RESUMO
AIM: The abnormal secretion of luteinizing hormone (LH) is one of the typical features of polycystic ovary syndrome (PCOS) and adopted in the diagnostic criteria of the Japan Society of Obstetrics and Gynecology (JSOG). We investigated cut-off values for LH and the LH/follicle-stimulating hormone (FSH) ratio in resent two measurement systems for the diagnosis of PCOS. METHODS: Ninety-nine controls and 106 patients with PCOS were enrolled. Serum LH and FSH levels were measured using an electrochemiluminescence immunoassay (ARCHITECT) and chemiluminescence immunoassay (ECLusys). We examined the distribution of the measured levels, selected the conversion closest to the standard normal distribution in the control group, and calculated mean + 1 SD values for LH and the LH/FSH ratio as candidates. Cut-off values coincided with the medians of the candidates in the two assay systems using a regression equation. We calculated the endocrinological abnormality rate in PCOS according to the JSOG criteria by abnormal LH secretion and elevated T. RESULTS: Cut-off values for LH (mIU/mL) and the LH/FSH ratio were 7.1 and 1.21, respectively, in ARCHITECT, and 9.9 and 1.51, respectively, in ECLusys. The detection rates of endocrinological abnormalities in PCOS were 72.2% and 70.6% in the nonoverweight/obese PCOS group and overweight/obese PCOS group, respectively, in ARCHITECT, and 69.4% and 73.5%, respectively, in ECLusys. CONCLUSION: We obtained cut-off values of LH and the LH/FSH ratio for diagnostic criteria of JSOG criteria for PCOS, that were highly compatible between two major assay systems. These cut-off values will contribute to the diagnosis of PCOS in Japan and presumably in women of Asian ethnicities.
Assuntos
Hormônio Foliculoestimulante Humano , Hormônio Luteinizante , Síndrome do Ovário Policístico , Feminino , Humanos , Hormônio Foliculoestimulante Humano/sangue , Japão , Hormônio Luteinizante/sangue , Síndrome do Ovário Policístico/diagnósticoRESUMO
MATERIALS AND METHODS: In this cross-sectional case control study, the serum level of LH, FSH, and prolactin of 40 women with lichen planus who have been referred to Shiraz Dental Faculty, Oral and Maxillofacial Disease Department during 2018-2019 has been evaluated in comparison to 40 healthy controls. Data were analyzed by SPSS version 18. Two-way ANOVA and Mann-Whitney test were used for data analysis. RESULTS: The mean serum level of FSH and LH was significantly higher in OLP patients while this difference was not reported for prolactin. Only FSH mean serum level was significantly higher in nonmenopausal OLP patients. The distribution of prolactin and FSH hormones' serum level was in normal range. CONCLUSIONS: The high serum level of FSH and LH can affect OLP pathogenesis by estrogen and progesterone modulation.
Assuntos
Hormônio Foliculoestimulante Humano/metabolismo , Líquen Plano Bucal/metabolismo , Hormônio Luteinizante/metabolismo , Adulto , Estudos de Casos e Controles , Estudos Transversais , Estradiol/sangue , Feminino , Hormônio Foliculoestimulante/sangue , Hormônio Foliculoestimulante Humano/sangue , Hormônio Liberador de Gonadotropina/sangue , Humanos , Líquen Plano Bucal/sangue , Hormônio Luteinizante/sangue , Pessoa de Meia-Idade , Progesterona/sangue , Prolactina/análise , Prolactina/sangueRESUMO
INTRODUCTION: The coronavirus disease 2019 (COVID-19) is a global pandemic which may affect multiple organs and systems including testes and disrupt the gonadal functions. The current study aimed to evaluate the effect of COVID-19 on the semen parameters and sex-related hormone levels in infertile men. METHODS: The study included 21 patients who were evaluated in Ankara City Hospital, Andrology Clinic, for male infertility and have had the diagnosis of COVID-19. All the patients were evaluated in terms of semen parameters. The follicle-stimulating hormone, luteinizing hormone, and testosterone (T) levels were also evaluated in 8 of the patients. The results were presented through 2 dependent group analyses, based on the data of the patients collected before and after the diagnosis of COVID-19. RESULTS: None of the patients needed to be hospitalized at any time through the course of COVID-19. There was a significant decrease in semen volume, percentage of total motility, percentage of progressive motility, and normal sperm morphology after COVID-19 (3 [1-8] vs. 2.5 [1.5-5], p = 0.005; 48.6 ± 22.1 vs. 34.7 ± 20.7, p = 0.001; 35.1 ± 21.7 vs. 21.8 ± 15.9, p < 0.001; 6 [3-24] vs. 5 [3-18], p = 0.015; respectively). There was also a significant decline in T level of the patients after the diagnosis of COVID-19 (350.1 ± 115.5 vs. 289.8 ± 103.3, p = 0.009). CONCLUSION: COVID-19 may have unfavorable effects on the gonadal functions and may lead to further deterioration of the semen parameters in infertile men, which should be considered through the evaluation for infertility.
Assuntos
COVID-19/virologia , Infertilidade Masculina/patologia , SARS-CoV-2/patogenicidade , Análise do Sêmen , Espermatozoides/patologia , Adulto , COVID-19/diagnóstico , Fertilidade , Hormônio Foliculoestimulante Humano/sangue , Interações Hospedeiro-Patógeno , Humanos , Infertilidade Masculina/sangue , Infertilidade Masculina/virologia , Hormônio Luteinizante/sangue , Masculino , Estudos Retrospectivos , Fatores de Risco , Espermatozoides/virologia , Centros de Atenção Terciária , Testosterona/sangue , Turquia , Adulto JovemRESUMO
BACKGROUND: Adding ovarian function suppression (OFS) after chemotherapy improves survival in young women with moderate- and high-risk breast cancer. Assessment of ovarian function restoration after chemotherapy becomes critical for subsequent endocrine treatment and addressing fertility issues. PATIENTS AND METHODS: In the adding OFS after chemotherapy trial, patients who resumed ovarian function up to 2 years after chemotherapy were randomised to receive either 5 years of tamoxifen or adding 2 years of OFS with tamoxifen. Ovarian function was evaluated from enrolment to randomisation, and patients who did not randomise because of amenorrhoea for 2 years received tamoxifen and were followed up for 5 years. Prospectively collected consecutive hormone levels (proportion of patients with premenopausal follicle-stimulating hormone [FSH] levels <30 mIU/mL and oestradiol [E2] levels ≥40 pg/mL) and history of menstruation were available for 1067 patients with breast cancer. RESULTS: Over 5 years of tamoxifen treatment, 69% of patients resumed menstruation and 98% and 74% of patients satisfied predefined ovarian function restoration as per serum FSH and E2 levels, respectively. Menstruation was restored in 91% of patients younger than 35 years at baseline, but in only 33% of 45-year-old patients over 5 years. Among these patients, 41% experienced menstruation restoration within 2 years after chemotherapy and 28% slowly restored menstruation after 2-5 years. Younger age (<35 years) at baseline, anthracycline without taxanes and ≤90 days of chemotherapy were predictors of menstruation restoration. CONCLUSIONS: During 5 years of tamoxifen treatment after chemotherapy, two-thirds of the patients experienced menstruation restoration, especially patients younger than 35 years. Young age, Adriamycin without taxanes and short duration of chemotherapy appeared to have a positive effect on ovarian reserves in the long term. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT00912548.
Assuntos
Antineoplásicos Hormonais/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Menstruação/efeitos dos fármacos , Ovário/efeitos dos fármacos , Pré-Menopausa , Tamoxifeno/uso terapêutico , Adulto , Fatores Etários , Antineoplásicos Hormonais/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Biomarcadores/sangue , Estradiol/sangue , Feminino , Hormônio Foliculoestimulante Humano/sangue , Humanos , Menstruação/sangue , Pessoa de Meia-Idade , Ovário/metabolismo , Ovário/fisiopatologia , Recuperação de Função Fisiológica , República da Coreia , Medição de Risco , Fatores de Risco , Tamoxifeno/efeitos adversos , Fatores de Tempo , Resultado do Tratamento , Adulto JovemRESUMO
Non-obstructive azoospermia (NOA) is one of the leading causes of male factor infertility, which results from impaired spermatogenesis. Currently, the sole feasible therapeutic option for men with NOA to father their biologic children is sperm retrieval by testicular sperm extraction (TESE) approaches followed by an intracytoplasmic sperm injection program. Nevertheless, the rate of sperm retrieval from NOA men following TESE has remained as low as 50%, leading to a significant number of unsuccessful TESE operations. Given that TESE is associated with multiple side effects, the prediction of TESE outcome preoperatively can abolish unnecessary operations and thereby prevent NOA patients from sustaining adverse side effects. As the process of spermatogenesis is under the regulation of hormones, the hormonal profile of serum and/or seminal plasma may contain useful information about spermatogenesis status and can potentially predict the chance of sperm retrieval from NOA patients. A large body of literature is available on the predictive capability of different serum and seminal plasma hormones such as FSH, LH, testosterone, inhibin B, AMH, estradiol, prolactin, and leptin in a stand-alone basis or combinational fashion with respect to the TESE outcome. The present review aimed to evaluate the potential of these hormonal markers as noninvasive predictors of sperm retrieval in men with NOA.
Assuntos
Azoospermia/genética , Hormônios/sangue , Sêmen/metabolismo , Espermatogênese/genética , Azoospermia/sangue , Azoospermia/patologia , Estradiol/sangue , Hormônio Foliculoestimulante Humano/sangue , Hormônios/genética , Hormônios/metabolismo , Humanos , Inibinas/sangue , Leptina/sangue , Hormônio Luteinizante/sangue , Masculino , Prolactina/sangue , Injeções de Esperma Intracitoplásmicas , Recuperação Espermática , Testosterona/sangueRESUMO
BACKGROUND AND OBJECTIVE: Male fertility depends on the availability of the potent androgen called testosterone. Testosterone production is regulated by the hypothalamic anterior pituitary axis. Two anterior pituitary hormones Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH) are involved in spermatogenesis and testosterone production, respectively. Hypoxia, resulting from high altitude, may induce a change in these four hormones and may affect male fertility. This study was done to evaluate and compare the changes that occur in FSH, LH, testosterone and prolactin in males lived in moderate versus low altitude. MATERIALS AND METHODS: This study was conducted on 300 individuals who were categorized based on the altitude of their habitat into two equal groups, namely: Inhabitants at moderate altitudes and inhabitants at low altitudes. A venous blood sample was collected from each individual to measure the levels of FSH, LH and prolactin. RESULTS: Both LH and testosterone levels were significantly lower in high altitude inhabitants compared with low altitude inhabitants (p<0.01). The FSH level showed a significant statistical difference between two groups with a lower level in individuals living at high altitudes compared with low altitude inhabitants but on a value (p<0.05). CONCLUSION: Moderate altitude hypoxia suppresses LH, FSH and testosterone levels as much as high altitude hypoxia does and these changes may depend on prolactin level.
Assuntos
Aclimatação , Altitude , Hormônio Foliculoestimulante Humano/sangue , Hormônio Luteinizante/sangue , Prolactina/sangue , Testosterona/sangue , Adulto , Fertilidade , Humanos , MasculinoRESUMO
Herbal products with an antioxidant capacity can boost male reproductive functions. The empiric use of Ceratonia siliqua (carob) for its antioxidant properties is common among infertile men in Iran and Turkey. The objective of this study is to investigate the effects of C. siliqua (carob) on semen parameters, oxidative stress markers, and pregnancy rate in a parallel randomized, controlled study. A total of 60 infertile men with oligozoospermia, asthenospermia, and teratospermia were recruited from April 2018 to March 2019. Participants were divided randomly into the following two groups: carob syrup twice a day or vitamin E 100 mg twice a day for 3 months. Semen analysis was performed and hormonal levels and stress oxidative markers were measured in each treatment arm after 3 months. The quality of semen parameters improved in the carob group compared with Vit E semen count (p = 0.04 Cohen's d = .51), morphology (p = 0.001 Cohen's d = .93) and motility parameters (p = 0.002 Cohen's d = .90) were significantly higher in the carob group. No significant difference can be detected in post-treatment hormonal parameters and oxidative markers between groups, except for total antioxidant capacity(TAC) which was higher after post-treatment in carob group. A significantly higher pregnancy rate was found among the carob group. The administration of carob may be an effective agent for the improvement of semen parameters, probably related both to its involvement in the changing of testosterone level and to its antioxidant properties. Nevertheless, additional studies to evaluate the optimal dose and duration of treatment are needed. The trial has been registered in the Iranian Registry of Clinical Trials (Registration number: IRCT20171209037794N1.
Assuntos
Antioxidantes/uso terapêutico , Fabaceae , Fármacos para a Fertilidade Masculina/uso terapêutico , Galactanos/uso terapêutico , Hormônios/sangue , Infertilidade Masculina/tratamento farmacológico , Mananas/uso terapêutico , Estresse Oxidativo/efeitos dos fármacos , Gomas Vegetais/uso terapêutico , Espermatozoides/efeitos dos fármacos , Vitamina E/uso terapêutico , Adulto , Antioxidantes/efeitos adversos , Antioxidantes/isolamento & purificação , Biomarcadores/sangue , Fabaceae/química , Feminino , Fármacos para a Fertilidade Masculina/efeitos adversos , Fármacos para a Fertilidade Masculina/isolamento & purificação , Hormônio Foliculoestimulante Humano/sangue , Galactanos/efeitos adversos , Galactanos/isolamento & purificação , Humanos , Infertilidade Masculina/sangue , Infertilidade Masculina/diagnóstico , Irã (Geográfico) , Hormônio Luteinizante/sangue , Masculino , Mananas/efeitos adversos , Mananas/isolamento & purificação , Gomas Vegetais/efeitos adversos , Gomas Vegetais/isolamento & purificação , Gravidez , Taxa de Gravidez , Contagem de Espermatozoides , Motilidade dos Espermatozoides/efeitos dos fármacos , Espermatozoides/metabolismo , Espermatozoides/patologia , Testosterona/sangue , Fatores de Tempo , Resultado do Tratamento , Vitamina E/efeitos adversosRESUMO
BACKGROUND: A novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causing the pandemic of coronavirus disease 2019 (COVID-19), may attack testes by angiotensin-converting enzyme 2. OBJECTIVE: To assess whether SARS-CoV-2 infection can affect sex-related hormones and testicular function in recovering patients. MATERIALS AND METHODS: The patients were separately classified according to the duration of viral shedding (long-term positive vs normal-term group, with the former cases having a duration > 50 days) and disease severity (moderate vs severe group). Differences in sex-related hormone levels were compared between groups and linear regression analysis was used to compare the associations of testosterone (T) and estradiol with various clinical and laboratory factors. RESULTS: A total of 39 COVID-19-infected patients were included in this study. The mean T level was in the normal reference range while the mean estradiol level was above the normal limit. There were no significant differences between the long-term positive and normal-term groups in T (P = .964), follicle-stimulating hormone (FSH; P = .694), luteinizing hormone (LH; P = .171), prolactin (PRL; P = .836), or T/LH (P = .512). However, estradiol was higher in the normal-term group than the long-term positive group (P < .001). Moreover, there were also no significant differences between the moderate and severe groups in sex-related hormones, duration of viral shedding, or serum biochemical or inflammation indicators. Additionally, regression analyses showed that there were no associations between the T level and the clinical and laboratory factors, while estradiol was negatively associated with the duration of viral shedding. CONCLUSION: In males infected with SARS-CoV-2, most sex-related hormones (T, FSH and LH levels) remain within the normal reference ranges after recovery from COVID-19, and no significant associations were observed between T level and disease duration or severity. At present, there is insufficient evidence to show that SARS-CoV-2 causes hypogonadism and sterility, but the potential risk should not be ignored.
Assuntos
COVID-19/sangue , Estradiol/sangue , SARS-CoV-2/patogenicidade , Testículo/metabolismo , Testosterona/sangue , Idoso , Biomarcadores/sangue , COVID-19/diagnóstico , COVID-19/terapia , COVID-19/virologia , Estudos de Casos e Controles , Hormônio Foliculoestimulante Humano/sangue , Interações Hospedeiro-Patógeno , Humanos , Hormônio Luteinizante/sangue , Masculino , Pessoa de Meia-Idade , Prolactina/sangue , Indução de Remissão , Índice de Gravidade de Doença , Fatores de Tempo , Eliminação de Partículas ViraisRESUMO
BACKGROUND: Spermatogenesis depends on stimulation by follicle-stimulating hormone (FSH) which binds to FSH receptors (FSHR) on testicular Sertoli cells. Three FSH-related single-nucleotide polymorphisms (SNPs), FSHB -211G>T (rs10835638), FSHR -29G>A (rs1394205) and FSHR 2039A>G (rs6166) affect FSH action, and have been suggested to affect testicular function, but the evidence is uncertain. OBJECTIVE: To describe the associations between the three SNPs and testicular function in a large and well-characterised cohort of men from the general population. MATERIALS AND METHODS: A cross-sectional study of 2020 Danish men unselected regarding testicular function. Outcome variables were semen parameters, reproductive hormones and testis size. Genotyping was done by competitive allele-specific quantitative PCR. Differences in genotype frequencies were tested by chi-square test and associations between genotypes and outcomes were assessed by multivariate linear regressions. RESULTS: The SNPs affected serum FSH; carriers of the variant affecting FSH secretion (FSHB -211G>T) had lower FSH levels while carriers of variants affecting receptor expression (FSHR -29G>A) and receptor sensitivity (FSHR 2039A>G) had higher FSH levels. Carriers of FSHB -211G>T had lower calculated free testosterone/LH ratio. Although both FSHB -211G>T and FSHR 2039A>G were associated with smaller testis size, no clear association was detected in relation to any semen parameters, except a lower total number of morphologically normal spermatozoa in the heterozygous carriers of the FSHB -211G>T DISCUSSION AND CONCLUSION: The studied polymorphisms have only minor modulating influence on testis size and function in healthy men. We detected subtle effects of the three SNPs on FSH levels, but also effects of FSHB -211G>T on calculated free testosterone/LH ratio, compatible with altered Leydig cell function. Thus, the role of these FSH-related polymorphisms is complex and modest in men with normal testicular function, but the possible importance of FSH polymorphisms in men with impaired testicular function should be evaluated in future studies in more detail.
Assuntos
Hormônio Foliculoestimulante Humano/sangue , Subunidade beta do Hormônio Folículoestimulante/genética , Receptores do FSH/genética , Análise do Sêmen , Testículo/anatomia & histologia , Adolescente , Alelos , Dinamarca , Frequência do Gene , Genótipo , Humanos , Masculino , Tamanho do Órgão/genética , Polimorfismo de Nucleotídeo Único , Adulto JovemRESUMO
PURPOSE: Women with polycystic ovary syndrome (PCOS) have an increased ovarian responsiveness to exogenous recombinant follicle stimulating hormone (rFSH) but also have high rates of obesity, which is known to affect serum FSH concentrations following exogenous injection. The purpose of this study was to compare rFSH absorption and ovarian response between lean and overweight/obese PCOS subjects and normo-ovulatory controls. METHODS: Fourteen women with PCOS aged 18-42 years old with a BMI of 18.5-24.9 kg/m2 (normal) or 25.0-40.0 kg/m2 (overweight/obese) and eleven normo-ovulatory controls matched by age and BMI were included. After downregulation with oral contraceptives, participants were administered a single subcutaneous injection of 225 IU rFSH and underwent serial blood draws over 72 h. RESULTS: Lean PCOS subjects exhibited a significantly higher area under the curve (AUC) of baseline-corrected serum FSH over 72 h when compared with overweight/obese PCOS subjects (183.3 vs 139.8 IU*h/L, p = 0.0002), and lean, normo-ovulatory women had a significantly higher AUC FSH when compared with overweight/obese, normo-ovulatory women (193.3 vs 93.8 IU*h/L, p < 0.0001). Within overweight/obese subjects, those with PCOS had a significantly higher AUC FSH compared with normo-ovulatory controls (p = 0.0002). Lean PCOS subjects similarly had the highest AUC of baseline-corrected estradiol (6095 pg h/mL), compared with lean normo-ovulatory subjects (1931 pg h/mL, p < 0.0001) and overweight/obese PCOS subjects (2337 pg h/mL, p < 0.0001). CONCLUSION: Lean PCOS subjects exhibited significantly higher baseline-corrected FSH and estradiol levels following rFSH injection compared with overweight/obese PCOS subjects with similar ovarian reserve markers. Amongst overweight/obese subjects, those with PCOS had significantly higher FSH and E2 levels when compared with normo-ovulatory controls.
Assuntos
Hormônio Foliculoestimulante Humano/administração & dosagem , Obesidade/tratamento farmacológico , Síndrome do Ovário Policístico/tratamento farmacológico , Proteínas Recombinantes/administração & dosagem , Adolescente , Adulto , Índice de Massa Corporal , Feminino , Hormônio Foliculoestimulante Humano/sangue , Humanos , Hormônio Luteinizante/sangue , Obesidade/sangue , Obesidade/complicações , Obesidade/patologia , Ovário/crescimento & desenvolvimento , Ovário/patologia , Sobrepeso/sangue , Sobrepeso/complicações , Sobrepeso/tratamento farmacológico , Sobrepeso/patologia , Síndrome do Ovário Policístico/sangue , Síndrome do Ovário Policístico/complicações , Síndrome do Ovário Policístico/patologia , Testosterona/sangue , Adulto JovemRESUMO
BACKGROUND: Studies have reported associations between psychological stress and semen quality, but most have been performed on selected populations using different stress measures. Thus, it is uncertain which stress scale best quantifies the effects of stress on testicular function. OBJECTIVE: To study the association between three different measures of stress and testicular function in young men. MATERIAL AND METHODS: In total, 1362 men (median age 19 years) delivered semen and blood samples. They also answered a questionnaire including information from three stress scales: Stress Symptoms, Stressful Life Events and Perceived Stress. Various statistical analyses for associations between stress and testicular function (semen quality and reproductive hormones) were performed. RESULTS: Perceived Stress was negatively associated with sperm concentration, total count and motility and positively associated with serum FSH. Men with the highest scores (>30 points) had 38% (95% CI 3-84%) lower sperm concentration, 42% (95% CI 5-91%) lower total count and 22% (95% CI 2-32%) lower proportion of motile spermatozoa than men with the lowest scores (0-10 points). For the stress symptoms score, men with highest scores (>95th percentile vs. lower) had lower sperm concentration, total sperm count, motility and serum Inhibin-B/FSH-ratio. Although men with highest stress levels were characterized by an unhealthier lifestyle, adjusting for lifestyle factors did not attenuate results suggesting that the associations between stress and testicular function were not mediated by lifestyle. Stressful Life Events were not associated with testicular function. DISCUSSION AND CONCLUSION: The linear association between Perceived Stress and semen parameters and lack of dose-response association for the other two stress scales indicated that perceived stress was the most sensitive marker of stress affecting semen quality in young men. The lack of associations between Stressful Life Events and testis function confirmed that the perception of stressful events rather than the stressful event per se matters.
Assuntos
Infertilidade Masculina/diagnóstico , Acontecimentos que Mudam a Vida , Análise do Sêmen , Espermatogênese , Estresse Psicológico/diagnóstico , Inquéritos e Questionários , Testículo/fisiopatologia , Biomarcadores/sangue , Estudos Transversais , Dinamarca , Hormônio Foliculoestimulante Humano/sangue , Humanos , Infertilidade Masculina/sangue , Infertilidade Masculina/fisiopatologia , Infertilidade Masculina/psicologia , Masculino , Valor Preditivo dos Testes , Fatores de Risco , Contagem de Espermatozoides , Motilidade dos Espermatozoides , Espermatozoides/patologia , Estresse Psicológico/sangue , Estresse Psicológico/fisiopatologia , Estresse Psicológico/psicologia , Testículo/metabolismo , Adulto JovemRESUMO
FSH in infertile patients may be measured in the normal range and abnormal semen analysis findings may be observed in patients with normal FSH values. A recent study predicts that the sperm morphology and concentration may be impaired if the FSH value is above 4.5 IU/L. Therefore, this study aimed to define a clinically more useful upper limit for FSH as an indicator for male infertility. In this study 1,893 infertile male patients were evaluated retrospectively. Physical examination, hormone analysis (total testosterone (TT), FSH, luteinizing hormone (LH), estradiol (E2), sex hormone binding globulin (SHBG) and prolactin (PRL)), semen analyzes were recorded and analyzed retrospectively. Logistic regression analysis, 95% confidence intervals and probability ratios were calculated to show the relationship between categorical hormone levels (quarters) and semen parameters. Hormone levels were categorized using the distribution quarters in the study population. FSH values of 62% of the cases with sperm concentration <15 million/ml were greater than 4.8 IU/L. 59.7% of patients with sperm count <39 million had FSH values greater than 4.8 IU/L. In conclusion, FSH values above 4.8 IU/L were found to be abnormal when the male factor was investigated for infertility. ABBREVIATIONS: FSH: Follicular Stimulating Hormone; GnRH: Gonadotropin-releasing Hormone; HPGA: Hypothalamic-Pituitary-Gonadal Axis; TT: Total Testosterone; LH: Luteinizing Hormone; E2: Estradiol; SHBG: Sex Hormone Binding Globulin; PRL: Prolactin; WHO: World Health Organization; AUC: Area Under the Curve.
Assuntos
Fertilidade , Hormônio Foliculoestimulante Humano/sangue , Infertilidade Masculina/sangue , Adolescente , Adulto , Biomarcadores/sangue , Humanos , Infertilidade Masculina/diagnóstico , Infertilidade Masculina/fisiopatologia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Valores de Referência , Estudos Retrospectivos , Contagem de Espermatozoides , Adulto JovemRESUMO
Male infertility is a rising problem around the world. Often the cause of male infertility is unclear, and this hampers diagnosis and treatment. Spermatogenesis is a complex process under sophisticated regulation by many testis-specific genes. Here, we report the testis-specific gene 1700102P08Rik is conserved in both the human and mouse and highly expressed in spermatocytes. To investigate the role of 1700102P08Rik in male fertility, knockout mice were generated by CRISPR-Cas9. 1700102P08Rik knockout male mice were infertile with smaller testis and epididymis, but female knockout mice retained normal fertility. Spermatogenesis in the 1700102P08Rik knockout male mouse was arrested at the spermatocyte stage, and no sperm were found in the epididymis. The deletion of 1700102P08Rik causes apoptosis in the testis but did not affect the serum concentration of testosterone, luteinizing hormone, and follicle-stimulating hormone or the synapsis and recombination of homologous chromosomes. We also found that 1700102P08Rik is downregulated in spermatocyte arrest in men. Together, these results indicate that the 1700102P08Rik gene is essential for spermatogenesis and its dysfunction leads to male infertility.
Assuntos
Fertilidade/genética , Genes Essenciais , Infertilidade Masculina/genética , Peptídeos e Proteínas de Sinalização Intercelular/genética , Proteínas/genética , Testículo/fisiopatologia , Animais , Apoptose/genética , Células Cultivadas , Regulação para Baixo/genética , Feminino , Hormônio Foliculoestimulante Humano/sangue , Técnicas de Inativação de Genes , Humanos , Infertilidade Masculina/sangue , Hormônio Luteinizante/sangue , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Endogâmicos ICR , Camundongos Knockout , Espermatócitos/metabolismo , Espermatogênese/genética , Testículo/patologia , Testosterona/sangueRESUMO
BACKGROUND: While sex differences characterize susceptibility and severity of idiopathic pulmonary arterial hypertension (IPAH), our understanding of the relationship between levels of gonadotropins and sex hormones in fertile women and the disease is limited. We aimed to investigate whether gonadotropin and sex hormone levels in women of reproductive age were associated with risk and mortality of IPAH. METHODS: We did a matched case-control study. Cases were reproductive female patients with idiopathic pulmonary arterial hypertension admitted in Shanghai Pulmonary Hospital (Tongji University School of Medicine, Shanghai, China) during 2008-2014. Healthy controls were matched on age and body mass index. We also did a prospective cohort study to assess the effects of hormone levels on mortality in IPAH fertile female patients. RESULTS: One hundred sixty-four cases and 133 controls were included. After adjustment for age and body mass index, the odds ratios of having IPAH for follicle-stimulating hormone, testosterone, and progesterone as expressed on natural log scale were 1.51 (95% confidence interval: 1.06, 2.16), 0.42 (0.31-0.57), and 0.52 (0.43-0.63), respectively. In the cohort study with a median follow-up of 77 months, the hazard ratios for dying after adjustment for baseline characteristics and treatments among IPAH patients were 2.01 (95% confidence interval: 1.22-3.30) and 0.78 (95% confidence interval: 0.62-0.98) for follicle-stimulating hormone and progesterone in natural log scale, respectively. CONCLUSIONS: In reproductive women with IPAH, high follicle-stimulating hormone and low progesterone tended to be associated with high risk of IPAH and mortality among patients.
Assuntos
Pressão Arterial , Hipertensão Pulmonar Primária Familiar/sangue , Hormônio Foliculoestimulante Humano/sangue , Progesterona/sangue , Reprodução , Adolescente , Adulto , Fatores Etários , Biomarcadores/sangue , Estudos de Casos e Controles , Hipertensão Pulmonar Primária Familiar/diagnóstico , Hipertensão Pulmonar Primária Familiar/mortalidade , Hipertensão Pulmonar Primária Familiar/fisiopatologia , Feminino , Humanos , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Fatores Sexuais , Adulto JovemRESUMO
OBJECTIVE: The aim of the study was to assess the effectiveness of Chinese herbal medicine combined with traditional Chinese medicine (TCM)-based psychotherapy (TBP) on perimenopausal depression (PMD). METHODS: This multicenter, randomized, placebo-controlled clinical trial was conducted in nine hospitals in China between August 2015 and June 2017. The study included 307 women with PMD who were divided randomly into two treatment groups: the Bushen Tiaogan formula (BSTG) plus TBP (nâ=â156) and placebo plus TBP (nâ=â151). All participants underwent treatment for 8 weeks and were followed up for 4 weeks. The primary outcome measures included scores of the Greene Climacteric Scale (GCS), Self-Rating Depression Scale (SDS), and Self-Rating Anxiety Scale (SAS). Secondary outcomes included serum levels of sex hormones and lipids, as well as adverse events. RESULTS: The average GCS, SDS, and SAS scores after treatment were significantly lower in the BSTG-plus-TBP group than those in the placebo-plus-TBP group, and the differences were greatest at the end of the 12th week: the average GCS scores were 10.8 in the BSTG-plus-TBP group versus 18.5 in the placebo-plus-TBP group (Pâ<â0.001); the average SDS scores were 30.7 in the BSTG-plus-TBP group versus 45.4 in the placebo-plus-TBP group (Pâ<â0.001); the SAS scores were 28.6 in the BSTG-plus-TBP group versus 42.6 in the placebo-plus-TBP group (Pâ<â0.001). In addition, treatments with BSTG plus TBP significantly reduced the levels of basal follicle-stimulating hormone (Pâ=â0.045) and triglycerides (Pâ=â0.039) and increased the level of high-density lipoprotein cholesterol (Pâ<â0.001) compared to placebo treatments with TBP. No serious adverse events occurred, and the safety indices of complete blood counts, renal function, and liver function were within normal ranges, before and after treatments. CONCLUSIONS: Treatment with BSTG formula plus TBP was more effective than TBP alone for improving PMD symptoms, sexual hormone levels, and blood lipid conditions in women with mild PMD.
Assuntos
Depressão/terapia , Medicamentos de Ervas Chinesas/uso terapêutico , Medicina Tradicional Chinesa/métodos , Perimenopausa/psicologia , Psicoterapia/métodos , Ansiedade/sangue , Ansiedade/tratamento farmacológico , China , HDL-Colesterol/sangue , Depressão/sangue , Formas de Dosagem , Medicamentos de Ervas Chinesas/efeitos adversos , Feminino , Hormônio Foliculoestimulante Humano/sangue , Seguimentos , Humanos , Pessoa de Meia-Idade , Perimenopausa/sangue , Autorrelato , Resultado do Tratamento , Triglicerídeos/sangueRESUMO
OBJECTIVE: To evaluate which factor, AMH or FSH, was superior in predicting live birth after assisted reproductive technologies (ART) when the tests are discordant, using data from the Society for Assisted Reproductive Technology Clinical Outcomes Reporting System database. DESIGN: Retrospective cohort. SETTING: Clinic-based data. PATIENT(S): The study population included 44,696 fresh embryo transfer cycles using autologous oocytes. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Live birth (≥22 wk gestation and ≥300 g birth weight). RESULT(S): Live birth rate per started cycle was lower in patients with low AMH and normal FSH than in patients with normal AMH and elevated FSH (26% vs. 39%). A multivariate analysis was performed on patients with normal FSH and low AMH, and the following factors were independently associated with live birth: AMH, age >40 years, body mass index >30 kg/m2, race African-American or Asian, IVF clinic region West, uterine factor infertility diagnosis, agonist suppression, and FSH dosage. IVF cycle cancellation rate was higher in patients with low AMH and normal FSH (30%). CONCLUSION(S): AMH is a superior predictor of live birth in patients undergoing IVF when FSH and AMH values are discordant. Lower AMH is independently associated with lower live birth and higher IVF cycle cancellation rates than elevated FSH in patients with discordant values.
Assuntos
Hormônio Antimülleriano/sangue , Fertilização in vitro/efeitos adversos , Hormônio Foliculoestimulante Humano/sangue , Infertilidade/terapia , Adolescente , Adulto , Biomarcadores/sangue , Regulação para Baixo , Feminino , Fertilidade , Humanos , Infertilidade/sangue , Infertilidade/fisiopatologia , Nascido Vivo , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Gravidez , Taxa de Gravidez , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento , Adulto JovemRESUMO
OBJECTIVE: The purpose of this study was to evaluate the relation between FSH and lipid levels in postmenopausal women from the Kuopio Ischaemic Heart Disease Risk Factor Study. METHODS: Postmenopausal women (nâ=â588) aged 53 to 73 years and not using hormone therapy were included. The relation between FSH and total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TGs) was evaluated using linear regression, adjusting for estradiol, body mass, smoking, and other hormonal and lifestyle factors. The relation between FSH, dyslipidemia, and abnormal lipid levels were also evaluated. RESULTS: FSH was positively and linearly associated with TC (Pâ=â0.001) and LDL-C (Pâ=â0.01) in all participants, with stronger relations seen in younger compared with older postmenopausal women. FSH was less strongly associated with HDL-C and TG. FSH was not associated with dyslipidemia; however, higher FSH was associated with increased risk of high TC (Pâ=â0.02) and high LDL-C (Pâ=â0.03). CONCLUSIONS: These data suggest that higher FSH in postmenopausal women is related to higher levels of both TC and LDL-C.
Assuntos
HDL-Colesterol/sangue , LDL-Colesterol/sangue , Hormônio Foliculoestimulante Humano/sangue , Pós-Menopausa/sangue , Triglicerídeos/sangue , Idoso , Índice de Massa Corporal , Dislipidemias , Estradiol/sangue , Feminino , Finlândia , Humanos , Estilo de Vida , Pessoa de Meia-Idade , Estudos Prospectivos , FumarRESUMO
Menopause is associated with dyslipidemia and an increased risk of cardio-cerebrovascular disease. The classic view assumes that the underlying mechanism of dyslipidemia is attributed to an insufficiency of estrogen. In addition to a decrease in estrogen, circulating follicle-stimulating hormone (FSH) levels become elevated at menopause. In this study, we find that blocking FSH reduces serum cholesterol via inhibiting hepatic cholesterol biosynthesis. First, epidemiological results show that the serum FSH levels are positively correlated with the serum total cholesterol levels, even after adjustment by considering the effects of serum estrogen. In addition, the prevalence of hypercholesterolemia is significantly higher in peri-menopausal women than that in pre-menopausal women. Furthermore, we generated a mouse model of FSH elevation by intraperitoneally injecting exogenous FSH into ovariectomized (OVX) mice, in which a normal level of estrogen (E2) was maintained by exogenous supplementation. Consistently, the results indicate that FSH, independent of estrogen, increases the serum cholesterol level in this mouse model. Moreover, blocking FSH signaling by anti-FSHß antibody or ablating the FSH receptor (FSHR) gene could effectively prevent hypercholesterolemia induced by FSH injection or high-cholesterol diet feeding. Mechanistically, FSH, via binding to hepatic FSHRs, activates the Gi2α/ß-arrestin-2/Akt pathway and subsequently inhibits the binding of FoxO1 with the SREBP-2 promoter, thus preventing FoxO1 from repressing SREBP-2 gene transcription. This effect, in turn, results in the upregulation of SREBP-2, which drives HMGCR nascent transcription and de novo cholesterol biosynthesis, leading to the increase of cholesterol accumulation. This study uncovers that blocking FSH signaling might be a new strategy for treating hypercholesterolemia during menopause, particularly for women in peri-menopause characterized by FSH elevation only.
Assuntos
Colesterol/biossíntese , Hormônio Foliculoestimulante Humano/antagonistas & inibidores , Hormônio Foliculoestimulante Humano/sangue , Hipercolesterolemia/epidemiologia , Fígado/metabolismo , Menopausa/metabolismo , Adulto , Animais , Anticorpos/farmacologia , Anticolesterolemiantes/farmacologia , Estudos Transversais , Modelos Animais de Doenças , Estrogênios/metabolismo , Feminino , Células Hep G2 , Humanos , Hipercolesterolemia/induzido quimicamente , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Pessoa de Meia-Idade , Prevalência , RNA Interferente Pequeno/genética , Receptores do FSH/genética , Receptores do FSH/metabolismoRESUMO
OBJECTIVE: The aim of the study was to evaluate if there are differences in endothelial function before and after acute exercise in women at different menopausal stages with high and low cardiorespiratory fitness. METHODS: Participants were healthy high-fit premenopausal (nâ=â11), perimenopausal (nâ=â12), and postmenopausal women (nâ=â13) and low-fit perimenopausal (nâ=â7) and postmenopausal women (nâ=â8). Brachial artery flow-mediated dilation (FMD) was measured before and after acute moderate intensity exercise. FMD was calculated as (Diameterpeak-Diameterbaseline)/ Diameterbaseline) × 100. Differences between high-fit women and between high- and low-fit perimenopausal and postmenopausal women were assessed with repeated-measure ANOVAs. Relations with FMD were assessed with Pearson correlations. RESULTS: FMD was reduced with progressive menopausal stage in high-fit women (Pâ=â0.005) and was lower in perimenopausal compared to postmenopausal women (Pâ=â0.047). FMD was lower in high-fit compared to low-fit women (Pâ=â0.006) and there was no relation between FMD and VO2peak (Pâ>â0.05). There was an inverse relation between FMD and follicle-stimulating hormone (Pâ<â0.05), but not estradiol (Pâ>â0.05). CONCLUSIONS: These data suggest that endothelial function is lower with progressive menopausal stage in women with high cardiorespiratory fitness; that FMD is lower in women with higher cardiorespiratory fitness; and that FSH, but not estradiol, is associated with FMD.
Assuntos
Artéria Braquial/fisiologia , Aptidão Cardiorrespiratória/fisiologia , Endotélio Vascular/fisiologia , Hormônio Foliculoestimulante Humano/sangue , Menopausa , Vasodilatação/fisiologia , Adulto , Idoso , Estudos Transversais , Estradiol/sangue , Exercício Físico/fisiologia , Teste de Esforço , Feminino , Humanos , Pessoa de Meia-Idade , AutorrelatoRESUMO
OBJECTIVE: Women exhibit reduced ovarian sex hormones during the menopausal period that result in well-known physical and psychological symptoms. However, symptoms related to gastric motility (GM) have not been thoroughly investigated. We hypothesized that stress response gastric motility (SRGM) is lower in postmenopausal (PM) and perimenopausal (PERIM) women than in premenopausal (PREM) women. Estrogenic decline leads to neuroendocrine changes in different areas of the brain. These changes can result in hypothalamic vasomotor symptoms, disorders in eating behaviours, and altered blood pressure, in addition to psychological disorders such as stress, anxiety, depression, and irritability related to alterations in the limbic system. METHODS: In this pilot study, 55 PREM, PERIM, and PM women were clinically evaluated using the Nowack stress profile (SP) and State-Trait Anxiety Inventory (STAI). GM was assessed via electrical bioimpedance using two psychological stress tests (Stroop and Raven tests). RESULTS: Basal SP and STAI-anxiety test scores were similar among the three groups of women (Pâ>â0.05). PERIM women had lower GM in the basal state (Pâ<â0.05) than did other women. PREM and PM women had significantly decreased GM during the stress tests (Pâ<â0.05). However, PERIM did not exhibit GM changes during stress tests (Pâ>â0.05). CONCLUSION: Changes in sex hormones during PERIM may affect GM and SRGM.