Comparison of GnRH antagonist and agonist mini-dose long protocols in infertile cases undergoing controlled ovarian hyperstimulation.

AIM: The purpose of the present study was to determine if there is a difference between multi-dose gonadotropin releasing hormone (GnRH) antagonist protocol and long GnRH agonist protocol. MATERIALS AND METHODS: This retrospective study compared the data pertaining to patients chosen as per predetermined acceptance criteria, 113 of whom were administered multi-dose antagonist protocol for controlled ovarian hyperstimulation (COH) while 133 were administered long agonist protocol for COH at Suleymaniye Teaching Hospital of Obstetrics and Gynecology. RESULTS: While cancellation rate was found to be significantly higher in antagonist group (17.7% vs 11.28%), the number of follicles > 14 mm and > 16 mm, E2 level, and the number of retrieved oocytes on the day of hCG trigger were significantly lower in the same group. However, there was no difference between fertilization rates and embryonic development rates. The pregnancy rates per transfer and per cycle were found to be 40.9% and 31.7%, respectively; in the antagonist group they were lower, though not significantly, when compared to agonist group (44.1% and 39.1%, respectively). Ongoing pregnancy rates were found to be similar between the groups. CONCLUSION: GnRH antagonist treatment protocol has a level of efficacy similar to agonist treatment protocol in terms of pregnancy results for all groups.

A possible connection between tumor necrosis factor alpha and adropin levels in polycystic ovary syndrome.

CONTEXT: Adropin is a peptide hormone implicated in the regulation of insulin sensitivity and energy homeostasis. Polycystic ovary syndrome (PCOS) is a metabolic and reproductive disease associated with insulin resistance. It has been demonstrated that various inflammatory markers increased in PCOS including TNF-α. TNF-α regulates the secretion of certain peptides which play a crucial role in glucose and lipid homeostasis. There is also some evidence of a link between TNF-α and adropin. OBJECTIVE: To ascertain whether there is an association between circulating adropin levels and TNF-α in PCOS. PATIENTS AND DESIGN: 152 women with PCOS and 152 age- and body mass index-matched controls without PCOS were recruited for this cross-sectional study. MAIN OUTCOME MEASURES: Adropin and TNF-α levels were measured using ELISA. RESULTS: Adropin levels were lower in the PCOS group compared with the control group (7.43 ± 0.79 vs. 9.42 ± 0.76 ng/ml, P < 0.001), whereas TNF-α levels were higher (49.93 ± 3.39 vs. 35.83 ± 2.47 pg/ml, P < 0.001). A strongly negative correlation was found between circulating adropin levels and TNF-α levels in women with PCOS (r = -0.407, P < 0.001). Binary logistic regression analysis revealed that decreased adropin levels were significantly associated with high odds of having PCOS, although, after adjustment for TNF-α, this link vanished. Additionally, multiple linear regression analysis showed that HOMA-IR and TFN-α independently predicted adropin levels. CONCLUSIONS: Serum adropin levels are significantly decreased in PCOS and are inversely associated with TNF-α. Further dissection of the nature of this association can open new therapeutic options for metabolic diseases.

Serum adiponectin levels in high school girls with polycystic ovary syndrome and hyperandrogenism.

OBJECTIVE: To compare the serum adiponectin levels together with metabolic and hormonal parameters among teenage girls at the early onset of polycystic ovary syndrome (PCOS) and hyperandrogenism with controls. DESIGN: Prospective study. SETTINGS: Education and research hospital, outpatient gynecological endocrinology clinic. PARTICIPANTS: Four hundred seventy-nine teenage girls from a school of nursing were interviewed for the signs and symptoms of PCOS. Among them, 42 cases who had a definitive diagnosis of PCOS with hyperandrogenism based on Rotterdam diagnostic criteria were recruited for the study and other causes of hyperandrogenemia had been excluded. The controls were recruited from regularly cycling healthy teenage girls from the same high school of nursing; none of those who agreed to join the study met any of the diagnostic criteria for PCOS (n = 44). INTERVENTIONS: Cases were selected as group I: PCOS with body mass index (BMI) < 25 kg/m² (n = 20), group II: PCOS with BMI > 25 kg/m² (n = 22), group III: Controls with BMI < 25 kg/m² (n = 21) and group IV: Controls with BMI > 25 kg/m² (n = 23). Serum adiponectin, metabolic and hormonal parameters were compared in PCOS patients with BMI matched controls. MAIN OUTCOME MEASURES: Difference of serum adiponectin levels, metabolic and hormonal parameters between teenage girls with PCOS and controls. RESULTS: Serum adiponectin levels were not significantly different in group I and group II. Serum adiponectin levels were significantly decreased in group I and group II compared with both control groups (III and IV). CONCLUSION: Serum adiponectin levels were lower in teenage girls with PCOS and this reduction was independent from BMI.