.036). On multivariable Cox regression analysis, concurrent administration of ADT was the only significant predictor of rPFS [hazard ratio (HR)=0.525, 95% confidence intervals (CI) 0.284-0.970, p=0.040]. The median OS was 42.0 and 38.0 months in the DTX+ADT and DTX groups, respectively (log-rank p=0.796). On multivariable analysis, hemoglobin level at the time of DTX initiation was associated with OS (HR=0.532, 95% CI 0.381-0.744, p<0.001). CONCLUSION: In chemotherapy-naive patients with mCRPC, the combined use of ADT with DTX improved rPFS. Our result suggests that the concurrent administration of ADT and DTX is superior to DTX alone.

Informe de evaluación rápida de tecnología sobre seguridad y efectividad de degarelix para cáncer de próstata / Rapid evaluation report of technology on safety and effectiveness of degarelix for prostate cancer

Hoy en día, el cáncer de próstata se considera uno de los problemas médicos más importantes a los que se enfrenta la población masculina. En Europa, el cáncer de próstata es la neoplasia sólida más frecuente, con una incidencia de 214 casos por 1000 varones, superando en número a los cánceres de pulmón y colorrectal. Además, el cáncer de próstata constituye actualmente la segunda causa más frecuente de mortalidad por cáncer en los varones. Además, desde 1985, se ha producido un ligero aumento del número de muertes por cáncer de próstata en la mayoría de las naciones, incluso en países o regiones en los que el cáncer de próstata no es frecuente. El cáncer de próstata afecta a los varones ancianos con mayor frecuencia que a los jóvenes. Por consiguiente, supone un mayor problema de salud en los países desarrollados, ya que cuentan con una mayor proporción de varones ancianos. Así, alrededor del 15% de los cánceres en varones son cáncer de próstata en los países desarrollados, en comparación con el 4% en aquellos en vías de desarrollo. Conviene señalar que hay notables diferencias regionales en las tasas de incidencia de cáncer de próstata. La Vigilancia Epidemiológica de Cáncer en el Perú fue establecida por la Dirección General de Epidemiología del MINSA el año 2006, con el propósito de conocer el comportamiento epidemiológico del cáncer en nuestro país y brindar información para el desarrollo de intervenciones destinadas a reducir su incidencia y mortalidad. Los casos notificados de la Vigilancia Epidemiológica de Cáncer comprenden la información de los Registros Hospitalarios de Cáncer (RHC) a cargo de las Oficinas de Epidemiología y Salud Ambiental de los hospitales notificantes así como de las defunciones por cáncer que no accedieron a una atención hospitalaria a cargo de las Oficinas de Epidemiología de las DIRESA/GERESA/DISA. Para el caso de los hospitales. Los cánceres que a nivel nacional presentaron un mayor promedio de casos por año fueron los de cérvix, estómago, mama, piel y próstata. Diversos estudios han demostrado el papel que tiene la testosterona sobre el cáncer de próstata y que el control de sus niveles repercute favorablemente en la progresión de la enfermedad. La terapia con degarelix suprimen los niveles de testosterona rápidamente a niveles de castración (< 0.5 ng/ml), con posibilidad de reversión al suprimir el tratamiento. La sobrevida libre de progresión se reportó mayor en el grupo que recibió degarelix. Se recomienda cubrir con restricciones.(AU)

Factors affecting the success of resynchronization protocols with or without progesterone supplementation in dairy cows

The objective of this study was to investigate factors that influence the success of resynchronization protocols for bovines with and without progesterone supplementation. Cow synchronized and not found pregnant were randomly assigned to two resynchronization protocols: ovsynch without progesterone (P4) supplementation (n = 66) or with exogenous P4 administered from Days 0 to 7 (n = 67). Progesterone levels were measured on Days 0 and 7 of these protocols as well as 4 and 5 days post-insemination. Progesterone supplementation raised the P4 levels on Day 7 (p 3.5 had increased P/AI values while cows with BCS < 2.75 had decreased P/AI rates after P4 supplementation. Primiparous cows had higher P4 values on Day 7 than pluriparous animals (p = 0.04) and tended to have higher RRs (p = 0.06). Results of this study indicate that progesterone supplementation in resynchronization protocols has minimal effects on outcomes. Parity had an effect on the levels of circulating progesterone at initiation of the protocol, which in turn influenced the RR.

[In vitro fertilization outcome in patients with polycystic ovary syndrome treated with GnRH analogue]

Polycystic ovarian syndrome [PCOS] is the most common endocrinological disorders that affect approximately 5-7% of women in reproductive age. There is not any consensus about the efficient in vitro fertilization [IVF] protocol for patients with PCOS. The aim of the present study was to compare the half and one-third dose depot gonadotropin-releasing hormone [GnRH] agonist protocols versus the GnRH antagonist protocol in PCOS patients. In the present study, we retrospectively evaluated 119 infertile women with PCOS. The patients entered in the study in accordance with Rotterdam criteria. According to GnRH analogue used for pituitary suppression, patients were divided into three groups: half and one-third dose depot GnRH agonist protocols and GnRH antagonist protocol. In GnRH agonist protocol, half or one-third dose depot Decapeptyl [1.875 mg, 1.25 mg] was injected on 21[st] day of previous cycle. In GnRH antagonist cycles, cetrotide 0.25 mg were administered daily when the leading follicles reached 14 mm. All basal and controlled ovarian hyperstimulation [COH] characteristics were analyzed. Basal characteristics including: age, FBS, prolactin, hirsutism, length of menstrual cycle were similar between 3 groups. Statically significant decreases in days of stimulation, number of gonadotrophin ampoules and metaphase two [MII] oocytes were found in GnRH antagonist protocol [P<0.001, P<0.001 and P=0.045], while the decrease in biochemical pregnancy [P=0.083] and live birth rate [P=0.169] wasn't significant. Number of embryos transferred were similar in the half and one-third dose depot GnRH agonist and GnRH antagonist cycles [P=0.881]. The incidence of OHSS weren't significantly different between 3 groups [5%, 4.9% and 12.8%, P=0.308]. Our study suggest that one-third dose depot GnRH agonist protocol could be a suitable choice for treatment of PCOS because of lower incidence of ovarian hyperstimulation syndrome [OHSS] as compared with half dose depot GnRH agonist and higher pregnancy rate as compared with GnRH antagonist.

Dienogest: Uma nova opção terapêutica em endometriose / Dienogest: A new option in the treatment of endometriosis

Endometriose é uma doença crônica que afeta mulheres jovens em idade reprodutiva provocando dor, dispareunia, infertilidade e que também afeta a qualidade de vida das pacientes. Numerosos tratamentos existem, alguns clínicos e outros cirúrgicos. Entretanto, essa doença deve ser considerada como uma doença crônica que pode exigir muitos anos de tratamento, já que as recidivas são frequentes após as cirurgias ou após qualquer tratamento. Entre os novos tratamentos médicos, embora ainda não disponível no Brasil, está a administração oral de um novo progestagênio, Dienogest (DNG), o qual tem tido grande êxito no tratamento da endometriose, principalmente no tocante aos sintomas de dor associados. Esta revisão mostra os estudos mais relevantes realizados em diversos países com tratamentos em curto prazo - em geral 24 semanas - e em longo prazo - aproximadamente 53 semanas - e que mostraram alta eficácia, poucos eventos adversos e de pouca intensidade e alta satisfação das pacientes. A revisão também discute a relevância do DNG na prática clínica

Endometriosis is a chronic disease which affects young women at reproductive age and provokes pain, dyspareunia, infertility and which impaires patients' quality of life. Several treatments are available including medical and surgical. However, this disease must be considered as a chronic disease which could need many years of treatment because recurrences are common after surgery or any medical treatment. Among the new medical treatments, albeit not available in Brazil at the present time, there is the oral administration of a new progestin, Dienogest (DNG) which was successful in the treatment of endometriosis, mainly regarding pain-associated endometriosis. This review shows the main studies conducted in several countries with short term treatments - up to 24 weeks - as well as long-term treatments - in general up to 53 weeks - that showed high efficacy, few adverse events, and of middle or minimum intensity with high satisfaction of the patients. The review also discusses the relevance of DNG in the clinical practice

Efeito da frequência de amamentação sobre a taxa de ovulação após tratamento com desmame temporário + GnRH, sobre a incidência de luteólise prematura no primeiro ciclo estral pós-parto e sobre o desempenho da progênie de vacas Nelore / Effect of suckling frequency on ovulation rate after temporary weaning + GnRH treatment, incidence of premature luteolysis in the first postpartum estrous cycle, and performance of calves from Nelore cows

Avaliou-se o efeito da restrição na frequência de amamentação sobre o diâmetro folicular no dia 0 (DFOL), sobre a taxa de ovulação (TO), e sobre a incidência de luteólise prematura no primeiro ciclo estral pós-parto (ILP) de vacas Nelore multíparas, em anestro, submetidas à amamentação ad libitum (controle; n= 115) ou amamentação uma vez ao dia (restrito; n= 109), entre os dias -14 e 9 do experimento, e estudou-se o efeito desses tratamentos sobre o peso à desmama da progênie dessas vacas. Induziu-se ovulação com remoção de bezerros entre os dias -2 e 0 e aplicação de 100μg de GnRH no dia 0. Somente animais que ovularam foram mantidos no experimento (n= 125). A ocorrência de luteólise prematura foi avaliada por meio da dosagem da concentração sérica de progesterona nos dias 5 e 9. A TO não foi influenciada pelos tratamentos (55,8 por cento; P>0,1), e as vacas do tratamento restrito apresentaram maior DFOL (10,90±0,26 vs. 10,18±0,21mm; P<0,05) e menor ILP (21,4 por cento vs. 43,5 por cento; P<0,05). Os bezerros do tratamento controle foram mais pesados (162,32±2,08 vs. 155,91±4,12kg; P<0,05). Conclui-se que a restrição na frequência de amamentação em vacas Nelore reduz a ILP, porém com possível efeito negativo no desenvolvimento dos bezerros.

The effects of restricted suckling on follicular diameter at day 0 (FDDO), ovulation rate (OR), and incidence of premature luteolysis in the first post partum estrous cycle (PLI) of Nelore cows and the effects on weight at weaning (WW) of progenie of these cows were evaluated. Multiparous anestrous postpartum Nelore cows were submitted to ad libitum suckling (control; n= 115) or once-a-day suckling (restricted; n= 109) from days -14 to 9 of the experiment. For both treatments, a temporary calf removal was performed from days -2 to 0, and on day 0 cows received 100μg of GnRH. Only animals that ovulated after GnRH treatment were used in the experiment (n= 125). The occurrence of premature luteolysis was evaluated by dosage of serum progesterone concentrations on days 5th and 9th. The OR was not affected by treatments (55.8 percent; P>0.1), but cows from restricted treatment had larger FDDO at time of GnRH treatment (10.90±0.26 vs. 10.18±0.21mm; P<0.05) and lower PLI (21.4 percent vs. 43.5 percent; P<0.05) than cows from control treatment. Calves from control treatment had higher WW than calves from restricted treatment (162.32±2.08 vs. 155.91±4.12kg; P<0.05). These results indicate that the restriction in frequency of suckling in Nelore cows may decrease the incidence of premature luteolysis in the first postpartum estrous cycle; however, with possible negative effects on calves development.

Eficácia da dose reduzida de gonadorelina e diferentes prostaglandinas no protocolo ovsynch em vacas holandesas / Efficacy of decreasing dose of gonadorelin and comparison between different prostaglandins on ovsynch protocol in lactating Holstein cows

Avaliou-se a eficácia da dose de 0,10 ou de 0,25mg de gonadorelina nas taxas de ovulação e de sincronização no protocolo Ovsynch e de 150mcg de D-cloprostenol ou 0,530mg de cloprostenol sódico na regressão do corpo lúteo (CL) de sete dias e de todos os CL. Foram utilizadas 136 vacas lactantes da raça Holandesa, com média de produção de leite de 23,75,8kg/dia, com 138,4±72,0 dias em lactação. As vacas foram distribuídas aleatoriamente em quatro grupos, de acordo com a dose de gonadorelina e o tipo da prostaglandina. As taxas de ovulação e de sincronização foram de 52,9 por cento e 80,9 por cento para 0,10mg de gonadorelina e de 57,4 por cento e 80,9 por cento para 0,25mg de gonadorelina, respectivamente. A taxa de regressão do CL de sete dias foi de 97,1 por cento para o D-cloprostenol e de 97,5 por cento para o cloprostenol sódico. A taxa de prenhez não foi influenciada pelos tratamentos, mas foi influenciada pela taxa de ovulação à primeira aplicação de gonadorelina, 16,0 por cento vs. 6,6 por cento para as vacas que ovularam e não ovularam, respectivamente. Conclui-se que 0,10mg de gonadorelina foi eficiente e ambas prostaglandinas podem ser usadas em protocolos de sincronização da ovulação.

The efficacy of 150mcg D-cloprostenol or 0.530mg cloprostenol sodium on the 7- day corpus luteum (CL) regression rate, and of two doses of gonadorelin, 0.10mg vs. 0.25mg, on the ovulation and synchronization rates during the Ovsynch protocol were evaluated. Lactating Holstein cows (n=136), producing 23.75.8kg milk/d and 138.4±72.0 days in milk were randomly assigned to four groups, according to dose of gonadorelin and prostaglandin type. No effect of the products and doses tested on conception rate were observed. The ovulation and synchronization rates using 0.10mg or 0.25mg of gonadorelin were 52.9 percent and 80.9 percent vs. 57.4 percent and 80.9 percent, respectively. The CL regression rates in cows ovulating after the first GnRH using D-cloprostenol or cloprostenol sodium were 97.1 percent and 97.5 percent, respectively. The pregnancy rate was not affected by treatment, but by ovulation rate after the first injection of GnRH. The pregnancy rates were 16.0 percent and 6.6 percent for ovulated and non ovulated cows, respectively. The results suggest that 0.10mg dose of gonadorelin was efficient and both prostaglandins can be used in synchronization of ovulation protocols.

Evaluation of the effect of a 3rd GnRH injection administered six days after the 2nd GnRH injection of Ovsynch on the reproductive performance of Japanese black cows

This study was designed to evaluate the reproductive performance of Japanese black cows following the 3rd injection of gonadotropin releasing hormone (GnRH) analogue administered concurrently with Ovsynch-based treatment on day 6 (day 1 = the day of ovulation). In Experiment 1, 12 cows were allocated into three groups: a control group that was subjected to Ovsynch treatment and then injected with a placebo on day 6; group 1 (Ovsynch + GnRH), which was subjected to Ovsynch treatment and was injected with GnRH analogue on day 6, and group 2 (Ovsynch + controlled internal drug-release (CIDR) + GnRH), which received Ovsynch-CIDR treatment and was injected with GnRH analogue on day 6. Blood collection and ultrasonographic observation of the ovaries were conducted daily. Both treatments induced the formation of an accessory corpus luteum and significantly increased the cross-sectional area of the luteal tissue when compared to the control. However, plasma progesterone (P(4)) was significantly higher in the treatment groups than in the control group on days 11, 12, 17 and 18 in the group 1 and from day 10 to 21 in the group 2. In Experiment 2, 41 cows were assigned to the same three groups described above and then artificially inseminated on day 1. The pregnancy rates on day 45 did not differ among groups. In conclusion, administration of GnRH analogue on day 6 following Ovsynch-based treatment did not improve the reproductive performance of Japanese black cows, even though the P(4) concentration was higher in groups that received the GnRH.

Efeito do intervalo entre recrutamentos foliculares na superovulação de vacas da raça Holandesa não-lactantes / Effect of interval between follicular recruitments on superovulatory response in non-lactanting Holstein cows

Vacas da raça Holandesa não-lactantes, distribuídas em dois grupos, foram sincronizadas com o protocolo Ovsynch modificado. No dia sete (dia 0 = dia do segundo GnRH), o grupo 7 (G-7; n=19) recebeu CIDR usado previamente por cinco dias e 100mcg de GnRH, e o grupo 14 (G-14; n=21), CIDR e 25mg de PGF2alfa. No dia 14 foi aspirado o folículo dominante (FD), trocado o CIDR usado por um novo e foram aplicados 25mg de PGF2alfa. Iniciou-se o tratamento com FSH 36h depois, removeu-se o CIDR com o sétimo FSH e aplicou-se GnRH 36h depois. As inseminações foram feitas 12 e 24h depois. Recuperaram-se os embriões sete dias depois da inseminação artificial. O diâmetro do FD no G-7 foi 13,1±0,57mm no dia sete e 11,2±0,57mm no dia 14. O diâmetro FD persistente no G-14 aumentou de 12,6±0,55mm no dia sete para 16,4±0,55mm no dia 14 (P<0,001). O número de folículos >8mm, 48h após o início do tratamento com FSH, foi maior (P<0,05) no G-7 (15,6±0,05) que no G-14 (12,5±0,05). Não foi detectado efeito de tratamento sobre o número de corpos lúteos e de embriões. O menor intervalo entre recrutamentos foliculares aumentou o número de folículos recrutados, porém não alterou a quantidade e a qualidade dos embriões produzidos

Dry Holstein cows were synchronized by a modified Ovsynch protocol. On day 7 (day 0 = day of the second GnRH), group 7 (G-7; n=19) received an used CIDR and GnRH (100'g). Group 14 (G-14; n=21) received an used CIDR and PGF2alpha (25mg). On day 14, the dominant follicle (DF) was removed, by aspiration; the used CIDR was changed for a new CIDR plus PGF2alpha. Thirty-six hours later, the FSH treatment was initiated. On the seventh injection of FSH, the CIDR was removed. Thirty-six hours after, the cows received GnRH. Donors were inseminated 12 and 24h after the GnRH injection. Embryos were recovered seven days after AI. The DF diameter in G-7 was 13.1mm on day 7 and 11.2mm on day 14. The persistent DF in the G-14 increased from 12.6mm on day 7 to 16.4mm on day 14 (P<0.001). The number of follicles >8mm, 48h after the beginning of the FSH treatment, was 15.6 in G-7 and 12.5 in G-14 (P<0.05). No treatment effects were detected on number of corpus luteum and embryos. The shorter interval between follicular recruitment the higher the number of recruited follicles, but it did not have effects on the number or quality of embryos produced

Incidence Rate of Injection-Site Granulomas Resulting from the Administration of Luteinizing Hormone-Releasing Hormone Analogues for the Treatment of Prostatic Cancer

PURPOSE: Granulomas resulting from the administration of luteinizing hormone-releasing hormone analogues (LH-RH analogues) are thought to be very rare. We report on our clinical experience with injection-site granulomas that result from the administration of LH-RH analogues, and we evaluate the incidence rate of these granulomas. MATERIALS AND METHODS: We used the clinical records of 118 patients who were administered LH-RH analogues in 2005. We describe the clinical data of patients who experienced injection-site granulomas and evaluated the incidence rate. RESULTS: Five patients demonstrated injection-site granulomas due to LH-RH analogue administration. The incidence rate was 4.2% (5 of 118 patients). Most of the granulomas occurred after the first or second administration of 11.25mg of leuprorelin acetate. CONCLUSION: The occurrence of granulomas resulting from the administration of LH-RH analogues was thought to be very rare. Our study, however, revealed a higher incidence rate than expected, especially for leuprorelin acetate.

Ingestão de concentrado e concentração plasmática de progesterona em vacas da raça Holandesa / Concentrate intake and plasmatic progesterone concentration in Holstein cows

Vacas da raça Holandesa não-lactantes (n=7), que receberam 4kg/dia de concentrado durante 28 dias e pasto ad libitum, foram sincronizadas com protocolo Ovsynch. No dia 0 (segunda aplicação de GnRH), as vacas foram distribuídas em dois grupos: as do grupo 2kg receberam 2kg/dia, e as do grupo 8kg receberam 8kg/dia de concentrado, oferecido duas vezes/dia. Os animais foram sincronizados novamente na fase 2. Aqueles que receberam 2kg de concentrado na primeira fase passaram a receber 8kg na segunda fase e vice-versa. As estruturas ovarianas foram avaliadas diariamente por ultra-sonografia. Amostras de sangue para dosagem de progesterona (P4), por radioimunoensaio, foram colhidas diariamente, antes do fornecimento do concentrado e quatro horas depois, até o dia 16 do ciclo estral. Não houve diferença entre os grupos quanto ao diâmetro do folículo ovulatório no dia 0 e ao diâmetro do maior folículo no dia 16. O diâmetro do corpo lúteo foi maior (P<0,05) no dia 16 nos animais do grupo 8kg. Observou-se interação (P<0,05) da quantidade de concentrado fornecida versus dia da colheita das amostras quanto à concentração plasmática de P4. A concentração plasmática de P4, imediatamente antes do fornecimento do concentrado e quatro horas depois, foi menor no grupo 8kg, após o dia 9 do ciclo estral.

Non-lactating Holstein cows (n=7) fed 4kg/day of concentrate for 28 days and kept on pasture were synchronized by Ovsynch protocol. On day 0 (day of 2nd GnRH injection), the cows were distributed in two groups: Group2 = 2kg/day and Group8 = 8kg/day of concentrate, fed twice a day. One replicate was performed (phase 1 and 2). Animals were synchronized again at the beginning of phase-2 and those that fed 2kg of concentrate on phase-1, fed 8kg on phase-2 and vice-versa. The ovarian structures were daily evaluated by ultrasound. Blood samples for progesterone (P4)dosage by RIA were collected daily, just before feeding the concentrate and 4 hours afterwards, until day 16 of the estrous cycle. No difference was detected between the groups in ovulatory follicle diameter on day 0 and in diameter of the largest follicle on day 16. The CL diameter was higher (P<0.05) in Group 8 on day 16 of the estrous cycle. There was an interaction (P<0.05) between the amount of concentrate intake and the day of blood sampling regarding P4 plasma concentration. Cows from Group 8 showed lower P4 plasma concentration, just before feed intake and four hours afterwards, after day 9 of the estrous cycle.

Indução da ovulação em cabras, fora da estação reprodutiva, com LH e GnRH e com estro induzido por progestágenos / Induction of the out-of-season ovulation (with LH and GnRH) and estrus (with progesterone) in goats

Quarenta e cinco cabras foram sincronizadas com o uso de esponjas intravaginais impregnadas com 60mg de acetato de medroxiprogesterona (MAP) por nove dias, associadas com 200UI de gonadotrofina coriônica equina (eCG) e 37,5µg de cloprostenol no sétimo dia. Os animais foram separados em três grupos e receberam, 24 horas após a retirada das esponjas, solução salina ou hormônios, no seguinte esquema: T1 (controle) - 1ml de solução salina; T2 - 5mg de hormônio luteinizante (LH) e T3 - 12,5µg do hormônio liberador de gonadotrofina (GnRH). Houve diferença (P<0,05) na porcentagem de animais em estro, 100,0 por cento, 73,3 por cento e 66,6 por cento, para T1, T2 e T3, respectivamente. Na mesma ordem, não houve diferença (P>0,05) quanto ao intervalo da retirada da esponja ao aparecimento do estro, que foi, em média, 34,8, 29,3 e 31,5 horas, respectivamente. O intervalo médio da retirada da esponja à ovulação foi de 46,6, 52,1 e 41,6 horas, respectivamente, com diferença significativa entre T2 e T3 (P<0,01). As ovulações ocorreram, em média, 21,3, 26,8 e 22,3 horas após as aplicações (P>0,05). A aplicação de LH e do GnRH para induzir e sincronizar a ovulação em cabras fora da estação reprodutiva não apresentou resultados satisfatórios.

In order to achieve estrous synchronization, intravaginal sponges impregnated with 60mg of medroxyprogesterone acetate (MPA) were implanted in 45 goats for nine days. On day 7, 200IU of equine chorionic gonadotropin (eCG) and 37.5µg of cloprostenol were administered to each doe. The animals were randomly allocated in three treatments with 15 animals each. Twenty four hours after intravaginal sponge removal, does were administered 1ml saline solution (control T1), 5mg LH (T2) and 2.5µg GnRH (T3) intramuscular injection. Percentages of animals in estrus were 100.0; 73.3 and 66.6 (P<0.05) and average intervals from sponge removal to start of estrus were 34.8, 29.3 and 31.5 hours for T1, T2 and T3, respectively, being those differences not statistically significant. The average intervals from sponge removal to ovulation were 46.6, 52.1 and 41.6 hours for T1, T2 and T3, respectively, with the difference between T2 and T3 being statistically significant (P<0.01). Ovulation time averages were 21.3, 26.8 and 22.3 hours after injections for T1, T2 and T3 , respectively.

Pattern of prolactin secretion after administration of gonadotropin-releasing hormone agonist at the preovulatory phase of intrauterine insemination cycles

CONTEXTO E OBJETIVO: A administração de um agonista do hormônio liberador das gonadotropinas no momento pré-ovulatório é uma opção para desencadear a ovulação nos ciclos de reprodução assistida. O objetivo deste trabalho é investigar o padrão da secreção de prolactina após a administração de dose única de agonista no momento pré-ovulatório. TIPO DE ESTUDO E LOCAL: Estudo descritivo realizado em um centro de referência terciário. PARTICIPANTES: 15 pacientes normo-ovulatórias submetidas a indução da ovulação para inseminação intra-uterina. MÉTODOS: A estimulação ovariana foi realizada com gonadotropinas da mulher menopausada (75 UI por via intramuscular diariamente). Na presença de pelo menos um folículo de 17 mm (observado por ultra-sonografia), administrou-se 0,5 mg de acetato de buserelina. Foram colhidas amostras de sangue para determinação dos níveis de prolactina no momento da injeção do agonista e 4, 8, 12, 24 e 48 horas depois. RESULTADOS: Observou-se aumento significante nas concentrações séricas de prolactina 4, 8 e 12 horas após a administração do análogo, com um pico após 8 horas. CONCLUSÃO: A administração de uma dose única de análogo agonista no momento pré-ovulatório de pacientes estimuladas com gonadotropinas da mulher menopausada promove aumento significante nas concentrações séricas de prolactina.

Uso do hCG, GnRH ou 17beta-Estradiol e progesterona associados ao acetato de melengestrol e prostaglandina f2alfa em novilhas cruzadas (Bos taurus indicus x Bos taurus taurus) / Use of hCG, GnRH or 17beta-estradiol and progesterone associated with melengestrol acetate and prostaglandin F2alfa in cross-bred heifers (Bos taurus indicus x Bos taurus taurus)

O objetivo do presente experimento foi avaliar a performance reprodutiva e as características de estros em novilhas cruzadas de corte (Bos taurus indicus x Bos taurus taurus) tratadas com o protocolo MGA/Prostaglandina (PG) em associação a outros hormônios. No dia 0 (Dia 0 = início da ingestão do MGA) as novilhas foram distribuídas ao acaso para receber 2mL de solução salina (grupo Salina), 2500UI de hCG (grupo hCG), 20müg de acetato de buserelina (grupo GnRH) ou 5mg de 17beta-estradiol + 100mg de progesterona (grupo 17beta-E2 +P4. Amostras de sangue foram colhidas nos dias - 7, 0, 7 e 10 para a mensuração das concentrações plasmáticas de progesterona. Independentemente do tratamento, todas as novilhas receberam 0,5mg MGA/ animal/ dia durante 8 dias (Dia 0 ao 7) e PG (Dia 7). Os estros foram observados durante 120h, a partir da injeção de PG, pelo sistema Heat- Watch. As novilhas foram inseminadas 12 horas após o início dos estros ou 72h depois da injeção de PG. O diagnóstico de gestação foi realizado 35 dias após a última inseminação, por ultrasonografia. As respostas em estros foram de 50,0%, 22,2%, 59,5% e 71,8% para os grupos Salina, hCG, GnRH e 17beta-E2 +P4, respectivamente (P< ou =0,01). O intervalo médio da injeção de PG ao estro foi de 72,8 + ou - 22,2, 102,0 + ou - 22,7,84,6 + ou - 19,0 e 72,5 + ou - 24,4 horas (P< ou =0,01), sendo o grau de sincronização similar entre os grupos. As taxas de concepção foram de 57,9%, 37,5%, 40,9% e 39,3% e as taxas de prenhez de 29,0%, 11,1 %,27,0% e 28,2%, para os grupos Salina, hCG, GnRH e 17beta-E2 +P4, respectivamente. Não houve efeito do tratamento na duração dos estros (10,4 + ou - 5,7 horas), número de montas (23,0 + ou - 16,9) e duração das montas (2,7 + ou - 0,3 segundos), sendo os valores entre parênteses correspondentes às médias gerais e desvios padrão. Em conclusão, a performance reprodutiva não foi alterada pela adição do hCG, GnRH ou 17beta-E2 +P4 ao protocolo de sincronização MGA/PG.

Management of endometriosis and its impact on infertility.

Endometriosis is defined as the presence of tissue, histologically similar to endometrium, in any other site but that of uterine cavity. Transplantation of endometrial tissue that comes as a retrograde menstrual flow is the most accepted possible theory. Endometriosis is associated with marked subfertility, but the mechanism of causation of infertility is poorly understood unless it has caused very definite anatomical distortion of internal genitalia. Management of infertility in endometriosis is discussed in detail.

Does GnRH analog improve the final height in Thai girls with idiopathic central precocious puberty?

Ten Thai girls with idiopathic central precocious puberty (ICPP) were treated with gonadotrophin releasing hormone (GnRH) analog for a mean period of 1.5+/-0.4 years. The predicted adult height at the end of treatment was significantly higher than that at the start of treatment (158.2+/-7.9 vs 153.0+/-8.7 cm, p=0.009). In addition, treatment with GnRH analog could significantly regress the breast staging from 3.4+/-0.8 to 2.6+/-1.0 (p=0.04),but not the pubic hair staging. Five of them reached a final height which was not significantly higher than the predicted adult height before treatment (153.1+/-4.8 vs 150.7+/-1.0 cm, p=0.5). In conclusion, treatment with GnRH analog in Thai girls with ICPP can improve the predicted adult height and regress the breast staging. However, the improvement of final height is not promising.

Gestaçäo após administraçäo do antagonista do GnRH (Cetrorelix) em ciclo de fertilizaçäo in vitro de acordo com o protocolo de múltiplas doses: relato de caso / Pregnancy after administration of midcycle GnRH antagonist Cetrorelix according to the mutiple dose protocol for in vitro fertilization: case report

Os autores relatam um caso de gestaçäo gemelar obtida após um ciclo de fertilizaçäo in vitro com injeçäo intracitoplasmática de espermatozóide (FIV-ICSI), em cujo protocolo de estimulaçäo ovariana foi utilizado o FSH recombinante em associaçäo com o antagonista do GnRH (Cetrorelix), segundo o protocolo de múltiplas doses (0,25 mg/dia a partir do 7§ dia de estímulo). Os resultados obtidos nos recentes estudos de ensaio clínico que analisaram a utilizaçäo do Cetrorelix em ciclos de FIV foram amplamente revisados e comparados aos resultados obtidos com o emprego dos análogos do GnRH

Protección funcional ovárica con análogos de GnRH y preservación de la fertilidad en adolescentes durante la terapéutica oncológica / Protection of the ovarian function with GnRH analogs and preservation of fertility during cancer therapy

Objetivos: Investigar si los análogos de GnRH pueden evitar la falla ovárica precoz post-quimioterapia antineoplásica y tener así un efecto protector de la fertilidad. Diseño del Estudio: Veintiún pacientes oncológicas fueron divididas en dos grupos y seguidas a lo largo de 18 años. A: premenarca, 3-7,5 años (n:5) recibió poliquimioterapia (PCT). B: post-menarca, 14,7 - 20 años (N:12), ciclos menstruales ovulatorios normales, recibieron análogos de GnRH antes de la PCT.B1 (n:5) trasplante de médula ósea previo (BMT) a la PCY.B2 (n:7) recibió PCT y cobaltoterapia supradiafragmática. C: post-menarca, 15,9 - 20 años (n:4) recibió PCT y fue sometida a BMT. La inhibición se obtuvo mediante la administración de acetato de Leuprolide de depósito en dosis mensuales antes y durante la poliquimioterapia. Resultados: A: menarca espontánea (12.17.8 años), ciclos menstruales ovulatorios normales, cinco embarazos normales. B: ciclos ovulatorios normales desde la supresión del análogo de GnRH, tres embarazos. C: amenorrea hipergonadotrófica hipoestrogénica. Conclusiones: El seguimiento de estas pacientes demostró que la administración de análogos de GnRH antes y durante la poliquimioterapia protege la función ovárica y preserva la fertilidad futura de las adolescentes