1/6. Spontaneous disappearance of a normal adnexa associated with a contralateral polycystic-appearing ovary.BACKGROUND: Absence of the adnexa may be congenital or acquired. However, the etiology is often uncertain. CASE: A 27-year-old woman presented with a 3-year history of subfertility. Her irregular menstruation was associated with acne vulgaris, alopecia, and elevated body mass index. Transvaginal ultrasonography of the pelvis showed a normal uterus, a normal right ovary, but a polycystic-appearing left ovary. A hysterosalpingogram demonstrated a normal uterine cavity, prompt filling and spilling of contrast material from the left fallopian tube, but no filling on the right. Subsequent laparoscopy showed an unexpected absence of right adnexa and presence of a solitary rounded free-floating mass enshrouded in the omentum. She did not have a history of abdominal pain or surgery. CONCLUSION: The evidence suggests that the patient might have had an asymptomatic infarction of the right adnexa.- - - - - - - - - - ranking = 1keywords = menstruation (Clic here for more details about this article) |
2/6. Cyclic estrogen-progestin hormone therapy as a new therapeutic approach in the treatment of functional alterations of the hypothalamus-pituitary-ovary axis: case reports.amenorrhea is a clinical condition characterized by failure of menarche or by the absence of menstruation for six months in a woman with previous periodic menses. We report a first case of a 30 year-old woman affected by polycystic ovarian disease (PCOD) whose amenorrhea ceased after a 6-month combination treatment with cyclic estradiol-norethisterone acetate. After the withdrawal of the hormone therapy, a stable recovery of periodic menses was observed. We describe a second case of a 23 year-old woman whose amenorrhea was caused by a hypogonadotropic hypogonadism due to a non-functioning pituitary adenoma. After the administration of the previously described therapy both a disappearance of the adenoma and a recover of periodic menses were observed. We hypothesized that the outcomes in our cases could be the consequence of a balancing action induced by the exogenous hormone administration. The exogenous hormones may have reset the feedback between the hypothalamus and pituitary gland through mimicking the physiological hormones pattern of the 28-day cycle.- - - - - - - - - - ranking = 1keywords = menstruation (Clic here for more details about this article) |
3/6. Successful monozygotic twin delivery following in vitro maturation of oocytes retrieved from a woman with polycystic ovary syndrome: case report.The incidence of monozygotic twinning (MZT) appears to be increasing within the field of assisted reproductive technology (art), although the factors contributing to the phenomenon are still far from being identified. On the contrary, in vitro maturation (IVM) of oocytes is becoming more accepted and more and more babies have been born worldwide using this procedure. Assessing its safety and impact on monozygotic twinning (MZT), and following up the health of these babies, is essential. We report here a first case of successful monozygotic (MZ) twin delivery following IVM. The patient was a 28-year-old Japanese female, referred to the IVF clinic for primary infertility. Several previous cycles of ovarian stimulation had resulted in ovarian hyperstimulation syndrome (OHSS). The patient received norethisterone-mestranol to initiate the menstruation, and oocyte retrieval was performed 36 h after hCG. A total of 22 immature oocytes were obtained. Following incubation for 24 h in IVM medium, 50% of the oocytes were matured to the metaphase II (MII) stage. Nine oocytes were fertilized after ICSI with the husband's sperm. Three day 3 embryos were transferred into the uterus on the fourth day following oocyte retrieval. Three weeks after embryo transfer, a single gestational sac was visualized in the uterus. At 7 weeks of gestation, two fetal poles with cardiac activity were seen in the single gestational sac. Serial ultrasound examinations revealed a MZ, monochorionic diamniotic pregnancy. After intensive perinatal monitoring, two healthy male infants were delivered by Caesarean section at 35 weeks of gestation.- - - - - - - - - - ranking = 1keywords = menstruation (Clic here for more details about this article) |
4/6. A syndrome of hyperandrogenism, insulin resistance, and acanthosis nigricans associated with polycystic ovary syndrome: clinical and laboratory features.We describe an adolescent Japanese girl with acanthosis nigricans and irregular anovulatory menstruation following menarche. serum LH levels were elevated, whereas serum FSH levels were within normal range. An exaggerated response to LHRH was observed. Further, serum androstenedione levels were markedly elevated. Ultrasonogram revealed bilateral polycystic changes of ovaries. She had a mild degree of insulin resistance. Insulin binding studies using erythrocytes demonstrated a decreased binding capacity of insulin. From the above findings, this patient presents the syndrome consisting of hyperandrogenism, insulin resistance, and acanthosis nigricans and also has clinical and biochemical features compatible with polycystic ovary syndrome.- - - - - - - - - - ranking = 1keywords = menstruation (Clic here for more details about this article) |
5/6. Hormonal effects of wedge resection of polycystic ovaries.plasma FSH, LH, estradiol, testosterone, and progesterone were measured serially before, during, and after bilateral ovarian wedge resection in 2 patients with polycystic ovaries. Preoperatively both were anovulatory with persistently elevated plasma LH values and 1 patient had high testosterone concentrations. plasma FSH, estradiol, and progesterone were within the normal midfollicular phase range. The LH:FSH ratio was increased and no cyclic gonadotropic activity occurred. During surgery progesterone levels rose while estradiol concentrations fell. In both patients, the initial reduction in estradiol secretion was observed after unilateral wedge resection but testosterone concentrations only declined 6-24 hours postoperatively. During the first postoperative week the LH:FSH ratio fell significantly and cyclic gonadotropic activity, in the form of sporadic LH and FSH spurts, was noted. In the second week after surgery, and estradiol surge occurred followed by preovulatory LH and FSH peaks, ovulation, and a normal luteal phase. Spontaneous menstruation occurred by the end of the first postoperative month and both patients conceived within 4 months of surgery.- - - - - - - - - - ranking = 1keywords = menstruation (Clic here for more details about this article) |
6/6. amenorrhea with cryptic hyperandrogenemia.It is current practice to assume that when menstrual disturbances are associated with androgen excess there will be additional clinical evidence of this. We have recently seen three women with secondary amenorrhea who did not have any other clinical features of androgen excess, i.e. hirsutism, acne, etc., but who had elevated plasma testosterone and androstenedione levels in addition to increased estrone values. Correction of hypertestosteronemia and elevated estrone levels was followed by ovulation, regular menstruation, and pregnancy. Variable tissue sensitivity to androgens probably accounts for these observations. If measurement of androgen levels is omitted in the evaluation of patients with amenorrhea without hirsutism, cryptic hyperandrogenemia will remain undetected. plasma testosterone levels should be measured in all patients with amenorrhea of unknown etiology, and only if these are normal should a diagnosis of functional amenorrhea be assigned.- - - - - - - - - - ranking = 1keywords = menstruation (Clic here for more details about this article) |