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The effects of sex hormones on the in vitro chemotaxis of polymorphonuclear leukocytes (PMNs) and monocytes were investigated using fMLP as the chemoattractant. PMNs, monocytes, and plasma were obtained from heparinized peripheral blood of healthy adults. Chemotaxis of PMNs or monocytes treated with sex hormones were tested using 48-well chemotaxis microchambers. The correlation between sex hormone levels in plasma and the chemotactic ability of PMNs from the same donor was also investigated. The chemotaxis of PMNs was enhanced by progesterone, while it was reduced by estradiol. Random migration of PMNs was also enhanced by progesterone and reduced by estradiol. The effect of estradiol on PMN chemotaxis was inhibited by addition of antiestrogens or progesterone. Testosterone did not have a measurable effect on PMN chemotaxis. A significant positive correlation was found between the concentration of progesterone in plasma of females and PMN chemotactic ability in vitro. For males, there was no significant relationship between plasma levels of sex hormones and PMN chemotactic ability. Estradiol and testosterone levels in plasma did not correlate with PMN chemotactic ability. Sex hormones had no effect on the chemotaxis of monocytes. These results suggest that the altered PMN chemotaxis associated with gingival inflammation may be due to the effects of sex hormones.
A randomized study.
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We are investigating the most practical parameters i.e. reliable and with a rapid response, which allow the time of insemination to be determined in women undergoing stimulation because of anovulation. We have already shown the advantage of rapid radio-immunological determinations of 17 beta-oestradiol (E2) to induce the releasing action of chorionic gonadotrophic hormone (hCG). We have carried out our investigations directed towards the rapid-immunological determination of luteotrophic hormone (LH), and have recorded a good temporal correlation between E2 and LH, the rise of E2 preceding by some hours that of LH, and the two summits succeeding each other. Inseminations are followed by fertilization in women who present with the following: a mean oestradiolaemia of about 500 pg/ml in the second part of the follicular phase, maintained after interruption of HMG administration (alone or after clomiphene citrate), which decreases only slowly after administration of hCG; a level of LH increasing from 9-14 ng/ml (mean) in the last two days preceding the summit of LH; the level of LH multiplied at least by 2 after the administration of hCG, whatever the mode of stimulation. Clomiphene citrate, not provoking a constant ovulatory discharge, does not dispense with the administration of hCG in the majority of cases. These considerations result from the study of a group of 22 anovulatory women, in whom stimulation followed by determination of E2 and LH, under echographic control, have allowed 12 pregnancies to be obtained (7 by clomiphene citrate + HMG + hCG; 5 by HMG + hCG), decreasing the mean number of inseminated cycles to 3 per woman thus studied.
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The short-course pretreatment with metformin decreased hyperandrogenism and insulin resistance and improved cervical sores, ovulation rate, and pregnancy rate among women with CC-resistant PCOS.
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Infertility affects 6.1 million U.S. couples-representing 10% of reproductive-age adults and 15% of all couples trying to conceive. Half of the time, infertility is the result of an abnormal semen analysis or other male factors, with 40%-50% of these infertile men diagnosed with idiopathic or nonclassifiable infertility. While the role of hormone therapy for men with an identified abnormality is well defined, the literature remains inconclusive and controversial regarding hormone manipulation using empirical (off-label) medical therapies for men with idiopathic infertility. This manuscript reviews the commonly used off-label medications used to treat idiopathic male factor infertility: clomiphene citrate, letrozole/anastrozole, exogenous androgens, and pentoxifylline.
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Four hundred two women underwent ovarian reserve screening. Twenty had intrauterine diethylstilbestrol exposure, and 382 women did not have exposure. The groups were compared regarding age, the incidence of diminished ovarian reserve, and cycle length. Nine women with and 204 women without diethylstilbestrol exposure underwent comparison of the total human menopausal gonadotropin dose, the day of human chorionic gonadotropin administration, the peak estradiol level, and the number of mature follicles.
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Relation of patient characteristics, ovarian stimulation, and sperm characteristics after washing to the occurrence of multiple pregnancy.
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To study the effect of the ultra-short protocol of gonadotropin releasing hormone agonist (GnRH-a) combined with human menopausal gonadotropin (hMG) regimen for ovarian hyperstimulation.
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A cross-section of women attending for fertility advice and treatment.
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Tamoxifen and clomiphene citrate seem to be similarly effective in achieving pregnancy in patients with luteal phase dysfunction. However, Tamoxifen therapy is associated with a lower incidence of spontaneous abortion; thus Tamoxifen may be the better choice for the therapy of infertile women with luteal phase dysfunction.
Results of ultrasonical folliculometry during treatment by 5 different stimulation protocols were evaluated in 122 cycles of IVF-patients. Additionally, the structure of follicular population was investigated by measurement of follicular volume which was the basis of a follicular hierarchy. - Number of developing, sonographically detectable and punctured follicles increased significantly from stimulation by Clomiphene to stimulation by Folistiman. Only in stimulation by Clomiphene number of sonographical visible follicles was in accordance with laparoscopically punctured follicles. Development of relationship of the follicular classes during treatment supports hypothesis that exogenous gonadotropins do not increase follicular recruitment in the follicular phase but prevent atresia of follicles recruited earlier. Long lasting action of FSH as in stimulation by gonadotropins stimulates a greater number of follicles more intensively as demonstrated by an increased follicular volume in follicles with high rank numbers in gonadotropin treated patients compared with treatment by Clomiphene and Clomiphene/Anthrogon. Very high FSH-levels probably cause a heterogenous population of follicles with an increased number of small follicles at time of follicular puncture.
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To investigate I. suffruticosum leaf extracts for male fertility parameters.
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In the present prospective randomized trial, 140 women with clomiphene-citrate-resistant PCOS were randomly allocated to receive 5mg letrozole from day 3 to day 7 of menses for 6 consecutive cycles, or to undergo LOD. When a leading follicle of at least 18 mm was present, ovulation was triggered with human chorionic gonadotropin (hCG). The 6-month rates of ovulation, pregnancy, abortion, and live births were evaluated.
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Pregnancy rate (PR), pregnancy outcome.
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Estrogen regulation of the intranuclear distribution of estrogen-binding proteins has been examined in the chicken liver. Administration of estrogen [diethylstilbestrol (DES)] resulted in a rapid, dose-dependent increase in two types of estrogen-binding sites associated with the nuclear matrix. Type I appeared to be the estrogen receptor (ER; Kd for estradiol = 2.0 nM), whereas type II was equivalent to binding sites previously defined in rat uterine nuclei (Kd = 15 nM). The association of nuclear ER and type II sites with the nuclear matrix followed a time course corresponding to the maximal accumulation of nuclear ER in the liver. A 2-fold enrichment (per U protein) of nuclear ER in the matrix was obtained at a dose of 20 micrograms DES/0.2 kg compared to control values. Further enrichment was observed with higher doses of DES (200 and 2000 micrograms). The antiestrogens tamoxifen (tamoxifen-citrate) and zuclomiphine 2-[p-(chloro-1,2-diphenyl-vinyl)phenoxyl]citrate) were potent inhibitors (greater than or equal to 50%) of the estrogen-stimulated association of both ER and type II sites with the matrix. However, they did not increase total nuclear or matrix ER concentrations when administered alone. These data demonstrate that the association of ER with liver nuclear matrix is estrogen dependent and suggest that the biological effects of estrogen at the nuclear level may be mediated by this association.
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The overall pregnancy rate per cycle was 18.1% (31/171), 15.2% (Group A), 20.3% (Group B) and 22.7% (Group C), (p > 0.50).
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The Cochrane Subfertility Review Group specialised register of controlled trials was searched.
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Forty two women with polycystic ovarian disease and primary recurrent spontaneous abortions.
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A 28-year-old woman with primary infertility and severe menorrhagia underwent a hysterectomy after failed hormonal therapy for multiple leiomyomas. The postoperative pathologic findings established the diagnosis of diffuse uterine leiomyomatosis, which demonstrated histologic, immunohistochemical, and ultrastructural similarity to leiomyomas of the uterus. The rapid growth of the tumor coincided with the administration of clomiphene citrate, an estrogenic agonist. As with the common leiomyoma, intralesional hemorrhage in this case of diffuse leiomyomatosis was associated with norethindrone acetate treatment given after the cessation of clomiphene therapy.
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In this randomized clinical trial 90 women with unexplained infertility referred to a university clinic from January 2011- December 2013 were enrolled. Thirty patients were randomized for letrozole, 30 patients for CC and 3o patients for control group. On the day 3 of cycle the patients were given letrozole 2.5mg/day or CC 100 mg /day orally or did not receive any treatment. Resistance index (RI) and pulsatility index (PI) of uterine artery were calculated and chemical pregnancy rate was evaluated.
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Twenty-eight infertile women aged 18 to 35 years. Thirteen patients were diagnosed with PCOS. Fifteen normal ovulatory patients who were matched for age and weight served as controls.
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None of the authors declared a conflict of interest. There was no study funding.