Vaginal Electrical Impedance Detects the Fertile Window in Healthy Women: a Pilot Study / La Impedancia Eléctrica Vaginal Detecta la Ventana Fértil en Mujeres Sanas: un Estudio Piloto

ABSTRACT This work analyzes the electrical impedance (EI) measurement of cervical mucus (CM) using a device to determine the fertile window. In this prospective and longitudinal study, fourteen healthy women aged 18 to 44 were enrolled to evaluate three menstrual cycles. EI was measured through a medical device inserted into the vagina for two minutes daily. Patients were monitored by urine luteinizing hormone (LH) strip, blood collection, and vaginal ultrasound to visualize the dominant follicle. Finally, the predictive EI capacity was validated by the receiver operating characteristic (ROC) of anovulatory vs. ovulatory impedances. The peak of LH was 35.7 (±4.5) mUI/ml and the dominant follicle size was 15.45 mm (±0.559). There were statistical differences in EI measurements between the follicular and luteal phases vs. the ovulation phase (p<0.0361 and p<0.0160). After data normalization, an area under the ROC curve (AUC) of 0.713 (P value= 0.0253), a Youden J index of 0.4545Ω, a sensitivity of 63.6%, and a specificity of 81.8% were found. Low EI in the ovulatory period belongs to the LH ovulatory peak and follicular release. EI can be used for ovulation monitoring, birth control, or promoting pregnancy as a safe and innocuous method.

RESUMEN Este trabajo analiza la medición de la impedancia eléctrica (IE) del moco cervical (MC) mediante un dispositivo para determinar la ventana fértil. En este estudio prospectivo y longitudinal, se incluyeron 14 mujeres sanas de 18 a 44 años para evaluar tres ciclos menstruales. La IE se midió a través de un dispositivo médico colocado en la vagina durante dos minutos diarios. Las pacientes fueron monitoreadas con una tira de hormona luteinizante (LH) en orina, recolección de sangre y ultrasonido vaginal para visualizar el folículo dominante. Finalmente, la capacidad predictiva de IE fue validada por la curva ROC (receiver operating characteristic) de impedancias anovulatorias vs. ovulatorias. El pico de LH fue de 35.7(±4.5) mUI/ml; el folículo de tamaño dominante fue de 15.45 mm (±0.559). Se encontraron diferencias estadísticas para la medición de la IE de las fases folicular y lútea versus la fase de ovulación (p<0.0361 y p<0.0160). Después de la normalización de los datos, se encontró un área bajo la curva ROC (AUC) de 0.713 (valor de P = 0.0253), un índice de Youden J de 0.4545 Ω, sensibilidad del 63.6 % y especificidad del 81.8 %. La IE baja en el período ovulatorio que pertenece al pico ovulatorio de LH y liberación folicular. La IE se puede utilizar para el control de la ovulación, el control de la natalidad o la promoción del embarazo como método seguro e inocuo.

Effects of aging and the body mass index on male sex hormones: a cross-sectional study in 701 Brazilian men / Efeitos do envelhecimento e do índice de massa corporal sobre os hormônios sexuais masculinos: um estudo transversal em 701 homens brasileiros

Background: Some studies indicated that body mass index (BMI) is inversely proportional to serum testosterone concentrations in men. Purposes: This study aimed to analyze the effects of aging and obesity on total testosterone (TT), free testosterone (FT), bioavailable testosterone (BT), luteinizing hormone (LH), and sex hormone-binding globulin (SHBG) levels. Methods: A cross-sectional study was performed to assess the clinical and laboratory profiles of 701 patients treated at a private urology clinic in Ponta Grossa, Brazil, from January 2016 to December 2018. Results: Patients' age ranged from 16 to 88 years (mean, 56.9 ± 13.62 years). Age did not significantly influence serum TT concentrations, except compared to patients aged >70 years. However, changes were observed in FT and BT (p < 0.05). The mean SHBG increased with age (p < 0.05). A tendency toward LH elevation was observed in older patients, but it was not statistically significant. An inverse proportional relationship between TT, FT, and BT and the testosterone deficiency rate (TT < 300 ng/dL) was observed within BMI groups (p < 0.05). The testosterone deficiency rate was 21.5% in individuals with normal BMI, 29% in overweight individuals, and 37% in obese individuals. Conclusions: Aging affected the testosterone concentrations in men and became increasingly evident using FT and BT instead of TT. SHBG increased with age. Obesity was associated with a decrease in TT, FT, and BT but also increased the rate of hypogonadism. (AU)

Fundamentos: Alguns estudos indicam que o índice de massa corporal (IMC) é inversamente proporcional à con-centração de testosterona sérica em homens. Objetivos: O objetivo deste estudo é analisar o efeito do envelhe-cimento e da obesidade na testosterona biodisponível total e livre, bem como nos níveis de hormônio luteinizante e globulina ligadora de hormônio sexual. Métodos: Foi realizado um estudo transversal abordando o perfil clínico e laboratorial de 701 pacientes atendidos em uma clínica privada de urologia em Ponta Grossa, Brasil, de janei-ro de 2016 a dezembro de 2018. Resultados: A idade dos pacientes variou de 16 a 88 anos (média de 56,9 ± 13,62 anos). A idade não influenciou significativamente as concentrações séricas de testosterona total, exceto quando comparada a pacientes com mais de 70 anos. No entanto, foi observada diferença na testosterona livre e biodisponível (p <0,05). A média de globulina de ligação aos hormônios sexuais aumentou com a idade (p <0,05). Embora uma tendência à elevação da luteinização tenha sido observada em pacientes mais idosos, ela não foi significativa. Relação inversa entre testosterona total, livre e biodisponível e taxa de deficiência de testosterona (testosterona total <300 ng / dL) foi observada dentro dos grupos de índice de massa corporal (p <0,05). A taxa de deficiência de testosterona em indivíduos com índice de massa corporal normal foi de 21,5%, indivíduos com sobre-peso foi de 29% e em indivíduos com obesidade foi de 37%. Conclusões: O envelhecimento afetou a concentração de testosterona em homens, mais evidente ao avaliar testosterona livre e biodisponível em vez de testosterona total. A globulina de ligação aos hormônios sexuais aumentou com a idade. A obesidade foi associada à redução da testosterona total, livre e biodisponível e ao aumento da taxa de hipogonadismo. (AU)

Evaluation of fertility and embryo implantation in rats after the oral administration of Salvia officinalis (sage) extract / Evaluación de la fertilidad y la implantación de embriones en ratas después de la administración oral de extracto de Salvia officinalis (salvia)

SUMMARY: In Saudi Arabia, it is widely believed that women with reproductive problems can use the extract of the sage plant as a tea drink. This study was conducted to investigate the effects of this herb on the fertility of female rats and embryo implantation. Forty-eight Wistar virgin female rats were divided into four groups at random, with 12 rats in each group. The control group received distilled water orally. The three treatment groups received different concentrations of sage extract: 15, 60, or 100 mg/kg for 14 days before mating, then mated with a male and sacrificed on the 7th day of gestation, the uterine horns removed, and photographed. The total body weight of mothers, weight of uteri and ovaries and number of fetuses were determined. Ovarian and uteri tissues were cut into 5 µ sections and stained with hematoxylin and eosin. Serum FSH, LH were determined by the ELISA method. The present study showed that low dose of sage (15 mg/kg) have no effects on serum concentration levels of FSH and LH hormones, also has no effect on the number of growing follicles. The present study showed a significant differences (P≤0.05) in body weight, ovary and uterus weight in the groups treated with high doses of Salvia officinalis as compared to control group. Also a significant differences (P≤0.05) found in FSH, LH hormones. Histological study showed overall histomorphological structural configurations including growing and matured graafian follicular countable changes, besides a number of corpora lutea and regressed follicles in the treated groups with high doses of Salvia officinalis as compared to control group. The researchers concluded that the extract of the sage plant with high doses can stimulate the growth graafian follicles and improve fertility in female rats.

RESUMEN: En Arabia Saudita, se cree ampliamente que las mujeres con problemas reproductivos pueden usar el extracto de la planta de salvia como bebida de té. Este estudio se realizó para investigar los efectos de esta hierba sobre la fertilidad de las ratas hembra y la implantación del embrión. Se dividieron cuarenta y ocho ratas hembra vírgenes Wistar en cuatro grupos al azar, con 12 ratas en cada grupo. El grupo control recibió agua destilada por vía oral. Los tres grupos de tratamiento recibieron diferentes concentraciones de extracto de salvia: 15, 60 o 100 mg/kg durante 14 días antes del apareamiento, luego se aparearon con un macho y se sacrificaron el día 7 de gestación, se extrajeron los cuernos uterinos y se fotografiaron. Se determinó el peso corporal total de las madres, el peso del útero y los ovarios y el número de fetos. Los tejidos ováricos y uterinos se cortaron en secciones de 5 µ y se tiñeron con hematoxilina y eosina. FSH sérica, LH se determinaron por el método ELISA. El presente estudio mostró que dosis bajas de salvia (15 mg/kg) no tienen efectos sobre los niveles de concentración sérica de las hormonas FSH y LH, tampoco tienen efecto sobre el número de folículos en crecimiento. El presente estudio mostró diferencias significativas (P≤0,05) en el peso corporal, peso de ovario y útero en los grupos tratados con altas dosis de Salvia officinalis en comparación con el grupo control. También se encontraron diferencias significativas (P≤0,05) en las hormonas FSH, LH. El estudio histológico mostró configuraciones estructurales histomorfológicas generales que incluyen cambios contables en los folículos maduros (de Graaf) y en crecimiento, además de una cantidad de cuerpos lúteos y folículos en regresión en los grupos tratados con altas dosis de Salvia officinalis en comparación con el grupo de control. Los investigadores concluyeron que el extracto de la planta de salvia en altas dosis puede estimular el crecimiento de los folículos maduros y mejorar la fertilidad en ratas hembra.

Improving Implantation Rate in 2nd ICSI Cycle through Ovarian Stimulation with FSH and LH in GNRH Antagonist Regimen / Melhorando a taxa de implantação no 2° ciclo de ICSI através do estímulo ovariano com FSH e LH no regime com antagonista do GnRH

Abstract Objective To investigate whether patients with a previous recombinant follicle stimulating hormone (rFSH)-stimulated cycle would have improved outcomes with rFSH + recombinant luteinizing hormone (rLH) stimulation in the following cycle. Methods For the present retrospective case-control study, 228 cycles performed in 114 patients undergoing intracytoplasmic sperm injection (ICSI) between 2015 and 2018 in an in vitro fertilization (IVF) center were evaluated. Controlled ovarian stimulation (COS) was achieved with rFSH (Gonal-f, Serono, Geneva, Switzerland) in the first ICSI cycle (rFSH group), and with rFSH and rLH (Pergoveris, Merck Serono S.p.A, Bari, Italy) in the second cycle (rFSH + rLH group). The ICSI outcomes were compared among the groups. Results Higher estradiol levels, oocyte yield, day-3 high-quality embryos rate and implantation rate, and a lower miscarriage rate were observed in the rFSH + rLH group compared with the rFSH group. In patients < 35 years old, the implantation rate was higher in the rFSH + rLH group compared with the rFSH group. In patients ≥ 35 years old, higher estradiol levels, oocyte yield, day-3 high-quality embryos rate, and implantation rate were observed in the rFSH + rLH group. In patients with ≤ 4 retrieved oocytes, oocyte yield, mature oocytes rate, normal cleavage speed, implantation rate, and miscarriage rate were improved in the rFSH + rLH group. In patients with ≥ 5 retrieved oocytes, higher estradiol levels, oocyte yield, and implantation rate were observed in the rFSH + rLH group. Conclusion Ovarian stimulation with luteinizing hormone (LH) supplementation results in higher implantation rates, independent of maternal age and response to COS when compared with previous cycles stimulated with rFSH only. Improvements were also observed for ICSI outcomes and miscarriage after stratification by age and retrieved oocytes.

Resumo Objetivo: Investigar se há algum efeito da suplementação com hormônio luteinizante (LH, na sigla em inglês) no regime com antagonista do hormônio liberador de gonadotropina (GnRH, na sigla em inglês) sobre os resultados dos ciclos consecutivos de injeção intracitoplasmática de espermatozoides (ICSI, na sigla em inglês). Métodos Para o presente estudo retrospectivo de caso-controle, foram avaliados 228 ciclos de microinjeção intracitoplasmática de espermatozoides (ICSI, na sigla em inglês) realizados em 114 pacientes entre 2015 e 2018 em um centro privado de fertilização in vitro (FIV) afiliado a uma universidade. O estímulo ovariano controlado (EOC) foi feito com hormônio folículo- estimulante recombinante (rFSH, na sigla em inglês) (Gonal-f, Serono, Genebra, Suíça) no primeiro ciclo de ICSI (grupo rFSH), e com rFSH e rLH (Pergoveris, Merck Serono S.p.A, Bari, Itália) no segundo ciclo (grupo rFSH + rLH). Os desfechos dos ciclos de ICSI foram comparados entre os grupos. Resultados Níveis mais elevados de estradiol, de recuperação oocitária, taxa de embriões de alta qualidade no 3° dia e taxa de implantação, e menor taxa de aborto foram observados no grupo rFSH + rLH. Em pacientes < 35 anos, a taxa de implantação foi maior no grupo rFSH + rLH em comparação com o grupo rFSH. Em pacientes com ≥ 35 anos, maiores níveis de estradiol, recuperação oocitária, a taxa de embriões de alta qualidade no 3° dia e a taxa de implantação foram observados no grupo rFSH + rLH. Em pacientes com baixa resposta ao EOC (≤ 4 oócitos recuperados), a recuperação oocitária, a taxa de oócitos maduros, a taxa de velocidade normal de clivagem, a taxa de implantação e a taxa de aborto foram melhoradas no grupo rFSH + rLH. Em pacientes com resposta normal ao EOC (≥ 5 oócitos recuperados), níveis mais elevados de estradiol, recuperação oocitária e taxa de implantação foram observados no grupo rFSH + rLH. Conclusão A estimulação ovariana com suplementação de LH resultou em taxas de implantação mais altas, independentemente da idade materna e da resposta ao EOC, em comparação com os ciclos anteriores estimulados apenas com rFSH. Melhorias também foram observadas nos resultados da ICSI e na taxa de aborto quando as pacientes foram estratificadas por idade e número de oócitos recuperados.

Morphology and Biochemistry of Ovulation Morfologia e bioquímica da ovulação

Abstract The process of ovulation involves multiple and iterrelated genetic, biochemical, and morphological events: cessation of the proliferation of granulosa cells, resumption of oocyte meiosis, expansion of cumulus cell-oocyte complexes, digestion of the follicle wall, and extrusion of the metaphase-II oocyte. The present narrative review examines these interrelated steps in detail. The combined or isolated roles of the folliclestimulating hormone (FSH) and luteinizing hormone (LH) are highlighted. Genes indiced by the FSH genes are relevant in the cumulus expansion, and LH-induced genes are critical for the resumption ofmeiosis and digestion of the follicle wall. A nonhuman model for follicle-wall digestion and oocyte release was provided.

Resumo O processo de ovulação envolve modificações genéticas, bioquímicas e morfológicas múltiplas e interrelacionadas: suspensão da proliferação das células da granulosa, reinício da meiose do oócito, expansão das células do complexo cumulus-oócito, digestão da parede folicular, e extrusão do oócito. Esta revisão narrativa examina em detalhes cada um desses eventos e os principais genes e proteínas envolvidos. Mais importante, a ação combinada ou isolada do hormônio folículo-estimulante (HFE) e do hormônio luteinizante (HL) é destacada. Detalha-se o papel do HFE na expansão do cumulus e do HL na digestão da parede folicular, permitindo a extrusão do oócito na superfície ovariana. Proveu-se um modelo não humano para explicar a digestão da parede folicular.

Diagnóstico de pubertad precoz / Diagnosis of precocious puberty: clinical guideline for the diagnosis and treatment of precocious puberty

Resumen La Sociedad Mexicana de Endocrinología Pediátrica elaboró una guía de práctica clínica para el diagnóstico y el tratamiento de la pubertad precoz. Este documento presenta recomendaciones relacionadas con el diagnóstico de pubertad precoz. La descripción detallada de la metodología para el desarrollo de esta guía y del sistema de gradación, así como la síntesis de la evidencia en la que se basa, pueden consultarse en este suplemento.

Abstract The Mexican Society of Pediatric Endocrinology developed a clinical practice guide for the diagnosis and treatment of precocious puberty. This document presents recommendations related to the diagnosis of precocious puberty. The detailed description of the methodology for the development of this guide and the grading system, as well as the synthesis of the evidence on which it is based can be accessed in this same supplement.

Relevancia de componentes del eje hipotálamo-hipófisis-gonadal en la fisiopatología de proteinopatías del sistema nervioso / Relevance of components of the hypothalamic-pituitary-gonadal axis in the pathophysiology of proteinopathies of the nervous system

RESUMEN Introducción: Varias proteinopatías del sistema nervioso están asociadas a la ocurrencia de alteraciones en componentes del eje hipotálamo-hipófisis-gonadal. Objetivo: Reflejar la relevancia de componentes del eje hipotálamo-hipófisis-gonadal en la fisiopatología de proteinopatías del sistema nervioso. Material y Métodos: Se realizó una revisión bibliográfica durante los meses de enero de 2018 a diciembre de 2018. Fueron consultadas bases de datos de referencia, con el uso de descriptores y operadores booleanos. La estrategia de búsqueda avanzada para la selección de los artículos fue empleada, teniendo en cuenta la calidad metodológica o validez de los estudios. Desarrollo: Fueron identificaron alteraciones del funcionamiento normal del eje hipotálamo-hipófisis-gonadal en varias proteinopatías del sistema nervioso. Las alteraciones más frecuentemente reportadas fueron el incremento en los niveles de gonadotropinas, principalmente de la hormona luteinizante, en la enfermedad de Alzheimer, y la disminución de los niveles de testosterona en las enfermedades de Alzheimer, Parkinson, Huntington y Esclerosis Lateral Amiotrófica, con el consiguiente agravamiento del fenotipo clínico. Se obtuvieron evidencias de naturaleza preliminar, que fundamentan la posible ocurrencia de disfunción hipotalámica en pacientes con ataxias espinocerebelosas. Conclusiones: Aun cuando existen evidencias que demuestran la existencia de un vínculo entre la fisiopatología de proteinopatías del sistema nervioso y alteraciones en componentes del eje hipotálamo-hipófisis-gonadal, se requerirán estudios más extensos e integrales para confirmar estas asociaciones y para caracterizar los mecanismos moleculares implicados.

ABSTRACT Introduction: Several proteinopathies of the nervous system are associated with disturbances in components of the hypothalamic-pituitary-gonadal axis. Objective: To assess the relevance of components of the hypothalamic-pituitary-gonadal axis in the pathophysiology of proteinopathies of the nervous system. Material and Methods: A literature review was carried out from January to December 2018. Several databases were searched by using descriptors and Boolean operators. Advanced search strategy was used for the selection of articles, taking into account the methodological quality and validity of the studies. Results: Disturbances of the normal function of the hypothalamic-pituitary-gonadal axis were identified in proteinopathies of the nervous system. The most frequently reported disturbances were the increase in gonadotropin levels, mainly in luteinizing hormone in Alzheimer´s disease, and the decrease in testosterone levels in Alzheimer´s, Parkinson´s and Huntington´s diseases, and Amyotrophic Lateral Sclerosis, with the resulting worsening of the clinical phenotype. Preliminary evidence was obtained, which was pointing to a possible hypothalamic dysfunction in Spinocerebellar ataxia patients. Conclusions: Even when evidences were gathered supporting a link between the pathophysiology of proteinopathies of the nervous system and disturbances in components of the hypothalamic-pituitary-gonadal axis, deeper and more comprehensive studies will be needed to confirm these associations and to characterize the underlying molecular mechanisms.

Sincronización del estro en ovejas de pelo mediante protocolo basado en prostaglandinas + GnRH / Estrous synchronization in hair sheep using a protocol based on prostaglandin + GnRH

Resumen El uso de progestágenos puede contaminar el medio ambiente y el tejido animal, por lo que el uso de prostaglandinas F2α (PGF2α) y hormona liberadora de gonadotropinas (GnRH) pueden representar una alternativa viable. El objetivo del presente trabajo fue evaluar el efecto de aplicar una dosis de GnRH en el intervalo de aplicación de dos dosis de PGF2α, y compararlo con protocolos basados en progestágenos y PGF2α, comúnmente utilizados en la sincronización de estros, con respecto al pico pre-ovulatorio de la hormona luteinizante (LH), concentraciones de progesterona post-estro, tasa de preñez, pariciones y prolificidad. Después de una pre-sincronización con doble aplicación de PGF2α, 30 ovejas adultas multíparas (peso vivo = 45 ± 3.1 kg, condición corporal= 3.2 ± 0.5 unidades y tiempo post-parto = 60 d a 90 d) fueron asignadas aleatoriamente a uno de tres tratamientos (n = 10). Grupo 1: P (Testigo), recibieron dosis única de 125 μg de cloprostenol por vía IM (intramuscular); Grupo 2: FP, recibieron esponjas intravaginales que contenían 20 mg de acetato de fluorgestona por 5 d, y al retiro de la esponja fueron inyectadas con 125 μg de cloprostenol vía IM; Grupo 3: GP, recibieron 50 μg de GnRH IM, y 7 d después fueron inyectadas con 125 μg de cloprostenol. El inicio del estro fue más rápido (P ≤ 0.05) en el grupo P comparado con el grupo FP. El grupo GP (P ≤ 0.05) tuvo mayores concentraciones de progesterona después de 5 d postestro, comparado con los grupos P y FP. La tasa de preñez no fue diferente (P > 0.05) entre grupos. Los protocolos de sincronización evaluados fueron semejantes en su efectividad para mejorar el comportamiento reproductivo en ovejas de pelo. Se recomienda usar protocolos basados en su aplicación de PGF2α, debido a su facilidad de aplicación.

Abstract The use of progestogens can contaminate the environment and animal tissue. Therefore, the use of prostaglandins F2α (PGF2α) and gonadotropin-releasing hormone (GnRH) may represent a viable alternative. The aim of the present work was to evaluate the effect of applying a dose of GnRH within the range of application of two doses of PGF2α, and compare it with protocols based on progestogens and PGF2α, commonly used in the synchronization of estrus, with respect to the pre-ovulatory peak of luteinizing hormone (LH), post-estrus progesterone concentrations, pregnancy rate, calving and prolificacy. After a pre-synchronization with a double application of PGF2α, 30 multiparous adult ewes (live weight = 45 ± 3.1 kg, body condition = 3.2 ± 0.5 units and postpartum time = 60 d to 90 d, were randomly assigned to one of three treatments (n = 10). The ewes in Group 1: P (Control) received a single dose of 125 μg of cloprostenol via IM (intramuscular); the ewes in Group 2: FP received intravaginal sponges containing 20 mg of fluorogestone acetate for 5 d; and upon removal of the sponge, they were injected with 125 μg of cloprostenol via IM; the ewes in Group 3: GP received 50 μg of GnRH IM, and 7 d later they were injected with 125 μg of cloprostenol. The onset of estrus was detected faster (P ≤ 0.05) in P and GP groups than in the FP group. The GP group (P ≤ 0.05) had higher concentrations of progesterone after 5 d post-estrus, compared to the P and FP groups. The pregnancy rate was not different (P > 0.05) between groups. All the synchronization protocols evaluated were similar in the effectiveness to improve the reproductive behavior in hair sheep. Therefore, the use of protocols based on the application of PGF2α is recommended, due to their its ease of application.

Climaterio y menopausia / Climacteric and menopause

Resumen La menopausia es el cese de los periodos menstruales de una mujer, diagnosticada en retrospectiva, una vez que han transcurrido 12 meses consecutivos de amenorrea, que sucede por atresia de los folículos ováricos y su capacidad de producir estrógenos ante el estímulo de las hormonas folículo-estimulante y luteinizante. A los signos y síntomas que se presentan en esta transición se les denomina síndrome climatérico y los más característicos son los bochornos, alteraciones del ánimo, osteoporosis, aumento de riesgo cardiovascular y alteraciones genitourinarias. Si el descenso de la producción de estrógenos produce esta sintomatología, entonces el tratamiento será reemplazar ese descenso hormonal con estrógenos y progestágenos exógenos, considerando siempre la sintomatología de la paciente y el riesgo-beneficio, esperando mejorar su calidad de vida. También es importante hacer una evaluación integral y modificar estilos de vida.

Abstract Menopause is a retrospective diagnosis given by the end of menstrual periods for 12 months, it´s consenquence by lack stimulus of Follicle stimulanting hormone and Luteinizing hormone and ovarian follicles atresia which leads to the inability to produce estrogens. Climateric syndrome is the set of signs and symptoms that occur in this transition, among the most important characteristic are hot flashes, emotional lability, osteoporosis, increased cardiovascular risk and genitourinary disorders. The decrease in the estrogen production produces this symptomatology therefore the treatment is hormonal replacement with exogenous estrogens and progestogens, always considering the patient's symptomatology and the risk-benefit, looking for improving their quality of life. It´s important to remember to make an evaluation of current lifestyle to make changes for the benefit patient.

Advanced bone age as an indicator facilitates the diagnosis of precocious puberty / Idade óssea avançada como um indicador de facilitação do diagnóstico de puberdade precoce

Abstract Objective: Diagnosis of central precocious puberty has always been challenging in clinical practice. As an important method in the diagnosis of central precocious puberty, luteinizing hormone-releasing hormone stimulation test is complex and time-consuming. In many cases, clinical traits are inconsistent with luteinizing hormone-releasing hormone stimulation test results, therefore not reliable for diagnosis. In this study, the authors intended to find an indicator that predicts the results of the luteinizing hormone-releasing hormone stimulation test among subjects with early pubertal signs. Methods: Cases of 382 girls with early breast development before 8 years old and luteinizing hormone-releasing hormone stimulation test before 9 years old were included and underwent follow-up tests. Patients with peak luteinizing hormone level ≥5 IU/L were considered positive in the luteinizing hormone-releasing hormone stimulation test. Anthropometric data, body mass index, bone age evaluation, blood hormones levels of luteinizing hormone, estradiol, follicle-stimulating hormone, and uterine and ovarian volumes were analyzed. Results: Subjects with positive results in the initial test demonstrated early bone maturation, accelerated growth, and elevated basal blood luteinizing hormone, estradiol, and follicle-stimulating hormone levels, when compared with subjects with negative results in the initial test. Subjects with positive results in the follow-up test presented a more advanced bone age and more accelerated linear growth, when compared with subjects with negative results in the follow-up test. Conclusions: According to the statistical analysis, advanced bone age is the most effective predictor of the result of luteinizing hormone-releasing hormone stimulation test.

Resumo Objetivo: O diagnóstico da puberdade precoce central sempre foi complicado na prática clínica. Como um importante método no diagnóstico de puberdade precoce central, o teste de estimulação do hormônio liberador do hormônio luteinizante é complexo e demorado. Em muitos casos, as características clínicas são incompatíveis com os resultados do teste de estimulação do hormônio liberador do hormônio luteinizante e, assim, não são confiáveis para o diagnóstico. Neste estudo, visamos constatar um indicador que previsse os resultados do teste de estimulação do hormônio liberador do hormônio luteinizante entre indivíduos com sinais puberais precoces. Métodos: Foram incluídos casos de 382 meninas com desenvolvimento precoce das mamas antes dos 8 anos de idade e teste de estimulação do hormônio liberador do hormônio luteinizanteantes dos 9 anos e elas foram submetidas a testes de acompanhamento. Os resultados das pacientes com nível máximo de hormônio luteinizante ≥ 5 IU/L foram consideradas positivos no teste de estimulação do hormônio liberador do hormônio luteinizante. Foi feita uma análise dos dados antropométricos, do índice de massa corporal, da avaliação da idade óssea, dos níveis sanguíneos de hormônio luteinizante, volumes uterinos e ovarianos de estradiol (E2) e do hormônio folículo-estimulante. Resultados: Os indivíduos com resultado positive no teste inicial demonstraram maturação precoce do osso, crescimento acelerado e níveis sanguíneos elevados de hormônio luteinizante, estradiol e hormônio folículo-estimulante, em comparação aos indivíduos com resultados negativos no teste inicial. Os indivíduos com resultados positivos no teste de acompanhamento apresentaram um maior avanço na idade óssea e crescimento linear mais acelerado, em comparação aos indivíduos com resultados negativos no teste de acompanhamento. Conclusões: De acordo com a análise estatística, a idade óssea avançada é o indicador mais efetivo do resultado do teste de estimulação do hormônio liberador do hormônio luteinizante.

Resultados en ciclos de FIV-ICSI adicionando hormona luteinizante recombinante a la hormona folículo estimulante recombinante con menotropinas durante la estimulación ovárica en pacientes mayores de 35 años / Results in IVF-ICSI cycles adding luteinizing hormone recombinant to follicle stimulating hormone recombinant with menotropins during ovarian stimulation in patients over 35 years-old

Resumen OBJETIVO Evaluar los resultados en ciclos de FIV-ICSI de dos protocolos de estimulación ovárica en mujeres mayores de 35 años e investigar si agregar hormona luteinizante recombinante a FSH-r en un protocolo de estimulación mejora la respuesta ovárica y, en consecuencia, las tasas de embarazo en este grupo poblacional. MATERIALES Y MÉTODOS Estudio longitudinal, observacional y retrospectivo efectuado en pacientes de la Clínica de Reproducción Hisparep del Hospital Español con diagnóstico de infertilidad, mayores de 35 años, que recibieron un ciclo de hiperestimulación ovárica controlada con FIV-ICSI durante el periodo 2014-2016. El análisis estadístico se efectuó con la prueba de t de Student para muestras independientes. Los estudios se analizaron con el paquete estadístico SPSS IBM, versión 22. RESULTADOS Se analizaron 201 mujeres con infertilidad, mayores de 35 años. El grupo 1 (n = 101) de FIV-ICSI recibió estimulación con hormona folículo estimulante recombinante y hormona luteinizante recombinante 2:1 con menotropinas (Pergoveris® y Merapur®) a partir del segundo día del ciclo. El grupo 2 (n = 100) recibió hormona folículo estimulante recombinante y menotropinas (Gonal F® y Merapur®); en ambos esquemas se utilizó antagonista de GnRH a partir del día 7 del ciclo. La media de ovocitos aspirados fue de 7.5 en el grupo 1 y 9.1 en el grupo 2 (p = 0.058). La media de ovocitos maduros fue 6.2 en el Grupo 1 vs 7.4 en el grupo 2 (p = 0.085). La tasa de fecundación en el grupo 1 fue de 57 vs 67% en el grupo 2 (p = 0.045). En el grupo 1 la tasa de implantación por embrión transferido en fresco fue 24.1 vs 10.3% en el Grupo 2 (p = 0.40), la tasa de recién nacido vivo fue de 30% en el Grupo 1 vs 20.6% en el Grupo 2. La media de embriones vitrificados en el Grupo 1 fue 1.47 vs 1.38 en el Grupo 2. CONCLUSIONES La probable ventaja de la complementación con hormona folículo estimulante recombinante durante la estimulación ovárica en mujeres mayores de 35 años es de interés y se requiere su evaluación en estudios posteriores.

Abstract OBJECTIVE To evaluate the reproductive effects when recombinant luteinizing hormone is added and to compare two stimulation schemes by number of aspirated oocytes, mature oocytes, fertilization and implantation rates, live newborn and number of vitrified embryos. MATERIALS AND METHODS Longitudinal, observational and retrospective study carried out in patients of the Hisparep Reproduction Clinic of the Spanish Hospital with diagnosis of infertility, over 35 years old, who received a controlled ovarian hyperstimulation cycle with IVF-ICSI during the period 2014-2016. The statistical analysis was carried out with the Student t test for independent samples. The studies were analyzed with the IBM SPSS statistical package, version 22. RESULTS We analyzed 201 women with infertility, over 35 years of age. Group 1 (n = 101) of IVF-ICSI received stimulation with recombinant follicle-stimulating hormone and recombinant luteinizing hormone 2: 1 with menotropins (Pergoveris® and Merapur®) from the second day of the cycle. Group 2 (n = 100) received recombinant follicle stimulating hormone and menotropins (Gonal F® and Merapur®); in both schemes, GnRH antagonist was used from day 7 of the cycle. The average number of aspirated oocytes was 7.5 in Group 1 and 9.1 in Group 2 (p = 0.058). Mean mature oocytes were 6.2 in Group 1 vs 7.4 in Group 2 (p = 0.085). The fertilization rate in group 1 was 57 vs. 67% in Group 2 (p = 0.045). In Group 1 the implantation rate per embryo transferred fresh was 24.1 vs 10.3% in Group 2 (p = 0.40), the live newborn rate was 30% in Group 1 vs 20.6% in Group 2. The mean number of vitrified embryos in Group 1 was 1.47 vs 1.38 in Group 2. CONCLUSIONS The probable advantage of supplementation with recombinant follicle-stimulating hormone during ovarian stimulation in women over 35 years of age is of interest and its evaluation is required in subsequent studies.

Acción de Lachesis trigonocephalus en diferentes potencias sobre las catecolaminas cerebrales / Lachesis trigonocephalus action in different potencies on brain catecholamines

Durante el Congreso Internacional del Centenario de la Escuela Libre de Homeopatía de México, celebrado en 2012, la doctora Josefina Sánchez Reséndiz presentó esta ponencia para hablar de los beneficios que la salud femenina puede tener gracias al uso de algunos medicamentos homeopáticos, en especial Lachesis trigonocephalus. De manera breve y precisa, la doctora Sánchez Reséndiz recordó los resultados de las investigaciones que realizó con el doctor Ángel Lerdo de Tejada y colaboradores sobre las catecolaminas cerebrales, partiendo de que la dopamina cerebral, a nivel del hipotálamo, tiene una gran influencia en la hormona luteinizante y en la conducta. Se pudo observar que el medicamento homeopático Lachesis trigonocephalus, a diferentes potencias, puede generar modificaciones estadísticamente significativas en las catecolaminas cerebrales, mecanismo por el cual, su uso podría ser capaz de mejorar los síntomas de la mujer durante el climaterio y la menopausia...

During the International Congress, in the 100th aniversary of the Escuela Libre de Homeopatía in Mexico, held in 2012, Josefina Sanchez Resendiz MD presented this conference to discuss about women’s health benefits that can be obtained by the use of some homeopathic medicines, especially Lachesis trigonocephalus. In a brief and precise way, Dr. Sanchez Resendiz recalled the results of the research conducted with Angel Lerdo de Tejada MD and collaborators on brain catecholamines, since brain dopamine in the hypothalamus, has a great influence in the luteinizing hormone its behavior. She observed that different potencies of the homeopathic remedy Lachesis trigonocephalus, can generate statistically significant changes in brain catecholamines. This could explain why its use may improve women’s symptoms during perimenopause and menopause...

Efecto de Lachesis trigonocephalus sobre dopamina cerebral en la rata / Lachesis trigonocephalus effect on dopamine in the rat brain

La dopamina (DA) estimula el factor liberador de hormona luteinizante (LHR), incrementa la hormona luteinizante (LH) e induce ovulación. El precursor inmediato, la L-dopa, ha sido usado para inducir la ovulación y en el síndrome amenorrea-galactorrea, pero esta droga produce varios efectos indeseables. Por esta razón pareció conveniente investigar drogas capaces de elevar la DA cerebral con menos efectos colaterales. La acción del veneno de la serpiente Lachesis trigonocephalus sobre la DA cerebral fue estudiada en ratas Wistar. Treinta y nueve animales recibieron el veneno a una dinamización de 1 x 10-24 = 12CH en etanol al 22.5%. La droga fue administrada per os con un catéter a la dosis de 0.25 ml, con intervalos de 8 horas, durante 10 días. Treinta y tres ratas sirvieron como controles y recibieron la misma dosis de etanol sin la droga. El grupo control mostró un nivel medio de 998 ± 43 ng/g (X ± SE) y los animales que recibieron la droga 1136 ± 57 ng/g (P < 0.05). La concentración de noradrenalina (NA) fue de 528 ± 29 ng/g en el grupo control y de 452 ± 16 ng/g en el grupo que recibió Lachesis (P < 0.025). Los niveles de adrenalina no mostraron cambios significativos con la droga...

Dopamine (DA) stimulates hormone luteinizing liberator (LHR), increases hormone luteinizer (LH) and induces ovulation. L-Dopa, its immediate precursor, has been used to induce ovulation and in the amenorrhea-galactorrhea syndrome, but this drug produces several undesirable effects. It was therefore considered convenient to investigate drugs which can raise Brain DA with less side effects. The effect of Lachesis trigonocephalus snake poison was studied in rats. Thirty nine animals received the venom at a 1 x 10-24 dynamization (Lachesis trig. 12CH), in ethanol at 22.5%. The drug was administered per os through a catheter on a 0.25 ml dose, at 8 hour intervals during 10 days. Thirty three rats were used as controls and received the same dosage of ethanol without the drug. The control batch gave a mean level of 998 ± 29 ng/g (X ± SE) and animals which received the drug showed 1136 ± 57 ng/g (P < 0.025). The concentration of noradrenaline (NA) was 528 ± 29 ng/g in the group which received Lachesis trig. 12CH (P < 0.025). No significant variations of adrenaline levels were apparent with the drug...

El síndrome de Pasqualini: hipoandrogenismo con espermatogénesis conservada

Pasqualini y Bur publican el primer caso de eunucoidismo con espermatogénesis conservada en 1950 en la Revista de la Asociación Médica Argentina. El síndrome de hipoandrogenismo con espermatogénesis incluye: (a) eunucoidismo bien definido, (b) testículos de volumen normal con espermatogénesis completa, llegando a espermatozoides maduros en una elevada proporción de tubos seminíferos, con células de Leydig indiferenciadas e inmaduras, (c) compensación funcional completa mediante la administración de gonadotrofina coriónica, mientras ésta se aplique (d) gonadotrofinas urinarias totales dentro de límites normales, y (e) esta definición fue ampliada con la actividad normal de las otras hormonas adenohipofisarias y la ausencia de malformaciones congénitas en la mayoría de los casos. En la fisiopatogenia del síndrome de Pasqualini, conocido también como síndrome del "eunuco fértil", se demostró primero la ausencia de hormona luteinizante (LH) en el plasma y orina de estos pacientes. El segundo gran avance fueron los estudios funcionales y genéticos que validaron la hipótesis de un déficit funcional de LH en estos hombres, extendido luego a las mujeres. Varios grupos, incluyendo el nuestro, demostrarían en estos casos una LH con diferentes grados de actividad inmunológica pero biológicamente inactiva, a partir de una o más mutaciones invalidantes en el gen LHB. Por último, la comprensión acabada del síndrome de Pasqualini permitiría revertir el fenotipo y la infertilidad de estos pacientes a partir de la utilización de gonadotrofina coriónica y las modernas técnicas de fertilidad in vitro. Este artículo es una revisión histórica y un homenaje a la memoria de Rodolfo Q. Pasqualini.

Pasqualini and Bur published the first case of eunuchoidism with preserved spermatogenesis in 1950 in Revista de la Asociación Médica Argentina. The hypoandrogenism with spermatogenesis syndrome included: (a) eunuchoidism, (b) testis with normal spermatogenesis and full volume, with mature spermatozoa in a high proportion of seminiferous tubes and undifferentiated and immature Leydig cells (c) full functional compensation through the administration of chorionic gonadotropin hormone, while hCG is administered (d) total urinary gonadotrophins within normal limits (e) this definition supposes the normal activity of the pituitary and the absence of congenital malformations in general. A first step in the understanding of the physiopathogeny of Pasqualini syndrome or the so called "fertile eunuch" syndrome was the absence of LH in plasma and urine of patients. The second breakthrough was the functional and genetic studies that validated the hypothesis of a functional deficit of LH in these men: it will then also be described in some women. Different groups including ours demonstrated in these cases a LH with varying degrees of immunological activity but biologically inactive in most of the patients, due to one or more inactivating mutations in the LHB gene. Finally, the full comprehension of Pasqualini syndrome allowed to reverse the hypoandrogenic phenotype and to restore fertility in these patients through the use of chorionic gonadotropin and the modern in-vitro fertility techniques. This article is an historical review and a tribute to the memory of Rodolfo Q. Pasqualini.

Hypothalamic-pituitary-ovarian axis in thyroid dysfunction / El eje hipotalámico-pituitario-ovárico en la disfunción tiroidea

BACKGROUND: It has been established that thyroid dysfunction causes impairment of reproductive function. However, laboratory and human studies that associated this with female reproductive hormones are conflicting and data reporting the effects of thyroid dysfunction on reproductive organs are insufficient. AIM: This study investigated the effect of experimental hypothyroidism and hyperthyroidism on hypothalamic-pituitary-ovarian axis and reproductive organs morphometry and histology in female rats. METHODS: Laboratory animals were randomized into one of the three groups: control, carbimazole-induced hypothyroidism and levothyroxine-induced hyperthyroidism. RESULTS: Organ morphometry and serum follicle stimulating hormone (FSH) were statistically comparable across all groups. Serum progesterone increased in hypothyroid rats but was reduced in hyperthyroid rats when compared with the control (p < 0.05). Body weight gain, serum luteinizing hormone and oestradiol were significantly reduced in both hypothyroid and hyperthyroid states when compared to the control. Hypothyroidism and hyperthyroidism also led to alterations in organ cytoarchitecture. CONCLUSION: Findings from this study suggest that impairment ofreproductive function associated with thyroid dysfunction is attendant with derangement of hormonal milieu and alteration in reproductive organs cytoarchitecture. Luteinizing hormone and oestradiol are implicated.

ANTECEDENTES: Se ha establecido que la disfunción de la tiroides causa deterioro de la función reproductiva. Sin embargo, los estudios humanos y de laboratorio que asociaban tal disfunción a las hormonas reproductoras femeninas son contradictorios, y los datos que reportan los efectos de la disfunción tiroidea sobre los órganos reproductores son insuficientes. OBJETIVO: Este estudio investigó el efecto del hipotiroidismo y el hipertiroidismo experimentales sobre el eje hipotalámico-pituitario-ovárico, y la morfometría e histología de los órganos reproductores en ratas hembras. MÉTODOS: Los animales de laboratorio fueron asignados al azar a uno de estos tres grupos: control, hipotiroidismo inducido por carbimazol, e hipertiroidismo inducido por levotiroxina. RESULTADOS: La morfometría de los órganos y hormona folículo-estimulante (FSH) en suero, fueron estadísticamente comparables en todos los grupos. La progesterona sérica aumentó en las ratas hipotiroideas, pero se redujo en las ratas hipertiroideas en comparación con el grupo de control (p < 0.05). El aumento de peso corporal, la hormona luteinizante en suero, y el estradiol se redujeron significativamente tanto en condiciones de hipotiroidismo como en estado de hipertiroidismo, en comparación con el grupo control. El hipotiroidismo y el hipertiroidismo condujeron también a alteraciones en la citoarquitectura de los órganos. CONCLUSIÓN: Resultados de este estudio sugieren que la debilitación de la función reproductora asociada con la disfunción de la tiroides, va acompañada de trastornos del medio hormonal, e implica alteraciones de la citoarquitectura de los órganos reproductores, la hormona luteinizante, y el estradiol.

Hormonas reprodcctivas de importancia veterinaria en hembras domésticas rumiantes / Reproductive hrmmones of veterinary importance in domestic ruminant females

En el presente trabajo se revisan las principales hormonas reproductivas en hembras domésticas rumiantes, considerando sus características e interacciones, además de los métodos de determinación y las concentraciones que se reportan de cada una de dichas hormonas, durante las diferentes fases del ciclo estral. El eje hipotálamo-pituitario-ovárico controla la actividad reproductiva, principalmente, a través de las interacciones entre la Hormona Folículo Estimulante (FSH), la Hormona Luteinizante (LH), el Estradiol (E2) y la Progesterona (P4). Durante la fase folicular, las gonadotropinas estimulan el desarrollo de los folículos, promoviendo la proliferación de las células de la granulosa por parte de la FSH; su pico está asociado al surgimiento de la onda folicular, después de la cual decrece la concentración plasmática de FSH, y da inicio a la desviación folicular. Esto permite al folículo dominante expresar receptores para la LH, además de producir inhibina y E2. El alto nivel circulante de E2 induce la liberación de la Hormona Liberadora de Gonadotropinas (GnRH) desde el hipotálamo, resultando en un pico de LH, de amplitud y frecuencia suficiente para estimular la maduración final del folículo y la posterior ovulación. Las altas concentraciones de E2 influyen también sobre la presentación de los cambios fisiológicos y comportamentales durante el estro. La fase luteal está caracterizada por el predominio de la P4, cuya concentración se relaciona con el desarrollo del cuerpo lúteo. Esta hormona es indispensable para el reconocimiento y mantenimiento de la preñez y sus perfiles pueden llegar a determinar si existe la predisposición de un animal a sufrir pérdidas embrionarias tempranas. Se considera que los incrementos o disminuciones en las concentraciones séricas de cada hormona marcan cambios en las fases del ciclo estral, y es fundamental conocer la actividad de dichas hormonas mediante la determinación de su concentración sanguínea normal para cada una de las etapas reproductivas.

The main reproductive hormones in domestic female ruminants are reviewed in this paper, including their characteristics, interactions and concentrations besides the determination methods and concentrations reported in each hormone during the different phases of the estrous cycle. The hypothalamus-pituitary-ovarian axis, controls reproductive activity, mainly, through interactions between the Follicle-stimulating Hormone (FSH), Luteinizing Hormone (LH), Progesterone (P4) and Estradiol (E2). During the follicular phase, gonadotropin hormones stimulate follicle development, promoting the proliferation of granulosa cells on the FSH side. The FSH peak is associated with the emergence of the follicular wave after which, its plasmatic concentration decreases and the follicular deviation begins. This allows the dominant follicle to express LH-receptors and to produce inhibine and E2. The high level of flowing E2 induces the release of Gonadotropin Releasing Hormone (GnRH) from the hypothalamus, resulting in a LH of enough amplitude and frequency to stimulate the final maturation of the follicle and the subsequent ovulation. High plasma concentrations of E2, also influence the appearance of physiological and behavioral changes during estrous. The luteal phase is characterized by the dominance of P4, whose concentration is related to the development of the luteal body. This hormone is essential for pregnancy and its profiles recognition and maintenance, and it can even determine if there exist predisposition of an animal to suffer early embrionary loss. It is considered that increase or decrease in plasma concentration of each hormone, determine changes in the estrous cycle phases and, it is fundamental to know the activity of such hormones, by determining their normal blood concentration for each of the reproductive stages.

Seasonal differences in endocrine and ovarian patterns of Bos taurus indicus (Nelore) heifers estrous cycles / Diferenças sazonais no padrão endócrino e ovariano do ciclo estral de novilhas Bos taurus indicus (Nelore)

Estrous cycle of eight Nelore heifers were evaluated during different seasons of the year (autumn n=11; winter n=8; spring n=9 and summer n=9) with daily count and measurement of follicles ≥3mm, blood was collected every 12h for LH and progesterone (P4), and after estrous every 3h for LH peak. Five ovariectomized heifers were injected with 17β-estradiol (2μg/kg) every season and blood samples collected every 3h (for 30h) thereafter for LH quantification. The monthly percent body weight difference (Δ%) did not vary among seasons. P4 concentration was higher (p<0.01) and follicle number lower during autumn and summer compared to winter and spring. During winter there were more estrous cycles with three and during summer only cycles with two follicular waves (p<0.01). As LH secretion did not vary despite P4 concentration and as there was negative correlation between higher P4 values and daily percentile variation of photoperiod (Δ%, p<0.01; r= -0.45) it is possible to suppose that there is seasonal variation on luteal cell sensitivity to LH. In the ovariectomized Nelore heifers, the LH basal concentration (without estradiol stimulus, p=0.02) and the LH response to estradiol (p<0.01) were lower during summer, leading to the hypothesis that there is seasonal variation of hypothalamic sensitivity to estradiol. According to the present experiment there are suggestions of seasonal reproduction in Nelore heifers.

Ciclos estrais em oito novilhas Nelore foram acompanhados durante diferentes estações (outono n=11; inverno n=8; primavera n=9; verão n=9) com contagem e diâmetro de folículos ≥ 3 mm diariamente, com colheitas de sangue a cada 12 h para LH e P4, e a cada 3 h para o pico de LH. Cinco novilhas ovariectomizadas receberam 17β estradiol (2μg/kg) em cada estação, com colheitas de sangue a cada 3 h para quantificar LH. A diferença percentual (Δ%) do peso entre os meses não variou entre as estações. Durante o ciclo estral, a concentração de P4 (média e máxima) foi maior (p<0,01), e o número de folículos menor (p<0,01), no outono e verão, se comparados ao inverno e primavera. No inverno houve mais ciclos com três ondas e no verão somente ciclos com duas ondas foliculares (p<0,01). Como as características da secreção de LH não foram diferentes apesar da variação na concentração de P4, e como houve correlação negativa entre os valores máximos de P4 e a variação percentual (Δ%) diária no fotoperíodo (p<0,01; r= -0,45), supõe-se que haja variação sazonal na sensibilidade das células luteínicas ao LH. Nas novilhas ovariectomizadas, a concentração basal (sem estradiol) circanual de LH foi menor no verão (p=0,02), assim como a sua secreção em resposta ao estradiol (p<0,01), o que permite supor que também haja uma variação sazonal na sensibilidade hipotalâmica ao estradiol. De acordo com o presente experimento, há indícios de sazonalidade reprodutiva em novilhas Nelore.

Hormonal and Histomorphologic Effects of Azadirachta indica leaf Extract on the Pars Anterior of Wistar Rats / Efectos Hormonales e Histomorfológicosdel Extracto de la Hoja de Azadirachta indica en la Pars Anterior de Ratas Wistar

Azadirachta indica is a tree whose medicinal value is unquantifiable. Any part of the tree can be used in the treatment of malarial infection. Reports have indicated its antifertility effects, and this necessitated this study on the effects of the methanol leaf extract on serum luteinizing (LH) and follicle stimulating hormones (FSH) levels and the histomorphology of the pars anterior of Wistar rats. Thirty adult male Wistar rats were equally divided into 3 groups of A, B and C. Group A was the control and the animals received distilled water orally, while groups B and C were treated with 200mg/kg and 400mg/kg respectively of the leaf extract by oral gavage for fourteen days. On day fifteen, the animals were sacrificed by chloroform anaesthesia. Blood was obtained from their hearts, while the skull was opened to assess the hypophysis. Hormonal assay showed that luteinizing (LH) and follicle stimulating (FSH) hormone levels in the serum were lower in groups B and C treated with 200mg/kg and 400mg/kg respectively of the leaf extract, while that of LH were significant (P<0.001). Histomorphologic sections of the pars anterior revealed reduced acidophil and basophil populations, with prominent degranulated chromophobes which were larger in the group treated with 400mg/kg of A. indica leaf extract. This group also presented hypertrophy of the basophils compared to the control. In conclusion, methanol leaf extract of A. indica decreases serum LH and FSH and caused histomorphologic changes in the pars anterior of adult male Wistar rats.

Azadirachta indica es un árbol cuyo valor medicinal es invaluable. Cualquier parte del árbol se puede utilizar en el tratamiento de la infección por malaria. Reportes han indicado su efecto antifertilidad, lo que requirió estudiar los efectos del extracto metanólico de la hoja sobre los niveles séricos de las hormonas luteinizante (LH) y folículo estimulante (FSH) y la histomorfología de la pars anterior de ratas Wistar. Treinta ratas Wistar adultas fueron divididas en tres grupos. El grupo A fue utilizado como control y los animales recibieron agua destilada por vía oral, mientras que los grupos B y C fueron tratados con 200 mg/kg y 400 mg/kg respectivamente, con extracto de hoja mediante una sonda nasogástrica durante catorce días. A los quince días, los animales fueron sacrificados por anestesia con cloroformo. Se obtuvo sangre desde sus corazones, mientras que el cráneo fue abierto para evaluar la hipófisis. Los ensayos hormonales mostraron que los niveles en suero de la LH y FSH se redujeron en los grupos B y C, tratados con 200 mg/kg y 400 mg/kg respectivamente, siendo la reducción de LH significativa (p<0,001). Secciones histomorfológicos de la pars anterior revelaron una reducción de las poblaciones acidófilas y basófilas, con prominentes cromófobos degranulados que fueron mayores en el grupo tratado con 400 mg/kg del extracto de A. indica. Este grupo también presentó hipertrofia de los basófilos en comparación con el control. En conclusión, el extracto alcohólico de la hoja de de A. indica disminuye el nivel sérico de LH y FSH y provoca cambios histomorfológicos en la pars anterior de ratas Wistar adultas.

Cambios en la sccreción de los esteroides ovários y de la hormona luteinizantee durante el ciclo estral en la oveja: una revisión / Changes in theseecretion of ovrian steroids and luteinizing hormone during thhe estrous cycle in the ewe: a review

Los machos y las hembras ovinas ubicadas en altas latitudes presentan variaciones estacionales en la actividad reproductiva. La actividad sexual de las ovejas es estimulada por la disminución del fotoperiodo, de suerte que los animales que muestran estacionalidad reproductiva pueden disminuir su respuesta al reducirse la latitud. El eje hipotalámico hipofisiario funcional es esencial para la reproducción en mamíferos. El hipotálamo secreta el decapéptido, hormona liberadora de gonadotropinas (GnRH), responsable de iniciar una cascada de eventos que regula las gónadas. Durante el ciclo estral de la oveja, los niveles circulantes de la hormona luteinizante (LH) y de la progesterona (P4) están inversamente relacionados, evidenciando que la P4 podría inhibir la secreción tónica de LH. La P4, de acuerdo con sus efectos, es el esteroide ovárico más importante en las hembras mamíferas y está implicada en la compleja regulación de la función reproductiva. Durante la fase luteal del ciclo estral, la P4, producida por el cuerpo lúteo, inhibe la secreción de la GnRH hipotalámica y, consecuentemente, disminuye la concentración periférica de las gonadotropinas. La fase folicular inicia con la disminución de las concentraciones de P4, ocurrida después de la luteólisis, y es caracterizada por el aumento en la secreción de las gonadotropinas y del estradiol (E2). Esta elevación en el E2 circulante provoca el surgimiento del pico preovulatorio de LH, causado por el abrupto y continuo incremento en la secreción de GnRH. Las mediciones seriadas de E2, P4 y LH al momento de la ovulación en la oveja han demostrado que la secreción máxima del estrógeno desde los folículos preovulatorios precede el surgimiento de la LH. Datos recientes han mostrado que otros esteroides secretados por el folículo preovulatorio pueden actuar sinérgicamente con el estradiol para inducir la ovulación. La presente revisión pretende abordar las relaciones temporales existentes entre la circulación de LH y la secreción de los esteroides ováricos, 17-β estradiol y progesterona, durante el ciclo estral de la oveja.

Ewes and rams from temperate latitudes show seasonal variations in reproductive activity. Sheep sexual activity is stimulated by alterations in the photoperiod, so that animals displaying reproductive seasonality can reduce their response to seasonality as latitude decreases. A functional hypothalamic pituitary axis is essential for mammalian reproduction, since the hypothalamus secretes the decapeptide, gonadotropin-releasing hormone (GnRH) that is responsible for initiating the cascade of events that regulate gonadal function. During the estrous cycle of the ewe, circulating LH and P4 levels are inversely related, thus providing circumstantial evidence that progesterone may inhibit tonic LH secretion. Progesterone (P4), in terms of the cumulative duration of its effects, is the most important ovarian steroid secreted during the lifetime of the female mammal and it’s central to the complex regulation of normal reproductive function. During the luteal phase of the estrous cycle, the P4 produced by the corpus luteum inhibits hypothalamic GnRH secretion, and consequently, peripheral gonadotrophin concentrations are low. The follicular phase, which is initiated by the decline in circulating P4 concentrations after luteolysis, is characterized by increased gonadotrophin and Estradiol (E2) secretion. This rise in circulating E2 induces the preovulatory LH surge, which is caused by a robust, abrupt, and continuous increase in GnRH secretion. Serial measurements of E2, P4 and LH during ovulation time in the ewe have shown that maximum secretion of estrogen from pre-ovulatory follicles precedes the LH surge. Recent data show that other steroids secreted by the pre-ovulatory follicle may act synergistically with oestradiol in inducing ovulation. The present review was undertaken to observe discuss the temporal relationship between circulating LH and the secretion of the ovarian steroids, estradiol 17-β and progesterone, during the oestrous cycle in the ewe.

Hormônio luteinizante e reprodução assistida / Assisted reproduction and luteinizing hormone

Com os avanços no conhecimento da fisiologia da foliculogênese, vários medicamentos e protocolos estão sendo desenvolvidos com o intuito de promover uma hiperestimulação ovariana controlada eficaz e segura. O uso do hormônio folículo-estimulante (FSH) recombinante nos esquemas de indução de ovulação já está bem definido e respaldado na literatura. Mais recentemente, vários estudos observaram que o hormônio luteinizante(LH) parece ter papel fundamental na maturação folicular tardia, otimizando os resultados dos esquemas de indução em determinados grupos de pacientes. Ainda não há um consenso para sua utilização rotineira e as conclusões são muitas vezes conflitantes. Este artigo visa abordar de forma objetiva o papel do LH nas técnicas de reprodução assistida, fazendo uma ampla revisão da literatura.

As folliculogenesis phisiology, several medicinal products and protocols have been developed to promote an effective and safe controlled ovarian hyperstimulation . The use of recombinant follicle-stimulating hormone (FSH) in schemes of ovulation stimulation is well defined and established in literature. More recently, several studies pointed out that luteinizing hormone seems to play a fundamental role in final stages of follicular maturation, optimizing results of induction schemes in certain groups of patients. There is no consensus about its routine use, and conclusions are often conflicting. This article aims to describe objectively the LH’s role in assisted reproduction techniques, thus offering a comprehensive review of the literature.