Genome-wide association studies have paved the way for the discovery of new markers regarding man... more Genome-wide association studies have paved the way for the discovery of new markers regarding many diseases, including male infertility. A previous study on Caucasians highlighted 172 polymorphisms for their putative association with male infertility and we attempted to replicate these findings on our dataset comprising of Greek male individuals (n = 360). We retrieved 59 out of 172 polymorphisms and tested for all association models on 278 normospermic men and 82 patients with an abnormal seminogram, later separated into oligozoospermic and asthenozoospermic groups . Our findings indicate that two SNPs (rs2296225 in KIF17, rs7224496 in SMYD4) are associated with male infertility in the Greek population and have not been recorded in literature as of yet. These novel markers need further validation via additional studies and an increased individual number. All in all, replication studies, possess the power to validate existing polymorphisms found across all population and thus increase both statistical significance as well as identify novel potentially diagnostic markers.
The corpus luteum is formed from the pre-ovulatory follicle under the action of the mid-cycle LH ... more The corpus luteum is formed from the pre-ovulatory follicle under the action of the mid-cycle LH surge. LH is the main luteotrophic hormone in women controlling luteal structure and function during the normal menstrual cycle. Local factors, however, including progesterone are also involved. If conception does not take place, luteolysis occurs as a physiological apoptotic process. Human chorionic gonadotrophin, secreted after implantation, is able to rescue the corpus luteum and extend its lifespan. In ovulation-induction cycles, the negative feedback effect of the ovarian steroids on the pituitary is markedly potentiated, leading to the suppression of endogenous LH secretion during the whole menstrual cycle. The marked suppression of LH secretion disrupts corpus luteum function regardless of the treatment regimen.
To study the role of oxytocin in basal and GnRH-induced gonadotrophin secretion in normal women. ... more To study the role of oxytocin in basal and GnRH-induced gonadotrophin secretion in normal women. Normal women were studied in three cycles. When the diameter of the leading follicle was 15-16 mm, the women were infused intravenously (i.v.) for 3 h with normal saline (cycle 1), atosiban (cycle 2) or oxytocin (cycle 3). The study included 12 normally cycling women aged 23-38 years. After cessation of treatment, two injections of GnRH, 10 microg each, were administered i.v. 2 h apart and blood samples were collected every 30 min for a total of 240 min. The 30-min pituitary response (sensitivity) to a single GnRH injection (10 microg i.v.) was investigated thereafter every 12 h from the end of the 3-h infusion until the day of LH surge onset. No significant differences in LH and FSH response to GnRH (sensitivity and reserve) during the 240-min experiment were found between the three cycles. The time of LH surge onset from the initiation of the infusion was similar in the three cycles. Also similar in the three cycles were oestradiol (E2) and gonadotrophin levels as well as the 30-min response to GnRH for 48 h following the 3-h infusion. The present study demonstrates that neither exogenous oxytocin administration nor blockage of endogenous oxytocin action influences pituitary sensitivity to GnRH in cycling women.
Abstract Excessive amount of weight is a common characteristic of the polycystic ovary syndrome (... more Abstract Excessive amount of weight is a common characteristic of the polycystic ovary syndrome (PCOS). The incidence of obesity in PCOS varies between 35% and 80%. A higher prevalence of anovulation has been observed in obese compared to nonobese women with PCOS. Hyperandrogenism and insulin resistance are important causes of anovulation and may be deteriorated by obesity in PCOS. Other factors, such as increased secretion of luteinizing hormone as well as various adipokines, may also mediate the obesity-deteriorated fertility in PCOS. The success of the infertility treatment is highly affected by the increased body weight. Diet and lifestyle changes result in the improvement of various parameters and are recommended as first-line approach in obese women with PCOS. Bariatric surgery is getting more popular in recent years. Although still uncertain, it seems that weight reduction prior to any therapeutic intervention is the preferred approach in order to enhance the success of any attempt to restore fertility.
Endometrial polyps are endometrial masses that consist of glands, stroma, and vessels. They can b... more Endometrial polyps are endometrial masses that consist of glands, stroma, and vessels. They can be single or multiple, sessile or pedunculated, and range in size from some millimeters up to several centimeters. Despite the fact they rarely cause symptoms, they are usually found on a routine examination. Therefore, they are a common problem on daily clinical practice. The question of potential malignancy risk as well as the necessity of further treatment are often posed. The present chapter summarizes current evidence regarding risk of malignant transformation as well as indications and methods of appropriate treatment.
Page 1. 11 Obstetric anaesthesia in low-resource settings Robert A. Dyer, PhD, Professor *, Antho... more Page 1. 11 Obstetric anaesthesia in low-resource settings Robert A. Dyer, PhD, Professor *, Anthony R. Reed, FRCA, Senior Specialist Anaesthetist, Michael F. James, PhD, Professor and Head ... Internet Journal of Health 2006; 5. 47. Nafiu OO, Salam RA & Elegbe EO. ...
RESEARCH QUESTION Ganirelix is a gonadotrophin-releasing hormone (GnRH) antagonist used for the p... more RESEARCH QUESTION Ganirelix is a gonadotrophin-releasing hormone (GnRH) antagonist used for the prevention of premature LH surge during ovarian stimulation. What is the impact of ganirelix on follicle maturation in normal women? DESIGN Ten normally cycling women were investigated during two menstrual cycles, i.e. cycle 1 (control) and cycle 2 (ganirelix). During both cycles, daily blood samples were taken from day 2, while transvaginal ultrasound scans were performed on cycle days 8 and 10 and daily thereafter. During cycle 2, all women were given 0.25 mg/day subcutaneous injections of the GnRH antagonist ganirelix from day 2 until the day of the endogenous LH surge onset in cycle 1. RESULTS During treatment with ganirelix, serum FSH and oestradiol concentrations remained stable, while those of LH decreased significantly on days 3, 4, 7 and 9 (P < 0.05) compared with controls. Nevertheless, there was no significant within-cycle variation in LH concentrations. From day 10 onwards, no follicle maturation was observed in cycle 2, in contrast to cycle 1. Ovulation occurred in 9 of 10 women in cycle 1. In cycle 2, ovulation was delayed by at least 1 week in eight women. Follicle growth and ovulation occurred in only one woman while on ganirelix treatment. CONCLUSIONS This study demonstrates for the first time that in normal women dominant follicle selection failed during treatment with ganirelix. As there was a similar gonadotrophin profile in the two cycles, it is suggested that ganirelix interferes with the process of follicle selection by acting in the ovary.
The aim of the present study was to investigate changes of blood ghrelin, adiponectin and resisti... more The aim of the present study was to investigate changes of blood ghrelin, adiponectin and resistin levels in IVF/ICSI-ET cycles. Twenty women were stimulated with recombinant FSH in a GnRH agonist short protocol for IVF/ICSI. Blood samples were taken on cycle day 2 before the commencement of injections, on cycle day 6 and on the days of HCG injection, oocyte pick up (OPU), embryo transfer (ET) as well as 7 and 12 days post-ET. Serum E2 levels increased during the stimulation, peaking on the HCG day and declined thereafter (p<0.001). Serum progesterone levels started to increase on the OPU day, peaking on the ET day (p<0.001) and decreased on days 7 and 12 post-ET. Plasma ghrelin remained unchanged during the whole cycle. Serum adiponectin levels remained stable during the stimulation period until the ET day and decreased on days 7 and 12 post-ET (p<0.001). Serum resistin levels increased until the ET day (p<0.05), remained unchanged on day 7 post-ET and decreased on day ...
Genome-wide association studies have paved the way for the discovery of new markers regarding man... more Genome-wide association studies have paved the way for the discovery of new markers regarding many diseases, including male infertility. A previous study on Caucasians highlighted 172 polymorphisms for their putative association with male infertility and we attempted to replicate these findings on our dataset comprising of Greek male individuals (n = 360). We retrieved 59 out of 172 polymorphisms and tested for all association models on 278 normospermic men and 82 patients with an abnormal seminogram, later separated into oligozoospermic and asthenozoospermic groups . Our findings indicate that two SNPs (rs2296225 in KIF17, rs7224496 in SMYD4) are associated with male infertility in the Greek population and have not been recorded in literature as of yet. These novel markers need further validation via additional studies and an increased individual number. All in all, replication studies, possess the power to validate existing polymorphisms found across all population and thus increase both statistical significance as well as identify novel potentially diagnostic markers.
The corpus luteum is formed from the pre-ovulatory follicle under the action of the mid-cycle LH ... more The corpus luteum is formed from the pre-ovulatory follicle under the action of the mid-cycle LH surge. LH is the main luteotrophic hormone in women controlling luteal structure and function during the normal menstrual cycle. Local factors, however, including progesterone are also involved. If conception does not take place, luteolysis occurs as a physiological apoptotic process. Human chorionic gonadotrophin, secreted after implantation, is able to rescue the corpus luteum and extend its lifespan. In ovulation-induction cycles, the negative feedback effect of the ovarian steroids on the pituitary is markedly potentiated, leading to the suppression of endogenous LH secretion during the whole menstrual cycle. The marked suppression of LH secretion disrupts corpus luteum function regardless of the treatment regimen.
To study the role of oxytocin in basal and GnRH-induced gonadotrophin secretion in normal women. ... more To study the role of oxytocin in basal and GnRH-induced gonadotrophin secretion in normal women. Normal women were studied in three cycles. When the diameter of the leading follicle was 15-16 mm, the women were infused intravenously (i.v.) for 3 h with normal saline (cycle 1), atosiban (cycle 2) or oxytocin (cycle 3). The study included 12 normally cycling women aged 23-38 years. After cessation of treatment, two injections of GnRH, 10 microg each, were administered i.v. 2 h apart and blood samples were collected every 30 min for a total of 240 min. The 30-min pituitary response (sensitivity) to a single GnRH injection (10 microg i.v.) was investigated thereafter every 12 h from the end of the 3-h infusion until the day of LH surge onset. No significant differences in LH and FSH response to GnRH (sensitivity and reserve) during the 240-min experiment were found between the three cycles. The time of LH surge onset from the initiation of the infusion was similar in the three cycles. Also similar in the three cycles were oestradiol (E2) and gonadotrophin levels as well as the 30-min response to GnRH for 48 h following the 3-h infusion. The present study demonstrates that neither exogenous oxytocin administration nor blockage of endogenous oxytocin action influences pituitary sensitivity to GnRH in cycling women.
Abstract Excessive amount of weight is a common characteristic of the polycystic ovary syndrome (... more Abstract Excessive amount of weight is a common characteristic of the polycystic ovary syndrome (PCOS). The incidence of obesity in PCOS varies between 35% and 80%. A higher prevalence of anovulation has been observed in obese compared to nonobese women with PCOS. Hyperandrogenism and insulin resistance are important causes of anovulation and may be deteriorated by obesity in PCOS. Other factors, such as increased secretion of luteinizing hormone as well as various adipokines, may also mediate the obesity-deteriorated fertility in PCOS. The success of the infertility treatment is highly affected by the increased body weight. Diet and lifestyle changes result in the improvement of various parameters and are recommended as first-line approach in obese women with PCOS. Bariatric surgery is getting more popular in recent years. Although still uncertain, it seems that weight reduction prior to any therapeutic intervention is the preferred approach in order to enhance the success of any attempt to restore fertility.
Endometrial polyps are endometrial masses that consist of glands, stroma, and vessels. They can b... more Endometrial polyps are endometrial masses that consist of glands, stroma, and vessels. They can be single or multiple, sessile or pedunculated, and range in size from some millimeters up to several centimeters. Despite the fact they rarely cause symptoms, they are usually found on a routine examination. Therefore, they are a common problem on daily clinical practice. The question of potential malignancy risk as well as the necessity of further treatment are often posed. The present chapter summarizes current evidence regarding risk of malignant transformation as well as indications and methods of appropriate treatment.
Page 1. 11 Obstetric anaesthesia in low-resource settings Robert A. Dyer, PhD, Professor *, Antho... more Page 1. 11 Obstetric anaesthesia in low-resource settings Robert A. Dyer, PhD, Professor *, Anthony R. Reed, FRCA, Senior Specialist Anaesthetist, Michael F. James, PhD, Professor and Head ... Internet Journal of Health 2006; 5. 47. Nafiu OO, Salam RA &amp;amp; Elegbe EO. ...
RESEARCH QUESTION Ganirelix is a gonadotrophin-releasing hormone (GnRH) antagonist used for the p... more RESEARCH QUESTION Ganirelix is a gonadotrophin-releasing hormone (GnRH) antagonist used for the prevention of premature LH surge during ovarian stimulation. What is the impact of ganirelix on follicle maturation in normal women? DESIGN Ten normally cycling women were investigated during two menstrual cycles, i.e. cycle 1 (control) and cycle 2 (ganirelix). During both cycles, daily blood samples were taken from day 2, while transvaginal ultrasound scans were performed on cycle days 8 and 10 and daily thereafter. During cycle 2, all women were given 0.25 mg/day subcutaneous injections of the GnRH antagonist ganirelix from day 2 until the day of the endogenous LH surge onset in cycle 1. RESULTS During treatment with ganirelix, serum FSH and oestradiol concentrations remained stable, while those of LH decreased significantly on days 3, 4, 7 and 9 (P < 0.05) compared with controls. Nevertheless, there was no significant within-cycle variation in LH concentrations. From day 10 onwards, no follicle maturation was observed in cycle 2, in contrast to cycle 1. Ovulation occurred in 9 of 10 women in cycle 1. In cycle 2, ovulation was delayed by at least 1 week in eight women. Follicle growth and ovulation occurred in only one woman while on ganirelix treatment. CONCLUSIONS This study demonstrates for the first time that in normal women dominant follicle selection failed during treatment with ganirelix. As there was a similar gonadotrophin profile in the two cycles, it is suggested that ganirelix interferes with the process of follicle selection by acting in the ovary.
The aim of the present study was to investigate changes of blood ghrelin, adiponectin and resisti... more The aim of the present study was to investigate changes of blood ghrelin, adiponectin and resistin levels in IVF/ICSI-ET cycles. Twenty women were stimulated with recombinant FSH in a GnRH agonist short protocol for IVF/ICSI. Blood samples were taken on cycle day 2 before the commencement of injections, on cycle day 6 and on the days of HCG injection, oocyte pick up (OPU), embryo transfer (ET) as well as 7 and 12 days post-ET. Serum E2 levels increased during the stimulation, peaking on the HCG day and declined thereafter (p<0.001). Serum progesterone levels started to increase on the OPU day, peaking on the ET day (p<0.001) and decreased on days 7 and 12 post-ET. Plasma ghrelin remained unchanged during the whole cycle. Serum adiponectin levels remained stable during the stimulation period until the ET day and decreased on days 7 and 12 post-ET (p<0.001). Serum resistin levels increased until the ET day (p<0.05), remained unchanged on day 7 post-ET and decreased on day ...
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