Reproductive implication of D-aspartic acid in human pre-ovulatory follicular fluid.

BACKGROUND: In the present study, we report that D-aspartic acid (D-Asp) occurs in human ovarian follicular fluid and that a relationship may exist between the concentration of this amino acid and oocyte quality. METHODS: Samples of pre-ovulatory follicle fluid were obtained from 20 patients undergoing an IVF programme. The concentration of D-Asp was measured by using specific high-performance liquid chromatography (HPLC) combined with a d-aspartate oxidase. RESULTS: D-Asp occurs in human follicular fluid at a mean concentration of 14.98 +/- 4.51 nmol/ml. A significant difference in the content of this amino acid in the follicular fluid in relation to patient's age exists. In younger women aged 22-34 years (group A), D-Asp was found at a concentration of 19.11 +/- 1.91 nmol/ml, whereas in patients aged 35-40 years (group B), it decreased to 10.86 +/- 1.22 nmol/ml (P < 0.01). In addition, this amino acid was linked to oocyte quality; a relationship exists between D-Asp follicular concentration and the percentage of good quality metaphase II oocytes (P < 0.01), as well as the fertilization rate. CONCLUSIONS: In human follicular fluid, D-Asp is present at a relatively higher concentration in younger women than in older patients and there appears to be a relationship between the concentration of d-Asp and fertility outcome parameters. These findings suggest that follicular D-Asp concentration may be considered as an alternative or additional biochemical marker for oocyte quality in patients undergoing IVF programmes.

Finasteride in the treatment of hirsutism: new therapeutic perspectives.

OBJECTIVE: To determine of the clinical and hormonal effects of finasteride (Proscar; Merck, Sharp, and Dohme, Rahway, NJ) in the treatment of idiopathic hirsutism and hirsutism in patients with polycystic ovary syndrome (PCOS). DESIGN: Controlled clinical study. SETTING: Istitute of Obstetrics and Gynecology, University of Naples "Federico II." PATIENTS: Ten women affected by idiopathic hirsutism and 15 women with PCOS. INTERVENTIONS: Finasteride was administered orally at a daily dose of 5 mg for a period of 6 months. MAIN OUTCOME MEASURES: Rating of hirsutism with the Ferriman-Gallwey method; serum androgen assays. RESULTS: Finasteride produced a reduction in the average hirsutism scores ( > 50% in all patients), whereas no change was observed in serum T, androstenedione, and DHEAS levels. A significant reduction was measured in serum dihydrotestosterone and 3 alpha, 17 beta-androstenediol glucuronide levels. CONCLUSIONS: This study demonstrates that symptomatic hirsutism has to be considered as a skin disease associated with the increased activity of the 5 alpha-reductase. It also indicates that the selective 5 alpha-reductase inhibitor, finasteride, is very effective and well tolerated in the treatment of both idiopathic hirsutism and of hirsutism in patients with PCOS.

Fetal fibronectin as a screening test for premature delivery in multiple pregnancies.

OBJECTIVE: To evaluate fetal fibronectin as a screening test for premature delivery in asymptomatic women with multiple pregnancies. METHODS: In the mid-second trimester, the concentrations of fetal fibronectin in the cervical and vaginal secretions of 68 patients with multiple gestations were sampled weekly by monoclonal antibody immunoassay in order to predict preterm labor. RESULTS: The results for the prediction of preterm labor differ according to whether we consider a single positive result (fetal fibronectin > 50 ng/ml) as predictive of preterm labor or whether we only consider at least two consecutive positive results as predictive of perterm labor. The fetal fibronectin test had a sensitivity for preterm birth before 37 weeks of 90.9% and 86.6%, respectively, with a specificity of 68.5% vs. 78.9% and a positive and negative values of 73.1% vs. 76.4% and 88.8% vs. 88.2%, respectively. Similar results were obtained for perterm birth before 34 weeks. CONCLUSIONS: In a condition such as multiple pregnancy which is already at risk for premature delivery the possibility of raising the specificity of the test with virtually no decrease in sensitivity guarantees better recognition of patients likely to develop premature labor. This possibility can be achieved simply by considering two positive consecutive samples as predictive of preterm labor.

Treatment of postmenopausal osteoporosis with salmon calcitonin nasal spray: evaluation by bone mineral content and biochemical patterns.

We studied 21 women with postmenopausal osteoporosis, treated with salmon calcitonin nasal spray (100 IU/daily) and calcium (1 g/daily) for six months. Bone mineral content (BMC), measured before and at the end of therapy with lumbar dual photon absorptiometry, showed a significant increase (p < 0.01). At the end of the study, there was also a clear improvement of osteoporotic pain. Among biochemical markers of bone turnover, there was a significant (p < 0.01) reduction of urinary excretion of hydroxyproline. No side effect was registered and all patients had a good compliance to therapy.

[Carcinoembryonic antigen in genital infections caused by HPV]. / Antigène carcino-embryonnaire dans les infections génitales à HPV.

The immunohistochemical search for the carcino-embryonic antigen (CEA) was positive in 28.14 per cent of the cases of plane cervical condylomata, in 25 per cent of the cases of infections of the vulva by HPV, and in up to 40 per cent of the cases of cervical or vulvar lesions. These data are in accordance with those reported in the literature, even if the number of cases studied is too limited to enable us to make a significant comparison. As a result, the CEA might prove to be a useful marker for a more accurate biological and chemical classification of genital lesions by HPV.

[Topical treatment with estriol in postmenopausal atrophic vaginitis]. / Traitement topique avec estriole de la vaginite atrophique post-ménopause.

The vaginal application of estriol leads to plasma free estriol levels validated on the basis of laboratory and clinical parameters at a dose very much less than that.

Laparoscopic findings and hormonal patterns in the treatment of endometriosis by danazol.

The authors have studied, in 120 women with sterility, the incidence of endometriosis in the laparoscopic diagnostics, the development of pathology after the treatment by Danazol alone (600 mg/daily/6 months) or preoperative Danazol and subsequent conservative surgery, the sera RIA levels of FSH, LH, PRL, 17 beta-oestradiol and progesterone during therapy, the pelvic findings in the laparoscopic second look and the pregnancy rates after the treatment. On the findings of the obtained results, which agree with the most recent studies, the authors point out the significance of laparoscopy in the diagnosis and staging of endometriosis; the correlation between staging and different therapies; the peculiarity of the laparoscopic second look in monitoring endometriosis evolution after therapy and at last the deep correlations, not yet well explained, among the mild endometriosis and alterations as the luteal phase defect and the anovulatory both in the acute fitness of the pathology and after treatment by Danazol alone or preoperative Danazol with subsequent conservative surgery as shown by persistence of sterility or of infertility, although without other well-known reasons which could explain the subsequent pregnancy failures.