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Xiumin Chen - One of the best experts on this subject based on the ideXlab platform.
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transvaginal ultrasound guided ovarian interstitial laser treatment in anovulatory women with Clomifene citrate resistant polycystic ovary syndrome
Fertility and Sterility, 2007Co-Authors: Xuemei Li, Xiumin ChenAbstract:WJ Zhu,a XM Li,a XM Chen,a Z Lin,b L Zhangc a Department of Reproductive Health bDepartment of Gynecology cDepartment of Central Laboratory, ShenZhen Maternity and Child Healthcare Hospital, ShenZhen, China Correspondence: Dr WJ Zhu, Department of Reproductive Health, ShenZhen Maternity and Child Healthcare Hospital, No. 3012# Fuqiang Road, Shenzhen 518048, Guangdong Province, China. Email zhuwenjie542004@yahoo.com.cn
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transvaginal ultrasound guided ovarian interstitial laser treatment in anovulatory women with Clomifene citrate resistant polycystic ovary syndrome
British Journal of Obstetrics and Gynaecology, 2006Co-Authors: Xuemei Li, Xiumin ChenAbstract:Objective To assess the effectiveness of transvaginal, ultrasound-guided, ovarian, interstitial laser coagulation treatment in anovulatory women with polycystic ovary syndrome (PCOS). Design A pilot study. Setting Assisted reproductive technology unit. Sample Twenty-three anovulatory women with Clomifene-citrate-resistant PCOS. Methods Ultrasound-guided, transvaginal, ovarian, interstitial yttrium-aluminium-garnet laser treatment. Main outcome measures Serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone, prolactin and estradiol levels, spontaneous ovulation rate and pregnancy rate were measured over 6 months of follow up. Results Regular ovulation occurred in 19 out of 22 (86.4%) women in the 6 months following ovarian treatment (one woman was lost to follow up). On the postoperative second, fourth and sixth month, the mean serum LH levels were 4.54 SD 1.21 iu/l, 4.90 SD 2.18 iu/l and 4.42 SD 1.03 iu/l, significantly (P < 0.001, P < 0.001, P < 0.001) lower than the preoperative level of 13.89 ± 3.62 iu/l; the mean serum testosterone levels were 2.69 SD 1.83 nmol/l, 2.42 SD 1.11 nmol/l and 2.28 SD 1.96 nmol/l and significantly (P < 0.001, P < 0.001, P < 0.001) lower than the preoperative baseline value of 5.37 SD 3.09 nmol/l; the mean LH/FSH ratios of 0.93 SD 0.26, 0.88 SD 0.17 and 0.81 SD 0.14 were also significantly lower than the preoperative value of 2.78 SD 1.21 (P < 0.001). Pregnancy occurred in eight women and there was a cumulative pregnancy rate at 6 months of 36% (8/22) among the subjects. There were no significant operative complications. Conclusion Ultrasound-guided, transvaginal, ovarian, interstitial laser treatment appears effective in improving hormonal profiles and inducing ovulation and successful pregnancy in women with Clomifene-resistant PCOS.
Xuemei Li - One of the best experts on this subject based on the ideXlab platform.
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transvaginal ultrasound guided ovarian interstitial laser treatment in anovulatory women with Clomifene citrate resistant polycystic ovary syndrome
Fertility and Sterility, 2007Co-Authors: Xuemei Li, Xiumin ChenAbstract:WJ Zhu,a XM Li,a XM Chen,a Z Lin,b L Zhangc a Department of Reproductive Health bDepartment of Gynecology cDepartment of Central Laboratory, ShenZhen Maternity and Child Healthcare Hospital, ShenZhen, China Correspondence: Dr WJ Zhu, Department of Reproductive Health, ShenZhen Maternity and Child Healthcare Hospital, No. 3012# Fuqiang Road, Shenzhen 518048, Guangdong Province, China. Email zhuwenjie542004@yahoo.com.cn
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transvaginal ultrasound guided ovarian interstitial laser treatment in anovulatory women with Clomifene citrate resistant polycystic ovary syndrome
British Journal of Obstetrics and Gynaecology, 2006Co-Authors: Xuemei Li, Xiumin ChenAbstract:Objective To assess the effectiveness of transvaginal, ultrasound-guided, ovarian, interstitial laser coagulation treatment in anovulatory women with polycystic ovary syndrome (PCOS). Design A pilot study. Setting Assisted reproductive technology unit. Sample Twenty-three anovulatory women with Clomifene-citrate-resistant PCOS. Methods Ultrasound-guided, transvaginal, ovarian, interstitial yttrium-aluminium-garnet laser treatment. Main outcome measures Serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone, prolactin and estradiol levels, spontaneous ovulation rate and pregnancy rate were measured over 6 months of follow up. Results Regular ovulation occurred in 19 out of 22 (86.4%) women in the 6 months following ovarian treatment (one woman was lost to follow up). On the postoperative second, fourth and sixth month, the mean serum LH levels were 4.54 SD 1.21 iu/l, 4.90 SD 2.18 iu/l and 4.42 SD 1.03 iu/l, significantly (P < 0.001, P < 0.001, P < 0.001) lower than the preoperative level of 13.89 ± 3.62 iu/l; the mean serum testosterone levels were 2.69 SD 1.83 nmol/l, 2.42 SD 1.11 nmol/l and 2.28 SD 1.96 nmol/l and significantly (P < 0.001, P < 0.001, P < 0.001) lower than the preoperative baseline value of 5.37 SD 3.09 nmol/l; the mean LH/FSH ratios of 0.93 SD 0.26, 0.88 SD 0.17 and 0.81 SD 0.14 were also significantly lower than the preoperative value of 2.78 SD 1.21 (P < 0.001). Pregnancy occurred in eight women and there was a cumulative pregnancy rate at 6 months of 36% (8/22) among the subjects. There were no significant operative complications. Conclusion Ultrasound-guided, transvaginal, ovarian, interstitial laser treatment appears effective in improving hormonal profiles and inducing ovulation and successful pregnancy in women with Clomifene-resistant PCOS.
Janake Gustafsson - One of the best experts on this subject based on the ideXlab platform.
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comparison of the ligand binding specificity and transcript tissue distribution of estrogen receptors alpha and beta
Endocrinology, 1997Co-Authors: George G J M Kuiper, Bo Carlsson, Kaj Grandien, Eva Enmark, Johan Haggblad, Stefan K Nilsson, Janake GustafssonAbstract:The rat estrogen receptor (ER) exists as two subtypes, ER alpha and ER beta, which differ in the C-terminal ligand binding domain and in the N-terminal transactivation domain. In this study we investigated the messenger RNA expression of both ER subtypes in rat tissues by RT-PCR and compared the ligand binding specificity of the ER subtypes. Saturation ligand binding analysis of in vitro synthesized human ER alpha and rat ER beta protein revealed a single binding component for 16 alpha-iodo-17 beta-estradiol with high affinity [dissociation constant (Kd) = 0.1 nM for ER alpha protein and 0.4 nM for ER beta protein]. Most estrogenic substances or estrogenic antagonists compete with 16 alpha-[125I]iodo-17 beta-estradiol for binding to both ER subtypes in a very similar preference and degree; that is, diethylstilbestrol > hexestrol > dienestrol > 4-OH-tamoxifen > 17 beta-estradiol > coumestrol, ICI-164384 > estrone, 17 alpha-estradiol > nafoxidine, moxestrol > Clomifene > estriol, 4-OH-estradiol > tamoxifen, 2-OH-estradiol, 5-androstene-3 beta, 17 beta-diol, genistein for the ER alpha protein and dienestrol > 4-OH-tamoxifen > diethylstilbestrol > hexestrol > coumestrol, ICI-164384 > 17 beta-estradiol > estrone, genistein > estriol > nafoxidine, 5-androstene-3 beta, 17 beta-diol > 17 alpha-estradiol, Clomifene, 2-OH-estradiol > 4-OH-estradiol, tamoxifen, moxestrol for the ER beta protein. The rat tissue distribution and/or the relative level of ER alpha and ER beta expression seems to be quite different, i.e. moderate to high expression in uterus, testis, pituitary, ovary, kidney, epididymis, and adrenal for ER alpha and prostate, ovary, lung, bladder, brain, uterus, and testis for ER beta. The described differences between the ER subtypes in relative ligand binding affinity and tissue distribution could contribute to the selective action of ER agonists and antagonists in different tissues.
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comparison of the ligand binding specificity and transcript tissue distribution of estrogen receptors alpha and beta
Endocrinology, 1997Co-Authors: George G J M Kuiper, Bo Carlsson, Kaj Grandien, Eva Enmark, Johan Haggblad, Stefan K Nilsson, Janake GustafssonAbstract:The rat estrogen receptor (ER) exists as two subtypes, ERα and ERβ, which differ in the C-terminal ligand binding domain and in the N-terminal transactivation domain. In this study we investigated the messenger RNA expression of both ER subtypes in rat tissues by RT-PCR and compared the ligand binding specificity of the ER subtypes. Saturation ligand binding analysis of in vitro synthesized human ERα and rat ERβ protein revealed a single binding component for 16α-iodo-17β-estradiol with high affinity[ dissociation constant (Kd) = 0.1 nm for ERα protein and 0.4 nm for ERβ protein]. Most estrogenic substances or estrogenic antagonists compete with 16α-[125I]iodo-17β-estradiol for binding to both ER subtypes in a very similar preference and degree; that is, diethylstilbestrol > hexestrol > dienestrol > 4-OH-tamoxifen > 17β-estradiol > coumestrol, ICI-164384 > estrone, 17α-estradiol > nafoxidine, moxestrol > Clomifene > estriol, 4-OH-estradiol > tamoxifen, 2-OH-estradiol, 5-androstene-3β,17β-diol, genistein f...
Fulco Van Der Veen - One of the best experts on this subject based on the ideXlab platform.
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health related quality of life in women with newly diagnosed polycystic ovary syndrome randomized between Clomifene citrate plus metformin or Clomifene citrate plus placebo
Human Reproduction, 2012Co-Authors: Etelka Moll, Patrick M.m. Bossuyt, Madelon Van Wely, Cornelis B. Lambalk, Fulco Van Der VeenAbstract:STUDY QUESTION: What is the health-related quality of life (HRQoL) in women with polycystic ovary syndrome (PCOS) undergoing ovulation induction with Clomifene citrate (CC) combined with metformin compared with those using CC combined with placebo? SUMMARY ANSWER: Overall quality of life in women with PCOS treated with CC plus metformin was significantly lower than in women treated with CC plus placebo. WHAT IS KNOWN ALREADY: There are no data on HRQoL in adult women who receive ovulation induction with the purpose of conceiving. Women with PCOS have higher scores on depression and anxiety scales and lower QoL scores than women without PCOS. STUDY DESIGN, SIZE AND DURATION: This study was a secondary analysis of a multi-centre RCT completed between June 2001 and May 2004. The randomization was stratified per centre, and the centres received blinded, numbered containers with medication. There were172 women available for the HRQoL assessment: 85 were allocated to metformin and 87 were allocated to placebo. PARTICIPANTS, SETTING AND METHODS: The Rotterdam Symptom Checklist (RSCL), a standard self-administered questionnaire, was used to assess physical symptoms, psychological distress, activity levels and overall HRQoL. MAIN RESULTS AND THE ROLE OF CHANCE: In the intention to treat analysis, we found differences between the treatment groups with respect to physical symptoms and overall HRQoL. Physical well-being was significantly impaired in women allocated to metformin but not in women allocated to placebo. The increase in physical symptoms in the metformin group was caused by side-effects typical of metformin, and was most pronounced at Week 1 (mean difference 12 [95% confidence interval (CI): 8-16] and still apparent at Week 16 [mean difference 7 (95% CI 2-12]. Overall well-being was significantly impaired in the metformin group compared with the placebo group [mean difference 13 (95% CI 6-20)]. LIMITATIONS AND REASONS FOR CAUTION: RSCL measurements were available only for three quarters of the participants. Although the number of missing questionnaires and the baseline measurements, were comparable between the treatment groups, some form of selection bias cannot be ruled out. WIDER IMPLICATIONS OF THE FINDINGS: Our finding that metformin was more burdensome than placebo, strengthens the recommendation that CC only and not CC plus metformin should be the drug of choice in this patient population. STUDY FUNDING/COMPETING INTEREST(S): None of the authors declared a conflict of interest. There was no study funding. TRIAL REGISTRATION NUMBER: ISRCTN55906981.
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does adding metformin to Clomifene citrate lead to higher pregnancy rates in a subset of women with polycystic ovary syndrome
Human Reproduction, 2008Co-Authors: Etelka Moll, Johanna C Korevaar, Patrick M.m. Bossuyt, Fulco Van Der VeenAbstract:BACKGROUND: An RCT among newly diagnosed, therapy naive women with polycystic ovary syndrome (PCOS) showed no significant differences in ovulation rate, ongoing pregnancy rate or spontaneous abortion rate in favour of Clomifene citrate plus metformin compared with Clomifene citrate. We wanted to assess whether there are specific subgroups of women with PCOS in whom Clomifene citrate plus metformin leads to higher pregnancy rates. METHODS: Subgroup analysis based on clinical and biochemical parameters of 111 women randomized to Clomifene citrate plus metformin compared with 114 women randomized to Clomifene citrate plus placebo. The data for age, BMI, waist-hip ratio (WHR) and plasma testosterone were available in all women, 2 h glucose in 80% of women and homeostatic model assessment for assessing insulin sensitivity (HOMA) in 50% of women. RESULTS: Of the women who were allocated to the metformin group, 44 women (40%) reached an ongoing pregnancy. In the placebo group, 52 women (46%) reached an ongoing pregnancy. There was a significantly different chance of an ongoing pregnancy for metformin versus placebo between subgroups based on age and WHR (P = 0.014). There was a positive effect of metformin versus placebo on pregnancy rate in older women (>or=28 years) with a high WHR, a negative effect of metformin versus placebo in young women ( <28 years) regardless of their WHR and no effect in older, not viscerally obese women. No significant differences in effect of treatment were found for groups based on BMI, 2 h glucose, HOMA or plasma testosterone. CONCLUSIONS: Metformin may be an effective addition to Clomifene citrate in infertile women with PCOS, especially in older and viscerally obese patients
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effect of Clomifene citrate plus metformin and Clomifene citrate plus placebo on induction of ovulation in women with newly diagnosed polycystic ovary syndrome randomised double blind clinical trial
BMJ, 2006Co-Authors: Etelka Moll, Johanna C Korevaar, Patrick M.m. Bossuyt, Cornelis B. Lambalk, Fulco Van Der VeenAbstract:Objective To compare the effectiveness of Clomifene citrate plus metformin and Clomifene citrate plus placebo in women with newly diagnosed polycystic ovary syndrome. Design Randomised clinical trial. Setting Multicentre trial in 20 Dutch hospitals. Participants 228 women with polycystic ovary syndrome. Interventions Clomifene citrate plus metformin or Clomifene citrate plus placebo. Main outcome measure The primary outcome measure was ovulation. Secondary outcome measures were ongoing pregnancy, spontaneous abortion, and Clomifene resistance. Results 111 women were allocated to Clomifene citrate plus metformin (metformin group) and 114 women were allocated to Clomifene citrate plus placebo (placebo group). The ovulation rate in the metformin group was 64% compared with 72% in the placebo group, a non-significant difference (risk difference - 8%, 95% confidence interval - 20% to 4%). There were no significant differences in either rate of ongoing pregnancy (40% v 46%; - 6%, - 20% to 7%) or rate of spontaneous abortion (12% v 11%; 1%, - 7% to 10%). A significantly larger proportion of women in the metformin group discontinued treatment because of side effects (16% v 5%; 11%, 5% to 16%). Conclusion Metformin is not an effective addition to Clomifene citrate as the primary method of inducing ovulation in women with polycystic ovary syndrome. Trial registration Current Controlled Trials ISRCTN55906981 [controlled-trials.com].
George G J M Kuiper - One of the best experts on this subject based on the ideXlab platform.
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comparison of the ligand binding specificity and transcript tissue distribution of estrogen receptors alpha and beta
Endocrinology, 1997Co-Authors: George G J M Kuiper, Bo Carlsson, Kaj Grandien, Eva Enmark, Johan Haggblad, Stefan K Nilsson, Janake GustafssonAbstract:The rat estrogen receptor (ER) exists as two subtypes, ER alpha and ER beta, which differ in the C-terminal ligand binding domain and in the N-terminal transactivation domain. In this study we investigated the messenger RNA expression of both ER subtypes in rat tissues by RT-PCR and compared the ligand binding specificity of the ER subtypes. Saturation ligand binding analysis of in vitro synthesized human ER alpha and rat ER beta protein revealed a single binding component for 16 alpha-iodo-17 beta-estradiol with high affinity [dissociation constant (Kd) = 0.1 nM for ER alpha protein and 0.4 nM for ER beta protein]. Most estrogenic substances or estrogenic antagonists compete with 16 alpha-[125I]iodo-17 beta-estradiol for binding to both ER subtypes in a very similar preference and degree; that is, diethylstilbestrol > hexestrol > dienestrol > 4-OH-tamoxifen > 17 beta-estradiol > coumestrol, ICI-164384 > estrone, 17 alpha-estradiol > nafoxidine, moxestrol > Clomifene > estriol, 4-OH-estradiol > tamoxifen, 2-OH-estradiol, 5-androstene-3 beta, 17 beta-diol, genistein for the ER alpha protein and dienestrol > 4-OH-tamoxifen > diethylstilbestrol > hexestrol > coumestrol, ICI-164384 > 17 beta-estradiol > estrone, genistein > estriol > nafoxidine, 5-androstene-3 beta, 17 beta-diol > 17 alpha-estradiol, Clomifene, 2-OH-estradiol > 4-OH-estradiol, tamoxifen, moxestrol for the ER beta protein. The rat tissue distribution and/or the relative level of ER alpha and ER beta expression seems to be quite different, i.e. moderate to high expression in uterus, testis, pituitary, ovary, kidney, epididymis, and adrenal for ER alpha and prostate, ovary, lung, bladder, brain, uterus, and testis for ER beta. The described differences between the ER subtypes in relative ligand binding affinity and tissue distribution could contribute to the selective action of ER agonists and antagonists in different tissues.
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comparison of the ligand binding specificity and transcript tissue distribution of estrogen receptors alpha and beta
Endocrinology, 1997Co-Authors: George G J M Kuiper, Bo Carlsson, Kaj Grandien, Eva Enmark, Johan Haggblad, Stefan K Nilsson, Janake GustafssonAbstract:The rat estrogen receptor (ER) exists as two subtypes, ERα and ERβ, which differ in the C-terminal ligand binding domain and in the N-terminal transactivation domain. In this study we investigated the messenger RNA expression of both ER subtypes in rat tissues by RT-PCR and compared the ligand binding specificity of the ER subtypes. Saturation ligand binding analysis of in vitro synthesized human ERα and rat ERβ protein revealed a single binding component for 16α-iodo-17β-estradiol with high affinity[ dissociation constant (Kd) = 0.1 nm for ERα protein and 0.4 nm for ERβ protein]. Most estrogenic substances or estrogenic antagonists compete with 16α-[125I]iodo-17β-estradiol for binding to both ER subtypes in a very similar preference and degree; that is, diethylstilbestrol > hexestrol > dienestrol > 4-OH-tamoxifen > 17β-estradiol > coumestrol, ICI-164384 > estrone, 17α-estradiol > nafoxidine, moxestrol > Clomifene > estriol, 4-OH-estradiol > tamoxifen, 2-OH-estradiol, 5-androstene-3β,17β-diol, genistein f...