Metformin administration was associated with a modification of LH, prolactin and insulin secretion dynamics in women with polycystic ovarian syndrome.

Unlabelled: AIM. To elucidate the dynamics of FSH, LH, prolactin (PRL), TSH and insulin secretion in women with polycystic ovarian syndrome (PCOS) treated with metformin (MET).

Patients And Methods: In a prospective, controlled and randomised trial, 32 women with PCOS and 32 with normal cycle were recruited to receive MET (850 mg b.

Cystic uterine tumors.

Background/aims: The differential diagnosis of cystic uterine tumors includes fibroids showing cystic degeneration, cystic adenomyomas, congenital cysts, and developmental anomalies.

Methods: The incidence, clinical presentation and accuracy in preoperative diagnosis of cystic uterine tumors were studied in a university hospital population over a 6-year period.

Results: 29 cases were included.

Insulin-like growth factor-1 isoform mRNA expression in women with endometriosis: eutopic endometrium versus endometriotic cyst.

Pathogenesis of endometriosis involves growth factors, which are synthesized locally. Insulin-like growth factor-1 (IGF-1) prevents apoptosis and has mitogenic action on endometrial cells. The IGF-1 gene undergoes alternative splicing and results in three isoforms (IGF-1Ea, IGF-1Eb, and IGF-1Ec or MGF).

Laparoscopy in the evaluation of women with unexplained ascites: an invaluable diagnostic tool.

Study Objective: To assess whether laparoscopy is a reliable technique for the investigation of women presenting with ascites and in whom the diagnosis remains obscure.

Design: Prospective nonrandomized clinical study (Canadian Task Force classification II-2).

Setting: University Departments of a tertiary referral center.

Laparoscopic evaluation of infertile patients with chronic pelvic pain.

In this study over a 10-year period, 1584 patients complaining of infertility of more than 1 year duration were evaluated for their laparoscopic findings in relation to the presence or not of chronic pelvic pain (CPP). Infertility was the only complaint in 1215 cases (group 1), whereas 369 patients complained of infertility and CPP (group 2). All cases underwent routine infertility investigation and pelvic ultrasonography, followed by diagnostic laparoscopy, with infertility-only cases acting as a control group.

Endometriosis in patients with chronic pelvic pain: is staging predictive of the efficacy of laparoscopic surgery in pain relief?

Background/aims: Endometriosis is considered an important cause of chronic pelvic pain. Despite its high prevalence, controversy still exists regarding the true association between the extent of endometriosis and the severity of symptoms. We conducted this prospective study to investigate the association between the stage of endometriosis and type and severity of pain, and to evaluate the efficacy of laparoscopic surgery in pain relief.

Effect of human hydrosalpinx fluid on the development of mouse embryos and role of the concentration of growth factors in culture medium with and without hydrosalpinx fluid.

The aim of this study was to investigate the effect of human hydrosalpinx fluid (HF) on the development and blastulation of mouse embryos and the role of the concentration of growth factors in culture medium with and without HF. In total, 2100 mouse embryos were cultured. Female mice were induced to superovulate and then mated with males.

Primary malignant mesothelioma of the peritoneum: a clinical and immunohistochemical study.

Background: Primary peritoneal mesothelioma is regarded as a fatal disease that presents with progressive ascites at a relatively late stage of its natural history. Differential diagnosis between this rare tumor and both serous papillary carcinoma of the peritoneum and ovary can be problematic.

Case: A 54-year-old woman presented to our institution with a 4-month history of dull epigastric pain and increased abdominal girth.

Tubo-ovarian abscesses in postmenopausal women: gynecological malignancy until proven otherwise?

Objective: To investigate the incidence of gynecological malignancy in menopausal women who develop tubo-ovarian abscesses (TOAs), and to address the differences in presentation and underlying pathology between premenopausal and postmenopausal women with TOAs.

Study Design: In a retrospective study we included 93 patients with a diagnosis of a TOA and compared a premenopausal group (group 1) with a postmenopausal group (group 2).

Results: Group 1 included 76 (82%), and group 2 17 (18%) patients.

Laparoscopic management of patients with endometriosis and chronic pelvic pain.

Endometriosis has been traditionally included among the most important causes of chronic pelvic pain (CPP) in women of reproductive age. The main clinical manifestations of endometriosis are dysmenorrhea, dyspareunia, and chronic nonmenstrual pain. Despite the high prevalence of endometriosis in women suffering from CPP, controversy still exists regarding the true association between the stage and extent of this peculiar disease and the severity of pain.

Urokinase-type plasminogen activator and insulin-like growth factor-binding protein 3 mRNA expression in endometriotic lesions and eutopic endometrium: implications for the pathophysiology of endometriosis.

The peritoneal fluid of women with endometriosis contains an increased insulin-like growth factor 1 (IGF-1) bioavailability, which is produced by limited hydrolysis of urokinase-type plasminogen activator (uPA) on IGF-binding protein 3 (IGFBP-3). Recently, IGF-1 was shown to inhibit apoptosis of endometrial-like cells in vitro, suggesting that a microenvironment of increased IGF-1 bioavailability can optimize the survival of endometrial cells grown ectopically. Here the expression of mRNA of IGFBP-3 and uPA in tissue biopsies from eutopic endometrium and endometriotic lesions obtained at laparoscopy from women with endometriosis have been analyzed, and it is documented that both IGFBP-3 and uPA mRNA expression are increased from 3- to 10-fold in endometriotic lesions versus eutopic endometrium.

Alternative approaches in the management of poor response in controlled ovarian hyperstimulation (COH).

Improving pregnancy rates in patients with many failed attempts remains a challenge during IVF-ET or ICSI-ET programs. The availability of good-quality oocytes is a prerequisite for good results in such programs. The use of a personalized protocol for controlled ovarian hyperstimulation (COH) that gives the best possible results for the specific patient is a main factor for the success in IVF or ICSI.

Evidence of differential control of FSH and LH responses to GnRH by ovarian steroids in the luteal phase of the cycle.

Background: It is known that during the follicular phase of the cycle, estradiol sensitizes the pituitary to GnRH. The aim of this study was to determine the role of ovarian steroids in the control of GnRH-induced gonadotrophin secretion in the luteal phase of the cycle.

Methods: Eighteen normally cycling women were studied during the week following bilateral ovariectomy plus hysterectomy performed in early to mid-luteal phase.