ABSTRACT
About 15% of pregnant women undergo missed abortion (MA), wherein women do not experience cramping and vaginal bleeding. Dysregulation of the immune molecules and steroid hormones contribute to early pregnancy loss. Collectins- surfactant protein A (SP-A), surfactant protein D (SP-D), and mannose-binding lectin (MBL) are a group of innate immune molecules regulated by the steroid hormones. Reduced levels of SP-A and SP-D during the early gestation exhibited a significant association with the severe early onset preeclampsia. In order to determine the serum profile of collectins throughout the normal pregnancy and explore their predictive potential during the 8-12 weeks of gestation for MA, we examined a prospective cohort of pregnant women (n = 221). The serum levels of SP-A and SP-D were significantly downregulated in the normal pregnant women in all the three trimesters (n = 30) compared with the non-pregnant women (n = 20) and were not significantly different across the three trimesters. Fourteen of the women from the cohort underwent MA during the 14-20 weeks of gestation and exhibited a significant downregulation in the serum levels of SP-D during 8-12 weeks of gestation. A significant inhibition of the HTR-8/SVneo cell proliferation and migration in the presence of a recombinant fragment of human SP-D suggested the relevance of SP-D in placental development. We report here that the serum levels of SP-A, SP-D, and MBL are consistently maintained during pregnancy in the Indian cohort. Dysregulated serum levels of SP-D and P4/E2 ratio during the early first trimester may predict occurrence of MA.
Subject(s)
Abortion, Missed/blood , Mannose-Binding Lectin/blood , Pulmonary Surfactant-Associated Protein A/blood , Pulmonary Surfactant-Associated Protein D/blood , Adult , Arabidopsis Proteins/physiology , Cell Line , Cell Movement/drug effects , Cell Proliferation/drug effects , Female , Humans , Pregnancy , Prospective Studies , Pulmonary Surfactant-Associated Protein D/pharmacology , Transcription Factors/physiology , Trophoblasts/drug effectsABSTRACT
A 52-year-old patient presented with complaints of menorrhagia. Endometrial biopsy revealed simple hyperplasia of the endometrium. Total abdominal hysterectomy with bilateral oophorectomy was carried out. The ovaries looked grossly normal, but histopathology reported granulosa cell tumor of the right ovary. Granulosa cell tumors belong to the sexcord stromal category and account for approximately 2% of all ovarian tumors. We review the features and treatment of granulosa cell tumors and the importance of screening for ovarian tumors in a case of endometrial hyperplasia and delayed menopause.
ABSTRACT
Forty subfertile men with idiopathic oligospermia were randomly treated with mesterolone or with placebo for more than 4 months. Seminal analysis was performed thrice before treatment, and twice after 16 weeks of treatment. There was a significant increase of semen volume (P less than .05), mean sperm concentration (P less than .01), and mean total sperm count per ejaculate (P less than .01) with mesterolone therapy. Sperm motility and morphological characteristics were not modified by mesterolone therapy. Mesterolone was found to be effective in improving the sperm concentration in mild and moderate rather than in severe idiopathic oligospermia.