No abstract available.
Amenorrhea* ; Anovulation* ; Female

OBJECTIVE: To evaluate the plasma concentration of plasminogen activator inhibitor 1, main regulator of fibrinolytic system in women with polycystic ovary syndrome and to clarify whether it may be involved in the pathogenesis of chronic anovulation. METHODS: Fibrinolytic system (plasma fibrinogen, plasminogen, plasminogen activator inhibitor 1 concentration) was assayed in women with polycystic ovary syndrome and compared to normal controls. RESULTS: Women with polycystic ovary syndrome had significantly higher plasminogen activator inhibitor 1 and fibrinogen concentration compared to normal controls. CONCLUSION: Women with polycystic ovary syndrome may have an imbalance in the fibrinolytic system that is tilted towards a reduced production of the proteolytic enzyme plasmin. It may result in impaired follicular rupture and anovulation at cellular level in the ovaries.
Anovulation ; Female ; Fibrinogen ; Fibrinolysin ; Humans ; Ovary ; Plasma ; Plasminogen ; Plasminogen Activator Inhibitor 1 ; Polycystic Ovary Syndrome* ; Rupture

Clomiphene citrate is the simplest and least expensive from of ovulation induction therapy. In most cases, women who fail to ovulate in response to maximal doses of clomiphene became candidates for treatment with gonadotropins or pulsatile GnRH. Recently, as an alternative to the use of gonadotropins and ovarian surgery, there are some studies of the effectiveness of extended duration clomiphene among the anovulatory women who were resistant to a standard 5-day course of treatment with clomiphene. We have experienced a case of successive ovulation induction and pregnancy with an extended 10-day course of clomiphene in women with clomiphene-resistant anovulatory disorders and reproted with brief reviews of related literatures.
Anovulation ; Clomiphene* ; Female ; Gonadotropin-Releasing Hormone ; Gonadotropins ; Humans ; Ovulation Induction* ; Ovulation* ; Pregnancy

Acupuncture Points ; Acupuncture Therapy ; methods ; Adult ; Anovulation ; therapy ; Female ; Humans ; Infertility, Female ; therapy ; Ovulation Induction

In the context of the new era, paying attention to maternal and child health and advocating prenatal and postnatal care can effectively improve the quality of the birth population. Traditional Chinese medicine has a long history of prenatal and postnatal healthcare with rich content, which is the theoretical basis of modern related services. With the social development and the improvement of people's awareness of prenatal and postnatal healthcare, people have gradually shifted the focus of prenatal and postnatal healthcare to the peri-pregnancy stage at present, namely that couples of childbearing age are guided to prepare for pregnancy under the premise of solving their basic diseases. Infertility is a common and refractory disease for women of childbearing age. Ovulation disorder is one of its common pathological mechanisms. Traditional Chinese medicine believes that kidney deficiency is the main cause and pa-thogenesis of anovulation infertility and blood stasis is an important factor throughout the disease course. In clinical practice, therapies for invigorating kidney and activating blood are safe and reliable to treat anovulatory infertility mainly by adjusting the hypothalamus-pituitary-ovarian axis, improving ovarian function, uterine environment and gamete quality and increasing endometrial volume. Under the guidance of the thought of prenatal and postnatal healthcare, the authors tried to explore the effect of therapies for kidney-tonifying and blood-activating in the treatment of anovulatory infertility in eugenics, with the purpose of providing ideas and basis for subsequent relevant clinical studies and contributing to prenatal and postnatal healthcare services.
Anovulation ; Child ; Eugenics ; Female ; Humans ; Infertility, Female/drug therapy* ; Kidney ; Medicine, Chinese Traditional ; Ovulation ; Pregnancy

OBJECTIVE: Polycystic ovarian syndrome (PCOS) is a heterogenous dysfunctional endocrinologic disorder with unknown etiology, clinically characterized by obesity, chronic anovulation, masculinization and infertility. Recently, the association between polycystic ovarian syndrome and insulin resistance have been brought up and insulin resistance is one of the most important factor related to the development of obesity. However, not all polycystic ovarian syndrome patients are obese, it would give a clue to understanding pathophysiology of obesity and PCOS if insulin resistance could be classified according to the degree of obesity in PCOS. Thus, we performed this prospective study to know the relationship between insulin resistance and obesity in the patients with PCOS. METHODS: Fourty eight polycystic ovary patients were included at Samsung Cheil Hospital from April to October 2002. These patients were grouped according to obeseness. HOMA index was used to evaluate insulin resistance calculated by using fasting blood sugar and serum insulin level. RESULTS: Twenty patients (41%) were classified as obese group, twenty eight patients (59%) had normal body mass index. Increased insulin resistance was observed in the patients with polycystic ovarian syndrome. And it was significantly higher in the obese patients compared to the patients with normal body mass index (6.8+/-2.8 vs. 2.7+/-0.9, t-test, p<0.01). CONCLUSION: For increased insulin resistance, immediate management would be needed in the patients of polycystic ovarian syndrome, especially combined with obesity.
Anovulation ; Blood Glucose ; Body Mass Index ; Fasting ; Female ; Humans ; Infertility ; Insulin Resistance* ; Insulin* ; Obesity* ; Ovary ; Polycystic Ovary Syndrome* ; Prospective Studies

Endometrial cancer is a rare condition in women under 40 years of age. However, patients with anovulatory polycystic ovary syndrome are at risk of developing endometrial cancer due to unopposed and prolonged effect of estrogen on the endometrium. Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women of reproductive age resulting from insulin resistance and the compensatory hyperinsulinemia. This has adverse effects on multiple organ systems and may result in alteration in serum lipids, anovulation, abnormal uterine bleeding and infertility. In addition, PCOS may place the patients at risk for the development of type 2 diabetes, hypertension, endometrial cancer and cardiovascular disease. We report a case of endometrial cancer in a young patient with PCOS with brief review of the literatures.
Anovulation ; Cardiovascular Diseases ; Endometrial Neoplasms* ; Endometrium ; Estrogens ; Female ; Humans ; Hyperinsulinism ; Hypertension ; Infertility ; Insulin Resistance ; Polycystic Ovary Syndrome* ; Uterine Hemorrhage

OBJECTIVE: To investigate the prevalence of subclinical hypothyroidism (SH) diagnosed by thyrotropin-releasing hormone (TRH) stimulating test in infertile women with basal thyroid-stimulating hormone (TSH) levels of 2.5 to 5.0 mIU/L. METHODS: This study was performed in 39 infertile women with ovulatory disorders (group 1) and 27 infertile women with male infertility only (group 2, controls) who had basal serum TSH levels of 2.5 to 5.0 mIU/L and a TRH stimulating test. Serum TSH levels were measured before TRH injection (TSH0) and also measured at 20 minutes (TSH1) and 40 minutes (TSH2) following intravenous injection of 400 microg TRH. Exaggerated TSH response above 30 mIU/L following TRH injection was diagnosed as SH. Group 1 was composed of poor responders (subgroup A), patients with polycystic ovary syndrome (subgroup B) and patients with WHO group II anovulation except poor responder or polycystic ovary syndrome (subgroup C). RESULTS: The prevalence of SH was significantly higher in group 1 of 46.2% (18/39) compared with 7.4% (2/27) in group 2 (P=0.001). TSH0, TSH1, and TSH2 levels were significantly higher in group 1 than the corresponding values in group 2 (P<0.001, P<0.001, P<0.001). In group 1, TSH1 and TSH2 levels were significantly lower in subgroup C compared with those in subgroup A and B (P=0.008, P=0.006, respectively). CONCLUSION: TRH stimulation test had better be performed in infertile women with ovulatory disorders who have TSH levels between 2.5 and 5.0 mIU/L for early detection and appropriate treatment of SH.
Anovulation ; Female ; Humans ; Hypothyroidism* ; Infertility ; Infertility, Male ; Injections, Intravenous ; Male ; Polycystic Ovary Syndrome ; Prevalence ; Thyrotropin* ; Thyrotropin-Releasing Hormone*

Ovulation induction in hypothalamic amenorrhea using gonadotropin- releasing hormone(GnRH) pulse therapy is complicated by widely variant patient responses ranging from anovulation to multiple pregnancy. Route of administration(intravenous vs subcutaneous), pulse therapy, GnRH dose, infusion interval, or hormone preparation may contribute. We evaluated the bioactivity of 4 GnRH preparations(Relisorm,Serono; Lutrelef,Ferring; Factrel,Ayerst; GnRH,Sigma) in a rat anterior cell bioassay. Dispersed rat anterior pituitary cells were placed for 48 hrs at 5x105 cells/well, washed and incubated with GnRH. The GnRH was diluted according to the manufacturer's culture medium(10(-12) to 10(-5)M). GnRH stimulated immunoreactive luteinizing hormone(LH) production was assested in culture medium after 4 hrs by radioimmunoassay(RIA). A linear dose-response relationship was exhibited by all preparations from 10(-10) to 10(-7)M. Msximal LH production was 249+/-24 ng/ml/4hrs(mean+/-SEM) and was not different among the preparations tested(ANOVA, p>0.05). The minimal effective dose of GnRH was 10-10M for all preparations(basa1=27+/-4ng/ml/4hrs:mean+/-SEM). No significant differences were noted for MED, or dose-response slope(p<0.05, ANOVA and slope test for parallelism, respectively). In addition, bioactive LH and immuno and bioactive follicular stimulating hormone(FSH) dose responses were confirmed. We concluded that the principal variability of patient response seen with GnRH pulse therapy cannot be attributed to the bioactivity of these commercial GnRH preparations. But rather, most of the variability is due to the inherent individualism in patient response or other factors of the treatment protocol.
Amenorrhea ; Animals ; Anovulation ; Biological Assay ; Clinical Protocols ; Female ; Gonadotropin-Releasing Hormone* ; Humans ; Lutein ; Ovulation Induction ; Pregnancy ; Pregnancy, Multiple ; Rats

Polycysytic Ovary Syndrome (PCOS) is a common endocrine disorder characterized by chronic anovulation and hyperandrogenism. The etiology of PCOS is complex and incompletely understood. Accumulating data conclude that hyperinsulinemia and hyperandrogenemia may cause hormonal abnormalities that lead to disturbance of ovarian function. Although insulin resistance is not a part of the diagnostic criteria for PCOS, its importance in its pathogenesis can not be ignored. Excess insulin is capable of stimulating steroidogenesis and therefore excessive androgen production occurs from the theca cell system. Recently, the effects of insulin sensitizer in PCOS patients are being reported and they include the improvement of menstrual pattern, improvement in hyperandrogenism, increased response in ovulation induction and prevention of cardiovascular diseases. Understanding the relation of PCOS and insulin resistance will offer an improvement in treatment of PCOS in the future.
Anovulation ; Cardiovascular Diseases ; Female ; Humans ; Hyperandrogenism ; Hyperinsulinism ; Insulin Resistance* ; Insulin* ; Ovary ; Ovulation Induction ; Polycystic Ovary Syndrome* ; Theca Cells