CA-125 Antigen ; blood ; Estradiol ; blood ; Female ; Gonadotropin-Releasing Hormone ; adverse effects ; agonists ; Humans ; Middle Aged ; Thromboembolism ; chemically induced

Ovarian hyperstimulation syndrome (OHSS) is a life-threatening iatrogenic complication of ovulation induction. Before ovarian stimulation, identification of patients vulnerable to developing OHSS is necessary. And ovarian stimulation should be started with low doses of gonadotropin or GnRH antagonist protocol. During monitoring of ovarian stimulation with risk of OHSS, coasting, low doses hCG and GnRH agonist for triggering ovulation are considered. If severe OHSS is predicted, cycle cancellation and cryopreservation of all embryos should be considered to reduce late-onset OHSS and morbidity. And metformin and dopamine agonist for reducing OHSS are being proposed as a prophylactic treatment for OHSS.
Cryopreservation ; Dopamine Agonists ; Embryonic Structures ; Female ; Gonadotropin-Releasing Hormone ; Gonadotropins ; Humans ; Metformin ; Ovarian Hyperstimulation Syndrome ; Ovulation ; Ovulation Induction ; Risk Factors

OBJECTIVETo evaluate the impact of the concentration of circulating luteinizing hormone (LH) in the late-follicle phase on the outcome of in vitro fertilization for normogonadotrophic women.

METHODSIntracytoplasmic sperm injection treatment was conducted in 432 consecutive cycles of normogonadotrophic women. A stimulation protocol with mid-luteal gonadotropin-releasing hormone (GnRH) agonist down-regulation and ovarian stimulation with follicle stimulating hormone (FSH) was used in all cycles. hMG was added when a follicle of > or = 14 mm was present (FSH + hMG group), not in the control group (FSH-alone). LH and oestradiol concentration in the serum on hCG day were detected. Based on LH levels, patients in the FSH + hMG group were again divided into four subgroups: LH < or = 1, 1 < LH < or = 2, 2 < LH < or = 3, and 3 < LH < or = 10 IU/L.

RESULTSOestradiol concentration on the day of hCG injection in the FSH + hMG group was higher than that in the FSH-alone group [(3435.51 +/- 2029.01) pg/ml vs (2620.62 +/- 1604.80) pg/ml, P < 0.05]. More embryos were transferred in the FSH-alone group than in the FSH + hMG group [(2.77 +/- 0.45) vs (2.22 +/- 0.46), P <0.001]. Fertilization rate, implantation rate, and clinical pregnancy rate were similar between the FSH-alone group and the FSH + hMG group (77.52% vs 78.31%, 41.42% vs 41.68%, 64.56% vs 62.64%, P > 0.05), as well as among the four subgroups of the FSH + hMG group (P > 0.05).

CONCLUSIONThe adding of suitable amount of hMG and physiologically limited LH concentration in the late-follicle phase have no negative effect on the outcome of in vitro fertilization/intracytoplasmic sperm injection for normogonadotrophic women.

Adult ; Down-Regulation ; Estradiol ; blood ; Female ; Fertilization in Vitro ; Follicle Stimulating Hormone ; therapeutic use ; Follicular Phase ; Gonadotropin-Releasing Hormone ; agonists ; Humans ; Luteinizing Hormone ; blood ; Ovulation Induction ; Treatment Outcome

OBJECTIVETo explore the effects of obesity on the peak level of luteinizing hormone (LH) in the gonadotropin-releasing hormone (GnRH) agonist test and obesity-related hormones in girls with central precocious puberty (CPP).

METHODSThree hundred and thirty-three girls with CPP who underwent the GnRH agonist test between 2012 and 2014 were classified into three groups: normal weight (n=123), overweight (n=108), and obesity (n=102), according to body mass index (BMI). The sexual development indices were compared between the three groups. Twenty girls were randomly selected from each group for evaluation of the serum levels of leptin, sex hormone binding globulin (SHBG), neurokinin B, and kisspeptin. The correlation of BMI with the levels of various hormones was assessed using Pearson correlation analysis.

RESULTSThere was no significant difference in mean age at diagnosis between the three groups; however, the bone age was significantly higher in the overweight and obesity groups than in the normal weight group (P<0.05). The peak level of LH in the GnRH agonist test and SHBG level in the normal weight group were significantly higher than those in the overweight and the obesity groups, while the serum levels of leptin and neurokinin B were significantly lower in the normal weight group than in the overweight and the obesity groups (P<0.05). BMI was negatively correlated with the peak level of LH in the GnRH agonist test and SHBG level (P<0.05), and positively correlated with the levels of leptin and neurokinin B (P<0.05).

CONCLUSIONSThe effects of BMI on the result of the GnRH agonist test and levels of obesity-related hormones should be taken into account in girls with precocious puberty.

Body Mass Index ; Child ; Female ; Gonadotropin-Releasing Hormone ; agonists ; Humans ; Leptin ; blood ; Luteinizing Hormone ; blood ; Neurokinin B ; blood ; Obesity ; blood ; Puberty, Precocious ; blood ; Sex Hormone-Binding Globulin ; analysis

OBJECTIVETo evaluate the application of gonadotrophin-releasing hormone antagonist (GnRH-ant) in patients with risk of poor response to controlled ovarian stimulation in IVF-ET.

METHODSClinical data of 48 patients undergoing IVF with or without ICSI were retrospectively analyzed. Among them 24 patients were allocated to the GnRH-ant protocol and 24 to the long gonadotrophin-releasing hormone agonist (GnRH-a) protocol. The duration of down-regulation, duration of stimulation, amps of gonadotropin estradiol level on hCG day, number of oocytes retrieved, fertilization rate, total embryos obtained, high quality embryo obtained, embryos transferred, embryos frozen, implantation rate per transfer, clinical pregnancy rate per transfer, embryo survival rate, clinical pregnancy rate per frozen embryos transfer and per cycle were compared between two groups.

RESULTThe duration of down-regulation, duration of stimulation, the amps of gonadotropin were significantly lower in the antagonist group than those in agonist group (P <0.001, <0.05, <0.05), the estradiol level on hCG day, the number of oocytes retrieved were significantly lower in the antagonist group than those in the agonist group (P<0.05, <0.05). No significant differences were noted in fertilization rate, total embryos obtained, high quality embryo obtained, embryos transferred, embryos frozen, implantation rate per transfer, clinical pregnancy rate per transfer, embryo survival rate, clinical pregnancy rate per frozen embryos transfer and per cycle.

CONCLUSIONCompared with long GnRH-a protocol, the GnRH-ant protocol in patients with risk of poor response can reduce the dosage of gonadotropin and shorten the duration of stimulation, although the estradiol level on hCG day and the number of oocytes retrieved are lower, which does not affect the implantation rate and clinical pregnancy rate.

Adult ; Embryo Transfer ; Female ; Fertilization in Vitro ; Gonadotropin-Releasing Hormone ; agonists ; antagonists & inhibitors ; Hormone Antagonists ; pharmacology ; therapeutic use ; Humans ; Infertility, Female ; therapy ; Ovulation Induction ; methods ; Retrospective Studies

OBJECTIVETo observe the effect of Kuntai Capsule (KC), a Chinese patent medicine, in add-back therapy for gonadotropin-releasing hormone agonist (GnRH-a) treatment for moderate-severe endometriosis (EM).

METHODSTotally 100 patients suffering from stage III/IV EM, who were confirmed by laparoscopic surgery were randomly assigned to the GnRH-a group (A) and the KC combined GnRH-a group (B), 50 in each group. Patients in Group A were hypodermically injected with goserelin (3.6 mg), once per 4 weeks. Those in Group B additionally took KC, 4 pills each time, three times per day. The therapeutic course for all was 12 weeks. Serum levels of estradiol (E2), follicle stimulating hormone (FSH), bone gamma-carboxyglutamic-acid-containing proteins (BGP) were measured respectively. Kupperman Menopausal Index (KMI) and bone mineral density (BMD) of the lumbar vertebra were also compared between the two groups.

RESULTSSerum levels of E2 and FSH both significantly decreased in the two groups at week 12 of the treatment (P < 0.05), when compared with pre-treatment. Compared with before treatment in the same group, KMI increased in the two groups (P < 0.05). Compared with before treatment in the same group, BMI decreased in the two groups with no statistical difference (P > 0.05). Serum BGP increased after 12-week treatment (P < 0.05). Compared with Group A after treatment, serum levels of E2 and FSH both significantly increased in Group B (P < 0.05). There was no statistical difference in KMI between the two groups (P > 0.05). As for the incidence of menopausal symptoms, better effects in improving symptoms such as hot flashes, sleep disorders, and vaginal dryness were obtained in Group B than in Group A (P < 0.05). There was no significant difference in the post-pre-treatment difference of BMI between the two groups, but with statistical post-pre-treatment difference in the BGP level (P < 0.05).

CONCLUSIONSHKC combined GnRH-a could effectively reduce GnRH-a treatment induced partial low estrogen symptoms, improve increased serum BGP levels after GnRH-a therapy.

Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Endometriosis ; drug therapy ; Estradiol ; blood ; Female ; Follicle Stimulating Hormone ; blood ; Gonadotropin-Releasing Hormone ; agonists ; Humans

OBJECTIVETo develop a new method for predicting adult height (PAH) based on the theory of Bayley-Pinneau and to evaluate the feasibility of this method in predicting adult height of girls with idiopathic central precocious puberty (ICPP) who were treated with gonadotropin releasing hormone agonist (GnRHa).

METHOD(1) The new method for PAH, i.e. PAH = Height/percentage of adult height for bone age, was established according to the theory of Bayley-Pinneau and the data from the national growth survey of children in the nine cities of China in the year 2005. (2) Data from seventeen female patients with ICPP received GnRHa treatment and achieved final adult height (FAH) were collected. Before and during the treatment, PAH was calculated by the method of Bayley-Pinneau and the new method.

RESULTThe mean FAH(cm) of the 17 patients with ICPP was 159.81 ± 4.95. The PAH (cm), before and after treatment for 1, 2 and 3 years, were 156.53 ± 3.63, 157.71 ± 3.62, 158.60 ± 3.50, 161.46 ± 4.50 and 161.56 ± 3.77, 161.68 ± 3.44, 162.04 ± 4.42, 163.13 ± 2.36 respectively by using the new method (PAH-D) and Bayley-Pinneau method(PAH-BP). The mean value of (PAH-D-FAH) and (PAH-BP-FAH) were -1.96 cm and 1.48 cm. However, the 95% confidence interval was (-3.82 cm to -0.11 cm), (-1.60 cm to 4.55 cm) for (PAH-D-FAH) and (PAH-BP -FAH). There was no significant difference between the values obtained before and after treatment in terms of PAH by use of Bayley-Pinneau method. By the new method, however, the results showed that the PAH increased and improved further with prolonged treatment periods. And at the end of treatment, there was no significant difference between PAH and FAH. The correlation coefficient was 0.93. Regression analysis showed that the trend line was in parallel with baseline data.

CONCLUSIONThe new method we established could predict better the final heights of girls with CPP who were treated with GnRHa.

Adult ; Body Height ; Child ; China ; Drug Therapy, Combination ; Female ; Gonadotropin-Releasing Hormone ; agonists ; Human Growth Hormone ; Humans ; Puberty, Precocious ; drug therapy ; Reference Values

OBJECTIVETo investigate the apoptosis-related mechanisms of levenorgestrel-releasing intrauterine system (LNG-IUS), oral medroxyprogesterone (MPA), and injective gonadotrophic hormone releasing hormone agonist (GnRHa) on eutopic endometrium of patients with endometriosis. Methods We collected the samples of endometrium from patients with endometriosis before operation and after insertion of LNG-IUS, administration of oral MPA, or injection of GnRHa. The ultrastructure of endometria was observed and compared by electron microscopy. Apoptotic cells were assessed by the terminal deoxynucleotidyl transferase-mediated deoxy-UTP nick-end labeling (TUNEL) assay, and the expressions of Bax, Fas, and Fas-L mRNA were determined by semi-quantitative reverse transcription-polymerase chain raction. Results After have been exposured to LNG-IUS, the apoptotic rate of endometrial epithelial cells and stromal cells increased from (24. 4 +/- 35.0)% to (51.0 +/- 37.8)% (P = 0.027) and (35.3 +/- 30.2)% to (76.4 +/- 11.2)% (P = 0.008), respectively. The degree of apoptosis under transmission electron microscopy was in an order of GnRHa > LNG-IUS > MPA. The expression of Fas-L mRNA in eutopic endometrium of patients with endometriosis was significantly higher than that of the normal control (P < 0.05). The expressions of three apoptosis-related proteins had no significant difference.

CONCLUSIONMedical treatments can increase the apoptosis of eutopic endometrial cells, and such effect was strongest in GnRHa and relatively weaker in LNG-IUS and MPA.

Apoptosis ; Endometriosis ; drug therapy ; pathology ; Endometrium ; drug effects ; pathology ; ultrastructure ; Female ; Gonadotropin-Releasing Hormone ; agonists ; Humans ; Intrauterine Devices, Medicated ; Levonorgestrel ; therapeutic use ; Medroxyprogesterone ; therapeutic use

OBJECTIVETo evaluate the outcomes of T3a prostate cancer with unfavorable prognostic factors treated with permanent interstitial brachytherapy combined with external radiotherapy and hormone therapy.

METHODSFrom January 2003 to December 2008, 38 patients classified as T3a prostate cancer with unfavorable prognostic factors were treated with trimodality therapy (brachytherapy + external radiotherapy + hormone therapy). The prescription dose of brachytherapy and external radiotherapy were 110 Gy and 45 Gy, respectively. The duration of hormone therapy was 2-3 years. The endpoints of this study included biochemical failure-free survival (BFFS), distant metastasis-free survival (DMFS), cancer-specific survival (CSS), and overall survival (OS). Survival curves were calculated using the Kaplan-Meier method. The Log-rank test was used to identify the prognostic predictors for univariate analysis.

RESULTSThe median follow-up was 71 months. The serum pre-treatment prostate-specific antigen (PSA) level ranged from 10.0 to 99.8 ng/ml (mean 56.3 ng/ml), the Gleason score ranged from 5 to 9 (median 8), and the percentage of positive biopsy cores ranged from 10% to 100% (mean 65%). The 5-year BFFS, DMFS, CSS, and OS rates were 44%, 69%, 82%, and 76%, respectively. All biochemical failures occurred within 40 months. The percentage of positive biopsy cores was significantly correlated with BFFS, DMFS, and OS (all P=0.000), and the Gleason score with DMFS (P=0.000) and OS (P=0.001).

CONCLUSIONST3a prostate cancer with unfavorable prognostic factors presents not so optimistic outcome. Hormone therapy should be applied to prolong the biochemical progression-free or metastasis-free survival. The percentage of positive biopsy cores and the Gleason score are significant prognostic factors.

Androgen Antagonists ; therapeutic use ; Brachytherapy ; Combined Modality Therapy ; Gonadotropin-Releasing Hormone ; agonists ; Humans ; Male ; Neoplasm Grading ; Prognosis ; Prostatic Neoplasms ; mortality ; pathology ; therapy ; Treatment Outcome

OBJECTIVE: To investigate the inhibitory effect of gonadotropin-releasing hormone II(GnRHII) and gonadotropin-releasing hormone I agonist (GnRH Ia) on the proliferation of endometrial stromal cells in vitro from endometriosis patients. METHODS: Different concentrations of GnRHII or GnRH Ia were added into the cultured endometrial stromal cells in vitro to detect the cell proliferation inhibition by MTT test. RESULTS: The inhibitory rate of GnRHII or GnRH Ia on eutopic and ectopic endometrial stromal cells in vitro was both dose- and time-dependent (P<0.05). Effect of GnRHII or GnRH Ia on the inhibitory rate of ectopic endometrial stromal cells was significantly higher than that of eutopic (P<0.05). GnRH II had a higher inhibitory rate on the endometrial stromal cells in vitro than did GnRH Ia (P<0.05). CONCLUSION GnRHII has more antiproliferative effect on endometrial stromal cells than GnRH Ia in vitro, especially on ectopic endometrial stromal cells, suggesting that GnRHII may be more effective than GnRH Ia on endometriosis.
Adult ; Cell Proliferation ; drug effects ; Cells, Cultured ; Endometriosis ; pathology ; Endometrium ; metabolism ; pathology ; Female ; Gonadotropin-Releasing Hormone ; agonists ; analogs & derivatives ; pharmacology ; Humans ; Middle Aged ; Stromal Cells ; pathology ; Young Adult