Gonadotropin-Dependent Precocious Puberty: Single-Center Experience From Western India

Objective: To describe the characteristics of gonadotropin-dependent precocious puberty (GDPP) in Indian children. Methods: Clinical profiles of GDPP (n=78, 61 females) and premature thelarche (n=12) from a single center in Western India were retrospectively studied. Results: Pubertal onset was earlier in boys than girls (29 vs 75 months, respectively; P=0.008). The basal luteinizing hormone (LH) was ?0.3 mIU/mL, except 18% of GDPP girls. At 60 minutes after GnRHa-stimulation, all patients (except one girl) had LH ?5 mIU/mL. The GnRHa-stimulated LH/FSH ratio was ?0.34 at 60 minutes in girls with GDPP unlike premature thelarche. Only one girl had an allergic reaction to long-acting GnRH agonist. Among GnRH agonist-treated girls (n=24), the predicted final adult height was -1.67±1.5 SDS, whereas the attained final height was -0.25±1.48 SDS. Conclusion: We establish the safety and efficacy of long acting GnRH agonist therapy in Indian children with GDPP. The 60-minute stimulated serum LH/FSH of ?0.34 differentiated GDPP from premature thelarche.

Ovarian steroid cell tumor, not otherwise specified: a case report and review of literature / 中华内分泌代谢杂志

We present a case of a postmenopausal women with hyperandrogenic symptoms and virilization signs , such as hirsutism, alopecia, acne and clitoromegaly, which was pathologically confirmed to be an ovarian steroid cell tumor, not otherwise specified(NOS). The levels of testosterone, dehydroepiandrosterone sulfate and estradiol in serum were increased, while the levels of luteinizing hormone and follicle stimulating hormone were decreased. Computed tomography(CT) scan and magnetic resonance imaging(MRI) identified a solid, left ovarian tumor and detected an additional tumor of hypodensity in the left adrenal gland. ACTH stimulation test, hCG stimulation test, adrenal and ovarian vein sampling indicated that excessive androgens were derived from the ovary. After the injection of gonadotropin hormone analogues(GnRHa), testosterone levels dropped to the normal range. Laparoscopic bilateral adnexectomy was performed, and pathology indicated NOS. The purpose of this report is to improve the understanding of NOS with hyperandrogenic presentation.

Advances in evidence-based medical research of GnRHa for fertility protection after chemotherapy / 中国临床药理学与治疗学

With an improvement in the long-term survival rates of cancer patients, the requirements for fertility protection of young cancer patients after chemotherapy are increasingly prominent. Early studies have shown that gonadotropin-releasing hormone agonist (GnRHa) has a protective effect on fertility. But in recenct year, relevant studies have shown that its protective effect is controversial. This article reviews the clinical researches of GnRHa for fertility protection in patients with common tumors, and explores its evidence-based medicine, in the hope of providing references for reasonable clinical application.

Comparative study of GnRHa stimulation test and GnRH stimulation test / 国际儿科学杂志

Objective To compare the results of GnRHa stimulation test and GnRH stimulation test in girls with Idiopathic central precocious puberty.Methods The girls aged 6-10 who were diagnosed with early breast development (＜ 8 years old) from January 2016 to June 2018 were randomly divided into GnRHa stimulation test group and GnRH stimulation test group according to clinical manifestations,auxiliary examinations and follow-up.The difference in the results of the stimulation test between the two groups was compared.Results A total of 108 girls were enrolled in this study,and 40 (37％) of the GnRHa stimulation tests were performed.Among them,25 (63％) patients with idiopathic central precocious puberty had the confirmed diagnosis,and the GnRH stimulation test was performed.Of the 68 (63％) patients,30 (44％) had idiopathic central precocious puberty.The peaks of LH in the GnRHa challenge test group and the GnRH challenge test groupwere 11.33 (6.81,15.79) and 7.89 (5.35,14.21),and the FSH peaks were 15.68 (10.18,20.06) and 17.26 (13.34,21.42),showing no significant differences (U =1078.50,P =0.07;U =1617.50,P=0.10).Thepeak values of LH/FSH were0.86 (0.37,1.17)and0.52 (0.31,0.83),respectively,and there was a statistical difference (U =953.00,P =0.01).GnRH challenge test showed the ICPP sensitivity of 90.91％ (81.10％-100.72％),specificity of 94.29％ (86.60％-101.98％),total coincidence rate of 92.65％ (86.44 ％-98.85％),Yoden index of 0.85 (0.72％-0.98％).Sensitivity of the GnRHa challenge test showed the ICPP diagnosis rate of 95.24％ (86.13％-104.35％),specificity of 73.68％ (53.88％-93.48％),total coincidence rate of 85.00％ (73.93％-96.07％),Yoden index of 0.69 (0.47-0.91).Conclusion For the diagnosis of idiopathic central precocious puberty in girls,the GnRHa challenge test is more sensitive than the GnRH challenge test,and the specificity and the Yoden index are both low.Therefore,routine use of GnRHa stimulation test as the replacement of GnRH stimulation test is not recommended.

Summary and expectation of the role of GnRHa in the treatment of breast cancer / 中华肿瘤杂志

Gonadotropin-releasing-hormone analogues (GnRHa) are widely used in the treatment of premenopausal breast cancer. The anti-tumor effect of GnRHa is similar to that of surgical castration or chemotherapy, through reversibly inhibiting ovarian function and downregulating the estrogen level in premenopausal female. At the same time, GnRHa can protect the ovarian function, avoiding premature ovarian failure. Also GnRHa can reduce the breast density and endometrial thickness, as a result of which GnRHa may be used to prevent breast cancer in the higher risk population and promote quality of life in breast cancer patients. We here review the clinical roles and research progress of GnRHa in breast cancer.

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.

Effects of Dane Fukang Jiangao combined with GnRH-a in preventing recurrence of postoperative endometriosis / 天津医药

Objective To observe the clinical efficacy of Dane Fukang Jiangao combined with gonadotropin-releasing hormone analogue(GnRH-a)in the treatment of endometriosis(EMT)after laparoscopic surgery. Methods A total of 120 EMT patients treated with GnRH-a after laparoscopic surgery were randomly divided into combine treatment group(n=60) and control group (n=60). In the control group, GnRH-a 3.75 mg was injected subcutaneously on the first day of menstruation and injected once every 28 days. The combine treatment group was given Dane Fukang Jiangao with oral administration 10 g per time, twice a day for 6 months. The changes of estradiol (E2), CA125 and visual analogue scale (VAS)were observed before and after treatment.Kupperman score was used to assess the degree of menopausal symptoms during treatment and follow-up records of recurrence. Results Before treatment, there were no significant differences in the serum levels of E2 and CA125 and VAS between both groups.After treatment,the serum levels of E2 and CA125 and VAS were significantly improved in both groups. And the serum level of E2 was significantly higher in combine treatment group than that of control group (P<0.05). The VAS and the serum level of CA125 were significantly lower than those of control group(P<0.05).Moreover,after treatment the Kuppermann score was significantly better in combine treatment group than that of control group (P<0.05). There was no significant difference in the recurrence rate in 6 months between the combine treatment group (21.7%) and the control group (38.3%, P>0.05). Conclusion Dane Fukang Jiangao in combination with GnRH-a can effectively prevent E2 from being too low,reduce the CA125 level after EMT surgery,relieve dysmenorrhea and menopausal symptoms,and prevent recurrence.

Desencadenantes de la maduración ovocitaria en ciclos de fecundación in vitro / Triggers of oocyte maturation in cycles of in vitro fertilization

Tradicionalmente, desde que se iniciaron las técnicas de reproducción asistida, se solía usar un bolo de 5 000-10 000 UI de gonadotropina coriónica humana para la maduración final de los ovocitos como método estándar. Recientemente, se ha introducido un nuevo concepto, en el que los agonistas de la hormona liberadora de gonadotropina juegan un papel esencial en este campo. Ofrece importantes ventajas, entre las que se incluyen: una virtual prevención completa del síndrome de hiperestimulación ovárica. No obstante, algunos estudios defienden que el uso de hormona liberadora de gonadotropina puede ocasionar un defecto en la fase lútea que puede finalizar en una disminución en las tasas de implantación, en las tasas de gestación clínica o en un aumento de las tasas de aborto precoz. Así pues, en esta revisión analizamos las diferentes opciones terapéuticas para desencadenar la maduración final de los ovocitos en las técnicas de reproducción asistida, y discutimos los riesgos, beneficios y posibles complicaciones del uso de los agonistas de la GnRH como inductor de ovulación en ciclos de fecundación in vitro/inyección intracitoplasmática de espermatozoides(AU)

Traditionally, a bolus of 5000-10000 IU human chorionic gonadotropin (hCG) was used for final follicular maturation and ovulation as a standard method since assisted reproduction techniques started (ART). Recently, a new concept in which the releasing gonadotropin hormone agonists (GnRH-a) play an essential role has been introduced. This offers important advantages, including virtually prevention of ovarian hyperstimulation syndrome (OHSS). However, some studies described that using GnRH-a, could lead to defects in the luteal-phase that may result in a reduction of the implantation and clinical pregnancy rates; and also in an increase of early abortion rates. Therefore, the aim of this review is the analysis of different pharmaceutical options to trigger final oocyte maturation in ART, and the discussion of the risks, benefits and likely complications associated with the use of GnRH-a as an inductor of the ovulation during in vitro fecundation/intracitoplasmatic sperm injection cycles (IVF/ICSI)(AU)

Effect of gonadotropin-releasing hormone agonist on uterine fibroids and its effect on immune function / 中国生化药物杂志

Objective To investigate the hysteromyoma treated with the gonadotropin releasing hormone agonist(GnRH-a)and the impact on immunologic function.Methods 130 cases selected from the patients with hysteromyoma enrolled from January 2016 to December 2016 in hospital have been randomly divided into two groups.The control group has been treated with mifepristone while the study group GnRH-a.Results The sizes of uterus and myoma of both groups have no significant difference before treatment.After treatment, both of them are significantly improved, and those of the study group is significantly smaller than that of the control group(P<0.05).The levels of serum sex hormone and immunologic function of both groups have no significant difference before treatment.They are both improved after treatment, and the study group is significantly better than the control group(P<0.05).Conclusion Applying GnRH-a therapy to the patients with uterine myoma benefits for improving the therapeutic effect, which can improve the serum sex hormone levels and immunologic function.

Effect of Letrozole Combined with GnRH-a on Serum Estrogen Levels and Ovulation Quality of Patients with Polycystic Ovary Syndrome / 现代生物医学进展

Objective:To study the clinical effect of letrozole combined with triptorelin acetate (GnRH-a) on the serum estrogen level and ovulation quality of patients with polycystic ovary syndrome(PCOS).Methods:112 cases of PCOS patients in our hospital from August 2014 to January 2016 were selected and randomly divided into the control group (50 cases) and the observation group (62 cases) according to the wishes of patients.During the first 3～7 days of the menstrual cycle,the patients in the observation group were treated by LE,2.5 mg/d;the patients in the control group were given intramuscular injection of human menopausal gonadotropin (HMG),75 IU/d.when the diameter of the largest follicle (MFD)≥ 18 mm,the patients in the observation group were were given subcutaneous injection of 0.1 mg triptorelin acetate induced ovulation,patients in the control group were given intramuscular injection of Human chorionic gonadotropin HCG6000～10000IU induced ovulation.The ovulation induced ovulation effect and the serum hormone levels and pregnancy outcome were compared between two groups.Results:On the induced ovulation day,no significant difference was found in the endometrial thickness,the number of mature follicles,serum LH and P levels,rate of pregnancy and the luteal function between two groups of patients (P＞0.05),the number of dominant follicles,serum E2 and T levels,multiple pregnancy rate,the incidence of OHSS and ovarian cyst in observed group were significantly lower than those of the control group (P＜0.05).Conclusion:LE combined with GnRH-a could effectively improve the quality of ovulation in patients with PCOS,reduce the serum level of estrogen,and prevent the occurrence of OHSS,improve the outcome of pregnancy.

Metabolism and Axis of Early Menarche Girls and Girls Treated with GnRHa / 中山大学学报(医学科学版)

[Objective] We assessed in a retrospective unicenter study the state of metabolism and gonadal axis of early menarche girls and girls who treated with Gonadotropin-releasing hormone analogs (GnRHa).[Methods] Thirty-nine early menarche girls and 58 girls who had been treated with GnRHa were enrolled in our study and 19 normal menarche girls were enrolled as control group.Data were collected in height,weight,gonadal hormone,blood glucose,insulin,blood lipid,leptin,adiponectin and the size of uterus and ovary.[Results] Both BMI SDS for chronological age (CA) and for bone age (BA) of early menarche girls were significantly higher than normal menarche girls (P ＜ 0.05).The ratio of insulin resistance in early menarche girls (20.5％) was also significantly higher than normal girls (0％).No significant difference in lipid metabolism and gonadal axis between two groups.In girls treated with GnRHa,BMISDS,insulin,HOMA-IR and the ratio of insulin resistance (20.7％) were all significantly higher than normal group (P ＜ 0.05).Meanwhile,DHEAS,androstenedione and testosterone of GnRHa treated girls were significantly higher than early menache girls,and DHEAS was higher than normal girls.The size of uterus in treated group was larger than the other two groups.[Conclusion] Early menarche and GnRHa treatment may take negative effect to BMI and glucose metabolism.Androgen was higher in GnRHa treated group.Therefore,suggestion was that BMI,insulin,blood glucose and androgen should be monitored in early menarche girls and girls treated with GnRHa.

Clinical Effects of Different Doses of Long-acting Gonadotropin Releasing Hormone Agonist (GnRH-a) Versus Daily Injections of Short-acting GnRH-a in IVF Cycles / 医学研究杂志

Objective Clinical efficacy was compared among single injections of different doses of long acting gonadotropin releasing hormone agonist (GnRH-a),and daily injections of short-acting GnRH-a in order to evaluate different methods of ovarian stimulation for in vitro fertilization (IVF) cycles.Methods A retrospective study of 214 patients who underwent IVF assisted fertility treatments was conducted.Patients were allocated into four study groups:the short protocol (group A),in which daily injections of 0.1 mg GnRH-a was administered in the mid-luteal phase until the day of human chorionic gonadotropin (hCG) administration (see below);or the long protocol (group B,C & D),in which single injections of 3.75mg,2.0mg,or 0.9mg of long-acting GnRH-a was given in the mid-luteal phase,respectively.Stimulation with gonadotropins (Gn) started when pituitary down-regulation was established.When vaginal ultrasonographic scans showed that at least two follicles had reached 16-20mm in diameter,Gn stimulation was withdrawn,and serum estradiol (E2),progesterone (P),and luteinizing hormone (LH) were determined.Additionally,human chorionic gonadotropin (hCG) was administered that evening.Egg collection was performed 38 hours after hCG injection and the standard IVF procedure was performed.Results There were no statistically significant differences amongst the four groups when measuring serum LH levels,number of oocytes,number of fertilized eggs,number of good quality embryos,and clinical pregnancy rate.The total amount of Gn administered was almost identical when comparing group A and group D,as well as when comparing group B and group C.However,Group A and D required less Gn stimulation to exhibit follicles of 16-20mm in diameter,compared to group B and C (P ＜0.005).Moreover,there was a significant difference in the time required for ovulation induction between group A and group C,where group A had a shorter time to ovulation.The fertilization rate was statistically different between group B and other groups (P ＜ 0.005).Conclusion Through our data analysis,we conclude based on outcome,cost,side-effects,and simplification of treatments,that the 0.9mg long-acting GnRH-a treatment is eminent for ovarian stimulation for IVF.

Gonadotropin-releasing hormone agonist super-long protocol elevates pregnancy rate of assisted reproductive technique in patients with moderate-to-severe endometriosis / 第二军医大学学报

Objective To explore the impact of gonadotropin-releasing hormone agonist (GnRH-a) super-long protocol on embryo implantation rate and clinical pregnancy rate of in vitro fertilization and embryo transfer (IVF-ET) in patients with moderate-to-severe endometriosis. Methods This retrospective study included 120 women with endometriosis who received IVF-ET from Jun. 2012 to Jul. 2016 in Reproductive Medical Center of Changhai Hospital of Second Military Medical University. Among the 120 patients, 42 received super-long GnRH-a protocol, 38 received long GnRH-a protocol, and 40 received short GnRH-a protocol during IVF-ET. We compared: (1) The patients’ age, infertility years, basal serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E2), and the levels of FSH, LH, E2 and progesterone on the human chorionic gonadotropin hCG day; (2) the average number of retrieved oocyte, fertilization rate, cleavage rate, number of available embryos, embryo implantation rate and clinical pregnancy rate. Results (1) There was no significantdifference in general characteristics between three protocols. (2) Compared with the short GnRH-a protocol group, the super-long GnRH-a protocol and long GnRH-a protocol had significantly decrease serum LH and progesterone levelson the hCG day (all P<0. 05). (3) The fertilization rate, cleavage rate, embryo implantation rate and clinical pregnancy rate of super-long GnRH-a protocol were significantly higher than those of the short GnRH-a protocol (P<0. 05). Conclusion The IVF-ET using super-long GnRH-a protocol can improve the embryo implantation rate and clinical pregnancy rate of the patients withmoderate-to-severe endometriosis compared with using long or short GnRH-a protocol.

Clinical impacts of laparoscopic surgery combined with GnRH-a on endometriosis infertility / 中国内镜杂志

Objective To discuss the clinical impact of laparoscopic surgery combined with GnRH-a for endometriosis infertility. Methods From June 2013 to June 2014, 88 endometriosis infertility patients were selected and divided into study group and the control group by the random number table method. The patients in study group were treated with laparoscopic surgery combined with GnRH-a. The patients in control group were treated with only laparoscopic surgery. The clinical efficacy, ovarian function and pregnancy outcomes of the patients in two groups were compared and analyzed. Results Compared with control group, the patients in study group, the clinical treatment for endometriosis achieved complete remission rate was 65.91 % (29/44) and total effective rate was 93.18 % (41/44), there were increased significantly, and the recurrence rate was 2.27 % (1/44), there was decreased significantly, after statistical analysis, the differences were significant statistically (P < 0.05). Compared with control group, the patients in study group after treatment, the level of E2 was (80.96 ± 17.65) ng/L, there were increased significantly, while the level of LH was (10.94 ± 3.20) IU/L and FSH was (6.24 ± 1.38) IU/L, there were decreased significantly, after statistical analysis, the differences were significant statistically (P < 0.05). Compared with control group, the patients in study group, the pregnancy rate was 47.73 % (21/44) and the living rate was 45.45 % (20/44), there were increased significantly, while the not pregnancy rate was 52.27 % (23/44), there was decreased significantly, after statistical analysis, the differences were significant statistically (P < 0.05). Conclusions Laparoscopic surgery combined with GnRH-a could improve the clinical efficacy of endometriosis infertility patients effectively, and further improve the ovarian function of patients, improve the pregnancy rate significantly.

Comparison of curative effects of GnRH-a and mifepristone in treatment of endometriosis after laparoscopic operation / 中国生化药物杂志

0bjective To compare the curative effects of GnRH-a and mifepristone in treatment of endometriosis after laparoscopic operation.Methods 114 cases of patients were selected from March 2012 to December 2014 in our hospital with endometriosis after laparoscopic surgery,randomly divided into mifepristone group,GnRH-a group and untreated group,each group for 38 cases.mifepristone group were treated by oral mifepristone one week after operation,25 mg,qd,continuing to take 6 months;GnRH-a group,post operative 1 week received injection of GnRH-a (Tamiflu)3.75 mg,once every 4 weeks,6 times in a row;The untreated group,fails to drug treatment.To compare the symptoms,relapse rate pregnancy rate and serum hormones including FSH, LH and E2 levels.Results After treatment, the total effective rate of GnRH-a and mifepristone group is significantly higher than the untreated group(P<0.05),and the recurrence rate is lower than the untreated group(P <0.05),the pregnancy rate is higher than the untreated groups(P<0.05).The recurrence rate,the remission rate and the pregnancy rate of mifepristone group are lower than the untreated group,there was no statistical significance.Conclusion Mifepristone and GnRH-a can both,effectively reduce the recurrence rate after EMT laparoscopic surgery,can guarantee the pregnancy rate,reduce the adverse reaction.

Precocious Pseudopuberty due to Ovarian Causes.

Background: It is important to differentiate central from peripheral causes of precocious puberty because of distinct management options. Case Characteristics: 4 girls with discordant pubertal development. Observations: All had low basal and GnRHa stimulated FSH & LH level with high estradiol level. Abdominal ultrasonogram helped in diagnosing precocious pseudopuberty- ovarian cyst in 3 children and juvenile granulosa cell tumour in one. Outcome: Case 1 and 4 underwent surgery in view of persistent cyst and tumor, respectively. Rest were managed conservatively. Regression of pubertal signs observed in all children during follow-up. Conclusion: Precocious pseudopuberty can be differentiated from central precocious puberty by GnRHa Stimulation test, bone age and abdominal ultrasound.

Effect of Danchi Decoction on Serum Interleukin of Endometriosis / 中国中医药信息杂志

Objective Based on the immunologic balance, to investigate the mechanisms of Danchi decoction for controlling the recurrence of endometriosis (EMs) of qi stagnation and blood stasis after conservative operation. Methods A multi-center and randomized clinical trial was adopted. EMs patients were divided into Chinese medicine group (CG, 20 cases) and western medicine group (WG, 10 cases). The two groups were given Danchi decoction and GnRH-a or gestrinone respectively for 3 months. The serum IL-2, IL-6 and IL-2/IL-6 were detected before operation, after 3 months of treatment and 3 months after withdrawal, and compared with the control group (5 cases of simple ovarian cysts). Results Before operation, the serum IL-2 level of CG and WG was lower than control group (P0.05), but 3 months after withdrawal, IL-2/IL-6 of WG was significantly lower than that of control group (P<0.05). Conclusion Immune imbalance is closely related to the occurrence and development of EMs. Danchi Decoction or GnRH-a or gestrinone can prevent the recurrence of EMs by adjusting the disorder of immune response, and Danchi Decoction has better effect on long-term result.

Clinical Study on Shaoyaozhitong Mixture in Treatment of Stage Ⅲ-Ⅳ Endometriosis / 中国中医药信息杂志

Objective To study the effect of Shaoyaozhitong Mixture on stageⅢ-Ⅳendometriosis, and explore its mechanism. Methods Ninty-five cases of stageⅢ-Ⅳ endometriosis were randomly divided into three groups. The traditional Chinese medicine (TCM) group (31 cases) was treated with Shaoyaozhitong Mixture, the GnRHa group (31 cases) was treated with Triptorelin Acetate for Injection, while the expectant group (33 cases) received no medications. The changes of CA125, TNF-α and VEGF levels, visual pain score and SF-36 score, total effective rate, pregnancy and recurrence were compared. Results There were significant increases in CA125, TNF-α and VEGF levels, visual analogue pain score and SF-36 score in all the three groups after treatment (P0.05). Conclusion Shaoyaozhitong Mixture is effective in treating endometriosis by inhibiting the growth of ectopic endometrium.

Buserelin acetate-induced spermiation in Leptodactylus ocellatus and evaluation of semen characteristics / Espermiação com acetato de buserelina em Leptodactylus ocellatus e avaliação de características seminais

By understanding the hormonal action behind the induction of spermiation in Leptodactylus ocellatus can help in the collection of semen for artificial insemination and cryopreservation. The experiments were conducted at the Experimental Frog Farm of the Federal University of Viçosa. Seven L. ocellatus males with the following secondary sexual characteristics were selected: black thorns, developed forelimbs, and amplexus reflex. Spermiation was induced in these animals by applying daily 0.4 µg buserelin acetate hormone (GnRHa) for 7 days, being the semen collected 90 min after the application. The volume, color, vigor, motility, sperm concentration, and spermatozoa morphology were subsequently evaluated. Three animals responded to GnRHa induction, enabling the collection of seven samples of semen, and the first sample was collected 97.5h after the first application. The semen of the creole frog presented the following characteristics: an average volume of 0.38 mL, murky color, sperm vigor of 3.71, sperm motility of 77.14%, sperm concentration of 6.60 x 106 SPTZ mL-1, and 69% of normal sperm. GnRHa can induce spermiation in the creole frog. Although the volume of collected semen was low, the color, vigor, motility, concentration, and spermatozoa content showed to be adequate.

O conhecimento da ação de hormônios na indução à espermiação de Leptodactylus ocellatus pode permitir a coleta de sêmen para estudos de fertilização artificial e criopreservação. O experimento foi realizado no Ranário Experimental da Universidade Federal de Viçosa, onde sete machos de L. ocellatus com as características sexuais secundárias: acúleos negros, membros anteriores desenvolvidos e reflexos ao amplexo foram induzidos à espermiação com aplicação do hormônio acetato de buserelina (GnRHa) na dosagem de 0,4 µg, durante sete dias a cada 24h e o sêmen coletado após 90 min. O volume, cor do sêmen, vigor espermático, motilidade espermática, concentração espermática e morfologia dos espermatozoides foram avaliados. Três animais responderam à indução pelo acetato de buserelina permitindo a coleta de sete amostras de sêmen, a primeira após 97,5h da primeira aplicação. O sêmen da rã-manteiga apresentou volume médio de 0,38 mL, coloração turva, vigor espermático de 3,71; motilidade espermática de 77,14%, concentração de 6,60 x 106 SPTZ mL-1 e 69% de espermatozoides normais. O acetato de buserelina pode induzir à espermiação da rã-manteiga. O volume seminal coletado foi baixo, mas a coloração, vigor, motilidade, concentração e número de espermatozoides de L. ocellatus foram adequados.

Near-final height in patients with congenital adrenal hyperplasia treated with combined therapy using GH and GnRHa / Altura quase normal em pacientes com hiperplasia adrenal congênita tratados com a combinação de GH e GnRHa

INTRODUCTION: Intrinsic limitations of glucocorticoid therapy in patients with congenital adrenal hyperplasia (CAH) determine frequent loss in final height. The association of secondary central precocious puberty and early epiphyseal fusion is also frequent. In these conditions, GnRHa treatment alone or in combination with GH has been indicated. OBJECTIVES: This is a retrospective study, describing the estatural findings of CAH patients with significant decrease in height prediction, who were submitted to combined GH plus GnRHa therapy up to near-final height. SUBJECTS AND METHODS: We studied 13 patients, eight females and five males, eight with the classical and five with the nonclassical form of the disorder. Treatment with hydrocortisone (10-20 mg/m²/day) or prednisolone (3-6 mg/kg/day) was associated with GnRHa (3.75 mg/months) for 4.0 (1.5) years, and GH (0.05 mg/kg/day) for 3.6 (1.4) years. RESULTS: Stature standard deviation score for bone age improved significantly after GH treatment, becoming similar to target height at the end of the second year of GH treatment. CONCLUSION: We conclude that combined GH plus GnRHa therapy can be useful in a subset of CAH patients with significant reduction of predicted final height associated with poor hormonal control and central precocious puberty.

INTRODUÇÃO: As limitações intrínsecas da terapia com glicocorticoides em pacientes com hiperplasia adrenal congênita (HAC) frequentemente determinam menor altura final. Também é frequente a associação de puberdade precoce central secundária e fusão epifisária precoce. Nessas condições, tem sido indicado o tratamento com GnRHa sozinho ou em combinação com o GH. OBJETIVOS: Este é um estudo retrospectivo que descreve os achados de altura em pacientes com HAC que apresentavam diminuição significativa na altura predita e que foram submetidos ao tratamento combinado de GH com GnRHa até a altura quase normal. SUJEITOS E MÉTODOS: Estudamos 13 pacientes, oito do sexo feminino e cinco do sexo masculino, oito com a forma clássica e cinco com a forma não clássica da doença. O tratamento com hidrocortisona (10-20 mg/m²/dia) ou prednisolona (3-6 mg/kg/day) foi associado com GnRHa (3,75 mg/meses) por 4,0 (1,5) anos, e GH (0,05 mg/kg/dia) por 3,6 (1,4) anos. RESULTADOS: O escore de desvio-padrão da estatura para a idade óssea melhorou significativamente após o tratamento com GH, tornando-se similar à altura normal ao final do segundo ano desse tratamento. CONCLUSÃO: Concluímos que o tratamento de combinação com GH e GnRHa pode ser útil em um subgrupo de pacientes com HAC que apresentem redução significativa da altura final predita, associado com controle hormonal inadequado e puberdade central precoce.