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1.
Fertil Steril ; 116(6): 1534-1556, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34384594

RESUMO

OBJECTIVE: To investigate the association between luteal serum progesterone levels and frozen embryo transfer (FET) outcomes. DESIGN: Systematic review and meta-analysis. SETTING: Not applicable. PATIENT(S): Women undergoing FET. INTERVENTION(S): We conducted electronic searches of MEDLINE, PubMed, CINAHL, EMBASE, the Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Web of Science, ClinicalTrials.gov, and grey literature (not widely available) from inception to March 2021 to identify cohort studies in which the serum luteal progesterone level was measured around the time of FET. MAIN OUTCOME MEASURE(S): Ongoing pregnancy or live birth rate, clinical pregnancy rate, and miscarriage rate. RESULT(S): Among the studies analyzing serum progesterone level thresholds <10 ng/mL, a higher serum progesterone level was associated with increased rates of ongoing pregnancy or live birth (relative risk [RR] 1.47, 95% confidence interval [CI] 1.28 to 1.70), higher chance of clinical pregnancy (RR 1.31, 95% CI 1.16 to 1.49), and lower risk of miscarriage (RR 0.62, 95% CI 0.50 to 0.77) in cycles using exclusively vaginal progesterone and blastocyst embryos. There was uncertainty about whether progesterone thresholds ≥10 ng/mL were associated with FET outcomes in sensitivity analyses including all studies, owing to high interstudy heterogeneity and wide CIs. CONCLUSION(S): Our findings indicate that there may be a minimum clinically important luteal serum concentration of progesterone required to ensure an optimal endocrine milieu during embryo implantation and early pregnancy after FET treatment. Future clinical trials are required to assess whether administering higher-dose luteal phase support improves outcomes in women with a low serum progesterone level at the time of FET. PROSPERO NUMBER: CRD42019157071.


Assuntos
Criopreservação/tendências , Transferência Embrionária/tendências , Fase Luteal/sangue , Taxa de Gravidez/tendências , Progesterona/sangue , Técnicas de Reprodução Assistida/tendências , Transferência Embrionária/métodos , Feminino , Humanos , Nascido Vivo/epidemiologia , Gravidez , Estudos Prospectivos , Estudos Retrospectivos
2.
Fertil Steril ; 115(6): 1416-1423, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33827766

RESUMO

Luteal phase deficiency (LPD) is a clinical diagnosis associated with an abnormal luteal phase length of ≤10 days. Potential etiologies of LPD include inadequate progesterone duration, inadequate progesterone levels, or endometrial progesterone resistance. LPD has not only been described in association with medical conditions but also in fertile, normally menstruating women. Although progesterone is important for the process of implantation and early embryonic development, LPD has not been proven to be an independent entity causing infertility or recurrent pregnancy loss. Controversy exists regarding the multiple proposed measures for diagnosing LPD and, assuming it can be diagnosed accurately, whether treatment improves outcomes. This document replaces the document entitled "Current clinical irrelevance of luteal phase deficiency: a committee opinion," last published in 2015 (Fertil Steril 2015;103:e27-e32).


Assuntos
Aborto Espontâneo/prevenção & controle , Fertilidade , Infertilidade Feminina/terapia , Fase Luteal/sangue , Progesterona/sangue , Medicina Reprodutiva/normas , Técnicas de Reprodução Assistida/normas , Aborto Espontâneo/sangue , Aborto Espontâneo/diagnóstico , Aborto Espontâneo/fisiopatologia , Biomarcadores/sangue , Consenso , Feminino , Humanos , Infertilidade Feminina/sangue , Infertilidade Feminina/diagnóstico , Infertilidade Feminina/fisiopatologia , Valor Preditivo dos Testes , Gravidez , Progesterona/deficiência , Fatores de Risco , Resultado do Tratamento
3.
Reprod Biomed Online ; 42(3): 595-608, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33608186

RESUMO

RESEARCH QUESTION: What is the difference in endometrial transcriptomics between women with normal and with low mid-luteal progesterone during the implantation window? DESIGN: An endometrial biopsy and serum progesterone concentration were taken from participants during the mid-luteal phase (LH+7 to LH+9). A total of 12 participants were recruited and categorized into two groups based on their progesterone concentrations: normal progesterone (>15 ng/ml, n = 6) and low progesterone (<15 ng/ml, n = 6). Global endometrial gene expression between the two groups was compared by microarray techniques. Principal component analysis was used to display the gene's expression pattern. Pathway and gene ontology enrichment analysis were performed to determine the biological mechanism of progesterone on the endometrium. RESULTS: Several key genes related to endometrial receptivity were found to be regulated by progesterone. With regard to gene ontology and pathway analysis, progesterone was shown to be mainly involved in structure morphogenesis predominantly during a process of decidualization, extracellular matrix-receptor interaction and cell adhesion. Distinct differences were observed in the transcriptomic profiles between the two groups, indicating potential impairment of endometrial receptivity in women with suboptimal progesterone concentrations. There was a relatively similar pattern of gene expression between endometrial samples with progesterone concentrations approximately 10 ng/ml and >15 ng/ml. Thus, a progesterone concentration of between 10 and 15 ng/ml appears to be sufficient to induce endometrial receptivity. CONCLUSIONS: Abnormally low progesterone below the threshold of 10-15 ng/ml during the implantation window results in aberrant endometrial gene expression that may affect implantation potential.


Assuntos
Implantação do Embrião , Endométrio/metabolismo , Fase Luteal/sangue , Progesterona/sangue , Transcriptoma , Adulto , Estudos de Casos e Controles , Feminino , Perfilação da Expressão Gênica , Humanos , Gravidez , Progesterona/deficiência
4.
Gynecol Endocrinol ; 37(2): 132-136, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32338103

RESUMO

AIM: The purpose of the study was to explore the efficacy of additional luteal support (ALS) for patients with low progesterone (P4) level in the middle luteal phase. METHODS: A retrospective study of 1401 women who underwent their first in vitro fertilization (IVF) treatment with a GnRH agonist protocol was analyzed. Patients were divided into five groups according to P4 level in the middle luteal phase (group I>40ng/mL, group II 31-40 ng/mL, group III 21-30 ng/mL, group IV 11-20 ng/mL and group V 0-10 ng/mL. Besides routine luteal support, the group V was offered with additional oral dydrogesterone 10 mg twice daily to HCG test (ALS group). RESULTS: After a multiple regression analysis, a similar higher hCG positive rate, clinic pregnancy rate and lower early pregnancy loss rate were achieved in group I and group V. In contrast to group I, group IV demonstrated significant lower HCG positive rate (OR = 0.65 [0.43; 0.99], p = .05), lower clinic pregnancy rate (OR = 0.60 [0.41; 0.88], p < .01) and significant higher early pregnancy loss rate (OR = 1.80 [1.08; 2.99], p = .02). The group III also resulted in significant lower clinic pregnancy rate (OR = 0.56 [0.36; 0.87], p = .01). The live birth rate tended to be higher in group I and group V but without a significant difference. CONCLUSION: Following agonist protocol, additional luteal support might improve IVF outcomes in patients with low serum P4 level in the middle luteal phase.


Assuntos
Didrogesterona/administração & dosagem , Fase Luteal/sangue , Indução da Ovulação/métodos , Progesterona/sangue , Progestinas/administração & dosagem , Feminino , Fertilização In Vitro , Humanos , Gravidez , Taxa de Gravidez , Estudos Retrospectivos
5.
Anim Reprod Sci ; 219: 106512, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32828398

RESUMO

The aim of the study was to determine the luteolytic dose of cloprostenol administered directly into the corpus luteum (CL; intra-luteal treatment, ILT) in dairy cattle. Cows of two control groups were treated with 500 µg of cloprostenol (Estrumate®) intramuscularly (IM-500) or via ILT with 0.2 mL of physiological solution (ILT-0). Cows of four experimental groups were treated by ILT with cloprostenol in doses 5, 25, 50 and 100 µg (ILT-5, -25, -50 and -100 groups). Progesterone concentrations (P4) and size of CL were evaluated to assess luteolysis at 0, 0.5, 1, 2, 4, 8, 24 and 48 h or at 0, 24 and 48 h after ILT, respectively. Cows in the ILT-0 and -5 groups were unaffected by ILT. The P4 concentrations were less in cows of the IM-500, as well as ILT-25, -50 and -100 groups at 48 h subsequent to ILT. The size of the CL was less in cows of IM-500, as well as ILT-25, -50 and -100 groups at 48 h after ILT. There were P4 concentrations of about 1 ng/mL 48 h after ILT in cows of the IM-500, as well as ILT-50 and -100 groups. In conclusion, the cloprostenol dose of 50 µg administered intra-luteally is a luteolytic dose in cows.


Assuntos
Bovinos , Cloprostenol/administração & dosagem , Corpo Lúteo/efeitos dos fármacos , Luteólise/efeitos dos fármacos , Animais , Cloprostenol/farmacologia , Corpo Lúteo/citologia , Corpo Lúteo/diagnóstico por imagem , Indústria de Laticínios , Vias de Administração de Medicamentos , Sincronização do Estro/efeitos dos fármacos , Sincronização do Estro/fisiologia , Feminino , Lactação/efeitos dos fármacos , Lactação/fisiologia , Fase Luteal/sangue , Fase Luteal/efeitos dos fármacos , Luteólise/fisiologia , Ovário/diagnóstico por imagem , Ovário/efeitos dos fármacos , Progesterona/sangue , Resultado do Tratamento , Ultrassonografia/métodos , Ultrassonografia/veterinária
6.
J Int Med Res ; 48(6): 300060520926026, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32495663

RESUMO

OBJECTIVE: To evaluate the efficacy and safety of multiple- versus single-dose gonadotropin-releasing hormone agonist (GnRH-a) addition to luteal phase support (LPS), in patients with a first in vitro fertilization (IVF) failure associated with luteal phase deficiency (LPD). METHODS: Eighty patients with a first IVF failure associated with LPD were randomly assigned into single-dose and multiple-dose GnRH-a groups. In the second IVF attempt, patients in the single-dose group were given standard LPS plus a single dose of GnRH-a 6 days after oocyte retrieval. Patients in the multiple-dose group received standard LPS plus 14 daily injections of GnRH-a. Children conceived were followed up for 2 years. RESULTS: Pregnancy (67.5% vs. 42.5%), clinical pregnancy (50.0% vs. 22.5%), and live birth rates (42.5% vs. 20.0%) were significantly higher in the multiple-dose versus single-dose GnRH-a group. Patients in the multiple-dose GnRH-a group had significantly higher progesterone levels 14 days after oocyte recovery (35.9 vs. 21.4 ng/mL). No significant difference existed in the status at birth or developmental and behavior assessments of 2-year-old children conceived in both groups. CONCLUSIONS: Daily addition of GnRH-a to standard LPS can achieve better pregnancy outcomes with a sustained safety profile in patients with a first IVF failure associated with LPD.


Assuntos
Fármacos para a Fertilidade Feminina/administração & dosagem , Fertilização In Vitro/métodos , Hormônio Liberador de Gonadotropina/agonistas , Infertilidade Feminina/terapia , Fase Luteal/efeitos dos fármacos , Adulto , Pré-Escolar , Gonadotropina Coriônica/administração & dosagem , Gonadotropina Coriônica/efeitos adversos , Esquema de Medicação , Feminino , Fármacos para a Fertilidade Feminina/efeitos adversos , Fertilização In Vitro/efeitos adversos , Hormônio Foliculoestimulante Humano/administração & dosagem , Hormônio Foliculoestimulante Humano/efeitos adversos , Seguimentos , Humanos , Lactente , Recém-Nascido , Infertilidade Feminina/sangue , Nascido Vivo , Fase Luteal/sangue , Indução da Ovulação/efeitos adversos , Indução da Ovulação/métodos , Gravidez , Taxa de Gravidez , Progesterona/sangue , Estudos Prospectivos , Proteínas Recombinantes/administração & dosagem , Proteínas Recombinantes/efeitos adversos , Retratamento/efeitos adversos , Retratamento/métodos , Resultado do Tratamento , Adulto Jovem
7.
Psychoneuroendocrinology ; 118: 104713, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32460195

RESUMO

OBJECTIVES: In this study, we evaluated the changes in leptin and ghrelin concentrations, eating behavior, depression, and impulsivity and their correlations within the luteal phase among women with premenstrual dysphoric disorder (PMDD). METHODS: In 63 women with PMDD and 53 healthy controls, we prospectively evaluated serum levels of leptin and ghrelin, Body Mass Index(BMI), and self-reported sweet cravings, cognitive restraint, uncontrolled eating, emotional eating, depression, and impulsivity during the early luteal (EL) and late luteal (LL) phases. RESULTS: Compared with the controls, the women with PMDD had higher BMI, higher leptin concentrations in the EL and LL phase, and leptin concentrations increased from the EL to the LL phase. However, there is no significant difference in ghrelin. Women with PMDD increased sweet cravings and uncontrolled eating from EL to LL phase. No significant correlation was observed between the EL-LL changes in leptin or ghrelin concentrations and those in eating behaviors. Both depression and impulsivity correlated with sweet craving and uncontrolled eating. Depression mediated the association between PMDD and uncontrolled eating. The BMI of women with PMDD positively correlated with their EL-LL change in leptin, and LL depression levels and emotional eating. CONCLUSION: Young women with PMDD had higher leptin concentrations and BMI in the luteal phase. The LL leptin level was not the primary factor responsible for the increased uncontrolled eating of PMDD. Whether the increased eating and depression in the LL phase contribute to the risk of obesity or hyperleptinemia among women with PMDD need to be evaluated in the future.


Assuntos
Comportamento Alimentar/fisiologia , Grelina/sangue , Leptina/sangue , Fase Luteal , Transtorno Disfórico Pré-Menstrual , Adulto , Índice de Massa Corporal , Estudos de Casos e Controles , Emoções/fisiologia , Comportamento Alimentar/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/sangue , Transtornos da Alimentação e da Ingestão de Alimentos/fisiopatologia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Feminino , Humanos , Fase Luteal/sangue , Fase Luteal/psicologia , Transtorno Disfórico Pré-Menstrual/sangue , Transtorno Disfórico Pré-Menstrual/fisiopatologia , Transtorno Disfórico Pré-Menstrual/psicologia , Adulto Jovem
8.
Artigo em Inglês | MEDLINE | ID: mdl-32265836

RESUMO

Introduction: It has recently been shown that late follicular phase progesterone levels correlate well with those in the early luteal phase, and that progesterone levels before and 12 h after human chorionic gonadotropin (hCG) administration predict levels during the early luteal phase. This study investigated determinants of serum hCG levels after a bolus dose of hCG for triggering ovulation in women undergoing in vitro fertilization (IVF). Materials and Methods: This retrospective analysis was performed on data from a prospective study of women aged 18-42 years with normal ovarian reserve receiving gonadotropin-releasing hormone (GnRH) antagonist co-treatment during ovarian stimulation with follicle-stimulating hormone (FSH) who were followed until 6 days after oocyte pick-up (OPU) in a single IVF cycle. The main outcome measures were early luteal phase serum hCG levels, and predictors of those levels. Results: There was wide inter-individual variability in early phase hCG concentrations over the period from 12 h after hCG injection up to 6 days after OPU. Patients with serum hCG values in the bottom 10% had a significantly higher body mass index (BMI; p = 0.038) and a significantly longer duration of stimulation (p = 0.014) than those with higher serum hCG values. Serum progesterone levels up to the first 36 h after hCG injection were significantly higher in the low vs. higher serum hCG group, but were similar at all other time points. There was a significant correlation between serum hCG level after hCG administration and BMI (lower BMI = higher serum hCG). In a cluster analysis, patients with the lowest serum hCG and progesterone levels at 12 h after hCG injection had significantly higher BMI, and significantly lower anti-Müllerian hormone level, duration of stimulation, and number of follicles of ≥11 and ≥14 mm compared with the other three clusters. Conclusion: Predictors of low serum hCG after a trigger bolus were difficult to determine, but BMI seems to be important. More detailed information on the luteal phase hormonal profile and data on predictors of hormone levels during this critical period can facilitate the development of strategies to allow individualization of the luteal phase support regimen, potentially improving IVF outcomes.


Assuntos
Gonadotropina Coriônica/sangue , Gonadotropina Coriônica/uso terapêutico , Fase Luteal/sangue , Folículo Ovariano/efeitos dos fármacos , Indução da Ovulação/métodos , Proteínas Recombinantes/uso terapêutico , Adolescente , Adulto , Relação Dose-Resposta a Droga , Feminino , Fármacos para a Fertilidade Feminina/uso terapêutico , Fertilização In Vitro , Hormônio Liberador de Gonadotropina/antagonistas & inibidores , Antagonistas de Hormônios/uso terapêutico , Humanos , Infertilidade Feminina/sangue , Infertilidade Feminina/diagnóstico , Infertilidade Feminina/terapia , Folículo Ovariano/fisiologia , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
9.
J Assist Reprod Genet ; 37(5): 1183-1194, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32221790

RESUMO

PURPOSE: The aim of this study is to provide data on the practice of Luteal Phase Oocyte Retrieval (LuPOR). The authors assess cell-free DNA levels in follicular fluid (ff cfDNA) from poor responders undergoing natural cycles, and comparing it to respective data originating from follicular phase oocyte retrievals. METHODS: Forty-seven women were eligible for this prospective study. Participants were classified as poor responders based on Bologna criteria while being detected with a second follicular wave. Follicular fluid was collected and prepared for cfDNA extraction. Levels of cfDNA were quantified via Q-PCR employing the ALU115 and ALU247 primers. These primers are associated with apoptotic and necrotic events. Levels of ff cfDNA resulting from follicular phase oocyte retrieval (FoPOR) and LuPOR-performed in a single menstrual cycle were associated with the number and maturation status of yielded oocytes and the number and fertilization status of resulting zygotes. Survival rate following thawing of cryopreserved zygotes, along with the resulting number of cleavage stage and blastocyst stage embryos are provided. RESULTS: Mean levels of ALU115 were significantly lower during FoPOR when compared to LuPOR (0.79 ± 0.72 vs 1.46 ± 1.59 ng/µl, p = 0.02). Regarding the FoPOR group, a significant positive correlation of serum estradiol and ALU115 concentration (p = 0.04) was revealed. A significant negative correlation between serum estradiol and cfDNA integrity was observed both during FoPOR (p = 0.03) and LuPOR (p = 0.03). A significant lower number of retrieved (1.09 ± 0.28 vs 1.29 ± 0.58, p = 0.02) and MII oocytes (0.77 ± 0.55 vs 1.08 ± 0.61, p = 0.02) was observed when comparing the FoPOR to LuPOR groups respectively. The integrity of cfDNA was observed to be higher in FoPOR originating embryos that arrested either prior to cleavage (0.28 ± 0.13 vs 0.17 ± 0.10, p = 0.006) or prior to blastocyst formation (0.28 ± 0.12 vs 0.13 ± 0.06, p = 0.04). In the case of LuPOR originating embryos, cfDNA integrity was observed to be higher in embryos that arrested only prior to the blastocyst stage (0.27 ± 0.20 vs 0.11 ± 0.07, p = 0.008). Similarly, cfDNA integrity was observed to be lower in top quality blastocysts originating from FoPOR (0.07 ± 0.04 vs 0.17 ± 0.05, p = 0.03) and in top quality cleavage stage embryos (0.09 ± 0.06 vs 0.31 ± 0.22, p = 0.01) and blastocysts (0.06 ± 0.02 vs 0.14 ± 0.06, p = 0.02) originating from LuPOR. CONCLUSIONS: Our results indicate that ff originating from LuPOR presents with higher levels of cfDNA. The higher cfDNA levels are attributed to mainly apoptotic events, as the ALU247 levels and DNA integrity did not differ statistically significantly between FoPOR and LuPOR. The absolute mean level of ALU247 corresponding to necrotic events was higher in LuPOR. Regarding embryological data, cfDNA integrity was correlated with both number and quality of cleavage stage embryos in both FoPOR and LuPOR, along with blastocyst stage embryos in LuPOR. Necrotic events were associated with poorer blastocyst formation rate and blastocyst quality in LuPOR. As the comparison between FoPOR and LuPOR results to similar IVF laboratory data, the practice of LuPOR may stand as a promising approach for poor responders, while it merits further investigation.


Assuntos
Ácidos Nucleicos Livres/sangue , Fertilização In Vitro , Fase Folicular/sangue , Infertilidade Feminina/sangue , Fase Luteal/sangue , Adulto , Elementos Alu/genética , Blastocisto/metabolismo , Ácidos Nucleicos Livres/química , Feminino , Líquido Folicular/química , Humanos , Infertilidade Feminina/patologia , Recuperação de Oócitos/métodos , Oócitos/crescimento & desenvolvimento , Oócitos/metabolismo , Folículo Ovariano/metabolismo , Indução da Ovulação/métodos , Adulto Jovem
10.
Int J Sports Med ; 41(7): 443-449, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32059242

RESUMO

This study aimed to investigate the effect of the menstrual cycle on serum carnitine and the endurance performance of healthy women. Fifteen eumenorrheic women underwent cycle ergometer exercise at 60% maximal oxygen uptake (V̇ O2max) for 45 min, followed by exercise at an intensity that was increased to 80% V̇ O 2max until exhaustion, during two menstrual cycle phases, including the early follicular phase (FP) and the midluteal phase (LP). The blood levels of estradiol, progesterone, total carnitine, free carnitine, and acylcarnitine were assessed. Compared with the FP, the LP had significantly lower serum total carnitine (p<0.05) and free carnitine (p<0.01). Moreover, the group with decreased endurance performance in the LP than in the FP showed a significantly higher change in serum free carnitine compared with the group that showed improved endurance performance in the LP than in the FP (p<0.05). The results of this study suggested that the changes in serum free carnitine during the menstrual cycle might influence endurance performance.


Assuntos
Carnitina/sangue , Exercício Físico/fisiologia , Fase Folicular/sangue , Fase Luteal/sangue , Resistência Física/fisiologia , Carnitina/análogos & derivados , Estradiol/sangue , Teste de Esforço , Feminino , Humanos , Progesterona/sangue , Adulto Jovem
11.
Psychoneuroendocrinology ; 112: 104512, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31780185

RESUMO

The neuroactive steroid 3α-5α-tetrahydroprogesterone (allopregnanolone), a metabolite of progesterone, is a positive allosteric modulator of GABAA receptors, and low levels have been implicated in the etiology of mood disorders. However, it is not known whether metabolism of progesterone to allopregnanolone varies across the menstrual cycle or is low after menopause. We hypothesized that the allopregnanolone/progesterone ratio would decrease from the follicular to luteal phase. We also hypothesized that postmenopausal women would have lower levels of progesterone and allopregnanolone but similar allopregnanolone/progesterone ratios as premenopausal women in the follicular phase. Serum fasting allopregnanolone and progesterone levels were measured by gas chromatography-mass spectrometry in ten premenopausal women at the follicular, mid-cycle, and luteal phases of the menstrual cycle and in twenty-four postmenopausal women. Although allopregnanolone and progesterone levels increased from the follicular to luteal phase, the allopregnanolone/progesterone ratio decreased 8-fold [0.33 ± 0.08 (follicular) vs 0.16 ± 0.09 (mid-cycle) vs 0.04 ± 0.007 (luteal), p = 0.0003]. Mean allopregnanolone and progesterone levels were lower in postmenopausal than premenopausal women at all menstrual cycle phases (p < 0.01). The mean allopregnanolone/progesterone ratio was similar in postmenopausal and premenopausal women in the follicular phase (0.39 ± 0.08 vs 0.33 ± 0.08, p = 0.94) but was significantly lower at mid-cycle and in the luteal phase than in postmenopausal women (p < 0.01). In conclusion, the serum allopregnanolone/progesterone ratio decreases 8-fold from the follicular to luteal phase and is lower at mid-cycle and the luteal phase than in postmenopausal women. Whether these data have implications for luteal phase and other mood disorders merits further study.


Assuntos
Fase Folicular/sangue , Fase Luteal/sangue , Menopausa/sangue , Pregnanolona/sangue , Progesterona/sangue , Adulto , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Adulto Jovem
12.
Menopause ; 27(2): 127-133, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31794501

RESUMO

OBJECTIVE: To further characterize the endocrinology of the menopause transition, we sought to determine: whether relationships between urine and serum hormones are maintained as women enter their sixth decade; whether a single luteal phase serum progesterone (P) is reflective of integrated-luteal urinary pregnanediol glucuronide (uPdg); and whether serum P, like luteal uPdg, declines as women approach their final menses (FMP). METHODS: The Study of Women's Health Across the Nation (SWAN) Daily Hormone Study's (DHS) is a community-based observational study. A subset of participants underwent a timed, luteal blood draw planned for cycle days 16 to 24 during the same month of DHS collection. Serum-luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol and P, and urine LH, FSH, estrone conjugates (E1c), and daily and integrated luteal uPdg were measured in 268 samples from 170 women. Serum/urine hormone associations were determined using Pearson's correlation and linear regression, adjusted for concurrent age, body mass index, smoking status, and race/ethnicity. RESULTS: Pearson's r ranged from 0.573 (for LH) to 0.843 (for FSH) for serum/urine correlations. Integrated luteal uPdg weakly correlated with serum P (Pearson's r = 0.26, P = 0.004) and explained 7% of the variability in serum P in adjusted linear regression (total R 0.09, P = 0.002). Serum P demonstrated a marginally significant decline with approaching FMP in adjusted analysis (P = 0.04). CONCLUSIONS: Urine and serum hormones maintain a close relationship in women into their sixth decade of life. Serum luteal P was weakly reflective of luteal Pdg excretion.


Assuntos
Fase Luteal/sangue , Fase Luteal/urina , Menopausa/sangue , Menopausa/urina , Saúde da Mulher , Adulto , Estradiol/sangue , Estradiol/urina , Feminino , Hormônio Foliculoestimulante/sangue , Hormônio Foliculoestimulante/urina , Humanos , Hormônio Luteinizante/sangue , Hormônio Luteinizante/urina , Pessoa de Meia-Idade , Pregnanodiol/análogos & derivados , Pregnanodiol/sangue , Pregnanodiol/urina , Progesterona/sangue , Progesterona/urina , Análise de Regressão
13.
Artigo em Inglês | MEDLINE | ID: mdl-31703451

RESUMO

: Objective/introduction: The dynamics of ovarian hormone fluctuations during the luteal phase of the menstruation cycle were previously suggested to contribute to the development of premenstrual dysphoric disorder (PMDD) symptoms, but adequate empirical evidence has not been obtained from hormone concentration studies. We prospectively evaluated estrogen and progesterone levels in the early luteal (EL) and late luteal (LL) phases in women with PMDD and the association of these levels with PMDD symptom severity. Methods: 63 women with PMDD and 53 controls without such severe symptoms were evaluated for the estrogen and progesterone levels, and PMDD severity in the EL and LL phases. Results: The results demonstrated that the women with PMDD had a lower EL-phase estrogen level than the controls. Covariant analysis demonstrated that the interaction term between EL-phase estrogen and EL-phase progesterone level was associated with PMDD severity. Among women with lower EL estrogen levels, higher EL-phase progesterone was observed among the women with PMDD versus controls. These results suggest that low EL-phase estrogen level could moderate the provoking effect of EL progesterone in women with PMDD. Overall, these data suggest a possible role of estrogen and progesterone in the development of PMDD symptoms.


Assuntos
Estrogênios/sangue , Fase Luteal/sangue , Transtorno Disfórico Pré-Menstrual/sangue , Progesterona/sangue , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Ciclo Menstrual , Síndrome Pré-Menstrual , Adulto Jovem
14.
Pain ; 160(8): 1781-1793, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31335647

RESUMO

The role of sex hormones on postsurgical pain perception is basically unclear. Here, we studied the role of endogenous gonadal hormones for pain and hyperalgesia in human volunteers after experimental incision. A 4-mm incision was made in the volar forearm of 15 female volunteers both in the follicular and the luteal phase (random block design). Somatosensory profiles were assessed at baseline and 1 to 72 hours after incision by quantitative sensory testing, compared between both cycle phases, and related to individual plasma levels of gonadal hormones. Sensory testing at baseline revealed significantly lower pain thresholds (25 vs 46 mN, P < 0.005) and increased pain ratings to pinprick (0.96 vs 0.47, P < 0.0001) in the luteal phase; similarly, 1 hour after incision, pain intensity to incision (38 vs 21/100, P < 0.005), pinprick hyperalgesia by rating (P < 0.05), and area of secondary hyperalgesia (P < 0.001) were enhanced in the luteal phase. Multiple regression analysis revealed that pinprick pain sensitivity at baseline was significantly predicted by progesterone (partial r = 0.67, P < 0.001), follicle-stimulating hormone (FSH) (partial r = 0.61, P < 0.005), and negatively by testosterone (partial r = -0.44, P < 0.05). Likewise, incision-induced pain and pinprick hyperalgesia (rating and area) were significantly predicted by progesterone (partial r = 0.70, r = 0.46, and r = 0.47, respectively; P < 0.05-0.0001) and in part by FSH; the contribution of estrogen, however, was fully occluded by progesterone for all measures. In conclusion, pinprick pain and incision-induced pain and mechanical hyperalgesia were greater in the luteal phase and predicted by progesterone, suggesting a major role for progesterone. Other hormones involved are testosterone (protective) and in part FSH.


Assuntos
Dor Aguda/sangue , Hiperalgesia/sangue , Fase Luteal/sangue , Progesterona/sangue , Adulto , Estradiol/sangue , Feminino , Hormônio Foliculoestimulante/sangue , Humanos , Hormônio Luteinizante/sangue , Medição da Dor , Limiar da Dor/fisiologia , Testosterona/sangue , Adulto Jovem
15.
PLoS One ; 14(7): e0220450, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31361764

RESUMO

OBJECTIVE: We sought to determine whether the early luteal serum progesterone (P4) level predicts the success of IVF treatment with oral dydrogesterone for luteal support. METHOD: This retrospective monocentric cohort study included 242 women who underwent IVF treatment with fresh embryo transfer (ET) between July 2017 and June 2018. The population was unselected, and women were treated according to our unit's usual stimulation protocols. For the luteal phase support (LPS), all women were supplemented with a 10 mg three-times-daily dose of oral dydrogesterone beginning on the day of oocyte pick-up (OPU). Blood sampling was performed on the day of ET (Day 2-3 after OPU) to determine the early luteal serum progesterone level. RESULTS: ROC curve analysis allowed us to determine two thresholds for the prediction of live birth using the early P4 level. Women who had early luteal P4 levels greater than 252 nmol/l had a significantly higher live birth rate (27.1%) than women with early luteal P4 between 115 and 252 nmol/l (17.2%) and women with early luteal P4 below 115 nmol/l (6.0%; p = 0.011). After a multiple regression analysis, an early luteal P4 level greater than 252 nmol/l was still associated with a higher chance of a live birth than a P4 between 115 and 252 nmol/l (OR = 0.40 [0.18-0.91]; p = 0.028) or a P4 below 115 nmol/l (OR = 0.10 [0.01-0.52]; p = 0.006). CONCLUSIONS: Our study suggests a positive association between early P4 levels and reproductive outcomes in IVF using oral dydrogesterone for luteal support. The inconsistencies between our results and those of other studies suggest that extrapolation is impractical. Further larger prospective cohort studies should be conducted to determine reliable thresholds that could be used to personalize luteal phase support.


Assuntos
Didrogesterona/administração & dosagem , Fertilização In Vitro/métodos , Fase Luteal/metabolismo , Taxa de Gravidez , Progesterona/sangue , Administração Oral , Adulto , Transferência Embrionária , Feminino , Humanos , Fase Luteal/sangue , Idade Materna , Pessoa de Meia-Idade , Indução da Ovulação , Gravidez , Estudos Prospectivos , Curva ROC , Estudos Retrospectivos
16.
Rev. bras. ciênc. vet ; 26(3): 111-115, jul./set. 2019. ilus, tab
Artigo em Português | LILACS, VETINDEX | ID: biblio-1491645

RESUMO

O objetivo deste estudo foi obter o perfil eletroforético das proteínas séricas em éguas cíclicas e verificar as diferenças entre as fases folicular e luteal do ciclo estral nesta espécie. Foram utilizadas 18 éguas, totalizando 36 amostras de soro, sendo duas de cada égua. As amostras foram colhidas no estro e no diestro. As proteínas séricas totais foram obtidas pelo método do Biureto, a partir da utilização de Kits comerciais (LABTEST®) e, as diferentes subfrações proteicas, por eletroforese em gel de poliacrilamida (SDS-PAGE). O eletroforetograma das proteínas séricas colocou em evidência a presença de 17 a 25 frações proteicas, cujos pesos moleculares variaram de 22 a 254 kDa. Identificaram-se duas proteínas ainda não nomeadas oficialmente, de massas moleculares (MM) 23 kDa e 144 kDa. Os valores médios ± SEM obtidos para cada variável no estro e no diestro, respectivamente, foram: proteínas totais (g/dL) 7,11 ± 0,07 e 7,36 ± 0,07; albumina (mg/dL) 4790,83 ± 69,10 e 5027,19 ± 69,10; α1 glicoproteína ácida (mg/dL) 4,90 ± 0,31 e 4,93 ± 0,31; ceruloplasmina (mg/dL) 15,28 ± 1,31 e 10,65 ± 1,31; haptoglobina (mg/dL) 22,70 ± 1,16 e 27,06 ± 1,16; transferrina (mg/dL) 329,00 ± 9,78 e 350,16 ± 9,78; IgA (mg/dL) 119,91 ± 6,30 e 107,03 ± 6,30; IgG (mg/dL) 1525,07 ± 40,18 e 1517,25 ± 40,18; MM 23 (mg/dL) 204,44 ± 8,61 e 219,79 ± 8,61; MM 144 (mg/dL) 22,13 ± 0,55 e 21,49 ± 0,55. Não houve diferença significativa das proteínas totais e suas frações do estro para o diestro. Conclui-se que as modificações hormonais durante as fases do ciclo estral da égua não interferem no proteinograma sérico.


This study aimed to obtain the electrophoretic profile of serum proteins in cyclic mares and to verify the differences between the follicular and luteal phases of the estrous cycle in this species. Eighteen mares were used, totaling 36 serum samples, two of each mare. Samples were collected both in estrus and in diestrus. Total serum proteins were obtained by the Biureto method, by using commercial kits (LABTEST®), while the different protein subfractions by polyacrylamide gel electrophoresis (SDS-PAGE). The electroforetogram of serum proteins evidenced the presence of 17 to 25 protein fractions, whose molecular weights ranged from 22 to 254 kDa. Two proteins that were not yet officially named were identified, of molecular weights (MW) of 23 kDa and 144 kDa. The mean values (± SEM) obtained for each variable in estrus and diestrus were, respectively: total proteins (g/dL) 7.11 ± 0.07 and 7.36 ± 0.07; albumin (mg/dL) 4790.83 ± 69.10 and 5027.19 ± 69.10; α1 acid glycoprotein (mg/dL) 4.90 ± 0.31 and 4.93 ± 0.31; ceruloplasmine (mg/dL) 15.28 ± 1.31 and 10.65 ± 1.31; haptoglobine (mg/dL) 22.70 ± 1.16 and 27.06 ± 1.16; transferrin (mg/ dL) 329.00 ± 9.78 and 350.16 ± 9.78; IgA (mg/dL) 119.91 ± 6.30 and 107.03 ± 6.30; IgG (mg/dL) 1525.07 ± 40.18 and 1517.25 ± 40.18; MW 23 (mg/dL) 204.44 ± 8.61 and 219.79 ± 8.61; MW 144 (mg/dL) 22.13 ± 0.55 and 21.49 ± 0.55. No significant difference was verified in total proteins and its fractions in estrus and diestrus. The hormonal changes during the specific stages of the estrous cycle of the mare do not interfere with the serum proteinogram.


Assuntos
Feminino , Animais , Cavalos , Ciclo Estral , Fase Folicular/sangue , Fase Luteal/sangue , Proteínas Sanguíneas/análise , Eletroforese das Proteínas Sanguíneas/veterinária
17.
Apunts, Med. esport (Internet) ; 54(202): 65-72, abr.-jun. 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-187683

RESUMO

BACKGROUND: Menstrual cycles are affected by the concentration of estrogen and progesterone hormones affecting the individual's functional and physical factors. Aims: The purpose of this study was to investigate the difference (and relationship) toward strength, muscular endurance, anaerobic power and hormonal changes between the three (follicular, ovulation, luteal) phases of the menstrual cycle of active young girls. METHODS: Twenty young girls were selected randomly and purposefully in the age group from 20 to 30. Hormonal changes in follicle-stimulating hormone (FSH), luteinizing hormone (LH), one repetition maximum (1RM or strength) of upper body and lower body, and muscular endurance test with 60% 1RM of upper body and lower body in the three phases of the menstrual cycle were measured. Also, running-based anaerobic sprint test (RAST) was used to estimate anaerobic power. RESULTS: The results of this study showed that there was no significant difference between muscular strength and endurance in the three phases of the menstrual cycle (upper and lower body muscle strength: P = 0.13, P = 0.23; muscular endurance: P = 0.33, P = 0.5, respectively). Also, the results indicated no significant difference in anaerobic power in the three phases of the menstrual cycle (P = 0.45). In contrast, there was a significant difference between LH and FSH levels in the menstrual cycle phases (P = 0.001). CONCLUSIONS: The different phases of the menstrual cycle practically do not limit the physical and physiological performance of active young girls, and girls can participate in sports activities without worrying about a drop in performance


ANTECEDENTES: Los ciclos menstruales son afectados por la concentración de estrógeno y progesterona, que afectan a los factores funcional y físico del individuo. OBJETIVO: El objetivo de este estudio fue investigar la diferencia (y relación) entre fuerza y resistencia muscular, potencia anaeróbica y cambios hormonales entre las tres fases (folicular, ovulación, lútea) del ciclo menstrual de las jóvenes activas. MÉTODOS: Se seleccionaron veinte chicas intencionada y aleatoriamente del grupo de edad comprendido entre 20 y 30 años. Se midieron los cambios hormonales de la hormona folículo-estimulante (FSH), la hormona luteinizante (LH), una repetición máxima (1RM o fuerza) del tren superior y el tren inferior, y la prueba de resistencia muscular con un 60% de 1RM del tren superior y el tren inferior en las tres fases del ciclo. Se utilizó también la prueba de carrera anaeróbica en sprint (RAST) para calcular la potencia anaeróbica. RESULTADOS: Los resultados de este estudio reflejaron que no existía diferencia significativa entre fuerza y resistencia muscular en las tres fases del ciclo menstrual (fuerza muscular de los trenes superior e inferior: p = 0,13, p = 0,23, y resistencia muscular: p = 0,33, p = 0,5, respectivamente). Los resultados indicaron también que no existía diferencia significativa en cuanto a potencia anaeróbica en las tres fases del ciclo menstrual (p = 0,45). Por contra, existía una diferencia significativa entre los niveles de LH y FSH en las fases del ciclo menstrual (p = 0,001). CONCLUSIONES: Las diferentes fases del ciclo menstrual no limitan prácticamente el desempeño físico y fisiológico de las jóvenes activas, pudiendo participar las chicas en actividades deportivas sin preocuparse acerca de la caída de rendimiento


Assuntos
Humanos , Feminino , Adulto Jovem , Adulto , Força Muscular/fisiologia , Resistência Física/fisiologia , Fase Folicular/fisiologia , Fase Luteal/fisiologia , Período Fértil/fisiologia , Hormônio Foliculoestimulante/sangue , Hormônio Luteinizante/sangue , Fase Luteal/sangue , Período Fértil/sangue , Biomarcadores/sangue , Anaerobiose
18.
Psychopharmacology (Berl) ; 236(6): 1817-1828, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30645681

RESUMO

RATIONALE: Sporadic reports of alcohol consumption being linked to menstrual cycle phase highlight the need to consider hormonally characterized menstrual cycle phase in understanding the sex-specific effects of risk for alcohol drinking in women. OBJECTIVES: We investigated the association between menstrual cycle phase, characterized by circulating progesterone and menses, with accurate daily alcohol intakes in rhesus monkeys, and the contribution of progesterone derived neuroactive steroids to cycle-related alcohol drinking. METHODS: Menses (daily) and progesterone (2-3×/week) were obtained in female monkeys (n = 8, 5 ethanol, 3 control) for 12-18 months. Ethanol monkeys were then induced to drink ethanol (4% w/v; 3 months) and given 22 h/day access to ethanol and water for approximately 1 year. In selected cycles, a panel of neuroactive steroids were assayed during follicular and luteal phases from pre-ethanol and ethanol exposure. RESULTS: There were minimal to no effects of ethanol on menstrual cycle length, progesterone levels, and follicular or luteal phase length. The monkeys drank more ethanol during the luteal phase, compared to the follicular phase, and ethanol intake was highest in the late luteal phase when progesterone declines rapidly. Two neuroactive steroids were higher during the luteal phase versus the follicular phase, and several neuroactive steroids were higher in the pre- vs. post-ethanol drinking menstrual cycles. CONCLUSIONS: This is the first study to show that normal menstrual cycle fluctuations in progesterone, particularly during the late luteal phase, can modulate ethanol intake. Two of 11 neuroactive steroids were selectively associated with the effect of cycle progesterone on ethanol drinking, suggesting possible links to CNS mechanisms of ethanol intake control.


Assuntos
Consumo de Bebidas Alcoólicas/sangue , Etanol/administração & dosagem , Fase Luteal/sangue , Fase Luteal/efeitos dos fármacos , Progesterona/sangue , Consumo de Bebidas Alcoólicas/psicologia , Animais , Estradiol/sangue , Feminino , Humanos , Macaca mulatta , Neurotransmissores/sangue
19.
Arch Womens Ment Health ; 22(5): 605-611, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-30535803

RESUMO

There is evidence that frequency of suicide attempts of fertile women is related to the menstrual cycle phases, while the influence of hormonal and psychiatric features has been hypothesized. This study aims to explore the distribution and possible differences in clinical characteristics of women who attempted suicide in relation to menstrual cycle. Seventy fertile female psychiatric patients, hospitalized in psychiatric department after a suicide attempt, were studied. Depression was assessed using Beck Depression Inventory, suicide intent with the Suicide Intent Scale, and aggression using the Buss-Perry Aggression Questionnaire. A profile of psychopathology was obtained by using Symptom Check List SCL-90-R. Attempts were more frequent during the last 4 days of luteal phase and during the 4 days of menses, with 59% of attempts to occur during these 8 days. Patterns of number of attempts and cycle phase were similar for subgroups regarding diagnosis, violent/non-violent mode of suicide attempt, and one or repeated attempts. Although attempts were unequally distributed during the cycle, none of the psychiatric features assessed in the present study were related to the higher frequency of attempts during premenstrual/menstrual days, indicating the need to include additional aspects of suicidal behavior in future studies.


Assuntos
Depressão/diagnóstico , Fase Luteal/psicologia , Ciclo Menstrual/psicologia , Transtornos Mentais/diagnóstico , Síndrome Pré-Menstrual/psicologia , Psicometria/estatística & dados numéricos , Tentativa de Suicídio/psicologia , Adulto , Depressão/epidemiologia , Depressão/psicologia , Feminino , Grécia/epidemiologia , Hospitalização , Humanos , Incidência , Pacientes Internados , Fase Luteal/sangue , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Síndrome Pré-Menstrual/diagnóstico , Síndrome Pré-Menstrual/epidemiologia , Escalas de Graduação Psiquiátrica , Psicopatologia , Tentativa de Suicídio/estatística & dados numéricos
20.
Reprod Domest Anim ; 54(1): 72-82, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30180283

RESUMO

The nutritional alteration of amino acids (AAs) profile in physiological fluid was poorly characterized in livestock. After oestrus synchronization, 24 ewes were randomly assigned to two groups based on the nutrient requirement recommended for maintenance (M): the feed-supplemented group (S, 1.5 × M, N = 12) and feed-restricted group (R, 0.5 × M, N = 12) on days 6-12 of their oestrous cycle, which occurred shortly before ovulation. The concentration of 30 AAs in peripheral blood (PB) and follicular fluid (FF) was quantified to calculate the PB-to-FF concentration gap for each AA and determine its correlation with metabolites and hormones in PB and FF. Results showed that the feed restriction enlarged the oestrous cycle length, decreased the number of follicles 2.5-3.5 mm, increased the number of follicles >3.5 mm and augmented the volume of follicles >2.5 mm. Nineteen AAs from PB were significantly different between the groups. The phosphoethanolamine (PEtN) and ration of essential AAs to nonessential AAs (EAA/NEAA) in FF significantly (p < 0.05) increased and decreased in the R group, respectively. Most AAs, except aspartate (Asp) and carnosine (Car) in the R group and alanine (aAla) in both groups, were significantly lower within FF than those within PB. The correlation of AAs with FSH and progesterone (P4 ) was more significant than that of AAs with other endocrine milieu characteristics. In conclusion, our results revealed that the influence of short-term nutritional manipulation during luteal phase on folliculogenesis might not be due to the variation of intrafollicular AAs profile but rather attribute to the peripheral blood AAs profile alteration.


Assuntos
Aminoácidos/sangue , Cromatografia Líquida de Alta Pressão/veterinária , Dieta/veterinária , Líquido Folicular/química , Animais , Cromatografia Líquida de Alta Pressão/métodos , Etanolaminas/análise , Feminino , Hormônio Foliculoestimulante/sangue , Líquido Folicular/metabolismo , Fase Luteal/sangue , Fase Luteal/metabolismo , Folículo Ovariano/fisiologia , Progesterona/sangue , Carneiro Doméstico/sangue , Carneiro Doméstico/metabolismo
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