Therapeutic effect of gonadotropins with and without a GnRH analogue (D6-tryptophan) in male infertility due to idiopathic oligoasthenospermia.

The authors evaluate the response to treatment with gonadotropins alone and in association with D6-tryptophan (a Gn-RH analogue) in a group of infertile men affected by idiopathic oligo-asthenospermia. An improvement of fast straight motility of spermatozoa at second hour from ejaculation have been observed in our patients, even if a larger number of cases is necessary to make definitive conclusion.

Estradiol, progesterone, 17-hydroxyprogesterone, androstenedione and CA125 in patients with ovarian carcinoma.

Estradiol, progesterone, 17-hydroxyprogesterone, androstenedione and CA125 were assayed in 25 women (12 oophorectomized before entering the study) with ovarian carcinoma. The data from patients were ordered according to the presence or absence of the gonads. The patients with ovaries (Group A) showed significantly higher levels of estradiol (p less than 0.01), progesterone (p less than 0.01) and 17-hydroxyprogesterone (p less than 0.01) than controls. This difference was not observed between oophorectomized patients (Group B) and controls. CA125 levels were significantly higher in patients that in controls (p less than 0.001) irrespective of the ovarian status of the patients. Eleven patients were followed during chemotherapy. Significant reductions of estradiol (p less than 0.01) and CA125 (p less than 0.001) levels after three courses of chemotherapy were observed. These data confirm that women with ovarian carcinoma produce an abnormal amount of steroids. Nevertheless, a marked difference between patients with and without ovaries was observed, suggesting that reported data might be biased by the presence of gonadal tissue. Thus the clinical application of steroids as tumor markers in unselected patients is limited.

Ovulatory patterns in women with juvenile and late-onset/persistent acne vulgaris.

The ovulatory patterns in women with acne vulgaris were evaluated in order to understand their relationship with androgenic levels. Ovulation disturbances were found in 58.3% of patients with prevalence of anovulation in the juvenile acne and of luteal insufficiency in the late-onset/persistent acne. Significant negative correlation was found between T free and P in the late-onset/persistent group (r: -0.629; p = 0.016): This may be interpreted as a rather steady endocrine status in which the raised androgenic levels, probably due to peripheral conversion, are concomitant to absent or insufficient ovulations. In the younger patients both the androgen excess and the ovulation disturbances could be due to an abnormal or delayed maturation of the hypothalamus-pituitary ovarian axis. The evaluation of the ovarian function in women with acne vulgaris may be useful to detect ovulatory disturbances in view of a possible resolution of both the problems by specific endocrine management.

[Usefulness and limitations of the evaluation of sex-hormone-binding globulin in women with a female pattern of androgen-induced baldness]. / Utilità e limiti della valutazione della globulina legante gli ormoni sessuali nella donna con pattern femminile di alopecia androgenetica.

Sex-hormone binding globulin (SHBG) and androgen serum levels have been evaluated in a homogeneous group of women with female pattern of androgenetic alopecia (AA), stage II, without any clinical or anamnestic evidence of acne, hirsutism, irregular menses. Results did not show any significant difference between patients and controls. Since SHBG levels are androgen-dependent, the discordant results of previous published series regarding women with AA could be related to the presence of a variable number of patients with clinical and/or anamnestic evidence of a "cryptic" hyperandrogenism in some series, and to their absence in others. Statistically significant low average SHBG values could have been sustained by a mild, heterogeneous and not significant androgen excess. In our opinion the genetically-determined response of the target organ to androgens seems to play the major pathogenetic role in AA, at least when the woman does not reveal any clinical or anamnestic evidence of cryptic or clear hyperandrogenism.

[Androgenic evaluation of women with late-onset or persistent acne]. / Valutazione androgenica in donne con acne ad insorgenza tardiva o persistente.

The authors have studied the androgenic patterns in 29 women with late-onset persistent acne vulgaris. Clinical evaluation of acne, menstrual history and serum determinations of SHBG, total-T, free-T, DHEAS, delta 4A have been carried out. A mild and heterogeneous hyperandrogenism was found in 70% of women, thus, a greater steroid bioavailability for peripheral conversion and/or a direct stimulation of the pilosebaceous unit can be postulated. Androgenic evaluation in women with late-onset or persistent acne vulgaris is useful, mainly for hormonal management.

[Tubal sterilization: psychological and endocrinological aspects]. / La sterilizzazione tubarica; aspetti endocrini e psicologici.

PIP: Sterilization today represents the ultimate contraceptive method and requires the consent of both marriage partners. The method consists of blocking the fallopian tubes by either fulguration, application of clips, tying the fallopian tubes, or by using laparotomy with certain techniques. This type of contraception presents not only technical and gynecological problems; it is often accompanied by a series of psychological reactions not always foreseen before the operation. The impossibility of being able to conceive is sometimes perceived, especially by adolescents, women in premenopause, and sterilized women, as a lack of femininity. A study of 211 sterilized women between the ages of 22-34, parity 2-5, was conducted. They each answered a questionnaire intended to measure the effect of sterilization on their psychological lives and whether it entailed any possible modifications in their sexual lives. 77.7% answered that they had the operation because of repeated past Cesarean sections. Before the operation, 61.2% used coitus interruptus as a means of birth control. 38.9% couples reported increased pleasure in their sexual life; decrease of libido was reported for 22.2%, and no change of libido for 38.9%. 55.6% were generally pleased with the operation, especially those who were sufficiently informed about the irreversibility of it, and those who had a stable emotional psyche. The multiparous women or those with impending pregnancies had had no 2nd thoughts. 27.8% evaluated the operation negatively and 16.6% were indifferent. Longterm effects included spotting 38.9%, pelvic infection 33.3%, premenstrual tensions 27.8%, and dysmenorrhea 22.2%. Menstrual irregularities are related to a condition of insufficiency of the corpus luteum due to altered vascularization.^ieng

[Serum levels of 17-beta-estradiol and progesterone in atherosclerotic subjects before and after HCG tests]. / Valori di 17 beta estradiolo e progesterone in soggetti aterosclerotici prima e dopo test con HCG.

In this work the Authors describe the results of 17 plasmatic beta estradiol and plasmatic progesterone in a group of 10 arteriosclerotic patients before and after a test with HCG. The data proved that this drug doesn't modify statistically the plasmatic values of the mentioned steroids. These data cannot explain the mechanism of the therapeutic action of the HCG through a stimulus of the gonads.

[Levels of prolactin in atherosclerotic subjects before and after HCG tests]. / Valori di prolattina in soggetti aterosclerotici prima e dopo test con HCG.

Among the researches concerning the therapeutic mechanism of HCG in the arteriosclerotic disease, in this work the Authors report the values of prolactin before and after a stimulus with HCG in a group of 10 arteriosclerotic patients. The prolactin values are not modified by HCG and would not confirm the eventual direct or indirect mediation of the hypophysis in the above mentioned therapeutic action.