Luteotropic effects of human chorionic gonadotropin administered 7.5 days after synchronous estrous induction in Morada Nova ewes.

This study was conducted in ewes to assess effects of human chorionic gonadotropin (hCG) administration after imposing an estrous induction treatment regimen. Ewes (n = 115) were treated with a 60 mg medroxyprogesterone-intravaginal-sponge for 6 d plus 200 IU of equine chorionic gonadotropin (eCG) im and 37.5 µg d-cloprostenol im 36 h before sponge removal (Day 0). After natural mating, ewes having at least one corpus luteum (CL; n = 108) were administered either 1 mL of saline (G-Control; n = 53) or 300 IU of hCG (G-hCG; n = 55) on Day 7.5 after sponge removal (Day 0). Ovarian ultrasonography and blood collection were performed on Days 7.5, 13.5, 17.5, 21.5, and 30.5. Accessory CL (aCL) were observed in 81.5 % (G-hCG) and 0.0 % (G-Control) of ewes (P = 0.0001). Diameter, area, and volume of luteal tissue were greater (P < 0.05) in G-hCG from Day 13.5 to 30.5. Progesterone (P4) concentrations were greater (P < 0.05) on Days 13.5, 17.5, 21.5 and 30.5 for ewes of the G-hCG group. Pregnancy percentage was similar (P = 0.25) between groups [47.1 % (G-control) compared with 60.0 % (G-hCG)], although total number of lambs produced by estrous synchronized ewes was greater (P = 0.005) in ewes of the G-hCG group (90.9 % compared with 66.0 %). In conclusion, hCG administration 7.5 days after sponge removal from Morada Nova ewes during the non-breeding season is an effective treatment to induce aCL formation, improve luteal tissue biometry and P4 concentrations, and to enhance the total number of lambs born.

A influência da nutrição e a atuação da leptina e kisspeptina no ciclo reprodutivo da égua / The influence of nutrition and the action of leptin and kisspeptin on the mare's reproductive cycle

A domesticação do equino pelo homem acarretou alterações de manejo e alimentação devido à necessidade de adaptação dos animais a novos exercícios e condições limitantes impostas a estes pelo homem. Um dos avanços alcançados através da mudança alimentar imposta aos equinos mediante o fornecimento de alimentos concentrados é a possibilidade de melhor eficiência reprodutiva. As éguas são poliéstricas estacionais fotoperíodo positivas, naturalmente entrando em anestro nos meses de inverno, em regiões afastadas da linha do Equador. Estudos indicam que éguas com bom índice de escore corporal podem não entrar em anestro nesse período, oferecendo a possibilidade de reprodução ao longo de todo o ano sem a necessidade de aplicação de hormônios exógenos. A correlação entre nutrição e reprodução equina vem sendo cada vez mais estudada, e os mecanismos de ação de diversos fatores atuantes nessa correlação como a leptina e a kisspeptina vem sendo elucidados. A presente revisão traz informações acerca da interação entre nutrição e reprodução equina e dois dos mais importantes peptídeos atuantes nessa correlação: leptina e kisspeptina.

Equine domestication by men brought alongside with it several alterations in equine management and feeding, due to the need of adaptation by the horses to new exercises and limiting conditions imposed to them by humans. One of the many advances achieved through feeding modification imposed to horses by providing concentrate feed is the possibility for better reproductive efficiency. Mares are photoperiodic poliestric seasonal breeders, naturally entering anestrus in winter months in regions far from the Equator line. Studies indicate that mares with optimum body score may not enter anestrus in such period, offering the possibility of reproduction through the year withholding the need for exogenous hormone administration. The correlation between nutrition and equine reproduction is being increasingly studied, and a confluence of factors that act in such correlation such as leptin and kisspeptin and are being elucidated. This revision brings information regarding the interaction between nutrition and equine reproduction and two of the major peptides that act in such correlation: leptin and kisspeptin.

A influência da nutrição e a atuação da leptina e kisspeptina no ciclo reprodutivo da égua / The influence of nutrition and the action of leptin and kisspeptin on the mare's reproductive cycle

A domesticação do equino pelo homem acarretou alterações de manejo e alimentação devido à necessidade de adaptação dos animais a novos exercícios e condições limitantes impostas a estes pelo homem. Um dos avanços alcançados através da mudança alimentar imposta aos equinos mediante o fornecimento de alimentos concentrados é a possibilidade de melhor eficiência reprodutiva. As éguas são poliéstricas estacionais fotoperíodo positivas, naturalmente entrando em anestro nos meses de inverno, em regiões afastadas da linha do Equador. Estudos indicam que éguas com bom índice de escore corporal podem não entrar em anestro nesse período, oferecendo a possibilidade de reprodução ao longo de todo o ano sem a necessidade de aplicação de hormônios exógenos. A correlação entre nutrição e reprodução equina vem sendo cada vez mais estudada, e os mecanismos de ação de diversos fatores atuantes nessa correlação como a leptina e a kisspeptina vem sendo elucidados. A presente revisão traz informações acerca da interação entre nutrição e reprodução equina e dois dos mais importantes peptídeos atuantes nessa correlação: leptina e kisspeptina.(AU)

Equine domestication by men brought alongside with it several alterations in equine management and feeding, due to the need of adaptation by the horses to new exercises and limiting conditions imposed to them by humans. One of the many advances achieved through feeding modification imposed to horses by providing concentrate feed is the possibility for better reproductive efficiency. Mares are photoperiodic poliestric seasonal breeders, naturally entering anestrus in winter months in regions far from the Equator line. Studies indicate that mares with optimum body score may not enter anestrus in such period, offering the possibility of reproduction through the year withholding the need for exogenous hormone administration. The correlation between nutrition and equine reproduction is being increasingly studied, and a confluence of factors that act in such correlation such as leptin and kisspeptin and are being elucidated. This revision brings information regarding the interaction between nutrition and equine reproduction and two of the major peptides that act in such correlation: leptin and kisspeptin.(AU)

Dose inseminante e embriogênese na fertilização assistida de carpa comum no nordeste brasileiro / Inseminating dose and embryogenesis in assisted fertilization of common carp in northeastern of Brazil

A presente pesquisa visou determinar a dose inseminante para a fertilização assistida da carpa comum, e o registro em imagens e o tempo de desenvolvimento de cada fase embrionária desta espécie em latitude equatorial. Verificou-se que a porcentagem de fertilização aumentou de forma linear, atingindo um platô em 45,5% na proporção de 208.295 espermatozoides/oócito. Assim, recomenda-se o uso da dose inseminante de aproximadamente 200.000 espermatozoides/oócito na rotina de fertilização assistida dessa espécie, no nordeste brasileiro. Além disso, o desenvolvimento embrionário da carpa em latitude equatorial segue a cronologia semelhante ao relatado para a espécie em clima temperado.

The present research aimed at determining insemination dose for artificial fertilization of common carp, and record images and time in the development of each embryonic stage of the species in equatorial latitude. The fertilization rate increased linearly up to the proportion of 208.295 spermatozoa/oocyte, and, from this point, the fertilization rate was maintained at 45.5%. Therefore, we recommend the use of the insemination dose of approximately 200.000 sperm/oocyte in the artificial fertilization routine of common carpin brazilian northeast. Moreover, embryonic development of carp in equatorial latitude follows the chronology similar to that reported for the species in temperate zones.

Dose inseminante e embriogênese na fertilização assistida de carpa comum no nordeste brasileiro / Inseminating dose and embryogenesis in assisted fertilization of common carp in northeastern of Brazil

A presente pesquisa visou determinar a dose inseminante para a fertilização assistida da carpa comum, e o registro em imagens e o tempo de desenvolvimento de cada fase embrionária desta espécie em latitude equatorial. Verificou-se que a porcentagem de fertilização aumentou de forma linear, atingindo um platô em 45,5% na proporção de 208.295 espermatozoides/oócito. Assim, recomenda-se o uso da dose inseminante de aproximadamente 200.000 espermatozoides/oócito na rotina de fertilização assistida dessa espécie, no nordeste brasileiro. Além disso, o desenvolvimento embrionário da carpa em latitude equatorial segue a cronologia semelhante ao relatado para a espécie em clima temperado.(AU)

The present research aimed at determining insemination dose for artificial fertilization of common carp, and record images and time in the development of each embryonic stage of the species in equatorial latitude. The fertilization rate increased linearly up to the proportion of 208.295 spermatozoa/oocyte, and, from this point, the fertilization rate was maintained at 45.5%. Therefore, we recommend the use of the insemination dose of approximately 200.000 sperm/oocyte in the artificial fertilization routine of common carpin brazilian northeast. Moreover, embryonic development of carp in equatorial latitude follows the chronology similar to that reported for the species in temperate zones.(AU)

Hormonal responses and clinical outcome are the same with three doses of gonadotropin-releasing hormone agonist used in the short stimulation protocol.

OBJECTIVE: The aim of this study was to compare 3 different doses of GnRH-a in a short protocol on ICSI outcome. METHODS: 91 ovulatory patients were randomly assigned to three groups; group A (N=34), group B (N=34) and group C (N=23). All started treatment with urinary gonadotropins, 2 ampoules per day and GnRH-a (Triptorelin) on the first day of the menstrual period and continued till the day of (hCG) administration. The daily dose of Triptorelin was 0.1 mg, 50 µg, and 25 µg in groups A, B and C respectively. RESULTS: Stimulation requirements, days of stimulation and total ampoules of gonadotropins did not differ between the three groups. The mean number of follicles aspirated and the mean number of Metaphase 2 oocytes retrieved were similar in the three groups. Fertilization and cleavage rates were similar in the three groups. The mean number of embryos available for transfer was 6.4±0.5, 9.4±0.5 and 7±0.7 in groups A, B and C, with a significant difference only between groups A and B. Pregnancy rates per cycle were 35.3%, 35.3% and 34.8 % for groups A, B and C, respectively with no significant difference. CONCLUSION: Early and late hormonal changes, stimulation requirements and final outcome were similar with the different doses of the agonist. Other factors should be considered, most importantly: treatment cost and side effects.

Overexpression of hyaluronan synthase 2 and gonadotropin receptors in cumulus cells of goats subjected to one-shot eCG/FSH hormonal treatment for ovarian stimulation.

Hormonal ovarian stimulation may affect transcripts in somatic cells of cumulus-oocyte complexes (COCs) and affect the resulting oocyte quality. Here, in parallel with morphological classification and in vitro maturation (IVM) rate analysis, we investigated the expression of hyaluronan synthase 2 (HAS2), gonadotropic receptors (FSHR and LHR) and connexin 43 (GJA1) in cumulus cells (CCs) from goat COCs after multi-dose FSH (MD) or one-shot FSH/eCG (OS) treatments, using bovine COCs as control groups. The MD treatment produced more large follicles, and the resulting COCs had a better morphology and IVM rate than were obtained with OS. The OS treatment produced COCs with increased HAS2, FSHR, LHR and GJA1 expression. This gene expression pattern was also observed in the CCs of COCs that showed poor morphological characteristics. On the other hand, the mRNA levels were more similar between groups after IVM; FSHR and LHR were the main genes that showed decreased expression. Some events that occurred in bovine CCs during IVM, such as cell expansion, increased HAS2 expression and decreased GJA1 expression, were less evident or did not occur in goat COCs. In conclusion, increasing HAS2, FSHR, LHR and GJA1 expression in goat COCs does not confer greater meiotic competence to oocytes. Instead, it may result from poor regulation of gene expression in CCs by lower quality oocytes. Finally, cumulus expansion, together with HAS2 upregulation and GJA1 downregulation, seems to be more important for bovine COCs than for goat COCs. Additional studies are needed to investigate the importance of other HAS isoforms and connexins in goat COCs.

Extending the duration of treatment with progesterone and equine chorionic gonadotropin improves fertility in suckled beef cows with low body condition score subjected to timed artificial insemination.

The objective of this study was to evaluate the effect of an extended progesterone treatment on follicular development and fertility in postpartum, suckled beef cows subjected to timed artificial insemination (TAI). In experiment 1, cows (n = 24) with body condition score (BCS) ≥4.5 received either a 2-g progesterone intravaginal device on Day -23 or a 0.558-g progesterone intravaginal device on Day -9. Then, all cows received 2 mg of estradiol benzoate on Day -9; removal of the device, 1-mg estradiol cypionate, and PGF2α on Day -2; and TAI on Day 0. Metabolic status was assessed between Days -9 and -2. Ovarian structures and plasma progesterone were determined weekly from Day -23 to -9, daily from Day -9 to 0, and weekly until Day 28. In experiment 2, cows (n = 302) with BCS ≥4.5 received identical treatment to cows in experiment 1, but on Day -2, cows received 400 IU of two different commercial preparations of equine chorionic gonadotropin (eCG). Ovarian structures were determined on Days -23 and -9 on a subset of cows (n = 40). Pregnancy was determined 39 days after TAI. In experiment 3, multiparous cows (n = 244) with BCS <5.0 received identical treatment as cows in experiment 1 initiated on Day -18, and on Day -2, cows received 400 IU of eCG or no treatment. Ovarian structures were determined in a subset of cows (n = 31) on Days -3, -2, -1, 0, 1, and on Day 10. Pregnancy was determined 39 days after TAI. The results indicated that in experiment 1, plasma progesterone was higher in treated than nontreated (control cows) during the first 14 days (P = 0.0001). The extended progesterone treatment increased the size of the largest follicle between Days -23 and Day -5 (Group by Day, P = 0.04) and tended to increase the size of the dominant follicle from Day -5 to Day -1 (Group by Day, P = 0.06). There was no effect of metabolic status or interaction between metabolic status and day on follicular growth. In experiment 2, extended progesterone treatment tended to increase the size of the largest follicle between Day -23 and -9 (P = 0.06). There was no effect of Group, eCG, BCS, and parity on pregnancy per AI. In experiment 3, extended progesterone treatment combined with eCG increased the size of the dominant follicle (P = 0.01). Both extended progesterone treatment (P = 0.02) and eCG (P = 0.03) increased pregnancy per AI. In conclusion, an extended progesterone treatment stimulated follicular growth postpartum and improved fertility only in cows with low BCS.

Efficacy and safety of triptorelin 6-month formulation in patients with central precocious puberty.

BACKGROUND: Triptorelin is an established treatment for central precocious puberty (CPP) as 1- and 3-month formulations. The current triptorelin 22.5 mg 6-month formulation is approved for prostate cancer therapy. This is the first study in patients with CPP. METHODS: The efficacy and safety of the triptorelin 6-month formulation in CPP were investigated. The primary objective was to evaluate the efficacy in achieving luteinizing hormone (LH) suppression to pre-pubertal levels at month 6. This was an international, non-comparative phase III study over 48 weeks. Eighteen medical centers in the US, Chile and Mexico participated. Forty-four treatment naïve patients (39 girls and five boys) aged at treatment start 2-8 years for girls and 2-9 years for boys with an advancement of bone age over chronological age ≥1 year were to be included. Triptorelin was administered im twice at an interval of 24 weeks. LH, follicle stimulating hormone (FSH) (basal and stimulated), estradiol (girls), testosterone (boys), auxological parameters, clinical signs of puberty and safety were assessed. RESULTS: Forty-one patients (93.2%) showed pre-pubertal LH levels (stimulated LH ≤5 IU/L) at month 6 and maintained LH suppression through month 12. The percentage of patients with LH suppression exceeded 93% at each time point and reached 97.7% at month 12. No unexpected drug-related adverse events were reported. CONCLUSIONS: The triptorelin 6-month formulation was safe and effective in suppressing the pituitary-gonadal axis in children with CPP. The extended injection interval may improve compliance and increase comfort in the management of CPP.

Homeopatia aplicada à reprodução animal / Homeopathy applied to animal reproduction / Homeopatía aplicada a la reproducción animal

A homeopatia é um sistema terapêutico que propõe abordagem clínica e terapêutica para o tratamento do indivíduo doente, desenvolvida por Christian Friedrich Samuel Hahnemann no final do século XVIII. No Brasil, a homeopatia foi introduzida por Benoit Mure, em 1840, tornando-se uma nova opção de tratamento. Como princípio básico tem-se a utilização de medicamentos dinamizados, ou seja, preparados a partir de substâncias animais, vegetais, minerais ou tecidos doentes. Existem duas leis que sustentam a homeopatia como parte da medicina. A primeira é a Lei dos Semelhantes - ?Similia simili buscurentur?- (os semelhantes que se curem pelos semelhantes) e, a segunda, a Lei do Vitalismo. O uso da homeopatia na reprodução se faz importante na busca de melhorias da fertilidade animal, tanto no diz respeito ao tratamento de patologias quanto na eficiência reprodutiva. Contudo, novos estudos devem ser desenvolvidos, uma vez que há divergências nos resultados encontrados na literatura.

Homeopathy is a therapeutic system proposing both clinical and therapeutic approaches to the treatment of the patient, developed by Christian Friedrich Samuel Hahnemann in the late eighteenth century. In Brazil, homeopathy was introduced by Benoit Mure in 1840, becoming a new treatment option. The use of dynamized medication, or prepared from animal, vegetable or mineral substances, or from diseased tissue is at the core of homeopathy. There are two laws that support homeopathy as part of medicine. The first one is the Law of Similars - ?Similia simili buscurentur? - (like cures like). The second law is the Law of Vitalism. The use of homeopathy in reproduction is important in the search for improvement in animal fertility, both regarding the treatment of diseases and as in reproductive efficiency. However, further studies still need to be developed, since there are differences in the results found in literature.

La homeopatía es un sistema terapéutico que ofrece enfoque clínico y terapéutico para el tratamiento de la persona enferma, desarrollado por Christian Friedrich Samuel Hahnemann a finales del siglo XVIII. En Brasil, la homeopatía fue introducida por Benoit Mure en 1840, convirtiéndose en una nueva opción de tratamiento. Como principio básico se ha utilizado drogas energizadas, es decir, sustancias preparadas a partir de animales, vegetales, minerales o tejidos enfermos. Hay dos leyes que apoyan la homeopatía como parte de la medicina. La primera es la ley de los semejantes - ?Similia simili buscurentur? - (los semejantes que se curen por los semejantes) y, la segunda, la Ley del Vitalismo. El uso de la homeopatía en la reproducción llega a ser importante en la búsqueda de la mejora de la fertilidad de los animales, tanto en lo que respecta al tratamiento de patologías como la eficiencia reproductiva. Sin embargo, nuevos estudios deben ser desarrollados, ya que hay divergencias en los resultados encontrados en la literatura.

Homeopatia aplicada à reprodução animal / Homeopathy applied to animal reproduction / Homeopatía aplicada a la reproducción animal

A homeopatia é um sistema terapêutico que propõe abordagem clínica e terapêutica para o tratamento do indivíduo doente, desenvolvida por Christian Friedrich Samuel Hahnemann no final do século XVIII. No Brasil, a homeopatia foi introduzida por Benoit Mure, em 1840, tornando-se uma nova opção de tratamento. Como princípio básico tem-se a utilização de medicamentos dinamizados, ou seja, preparados a partir de substâncias animais, vegetais, minerais ou tecidos doentes. Existem duas leis que sustentam a homeopatia como parte da medicina. A primeira é a Lei dos Semelhantes - ?Similia simili buscurentur?- (os semelhantes que se curem pelos semelhantes) e, a segunda, a Lei do Vitalismo. O uso da homeopatia na reprodução se faz importante na busca de melhorias da fertilidade animal, tanto no diz respeito ao tratamento de patologias quanto na eficiência reprodutiva. Contudo, novos estudos devem ser desenvolvidos, uma vez que há divergências nos resultados encontrados na literatura.(AU)

Homeopathy is a therapeutic system proposing both clinical and therapeutic approaches to the treatment of the patient, developed by Christian Friedrich Samuel Hahnemann in the late eighteenth century. In Brazil, homeopathy was introduced by Benoit Mure in 1840, becoming a new treatment option. The use of dynamized medication, or prepared from animal, vegetable or mineral substances, or from diseased tissue is at the core of homeopathy. There are two laws that support homeopathy as part of medicine. The first one is the Law of Similars - ?Similia simili buscurentur? - (like cures like). The second law is the Law of Vitalism. The use of homeopathy in reproduction is important in the search for improvement in animal fertility, both regarding the treatment of diseases and as in reproductive efficiency. However, further studies still need to be developed, since there are differences in the results found in literature.(AU)

La homeopatía es un sistema terapéutico que ofrece enfoque clínico y terapéutico para el tratamiento de la persona enferma, desarrollado por Christian Friedrich Samuel Hahnemann a finales del siglo XVIII. En Brasil, la homeopatía fue introducida por Benoit Mure en 1840, convirtiéndose en una nueva opción de tratamiento. Como principio básico se ha utilizado drogas energizadas, es decir, sustancias preparadas a partir de animales, vegetales, minerales o tejidos enfermos. Hay dos leyes que apoyan la homeopatía como parte de la medicina. La primera es la ley de los semejantes - ?Similia simili buscurentur? - (los semejantes que se curen por los semejantes) y, la segunda, la Ley del Vitalismo. El uso de la homeopatía en la reproducción llega a ser importante en la búsqueda de la mejora de la fertilidad de los animales, tanto en lo que respecta al tratamiento de patologías como la eficiencia reproductiva. Sin embargo, nuevos estudios deben ser desarrollados, ya que hay divergencias en los resultados encontrados en la literatura.(AU)

Effects of human chorionic gonadotropin on the normal testicular tissue of rats.

PURPOSE: To investigate the effects of human chorionic gonadotropin (hCG) on the testicular tissue of young male rats. METHODS: Male Wistar rats were assigned to groups (10 rats/group).Control Group received subcutaneous saline solution; Group 1 received hCG 50 UI/Kg/dose; and Group 2 received hCG 100 UI/Kg/dose, daily for 15 days. Half was submitted to bilateral orchiectomy on the 16th day and the other half 45 days after the beginning of the hormone application. Testicles were weighed, measured and has their volumes determined. The diameter of the tubules and the thickness of the seminiferous epithelium were measured. RESULTS: Control Group presented the highest values of testicles volume and weight. Rats in the Control presented normal histology. In G1 and G2 atrophy of the seminiferous tubules, apoptosis of germ cells and multinucleated giant cells were observed. Comparing groups, in the first operation Control rats had higher diameter values. In the second operation, the Control was only different from G1. As for thickness, Control had higher values in both operations. Comparing the time of operation, the diameter values were higher in G1 and G2 in the second operation. For all groups, the thickness of the epithelium was higher in the second operation. CONCLUSIONS: Human chorionic gonadotropin is gonadotoxic in rats. This effect was temporary and can affect reproductive potential. The total recovery of testicular damage in the studied range could not be proved, and the effects were not dose-dependent.

Effects of human chorionic gonadotropin on the normal testicular tissue of rats

PURPOSE: To investigate the effects of human chorionic gonadotropin (hCG) on the testicular tissue of young male rats. METHODS: Male Wistar rats were assigned to groups (10 rats/group).Control Group received subcutaneous saline solution; Group 1 received hCG 50UI/Kg/dose; and Group 2 received hCG 100UI/Kg/dose, daily for 15 days. Half was submitted to bilateral orchiectomy on the 16th day and the other half 45 days after the beginning of the hormone application. Testicles were weighed, measured and has their volumes determined. The diameter of the tubules and the thickness of the seminiferous epithelium were measured. RESULTS: Control Group presented the highest values of testicles volume and weight. Rats in the Control presented normal histology. In G1 and G2 atrophy of the seminiferous tubules, apoptosis of germ cells and multinucleated giant cells were observed. Comparing groups, in the first operation Control rats had higher diameter values. In the second operation, the Control was only different from G1. As for thickness, Control had higher values in both operations. Comparing the time of operation, the diameter values were higher in G1 and G2 in the second operation. For all groups, the thickness of the epithelium was higher in the second operation. CONCLUSIONS: Human chorionic gonadotropin is gonadotoxic in rats. This effect was temporary and can affect reproductive potential. The total recovery of testicular damage in the studied range could not be proved, and the effects were not dose-dependent. .

Pelvic surgery and hospitalization among Chilean women after nonsurgical sterilization with quinacrine pellets between 1977 and 1989.

BACKGROUND: Concern about quinacrine lingers because of its carcinogenic effects in rats. We describe results of long-term follow-up of women who underwent quinacrine pellet sterilization in Chile between 1977 and 1989 (N=1492). METHODS: We interviewed the women or relatives in five rounds of data collection between 1991-1993 and 2006-2007, and reviewed hospital records. Median follow-up was 18.5 years; total person-time was 23,894 woman-years. This analysis focuses on pelvic and abdominal surgeries and conditions. We used survival analysis to estimate the 15-year cumulative probability of hysterectomy, other pelvic surgical procedures and relevant adverse events. RESULTS: Uterine fibroids were by far the most common gynecologic condition, reported by 11% of the cohort. Surgical procedures were recorded for 15% of the cohort; hysterectomy was the most frequent procedure (10%), followed by salpingectomy (2%). The 15-year probability of any pelvic or abdominal procedure was 14.7 per 100 women (95% confidence interval 12.4-16.9). The probability of hysterectomy was 9.3 per 100 women (95% confidence interval 7.4-11.1). Number of quinacrine insertions had little impact on the probabilities. CONCLUSION: During long-term follow-up of women who received quinacrine pellets for nonsurgical sterilization, the incidence of noncancer adverse outcomes was not unusually high, and no alarming patterns emerged.

Effects of postbreeding gonadotropin treatments on conception rates of lactating dairy cows subjected to timed artificial insemination or embryo transfer in a tropical environment.

The objective of experiment 1 was to evaluate the effects of treatments with human chorionic gonadotropin (hCG) or GnRH 7 d after induced ovulation on reproductive performance of lactating dairy cows submitted to timed artificial insemination (TAI) or timed embryo transfer (TET). A total of 834 potential breedings were used from 661 lactating Holstein cows (37.3±0.3 kg of milk/d). Cows had ovulation synchronized and were assigned randomly to receive TAI on d 0 or TET on d 7. Within each group, cows were assigned randomly to receive on d 7 no additional treatment (control; nTAI=156; nTET=126), a 100 µg i.m. injection of GnRH (nTAI=155; nTET=124), or a 2,500 IU i.m. injection of hCG (nTAI=151; nTET=122). Postbreeding treatment affected the percentages of pregnant cows at TET on d 28 (control: 38.1%; GnRH: 52.4%; hCG: 45.1%) and on d 60 (control: 32.5%; GnRH: 41.1%; hCG: 38.5%), but postbreeding treatment did not affect percentages of pregnant cows at TAI on d 28 (control: 30.1%; GnRH: 32.2%; hCG: 32.4%) or on d 60 (control: 25.6%; GnRH: 27.1%; hCG: 29.8%). The objective of experiment 2 was to evaluate the effect of a treatment with GnRH 7 d after TET on reproductive performance of lactating dairy cows that received a previous GnRH treatment at TET. A total of 285 potential breedings were used from 257 lactating Holstein cows (35.1±0.8 kg of milk/d). Cows had ovulation synchronized and were assigned for TET on d 7. Immediately after TET, all cows were treated with a 100 µg i.m. injection of GnRH. On d 14, cows were assigned randomly to receive (G7-14; n=147) or not (G7; n=138) an additional injection of GnRH. Pregnancy diagnosis were performed on d 28 and 60. The additional treatment with GnRH on d 14 did not affect the percentages of pregnant cows on d 28 (G7: 48.5%; G7-14: 42.9%) or on d 60 (G7: 39.8%; G7-14: 37.4%). In conclusion, treatment with GnRH or hCG 7 d after induced ovulation increased conception rates in lactating dairy cows submitted to TET, but not in cows submitted to TAI. Moreover, treatment with GnRH 7 d after TET did not enhance reproductive performance of lactating dairy cows that received a previous GnRH treatment at TET.

Experiencia piloto con el uso extendido de un anticonceptivo oral combinado de baja dosis de estrógeno / Extended use of an oral combined contraceptive pill with low estrogen dose: pilot experience

Objetivo: Evaluar en una experiencia piloto la aceptabilidad y bienestar de la usuaria, después de un periodo de 12 meses de un anticonceptivo hormonal combinado oral de baja dosis estrogénica, con modalidad de uso extendido de 84 píldoras activas consecutivas, seguidas de 7 días de placebo. Método: Se incorporan 25 mujeres voluntarias que usan una combinación de 20 ug de etinilestradiol + 3 mg de drospirenona, con un tiempo de uso de 12 meses. En calendario de registro diario se consignan los días de sangrado o goteo genital así como todo tipo de fármaco ingerido. Al término de los 12 meses se efectúa una encuesta respecto al grado de satisfacción con la posología recibida. Resultados: 13 usuarias (52 por ciento) cumplen los 12 meses de uso. Todas ellas manifiestan un alto grado de conformidad, destacando las ventajas de presentar periodos menstruales ocasionales, mejoría marcada en la sintomatología compatible con el síndrome de tensión premenstrual con el consiguiente incremento del bienestar general. Siete usuarias (28 por ciento) no terminan el estudio por razones médicas, siendo 6 de estas por alteraciones de los flujos rojos y en 5 casos (20 por ciento) se producen retiros no médicos. Conclusión: Esta experiencia, que es la primera con la formulación descrita, confirma en un porcentaje de usuarias las bondades adicionales reportadas en las experiencias previas con otros productos similares, respecto al uso extendido de anticoncepción hormonal oral en un grupo de mujeres que deseaban espaciar sus periodos menstruales.

Objetives: A pilot study designed in order to know about the acceptability of an oral combined contraceptive pill, with low estrogen dose used in an extended way of 84 consecutive days, followed by 7 days of no pills ingestion during a scheduled follow up of 1 year. Methods: 25 volunteers women were recruited among those which wants to use oral combined contraceptive pills and who accepted this extended way of use. Combined contraceptive pills contains each 20 ug of ethinylestradiol plus 3 mg of drosperinone. At admission women were provided with menstrual diary cards in order to check all bleeding days plus any extra pharmaceutical compound received. At the end of the 12 months follow up an interview was done in order to know women experiences and acceptability of this extended way of use. Results: 52 percent of women end the study at the scheduled 12 months use. All of them feel that the main advantages of these extended way of use were to have few menstrual periods and improving premenstrual symtomatology with better quality of life. 7 women (28 percent) did not finish the study because of medical reasons being due in 6 of these for bleeding disturbances. Conclusions: This report is pioneer with the use this hormone combination in this extended type way of use. Results confirm previous positive reports experiences using another similar hormonal compounds with this extended way of use in women who want to reduce the interval of their menstrual periods.

Quinacrine sterilization: a retrospective.

OBJECTIVE: To trace development of quinacrine sterilization (QS). METHODS: Review of published reports. RESULTS: The high prevalence of septic abortion among high parity women in Santiago, Chile, motivated Zipper to find a safe, inexpensive method of non-surgical female sterilization. Various cytotoxic drugs were tried in rats. Because quinacrine was already accepted for intrapleural injection it was chosen for the first clinical trial. A slurry consisting of quinacrine and xylocaine was instilled into the uterine cavity with a transcervical syringe. Reasonable efficacy was noted and a limited scar of the intramural tube demonstrated. However, a side effect of cortical excitation and reports of 3 deaths ended this approach. Zipper and Wheeler hypothesized that the difficulty was due to rapid absorption of quinacrine under pressure and designed a pellet form that dissolves slowly and could be delivered transcervically using a modified IUD inserter. A standard protocol of 252 mg in seven 36 mg pellets placed at the uterine fundus on two occasions a month apart has now been widely used with considerable evidence for safety and efficacy. Indeed, protection is greater than 98% at 2 years of use. CONCLUSION: QS is ready for widespread use, especially where surgical sterilization is not safely available or when women are poor candidates for surgery or have such a fear of surgery that they will not seek surgical sterilization.

25 years of quinacrine sterilization experience in Chile: review of 2,592 cases.

OBJECTIVES: To assess short-term side effects, long-term risks and efficacy of quinacrine sterilization (QS) in Chile. METHODS: Review experience of 2,592 cases sterilized with 2 or 3 transcervical insertions of 252 mg quinacrine as pellets since 1977; review the Chilean pre-clinical experience and epidemiological studies on cervical, endometrial and other cancers. RESULTS: Among 2,592 women who underwent QS, the total number of pregnancies was 119 (4.6%); 59 (49.5%) were carried to term with no birth defects related to QS. Nine cases were ectopic pregnancies. The ectopic pregnancy risk per 1,000 woman-years was 0.41, similar to that for surgical sterilization. The cumulative life-table pregnancy rates per 100 women at 10 years varied from 5.2 to 6.9. Mild and transient side effects were reported in 13.5% of quinacrine intrauterine insertions and pelvic inflammatory disease was diagnosed in 4 cases (0.15%). Long-term follow-up of quinacrine-sterilized patients shows no increased risk of cervical, endometrial or other cancer. CONCLUSIONS: QS efficacy at 10 years is comparable to widely accepted tubal clip and single point bipolar electrocoagulation laparoscopic procedures. QS has a low risk of serious, immediate side effects. No long-term risks have been identified after 25 years of use.

Quinacrine female nonsurgical sterilization (QS): endometrial assessment by vaginal ultrasonography in 128 women.

OBJECTIVE: Investigate effectiveness, safety and endometrial pattern after QS. METHOD: This study began in March 1999 and ended March 18, 2003; 128 women received transcervical insertions of quinacrine. Follow-up visits with ultrasound were scheduled at 1, 3, 6, 12-month intervals. RESULTS: Two pregnancies occurred, one at 25 months, the other at 37. Adverse events (AE) were: yellow vaginal discharge, headache, mild abdominal pain, vaginal pruritus, nausea and transient decrease in endometrial thickness. One patient had allergic reaction. A third insertion was done in case of vaginal bleeding (16.4%). One year after QS 10% still had amenorrhea, which may be the result of the fact that 73% of our patients had received DMPH. Once inside the uterus, the dissolved quinacrine could be seen within seconds, via ultrasound as a "Lake of Quinacrine" which stays for up to two hours. Frequently, a transverse vaginal ultrasonographic view of the uterine cavity showed plug-like echogenic points at the cornua. CONCLUSION: Quinacrine sterilization is safe and effective. The echogenic points need to be more thoroughly studied in order to affirm whether ultrasonography may identify the blockage of the tubes. Since early pregnancy is due to imperfect tubal closure, the use of ultrasound may prevent failure. However, pregnancy due to later recanalization cannot be avoided.

Female sterilization with quinacrine using hysterosalpingography (HSG) as an endpoint after a single-insertion protocol in Caracas, Venezuela.

OBJECTIVE: To evaluate the intrauterine insertion of quinacrine as an alternative nonsurgical female sterilization method by confirming bilateral occlusion of the fallopian tubes using HSG in a group of women who desire permanent sterilization. METHODS: After doing hysterosalpingography to confirm patency of both fallopian tubes, 324 mg of quinacrine were introduced with a modified IUD inserter in 30 patients who came to Concepción Palacios Maternity Hospital seeking permanent sterilization, between June 2000 and September 2001. Follow-up with HSG was done 3 months later to verify occlusion of the fallopian tubes. RESULTS: 26 of 30 patients (86%) had bilateral tubal occlusion as determined by HSG. There were minor side effects such as: pain (66.7%), yellow discharge (100%) and menstrual abnormalities (13.3%). One woman became pregnant after HSG showed bilateral occlusion. HSG may interfere with the action of the quinacrine. CONCLUSION: QS is a simple and safe alternative to surgical sterilization with few side effects.