Induction of ovulation with pulsatile gonadotropin releasing hormone (GnRH) in anovulatory women.

In this study we employed pulsatile GnRH therapy in different anovulatory disorders to test its real efficacy on ovulation induction. Ten adult women, 25-35 years old with primary or secondary infertility, underwent our study; all women showed anovulatory disorders such as Secondary Amenorrhea (n. 4), PCOD (n. 3) or Oligomenorrhea resistant to Clomiphene Citrate (n. 3). Pulsatile gonadotropin releasing hormone (GnRH) was given intravenously via automatic micropump, with a pulse interval of 90' and a pulse dose of 5 mcg/day. Ovulation was achieved in 7 cases (70%), whereas the failure of therapy was observed in 3 patients (30%), all affected by PCOD. The mean duration of follicular phase was 15 days and the ovulatory cycles did not need the luteal phase support. The maximum length of infusional therapy was 20 days with a low incidence of adverse side effects such as phlebitis; only in one patient a mild ovarian hyperstimulation was observed. Our results confirm that infusional pulsatile GnRH therapy is a very important tool to ovulation induction and it is more successful in primary or secondary amenorrhea and in hypothalamic disorders than in PCOD.

What are the implications of melatonin in the peritoneal fluid?

The Authors evidence the presence of melatonin (MT) in the peritoneal fluid (PF). They researched possible correlations between MT and other protein and steroid hormones in the PF and in the plasma. The only significant correlation found was a "negative" one between plasma MT and plasma E2. The Authors exclude an ovarian source for peritoneal fluid MT. They believe that MT may have a role in menstrual cycle regulation, directly modulating ovarian steroid production. To determine if MT has indeed such a role, they feel it important to study the possible presence of ovarian MT receptors.

Integrated neuropsychopathological approach in patients affected by amenorrhea.

A compared study of neurovegetative modifications (following stress stimula) and of psychopathological aspects in patients affected by amenorrhea was carried out. Such an integrated approach is useful for a better definition of clinical characteristic and for a selection of a suitable therapeutic approach.

Lymphocytes subset in hyperandrogenic women with polycystic ovarian disease.

The correlation between the sex steroids and the immune system is already known but the relationships between testosterone, progesterone, estradiol, cortisol and the immune system are still controversial. The Authors have studied lymphocytes subset in ten women with polycystic ovarian disease (PCOD); it was observed: 1) a decrease of T8 in 64% and of natural killer activity (NK) in 60% of patients, and an increase of T4/T8 ratio in 55%; 2) a significant negative correlation between androstenedione and testosterone (P less than 0.05); 3) a significant positive correlation between the decreased T8 lymphocytes and NK cells and the increase of testosterone and androstenedione serum values. The data suggest that in PCOD a correlation between endocrine and immune system exists and the androgens can affect the lymphocyte subset.

Significance of free testosterone assay in comparison with traditional R.I.A. androgens in diagnosis of androgens excess.

In 35 women, 16-32 years old (average age 24) affected by hirsutism associated to menstrual disorders as oligomenorrhea or secondary amenorrhea, the real utility of testosterone's free fraction assay (FT) in comparison with conventional hormonal assays has been valued. The free testosterone (FT) resulted the most frequently elevated hormone (69%). The analysis of the different groups shows a good sensitivity and specificity of FT assay in some conditions as PCOD, but it is not so sensitive and specific in other conditions as secondary amenorrhea. We conclude that FT assay is particularly useful for the hyperandrogenism study, especially in the PCOD; for its high diagnostic sensitivity it would be assayed in all the women with hirsutism, but it isn't sufficient for the screening of the different hyperandrogenic states.