Males with low serum levels of vitamin D have lower pregnancy rates when ovulation induction and timed intercourse are used as a treatment for infertile couples: results from a pilot study

Background: Vitamin D (Vit D) is important for the regulation of reproductive physiology. In humans, maternal Vit D deficiency has been implicated in several reproductive- and pregnancy-related disorders. Very few data are available regarding the Vit D status in male partners of couples attempting pregnancy. This observational study (IRB Prot. N. 078/13) aimed to evaluate whether low Vit D serum levels in males might decrease the rate of successful conception in couples attempting pregnancy. Methods: Male and female partners of infertile couples (n = 102) were classified into 2 GROUPS according to normal (≥30 ng/ml) or low (below 30 ng/ml) serum Vit D levels in male partners. Semen analysis was performed in each male participant based on the WHO reference criteria. The female partners of both groups were subjected to 3 consecutive cycles of gonadotropin-induced mono-ovulation. The main outcome measures included the clinical pregnancy rate, delivery per patient and per cycle, and miscarriage rate between the 2 groups evaluated at the end of the three-month period of the study. Results: In male partners of both groups, standard semen analysis did not highlight substantial differences in sperm concentration, sperm progressive motility, or typical form. The pregnancy rates per patient and per cycle and delivery rates per patient and per cycle were all significantly higher (p< 0.05) in couples with normal Vit D levels. Conclusions: These results suggest the existence of a relationship between male Vit D serum levels and semen ability to begin a pregnancy during cycles of timed vaginal intercourse. © 2015 Tartagni et al

A rare case of pure uterine giant lipoma.

We encountered a rare case of uterine pure giant lipoma. Pure lipoma of the uterus is a very rare entity with an estimated occurrence of 0.03e0.12% [1,2]. To date, the histogenesis of lipomatous tumors has not been determined. A 73-year-old woman complained a sensation of pelvic heaviness and severe urge incontinence. Ultrasound showed an enlarged uterus, 16 weeks' size, with a round hyperechogenic lesion of 15 cm 14 cm, compressing the bladder and a bladder compression. Endometrial thickness was dislocated by the voluminous lesion. Magnetic resonance imaging (Figure 1A) showed the presence of two lesions with low-intensity signals (4 cm 3.2 cm; 2 cm 2.8 cm) and another one with a high-intensity signal on T1-weighted images (15 cm 12 cm). A hysteroscopic specimen showed atrophic endometrium. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. Hysterectomy revealed an enlarged uterus (19 cm 11 cm 13 cm) due to the presence of three globular masses, which appeared as well-circumscribed intramural tumors. The lipoma was the largest of these globular masses, soft in consistency and homogeneously yellow (Figure 1B). No smooth muscle cells or fibrous elements were present intratumorally (Figure 1C, D); therefore, it was diagnosed as a pure lipoma [1]

Predictive value of ovarian stroma measurement for cardiovascular risk in polycyctic ovary syndrome: a case control study

<p>Abstract</p> <p>Background</p> <p>To verify the feasibility of ovarian stromal evaluation and correlate ovarian parameteres (echogenicity and volume) with hyperandrogenism, and both cardiovascular and metabolic risk factors in PCOS.</p> <p>Methods</p> <p>Twenty four young PCOS patients and twelve age-matched control women were enrolled. Diagnosis of PCOS was based on the Rotterdam criteria. Ultrasound ovarian study included ovarian volume, stromal volume, stromal area and stromal area/total ovarian area ratio (S/A). Concerning hormones, insulin, LH, FSH, estradiol, androstenedione, testosterone, DHEAS, 17-hydroxy-progesterone, and SHBG were measured during the early follicular phase (days 2-5). Cardiovascular risk factors were represented by fasting plasma levels of glucose, lipids (total and HDL-cholesterol), plasminogen activator inhibitor 1 (PAI-1), von-Willebrand factor (vWF), and adiponectin. Carotid intima-media thickness (C-IMT) was measured as a parameter of cardiovascular risk.</p> <p>Results</p> <p>A positive correlation between the S/A ratio and plasma levels of testosterone (p < 0.05) and androstenedione (p < 0.05) was found. The stromal volume, stromal area and S/A ratio were also significantly and positively correlated with PAI-1, and vWF levels, and with IMT in PCOS women (P < 0.05).</p> <p>Conclusions</p> <p>This study shows that the ultrasound measurement of ovarian stroma is a predicting factor of hyperandrogenism degree, prothrombotic factors and cardiovascular risk in patients with PCOS.</p

Intermittent low-dose finasteride administration is effective for treatment of hirsutism in adolescent girls: a pilot study.

STUDY OBJECTIVE: Hirsutism has negative impact on adolescent psychosocial development for both cosmetic and endocrine reasons. This study evaluated the effectiveness of a new intermittent, low-dose finasteride regimen consisting of 2.5 mg of drug given every 3 days (1 day of treatment, 2 days of drug withdrawal) for 6 months in girls with hirsutism by polycystic ovarian syndrome (PCOS) or idiopathic hirsutism (IH). DESIGN AND PARTICIPANTS: Twenty-eight girls (15-19 y old) with hirsutism were randomly assigned to 2 treatment groups and treated for 6 months. Fourteen patients (7 with IH, 7 with PCOS) received finasteride; fourteen patients (7 with IH, 7 with PCOS) received placebo. Hirsutism score (HS), clinical, and hormonal effects were compared between the 2 groups. RESULTS: In patients treated with finasteride, the HS value at 6 months was 52.9% lower than that observed at baseline in girls with IH, and 52.8% lower in girls with PCOS (P < .0001 for both). Similarly, the 3α-17 β-androstenediol glucuronide serum levels were decreased by 34.8% in patients with IH, and by 47.5% in patients with PCOS (P < .0001, respectively). Finasteride treatment was well tolerated and did not alter values of BMI, serum levels of sexual hormones, metabolic parameters related to liver and kidney function as well as glycemic and lipidic asset. CONCLUSIONS: A low-dose of finasteride, given every 3 days, reduces the HS in young patients affected by PCOS or IH. Compared with conventional continuous finasteride administration, the intermittent low-dose regimen has similar efficacy with the advantage to be safer and less expensiv

Vitamin D Supplementation on Premenstrual Syndrome-Related Mood Disorders in Adolescents with Severe Hypovitaminosis D

STUDY OBJECTIVE: Premenstrual syndrome (PMS) may become severe enough to interfere with normal interpersonal relationships. This study was planned to assess whether administration of vitamin D (200.000 I.U. at first, followed by 25.000 I.U. every 2 weeks) for a 4 months period might be able to lessen the appearance and the intensity of mood disorders associated with PMS in young girls with severe hypovitaminosis D. DESIGN and Participants - One hundred-fifty eight young girls (15-21 years old) with PMS-related severe symptoms of the emotional and cognitive domains and low serum 25-hydroxycholecalciferol (25-OH-D) levels (≤ 10 ng/mL) were randomly assigned to two treatment groups and treated for 4 months with vitamin D (GROUP 1; n = 80) or placebo (GROUP 2; n = 78). Clinical and hormonal effects were compared between the two groups. RESULTS: In patients from GROUP 1 - Vitamin D, levels of vitamin D reached the normal range (35-60 ng/ml) after the first month and remained stable throughout the whole study. At the end of treatment anxiety score decreased from 51 to 20 (P < 0.001 vs. baseline); irritability score declined from 130 to 70 (P < 0.001 vs. baseline). Crying easily and sadness decreased by a score of 41 and 51 to a score of 30 and 31, respectively (P < 0.001). For disturbed relationships, the score decreased from 150 to 70 (P < 0.001). Conversely, no appreciable changes were noted in symptom intensity from patients of GROUP 2 - Placebo. The frequency of adverse events (nausea and constipation) was not different between participants of GROUP 1 and GROUP 2. CONCLUSIONS: Based on present findings, vitamin D therapy can be proposed as a safe, effective and convenient method for improving the quality of life in young women with severe hypovitaminosis D and concomitant mood disorders associated to PMS