OBJECTIVETo observe the efficacy differences between acupuncture combined with medication and medication alone for infertility patients with polycystic ovary syndrome (PCOS).

METHODSAccording to random number table, a total of 60 infertility patients with PCOS were randomly assigned into an observation group and a control group, 30 cases in each one. The patients in the control group were treated with diane-35 from the 3rd day into menstruation, and one menstrual cycle was taken as a session of treatment. At the same time of using diane-35, the patients in the observation group were treated with acupuncture at Guanyuan (CV 4), Qihai (CV 6), Sanyinjiao (SP 6), Zusanli (ST 36), Zigong (EX-CA 1), Shenshu (BL 23), Pishu (BL 20), Weishu (BL 21) and Ganshu (BL 18) during non-menstruation period; the acupuncture was given once every two days, three treatments per week. The patients in both groups were treated for two sessions. The basic sex hormone and body mass index (BMI) were compared between the two groups before and after treatment. After ovulation induction treatment, the endometrial thickness, amount of mature follicle, ovulation rate, clinical pregnancy rate, occurrence rate of ovarian hyperstimulation syndrome (OHSS) and the number of early spontaneous abortion were compared between the two groups during ovulation.

RESULTSAfter treatment, the luteinizing hormone (LH), testosterone (T) and BMI reduced in the observation group (all <0.05), while only LH reduced in the control group (<0.05). The reducing of estradiol (E), T and BMI in the observation group was more significant than that in the control group (all <0.05). The ovulation rate was 93.3% (28/30) in the observation group, which was higher than 80.0% (24/30) in the control group (<0.05). The rate of clinical pregnancy was 43.3% (13/30) in the observation group, which was higher than 33.3% (10/30) in the control group (<0.05). The differences of endometrial thickness, amount of mature follicle, occurrence rate of OHSS and number of early spontaneous abortion were not significant between the two groups (all >0.05).

CONCLUSIONAcupuncture as adjunctive treatment could improve BMI, reduce the levels of LH, E and T, increase ovulation reaction and effectively shorten reproduction cycles in infertility patients with PCOS.

Acupuncture Therapy ; Body Mass Index ; Combined Modality Therapy ; Cyproterone Acetate ; therapeutic use ; Drug Combinations ; Estradiol ; blood ; Ethinyl Estradiol ; therapeutic use ; Female ; Humans ; Infertility, Female ; therapy ; Luteinizing Hormone ; blood ; Ovulation Induction ; Polycystic Ovary Syndrome ; therapy ; Pregnancy ; Pregnancy Rate ; Testosterone ; blood

OBJECTIVETo investigate changes of serum total oxidation status (TOS) and total antioxidant status (TAS) and their association with apolipoprotein (a) [Apo(a)] in patients with polycystic ovary syndrome (PCOS) combined with infertility.

MWTHODSNinety patients with PCOS and infertility were selected as the study group, including 45 patients treated with antioxidants combined with Diane-35(group A) and 45 with Diane-35 therapy only (group B), with 45 healthy volunteers with normal menstruation and normal dual phase basic body temperatures as the control group. Serum TOS of the participants was determined by dual xylenol orange method, and serum TAS was determined with ABTS method; plasma Apo(a) level was determined by dual wavelength immune transmission turbidity method.

RESULTSBefore treatment, serum TOS, OSI, and Apo(a) levels were significantly higher and TAS level was significantly lower in the study group than in the control group (P<0.05). Serum TOS, OSI, and Apo (a) were significantly lowered and TAS was significantly increased in group A after the therapy as compared with the levels before therapy and the levels in group B. The rate of natural recovery of menstruation was significantly higher and the incidence of cardiovascular disease was significantly lower in group A than in group B (P<0.05). Pearson correlation analysis showed that serum TOS and OSI were positively correlated with plasma Apo(a) (r=0.524 and 0.531, P<0.05), and serum TAS was negatively correlated with plasma Apo(a) (r=-0.519, P<0.05).

CONCLUSIONAntioxidant therapy can lower TOS, OSI and Apo(a) levels and increase TAS level to lessen oxidative stress, improve the prognosis, and reduce the risks of cardiovascular disease in patients with PCOS and infertility.

Antioxidants ; metabolism ; Apoprotein(a) ; blood ; Cyproterone Acetate ; therapeutic use ; Drug Combinations ; Ethinyl Estradiol ; therapeutic use ; Female ; Humans ; Infertility, Female ; blood ; Oxidative Stress ; Polycystic Ovary Syndrome ; blood ; drug therapy

OBJECTIVE: To investigate the clinical efficacy of oral medicine and sodium hyaluronate in prevention of intrauterine adhesions after artificial abortion.
 METHODS: A total of 572 patients with early pregnancy termination through artificial abortion, who experienced two or more times of abortion, were retrospectively analyzed. Patients were randomly and voluntarily divided into 4 groups: an artificial cycle group, a drospirenone and ethinylestradiol tablets group, a sodium hyaluronate group, and a control group. The thickness of the endometrium, return time of menses, and the status of intrauterine adhesions were observed.
 RESULTS: The thickness of the endometrium in the artificial period group was greater than that in the control group (P<0.001). It was less in the drospirenone and ethinylestradiol tablets group comparing with that in the control group (P<0.001). There was no significant difference in the thickness of the endometrium between the sodium hyaluronate group and the control group (P=0.717). Return time of menses in the artificial menstrual cycle group and the drospirenone and ethinylestradiol tablets group was shorter than that in the control group (P<0.001). There was no significant difference in return time of menses between the sodium hyaluronate group and the control group (P=0.813). The incidence of intrauterine adhesions could be reduced by the 3 preventive measures (All P<0.01).
 CONCLUSION Drugs for artificial cycle and drospirenone and ethinylestradiol tablets medication immediately after artificial abortion can effectively promote endometrial repair and reduce the incidence of intrauterine adhesions. However, for the patients with poor compliance, drospirenoneand ethinylestradiol tablets are the first choice for prevention of intrauterine adhesion.
Abortion, Induced ; adverse effects ; Androstenes ; pharmacology ; therapeutic use ; Endometrium ; anatomy & histology ; drug effects ; Ethinyl Estradiol ; pharmacology ; therapeutic use ; Female ; Humans ; Hyaluronic Acid ; pharmacology ; therapeutic use ; Menstrual Cycle ; drug effects ; Menstruation ; drug effects ; Pregnancy ; Tissue Adhesions ; etiology ; prevention & control

OBJECTIVETo compare the difference in clinical efficacy on polycystic ovary syndrome (PCOS) between electroacupuncture (EA) and dyne-35 and to explore the effect mechanism.

METHODSSixty-five patients were randomized into an EA group (33 cases) and a western medication group (32 cases). In the EA group, the selected acupoints were Danzhong (CV 17), Qimen (LR 14), Zhongwan (CV 12), Tianshu (ST 25), Guanyuan (CV 4), Zigong (EX-CA 1), Sanyinjiao (SP 6), Zusanli (ST 36) and Taichong (LR 3), etc. After the arrival of qi, electric stimulation was attached to the acupoints for 30 min. The treatment was given 3 times a week. In the western medication group, dyne-35 was prescribed on the 5th day of natural menstruation or withdrawal bleeding, one tablet a day, continuously for 21 days. The treatment cycle was 3 months in the two groups. The menstrual condition, body mass, body mass index (BMI), serum testosterone (T), luteinizing hormone (LH), follicle-stimulating hormone (FSH) and LH/FSH were compared before and after treatment in the two groups. The clinical efficacy was assessed in the two groups.

RESULTSThe total effective rate was 90.6% (29/32) in the EA group and was 93.3% (28/30) in the western medication group. The efficacy was similar in the two groups (P > 0.05). After treatment, the levels of LH and LH/FSH were all reduced significantly in the two groups (all P < 0.01). After treatment, T level in serum was reduced apparently in the western medication group (P < 0.05). Before and after treatment, the differences in body mass and BMI in the EA group were more significant than those in the western medication group (P < 0.01, P < 0.05).

CONCLUSIONEA is the effective method for PCOS, similar to that of dyne-35. The effect of it for weight loss is superior to dyne-35 and no apparent adverse reactions happen. The effect mechanism of EA is related to the regulation of serum sexual hormone levels and their ratio, as well as to the regulation of body lipid metabolism.

Acupuncture Points ; Adolescent ; Adult ; Cyproterone Acetate ; administration & dosage ; Drug Combinations ; Electroacupuncture ; Ethinyl Estradiol ; administration & dosage ; Female ; Follicle Stimulating Hormone ; blood ; Humans ; Luteinizing Hormone ; blood ; Polycystic Ovary Syndrome ; blood ; drug therapy ; therapy ; Young Adult

Endocrine-disrupting chemicals (EDCs) are exogenous substances that alter the structure or function of the endocrine system. 4-Tert-octylphenol (OP) is one of the most representative EDCs and has estrogenic effects. In this study, we examined the effects of ethinyl estradiol (EE) and OP on the pituitary gland, placenta, and uterus of pregnant rats. Expression levels of human chorionic gonadotropin (hCG), oxytocin (OT), and contraction-associated proteins (CAPs) were determined, and uterine contractile activity was measured by uterine contraction assay. EE and OP both increased mRNA expression of OT and hCG in the pituitary gland but not the placenta. Since OT and hCG control uterine contraction, we next examined CAP expression in the uterus. Expression of 15-hydroxyprostaglandin-dehydrogenase (PGDH) was upregulated by OP, whereas expression of other CAPs was unaffected. To clarify the effect of OP on uterine contraction in pregnant rats, uterine contraction assay was performed. The 17beta-Estradiol (E2) did not affect contraction of primary uterine cells harvested from pregnant rats in a 3D collagen gel model. However, OP showed different effects from E2 by significantly reducing contraction activity. In summary, we demonstrated that OP interferes with regulation of OT and hCG in the pituitary gland as well as PGDH in the uterus, thereby reducing uterine contraction activity. This result differs from the action of endogenous E2. Collectively, these findings suggest that exposure to EDCs such as OP during pregnancycan reduce uterine contractile ability, which may result in contraction-associated adverse effects such as metratonia, bradytocia, and uterine leiomyomata.
Animals ; Chorionic Gonadotropin ; Collagen ; Endocrine System ; Estradiol ; Estrogens ; Ethinyl Estradiol ; Oxytocin* ; Pituitary Gland ; Placenta ; Rats* ; RNA, Messenger ; Uterine Contraction ; Uterus

Pulmonary embolism (PE) and deep vein thrombosis (DVT) is a serious medical problem causing considerable morbidity and mortality. Risk factors of thrombosis are surgery, trauma, pregnancy, tumor, oral contraceptive as well as genetic risk factors though genetic risk factors were found in about 5% to 10% of cases. Yasmin, a combined oral contraceptive containing ethinylestradiol 30 microg and drospirenon 3 mg was launched in the United Kingdom in 2002. We had experienced a patient, 24-year-old young woman with left inguinal pain on ambulation, and edema of left leg four months after taking Yasmin. We performed chest pulmonary angiography computed tomography (CT) and lower extremity venogram CT. She was diagnosed to PE in both lower lobes and DVT below the level of left external iliac vein, and treated by low molecular weight heparin and warfarin. We report this case with brief review of literatures.
Androstenes ; Angiography ; Edema ; Ethinyl Estradiol ; Female ; Great Britain ; Heparin, Low-Molecular-Weight ; Humans ; Iliac Vein ; Leg ; Lower Extremity ; Pregnancy ; Pulmonary Embolism ; Risk Factors ; Thorax ; Thrombosis ; Venous Thrombosis ; Walking ; Warfarin

The pharmaceutical ethynylestradiol (EE) is a potent endocrine modulator. Application enlargement of ethynylestradiol in clinics and abuse in livestock farming and fishing make it important to explore ethynylestradiol toxicological action on vertebrate embryonic development and to establish an in vivo method for EE toxicity detection efficiently and conveniently. In the present study, using a model animal zebrafish and 17alpha-ethynylestradiol as a representative compound, we have investigated EE2 teratogenicity, target tissues and target genes on zebrafish embryo. The results show that median teratogenesis concentration (TC50) of EE2 is 0.8 microg x mL(-1), and median lethal dose (LD50) is 3.3 microg x mL(-1). Targets of EE2 action were implicated in brain, eyes, heart, muscle, skeleton, pigment and viscera. Embryonic cardiac arrhythmia caused by EE2 is probably resulted from heart abnormal structure. The embryonic stage sensitive to EE2 mainly started at cleavage and last up to the organogenesis with time-accumulating effect. RT-PCR results indicate that EE2 treatment disturbed gene expression pattern at the early period of zebrafish embryonic development by suppressing transcription of gene boz that promotes brain development, upregulating genes for trunk and tail, such as ntl, spt, shh, and perturbing Nodal signal expression of TGFbeta superfamily, for example, cyc, sqt and oep. Using zebrafish, an efficient in vivo method for quick evaluation of EE toxicity on embryonic development has been developed.
Abnormalities, Drug-Induced ; etiology ; Animals ; Arrhythmias, Cardiac ; chemically induced ; embryology ; Dose-Response Relationship, Drug ; Embryo, Nonmammalian ; abnormalities ; drug effects ; Embryonic Development ; drug effects ; Ethinyl Estradiol ; administration & dosage ; toxicity ; Gene Expression Regulation, Developmental ; Teratogens ; toxicity ; Zebrafish ; abnormalities ; embryology

BACKGROUNDOur previous studies suggested that low-dose gossypol combined with steroid hormones has a reversible antifertility role in adult male rats, and the course of treatment was shorter than that of either gossypol or steroid hormones alone. This result suggested that low-dose gossypol and steroid hormones have a drug synergistic effect on antifertility. The aim of the study was to find the target organs of the antifertility synergistic effect of the combined regimen.

METHODSThirty-two adult male rats were divided into four groups randomly: group GH, rats were fed orally with gossypol acetic acid (GA, 12.5 mg×kg(-1)×d(-1)) and desogestrel (DSG, 0.125 mg×kg(-1)×d(-1))/ethinylestradiol (EE, 0.025 mg×kg(-1)×d(-1))/testosterone undecanoate (TU, 100 mg×kg(-1)×d(-1)); group G, a single dose of GA (12.5 mg×kg(-1)×d(-1)) was given; group H, the same dosage of DSG/EE/TU as in group GH were administered; group C, rats were treated with vehicle (1% methyl cellulose) as control. Testes and epididymis were removed at 8 weeks post-treatment for evaluating their weight, volumes, volume fraction, and total volume of testicular tissue structures and the seminiferous tubule diameter using stereological assay. Sperm cell numbers and the motility of epididymal sperm were quantitated by flow cytometry and morphological methods.

RESULTSCompared with group C, spermatogenesis was normal in group G and suppressed in groups H and GH. Similar changes of testicular tissue structures and sperm number were found in groups H and GH. The decreases of epididymal sperm number and motility in group GH were greater than that of the low-dose gossypol or steroid hormones alone group.

CONCLUSIONSThe suppression of spermatogenesis was induced by steroid hormones in the combined regimen, and the epididymis was the target organ of low-dose gossypol. Combined use of low-dose gossypol and steroid hormones played a comprehensive antifertility role in their synergistic effect on reducing the number and motility of epididymal sperm.

Animals ; Desogestrel ; pharmacology ; Epididymis ; drug effects ; Ethinyl Estradiol ; pharmacology ; Flow Cytometry ; Gossypol ; analogs & derivatives ; pharmacology ; Male ; Random Allocation ; Rats ; Sperm Motility ; drug effects ; Spermatogenesis ; drug effects ; Spermatozoa ; drug effects ; Testis ; drug effects ; Testosterone ; analogs & derivatives ; pharmacology

To establish a sensitive and specific method for simultaneous determination of gestodene, etonogestrel and ethinylestradiol in plasma by LC-MS/MS, plasma samples were extracted and derivatized before injection. An ESI ion source was used and operated in the positive ion mode with multiple reaction monitoring (MRM). Norgestrel was chosen as internal standard and performed on a C18 (100 mm x 2.1 mm, 5 microm) column. The concentrations of gestodene, etonogestrel and ethinylestradiol were measured, using step-gradient mobile phase and step-gradient flow rate. The method was validated over the concentration range of 0.1-20 ng x mL(-1) for gestodene and etonogestrel and 0.01-2 ng x mL(-1) for ethinylestradiol, and showed excellent linearity. The intra- and inter-assay accuracy and precision were below 10.0% and recovery was 93.6%-110.9% over the three concentration levels evaluated. The method was applied in pharmacokinetic study of the compound gestodene patch and the compound etonogestrel patch in rabbits. The LC-MS/MS method was selective, accurate and sensitive, especially the LOQ were 100 pg x mL(-1) for gestodene and etonogestrel and 10 pg x mL(-1) for ethinylestradiol. The method was successfully applied in pharmacokinetic study for contraceptives.
Animals ; Chromatography, Liquid ; Desogestrel ; blood ; pharmacokinetics ; Ethinyl Estradiol ; blood ; pharmacokinetics ; Norpregnenes ; blood ; pharmacokinetics ; Rabbits ; Sensitivity and Specificity ; Spectrometry, Mass, Electrospray Ionization

OBJECTIVETo study 17β-estradiol (E2), ethinylestradiol (EE2), estriol (E3), estrone (E1) on MCF-7 proliferation effects, and compare the effects of independent action (IA) model with concentration addition (CA) model in assessing the combined effects of estrogen.

METHODSThe combinations of E2 + EE2, E2 + E3 and E2 + E1 were chosen and the cellular proliferation effects were examined by MTT assay.

RESULTSThe maximum proliferation effects at dose of 10⁻⁹ mol/L was 325.48% for E2, 330.34% for EE2, 255.22% for E3, and 199.61% for E1. In the E2 + EE2, E2 + E3, E2 + E1 groups, the results of IA model analysis were very close to the experimental results. The IA model tend to overestimated the experimental results, while the CA model often underestimated the experimental results. In the EC (E2, 30) + C (EE2, 70) group, the results exceed the maximum estrogen effects of E2, while in other groups, the results were lower.

CONCLUSIONSThe estrogenic effects of the four tested substances from high to low efficiency were that: EE2 > E2 > E3 > E1. The effect of IA model in predicting the combined effects of binary mixture was better than CA model. A small proportion of binary mixture showed synergy.

Cell Line, Tumor ; Cell Proliferation ; drug effects ; Estradiol ; pharmacology ; Estriol ; pharmacology ; Estrogens ; pharmacology ; Estrone ; pharmacology ; Ethinyl Estradiol ; pharmacology ; Female ; Humans