Improved in vitro fertilization success and pregnancy outcome with autologous platelet-rich plasma treatment in unexplained infertility patients that had repeated implantation failure history.

Repeated implantation failure (RIF) due to suboptimal endometrial lining is a major challenge in reproductive medicine. The study aims to evaluate effect of intrauterine platelet-rich plasma (PRP) treatment on frozen-thawed embryo transfer (FET) cycles in patients whose endometrium was unable to achieve optimal lining in unexplained infertility patients with history of RIF. We retrospectively analyzed the charts of a total of 302 cycles performed in 273 patients attending Diyar Life ART Centre between January 2014 and January 2017. After excluding 232 cycles, we compared pregnancy outcomes of 34 patients who had suboptimal endometrial lining and underwent PRP + FET and 36 patients who had optimal endometrial lining and underwent only FET. We observed that, endometrial thickness was higher after 48 hours from PRP when compared to endometrial thickness before PRP (10 mm vs. 6.25 mm, p < .001). Clinical pregnancy rate, and importantly live birth rate were also significantly higher in PRP group than the control group. Based on this information, we showed that intrauterine autologous PRP infusion is a safe, inexpensive adjuvant treatment for optimizing endometrium especially in patients with RIF history and intrauterine PRP infusion improved not only endometrial lining but also in vitro fertilization success and pregnancy outcome.

Evaluation of Sexual Function in Women with Hypogonadotropic Hypogonadism Using the Female Sexual Function Index (FSFI) and the Beck Depression Inventory (BDI).

BACKGROUND Hypogonadotropic hypogonadism (HH), or secondary hypogonadism, results from reduced secretion of gonadotropins, including follicle-stimulating hormone (FSH) and luteinizing hormone (LH), by the pituitary gland, resulting in lack of production of sex steroids. The aim of this study was to evaluate self-reported sexual function in sexually active women with and without HH using two evaluation methods, the Female Sexual Function Index (FSFI) and the Beck Depression Inventory (BDI). MATERIAL AND METHODS The study recruited 88 women who attended an outpatient in vitro fertilization (IVF) clinic in Turkey for primary infertility, between August 2013 and August 2016. All patients were sexually active with an age that ranged from 20-41 years. Following an initial examination, including measurement of FSH and LH levels, all study participants were asked to complete the FSFI and BDI self-reporting questionnaires. Patients were divided into Group 1 (with HH) (N=42) and Group 2 (the control group) (N=46). RESULTS Analysis of the patient responses to questions regarding their sexual function in the FSFI and BDI showed that of the 42 patients in Group 1 (the HH group), 27 patients (64.28%) reported sexual dysfunction; of the 46 patients in Group 2 (the control group) 14 patients (30.34%) reported sexual dysfunction. Analysis of the FSFI lubrication scores and orgasm scores showed a statistically significant difference between the two groups (both, p<0.01). CONCLUSIONS Women with HH require both physical and psychological support to improve their sexual function, self-esteem, mental health, and quality of life.

Thrombophilia and Recurrent Pregnancy Loss: The Enigma Continues.

BACKGROUND Thrombophilic gene polymorphism is known to be a risk factor for recurrent pregnancy loss (RPL), but few studies have confirmed a possible role of thrombophilic genes polymorphism in RPL risk. This study was conducted to understand the relationship of the mutations of some thrombophilia-associated gene polymorphism (heterozygous/homozygous) with RPL. We compared patients with 2 abortions to patients with 3 or more abortions among Turkish women. MATERIAL AND METHODS In this study, patients previously diagnosed with habitual abortus at Obstetrics and Gynecology outpatient clinics in Turkey between 2012 and 2016 were included. In their peripheral blood, we detected factor V Leiden H1299R, prothrombin G20210A, MTHFR C677T, MTHFR A1298C, PAI-1 4G/5G, and PAI-1 4G/4G gene mutations. RESULTS In this study, we have observed statistically meaningful data (P<0.01) related to the relationship between RPL and thrombophilia-associated gene polymorphisms such as heterozygous factor V Leiden H1299R, heterozygous prothrombin G20210A, PAI-1 4G/5G, and PAI-1 4G/4G. CONCLUSIONS We found that diagnosis of thrombophilic genes polymorphism is useful to determine the causes of RPL, recognizing that this multifactorial disease can also be influenced by various acquired factors, including reproduction-associated risk factors and prolonged immobilization.

Prenatal diagnosis of an autosomal translocation with regular trisomy 21.

The coincidence of trisomy 21 and a structural rearrangement is very rare, and even it has not been reported as a prenatal diagnosis yet. In this article, we present an autosomal translocation carrier fetus with trisomy 21: 47,XX,+21, t(3;8)(p21;q24). Although the coincidence of reciprocal translocation and trisomy may be seen in reciprocal translocation carrier families, de novo cases are extremely rare. The presented case is diagnosed by amniocentesis, which was performed because of abnormal fetal ultrasonographic findings and increased trisomy 21 risk at maternal serum screening test. The postmortem pathologic examination of the fetus revealed that the findings of hypertelorism and right lung with two lobes are interesting novel findings of our cases associated with the breakpoints 3p21 and 8q24.

Neopterin: a promising marker for the inflammation in polycystic ovary syndrome.

BACKGROUND: Several markers of low-grade chronic inflammation are altered in women with polycystic ovary syndrome (PCOS). Neopterin (NEO) is a marker of celullar immunity, and oxidative stress, mainly produced by activated macrophages. We aimed to evaluate the NEO levels in PCOS patients and correlate them with antropometric and biochemical parameters. METHODS: The study groups consisted of 69 women with PCOS and 46 healthy controls. Both groups were divided into two subgroups according to their body mass index (BMI): <25 = normoweight, >25 = overweight. The clinical and biochemical parameters and serum NEO levels were analyzed. RESULTS: Circulating levels of NEO were significantly (p < 0.001) higher in women with PCOS (normoweight: 15.9 ± 4.7 nmol/l; overweight 13.3 ± 8.1 nmol/l) compared to controls (normoweight: 8.6 ± 2.0 nmol/l; overweight 9.2 ± 1.8 nmol/l) regardless of their weight classes. Waist-to-hip ratio (WHR) (p < 0.05), free and total testosterone (p < 0.001) were significantly elevated in women with PCOS compared to controls after controlling for the effect of obesity. CONCLUSION: Circulating NEO level s are elevated in PCOS independent of body mass index supporting the suggestion of PCOS is a low-grade chronic inflammatory state.

Can serum gamma-glutamyltransferase levels be useful at diagnosing gestational diabetes mellitus?

OBJECTIVE: The aim of this study was to evaluate plasma gamma-glutamyltransferase (GGT) in gestational diabetes mellitus (GDM) in pregnant women at oral glucose tolerance test (OGTT) and the diagnosis of GDM and to explore whether this activity is associated with metabolic parameters. METHOD: This prospective control study included 37 women with GDM and 42 women with normal glucose tolerance in pregnancy (control group). In the study group (GDM), blood was taken for analyzing 100 g OGTT from women who have abnormal 50 g glucose challenge test (GCT). RESULTS: Compared with the controls, the GDM group had significantly higher mean values for serum fasting glucose, insulin, homeostasis model assessment-insulin resistance (HOMA-IR), triglyceride and GGT. Within the GDM group, GGT levels were only negatively correlated with high-density lipoprotein (r = -0.41, p = 0.01). GGT was determined to be an independent metabolic parameter for GDM. While performing analyses receiver operational curve analysis, GGT cutoff set was set at 16 IU/L, the sensitivity was calculated as 86%, and specificity was as 37%. CONCLUSION: The increase at GGT level is an independent risk factor for GDM and identified as high-risk women for diagnosis of GDM.

Chitotriosidase levels in patients with severe endometriosis.

OBJECTIVE: To study the levels of chitotriosidase activity in the peritoneal fluid and the plasma of patients with severe endometriosis and control subjects. MATERIALS AND METHODS: Twenty-five women with laparoscopically and histopathologically confirmed endometriosis (study group) and 27 control patients who had undergone laparoscopic surgery were included. Peritoneal fluid and peripheral blood were obtained from all the patients before the surgery. Chitotriosidase activities were measured. RESULTS: Analysis of chitotriosidase activity in the peritoneal fluid of patients with endometriosis showed that there was no significant difference between endometriosis and control group, respectively (32.04 ± 64.20 vs. 15.25 ± 31.17 nmol/mL/h; p > 0.05). Analysis of chitotriosidase activity in plasma of patients with endometriosis showed significantly increased levels of chitotriosidase levels compared with the control group (74.81 ± 60.54 vs. 14.10 ± 26.17; p < 0.001), respectively. CONCLUSION: We found that the activity of chitotriosidase in plasma was statistically higher in severe endometriosis patients than women without endometriosis.

Comparison of risk of malignancy index (RMI), CA125, CA 19-9, ultrasound score, and menopausal status in borderline ovarian tumor.

OBJECTIVE: The aim of this study was to assess the prognostic values of risk of malignancy index (RMI IV), ultrasound score, menopausal status, and serum CA125 and CA19-9 level in patients with borderline ovarian tumor (BOT). METHODS: Fifty women having borderline ovarian tumor (BOT) and 5O individuals with benign adnexal mass were enrolled in this retrospective study. The sensitivity, specificity, positive predictive values, negative predictive values and diagnostic accuracy of preoperative serum levels of the CA125 and CA19-9, ultrasound findings and menopausal status, and RMI IV were calculated for prediction of discrimination between BOTs and benign adnexal masses and the results were compared. RESULTS: The RMI IV was the best method for discrimination between BOTs and benign adnexal masses and was more accurate than the other parameters. When Receiver Operator Characteristic area under the curves for menopausal status was analyzed, serum CA 125 and CA19-9 level, ultrasound score, RMI IV(CA125), and RMI IV(CA19-9) were, 0.580, 0.625, 0.548, 0.694, 0.734 and 0.711, respectively. The best RMI IV cut-off was found to be 200 for discrimination of benign and BOT lesions. In the RMI formulation, replacing CA125 with CA19-9 didn't affect RMI IV sensitivity and specificity for discrimination. CONCLUSION: Compared to ultrasound, menopausal status, CA-125, CA19-9, the RMI IV was found to be the best predictive method for differentiation of BOTs from benign adnexal masses. RMI IV cut-off value of 200 is suitable for differentiation of benign and BOT's.

A macrophage activation marker chitotriosidase in women with PCOS: does low-grade chronic inflammation in PCOS relate to PCOS itself or obesity?

OBJECTIVE: Polycystic ovary syndrome (PCOS) is described as a low-grade chronic inflammatory state where the macrophage infiltration increased in visceral fat play the major role. The aim of this study was to assess chitotriosidase (ChT) activity (an activated macrophage marker) in women with PCOS and controls and to evaluate its correlation with anthropometric and biochemical parameters. STUDY DESIGN: Seventy-nine women with PCOS and 60 healthy controls were included in the study. PCOS and controls were divided into two subgroups according to body mass indexes (BMIs) as normoweight (<25 kg/m(2)) and overweight (≥25 kg/m(2)). ChT activity, biochemical (free testosterone, luteinizing hormone, insulin resistance index, etc.) and clinical parameters [BMI, waist-to-hip ratio, modified Ferriman-Gallwey scores (mFG)] were analyzed according to groups. RESULTS: Serum ChT activity was significantly (p < 0.001) higher in women with PCOS than controls (normoweight, 87.1 ± 90.1 vs. 18.4 ± 9.0 nmol/ml/h; overweight, 92.0 ± 96.7 vs. 17.9 ± 12.1 nmol/ml/h PCOS and controls, respectively). No statistically significant difference was noted between ChT activity of normoweight and overweight PCOS subgroups. A positive correlation was found between ChT activity and PCOS status (r 0.598, p < 0.001), mFG scores (r 0.525, p < 0.001), free testosterone (r 0.402, p 0.001) and total testosterone (r 0.168, p 0.048) for the combined groups (PCOS + controls). In multivariant linear regression analysis participants' PCOS status (presence or absence) and LH levels were the main predictors of ChT activity in the whole study population (p 0.002 and p 0.041, respectively). CONCLUSION: ChT activity elevates in PCOS independent of obesity. Our findings support the concept of PCOS is a state of low-grade chronic inflammation where the macrophages could play the major role. Hyperandrogenism might also be related to this inflammatory state and can be a subject of further trials.

Chitotriosidase, interleukin-1 beta and tumor necrosis factor alpha levels in mild preeclampsia.

OBJECTIVE: Chitotriosidase (ChT) is an activated macrophage marker. Tumor necrosis factor alpha (TNF-α) and interleukin 1 beta (IL-1ß) are mainly produced macrophages. The aim of the present study was to evaluate the relationship between serum ChT activity, levels of TNF-α and IL-1ß in patients with mild preeclampsia and normal pregnancy. METHODS: An overall 64 cases, 32 healthy pregnant control women (control group) and 32 women with mild preeclamptic patients (study group), were enrolled in this study. At the beginning of the study, all study participants were matched for age and gestational age. Serum ChT activity was measured by fluorometer; TNF-α and IL-1ß levels were measured by enzyme-linked immunosorbent assay. RESULTS: The mean age, gestational week, parity and gravida were similar in the two groups (p > 0.05). Serum ChT activity was significantly higher in the preeclampsia group compared to the control group (p < 0.05). Levels of TNF-α and IL-1ß in patients with mild preeclampsia were similar compared to the control group (p > 0.05). In the PE group, serum ChT activity was not correlated with TNF-α and IL-1ß. CONCLUSION: Mild preeclampsia is found associated with higher ChT activity. This result suggests that activated macrophages play a role in the pathogenesis of preeclampsia. This suggestion needs to be confirmed in future studies with larger populations.

Comparative audiometric evaluation of hearing loss between the premenopausal and postmenopausal period in young women.

AIM: The aim of this study was to determine the audiologic status and severity of hearing loss in different frequencies between the premenopausal and postmenopausal period in women. MATERIALS AND METHODS: This prospective study involved 28 premenopausal and 27 postmenopausal women. Premenopausal and postmenopausal women were younger than 46 years. Age range for premenopausal and menopause patients was 37 to 46 years. The mean age of menopause women with sensorineural hearing loss in our study was not suitable for the age range of presbyacousis that is commonly seen. Each subject was tested with low- (250-2000 Hz) and high-frequency (4000-8000 Hz) audiometry. For each set of tests, mean values of air conduction at each frequency were calculated for the premenopausal and postmenopausal groups and compared. RESULTS: The mean ages of the women on premenopausal and postmenopausal groups were 42.0 ± 2.4 and 43.4 ± 2.6 years, respectively. Duration of menopausal period in second group was 2.03 ± 0.85 years. The corresponding mean body mass indexes were 29.7 ± 2.9 and 31.1 ± 3.8 kg/m(2). There was no statistical significance between the 2 groups in mean ages and mean body mass indexes. Hearing thresholds at low and high frequencies were analyzed between the 2 groups in Table 2. At low (250, 500, 1000, and 2000 Hz) and high frequencies (4000, 6000, and 8000 Hz), the mean air-conduction threshold values between the 2 groups were not statistically significant. CONCLUSION: Estrogen deficiency may not elevate hearing thresholds in early postmenopausal period; however, further studies of larger series are needed to confirm this.

Cytotoxic effects of nasal buserelin on nasal mucosal tissue in rabbits.

To investigate the cytotoxic effects of nasal buserelin on rabbit nasal mucosal tissue, twenty-four female rabbits were studied prospectively. The rabbits were divided into 4 groups including 6 rabbits. The rabbits' left noses were included in the all study groups: 150 µg/puff/day of buserelin acetate was administered topically twice daily during 21, 42 and 63 days. Saline was administered topically twice daily to the left nasal cavity in the control group. The nasal septal mucosal stripe tissue was carefully removed from underlaying cartilage after sedation. HE staining, Masson's trichrome, toluidine blue and TUNEL staining were used to evaluate mucosal changes. Each preparation was investigated via apoptotic cells, and they were accounted. Kruskal-Wallis test was used to evaluate nonparametric comparison of apoptotic cells. Mononuclear cells have been raised in the sub-epithelial connective tissue, nucleuses of epithelial cells in the apical region were pyknotic, and apoptotic cells were determined on 21-day group. In the 42-day group, nasal epithelial tissue was similar to 21-day group and epithelial cells including pyknotic nucleus were present in this group, too. In the 63-day group, epithelial cells were light colored. Venous sinuses in the sub-epithelial connective tissue were wide but not congested and not raised collagen filaments. In the intra-epithelial tissue, some of cells were TUNEL (+). Apoptotic cells were fewer in the control group according to 21-day group. In 42- and 63-day groups, these cells were fewer than in 21-day group. Numerical difference was present between the groups, but statistical significance was not found between the groups. We concluded that nasal buserelin cytotoxicity was not potent in the nasal cavity in rabbits. We use nasal buserelin in all indications with confidence.

Combined approach in a large placental chorioangioma case with intratumoral alcohol injection, cordocentesis, IU transfusion, and amnioreduction.

Large placental chorioangiomas (LPCs) are rare complications of pregnancy and these tumors are associated with increased risk of pregnancy complications. We presented a LPC case at 25th week of gestation, complicated by polyhydramnios and preterm labor in which intratumoral alcohol injection was performed succesfully. Cordocentesis, fetal intrauterine transfusion, and amnioreduction were performed at the same session, as a combined approach. The safety of the procedure was shown by the lack of alcohol in the fetal cord blood sample. Intratumoral alcohol injection is a reliable and effective treatment modality in the management of LPCs and may be combined with other invasive procedures.

Expression of EMSY gene in sporadic ovarian cancer.

The majority of familial breast and ovarian cancers arise from mutations in the BRCA1 and BRCA2 genes. Amplification at the 11q13.5 locus is commonly observed in breast and ovarian cancers. In 2003, Hughes-Davies et al. identified a novel gene (EMSY) at this locus which binds BRCA2 within a region deleted in some cancers. Although little is known about the cellular role of EMSY, indirect evidence suggests that this nuclear protein is capable of silencing the activation potential of BRCA2. In this study we aimed to investigate expression of the EMSY gene and its protein product in sporadic ovarian cancer. Real-time quantitative RT-PCR was performed in 50 ovarian cancer and 17 normal ovarian tissue samples. Overexpression of the EMSY gene was found in 6/50 cases (12%), but in none of the control samples. To determine the EMSY protein by Western blotting, semi-quantitative analysis of the EMSY protein was performed using the Scion Image Gel Analysis Program. Statistical analysis was performed using SPSS 11.5. All patients having EMSY overexpression also displayed increased levels of the EMSY protein. Sporadic ovarian cancer shows overexpression of EMSY at a prevalence similar to that found in breast cancer and the overexpression is correlated with the protein level.

Evaluation of carotid wall thickness and vertebro-basilar system insufficiency in patients with obese polycystic ovary syndrome.

AIM: To investigate the risk of cardiovascular disease by measuring carotid intima-media thickness (CIMT) and to evaluate the diameters and blood flow volume of vertebral arteries using Doppler ultrasound and the possible contribution of hyperandrogenemia that exists in these patients. MATERIAL AND METHODS: We prospectively studied 64 Caucasian women aged 18-35 years (31 with polycystic ovary syndrome [PCOS] and 33 healthy controls). Patients were classified according to body mass index into obese (BMI > 27 kg/m(2) ). All subjects were examined with ultrasound to measure CIMT and blood flow volume and diameters of vertebral arteries. RESULTS: A significant difference between the two groups in CIMT (0.51 ± 0.08 vs 0.39 ± 0.02 mm, P < 0.001) and diameters of vertebral arteries (right, 3.03 ± 0.37 vs 3.44 ± 0.68 mm and left, 2.94 ± 0.34 vs 3.33 ± 0.63 mm, P < 0.05) were found, respectively. Right-left and total flow volumes of the vertebral arteries (VA) were significantly lower in the PCOS group than in the control group (P ≤ 0.001). Compared to the control group, diameters of right and left VA decreased (P < 0.05). CONCLUSION: The results of this study suggest that hyperandrogenemia in obese PCOS patients affects carotid and vertebro-basilar system arteries wall thickness. Pre-atherosclerotic vascular impairment with androgen excess should determine early examination of vertebro-basilar system with ultrasound. All patients with PCOS must be routinely examined using color Doppler ultrasound to measure CIMT carotid and vertebro-basilar arteries, and diameters and blood flow volume of vertebral arteries.

Effects of hyperandrogenism on tear function and tear drainage in patients with polycystic ovary syndrome.

OBJECTIVE: Polycystic ovary syndrome (PCOS) is an endocrinopathy characterized by chronic anovulation and hyperandrogenism. Hormonal changes can affect ocular surface and tear functions. We evaluated dry eye symptoms, clinical tear film alterations, and tear clearance in patients with PCOS. STUDY DESIGN: Thirty-five women with PCOS and 22 healthy individuals were enrolled in the study. An ocular surface disease index (OSDI) questionnaire was administered, and after the routine ophthalmologic examination tear film breakup time (TBUT) and Schirmer tests were performed. Tear clearance was assessed via fluorescein dye disappearance test (FDDT). RESULTS: No difference was observed in Schirmer test between the groups, however OSDI scores were significantly higher (p = 0.01) and TBUT was significantly lower (p = 0.01) in PCOS patients than in the control women. FDDTs were not different between the PCOS and control subjects. CONCLUSION: Our findings suggest that patients diagnosed with PCOS should be advised to obtain an ophthalmic examination, especially for dry eye.

Intrauterine pregnancy after laparoscopic tubal sterilization with bipolar electrocoagulation: a case report.

BACKGROUND: Although ectopic pregnancies, nonviable missed abortions or blighted ova may occur subsequent to female sterilization, intrauterine pregnancy has not been reported. The sterilization failure risk persists for years after the procedure and varies by operator technique, method of tubal occlusion and female age. CASE: A viable, 8-week intrauterine pregnancy developed in a 36-year-old woman, gravidity 3, parity 2, five years after laparoscopic tubal sterilization. CONCLUSION: The possible mechanisms for a pregnancy after tubal sterilization may be spontaneous reanastomosis or fistula formation or a viable endosalpinx caused by the failure of electrocoagulation. Operator failure may occur when the occluding device is placed on the round ligaments. In this case study, the pregnancy was most likely related to a possible fistula formation which could have developed over the years following surgery.

Comparison of different preoperative sublingual misoprostol regimens for surgical termination of first trimester pregnancies: a prospective randomized trial.

OBJECTIVE: To determine the appropriate dose of sublingual misoprostol administration before dilation and curettage (D&C) of the uterus in first trimester pregnancies. STUDY DESIGN: Ninety nulliparous women who underwent surgical termination of first trimester pregnancy were analyzed prospectively. The first group (n = 30) received a single 200-microg dose, and the second (n = 30) and third (n = 30) groups were administered 2x 200 microg (400 microg) and 3 x 200 microg (600 microg) doses of misoprostol sublingually, respectively, with 1-hour intervals. The main outcomes evaluated were the degree of difficulty of cervical dilation, adverse effects of misoprostol according to dose administered, and participant satisfaction rate with the procedure. RESULTS: The improvement in cervical dilation and the ease of the D&C procedure were more significant in the 600-microg misoprostol arm (p = 0.008). Because the prevalence and severity of the side effects of misoprostol were increased in a dose-dependent manner, the 400-microg arm was found to be the most efficient dose of the study with its high satisfaction rate (p < 0.001). CONCLUSION: Premedication with misoprostol makes the D&C procedure easier by leading to cervical ripening. By sublingual route 400 microg of misoprostol regimen seems to be appropriate for planned first trimester surgical pregnancy termination under local anesthesia. Misoprostol should be administered only to select and hospitalized patients.

Narrow band imaging hysteroscopy: a new diagnostic technique in recurrent IVF failure?

Narrow band imaging (NBI) is an optical filter technology that improves the visibility of capillaries, veins and other subtle tissue structures, by narrowing the bandwidth of spectral transmittance using optical filters. In this short communication, we want to share our preliminary experience in assisted reproductive technology patients where we had used NBI hysteroscopy for the evaluation of uterine cavity abnormalities who had previous IVF failure.

Effects of estradiol-drospirenone hormone treatment on carotid artery intima-media thickness and vertigo/dizziness in postmenopausal women.

AIM: To investigate the effects of Angeliq on hormonal, metabolic, biochemical and cardiovascular profile, carotid intima-media thickness (CIMT) and vertigo/dizziness symptoms in postmenopausal women. METHODS: Angeliq is a drug used for hormone replacement therapy that composed of drospirenone 2 mg and estradiol 1 mg. Thirty-two postmenopausal women were recruited for the study. All women were evaluated using personal interview, medical examination and carotid artery ultrasound. They were questioned specifically about vertigo/dizziness experienced. Participants were randomly submitted to oral daily treatment with Angeliq. The duration of the study was 6 months and the participants were studied in basal condition and after 6 months of the therapy. RESULTS: Follicle-stimulating hormone was significantly higher and estradiol was significantly lower in before therapy (BT) than in after therapy (AT) (p < 0.001). No differences in fasting glucose, CRP and WBC values, and lipid-lipoprotein profile were detected between the groups. The systolic and diastolic blood pressures and heart rate were also significantly higher in BT than in AT (p < 0.05). A significant (p < 0.001) difference in CIMT (0.51 ± 0.04 vs. 0.49 ± 0.03 mm) was found between BT and AT. Seven of 32 patients (22%) had vertigo/dizziness symptoms before treatment. After 6 months, none of the patients showed complaints of vertigo/dizziness. CONCLUSIONS: Oral daily treatment with Angeliq reduces CIMT and climacteric complaints including vertigo/dizziness in postmenopausal women. They may relate to anti-androgenic and anti-mineralocorticoid effects of Angeliq, respectively.