PPARγ Agonists: Emergent Therapy in Endometriosis

Actuality. Ovarian insufficiency can be diagnosed in more than 30% of reproductive age women with obesity. The role of leptin in the pathogenesis of ovarian insufficiency in obesity is not well understood and needs to be detalised. The aim of the study: to ivestigate the role of leptin in the pathogenesis of ovarian insufficiency in obesity. Materials and methods. 50 reproductive age females with BMI > 26.5 kg/m2 were studied. 10 healthy reproductive age females were used as control. Blood levels of leptin, gonadotropins, prolactin, sex steroid hormones were measured by immunoenzymatic assay and pelvic echoscopy were performed in all studied patients and co ntrols. Results. 72% of obese women had signs of ovarian insufficiency, such as ovarian enlargement and increased antral follicular count. The level of leptin did not correlate with the presence or absence of ovarian insufficiency in our patient group. The positive correlation between leptin level and BMI, luteinizing hormone (LG) and oestradiol and negative correlation between leptin level and follicular stimulating hormone (FSH) were revealed. Conclusion. The results of our study do not support the hyperleptinemia as the main cause of ovarian dysfunction in alimentary obesity. The most potential reason of ovarian dysfunction in these women could be ovarian or non-ovarian origin hyperoestrogenia leading to premature LG piques, and, thus, disturbing folliculogenesis in ovaria.

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Endometriosis

10.2310/im.1005 ◽

2019 ◽

Author(s):

Valerie A Flores ◽

Hugh S Taylor

Keyword(s):

Pelvic Pain ◽

Treatment Options ◽

Reproductive Age ◽

Fertility Treatment ◽

Future Research ◽

Retrograde Menstruation ◽

Reproductive Age Women ◽

Aberrant Gene Expression ◽

Aberrant Gene

Endometriosis is a chronic, gynecologic disease affecting 6 to 10% of reproductive age women. Pelvic pain, dyspareunia, and infertility are the most common symptoms of endometriosis that can have a significant impact on patients’ lives. Although the etiology remains largely unknown, the role of estrogens in the development and growth of endometriosis is well characterized. Medical and surgical therapies are the two cornerstones of endometriosis management. Following diagnosis of endometriosis, treatment options will be dependent on patient preference (ie, seeking pain relief versus fertility treatment). Future research aimed at targeting altered molecular pathways in patients with endometriosis will hopefully help mitigate the burden of this debilitating disease. This review contains 5 figures, 7 tables, and 75 references. Key Words: aberrant gene expression, altered immunity, endometriosis, infertility, medical and surgical therapy, pelvic pain, retrograde menstruation, stem cells

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Endometriosis

10.2310/fm.1005 ◽

2019 ◽

Author(s):

Valerie A Flores ◽

Hugh S Taylor

Keyword(s):

Pelvic Pain ◽

Treatment Options ◽

Reproductive Age ◽

Fertility Treatment ◽

Future Research ◽

Retrograde Menstruation ◽

Reproductive Age Women ◽

Aberrant Gene Expression ◽

Aberrant Gene

Endometriosis is a chronic, gynecologic disease affecting 6 to 10% of reproductive age women. Pelvic pain, dyspareunia, and infertility are the most common symptoms of endometriosis that can have a significant impact on patients’ lives. Although the etiology remains largely unknown, the role of estrogens in the development and growth of endometriosis is well characterized. Medical and surgical therapies are the two cornerstones of endometriosis management. Following diagnosis of endometriosis, treatment options will be dependent on patient preference (ie, seeking pain relief versus fertility treatment). Future research aimed at targeting altered molecular pathways in patients with endometriosis will hopefully help mitigate the burden of this debilitating disease. This review contains 5 figures, 7 tables, and 75 references. Key Words: aberrant gene expression, altered immunity, endometriosis, infertility, medical and surgical therapy, pelvic pain, retrograde menstruation, stem cells

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Obstetric Scar Endometriosis: Retrospective Study on 19 Cases and Review of the Literature

International Scholarly Research Notices ◽

10.1155/2014/417042 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Mustafa Kaplanoglu ◽

Dilek Kaya Kaplanoğlu ◽

Ceren Dincer Ata ◽

Selim Buyukkurt

Keyword(s):

Case Series ◽

Uterine Cavity ◽

Scar Tissue ◽

Reproductive Age ◽

Pelvic Cavity ◽

Histopathologic Examination ◽

Review Of The Literature ◽

Scar Endometriosis ◽

Reproductive Age Women ◽

Extreme Variability

Endometriosis is defined as the presence of functioning endometrial tissue outside the uterine cavity. This disease is one of the most common gynecologic disorders in reproductive age women. It generally occurs in pelvic cavity. But extrapelvic location has been defined (such as extremities, central nervous system, lungs, pleurae, liver, umbilicus, pericardium, urinary tract, intestines, and surgical scar tissue). Scar endometriosis is a rare disease and defined as presence of endometriotic lesions on the abdominal (such as cesarean section and hysterectomy) or vaginal (episiotomy) excision line. It is difficult to diagnose due to the extreme variability in presentation. The symptoms are nonspecific, typically involving pain, swelling at the incision site at the time of menstruation. Excision and histopathologic examination are necessary for diagnosis. We present a case series of obstetric scar endometriosis and review of the literature.

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Dicarbonyl stress and glyoxalases in ovarian function

Biochemical Society Transactions ◽

10.1042/bst20140023 ◽

2014 ◽

Vol 42 (2) ◽

pp. 433-438 ◽

Cited By ~ 24

Author(s):

Carla Tatone ◽

Ursula Eichenlaub-Ritter ◽

Fernanda Amicarelli

Keyword(s):

Ovarian Function ◽

Reproductive Age ◽

Oocyte Competence ◽

Reproductive Age Women ◽

Glycation End Products ◽

Lower Fertility ◽

Main Regulator ◽

Ovarian Syndrome ◽

New Strategies

The ovary is the main regulator of female fertility. Changes in maternal health and physiology can disrupt intraovarian homoeostasis thereby compromising oocyte competence and fertility. Research has only recently devoted attention to the involvement of dicarbonyl stress in ovarian function. On this basis, the present review focuses on clinical and experimental research supporting the role of dicarbonyl overload and AGEs (advanced glycation end-products) as key contributors to perturbations of the ovarian microenvironment leading to lower fertility. Particular emphasis has been given to oocyte susceptibility to methylglyoxal, a powerful glycating agent, whose levels are known to increase during aging and metabolic disorders. According to the literature, the ovary and the oocyte itself can rely on the glyoxalase system to counteract the possible dicarbonyl overload such as that which may occur in reproductive-age women and patients with PCOS (polycystic ovarian syndrome) or diabetes. Overall, although biochemical methods for proper evaluation of dicarbonyl stress in oocytes and the ovarian microenvironment need to be established, AGEs can be proposed as predictive markers and/or therapeutic targets in new strategies for improving reproductive counselling and infertility therapies.

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Contraception in obese women

Obesity and metabolism ◽

10.14341/omet2016365-69 ◽

2016 ◽

Vol 13 (3) ◽

pp. 65-69

Author(s):

Elena Andreeva ◽

Dar’y Sokolova ◽

Ol'ga Grigoryan

Keyword(s):

Reproductive Age ◽

Modern World ◽

Specific Method ◽

Obese Patients ◽

Obese Women ◽

Overweight People ◽

Reproductive Age Women ◽

Carbohydrate And Lipid Metabolism ◽

Gynecological Diseases ◽

Selection Of

At present, the prevalence of overweight people in the world is more than 1.7 billion; 312 million people are obese. The 25% of them consist of reproductive age women. In the modern world contraception is not only the way to prevent unscheduled pregnancy but also the opportunity to treat endocrine and gynecological diseases. While choosing the method of contraception, it is important to realize it’s pharmacological effect on carbohydrate and lipid metabolism, hemocoagulation/fibrinolysis system, cardiovascular and other systems of body that are involved in cascade of pathological processes. Selection of contraception for overweight/obese patients needs an individualized approaches with evaluation of efficiency/risk for every specific method of fertility correction.

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The role of hysteroresectoscopy in the diagnosis and treatment of reproductive age women with uterine leiomyoma

Reproductive health of woman ◽

10.30841/2708-8731.5.2021.240028 ◽

2021 ◽

Vol 5 ◽

pp. 61-64

Author(s):

M.A. Flaksemberg

Keyword(s):

Menstrual Cycle ◽

Histological Examination ◽

Uterine Leiomyoma ◽

Endometrial Hyperplasia ◽

Ultrasound Examination ◽

Uterine Cavity ◽

Reproductive Age ◽

Chronic Endometritis ◽

Reproductive Age Women ◽

Ultrasound Findings

The objective: to investigate the features of hysteroscopic picture of the uterine cavity and endometrium condition in women with uterine leiomyoma (UL) and the possibility of using the results to choose a treatment method.Materials and methods. A total amount of reproductive age women with uterine leiomyoma that was examined is 216. Among them 118 women underwent surgical treatment for UL and 98 patients treated with conservative therapy. In addition to general clinical methods, ultrasound examination, hysterorectoscopy, and histological examination of the obtained material was performed, followed by a comparative analysis of the findings.Results. According to hysteroresectoscopy, the uterine cavity in women with UL was more frequently characterized by irregular wall relief (47.7%) and irregular shape (43.1%) due to submucosal (14.4%) and intramural nodes with centripetal growth (30.6% ), which was significantly more frequent compared to ultrasound findings (13.9%, p<0.05). Endometrial polyps predominated among endometrial pathology (55.6%), which was consistent with the histological finding (59.7%) and was twice as frequent as ultrasound findings (23.1%, p<0.05). And endometrial hyperplasia (14.8%), which was consistent with ultrasound findings (18.1%) but was twice as rare compared to histological examination (36.6%, p<0.05). Chronic endometritis was detected at hysteroscopy in less than 1% of subjects, whereas at histological examination, it was 26.4%, p<0.05. Ultrasound examination revealed no endometrial transformation during the cycle in 30.1% of women, which was consistent with a mismatch in endometrial development to the chronological day of the menstrual cycle according to histological examination (23.1%).Conclusion. Hysteroresectoscopy is an important stage in the examination of women with UL, which helps to assess the condition of the uterine cavity, in particular, the degree of deformation of leiomatous nodules, which determines the clinical course of the disease and is a contributing factor to infertility, and affects the choice of treatment tactics in this cohort of patients. Hysteroresectoscopy when combined with ultrasound and histological examination of the endometrium, a more comprehensive characterisation of the endometrial condition (chronic endometritis, mismatch of the day of the menstrual cycle) and the presence of associated pathological processes (polyps and endometrial hyperplasia) that require correction can be obtained.

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Review of role of jasad bhasma in management of shwetapradar

National Journal of Research in Ayurved Science ◽

10.52482/ayurlog.v6i02.31 ◽

2018 ◽

Vol 6 (02) ◽

Author(s):

Snehal Sambhaji Sawant ◽

Anjali Jadhav

Keyword(s):

Inflammatory Disease ◽

Vaginal Discharge ◽

Fungal Infections ◽

Reproductive Age ◽

Common Condition ◽

Medical Interventions ◽

Inflammatory Conditions ◽

Child Bearing ◽

Gynecological Diseases

Shwetapradar i.e leucorrhoea, also known as vaginal discharge is one of the major problems encountered in gynaecological practice. It is a very common condition that has been experienced by most women of all ages especially in child bearing or reproductive age. It may be due to various causes like Pelvic inflammatory disease , fungal infections, cervicitis, anaemia, diabetes etc. The disease mainly has complaints like yonistrav, yonikandu, yonishula, katishula. Usually its a non-pathological symptom secondary to inflammatory conditions of vagina or cervix and wants no medical interventions but it is significant if it is profuse, foul smelling, chnged in its color and consistency and blood stained. The white discharge is however caused by the presence of infection in any of these tissues and a variety of other factors. Bahya and abhyantar chikitsa are described in ayurveda. In ayurved , metal based preparations that is bhasmas are indicated for the treatment of several gynecological diseases . According to Rasa Tarangini, Jasad bhasma in management of shwetapradar for its properties. KEYWORDS: Shwetapradar, yonigatastrav , yonikandu , jasad bhasma .

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Role hyperleptinemia, insulin resistance and hyperestrogenemia in the development of ovarian failure in women with obesity

Journal of obstetrics and women s diseases ◽

10.17816/jowd65556-63 ◽

2016 ◽

Vol 65 (5) ◽

pp. 56-63

Author(s):

Ekaterina M Ryazantseva ◽

Elena V Misharina ◽

Vladimir V Potin ◽

Marina A Tarasova

Keyword(s):

Insulin Resistance ◽

Fasting Blood Glucose ◽

Tolerance Test ◽

Reproductive Age ◽

Whole Body ◽

Ovarian Insufficiency ◽

Reproductive Age Women ◽

Immunoenzyme Analysis ◽

Alimentary Obesity

Actuality of the study. Ovarian insufficiency is present in more that 30% of reproductive age women. The role of leptine and insuin resistance in the pathogenesis of ovarian insufficiency is not yet established and has to be clarified. The aim of the study to investigate the role of hyperleptinemia, insulin resistance and hyperestrogenemia in the pathogenesis of ovarian insufficiency in obesity.Materials and methods. Fifty reproductive age women with BMI > 25,6 kg/m2 were studied. Ten healthy reproductive age women were included as controls. The plasma level of leprin, honadotropins, prolactin, insulin and sex steroid hormones assayed by immunoenzyme analysis, morning fasting blood glucose and the glucose level after glucose tolerance test, pelvic echography, “whole body” program of dual x-ray absorptiometry were studied in both patients and controls.Results. Thirty-six out of 50 women had signs of ovarian insufficiency. The presence and severity of ovarian insufficiency did not correlate with the level of leptin in blood or with insulin resistance. The positive correlation between oestradiol level and both presence and severity of ovarian insufficiency could be demonstrated.Conclusion. The results of our study do not support the hyperleptinemia and insulin resistance as the main cause of ovarian insufficiency in alimentary obesity. The most potential reason of anovulation in these women could be hyperoestrogenia due to increased conversion of androgens into oestrogenes in fat tissues and ovaria.

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P–683 Correlation of vitamin D deficiency with anti-Mullerian hormone (AMH) among infertile women in comparison to fertile women in a tertiary health facility in North-Western Nigeria

Human Reproduction ◽

10.1093/humrep/deab130.682 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

B Lawal ◽

A Adesiyun ◽

M Manu ◽

J El-Bashir ◽

A Olorukooba ◽

...

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Reproductive Age ◽

P Value ◽

Infertile Women ◽

Reproductive Age Women ◽

Vitamin D Levels ◽

North Western ◽

Fertile Women

Abstract Study question is there correlation between Vitamin D Deficiency and AMH levels in infertile and fertile women? Summary answer there is no significant correlation between Vitamin D deficiency and AMH levels in both infertile and fertile women What is known already Vitamin D deficiency and insufficiency is a global health problem affecting over a billion people with higher prevalence among reproductive-age women, and blacks. Vitamin D is well known to play significant role in calcium-phosphate homeostasis and bone metabolism, however, recent studies have demonstrated diverse expression of vitamin D receptors in reproductive organs. This suggest the probable role of vitamin D in reproductive physiology and fertility. The pathogenesis of vitamin D in infertility is poorly understood, but thought to involve hypothalamo-pituitary axis, ovarian folliculogenesis and uterine implantation. Most studies are done in Assisted Reproduction Technology and in developed countries Study design, size, duration A case-control study that involved 128 consecutively consenting women within the reproductive age group; 64 infertile women as the cases and 64 age and body mass index (BMI) matched fertile women as the controls. The study was conducted over a period of six (6) months Participants/materials, setting, methods The study was conducted in Obstetrics and Gynaecology and Chemical pathology departments of Ahmadu Bello University Teaching Hospital Zaria, a tertiary hospital in North-Western Nigeria. It involved all cases of female-factor infertility as cases, while the controls were fertile women from 6 weeks postpartum to 1 year. Venous blood samples were assayed for serum 25(-hydroxy) vitamin D and AMH levels using Enzyme-Linked Immunosorbent Assay (ELISA) and data analysed with level of significance set as < 0.05 Main results and the role of chance The mean ± standard deviation (SD) of serum Vitamin D levels in the infertile women and fertile women were 17.01 ± 7.61ng/ml and 11.34 ± 6.12ng/ml respectively, significantly higher in the infertile women (p-value <0.000). The prevalence of Vitamin D deficiency (<20ng/ml) was found to be significantly higher in the fertile women compared to infertile women (89.1% versus 68.8%; p-value 0.007). Vitamin D levels were found to be positively correlated with age (r 0.374; p-value 0.002) and parity (r 0.338; p-value 0.006). There was no association between vitamin D with type of, and causes of infertility. Vitamin D deficient women were found to be 6.5 times less likely to be infertile than non-deficient women (aOR 95% confidence interval 1.96–21.55; p-value 0.002). There was no significant correlation between vitamin D and AMH levels in vitamin D deficient women of both study groups (rs 0.180; p-value 0.242 and rs 0.088; p-value 0.521). Interestingly, there was significant relationship between AMH levels and causes of infertility (p-value 0.001), with higher levels of AMH found in infertile women with polycystic ovarian syndrome Limitations, reasons for caution There is no consensus on the cut-off values for vitamin D levels as it relates to fertility, and no reference values for vitamin D deficiency and AMH levels in study area. The sample size was limited by cost, and the study was conducted in a single study area Wider implications of the findings: The vitamin D levels in women with infertility was low but yet not significantly correlated with AMH. Overall, prevalence of vitamin D deficiency among reproductive-age women was found high. There is need for life-style and dietary modifications. Further researches are needed to ascertain the effect of vitamin D on fertility. Trial registration number Not applicable

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