Successful control of disseminated follicular cysts in a dog with low dose isotretinoin.

A case of disseminated cysts in a dog is described. Histopathological examination revealed the presence of follicular infundibular cysts, which were treated with isotretinoin at a dose of 2 mg/kg body weight (BW), q24h for 1 week, followed by a dose of 1 mg/kg BW for 3 months. Symptoms resolved after this course of treatment.

Contrôle réussi de kystes folliculaires disséminés chez un chien à l'aide d'une faible dose d' isotrétinoïne . Nous décrivons un cas de kystes disséminés chez un chien. L'examen histopathologique a révélé la présence de kystes infundibuliformes folliculaires qui ont été traités à l'aide de l'isotrétinoïne à une dose de 2 mg/kg poids corporel (PC), q24h pendant 1 semaine, suivie d'une dose de 1 mg/kg PC pendant 3 mois. Les symptômes se sont résorbés après ce régime de traitement.(Traduit par Isabelle Vallières).

[Folliculosebaceous cystic hamartoma: anatomo-clinical study]. / Hamartome folliculo-sébacé kystique : étude anatomoclinique.

BACKGROUND: Folliculosebaceous cystic hamartoma (FSCH) is a relatively recently described malformation with follicular and sebaceous components and a particular type of stroma with adipocytes. We conducted an anatomo-clinical study in order to clarify the clinical and histological characteristics of FSCH. MATERIALS AND METHODS: We included all cases of FSCH diagnosed between 1985 and February 2011 at our dermatopathology laboratory. Clinical information was obtained from medical records and requests for histological examination. RESULTS: We studied 25 cases of FSCH in 25 patients of mean age 51 years. The sex ratio was 1.3. The mean disease duration was 9 years. Lesions were described mainly as flesh-colored, occasionally pedunculated nodules and were found primarily on the face (60%). The diagnosis of FSCH had never been mentioned by the clinician. Histological examination revealed in all cases one or more follicular cystic structures surrounded by sebaceous glands in a stroma containing adipocytes. A number of variants were identified, such as the presence of a mucinous stroma, a neuroid component with protein S 100 expression, and rudimentary hair follicles in adjacent dermis. One case involved a proliferating cyst while another was on the scalp in the area of pre-existing radiodermatitis. Only one relapse was noted, 5 years after the initial excision. DISCUSSION: FSCH is a benign, underdiagnosed lesion, localized on the face, particularly on the nose. It is dome-shaped or pedunculated and grows slowly. Differential diagnoses include nevus lipomatosus superficialis and "sebaceous" trichofolliculoma. FSCH can be readily identified by the presence of adipocytes and a fibrous stroma. One case was unique in its appearance of a large pedunculated nodule with a proliferating cyst. Prior to the invidualization of this entity, such cases were interpreted as nevus lipomatosus superficialis or "sebaceous" trichofolliculoma, although their histological appearance was inconsistent with such a diagnosis.

In vivo and in vitro studies of the role of the adrenergic system and follicular wall contractility in the pathogenesis and resolution of bovine follicular cysts.

Bovine follicular cysts (FCs) are a common cause of economic loss in modern dairy herds. Their aetiopathogenesis is not completely understood, even though an inadequate hypothalamic release of GnRH at the time of ovulation is considered to be their main cause. Much evidence, however, suggests a role for adrenergic innervation in ovarian functions, such as follicular development, steroid hormone secretion, and follicular contractility, the latter being an event important for ovulation. Moreover, in humans, polycystic ovary syndrome, a disease very similar to bovine follicular cysts, is characterised by increased density of adrenergic nerves. Given these premises, the aim of our study was to evaluate the effectiveness and mode of action of a novel strategy for the treatment of bovine follicular cysts. In the in vivo experiment, 170 Friesian cows diagnosed with follicular cysts were assigned to four groups (groups A, B, C, and D) to assess the effects of epidural administration of a ß-adrenergic antagonist (carazolol) alone or in combination with a GnRH analogue (lecirelin). The four groups underwent the following treatments: Group A was administered lecirelin in combination with carazolol; Group B was administered carazolol; Group C was administered lecirelin; and Group D was administered only normal saline solution. In the in vitro experiment, strips of the walls of cystic follicles recovered post-mortem were suspended in an organ bath, connected to an isometric force transducer and exposed to increasing doses of epinephrine or to the same treatment after exposure to carazolol for 15 min (n = 10). The amplitude and frequency of the contractile activity were recorded. None of the control cows was observed in oestrus or was submitted to AI. The combination of lecirelin and carazolol induced a significant increase in the number of cows in oestrus (88%) compared to lecirelin alone or to carazolol alone (P < 0.05 and P < 0.01, respectively). The combination of lecirelin and carazolol and lecirelin alone were significantly more efficacious than carazolol alone (P < 0.01 and P < 0.05, respectively). In the in vitro experiment, epinephrine increased the amplitude of the contractions of the strips in a dose-dependent manner. This response was significantly enhanced in strips pre-treated with carazolol. The treatments had no effect on the frequency of contractions. In conclusion, our work demonstrates that the epidural administration of a GnRH analogue and a ß-adrenergic blocker is an effective means of treating cows with cystic ovarian disease. Moreover, it confirms, from a clinical point of view, that alterations of the adrenergic system and of the contractility of the follicular wall can be considered aetiopathogenic factors involved in the development of FCs. The results of this study lay the basis for a new therapeutic approach to FCs.

Epidural vs intramuscular administration of lecirelin, a GnRH analogue, for the resolution of follicular cysts in dairy cows.

Bovine follicular cysts are an ovarian disorder of dairy cows associated with abnormal estrous behaviour and infertility. The treatment of choice is intramuscular administration of a GnRH analogue, which acts by triggering pituitary release of LH. However, the presence of GnRH and GnRH receptors on spinal cord and ovary in some species, and the kind of innervation of the ovary, let us hypothesize that GnRH and its analogues may also act when administered by epidural route, as happens for other drugs. Therefore the aim of this study was to compare the effects of epidural vs intramuscular administration of lecirelin (a GnRH analogue) on FC regression, estrus detection and pregnancy outcomes. The study was conducted on 220 Friesian cows affected by follicular cysts, divided among 4 groups: Group L(epid) and Group L(im) received, respectively 50 µg of lecirelin in the epidural space and intramuscular; Group C(epid) and Group C(im) were used as control groups. In Group L(epid), estrus induction and pregnancy rates were significantly higher than in Group L(im). The results of this study show that the epidural administration of lecirelin promoted the remission of follicular cysts and an improvement of reproductive parameters compared to intramuscular administration. Thus, an alternative therapeutical approach is available for FC treatment, in order to obtain an easier restoration of the ovarian activity, especially in those cases refractory to classical therapeutic approaches.

Partial budgeting assessment of the treatment of pyometra, follicular cysts and ovarian inactivity causing postpartum anoestrus in dairy cattle.

A total of 412 multiparous German Holstein cows were screened for postpartum pyometra, follicular cysts and ovarian inactivity to assess economic and productivity losses in relation to pharmaceutical expenditures. Our results show that cows treated for pyometra with prostaglandin f2 alpha (PGF2α) and oxytetracycline had significantly (P<0.05) greater total and net returns than untreated cows or those treated with PGF2α+cephapirin or PGF2α alone. Milk yields from untreated cows affected by follicular cysts were significantly (P<0.05) lower than the yields from cows treated with gonadotrophin-releasing hormone (GnRH)- and GnRH+PGF2α. In addition, the use of GnRH to treat cows with ovarian inactivity resulted in significantly (P<0.05) lower costs and greater total and net return values compared to untreated controls.

Bovine ovarian follicular cysts: in vitro effects of lecirelin, a GnRH analogue.

This study investigates the mechanisms of action by which a GnRH analogue may modulate the contractility of the bovine ovarian follicular wall. The in vitro evaluation of the spontaneous basal contractility of bovine preovulatory and cystic follicles was performed, followed by testing the effects of lecirelin, a GnRH analogue, on their basal contractility. Strips of tissue in isolated organ bath were employed. In addition, to better investigate the mechanism of action of lecirelin, the study of the effects of cumulative doses of nifedipine (a calcium channel blocker), phentolamine (an α-adrenoceptor antagonist) and reserpine (an inhibitor of the vesicular up-take of catecholamines) alone and, at the highest doses employed, associated to lecirelin, was set up. The results demonstrate that in basal conditions and after the addition of lecirelin, the strips from preovulatory follicles contract significantly more than strips from cysts. Furthermore, among the patterns of contractility evoked by the three drugs employed, the one induced by nifedipine was the only one unaffected by the addition of lecirelin. The data obtained provide the hypothesis that one of the main mechanisms of action of GnRH, could involve calcium channels.

Renin and ovarian vascularization in cows with follicular cysts after epidural administration of a GnRH analogue.

The ovarian renin-angiotensin system may play an important role in follicular growth and maturation, as well as in the process of ovulation. The aim of this study was to investigate the effects of administration of a GnRH analogue to cows with ovarian follicular cysts on plasma renin concentrations and ovarian vascularization. This study was performed with 60 Friesian cows, which were diagnosed with follicular cysts, and randomly allocated into two groups: group A (treatment; n=30) received 2ml of lecirelin (Dalmarelin((R)) - Fatro), per head via sacro-coccygeal epidural, and group B (control; n=30) received 2ml saline solution (0.9% NaCl) per head by the same route. Blood samples were immediately collected prior to administration (T0) and then 24h (T1), 48h (T2) and 8 days (T3) after administration of the treatment, for both groups. Ovarian vascularization was evaluated utilizing Power Doppler on these same days in 10 animals from each group. The number of pixels detected by Power Doppler was used as an indicator of the degree of vascularization. Plasma renin concentrations remained relatively constant for the control (group B) animals, but increased as the sampling period progressed (NS) for the treated cows (group A). Similarly, there were no changes in ovarian vascularization (number of pixels) for the control cows, but vascularization increased throughout the sampling period in the treated animals. The number of pixels associated with cysts was significantly higher for treated compared to control cows at 24h after treatment (P<0.001). The epidural administration of a GnRH analogue was determined to be a highly effective therapy for follicular cysts (regression occurred in 82% of treated cows within 8+/-2 days after treatment, but in none of the control cows), which also enhanced ovarian vascularization.

Comparison of the effect of estradiol benzoate plus progesterone and GnRH on the follicular wave emergence and subsequent follicular development in CIDR-treated, lactating dairy cows with follicular cysts.

This study examined the effect of estradiol benzoate (EB) plus progesterone (P4) as compared with GnRH on follicular wave emergence and follicular development, and synchrony of ovulation and pregnancy rates following a second injection of GnRH in a controlled internal drug release (CIDR)-based timed AI (TAI) protocol in lactating dairy cows with follicular cysts. Lactating dairy cows diagnosed with follicular cysts received a CIDR device, with an injection of 2mg EB plus 50mg P4 (EB+P4 group) or with an injection of 100 microg GnRH (GnRH group) at the beginning of the experiment (day 0). Thereafter, all received PGF(2alpha) at the time of CIDR removal on day 7, GnRH on day 9, and TAI 16 h later. Follicular wave emergence occurred within 7 days in 12/15 EB plus P4-treated and 14/15 GnRH-treated cows (P>0.05). The interval to wave emergence was longer in the EB+P4 group (4.8+/-0.4 days) than in the GnRH group (2.0+/-0.2 days). The mean diameters of preovulatory follicles and the proportion of cows with preovulatory follicles greater than 12 mm on day 9 did not differ between groups (P>0.05). The proportion of cows with synchronized ovulations by 40 h after the GnRH injection on day 11 and pregnancy rates to TAI did not differ between the EB+P4 (13/15 and 36.7%) and the GnRH (14/15 and 53.3%) groups, respectively. Results suggest that a single treatment with EB plus P4 as compared with GnRH simultaneously with CIDR insertion in lactating dairy cows with follicular cysts will result in relatively asynchronous emergence of a new follicular wave, but subsequently similar sizes of preovulatory follicles and synchronous ovulation, resulting in similar pregnancy rates to TAI.

[Clinical aspect, diagnostics and treatment of follicular ovarian cysts].

48 young women aged 16 to 40 were observed for the menstrual cycle disorders and pain of various intensity in the lower abdominal region have been diagnosed for having at ovarian follicular cyst. The peculiarities of hormonal secretion in 30 patients have been studied. Existence of transitory hyperprolactinemia, excessive production of the lutheinizing hormone and deficit of progesterone production was determined. These factors hamper the folliculorexis and the follicular cyst does develop. Thus, in the occurrence of follicular cysts the major role belongs to the hypothalamic-pituitary disregulation. Therefore, the suppressive hormonal therapy is justified as highly effective. Dynamic ultrasound makes it possible to identify the conservative treatment terms and where necessary, timely transfer of the patient to the laparoscopic treatment.

Effect of a single injection of progesterone on ovarian follicular cysts in lactating dairy cows.

The objective of this experiment was to evaluate the effect of a single injection of progesterone on the lifespan of ovarian follicular cysts and to examine the fate of follicles that mature following treatment. Lactating Holstein and Jersey cows with ovarian follicular cysts were identified by rectal palpation. The ovaries of cystic cows were then examined by transrectal ultrasonography three times weekly to monitor formation of new follicular cysts. Cows with newly formed follicular cysts were treated either with a single injection of progesterone (200 mg, IM, n = 11) or corn oil vehicle (n = 7). Venous blood samples were collected daily for quantification of progesterone. Blood sampling and ultrasonography continued until ovulation or a new follicular cyst formed. Treatment reduced the lifespan of the cyst by 12 days, from 29.8 +/- 2.3 days in control cows to 17.2 +/- 1.8 days in progesterone-treated cows (P = 0.01). Progesterone treatment also tended to alter the frequency of subsequent follicular events. Ovulation occurred in 4/11 cows that were treated with progesterone whereas none of the vehicle treated cows ovulated (P = 0.07). In conclusion, a single injection of 200mg of progesterone, administered early in the life of an ovarian follicular cyst, shortened its lifespan and in some cases was followed by ovulation of a new follicle.

A CIDR-based timed AI protocol can be effectively used for dairy cows with follicular cysts.

The present study evaluated whether a controlled internal drug release (CIDR)-based timed AI (TAI) protocol could be used as an efficient tool for the treatment of ovarian follicular cysts in lactating dairy cows. In the first experiment, lactating dairy cows diagnosed with follicular cysts were randomly assigned to two treatments: (1) a single injection of GnRH at diagnosis (Day 0) and AI at estrus (AIE) within 21 days (GnRH group, n=70), or (2) insertion of a CIDR device containing progesterone and an injection of GnRH on Day 0, PGF(2alpha) injection at the time of CIDR removal on Day 7, GnRH injection on Day 9, and TAI 16h after the GnRH injection (CIDR-based TAI group, n=65). Conception rate after the CIDR-based TAI protocol (52.3%) was greater (P<0.05) than that after AIE following a single GnRH injection (26.9%). In the second experiment, lactating dairy cows diagnosed with follicular cysts (Cyst group, n=16) and cows having normal estrous cycles (CYC group, n=15) received the same treatment: a CIDR device containing progesterone and an injection of GnRH on Day 0, PGF(2alpha) injection at the time of CIDR removal on Day 7, and GnRH injection on Day 9. The proportion of cows with follicular wave emergence and the interval from treatment to follicular wave emergence did not differ (P>0.05) between groups. The mean diameters of dominant follicles on Days 4 and 7 as well as preovulatory follicles on Day 9, and the synchrony of ovulation following the second injection of GnRH did not differ (P>0.05) between groups. These data suggest that the CIDR-based TAI protocol results in an acceptable conception rate in dairy cows with follicular cysts.

Length of progesterone exposure needed to resolve large follicle anovular condition in dairy cows.

Hypothalamic unresponsiveness to an estradiol surge appears to be an underlying cause of large follicle anovular condition (follicular cysts), but progesterone exposure for 7 days resolves this condition. In this study, dairy cows with induced (Experiment 1) or naturally occurring (Experiment 2) follicular cysts were treated for different times with progesterone. In Experiment 1, 16 of 26 cows (62%) were induced into anovulation by causing a GnRH/LH surge when no ovulatory follicle was on the ovary. Anovular cows (n = 16) were assigned to one of four treatment groups ( 0, 1, 3, or 7 days of progesterone treatment) using an intravaginal, progesterone-releasing implant (CIDR). All anovular cows had low circulating progesterone concentrations before controlled internal drug releasing (CIDR) and greater concentrations that reached steady state (1.3 +/- 0.1 ng/mL progesterone) by 3 h after CIDR insertion. Circulating progesterone decreased to basal concentrations by 4 h after CIDR removal. Cows were treated with 5mg estradiol benzoate (EB) 12 h after CIDR removal. None (n = 4) of the control cows (0 day) had an LH surge after EB. All of the 3 days (5/5) and 7 days (4/4) CIDR-treated cows had an LH surge following EB, but only one of the 1 day (1/3) CIDR-treated cows. Magnitude of the LH peak was similar in the 3 and 7 days cows. All cows treated for 7 days ovulated (4/4), whereas, ovulation occurred in only 3/5, 1/3, and 0/4 of the cows treated for 3, 1, and 0 day, respectively. The two cows in the 3 days group that did not ovulate had a normal LH surge, but these two cows had a smaller maximal follicle size than cows that ovulated. In Experiment 2, naturally anovular lactating dairy cows (24 of 248) were identified using weekly ultrasonography. All anovular cows grew follicles to >12 mm, with 54% (13 of 24) having follicles larger than ovular size (15-24 mm) and 33% (8 of 24) having follicles that would be considered cystic (>25 mm). Anovular cows were randomly assigned to CIDR treatment for 0, 1, or 3 days. All (7/7) of 3 days, 33% (3/9) of 1 day, and 25% (2/8) of control (0 day) cows ovulated by 1 week after CIDR removal. Thus, 3 days but not 1 day of progesterone exposure appears to be sufficient to reinitiate estradiol responsiveness of the hypothalamus.

Ovarian and endocrine responses associated with the treatment of cystic ovarian follicles in dairy cows with gonadotropin releasing hormone and prostaglandin F2alpha, with or without exogenous progesterone.

The objectives of this observational study were to document ovarian and endocrine responses associated with the treatment of cystic ovarian follicles (COFs) in dairy cows, using gonadotropin releasing hormone (GnRH) and prostaglandin F2alpha (PGF) with or without exogenous progesterone. A secondary objective was to determine pregnancy establishment following synchronization of ovulation and timed insemination in cows diagnosed with COFs. In trial I, 18 Holstein cows diagnosed with COFs received 2 injections of 100 microg GnRH, 9 d apart, with 25 mg PGF given 7 d after the 1st GnRH. A new follicle developed in all 18 cows after the 1st GnRH, and 83% of cows ovulated following the 2nd GnRH. Cows were inseminated 16 h after the 2nd GnRH. Of the 17 cows available for pregnancy diagnosis, 7 were confirmed pregnant. In trial II, 8 cows with COFs received GnRH and an intravaginal progesterone device (CIDR) concurrently, then PGF 7 d later. The CIDR was removed 2 d after PGF administration. Plasma estradiol concentrations declined following CIDR insertion. In all cows, a new follicle developed following GnRH treatment; estradiol-surge and estrus occurred spontaneously after CIDR-removal. Seven of 8 cows ovulated the new follicle. In dairy cows diagnosed with COFs, treatment with GnRH followed by PGF 7 d later, with or without exogenous progesterone, resulted in the recruitment of a healthy new follicle; synchronization of ovulation and timed insemination resulted in a 41% pregnancy rate.

Induction of luteinizing hormone surge by pulsatile administration of gonadotropin-releasing hormone analogue in cows with follicular cysts.

LH release in response to pulsatile administration of small amounts of GnRH analogue in cows with follicular cysts was examined. The pulsatile administration of GnRH analogue induced a LH-surge like peak over 10 hr in both normal cows and cows with follicular cysts. The mean peak value of LH in follicular cystic cows did not differ significantly from that of normal cows. All the cows with cysts resumed normal estrous cycles with ovulations within 3 weeks of this treatment. These results suggest that the function of the anterior pituitary for LH release in response to GnRH analogue is not abnormal in cows with follicular cysts, and that cystic cows recover to normal conditions after the pulsatile administration of GnRH analogue.

Gonadotrophin releasing hormone treatment of Holstein cows with follicular cysts monitored by skim milk progesterone determination.

Progesterone was assayed in skim milk fraction of 38 cystic cows, 26 (68.4%) of which had basal ( < 0.5 ng/ml) progesterone concentrations and were diagnosed as having follicular cysts. These cows were allotted at random to one of 3 treatments: (1) a sham injection of sterile water in 7 cows as controls; (2) a single injection (1 mg) of GnRH analog in 8 cows; (3) double injections (1 mg) of GnRH analog at 7-day interval in 11 cows. According to rectal palpation confirmed by skim milk progesterone determination, the double injection group responded well (P < 0.05) compared with the single injection and control groups (81.8% vs 62.5 vs 42.9%). The interval calving to 1st insemination, interval treatment to conception and interval calving to conception were significantly (P < 0.01) shorter in the double injection group than in the other 2 groups. Also, the conception rate to first insemination was significantly (P < 0.05) higher (63.6% vs 37.5% vs 42.9%). The data provide evidence for reduction in infertility and reproductive disorders in cystic cows given double injections of GnRH.

[How to manage a symptomatic ovarian follicular cyst in a female child?]. / Que faire devant un kyste folliculaire ovarien symptomatique chez la petite fille?

BACKGROUND: --Ovarian cysts are common in childhood but most are non functioning. Treatment of those follicular cysts that develop in young children may be difficult. CASE REPORTS: Case no. 1.--A 1 1/2 month-old baby was admitted because of an acute abdominal syndrome. Ultrasonography showed a pelvic, heterogeneous mass without calcifications. Laparotomy showed right ovarian torsion with necrosis of a cyst requiring ovariectomy. At that time, there was an isolated increase in FSH after LHRH stimulation. A transitory premature thelarche without pubertal type response to LHRH was seen at the age of 3 months. Clinical and ultrasonographic controls remain normal with a follow-up of 1 year. Case no. 2.--A 4 yr 10 m-old girl was admitted because of an acute abdominal syndrome. Ovariectomy was necessary because laparotomy showed right ovarian torsion with necrosis of a cyst. Recurrent abdominal pain, 4 months later, was associated with an enlarged left ovary without sexual precocity. Gonadotropin were slightly increased after LHRH stimulation and the patient was given LHRH agonist that suppressed endogenous LHRH within 3 months. Clinical and ultrasonographic controls remain normal 1 year after cessation of treatment. Case no. 3.--A 19 month-old girl was admitted because of a genital hemorrhage with recent development of secondary sexual characteristics. Skeletal age was 2 yrs. Ultrasonography showed an enlarged uterus and a left ovarian cyst, heterogenous with calcifications. Plasma levels of estradiol were increased but gonadotropin were normal. Ovariectomy was performed, followed by disappearance of secondary sexual characteristics. However, the patient was given LHRH agonist at the age of 2 yr 7 mo because of recurrent pubertal activity. CONCLUSIONS: --These cases underline the difficulty in treating follicular cysts in young girls. The possibility of cyst recurrence with manifestations of pubertal activity after ovariectomy lead to discuss indication of LHRH agonists for an undetermined duration.

[Gonadotropin release and course of diseases after administration of a GnRH-analog in cattle with follicular-thecal cysts]. / Gonadotropin-Ausschüttung sowie Krankheitsverlauf nach Applikation eines GnRH-Analogs bei Rindern mit Follikel-Theka-Zysten.

Twenty-five heifers and cows with follicular cysts (high level of total oestrogens, low level of progesterone in plasma) were treated with 20 or 50 micrograms buserelin i.m. 5-84 weeks after parturition. Two hours after medication an increased LH release was observed in all animals. In contrast to LH, FSH concentration was not increased in all cows. Twelve days after treatment a high progesterone concentration in plasma could be determined in 17 of 25 treated animals. Twenty cows showed oestrous symptoms 23.5 +/- 9.6 days after medication. The oestrous cycle was prolonged in 10 cows. Nineteen cows were inseminated and 14 cows became pregnant after 1-4 (phi 1.7 +/- 0.9) inseminations (73.6% of all inseminated cows and 56% of all treated cows). The differences in conception rate and in services per conception after treatment with 20 or 50 micrograms buserelin in favour of the higher dosage cannot be attributed to the medication.

[The experimental use of surfagon, a synthetic analog of luliberin, in follicular ovarian cysts]. / Primenenie surfagona, sinteticheskogo analoga liuliberina, pri follikuliarnykh kistakh iaichnikov v éksperimente.

The use of a synthetic peptide analog of LH-RH agonist--[D-Ala6, des Gly10, Pro9]-LH-RH ethylamide (surfagon) at microdoses and in short courses returned to normal the ovulatory cycle in the anovulatory condition in rats and caused luteinization of follicular cysts in rats and cows with further normalization of ovarian function. It is assumed that surfagon will be effective for the treatment of anovulatory condition and ovarian follicular cysts in women.