Association of obesity and anovulatory infertility / Associação entre obesidade e infertilidade anovulatória

ABSTRACT Objective To verify the association of obesity and infertility related to anovulatory issues. Methods This case-control study was carried out with 52 women, aged 20 to 38 years, divided into two groups (infertile − cases − and fertile − control), seen at outpatient clinics, in the period from April to December, 2017. Results We found significant evidence that obesity negatively affects women's fertility (p=0.017). The group of infertile women was 7.5-fold more likely to be obese than fertile women. Conclusion Strategies that encourage weight control are indicated for women with chronic anovulation, due to hight metabolic activity of adipose tissue.

RESUMO Objetivo Verificar em mulheres a associação entre obesidade e infertilidade relacionada a questões anovulatórias. Métodos Estudo de caso-controle com 52 mulheres, de 20 a 38 anos, divididas em dois grupos (mulheres inférteis − casos − e férteis − controles), atendidas em ambulatórios, no período de abril a dezembro de 2017. Resultados Verificou-se evidência significativa de que a obesidade afeta negativamente na fertilidade das mulheres (p=0,017). O grupo de mulheres inférteis teve 7,5 vezes mais chances de serem obesas quando comparadas às mulheres férteis. Conclusão Estratégias que estimulem o controle do peso são indicadas para mulheres com anovulação crônica devido à elevada atividade metabólica do tecido adiposo.

Long latency auditory evoked responses in ovulatory and anovulatory menstrual cycle.

Central nervous system pathways get influenced by the changing hormonal levels across the menstrual cycle. In an effort to see the effects on the conduction in central auditory pathways we recorded long latency auditory evoked potentials (LLAEPs) across the 4 different phases of the menstrual cycle. 20 females having normal ovulatory menstrual cycles were tested 4 times in a single cycle and LLAEPs were recorded from Cz-A1 and Cz-A2 position with alternating 90 dB sound pressure click stimuli. Twenty age matched control females having anovulatory menstrual cycles were also tested on the corresponding days. All control females were taking oral contraceptive (O.C.) pills. The LLAEPs were compared inter-group wise as well as inter-phase wise for each parameter by using hierarchal ANOVA design and Tukey test was applied to find out the significance level. Peak latencies of waves P2 and N2 were found to be delayed during mid-cycle and relatively reduced mid-luteal phase in ovulatory menstrual cycles. No such response was noticed in oral contraceptive using group. This indicates that normal cyclic variations of female sex hormones especially estrogen and progesterone modify the central processing of the auditory information. Estrogen may be responsible for delaying the conduction by influencing GABA release at the level of polysensory association areas of the brain.

Chronic anovulation: its phases and the associated hormonal perturbation

A total of 230 cases of infertility due to anovulation was selected for this study. Amenorrhea, PCOs, galactorrhea and hirsutism were clinically associated with these cases. FSH, LH, PRL, E2, free testosterone and DHEA-S04 were assayed in all cases by IRMA and RIA methods. One- and two-gravida was found in 102 cases and nulligravidae in the rest. Anovulation was proved in all cases by endometrial biopsy. All cases were assessed clinically for the progress of the disease and to exclude other causes of infertility. It was concluded that chronic anovulation must be considered a single clinico endocrinal entity with variable phases. Accordingly, hormonal assay is essential to confirm the diagnosis and to determine the state of chronicity or its phase

Hiperinsulinemia y anovulación / Anovulation and hiperinsulinemia

El objetivo de este estudio fue revisar las características endocrinas y metabólicas del síndrome de ovario poliquístico en relación con el hiperandrogenismo, obesidad y trastornos ovulatorios

¿Tiene la oligomenorrea un siginificado patológico?: importancia de este síntoma en medicina interna / Has oligomenorrhea a pathological meaning?: the importance of this symptom in internal medicine

Background: Oligomenorrhea, defined as a menstrual cycle lasting 36 to 90 days, can be a normal condition in the first years after the menarche. When it persists or appears after a period of normal menstrual cycles, an underlying illness must be sought. Aim: To assess ovulation and causes of anovulatory cycles in women with oligomenorrhea, compared with causes of secondary amenorrhea. Patients and methods: One hundred one women of less the 35 years old, presenting with oligomenorrhea persisting 5 years after menarche or lasting more than two years after a period of normal menstrual cycles, were studied. Ovulation was studied measuring serial plasma progesterone during normal or induced (with intramuscular progesterone) menstrual cycles. Results: Eighty nine percent of women had anovulatory oligomenorrhea. The main causes were polycystic ovarian disease in 51percent and hypothalamic dysfunction in 31percent. Thirty percent of women with secondary amenorrhea had polycystic ovarian disease and 14percent had hyperprolactinemia. Women older than 20 years old or with more than 10 years of gynecological age had a higher frequency of polycystic ovarian disease and a lower prevalence of hypothalamic dysfunction. Conclusions: There is a high frequency of anovulatory oligomenorrheas. Therefore, this symptom deserves a thorough endocrinological assessment to uncover underlying diseases. Special attention must be paid to polycystic ovary syndrome, due to its importance in internal medicine as a risk factor for myocardial infarction, high blood pressure, and type 2 diabetes mellitus

Consideraciones etiológicas y fisiopatológicas en el síndrome del ovario poliquístico y los mecanismos de anovulación / Etiologic and physiopathology considerations in the policystic ovary syndrome and anovulation mechanism

El síndrome del ovario poliquístico es una entidad que ha causado gran interés por su frecuencia, por la controversia acerca de su origen y por las repercusiones que conlleva. El estado de anovulación crónico es la vía a través de la cual se originan las alteraciones morfológicas y endocrinas del síndrome, produciendo un complejo sintomático muy variable. Dentro de las alteraciones hormonales más importantes están un hiperandrogenismo y un estado estrogénico aumentado y no antagonizado. Nuestro intés estriba en revisar los factores etiológicos y fisicopatológicos de este síndrome, así como los mecanismos de anovulación implicados