Effect of oral contraceptives and ovarian cycle on platelet function

In past decades, numerous epidemiological and clinical studies in women taking oral contraceptives revealed the impact of sex steroids on coagulation factors and the incidence of venous thrombosis. To date, only scarce data regarding the impact of oral contraceptives on platelet function are available. The aim of this study was to further elucidate the impact of sex steroids on platelet function. We conducted an observational study in young women using different types and dosages of monophasic oral contraceptives (OCs) compared to women not taking OCs. During the follicular phase, the mean closure time (CT) in Col/Epi was 168.0 +/- 64.9 s compared to 131.5 +/- 28.9 s during the luteal phase (p=0.012). In Col/Epi cartridges, no difference was detected between women taking second/third generation OCs and low-dose OCs (145.2 +/- 44.3 vs. 169.4 +/- 63.5, p=0.34). In contrast, mean Col/Epi values of women using anti-androgen-containing OCs were less (110.3 +/- 15.6 s) than in both other OC groups (p=0.03 for both comparisons). The same holds for Col/Epi values from women during the follicular- and luteal phases compared to women using anti-androgen-containing OCs (p=0.0002, p=0.013). Significant correlations between progesterone and platelet function in women not using OCs (p=0.02) could be found. In conclusion, the results of the study show that platelet function might be modulated by OCs and the female cycle. As for OCs, the main factor seems to be the progestagen. During the female cycle, the main impact on platelet function might be mediated by progesterone.

The effect of luteal phase support protocol on cycle outcome and luteal phase hormone profile in long agonist protocol intracytoplasmic sperm injection cycles: a randomized clinical trial

OBJECTIVE

To study the effect of luteal phase support protocol on cycle outcome and luteal phase hormone profile, in long agonist protocol intracytoplasmic sperm injection (ICSI) cycles.

DESIGN

Prospective randomized trial.

SETTING

Private infertility center.

PATIENT(S)

Two hundred seventy-four women undergoing first ICSI cycles were randomized after ovum pickup into three groups of luteal support.

INTERVENTION(S)

Group I received IM P (P(4)) only, group II received P(4) + oral E(2) valerate, group III received P(4) + hCG.

MAIN OUTCOME MEASURE(S)

Pregnancy rate (PR), implantation rate, rates of multiple pregnancy and miscarriage, and midluteal serum E(2) and P(4), and midluteal E(2):P(4) ratio.

RESULT(S)

The PR and implantation rates were significantly higher in group II compared to group I and the miscarriage rate was significantly lower in group II compared with group I. Midluteal E(2) was significantly higher in group II compared with group I. The decline in E(2) after ovum pickup was lowest in group II, highest in group I. The midluteal E(2):P(4) ratio was significantly higher in group II compared with groups I and III.

CONCLUSION(S)

The E(2) luteal phase supplementation in long GnRH-agonist (GnRH-a) protocol ICSI cycles resulted in better cycle outcome and better luteal phase hormone profile.

Analysis of human mammary fibroadenoma by Ki-67 index in the follicular and luteal phases of menstrual cycle

OBJECTIVES

Fibroadenoma is the most common benign mammary condition among women aged 35 or younger. Expression of Ki-67 antigen has been used to compare proliferative activity of mammary fibroadenoma epithelium in the follicular and luteal phases of the menstrual cycle.

MATERIALS AND METHODS

Ninety eumenorrheic women were selected for tumour excision; they were assigned to either of the two groups, according to their phase of menstrual cycle. At the end of the study, 75 patients with 87 masses were evaluated by epithelial cell Ki-67 expression, blind (no information given concerning group to which any lesion belonged).

RESULTS

Both groups were found to be homogeneous relative to age, menarche, body mass index, previous gestation, parity, breastfeeding, number of fibroadenomas, family history of breast cancer and tabagism. Median tumour size was 2.0 cm and no relationship between proliferative activity and nodule diameter was observed. No typical pattern was observed in the expression of Ki-67 in distinct nodules of the same patient. Average values for expression of Ki-67 (per 1000 epithelial cells) in follicular and luteal phases were 27.88 and 37.88, respectively (P = 0.116).

CONCLUSION

Our findings revealed that proliferative activities in the mammary fibroadenoma epithelium did not present a statistically significant difference in the follicular and luteal phases. The present study contributes to clarifying that fibroadenoma is a neoplasm and does not undergo any change in the proliferative activity during the menstrual cycle.

High expression levels of cyclin B1 and Polo-like kinase 1 in ectopic endometrial cells associated with abnormal cell cycle regulation of endometriosis

OBJECTIVE

To investigate the possible roles of cyclin B1/cyclin-dependent kinase (cdc2) and Polo-like kinase 1 (Plk1) in the pathogenesis of endometriosis.

DESIGN

A case-control study.

SETTING

University hospital.

PATIENT(S)

Patients with or without endometriosis were diagnosed by pathological examination or laparoscopy. The patients with the following criteria within the past 6 months were excluded: endocrine or inflammatory diseases, pregnancy or lactation, hormonal therapy, and neoplasm in the uterine cavity.

INTERVENTION(S)

Eutopic and ectopic endometria were obtained at the time of surgery. Blood was collected on the same day as surgery.

MAIN OUTCOME MEASURE(S)

The mRNA/protein expression and localization of cyclin B1, cdc2, and Plk1 in endometrium, and serum levels of E(2) and P.

RESULT(S)

The expression levels of cyclin B1 and Plk1, but not cdc2, in ectopic endometria were significantly higher than in eutopic endometria. The immunohistochemical staining of cyclin B1 and Plk1 was detected in the nuclei of ectopic and eutopic endometrial cells. Furthermore, ectopic endometrial expression levels of cyclin B1 or Plk1 were positively correlated with serum E(2) levels.

CONCLUSION(S)

Cyclin B1 and Plk1 may play important roles in the pathogenesis of endometriosis by mediating ectopic endometrial cell proliferation under regulation of ovarian hormones.

Progesterone rise on the day of human chorionic gonadotropin administration impairs pregnancy outcome in day 3 single-embryo transfer, while has no effect on day 5 single blastocyst transfer

Four hundred eighty-two patients undergoing single ET with GnRH-antagonist/recFSH protocol were analyzed. The incidence of premature luteinization (P above 1.5 ng/mL on the day of hCG administration) was 18.2%. Even modest rises of P in the follicular phase have detrimental effect on the implantation potential of a good-quality cleavage stage embryo. On the contrary, premature luteinization in the blastocyst subgroup had no effect on the pregnancy outcome.

Acylation-stimulating protein increases and correlates with increased progesterone levels during the luteal phase of the menstrual cycle

OBJECTIVE

The menstrual cycle represents a continuous state of change in terms of female sex steroid environment. Progesterone is linked to increased fat storage while estrogen exerts anti-lipogenic effects. This study investigated variations in the potent lipogenic factor acylation-stimulating protein (ASP), and examined its association with hormonal and lipid profile alterations across the menstrual cycle.

METHODS AND DESIGN

Nineteen non-obese women with regular menstrual cycles were investigated in a longitudinal study during the follicular, ovulatory, and mid-luteal phases (ML) of the cycle. Fasting ASP, LH, FSH, progesterone, estradiol, insulin, lipid profile, and apoproteins were evaluated during different phases of the cycle.

RESULTS

ASP levels changed significantly throughout the menstrual cycle (K-related Friedman test: P=0.013). Interestingly, these changes coincide with variations in progesterone levels across the cycle as no significant change in the ASP levels was seen across the follicular phases of the cycle, followed by a significant increase in the ovulatory phase, which continued to elevate toward the ML. The ASP levels correlated positively with the progesterone levels normally elevated in the ML. No significant correlation was seen between ASP and estrogen or any other measured female hormone. Multiple regression analysis including all measured parameters and body mass index showed that progesterone was the only significant predictor of the ASP levels.

CONCLUSION

Our findings suggest that during the menstrual cycle of normal women, the ASP levels coincidentally fluctuate with the progesterone levels, possibly reflecting cooperation between them in fat storage enhancement.

Serum pattern of circulating adipokines throughout the physiological menstrual cycle

This study investigated the serum levels of resistin, adiponectin and leptin during the physiological menstrual cycle. Sixteen women (age: 19-30 years; body mass index: 19.46-24.9) with regular menstrual cycles participated. Fasting blood samples were collected on alternate days throughout a full menstrual cycle. Mean resistin concentrations were slightly higher during the luteal phase (5.30+/-0.23 ng/ml) compared to the follicular (4.68+/-0.07 ng/ml) and midcycle (4.86+/-0.09 ng/ml) phases (p=0.032). Mean leptin concentrations during the follicular phase (18.14+/-0.28 ng/ml) were significantly lower compared to the midcycle (21.79+/-0.29 ng/ml, p=0.006) and luteal phases (23.75+/-0.64 ng/ml, p<0.001). The variation of adiponectin concentrations throughout the menstrual cycle was not significant. According to the results, circulating resistin, likewise leptin concentrations vary significantly during the physiological menstrual cycle presenting with higher values during the luteal phase. This pattern, although its physiological importance is not clear, suggests that resistin, likewise to leptin, may have a role in the regulation of cyclic female reproductive functions. The stable adiponectin concentrations throughout the menstrual cycle indicate that this adipokine probably does not play a considerable role in female reproductive functions.

Developmental programming: exogenous gonadotropin treatment rescues ovulatory function but does not completely normalize ovarian function in sheep treated prenatally with testosterone

Prenatal testosterone treatment leads to LH excess as well as ovarian follicular and ovulatory defects in the adult. These disruptions may stem from LH excess, abnormal FSH input, compromised ovarian sensitivity to gonadotropins, or intrinsic ovarian defects. To determine if exogenous gonadotropins rescue ovarian and ovulatory function of testosterone-treated sheep, the release of endogenous LH and biopotent FSH in control and prenatal testosterone-treated sheep was blocked with a GnRH antagonist during the first two breeding seasons and with LH/FSH coadministered in a manner approximating natural follicular phase. An acidic mix of FSH was administered the first 36 h at 2-h intervals and a less acidic mix for the next 12 h at 1-h intervals (different FSH preparations were used each year), and ovulation was induced with hCG. Circulating FSH and estradiol responses to gonadotropins measured in 2-h samples differed between treatment groups in Year 1 but not in Year 2. Ovarian follicular distribution and number of corpora lutea (in ewes that ovulated) tracked by ultrasonography and luteal progesterone responses were similar between control and prenatal testosterone-treated females but differed between years. Furthermore, hCG administration induced large cystic and luteinized follicles in both groups of females in Year 2, although the growth rate differed between control and prenatal testosterone-treated females. Our findings provide evidence that 1) ovulatory response in prenatal testosterone-treated females can be rescued with exogenous gonadotropins, 2) resultant follicular response is dependent on the nature of gonadotropic input, and 3) an abnormal follicular milieu may underlie differences in developmental trajectory of cystic follicles in prenatal testosterone-treated females.

Endometrial development and function in experimentally induced luteal phase deficiency

CONTEXT

It is generally assumed that delayed endometrial development observed in luteal phase deficiency (LPD) is the result of abnormally low progesterone (P) levels. This hypothesis has never been tested by direct experiment.

OBJECTIVE

Our objective was to evaluate the effects of P concentrations on human endometrium.

DESIGN AND SETTING

A randomized trial was conducted at an academic medical center.

SUBJECTS

Twenty-nine healthy, ovulatory 18- to 35-yr-old women participated.

INTERVENTION

Endometrial samples were obtained from women in natural cycles and two groups of experimentally modeled cycles. Women undergoing modeled cycles were treated with GnRH agonist and a fixed physiological dose of transdermal estradiol, followed by randomization to 10 or 40 mg daily im P administration to achieve either normal circulating luteal P or 4-fold lower P concentrations, the latter representing an experimental model of LPD.

MAIN OUTCOME MEASURES

Tissue specimens, obtained after 10 days of P exposure, were analyzed by histological dating, immunohistochemistry, immunoblot, and real-time quantitative RT-PCR (qRT-PCR).

RESULTS

Histological dating of endometrium, immunohistochemistry for endometrial integrins, and qRT-PCR analysis for nine putative functional markers showed no differences between the three groups. Preliminary data from Western analysis suggest that some proteins may be affected by low serum P concentrations.

CONCLUSIONS

Histological endometrial dating does not reflect circulating P concentrations and cannot serve as a reliable bioassay of the quality of luteal function. Assessment of selected functional markers by either immunohistochemistry or qRT-PCR is similarly insensitive to decreased circulating P. Preliminary evidence suggests that abnormally low luteal phase serum P concentrations may have important functional consequences not otherwise detected.

Luteotrophic and luteolytic effects of nitric oxide in sheep are dose-dependent in vivo

It has been suggested that nitric oxide (NO) acts in either an anti-luteolytic or in a luteolytic manner, but the mechanism for these opposing roles is unclear. We hypothesized that NO may act in a dose-dependent manner to regulate luteal function, whereby low concentrations of NO might stimulate luteal progesterone production (i.e. luteotrophic) and high concentrations of NO might reduce concentrations of plasma progesterone (i.e. luteolytic). To test this hypothesis we infused increasing concentrations of the fast-acting NO donor, dipropylenetriamine NONOate (DPTA), into the arterial supply of sheep with ovarian transplants bearing a corpus luteum (CL). Infusions were performed on sheep with CL 11 days of age (n=9) or over 30 days of age (n=15). We measured changes in the concentration of progesterone in ovarian venous plasma during the 1-h infusion and for 24h after the infusion, and then compared the mean concentration of progesterone between treatment groups for effects by dose and dose by period interactions. Compared with saline-treated controls (n=6), the highest dose of 1000 microg/min DPTA (n=6) reduced (P<or=0.05) the mean concentration of progesterone after the infusion. In sheep bearing a CL over 30 days of age, the 10 microg/min DPTA dose (n=3) markedly increased (P<or=0.05) the mean concentration of progesterone both during and after the infusion, whereas the 100 microg/min DPTA dose (n=3) increased (P<or=0.05) the mean concentration of progesterone only during the 1-h infusion. The mean concentration of progesterone was not different (P>0.05) in sheep infused with the lowest dose of 1 microg/min DPTA (n=6) compared with controls. We conclude that NO regulates luteal function in a dose-dependent manner in sheep in vivo.

Depressive behavior and coronary artery atherogenesis in adult female cynomolgus monkeys

OBJECTIVE

To examine depressive behavior and early coronary artery atherogenesis in 36 socially housed female cynomolgus monkeys, an established model of atherogenesis and depression. Coronary heart disease (CHD) is caused by coronary artery atherosclerosis (CAA) and its sequelae which develop over a period of decades. Thus, in prospective studies of depression and CHD, CAA was likely present at baseline in most subjects who experienced cardiac events. Little is known about the relationship between depression and CAA.

METHODS

The monkeys were free of atherosclerosis before being fed a diet containing moderate amounts of fat and cholesterol for 52 months. Depressed behavior and activity levels recorded in weekly 15-minute focal samples, telemetered 24-hour heart rate, plasma total (TPC) and high-density lipoprotein cholesterol (HDLC), luteal phase serum progesterone concentrations, basal cortisol, cortisol response to corticotrophin-releasing hormone (CRH), and CAA extent were assessed.

RESULTS

Time spent in depressed behavior over 4 years was significantly associated with early CAA (r = .73, p < .001), as were activity level, 24-hour heart rate, TPC, HDLC, cortisol response to CRH, and mean peak progesterone (all p < or = 0.05). Depressed females had four times the CAA compared with nondepressed females.

CONCLUSIONS

Depression in primates is associated with perturbations in multiple CHD risk factors and accelerated early atherogenesis. These data are consistent with the hypotheses that depression and CAA both stem from a common mechanism and that depression may cause CAA.

Changes in mood, cognitive performance and appetite in the late luteal and follicular phases of the menstrual cycle in women with and without PMDD (premenstrual dysphoric disorder)

Although it's been reported that women with premenstrual dysphoric disorder (PMDD) have increased negative mood, appetite (food cravings and food intake), alcohol intake and cognitive deficits premenstrually, few studies have examined these changes concurrently within the same group of women or compared to women without PMDD. Thus, to date, there is not a clear understanding of the full range of PMDD symptoms. The present study concurrently assessed mood and performance tasks in 29 normally cycling women (14 women who met DSM-IV criteria for PMDD and 15 women without PMDD). Women had a total of ten sessions: two practice sessions, 4 sessions during the follicular phase and 4 sessions during the late luteal phase of the menstrual cycle. Each session, participants completed mood and food-related questionnaires, a motor coordination task, performed various cognitive tasks and ate lunch. There was a significant increase in dysphoric mood during the luteal phase in women with PMDD compared to their follicular phase and compared to Control women. Further, during the luteal phase, women with PMDD showed impaired performance on the Immediate and Delayed Word Recall Task, the Immediate and Delayed Digit Recall Task and the Digit Symbol Substitution Test compared to Control women. Women with PMDD, but not Control women, also showed increased desire for food items high in fat during the luteal phase compared to the follicular phase and correspondingly, women with PMDD consumed more calories during the luteal phase (mostly derived from fat) compared to the follicular phase. In summary, women with PMDD experience dysphoric mood, a greater desire and actual intake of certain foods and show impaired cognitive performance during the luteal phase. An altered serotonergic system in women with PMDD may be the underlying mechanism for the observed symptoms; correspondingly, treatment with specific serotonin reuptake inhibitors (SSRIs) remains the preferred treatment at this time.

Relationships of circulating pregnanolone isomers and their polar conjugates to the status of sex, menstrual cycle, and pregnancy

Pregnanolone isomers (PIs) and their polar conjugates (PICs) modulate ionotropic receptors such as gamma-aminobutyric acid or pregnane X receptors. Besides, brain synthesis, PI penetrates the blood-brain barrier. We evaluated the physiological importance of PI respecting the status of sex, menstrual cycle, and pregnancy. Accordingly, circulating levels of allopregnanolone (P3alpha 5alpha ), isopregnanolone (P3beta 5alpha ), pregnanolone (P3alpha 5beta ), epipregnanolone (P3beta 5beta ), their polar conjugates, and related steroids were measured in 15 men (M), 15 women in the follicular phase (F), 16 women in the luteal phase (L), and 30 women in the 36th week of gestation (P) using GC-MS. The steroid levels were similar in M and F, increased about thrice in L and escalated in P (38-410 times compared with F). The PICs were prevalent over the PIs (16-150 times). Higher ratios of 5alpha-PIC to 5alpha-PI found in P indicate the more intensive conjugation of 5alpha-PI during pregnancy. This mechanism probably provides for the elimination of neuroinhibitory P3alpha 5alpha in the maternal compartment. Additionally, our result points to a limited sulfation capacity for neuroinhibitory P3alpha 5beta in P. In contrast to the situation in M, F, and L where the P3alpha 5beta C is the most abundant PIC, and P3alpha 5beta is present in minor quantities compared with the P3alpha 5alpha, P3alpha 5beta may acquire physiological importance during pregnancy, contributing to the sustaining thereof. On the other hand, the declining formation of P3alpha 5beta may participate in the initiation of parturition, given the relative abundance of the steroid, its potency to suppress the activity of oxytocin-producing cells and its effectiveness in uterine relaxation.

Adrenal involvement in the biostimulatory effect of bulls

BACKGROUND

The objective was to evaluate if cortisol concentrations are associated with the resumption of luteal activity in postpartum, primiparous cows exposed to bulls. The hypotheses were that 1) interval from start of exposure to resumption of luteal activity; 2) proportions of cows that resumed luteal function during the exposure period; and 3) cortisol concentrations do not differ among cows exposed or not exposed to bulls (Exp. 1), and cows continuously exposed to bull or steer urine (Exp. 2).

METHODS

In Exp. 1, 28 anovular cows were exposed (BE; n = 13) or not exposed (NE; n = 15) to bulls for 30 d at 58 d after calving. In Exp. 2, 38 anovular cows were fitted with a controlled urine delivery device at 45 d after calving and exposed continuously (24 h/d) to bull (BUE; n = 19) or steer (SUE; n = 19) urine. Length of exposure was ~64 d. Blood samples were collected from each cow on D 0 and every 3 d throughout exposure periods in both experiments and assayed for progesterone. Cortisol was assayed in samples collected on D 0, 8, 16, and 24 in Exp. 1; and, D 0, 19, 38, and 57 in Exp. 2.

RESULTS

In Exp. 1, interval from the start of exposure to resumption of luteal activity was shorter (P < 0.05) for BE cows than NE cows, similarly, more (P < 0.05) BE cows than NE cows resumed luteal function during the exposure period. In Exp. 2, there was no difference in intervals from the start of exposure to resumption of luteal activity and proportions of cows that resumed luteal function during the exposure period between BUE and SUE cows. In Exp. 1, there was no difference in cortisol concentrations between BE and NE cows at the start of the experiment (D 0), however, cortisol concentrations were greater (P < 0.05) in BE cows than NE cows on D 9, 18, and 27. In Exp. 2, cortisol concentrations were higher for BUE than SUE cows on D 0 (P < 0.05), thereafter cortisol decreased (P < 0.05) but did not differ between BUE and SUE cows.

CONCLUSION

We conclude that the physical presence of bulls stimulates resumption of luteal activity and is coincident with increased cortisol concentrations, and hypothesize a possible association between adrenal activation and the biostimulatory effect of bulls.

Endocrine features of menstrual cycles in middle and late reproductive age and the menopausal transition classified according to the Staging of Reproductive Aging Workshop (STRAW) staging system

CONTEXT

Female reproductive aging based on changes in menstrual cycle length and frequency progresses through a number of stages as defined by the Stages of Reproductive Aging Workshop (STRAW) staging criteria.

OBJECTIVE

This paper provides a comprehensive description of the endocrine features associated with the STRAW stages.

DESIGN

Healthy women aged 21-35 and 45-55 yr submitted three blood samples a week over a single menstrual cycle. They were classified as mid-reproductive age (n = 21), late-reproductive age (n = 16), early menopause transition (n = 16), and late menopause transition (n = 23).

RESULTS

There were nine, one, zero, and two anovulatory cycles identified in the late menopause transition, early menopause transition, late-reproductive age, and mid-reproductive age groups, respectively. Ovulatory cycle FSH, LH, and estradiol levels increased with progression of STRAW stage (P = 0.001, P < 0.01, and P < 0.05, respectively), and mean luteal phase serum progesterone decreased (P < 0.01). Early cycle (ovulatory and anovulatory) inhibin B decreased steadily across the STRAW stages (P < 0.01) and was largely undetectable during elongated ovulatory and anovulatory cycles in the menopause transition. Anti-Mullerian hormone decreased markedly (10- to 15-fold) and progressively across the STRAW stages (P < 0.01 and P < 0.001, respectively).

CONCLUSIONS

Progression through the STRAW stages is associated with elevations in serum FSH, LH, and estradiol and decreases in luteal phase progesterone. The marked fall in inhibin B and particularly anti-Mullerian hormone indicate that they may be useful in predicting STRAW stage but future analyses of early cycle measurements on larger cohorts are needed to draw predictive conclusions.

Amiloride-insensitive nasal potential difference varies with the menstrual cycle in cystic fibrosis

RATIONALE

There is no adequate explanation for gender-based differences in rates of mortality and of deterioration in pulmonary function in cystic fibrosis (CF) patients. One potential explanation is that gender hormones (sex steroids) may modulate the severity of CF lung disease, the principal cause of mortality in CF, by altering respiratory transepithelial ion transport.

OBJECTIVE

To determine whether respiratory epithelial ion transport varied during the menstrual cycle of CF females.

METHODS

The nasal transepithelial electrical potential difference (NPD) was determined as a measure of ion transport across human respiratory epithelium, coincident with measurements of endogenous serum hormone levels in the luteal and follicular phases of the menstrual cycle in CF females aged 16-22 years.

RESULTS

The component of the NPD that is insensitive to the Na(+) transport blocker amiloride, but not the amiloride-sensitive component, changed in association with endogenous, menstrual cycle-induced changes in serum levels of progesterone and estrogen (P=0.02, n=7, paired t-test). Measurements using Cl(-) free perfusates suggested that the changes are not a result of Cl(-) conductance.

CONCLUSIONS

Our results suggest that in CF respiratory epithelium amiloride-insensitive, but not amiloride-sensitive, ion transport is altered by female gender hormones in vivo. We speculate that amiloride-insensitive ion transport may contribute to the regulation of human airway surface fluid.

Physical activity of adult female rhesus monkeys (Macaca mulatta) across the menstrual cycle

Physical activity is an important physiological variable impacting on a number of systems in the body. In rodents and several species of domestic animals, levels of physical activity have been reported to vary across the estrous cycle; however, it is unclear whether such changes in activity occur in women and other primates across the menstrual cycle. To determine whether significant changes in activity occur over the menstrual cycle, we continuously measured physical activity in seven adult female rhesus monkeys by accelerometry over the course of one menstrual cycle. Monkeys were checked daily for menses, and daily blood samples were collected for measurement of reproductive hormones. All monkeys displayed ovulatory menstrual cycles, ranging from 23 to 31 days in length. There was a significant increase in estradiol from the early follicular phase to the day of ovulation (F(1.005,5.023) = 40.060, P = 0.001). However, there was no significant change in physical activity across the menstrual cycle (F(2,12) = 0.225, P = 0.802), with activity levels being similar in the early follicular phase, on the day of the preovulatory rise in estradiol and during the midluteal phase. Moreover, the physical activity of these monkeys was not outside the range of physical activity that we measured in 15 ovariectomized monkeys. We conclude that, in primates, physical activity does not change across the menstrual cycle and is not influenced by physiological changes in circulating estradiol. This finding will allow investigators to record physical activity in female primates without the concern of controlling for the phase of the menstrual cycle.

Allopregnanolone decrease with symptom improvement during placebo and gonadotropin-releasing hormone agonist treatment in women with severe premenstrual syndrome

BACKGROUND

Neurosteroids such as allopregnanolone and pregnanolone are suggested to be of importance for the pathophysiology of premenstrual dysphoric disorder. The aim of this study was to investigate whether the luteal-phase serum concentrations of these neurosteroids are associated with improvement of premenstrual symptoms in 12 women with severe premenstrual syndrome after treatment with low-dose gonadotropin-releasing hormone agonist and placebo.

METHODS

Daily ratings for mood and physical symptoms were made prior to treatment and throughout the study. Serum progesterone, allopregnanolone and pregnanolone were assessed in the luteal phase (cycle day -9 to cycle day -1). Based on their symptom ratings, subjects were grouped as either buserelin responders (n = 6) or placebo responders (n = 6).

RESULTS

Buserelin responders displayed decreased levels of allopregnanolone (p < 0.05) and progesterone (p < 0.05) in parallel with improvement of symptoms. During the placebo treatment, the placebo responders had lower serum allopregnanolone concentrations than buserelin responders (p < 0.05). This was associated with improvement in symptoms compared with pre-treatment ratings.

CONCLUSION

Treatment response, whether induced by buserelin or placebo, appears to be associated with a decrease in allopregnanolone concentration.

VEGF, IVF clinical variables and ovarian hyperstimulation syndrome: a prospective study of the preimplantation luteal phase

OBJECTIVE

To explore the relationships between vascular endothelial growth factor (VEGF) levels in the preimplantation luteal phase and ovarian response, embryonic development, pregnancy outcome and occurrence of ovarian hyperstimulation syndrome (OHSS) in women undergoing in vitro fertilization (IVF).

STUDY DESIGN

The level of total VEGF in peritoneal fluid and serum was determined in 61 consecutive women undergoing day 3 tubal embryo transfer via laparoscopy. A MEDLINE search of the literature for 1996 to 2003 was conducted to review the relationship between VEGF levels and clinical variables at different time points during the IVF treatment cycle.

RESULTS

No correlation existed between total VEGF levels and patient age, estradiol production, number of oocytes retrieved, embryo development or pregnancy outcome. There was no significant difference between the 12 patients who developed OHSS and the 49 who did not. A literature review yielded inconclusive results.

CONCLUSION

A single measurement of total VEGF obtained from the serum or peritoneal fluid during the preimplantation luteal phase adds little to the clinical assessment of IVF response or to predicting the risk of OHSS. Large-scale studies at different times during the IVF cycle are needed to better define its potential use as a biomarker.

Clinical aspects and luteal phase assessment in patients with recurrent vulvovaginal candidiasis

OBJECTIVE

This study was undertaken to characterize the patients with recurrent vulvovaginal candidiasis.

STUDY DESIGN

Basic data of personal history and history of recurrent vulvovaginal candidiasis, lower genital tract symptoms and signs in 50 patients were analyzed in this longitudinal follow-up study including the determination of midluteal serum progesterone and urinary pregnanediol levels during the luteal phase in 84 cycles (recurrent vulvovaginal candidiasis) and 60 cycles (healthy controls).

RESULTS

All patients suffered primary idiopathic form of recurrent vulvovaginal candidiasis. Frequently, there was a striking discrepancy between severe symptoms and clinical finding, which was often negligible or normal. There was no redness and no or minimum discharge in 52% of culture documented attacks. In contrast to the healthy controls, the patients had significantly lower levels of progesterone (p<0.01) as well as those of urinary pregnanediol (p<0.05).

CONCLUSION

Culture positive attacks in patients with recurrent vulvovaginal candidiasis represented rather a form of vulvovaginal discomfort than attacks of vulvovaginal candidiasis with typical inflammatory changes. Significantly lower progesterone levels in the RVVC patients as compared to the healthy controls suggest a link between an altered hormonal status and one of possible causes of RVVC in these women.

Expansion of CD4+CD25+and FOXP3+ regulatory T cells during the follicular phase of the menstrual cycle: implications for human reproduction

Regulatory T cells (Tregs) are thought to affect the severity of various infectious and autoimmune diseases. The incidence of autoimmune disease is higher in fertile women than in men. Thus, we investigated whether Treg numbers were modulated during the menstrual cycle by sex hormones. In fertile nonpregnant women, we detected an expansion of CD4(+)CD25(+)FOXP3(+) Tregs in the late follicular phase of the menstrual cycle. This increase was tightly correlated with serum levels of estradiol and was followed by a dramatic decrease in Treg numbers at the luteal phase. Women who have had recurrent spontaneous abortions (RSA) showed similarly low numbers of Tregs at both the follicular and luteal phases, comparable to numbers we observed in postmenopausal women. In addition to decreased numbers, Tregs from women with RSA were also functionally deficient, as higher numbers were required to exert a similar magnitude of suppression to CD4(+)CD25(+)FOXP3(+) cells from fertile women. Consequently, reproductive failure might result from the inability of Tregs in women with RSA to expand during the preimplantatory phase combined with their lower functional capacity. Additionally, the modulation of Treg numbers we observed in fertile women suggests that the stage of the menstrual cycle should be taken into account when Treg numbers are investigated clinically.

Subclinical hyperthyroidism as a potential factor for dysfunctional uterine bleeding

OBJECTIVE

To evaluate the functional status of the thyroid gland in apparently euthyroid women with dysfunctional uterine bleeding.

MATERIALS AND METHODS

Forty apparently euthyroid women with menorrhagia and no pathologic lesion in the genital tract were compared with 20 women having normal menstrual cycles as controls. All women underwent hormonal evaluation: serum total and free triiodothyronine (T3), thyroxine (T4), thyroid-stimulating hormone (TSH) and serum prolactin.

RESULTS

Statistically significant differences were observed in the values of TSH, total T3, free T3, free T4 and total T4 between the menorrhagia and the control group. Prolactin was increased significantly in the menorrhagia group.

CONCLUSION

Subclinical hyperthyroidism can be a potential risk factor for dysfunctional uterine bleeding. Other studies are needed to confirm our findings.

[Steroid-binding protein levels in breast cancer patients]

Blood levels of sex hormone-binding globulin (SHBG), transcortin and pregnancy-related alpha2-glycoprotein (PalphaGP) were assayed using commercial kits for alpha-protein analysis in 223 breast cancer patients and 180 healthy women. Elevated concentration of SHBG was characteristic of both the luteal stage of menstrual cycle and menopause. It occurred chiefly in patients under 59 whereas at older age no differences from control were observed. Blood- transcortin in tumor patients was significantly lower than in control; conversely, PalphaGP concentration was higher irrespective of age. Since steroid-binding protein levels in the blood of breast cancer patients appeared to differ from those in healthy women, relevant data should be considered when hormone-metabolic status of reproductive and menopausal patients is identified.

Effect of stress on erythrocyte deformability, influence of gender and menstrual cycle

This study aimed to investigate the effect of acute mental stress on erythrocyte deformability (ED) in women during different phases of the menstrual cycle and to compare the results with men. For this purpose, healthy males (n=10) and females (n=10) (during follicular and luteal phases) underwent Stroop color-word interference and cold pressor tests. Hemoglobin, hematocrit and leukocyte counts before and after this stress test revealed no difference in either group; erythrocyte sedimentation rate was significantly lower in the post-test samples in all. In all groups erythrocyte filtration time was significantly higher and thus ED was significantly lower after the stress test (mean+/-SEM, PRE-TEST: follicular: 3.08+/-0.05; luteal: 2.07+/-0.05; men: 2.9+/-0.05) (POST-TEST: follicular: 4.5+/-0.07; luteal: 4.1+/-0.07; men: 4.39+/-0.1). ED was appreciably influenced by gender and menstrual cycle. Women at the luteal phase had better ED compared to both women at the follicular phase and men, the effect being especially pronounced in the pre-test samples. Our results suggest that stress may induce cardiovascular diseases by lowering ED in both genders. The effect of stress on ED varies with gender and during different phases of the menstrual cycle, which may be explained by variations in the sex hormones.

Menstruation does not cause anemia: endometrial thickness correlates positively with erythrocyte count and hemoglobin concentration in premenopausal women

Menstruation has often been cited as a risk factor for iron-deficiency anemia. This study tested whether normal, premenopausal women's luteal endometrial thickness (ET) was associated with their red blood cell count (RBC) and hemoglobin concentrations (Hg), and therefore whether a high ET put women at risk for anemia. Endometrial thickness can be considered a reasonable proxy for menstrual blood loss in normal women. Twenty-six healthy women from the Mogielica Human Ecology Study Site in Poland, aged 20-40 years (29 +/- 5.3 years, mean +/- SD), were selected. Subjects' ET was measured by transvaginal ultrasound in the luteal phase of the menstrual cycle, and their red blood cell count and hemoglobin concentrations were measured by fasting morning blood samples. Controlling for day of ET measurement, RBC and Hg were positively correlated with ET (r(2) = 0.24, P = 0.05; r(2) = 0.25, P = 0.04, respectively). We propose that, contrary to popular understanding, a thicker endometrium suggests greater iron reserves, rather than greater risk for anemia, in healthy women.

No effect of menstrual cycle phase on basal very-low-density lipoprotein triglyceride and apolipoprotein B-100 kinetics

Dyslipidemia, manifested by increased plasma triglyceride (TG), increased total and LDL-cholesterol concentrations and decreased HDL-cholesterol concentration, is an important risk factor for cardiovascular disease. Premenopausal women have a less atherogenic plasma lipid profile and a lower risk of cardiovascular disease than men, but this female advantage disappears after menopause. This suggests that female sex steroids affect lipoprotein metabolism. The impact of variations in the availability of ovarian hormones during the menstrual cycle on lipoprotein metabolism is not known. We therefore investigated whether very-low-density lipoprotein (VLDL)-TG and VLDL-apolipoprotein B-100 (apoB-100) kinetics are different during the follicular (FP) and luteal phases (LP) of the menstrual cycle. We studied seven healthy, premenopausal women (age 27 +/- 2 yr, BMI 25 +/- 2 kg/m(2)) once during FP and once during LP. We measured VLDL-TG, VLDL-apoB-100, and plasma free fatty acid (FFA) kinetics by using stable isotope-labeled tracers, VLDL subclass profile by nuclear magnetic resonance spectroscopy, whole body fat oxidation by indirect calorimetry, and the plasma concentrations of lipoprotein lipase (LPL) and hepatic lipase (HL) by ELISA. VLDL-TG and VLDL-apoB-100 concentrations in plasma, VLDL-TG and VLDL-apoB-100 secretion rates and mean residence times, VLDL subclass distribution, FFA concentration and rate of appearance in plasma, whole body substrate oxidation, and LPL and HL concentrations in plasma were not different during the FP and the LP. We conclude that VLDL-TG and VLDL-apoB-100 metabolism is not affected by menstrual cycle phase.

[Ovarian activity of Agouti paca (Rodentia: Agoutidae) under captivity]

The ovarian activity of Agouti paca was characterized by hormonal profiles and ovarian structures. Samples of blood were taken from eight females (seven adults and one juvenile) at the breeding grounds of the Facultad de Medicina Veterinaria y Zootecnia in Yucatśn, Mexico. Sampling lasted approximately two months and was done every three and six days. Blood was collected from anesthetized animals, and the levels of progesterone (P4) and 17 beta estradiol (E2) were analized by radioimmunoassay technique. Macroscopic and microscopic analyses were carried out in ovaries of dead animals. The estrous cycle lasted 29+/-8.4 days, levels of 1.61+/-0.65 ng/ml for P4 and 39+/-24 pg/ml for E2 were observed for a follicular phase, 6.18+/-3.70 ng/ml and 29+/-16 pg/ml for P4 and E2 respectively in the luteal phase. Statistically significant differences were found between phases for P4 but not for E2. The presence of extragonadal steroids with levels of P4 of 1.9+/-0.77 ng/ml and E2 of 22+/-17 pg/ml were observed, which are not produced by the effects of managing stress. The changes in the levels of P4 during the cycle are indicators of luteal activity, with the intersticial tissue acting probably as active steroids-producing gland. Follicular growth was observed during the entire cycle.

Luteal phase of the menstrual cycle increases sweating rate during exercise

The present study evaluated whether the luteal phase elevation of body temperature would be offset during exercise by increased sweating, when women are normally hydrated. Eleven women performed 60 min of cycling exercise at 60% of their maximal work load at 32 degrees C and 80% relative air humidity. Each subject participated in two identical experimental sessions: one during the follicular phase (between days 5 and 8) and the other during the luteal phase (between days 22 and 25). Women with serum progesterone >3 ng/mL, in the luteal phase were classified as group 1 (N = 4), whereas the others were classified as group 2 (N = 7). Post-exercise urine volume (213 +/- 80 vs 309 +/- 113 mL) and specific urine gravity (1.008 +/- 0.003 vs 1.006 +/- 0.002) changed (P < 0.05) during the luteal phase compared to the follicular phase in group 1. No menstrual cycle dependence was observed for these parameters in group 2. Sweat rate was higher (P < 0.05) in the luteal (3.10 +/- 0.81 g m-2 min-1) than in the follicular phase (2.80 +/- 0.64 g m(-2) min(-1)) only in group 1. During exercise, no differences related to menstrual cycle phases were seen in rectal temperature, heart rate, rate of perceived exertion, mean skin temperature, and pre- and post-exercise body weight. Women exercising in a warm and humid environment with water intake seem to be able to adapt to the luteal phase increase of basal body temperature through reduced urinary volume and increased sweating rate.

Moderate doses of ethanol fail to increase plasma levels of neurosteroid 3alpha-hydroxy-5alpha-pregnan-20-one-like immunoreactivity in healthy men and women

RATIONALE

The endogenous GABAergic neuroactive steroid 3alpha-hydroxy-5alpha-pregnan-20-one (3alpha,5alpha-THP, allopregnanolone) has been proposed to contribute to ethanol actions. Humans synthesize 3alpha,5alpha-THP, but its role in response to systemic administration of ethanol is unclear.

OBJECTIVE

The present study aims to determine the effect of a moderate dose of ethanol on progesterone and 3alpha,5alpha-THP concentrations in plasma samples of healthy male and female subjects and to determine if these levels are related to the subjective effects of ethanol. Females were tested in both the follicular and luteal phases of the menstrual cycle.

METHODS

Healthy men (N=9) and women (N=12) aged 21-35 participated in the study. Men participated in two sessions on which they received ethanol (0.8 g/kg) or placebo. Women participated in four sessions on which they received ethanol (0.7 g/kg) or placebo during the follicular and luteal phases of their cycle. Subjective states and mood were measured by standardized self-report questionnaires and a measure of psychomotor performance. Steroid levels (progesterone, 3alpha,5alpha-THP, estradiol, and cortisol) were measured in plasma samples by radioimmunoassay.

RESULTS

Ethanol significantly increased plasma levels of progesterone, but not 3alpha,5alpha-THP-like immunoreactivity, in women in the luteal phase. Ethanol had no effect on progesterone or 3alpha,5alpha-THP-like immunoreactivity levels in women in the follicular phase or in men, and it did not increase cortisol in men or women. Ethanol also did not affect estradiol in men or women.

CONCLUSIONS

3alpha,5alpha-THP-like immunoreactivity levels in human plasma are not increased following moderate ethanol consumption, suggesting that circulating levels of progesterone or its tetrahydro-reduced metabolites do not play a major role in ethanol action. However, the possibility remains that ethanol increases endogenous brain production of GABAergic neurosteroids without affecting plasma levels. Moreover, humans synthesize 5beta-reduced GABAergic steroids, and levels of these steroids may be altered in plasma or brain.

Effects of menstrual cycle and oral contraceptive use on serum levels of lipid-soluble antioxidants

OBJECTIVE

The purpose of this study was to examine the influence of menstrual cycle and oral contraceptive use on serum levels of lipid-soluble antioxidants.

STUDY DESIGN

In this cross-section study, nonfasting blood samples were collected twice from 10 healthy premenopausal women during the follicular phase (between days 8 and 11) and the luteal phase (between days 18 and 22) of their same menstrual cycle. In addition, blood samples from 15 premenopausal women who used oral contraceptive for at least 6 months and 40 women who did not use oral contraceptive were collected randomly at any day of the menstrual cycle. Serum levels of coenzyme Q10, alpha-tocopherol, gamma-tocopherol, beta-carotene, alpha-carotene, and lycopene were determined using high pressure liquid chromatography.

RESULTS

Serum coenzyme Q10 and alpha-tocopherol levels were significantly lower during the follicular phase compared with the luteal phase of the same menstrual cycle (P < .05). Oral contraceptive use also significantly decreased coenzyme Q10 and alpha-tocopherol (P < .001). Other antioxidant levels were comparable.

CONCLUSION

Alterations in coenzyme Q10 and alpha-tocopherol levels during the menstrual cycle and in oral contraceptive users should be taken into consideration, concerning the future antioxidant research in premenopausal women. Further studies are needed to investigate the potential role of endogenous and exogenous ovarian hormones on oxidative stress in women.

Relation of cardiovascular risk factors in women approaching menopause to menstrual cycle characteristics and reproductive hormones in the follicular and luteal phases

CONTEXT

Menstrual cycle characteristics may be associated with cardiovascular disease (CVD) risk.

OBJECTIVE

The objective of this study was to describe the relationships between menstrual cycle characteristics and daily reproductive hormone measures with CVD risk factors in middle-aged women.

DESIGN AND SETTING

Cross-sectional associations were examined between CVD risk factors and urinary LH, FSH, estrone conjugates, and pregnanediol glucuronide (Pdg) measured across one menstrual cycle or 50 d.

PARTICIPANTS

Menstruating women (n = 500) who were free from diabetes or past stroke or heart attack enrolled in the Daily Hormone Study-Study of Women's Health across the Nation were studied.

MAIN OUTCOME MEASURES

Body mass index (BMI), blood pressure, hemostatic, and metabolic factors were measured.

RESULTS

Few differences existed in risk factors between women with evidence of luteal activity and those with no evidence of luteal activity. Associations between elevated CVD risk factors and long cycle length were reduced substantially by age and BMI adjustments. Those with lower estrone conjugate and PdG averaged across the follicular phase had higher waist circumference, triglycerides, insulin, plasminogen activator inhibitor type-1, tissue type plasminogen activator-antigen, and factor VIIc levels in age- and BMI-adjusted analyses (P < 0.05).

CONCLUSIONS

In midlife menstruating women, a longer cycle length was related to CVD risk factors, in large part through their common association with BMI. More favorable levels of metabolic and hemostatic factors were associated with higher levels of follicular-phase estrogen, a pattern consistent with a more competent ovary, and higher levels of follicular-phase PdG, perhaps of adrenal origin. Metabolic and hemostatic factors may be sensitive to hormonal variation during the early perimenopausal transition.

No effect of menstrual cycle phase on glycerol or palmitate kinetics during 90 min of moderate exercise

The systemic flux of glycerol and palmitate [a representative nonesterified free fatty acid (NEFA)] was assessed in three different phases of the menstrual cycle at rest and during moderate-intensity exercise. It was hypothesized that circulating glycerol and NEFA turnover would be greatest in the midfollicular (MF) phase of the menstrual cycle, when estrogen is elevated but progesterone low, followed by the midluteal phase (ML; high estrogen and progesterone), and lowest in the early follicular (EF) phase of the menstrual cycle (low estrogen and progesterone). Subjects included moderately active, eumenorrheic, healthy women. Testing occurred after 3 days of diet control and after an overnight fast (12-13 h). Resting and exercise (50% maximal oxygen uptake, 90 min) measurements of tracer-determined glycerol and palmitate kinetics were made. There was a significant increase in both glycerol and palmitate turnover from rest to exercise in all phases of the menstrual cycle (P<0.0001). No significant differences, however, were observed between cycle phases in the systemic flux of glycerol or palmitate, at rest or during exercise. Maximal peripheral lipolysis during exercise, as represented by glycerol rate of appearance at 90 min, equaled 8.45+/-0.96, 8.35+/-1.12, and 7.71+/-0.96 micromol.kg-1.min-1 in the EF, MF, and ML phases, respectively. Circulating free fatty acid utilization also peaked at 90 min of exercise, as indicated by the palmitate rate of disappearance (3.31+/-0.35, 3.17+/-0.39, and 3.47+/-0.26 micromol.kg-1.min-1) in the EF, MF, and ML phases, respectively. In conclusion, systemic rates of glycerol and NEFA turnover (as represented by palmitate flux) were not significantly affected by the cyclic fluctuations in estrogen and progesterone that occur throughout the normal menstrual cycle, either at rest or during 90 min of moderate exercise.

Phasic menstrual cycle effects on the control of breathing in healthy women

This study examined the effects of menstrual cycle phase on ventilatory control. Fourteen eumenorrheic women were studied in the early follicular (FP; 1-6 days) and mid-luteal (LP; 20-24 days) phase of the menstrual cycle. Blood for the determination of arterial PCO(2) (PaCO(2)) , plasma strong ion difference ([SID]), progesterone ([P(4)]), and 17beta-estradiol ([E(2)]) concentrations were obtained at rest. Subjects performed a CO(2) rebreathing procedure that included prior hyperventilation and maintenance of iso-oxia to evaluate central and peripheral chemoreflex, and nonchemoreflex drives to breathe. Resting PaCO(2) and [SID] were lower; minute ventilation (V (E)), [P(4)] and [E(2)] were higher in the LP versus FP. Within the LP, significant correlations were observed for PaCO(2) with [P(4)], [E(2)] and [SID]. Menstrual cycle phase had no effect on the threshold or sensitivity of the central and/or peripheral ventilatory chemoreflex response to CO(2). Both (V (E)) and the ventilatory response to hypocapnia (representing nonchemoreflex drives to breathe) were approximately 1L/min greater in the LP versus FP accounting for the reduction in PaCO(2) . These data support the hypothesis that phasic menstrual cycle changes in PaCO(2) may be due, at least in part, to the stimulatory effects of [P(4)], [E(2)] and [SID] on ventilatory drive.

Acute effects of prostaglandin F(2alpha) on systemic oxytocin and progesterone concentrations during the mid- or late-luteal phase in mares

The acute effects of prostaglandin F(2alpha) (PGF) on circulating oxytocin and progesterone concentrations were characterized in mares during the mid- or late-luteal phase. Pony mares were randomly assigned to the following experimental groups based on treatment with PGF (2.5mg) or saline on Day 8 or Day 13 (Day 0=ovulation): PGF-8, PGF-13, saline-8, or saline-13 (n=7/group). Mares were fitted with indwelling, jugular vein catheters and two blood samples (-5 and 0 min) were collected prior to treatment. Treatments were administered into the jugular vein (0 min) and blood collection continued thereafter at 1 min intervals until 5 min and then at 5 min intervals until 60 min. Based on the combined data of -5 and 0 min samples, mares on Day 8 had greater (P<0.05) oxytocin concentrations than mares on Day 13. On Day 8, PGF treatment resulted in a biphasic pattern of oxytocin release. Oxytocin concentrations increased (P<0.05) 1 min after PGF treatment, decreased (P<0.05) from 1 to 10 min, and increased (P<0.05) from 10 to 30 min. Oxytocin concentrations were greater (P<0.05) from 1 to 3 min in PGF-treated than saline-treated mares and at most sample times from 15 to 60 min. On Day 13, oxytocin concentrations were greater (P<0.05) in PGF-treated than in saline-treated mares for most sample times. Mares treated with PGF on Day 8 had greater (P<0.05) oxytocin concentrations at 25, 30, and 40 min than mares on Day 13. Progesterone concentrations on Day 8 also increased by 1 min after PGF, decreased toward basal concentrations by 2-3 min, and then increased to a maximum 10 min after treatment. Subsequently, circulating progesterone decreased (P<0.05) below pretreatment concentrations by 40-50 min after PGF. In conclusion, treatment with PGF resulted in an immediate and biphasic increase in progesterone concentrations prior to the expected decrease. Treatment of mares with PGF on Day 8 resulted in an overall greater increase in systemic oxytocin concentrations compared to treatment on Day 13, and the increase on Day 8 was biphasic.

Concentrations of progesterone, prolactin and relaxin in the luteal phase and pregnancy in normal and short-cycling German Shepherd dogs

Twenty-two nonpregnant and 19 pregnant German Shepherd dogs were assigned to either a control group or a suspected short-cycling group, based on the interestrous interval (> or = 6 month and < 5 month, respectively) and data from previous pregnancies. Blood serum concentrations of progesterone and prolactin were determined from days 5 to 60 (day 0 = ovulation) for characterization of luteal function. In pregnant bitches, placental integrity was additionally assessed by relaxin concentrations. The nonpregnant, suspected short-cycling bitches had significantly lower progesterone concentrations than the controls, indicating decreased luteal activity both in the autonomous and prolactin-dependent period. In the pregnant suspected short-cycling bitches, unavoidable progesterone supplementation prevented assessment of luteal function; it may have suppressed prolactin secretion (significantly lower prolactin concentrations from days 20 to 60, compared with the pregnant control group), but deficient prolactin secretion affecting luteal function cannot be excluded. The significantly lower relaxin concentrations, together with a high incidence of embryonic death found in the pregnant, suspected short-cycling group, may indicate loss of placental integrity and may have caused decreased prolactin concentrations.

Hormone levels before and after tubal sterilization

OBJECTIVE

The aim of this study was to determine whether women experience significant luteal phase hormonal changes following interval tubal sterilization.

DESIGN

This is a partly randomized, prospective clinical study.

SETTING

This study involved healthy volunteers in an academic research environment.

PATIENTS

This study involved 118 fertile women seeking tubal sterilization and 57 fertile controls with at least three normal cyclic menstrual periods before entry into the study.

INTERVENTIONS

The patients were randomized to bipolar cautery or Hulka clip as sterilization methods. Barrier contraception or abstinence was used by controls.

MAIN OUTCOME MEASURES

The main outcome measures are serum estradiol and progesterone levels and urinary estradiol and pregnanediol levels obtained during the luteal phase before, 1 year and 2 years after sterilization.

RESULTS

The women randomized to the bipolar cautery group had higher midluteal progesterone levels measured between Days 5 and 11 postovulation (15.5 ng/mL before sterilization, 14.5 ng/mL at 1 year and 14.5 ng/mL at 2 years) than did the other two groups. The clip group had progesterone levels of 14.1, 12.0 and 12.5 ng/mL at baseline, 1 year and 2 years, respectively, and the control group had levels of 12.0, 11.9 and 11.3 ng/mL for the same periods. Serum estradiol and progesterone and urinary pregnanediol and estradiol were not significantly changed over the 2-year period, nor were there significant differences between the two groups.

CONCLUSIONS

There were no significant hormonal changes in sterilized women over a period of 2 years when compared with their baseline levels or when compared with unsterilized age-matched controls.

Sex steroid milieu does not alter the impact of fasting on leptin levels in women

The impact of stressors upon some metabolic and endocrine parameters differs when the gonad is present and in the follicular vs. luteal phase. However, a high vs. low sex steroid milieu did not alter the metabolic response, as assessed by leptin levels, in response to the stressor of fasting.

Ovarian follicular and luteal dynamics in wapiti during the estrous cycle

The reproductive tracts of 13 mature hinds were examined daily by transrectal ultrasonography and blood samples were taken daily from October to January to characterize follicular, luteal, and endocrine dynamics in wapiti during the estrous season. Follicle development occurred in waves characterized by regular, synchronous development of a group of follicles in temporal succession to a surge in serum FSH concentration. The mean interovulatory interval was 21.3 +/- 0.1 d, but was shorter in hinds exhibiting two follicular waves than in hinds exhibiting three and four waves (P < 0.05). The interwave interval was similar among waves in two-wave cycles and the first wave of three-wave cycles. All other interwave intervals in three- and four-wave cycles were shorter (P < 0.05). The maximum diameter of the dominant follicle of the first wave was similar among two-, three-, and four-wave cycles. For all other waves in three- and four-wave cycles, the maximum diameter was smaller (P < 0.05). Corpus luteum diameter and plasma progesterone concentrations were similar between two- and three-wave cycles, but the luteal phase was longer (P < 0.05) in four-wave cycles. The dominant follicle emerged at a diameter of 4 mm at 0.4 +/- 0.1 and 0.8 +/- 0.1 d before the largest and second largest subordinate follicles, respectively. The follicle destined to become dominant was larger (P < 0.05) than the largest subordinate follicle one day after emergence, which coincided with the first significant decrease in serum FSH concentration. We concluded that the estrous cycle in wapiti is characterized by two, three, or four waves of follicular development (each preceded by a surge in circulating FSH), that there is a positive relationship between the number of waves and the duration of the cycle, and an inverse relationship between the number of waves and the magnitude of follicular dominance (diameter and duration of the dominant follicle).

Identification of wild type and variants of oestrogen receptors in polymorphonuclear and mononuclear leucocytes

OBJECTIVE

Leucocytes play an important role in the pathogenesis of autoimmune and cardiovascular diseases. Clinical and epidemiological observations indicate that the sex steroid hormones, particularly oestrogens, may regulate leucocyte functions. The assumption that oestrogens have a direct effect on leucocytes has to be supported by identification of functional oestrogen receptors (ER) in leucocytes. This study aimed at investigating the presence of ER subtypes in different types of leucocytes isolated from peripheral blood of female and male donors.

DESIGN AND PATIENTS

A total of nine men (age range 18-43 years) and nine women (age range 19-42 years) all healthy blood donors, were recruited for the study. The donors did not receive any medication or hormonal contraceptives for the last three months. Ten millilitres of peripheral blood was collected from each donor. Polymorphonuclear leucocytes (PMN) and peripheral blood mononuclear cells (PBMC) were purified by density gradient centrifugation.

MEASUREMENTS

ERalpha and ERbeta mRNA expression was measured by real-time reverse transcriptase-polymerase chain reaction (RT-PCR), and ER proteins were analysed by Western blot in the PBMC and PMN leucocyte populations. In addition, expression profiles of ER variant isoforms were characterized by conventional PCR using the splice-targeted primer approach.

RESULTS

Although we detected wild-type ERalpha and ERbeta mRNAs in PBMC but not in PMN cells, the ERalpha and ERbeta proteins were found in both cell types using Western blot. We observed that both ERalpha and ERbeta proteins differ in size between PMN and PBMC, suggesting that the two leucocyte populations contain diverse variant isoforms of ERalpha and ERbeta. RT-PCR analysis of exon-deleted ER splice variants revealed that PBMC express several exon-deleted variants of ERalpha and ERbeta, along with wild-type receptor, whereas the PMN cells only express exon-deleted variant isoforms and no wild-type ERalpha or ERbeta.

CONCLUSIONS

Our study demonstrates the presence of ERalpha and ERbeta in PBMC and PMN cells from female and male donors. The ERalpha and ERbeta genes have complex transcriptional profiles, with many receptor variant isoforms being expressed. Considering the diversity of ER isoforms in leucocyte subtypes, we conclude that the expected effect of oestrogen would be highly cell type-specific. Further studies are needed to test the functional activity of ER isoforms and their relation to disease.

Exploratory study of premenstrual symptoms and serotonin variability

Premenstrual symptoms can pose significant problems for a large number of women; this small exploratory study was designed to investigate biological markers that may provide etiological clues. Using an algorithm based on daily symptom charting for two months, 15 participants were assigned to one of three study groups: non-symptomatic (n = 9), probable PMS (n = 3) and probable PMDD (n = 3). During two overnight admissions, one prior to and one following the onset of menses, participants had blood drawn to assess the level of available serotonin via one of its metabolites, 5-HIAA. The three groups exhibited potentially significant differences in several biological markers. This study's results are consistent with a hypothesis implicating serotonin in the generation of premenstrual symptomology.

Effect of aerobic exercise on lipaemia and its fatty acid profile after a meal of moderate fat content in eumenorrhoeic women

Exercise prior to eating has repeatedly been shown to reduce postprandial lipaemia. The aim of the present study was to investigate whether this effect was manifest in the presence of two factors that independently mitigate postprandial lipaemia: eumenorrhoea and moderate fat intake. Eight healthy eumenorrhoeic rowers consumed a meal of moderate fat content (35 % total energy, 0.66 g/kg body mass) 14 h after having either rowed at 55 % of maximal aerobic power (81 % of maximal heart rate) for 80 min or rested. Both trials were performed during the luteal phase. Blood samples were drawn before the meal and for 8 h postprandially for the measurement of individual fatty acids in the triacylglycerol and NEFA fractions, as well as of glucose, insulin and oestradiol. Plasma oestradiol concentrations were not significantly different in the two trials. The postprandial lipaemic response, expressed as either plasma triacylglycerol concentration or area under the triacylglycerol-time curve, was 35 % lower (P<0.05) after exercise. The postprandial glycaemic and insulinaemic responses were also lower, indicating increased insulin sensitivity, whereas the NEFA response was higher, suggesting a lower entrapment of dietary fatty acids in adipose tissue after exercise. Finally, exercise increased the proportion of unsaturated:saturated NEFA during the postprandial period. In conclusion, aerobic exercise performed 14 h before a moderate-fat meal reduced postprandial lipaemia in women in the luteal phase. This effect shows the potential of exercise to mitigate even moderate lipaemic responses in eumenorrhoeic women.

Cortisol and memory retrieval in women: influence of menstrual cycle and oral contraceptives

RATIONALE

Studies in rodents observed that the effects of stress on memory are modulated by gonadal hormones. In animals and humans, stress and cortisol treatment impairs memory retrieval.

OBJECTIVES

To investigate if the acute impairing effect of cortisol on memory retrieval in women is influenced by endogenous or exogenous gonadal steroids.

METHODS

Three groups of women were studied: women during mensis (n=13), women in the luteal phase (n=14), and women using oral contraceptives (OCs; n=20). In a double-blind crossover fashion, they received cortisol (30 mg) or placebo 1 h prior to memory retrieval testing.

RESULTS

Overall cortisol led to a significant impairment of memory retrieval. Further exploratory analysis using t tests showed that both groups of naturally cycling women were significantly impaired (p<0.05), while no effect was apparent in the OC users (p=0.29).

CONCLUSIONS

The current results could suggest that OC use is associated with a reduced sensitivity of the brain to acute cortisol elevations. In contrast, menstrual-cycle-associated changes in estradiol and progesterone concentrations appear to have no strong influence on this acute cortisol effect. The underlying neurobiological mechanisms of these behavioral findings remain to be elucidated.

Hemostatic status and fibrinolytic response potential at different phases of the menstrual cycle

Coagulation and fibrinolytic variables including platelet function and endogenous fibrinolytic response were determined in 30 normal healthy women volunteers not on any known medication during the period of study. They were between 18 years and 38 years old and had normal menstrual cycles of between 28 days and 30 days. Blood samples were obtained within one menstrual cycle and after having fasted overnight within days 1 to 3 (menstruation), 5 to 9 (follicular), 10 to 14 (mid-cycle), and 21 to 26 (luteal) of the menstrual cycle. Analysis of variance (ANOVA) showed no significant differences in the hemostatic parameters studied between the phases of the menstrual cycle except for a reduced D-dimer level at midcycle. Significant fibrinolytic response was seen after venous occlusion but they were not significantly different between the phases of the menstrual cycle. The women were then divided into either normal weight (n=22) or overweight (n=8) according to World Health Organization (WHO) classification and the data reanalyzed. Elevated tissue plasminogen activator antigen and plasminogen activator inhibitor-1 levels except at menstruation and total protein S except at follicular phase were observed in overweight women together with increased plasminogen level only at luteal phase. Significant endogenous fibrinolytic response seen during the menstrual cycle was not different between normal and overweight women. The study demonstrated that systemic coagulation, fibrinolysis, and platelet function were probably not influenced by natural hormonal changes occurring during the menstrual cycle except for an associated reduced fibrinolytic state at mid-cycle. The hemostatic system in this small group of healthy overweight women studied appeared to be physiologically compromised.

The effect of a low dose of alcohol on allopregnanolone serum concentrations across the menstrual cycle in women with severe premenstrual syndrome and controls

BACKGROUND

Neurosteroids have been proposed to play an important role in the interaction between alcohol and GABA(A) receptors and for the symptomatology of premenstrual dysphoric disorder (PMDD). The primary aim of this study was to investigate possible alcohol-induced changes in allopregnanolone serum concentrations across different menstrual cycle phases in women with severe premenstrual syndrome (PMS) and controls.

METHODS

The allopregnanolone and cortisol responses to a low-dose of alcohol were evaluated in 14 women with and 12 women without severe premenstrual syndrome in the follicular and late luteal phases. The effect of a 30-min intravenous alcohol infusion (0.2 g/kg) on allopregnanolone and cortisol serum concentrations was compared to placebo, and compared between cycle phases and groups. Blood samples for measuring allopregnanolone were taken at baseline 25, 55, and 75 min after the start of the alcohol infusion.

RESULTS

In the late luteal phase, the alcohol infusion decreased allopregnanolone levels, compared to baseline levels as well as to placebo. The difference in allopregnanolone levels between alcohol and placebo was evident 25 min (P < 0.01), 55 min (P < 0.01), and 75 min (P < 0.05) after start of the infusion. There was no change in allopregnanolone levels during the alcohol infusion in the follicular phase. Also, no difference in alcohol-induced allopregnanolone response between PMS patients and control subjects was detected. Cortisol levels declined during both the placebo and alcohol infusion, but did not differ with respect to which infusion had been given.

CONCLUSION

During the late luteal phase, independent of PMS diagnosis, the low-dose alcohol infusion resulted in decreasing peripheral allopregnanolone levels.

Luteal phase serum cell-free DNA as a marker of failed pregnancy after assisted reproductive technology

PURPOSE

DNA-damaging factors have been reported in patients that failed to achieve pregnancy after assisted reproductive technologies (ART). The hypothesis was that increased circulating cell-free DNA released by damaged cells could predict unfavorable conditions leading to failed ART treatment. The objective was to compare the relative concentrations of cell-free DNA in the luteal phase sera of nonpregnant versus pregnant patients.

METHODS

Frozen-thawed sera (30 IVF cases) were obtained 1 week after embryo transfer. There were 16 pregnant and 14 nonpregnant cases and controls consisting of male sera (n = 8 cases). Modified isocratic capillary electrophoresis was performed and the images analyzed for cell-free DNA.

RESULTS

Circulating cell-free DNA were identified in the sera of all patients. The serum concentrations of high (12 kb) and low (1 kb) molecular weight cell-free DNA were similar for both nonpregnant and pregnant patients. Male control sera had higher cell-free DNA concentrations compared with females. Evaluation of sera from a control case showed no fluctuations in cell-free DNA concentrations throughout specific days of the menstrual cycle.

CONCLUSIONS

The results do not support the use of the luteal phase cell-free DNA concentration as a marker for failed pregnancies. The equal concentrations of high and low molecular weight cell-free DNA and ladder band-like gel patterns suggested cell apoptosis as the source of DNA.

Relationship between sex hormone-binding globulin and pregnancy outcome in women undergoing controlled ovarian hyperstimulation for assisted reproduction

The purpose of this study was to determine whether the changes of sex hormone-binding globulin (SHBG) affect the pregnancy outcome in women undergoing controlled ovarian hyperstimulation (COH) for assisted reproduction. Forty-five infertile women who were undergoing pituitary desensitization and COH for in vitro fertilization (IVF) with or without intracytoplasmic sperm injection (ICSI) and 19 women with normal menstrual cycles participated in the study. Fasting blood samples of the follicular and luteal phases, including follicular fluid during oocyte retrieval, were obtained for determination of estradiol (E(2)), progesterone (P(4)), testosterone (T), and SHBG concentrations. The SHBG levels increased progressively during the course of COH, but remained constant throughout normal menstrual cycles. A positive correlation existed between E(2) and SHBG levels in both the follicular and luteal phases. The mean plasma SHBG concentration and E(2)/T ratio were significantly higher, while the level of T and the free androgen index were significantly lower, in the luteal phase of women who conceived than in those who did not conceive following COH. The changes of follicular fluid SHBG level and E(2)/T ratio were similar to those in plasma. We concluded, therefore, that increases in SHBG in the follicular and luteal phases may be a reflection of the functional state of ovarian stimulation, and further that such elevations may influence the pregnancy outcome through the modulation of circulating estrogen and androgen balance during down-regulated COH cycles for IVF/ICSI.

A prospective, randomized, double-blind study to compare two doses of recombinant human chorionic gonadotropin in inducing final oocyte maturity and the hormonal profile during the luteal phase

CONTEXT

Different doses of human chorionic gonadotropin (hCG) have been used in various in vitro fertilization (IVF) treatment protocols to achieve final oocyte maturation. There is as yet no agreement on the optimum dose required.

OBJECTIVES

The objective of this study was to compare the effectiveness of 250 and 500 microg recombinant hCG (r-hCG), which represented the lower and upper limits of the dose range, in inducing final oocyte maturation during IVF and intracytoplasmic sperm injection cycles.

DESIGN

This was a prospective, randomized, double-blind study.

SETTING

This study was performed at an IVF clinic in a teaching hospital.

PATIENTS

Sixty patients with an indication for intracytoplasmic sperm injection were studied.

INTERVENTION

The treatment dose used was 250 or 500 microg r-hCG.

MAIN OUTCOME MEASURES

The percentage of metaphase II oocytes retrieved per patient, as an indicator of oocyte maturation, and the hormone profiles of the treatment cycle starting from the day of hCG up to hCG+10 d were the main outcome measures.

RESULTS

The percentage of metaphase II oocytes was similar in the two groups (89.3% vs. 86.0%; P = 0.326) despite higher serum and follicular fluid hCG levels on hCG+2 and hCG+4 d, as was the follicular fluid to serum hCG ratio in the 500-microg r-hCG group. Serum estradiol and progesterone levels were comparable initially, but became significantly higher in the 500-microg r-hCG group on hCG+10 d.

CONCLUSION

The two doses of r-hCG were equally effective in inducing final oocyte maturation. It remains unclear whether the higher midluteal estradiol and progesterone levels in the 500-microg r-hCG group confer any benefit.

The pattern of growth hormone secretion during the menstrual cycle in normal and depressed women

OBJECTIVE

Major depression is associated to altered hypothalamic-pituitary function. Stress is linked to elevated cortisol as well as menstrual cycle disturbance; however, there is no known relationship between depression and menstrual cycle disruption. The aim of this study was to investigate changes of growth hormone (GH) secretion during the menstrual cycle in normal and depressed women.

DESIGN

Case-control study.

PATIENTS AND METHODS

Nineteen women affected with depression and 24 normal controls were included. The two groups had comparable body mass index (BMI), and age (29.4 +/- 9.8 vs. 28.6 +/- 9.7 years). Nine depressed and 10 controls were studied in the follicular phase, while 10 depressed and 14 controls were studied in the luteal phase of the cycle. GH was sampled every 10 min for 24 h, and the data were analysed by the cluster pulse detection method.

RESULTS

There was no difference in 24-h mean GH concentrations between depressed and control subjects (P = 0.93), even after accounting for menstrual cycle phase (P = 0.38). GH pulse frequency was higher during the follicular phase of the cycle (P = 0.032), and nocturnal GH was higher in the follicular phase of the cycle (P = 0.05, and after adjusting for 24-h GH, P = 0.0138) regardless of whether the subjects were depressed or healthy.

CONCLUSIONS

In studies of GH secretion in women with or without depression, it is necessary to control for the phase of menstrual cycle.