Micronutrients in support to the one carbon cycle for the modulation of blood fasting homocysteine in PCOS women.

PURPOSE: Fasting blood homocysteine is increased in PCOS women and is involved in several of its co-morbidities including cardiovascular disease and infertility. Corrective interventions based on the administration of supra-physiologic doses of folic acid work to a low extent. We aimed to test an alternative approach. METHODS: This was a prospective, randomized, parallel group, open label, controlled versus no treatment clinical study. PCOS women aged > 18, free from systemic diseases and from pharmacological treatments were randomized with a 2:1 ratio for treatment with activated micronutrients in support to the carbon cycle (Impryl, Parthenogen, Switzerland-n = 22) or no treatment (n = 10) and followed-up for 3 months. Fasting blood homocysteine, AMH, testosterone, SHBGs, and the resulting FTI were tested before and at the end of the follow-up. RESULTS: The mean baseline fasting blood homocysteine was above the normal limit of 12 µMol/L and inversely correlated with SHBG. AMH was also increased, whereas testosterone, SHBG, and FTI were within the normal limit. The treatment achieved a significant reduction of homocysteine, that did not change in the control group, independently of the starting value. The treatment also caused an increase of AMH and a decrease of SHBGs only in the subgroup with a normal homocysteine at baseline. CONCLUSIONS: In PCOS ladies, blood homocysteine is increased and inversely correlated with the SHBGs. Physiologic amounts of activated micronutrients in support to the carbon cycle achieve a reduction virtually in all exposed patients. Whether this is of clinical benefit remains to be established.

A comparison of the delta copper T and the copper T 200 in Bologna, Italy.

An analysis is presented of a comparative study of the Delta T and Copper T 200 IUDs. A total of 195 postabortion insertions was performed between March 1981 and August 1982. All insertions were performed with an inserter. Primary bleeding/pain complaints after insertion were largely related to intermenstrual problems, with spotting the most frequently reported. Nine women had their devices removed for PID. One pregnancy occurred at ten months in the Delta T group. Both groups had one expulsion/displacement. Eight devices in each group were removed for bleeding/pain. Two women in the TCu group had their devices removed for personal reasons. The 6-months continuation rates for the two groups were 85.5 for the Delta T group and 82.2 for the TCu group. The 6-months follow-up rate for the Delta T group was 39.4 and 38.8 for the TCu group.

PIP: Complications associated with postabortion insertion of the Delta T and Copper T 200 IUDs were compared in 195 women. All insertions were performed with an inserter. There were no reported incidents of inserter-related problems, pelvic pain, or other complications at insertion. At follow-up, intermenstrual spotting was the most frequently reported complaint, involving 14 women (18.2%) in the Delta T group and 7 women (9.5%) in the TCu group. 8 Delta T acceptors (10.4%) and 12 TCu acceptors (16.2%) experienced intermenstrual bleeding. Intermenstrual pain was reported by 7 (9.1%) Delta T users and 4 (5.4%) TCu users. Other primary bleeding and pain complaints included menorrhagia, reported by 9 (11.7%) Delta T users and 9 (12.2%) TCu users, and dysmenorrhea, reported by 5 (6.5%) Delta T users and 4 (5.4%) TCu users. Pelvic inflammatory disease (PID) confined to the uterus was diagnosed in 9 (11.7%) Delta T acceptors and 5 (6.8%) TCu acceptors. 7 women (9.1%) in the Delta T group and 8 women (10.8%) in the TCu group reported PID confined to the adnexa. 1 woman from each group had PID confined to the uterus and adnexa and 5 TCu users reported PID beyond the uterus and adnexa. Of the 36 women diagnosed with PID, 9 had their devices removed. There was 1 pregnancy in the Delta T group and 1 device from each group was expelled. There were 3 removals for pain and bleeding in the Delta T group and 4 removals for this reason in the TCu group. The 6-month continuation rate was 85.5 for the Delta T device and 82.2 for the TCu IUD. Given the high incidence of spotting, intermenstrual bleeding, and PID recorded in this sample, insertion of an IUD in the immediate postabortion period is not recommended.