Influence of sexually inactive bucks subjected to long photoperiod or testosterone on the induction of estrus in anovulatory goats.

The objective of this study was to evaluate the efficacy of treating sexually inactive bucks with artificial long photoperiod or testosterone on the induction of estrus in anovulatory grazing goats. A total of 91 multiparous mixed-breed anestrous goats were randomly assigned to one of three treatment groups: (1) joining with bucks subjected to 2.5 month of artificial long days (16 h of light/day; n=31), (2) joining with testosterone-treated bucks (n=30), and (3) joining with untreated bucks (control; n=30). There were no differences between the light-treated (100%) and testosterone-treated (93%) bucks in their ability to induce estrus in anovulatory does. On the other hand, none of the goats in contact with control bucks exhibited estrus. The interval from start of mating to estrus was shorter in goats with the light-treated bucks (37.9 ± 4.8 h) compared with does in contact with testosterone-treated bucks (58.3 ± 8.7 h). The overall pregnancy rate in goats joined with light-treated, testosterone-treated and control bucks was 84%, 77% and 0%, respectively, with no difference (P>0.05) between the first two groups. Anogenital sniffing, approaches, mounting attempts, and mounts were highest (P<0.01) in light-treated bucks and lowest in control bucks. It was concluded that testosterone-treated bucks and long-day-treated bucks were equally effective in synchronizing estrus in anovulatory goats and resulted in similar levels of fertility. Given that light-treated bucks are unviable in communal production systems of goats raised by resource-poor farmers, the sexual arousal of bucks with testosterone is a practical and reliable method to induce ovulation in anovulatory goats in pastoral goat systems in hot environments.

Four hours of daily contact with sexually active males is sufficient to induce fertile ovulation in anestrous goats.

The study was conducted on two consecutive years to determine whether ovulatory activity can be induced in anovulatory goats by exposing them to sexually active bucks for 4, 8, 12 or 16 h per day during 15 consecutive days. In experiment 1, females remained continuously in the experimental pens where they were in contact with males. One group remained isolated from males (controls) and four other groups were exposed to sexually active males for 4, 8, 12 or 16 h per day. In experiment 2, females were taken away to "resting" pens free of male odours between the periods of contact with bucks. They were allocated to 5 groups as in experiment 1. Ovulations were determined by progesterone plasma levels and transrectal ultrasonography. Pregnancy was determined by abdominal ultrasonography. In both experiments, more than 90% of females exposed to the bucks had at least one ovulation during the whole experiment whereas only 11 or 0% (experiments 1 and 2, respectively) did so in the control group (P<0.001). Furthermore, the proportion of females ovulating did not differ among groups depending on duration of contact with bucks (P>0.05). In both experiments, pregnancy rates were not affected by the daily duration of contact with males (P>0.05). To conclude, 4h of daily contact with sexually active males is sufficient to stimulate ovulatory activity in anovulatory goats and this effect is not due to the presence of olfactory cues from the males remaining in the pens.

Anovulación y disfunción ovulatoria e infertilidad / Anovulation, ovulatory disfunction and infertility

La anovulación crónica es una de las alteraciones más frecuentes que ven los ginecólogos en la consulta. Ciclos menstruales irregulares, sangrados uterinos anormales, amenorrea e infertilidad son los síntomas clínicos más frecuentemente observados. El objetivo principal en la evaluación de estas pacientes es identificar la causa que está provocando la anovulación crónica. Para propósitos de esta revisión, las causas potenciales se han agrupado en: a) amenorreas hipotalámicas, b) Anovulación crónica funcional, c) Síndrome de ovario poliquístico, d) hiperprolactinemia, e) Disfunción tiroídea, f) Falla ovárica prematura. El tratamiento está enfocado en corregir la condición que pueda estar causando el problema, optimizar la calidad de vida de la paciente y su salud, y reestablecer ciclos normales o inducir la ovulación si es que fuera necesario. Respecto a este último punto, los diferentes medicamentos y protocolos más comúnmente usados para inducción de la ovulación se analizan endetalle.

Chronic anovulation is one of the most frequent disorders seen by gynaecologists. Irregular cycles, abnormal uterine bleeding, amenorrhea and infertility are the most common clinical symptoms. The main target during the evaluation of these patients is to identify the disorders that cause chronic anovulation. For the purpose of this review, the potential causes have been grouped as follows: a) Hypothalamic amenorrhea, b) Hypothalamic functional anovulation, c) Polycystic ovary syndrome (PCO), d)Hyperprolactinemia, e) Thyroid dysfunction and f) Premature ovarian failure. The treatment of this conditionaims to correct any underlying disorder, to optimize the patient´s health and, to re-establish normal cycles or to induce regular ovulation, if required. With respect to the latter, the different drugs and protocols most commonly used for ovulation induction are reviewed in detail.

Síndrome da anovulação crônica hiperandrogênica e transtornos psíquicos / Hyperandrogenic chronic anovulation and psychologic disturbances

Os autores fazem uma revisão da síndrome dos ovários policísticos (SOP) com relação aos seus aspectos etiopatogênicos, clínicos, diagnósticos e terapêuticos, dando ênfase aos transtornos de ordem psíquica que freqüentemente acompanham esse distúrbiio. Tecem considerações sobre a importância não só de um efetivo tratamento médico, mas também de uma abordagem e um apoio psicológico, no sentido de melhorar ainda mais o bem-estar e a qualidade de vida dessas mulheres.

The authors have reviewed the main aspects of the polycystic ovary syndrome (PCOS) with respect to its etiopathogenic, clinical, diagnostic and therapeutic features, highlighting the psychological distresses that frequently arise in the syndrome. They also make considerations on the importance of an effective clinical treatment as well as on the approaches and psychological support, aiming to improve womenÆs well-being and quality of life.

Eletrocauterizacao laparoscopica ovariana bilateral no tratamento de mulheres inferteis com sindrome dos ovarios policisticos / Laparoscopic ovarian diathermy in the treatment of infertile women with polycystic ovary syndrome

A sindrome dos ovarios policisticos (SOP) e condicao endocrina comum que afeta a mulher em idade reprodutiva. Irregularidade menstrual, hirsutismo e infertilidade por...

Síndrome de ovario poliquístico, obesidad e hiperinsulinismo: un camino a la diabetes / Polycystic ovary syndrome POS, obesity and hyperinsulinism: a course to diabetes

El síndrome de ovario poliquístico(SOP) es una disfunción endocrinometabólica heterogénea de alta prevalencia, con una probable base genética, que compromete la función reproductiva de la mujer joven y que se encuentra en estrecha asociación a la insulinorresistencia (IR), Dentro de su compleja fisiopatología destacan la hipersecreción de LH e insulina, las cuales agravan una alteración preexistente de la biosíntesis esteroidal. La presencia de IR predispone a estas pacientes a desarrollar complicaciones cardiovasculares y metabólicas, las que suelen ser precoces. Por otro lado, la incidencia de patologías metabólicas asociadas a IR es mayor en los familiares de pacientes SOP que en los de mujeres normales, de ahí que el tratamiento de este síndrome no sólo debe ser sintomático, sino fundamentalmente preventivo. Asimismo, el SOP debería ser considerado un marcador de una patología familiar, un camino a la diabetes y un problema de salud pública

[Effect of weight reduction on the clinical and hormonal condition of obese anovulatory women]. / Efecto de la reducción de peso en la condición clínica y hormonal de mujeres anovulatorias obesas.

Obesity is associated to a variety of endocrine abnormalities that might lead to chronic anovulation in women. Weight loss may improve the hormonal profile and then restore ovulation in some of them. The aim of the current study was to evaluate the effect of a weight loss program on the clinical and hormonal characteristics of anovulatory obese women attending our reproductive clinic. We studied a group of 30 anovulatory obese patients between 18 and 35 years old without any thyroid disease. Before and after a weight loss of at least 5% of initial body weight we analyzed LH, FSH, estradiol, prolactine, testosterone, dehydroepiandrosterone sulfate, oral glucose tolerance test and progesterone, weight, BMI, waist/hip ratio and total body fat percentage. The mean weight loss was 9.5 +/- 4.3 kg. which represents a weight loss of 10.96% from initial body weight, with 26 patients (86.6%) resuming spontaneous ovulation. The women's mean plasma testosterone, LH, estradiol and DHEA-S decreased significantly and there was significantly increased on progesterone. At the beginning a total of 12 patients showed an impaired oral glucose tolerance test and after weight loss 9 of them improved it. The results shown in this study demonstrate that even a small weight reduction and a decrease in total body fat percentage improve the hormonal profile and restore ovulation in anovulatory obese women. Thus weight loss should be considered before starting with ovulation induction therapy.

Inducción de la ovulación con FSH pura en pacientes anovulatorias resistentes a citrato de clomifeno / ovulation induction with pure FSH in anovulatory patientas resistant to clomiphene cytrate

El obejtivo de este estudio fue evaluar la utilidad de la FSH para el tratamiento de pacientes anovulatorias con resistencia al citrato de clomiferno. Se trataron 72 pacientes con anovulación crónica resistente al citrato de clomifeno. La inducción de la ovulación fue iniciada el día tres del ciclo menstrual con 75 UI de FSH pura, se realizó control ultrasonográfico transvaginal del desarrollo folicular, las dosis posteriores de FSH se ajustaron según los resultados del ultrasonido transvaginal. Fueron administradas 10,000 UI de gonadotropina coriónica humana cuando el folículo dominante tuvo un diámetro ò 16 mm. La tasa de embarazo por cilo fue de 18.0 por ciento, mientras que la tasa acumulada de embarazos fue de 72.2 por ciento. No hubo diferencia significativa en la tasa de embarazos entre los grupos de esterilidad primaria y secundaria. La tasa de abortos espontáneos fue similar a la encontrada en la población general. Como conclusión, se puede afirmar que el tratamiento con FHS pura en mujeres resistentes al citrato de clomifeno es efectivo en la mayoría de ellas. Los resistentes a las gonadotropinas, pueden ser candidatos a la inducción quirúrgica de la ovulación

Síndrome de ovarios poliquísticos. Inducción de ovulación con FSH pura / Polycysric ovarian syndrome. Pure FSH ovulation induction

Objetivo. Adquirir experiencia institucional en el uso de FSH "pura" para inducir ovulación en mujeres con síndrome de ovarios poliquísticos. Material y métodos. Se estudiaron durante el periodo comprendido del 1o. de junio de 1990 al 31 de mayo de 1993, 110 mujeres con diagnóstico de esterilidad anovulatoria, secundaria a síndrome de ovario poliquísticos, sin ningún otro factor causal de esterilidad, en quienes previamente ya se había intentado y fracasado la inducción de ovulación con citrato de clomifen. Se realizaron 284 ciclos de tratamiento con FSH pura, con un protocolo en el que se inicia la administración de 150 UI por vía IM del medicamento a partir del primer día del ciclo menstrual espontáneo o inducido, implementando vigilancia estrecha mediante determinaciones seriadas de estradiol sérico y seguimiento del crecimiento folicular por ultrasonografía a partir del séptimo u octavo día del ciclo, y al encontrar datos inminentes de ruptura folicular, se administraron de 5 a 10,000 UI de Hormona Gonadotropina Coriónica para favorecer la ovulación. Resultados: Se logró ovulación en 205 ciclos (72.1 por ciento), con un total de 62 embarazos que corresponde al 56.3 por ciento del total de pacientes. De estas gestaciones, 13 fueron embarazos múltiples (un quíntuple, un cuádruple, cuatro triples y siete dobles). Se perdieron 15 embarazos (24.1 por ciento) en abortos del primer y segundo trimestre y un embarazo ectópico. El síndrome de hiperestimulación ovárica se presentó en 12 casos, constituyendo el 5.8 por ciento. Conclusión. La FSH pura es el medicamento de segunda elección para inducir la ovulación en el síndrome de ovarios poliquísticos, en aquellas mujeres en quienes previamente se haya fracasado con el citrato de clomifen

Tratamento da anovulaçäo: experiência do Setor de Esterilidade do Serviço de Ginecologia do Hospital dos Servidores do Estado / Treatment of anovulation: experience in the Department of Sterility of the Service of Gynecology at Hospital dos Servidores do Estado

Visa-se avaliar os resultados de tratamento da anovulaçäo. Inicia-se com um grupo de 77 casais submetidos à propedêutica da esterilidade, dos quais 24 pacientes eram portadoras de anovulaçäo diagnosticada pela biópsia de endometrio (incidência de 31,16%). Propöe-se esquema de tratamento de acordo com a etiologia da anovulaçäo e analisam-se os resultados

Induçäo da ovulaçäo / Ovulation induction

Os autores apresentam síntese de conhecimentos atuais sobre o mecanismo da ovulaçäo, abordando a participaçäo do eixo neuro-endócrino. Alinham, a seguir, os diversos recursos terapêuticos que podem ser empregados para induzir a ovulaçäo, especificando vários esquemas terapêuticos

Inducción de la ovulación con clomifeno / Ovulation induction with clomiphene

Se revisaron 52 pacientes anovulatorias que recibieron tratamiento concitrato de clomifeno, despus de concluir que su anovulación era el padecimiento central por difunción hipotálamo-hipofisaria, encontrando 30% de esta disfución cíclica pura y 70% con ovarios grandes, poliquísticos. Las 52 pacientes recibieron 336 ciclos en total y por un máximo de 9 meses. El 78,9% de las pacientes ovularon y 42,4% lograron embarazos con 86,4% de niños vivos y normales. El 30,8% de los embarazos y el 65,4% de las ovulaciones se lograron en los primeros 3 meses de tratamiento. Los efectos colaterales fueron escasos y poco importantes. El citrato de clomifeno demostró ser una droga segura y eficaz