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A genetic variation in the androgen receptor (AR) has been associated with the risk of developing endometriosis. The AR gene is located on the X chromosome and contains a highly polymorphic trinucleotide repeat (cytosine, adenine, and guanine: CAG) in its first exon, whose length and methylation pattern affect both AR expression and function. Thus, we sought to further investigate the potential association between endometriosis and the AR-CAG polymorphism.Genomic DNA was obtained from a consecutive series of 197 white Italian women of reproductive age who underwent laparoscopy for benign gynecologic pathologies. Molecular analysis of AR-CAG repeats was performed by polymerase chain reaction amplification and Genescan evaluation. The pattern of CAG repeat distribution was compared between subjects with and without endometriosis.Endometriosis was documented in 105 women (stage I-II in 33 women and stage III-IV in 72 women). We found no difference in the number of AR-CAG repeats between women with endometriosis and controls. The CAG repeat length ranged from eight to 27 (mean +/- standard deviation, 17.4 +/- 1.9) for endometriosis patients and from 11 to 27 (mean +/- standard deviation, 17.4 +/- 2) for controls. Moreover, no association was found between AR gene polymorphisms and the various clinical manifestations of the disease.We conclude that AR-CAG repeat length does not constitute an important factor for the genetic predisposition to endometriosis.

Objective : Given the great variability of human chorionic gonadotropin (HCG) levels after a single dose of methotrexate (MTX) for ectopic pregnancy, it remains complicated to identify cases undergoing persistence until a week from treatment. We evaluated whether pre-treatment patterns of HCG levels could be useful for an earlier detection of persistent trophoblast. Study design : A retrospective study on 62 patients treated by a systemic single dose of methotrexate (50 mg/m 2 ) for an ectopic pregnancy. Samples for HCG detection were obtained on days −2 and 0 before the therapy, on days +3, +7 and then weekly until values were undetectable. Patients were divided into three groups: Group U (up, meaning “increasing”) and Group D (down, meaning “decreasing”) when HCG levels on day 0 were respectively higher or lower than day −2 level of more than 20% and Group P (plateau) when the difference between day −2 HCG level and the level on day 0 was less than 20%. Results : All the patients of Group D underwent a complete resolution, with a percentage of 33.3% of cases who underwent an initial rise of HCG levels on day +3. The percentage of cases undergoing an initial rise of HCG levels in Group U patients was significantly higher than in Group P patients (60.0% versus 28.6%), but the resolution rate resulted similar in the two groups. For patients of Group P , an increase of HCG levels on day +3 was significantly correlated to the failure of the therapy. Indeed, comparing the cases with an immediate increase of HCG levels to the cases with immediate decrease of HCG levels on day +3, the persistence rate was 80% for the former and 12% for the latter ( P Conclusion : An initial rise of HCG levels after the therapy does not seem to have a clinical relevance in Group D and Group U patients, it well correlates to trophoblastic persistence in Group P patients.

Endometriosis is an estrogen-dependent disorder mostly occurring in reproductive-age women. Various therapies have been used in an attempt to treat endometriosis, including ovarian suppression therapy, surgical treatment or a combination of these strategies. However, in general, substantial surgery remains the primary treatment option for endometriosis at all stages. Recently, aromatase inhibitors and anti-estrogens have been proposed as novel potential candidates. The rationale for the use of aromatase inhibitors is mostly related to the high aromatase expression in endometriotic cysts and extra-ovarian endometriotic implants. Among anti-estrogens, raloxifene has been investigated in animal models with good results, but in premenopausal women, the compound does not seem to suppress estrogen production.