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Start Over Author "Cucinelli, F." Journal human reproduction
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2. Predicting the total number of retrieved oocytes following double ovarian stimulation (DuoStim).

Author

Marca, A La, Donno, V, Longo, M, Greco, P, Cucinelli, F, Varricchio, M T, Listorti, I, and Greco, E

Subjects
INDUCED ovulation, OVUM, OVARIAN reserve, MENSTRUAL cycle, HUMAN in vitro fertilization, FROZEN human embryos, BLASTOCYST
Abstract

STUDY QUESTION Can anti-Müllerian hormone (AMH) help predict how many oocytes will be retrieved following double stimulation (DuoStim)? SUMMARY ANSWER A simple clinical tool can use serum AMH values to predict ovarian response following DuoStim in IVF cycles. WHAT IS ALREADY KNOWN The knowledge that multiple follicular waves arise during a single ovarian cycle has led to the introduction of unconventional ovarian stimulation protocols. The DuoStim protocol involves two successive ovarian stimulations performed during a single ovarian cycle and has been proposed as an approach for patients with poor ovarian response and for medical fertility preservation. As AMH has been used as a marker of ovarian reserve and stimulation response, the current study aimed to investigate the diagnostic performance of AMH in predicting the number of retrieved oocytes following DuoStim. STUDY DESIGN, SIZE, DURATION This is a retrospective observational study involving 116 patients who received IVF treatment from January 2021 to September 2022. PARTICIPANTS/MATERIALS, SETTING, METHODS The study was conducted at a private IVF centre. Only patients who had their AMH measured prior to treatment and had complete patient records regarding their clinical and IVF/ICSI cycle characteristics were included. The primary outcome was the correlation between AMH values and the number of oocytes retrieved following DuoStim. Parametric and non-parametric tests were used to compare baseline characteristics and outcomes. Spearman's R was used to analyse correlations between variables, while the C statistic was used to calculate the diagnostic performance of AMH. MAIN RESULTS AND THE ROLE OF CHANCE AMH levels were significantly correlated with the total number of oocytes retrieved after the DuoStim (R 0.61; CI 0.44–0.70; P  < 0.0001). The difference in the total number of oocytes retrieved between the first (median 4 oocytes, interquartile range (IQR) 2–6) and second (median 6 oocytes, IQR 3.2–8) stimulation was statistically significant (P  < 0.0001). However, there was no significant difference in the number of mature oocytes that were retrieved (median of 3 and 4 in the first and second stimulations, respectively). After the first stimulation, 68% of patients had at least one blastocyst available, while after the second stimulation, 74% did (NS). Based on linear regression, each 0.25 ng/ml increase in basal AMH corresponds to one additional oocyte recovered at the end of both stimulations (R 2: 0.32, P  < 0.0001). LIMITATIONS, REASONS FOR CAUTION The results are limited owing to the observational nature of the study and the number of participants. WIDER IMPLICATIONS OF THE FINDINGS Counselling infertile couples regarding the intermediate outcome of IVF (i.e. number of retrieved oocytes) is one of the most demanding tasks that clinicians face. To our knowledge, this is the first study that provides an easy-to-use clinical tool that enables the quantitative prediction of ovarian response following DuoStim, based on serum AMH values. STUDY FUNDING/COMPETING INTEREST(S) No external funding was obtained for this study. The authors declare no conflicts of interest. TRIAL REGISTRATION NUMBER N/A. [ABSTRACT FROM AUTHOR]

Published
2023
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4. POSTER VIEWING SESSION - EMBRYOLOGY

Author

Fourati Ben Mustapha, S., primary, Khrouf, M., additional, Kacem Ben Rejeb, K., additional, Elloumi Chaabene, H., additional, Merdassi, G., additional, Wahbi, D., additional, Ben Meftah, M., additional, Zhioua, F., additional, Zhioua, A., additional, Azzarello, A., additional, Host, T., additional, Mikkelsen, A. L., additional, Theofanakis, C. P., additional, Dinopoulou, V., additional, Mavrogianni, D., additional, Partsinevelos, G. A., additional, Drakakis, P., additional, Stefanidis, K., additional, Bletsa, A., additional, Loutradis, D., additional, Rienzi, L., additional, Cobo, A., additional, Paffoni, A., additional, Scarduelli, C., additional, Capalbo, A., additional, Garrido, N., additional, Remohi, J., additional, Ragni, G., additional, Ubaldi, F. M., additional, Herrer, R., additional, Quera, M., additional, GIL, E., additional, Serna, J., additional, Grondahl, M. L., additional, Bogstad, J., additional, Agerholm, I. E., additional, Lemmen, J. G., additional, Bentin-Ley, U., additional, Lundstrom, P., additional, Kesmodel, U. S., additional, Raaschou-Jensen, M., additional, Ladelund, S., additional, Guzman, L., additional, Ortega, C., additional, Albuz, F. K., additional, Gilchrist, R. B., additional, Devroey, P., additional, Smitz, J., additional, De Vos, M., additional, Bielanska, M., additional, Leveille, M. C., additional, Borghi, E., additional, Magli, M. C., additional, Figueroa, M. J., additional, Mascaretti, G., additional, Ferraretti, A. P., additional, Gianaroli, L., additional, Szlit, E., additional, Leocata Nieto, F., additional, Maggiotto, G., additional, Arenas, G., additional, Tarducci Bonfiglio, N., additional, Ahumada, A., additional, Asch, R., additional, Sciorio, R., additional, Dayoub, N., additional, Thong, J., additional, Pickering, S., additional, Ten, J., additional, Carracedo, M. A., additional, Guerrero, J., additional, Rodriguez-Arnedo, A., additional, Llacer, J., additional, Bernabeu, R., additional, Tatone, C., additional, Heizenrieder, T., additional, Di Emidio, G., additional, Treffon, P., additional, Seidel, T., additional, Eichenlaub-Ritter, U., additional, Cortezzi, S. S., additional, Cabral, E. C., additional, Ferreira, C. R., additional, Trevisan, M. G., additional, Figueira, R. C. S., additional, Braga, D. P. A. F., additional, Eberlin, M. N., additional, Iaconelli Jr., A., additional, Borges Jr., E., additional, Zabala, A., additional, Pessino, T., additional, Blanco, L., additional, Rey Valzacchi, G., additional, Leocata, F., additional, Vanden Meerschaut, F., additional, Heindryckx, B., additional, Qian, C., additional, Deforce, D., additional, Leybaert, L., additional, De Sutter, P., additional, De las Heras, M., additional, De Pablo, J. L., additional, Navarro, B., additional, Agirregoikoa, J. A., additional, Barrenetxea, G., additional, Cruz, M., additional, Perez-Cano, I., additional, Gadea, B., additional, Herrero, J., additional, Martinez, M., additional, Roldan, M., additional, Munoz, M., additional, Pellicer, A., additional, Meseguer, M., additional, Galindo, N., additional, Scarselli, F., additional, Alviggi, E., additional, Colasante, A., additional, Minasi, M. G., additional, Rubino, P., additional, Lobascio, M., additional, Ferrero, S., additional, Litwicka, K., additional, Varricchio, M. T., additional, Giannini, P., additional, Piscitelli, P., additional, Franco, G., additional, Zavaglia, D., additional, Nagy, Z. P., additional, Greco, E., additional, Urner, F., additional, Wirthner, D., additional, Murisier, F., additional, Mock, P., additional, Germond, M., additional, Amorocho Llanos, B., additional, Calderon, G., additional, Lopez, D., additional, Fernandez, L., additional, Nicolas, M., additional, Landeras, J., additional, Finn-Sell, S. L., additional, Leandri, R., additional, Fleming, T. P., additional, Macklon, N. S., additional, Cheong, Y. C., additional, Eckert, J. J., additional, Lee, J. H., additional, Jung, Y. J., additional, Hwang, H. K., additional, Kang, A., additional, An, S. J., additional, Jung, J. Y., additional, Kwon, H. C., additional, Lee, S. J., additional, Palini, S., additional, Zolla, L., additional, De Stefani, S., additional, Scala, V., additional, D'Alessandro, A., additional, Polli, V., additional, Rocchi, P., additional, Tiezzi, A., additional, Pelosi, E., additional, Dusi, L., additional, Bulletti, C., additional, Fadini, R., additional, Lain, M., additional, Mignini Renzini, M., additional, Brambillasca, F., additional, Coticchio, G., additional, Merola, M., additional, Guglielmo, M. C., additional, Dal Canto, M., additional, Figueira, R., additional, Setti, A. S., additional, Worrilow, K. C., additional, Uzochukwu, C. D., additional, Eid, S., additional, Le Gac, S., additional, Esteves, T. C., additional, van Rossem, F., additional, van den Berg, A., additional, Boiani, M., additional, Kasapi, E., additional, Panagiotidis, Y., additional, Goudakou, M., additional, Papatheodorou, A., additional, Pasadaki, T., additional, Prapas, N., additional, Prapas, Y., additional, Vanderzwalmen, P., additional, Norasing, S., additional, Atchajaroensatit, P., additional, Tawiwong, W., additional, Thepmanee, O., additional, Saenlao, S., additional, Aojanepong, J., additional, Hunsajarupan, P., additional, Sajjachareonpong, K., additional, Punyatanasakchai, P., additional, Maneepalviratn, S., additional, Jetsawangsri, U., additional, Tejera, A., additional, Rubio, I., additional, Romero, J. L., additional, Nordhoff, V., additional, Schlatt, S., additional, Schuring, A. N., additional, Kiesel, L., additional, Kliesch, S., additional, Azambuja, R., additional, Okada, L., additional, Lazzari, V., additional, Dorfman, L., additional, Michelon, J., additional, Badalotti, M., additional, Badalotti, F., additional, Petracco, A., additional, Schwarzer, C., additional, Versieren, K., additional, De Croo, I., additional, Lierman, S., additional, De Vos, W., additional, Van den Abbeel, E., additional, Gerris, J., additional, Milacic, I., additional, Borogovac, D., additional, Veljkovic, M., additional, Arsic, B., additional, Jovic Bojovic, D., additional, Lekic, D., additional, Pavlovic, D., additional, Garalejic, E., additional, Albertini, D. F., additional, De Ponti, E., additional, Sanges, F., additional, Talevi, R., additional, Papini, L., additional, Mollo, V., additional, Rienzi, L. F., additional, Gualtieri, R., additional, Orteg, C., additional, Choi, J., additional, Lee, H., additional, Ku, S., additional, Kim, S., additional, Choi, Y., additional, Kim, J., additional, Moon, S., additional, Demilly, E., additional, Assou, S., additional, Moussaddykine, S., additional, Dechaud, H., additional, Hamamah, S., additional, Takisawa, T., additional, Doshida, M., additional, Hattori, H., additional, Nakamura, Y., additional, Kyoya, T., additional, Shibuya, Y., additional, Nakajo, Y., additional, Tasaka, A., additional, Toya, M., additional, Kyono, K., additional, Novo, S., additional, Penon, O., additional, Gomez, R., additional, Barrios, L., additional, Duch, M., additional, Santalo, J., additional, Esteve, J., additional, Nogues, C., additional, Plaza, J. A., additional, Perez-Garcia, L., additional, Ibanez, E., additional, Chavez, S., additional, Loewke, K., additional, Behr, B., additional, Reijo Pera, R., additional, Huang, S., additional, Wang, H., additional, Soong, Y., additional, Chang, C., additional, Okimura, T., additional, Kuwayama, M., additional, Mori, C., additional, Morita, M., additional, Uchiyama, K., additional, Aono, F., additional, Kato, K., additional, Takehara, Y., additional, Kato, O., additional, Minasi, M., additional, Casciani, V., additional, Arizzi, L., additional, Mencacci, C., additional, Piscitelli, C., additional, Cucinelli, F., additional, Tocci, A., additional, Wydooghe, E., additional, Vandaele, L., additional, Dewulf, J., additional, Van Soom, A., additional, Moon, J. H., additional, Son, W. Y., additional, Mahfoudh, A., additional, Henderson, S., additional, Jin, S. G., additional, Shalom-Paz, E., additional, Dahan, M., additional, Holzer, H., additional, Mahmoud, K., additional, Triki-Hmam, C., additional, Terras, K., additional, Hfaiedh, T., additional, Ben Aribia, M. H., additional, Otsubo, H., additional, Egashira, A., additional, Tanaka, K., additional, Matsuguma, T., additional, Murakami, M., additional, Murakami, K., additional, Otsuka, M., additional, Yoshioka, N., additional, Araki, Y., additional, Kuramoto, T., additional, Smit, J. G., additional, Sterrenburg, M. D., additional, Eijkemans, M. J. C., additional, Al-Inany, H. G., additional, Youssef, M. A. F. M., additional, Broekmans, F. J. M., additional, Willoughby, K., additional, DiPaolo, L., additional, Deys, L., additional, Lagunov, A., additional, Amin, S., additional, Faghih, M., additional, Hughes, E., additional, Karnis, M., additional, Ashkar, F., additional, King, W. A., additional, Neal, M. S., additional, Antonova, I., additional, Veleva, L., additional, Petkova, L., additional, Shterev, A., additional, Nogales, C., additional, Martinez, E., additional, Ariza, M., additional, Cernuda, D., additional, Gaytan, M., additional, Linan, A., additional, Guillen, A., additional, Bronet, F., additional, Cottin, V., additional, Fabian, D., additional, Allemann, F., additional, Koller, A., additional, Spira, J. C., additional, Agudo, D., additional, Martinez-Burgos, M., additional, Arnanz, A., additional, Basile, N., additional, Rodriguez, A., additional, Cho, Y. S., additional, Filioli Uranio, M., additional, Ambruosi, B., additional, Paternoster, M. S., additional, Totaro, P., additional, Sardanelli, A. M., additional, Dell'Aquila, M. E., additional, Zollner, U., additional, Hofmann, T., additional, Zollner, K. P., additional, Kovacic, B., additional, Roglic, P., additional, Vlaisavljevic, V., additional, Sole, M., additional, Boada, M., additional, Coroleu, B., additional, Veiga, A., additional, Martiny, G., additional, Molinari, M., additional, Revelli, A., additional, Chimote, N. M., additional, Chimote, M., additional, Mehta, B., additional, Chimote, N. N., additional, Sheikh, N., additional, Nath, N., additional, Mukherjee, A., additional, Rakic, K., additional, Reljic, M., additional, Ingerslev, H. J., additional, Kirkegaard, K., additional, Hindkjaer, J., additional, Agerholm, I., additional, Kitasaka, H., additional, Fukunaga, N., additional, Nagai, R., additional, Yoshimura, T., additional, Tamura, F., additional, Kitamura, K., additional, Hasegawa, N., additional, Nakayama, K., additional, Katou, M., additional, Itoi, F., additional, Asano, E., additional, Deguchi, N., additional, Ooyama, K., additional, Hashiba, Y., additional, Asada, Y., additional, Michaeli, M., additional, Rotfarb, N., additional, Karchovsky, E., additional, Ruzov, O., additional, Atamny, R., additional, Slush, K., additional, Fainaru, O., additional, Ellenbogen, A., additional, Chekuri, S., additional, Chaisrisawatsuk, T., additional, Chen, P., additional, Pangestu, M., additional, Jansen, S., additional, Catt, S., additional, Molinari, E., additional, Racca, C., additional, Ryu, C., additional, Kang, S., additional, Lee, J., additional, Chung, D., additional, Roh, S., additional, Chi, H., additional, Yokota, Y., additional, Yokota, M., additional, Yokota, H., additional, Sato, S., additional, Nakagawa, M., additional, Komatsubara, M., additional, Makita, M., additional, Oyama, K., additional, Naruse, K., additional, Kilani, S., additional, Chapman, M. G., additional, Kwik, M., additional, Chapman, M., additional, Guven, S., additional, Odaci, E., additional, Yildirim, O., additional, Kart, C., additional, Unsal, M. A., additional, Yulug, E., additional, Isachenko, E., additional, Maettner, R., additional, Strehler, E., additional, Isachenko, V., additional, Hancke, K., additional, Kreienberg, R., additional, Sterzik, K., additional, Zheng, X. Y., additional, Wang, L. N., additional, Liu, P., additional, Qiao, J., additional, Inoue, F., additional, Dashtizad, M., additional, Wahid, H., additional, Rosnina, Y., additional, Daliri, M., additional, Hajarian, H., additional, Akbarpour, M., additional, Abbas Mazni, O., additional, Knez, K., additional, Tomaevic, T., additional, Vrtacnik Bokal, E., additional, Zorn, B., additional, Virant Klun, I., additional, Koster, M., additional, Liebenthron, J., additional, Nicolov, A., additional, van der Ven, K., additional, van der Ven, H., additional, Montag, M., additional, Fayazi, M., additional, Salehnia, M., additional, Beigi Boroujeni, M., additional, Khansarinejad, B., additional, Deignan, K., additional, Emerson, G., additional, Mocanu, E., additional, Wang, J. J., additional, Andonov, M., additional, Linara, E., additional, Ahuja, K. K., additional, Nachef, S., additional, Pasqualotto, F. F., additional, Pasqualotto, E., additional, Chang, C. C., additional, Bernal, D. P., additional, Elliott, T. A., additional, Shapiro, D. B., additional, Toledo, A. A., additional, Economou, K., additional, Davies, S., additional, Argyrou, M., additional, Doriza, S., additional, Sisi, P., additional, Moschopoulou, M., additional, Karagianni, A., additional, Mendorou, C., additional, Polidoropoulos, N., additional, Papanicopoulos, C., additional, Stefanis, P., additional, Karamalegos, C., additional, Cazlaris, H., additional, Koutsilieris, M., additional, Mastrominas, M., additional, Gotts, S., additional, Doshi, A., additional, Harper, J., additional, Serhal, P., additional, Borini, A., additional, Guzeloglu-Kayisli, O., additional, Bianchi, V., additional, Seli, E., additional, Lappi, M., additional, Bonu, M. A., additional, Mizuta, S., additional, Hashimoto, H., additional, Kuroda, Y., additional, Matsumoto, Y., additional, Mizusawa, Y., additional, Ogata, S., additional, Yamada, S., additional, Kokeguchi, S., additional, Noda, Y., additional, Shiotani, M., additional, Stojkovic, M., additional, Ilic, M., additional, Markovic, N., additional, Stojkovic, P., additional, Feng, G., additional, Zhang, B., additional, Zhou, H., additional, Zhou, L., additional, Gan, X., additional, Qin, X., additional, Shu, J., additional, Wu, F., additional, Molina Botella, I., additional, Lazaro Ibanez, E., additional, Debon Aucejo, A., additional, Pertusa, J., additional, Fernandez Colom, P. J., additional, Li, C., additional, Zhang, Y., additional, Cui, Y., additional, Zhao, H., additional, Liu, J., additional, Oliveira, J. B. A., additional, Petersen, C. G., additional, Mauri, A. L., additional, Massaro, F. C., additional, Silva, L. F. I., additional, Ricci, J., additional, Cavagna, M., additional, Pontes, A., additional, Vagnini, L. D., additional, Baruffi, R. L. R., additional, Franco Jr., J. G., additional, Felipe, V., additional, Vilela, M., additional, Tiveron, M., additional, Lombardi, C., additional, Viglierchio, M. I., additional, Marconi, G., additional, Rawe, V., additional, Wale, P. L., additional, Gardner, D. K., additional, Nakagawa, K., additional, Sugiyama, R., additional, Nishi, Y., additional, Kuribayashi, Y., additional, Jyuen, H., additional, Yamashiro, E., additional, Shirai, A., additional, Inoue, M., additional, Hovatta, O., additional, Tohonen, V., additional, Inzunza, J., additional, Parmegiani, L., additional, Cognigni, G. E., additional, Bernardi, S., additional, Ciampaglia, W., additional, Infante, F. E., additional, Tabarelli de Fatis, C., additional, Pocognoli, P., additional, Arnone, A., additional, Maccarini, A. M., additional, Troilo, E., additional, Filicori, M., additional, Radwan, P., additional, Polac, I., additional, Borowiecka, M., additional, Bijak, M., additional, and Radwan, M., additional

Published
2011
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5. SELECTED ORAL COMMUNICATION SESSION, SESSION 63: PREIMPLANTATION GENETICS Wednesday 6 July 2011 10:00 - 11:45

Author

Colls, P., primary, Fischer, J., additional, Escudero, T., additional, Ketterson, K., additional, Harton, G., additional, Munne, S., additional, Capalbo, A., additional, Fiorentino, F., additional, Maggiulli, R., additional, Romano, S., additional, Borsatti, A., additional, Joseph, A., additional, Spizzichino, L., additional, Bono, S., additional, Biricik, A., additional, Colamaria, S., additional, Ubaldi, M. F., additional, Rienzi, L. F., additional, Rubino, P., additional, Arizzi, L., additional, Minasi, M. G., additional, Pena, R., additional, Scarselli, F., additional, Casciani, V., additional, Colasante, A., additional, Ferrero, S., additional, Litwicka, K., additional, Varricchio, M. T., additional, Cucinelli, F., additional, Nagy, Z. P., additional, Greco, E., additional, Beyazyurek, C., additional, Ekmekci, C. G., additional, Tac, H. A., additional, Ajredin, N., additional, Yelke, H., additional, Kahraman, S., additional, De Rademaeker, M., additional, Moutou, C., additional, Van Rij, M., additional, Dreesen, J., additional, De Rycke, M., additional, Liebaers, I., additional, Viville, S., additional, Geraedts, J., additional, De Die, C., additional, Wells, D., additional, Fragouli, E., additional, Colls, P., additional, Alfarawati, S., additional, Kashevarova, A., additional, Tolmacheva, E., additional, Sukhanova, N., additional, and Lebedev, I., additional

Published
2011
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11. Long-term results of laparoscopic myomectomy: recurrence rate in comparison with abdominal myomectomy.

Author

Rossetti, Alfonso, Sizzi, Ornella, Soranna, Liberato, Cucinelli, Francesco, Mancuso, Salvatore, Lanzone, Antonio, Rossetti, A, Sizzi, O, Soranna, L, Cucinelli, F, Mancuso, S, and Lanzone, A

Abstract

Laparoscopic myomectomy is still a debated procedure and there are conflicting opinions regarding the recurrence rate. Laparoscopic myomectomy may present a higher risk of recurrence compared with abdominal myomectomy. The aim of this investigation was to analyse the recurrence rate of myomas after surgery. From January 1991 to June 1998, 165 myomectomies were performed for symptomatic myomas measuring at least 3 cm in diameter and numbering seven or less per patient. During the first 3 years of this survey, 81 patients were randomized for abdominal or laparoscopic myomectomy. Transvaginal ultrasound examination was performed within 15–30 days of surgery and every 6 months for a post-operative period of 40 months. The two groups had similar pre-operative clinical features and the number and volume of myomas did not differ between the two groups. At the end of the study the group of abdominal myomectomies showed nine recurrences (23%) against 11 (27%) of the laparoscopic group. In order to evaluate the recurrence rate in relation to several risk factors, laparoscopic myomectomies were performed from 1991 in 84 patients who agreed to follow-up (and were not in the randomized group). Of these, 78 patients were evaluated with transvaginal ultrasound for a mean interval of 26 months and 17 (21.78%) recurrences were found. Most recurrences (75%) were seen at ultrasound between 10 and 30 months after surgery. The patient's age, pre- and post-operative gravidity and parity had no influence on recurrence. Neither the number of myomas removed nor the depth of penetration or size were positively associated with the risk of recurrence. However, an associated risk factor was pre-operative gonadotrophin-releasing hormone agonist treatment (P < 0.02). None of the women with recurrence required additional surgery. We conclude that laparoscopic myomectomy is a reliable procedure. The recurrence rate is similar to that seen after abdominal myomectomy. [ABSTRACT FROM PUBLISHER]

Published
2001
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12. Changes in luteinizing hormone and insulin secretion in polycystic ovarian syndrome.

Author

Fulghesu, AM, Cucinelli, F, Pavone, V, Murgia, F, Guido, M, Caruso, A, Mancuso, S, Lanzone, A, and Fulghesu, A M

Abstract

Uncertainties regarding the pathogenetic changes underlying the polycystic ovarian syndrome (PCOS) have been reported. The aim of this study was to investigate the endocrine and metabolic features of PCOS patients in relation to luteinizing hormone (LH) secretion. Androgen assays, oral glucose tolerance tests, hyperinsulinaemic euglycaemic clamps and gonadotrophin releasing hormone (GnRH) tests were performed in 100 patients. Sixty-six patients scheduled as hyperinsulinaemic and 34 as normoinsulinaemic showed similar concentrations of LH, follicle stimulating hormone (FSH), LH/FSH ratio, and LH response to GnRH testing. Hyperinsulinaemic subjects showed higher body mass index (BMI), insulin resistance, testosterone and free androgen index levels compared with those of normoinsulinaemic subjects; when clustered in relation to their LH basal concentrations, the two groups obtained differed only in androstenedione concentrations. Considering both insulin and LH plasma concentrations, four groups were obtained. Hyperinsulinaemia and hyper-LH secretion were not related in 54% and coexisted in the same subjects in 26% of cases. Hyperinsulinaemia as well as hyper-LH secretion affected the expression of the syndrome; the insulinaemia was directly correlated with testosterone concentrations and all metabolic parameters that affected the free androgen index. The LH concentrations were related to androgen production and were independent of BMI and insulin concentrations. It is concluded that the degree of hormonal alteration is the final sum of such pathogenetic factors. [ABSTRACT FROM PUBLISHER]

Published
1999
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13. Preconceptional and gestational evaluation of insulin secretion in patients with polycystic ovary syndrome.

Author

Lanzone, A, Fulghesu, A M, Cucinelli, F, Guido, M, Pavone, V, Caruso, A, and Mancuso, S

Subjects
TYPE 2 diabetes complications, GESTATIONAL diabetes, GLUCOSE tolerance tests, INSULIN, TYPE 2 diabetes, OBESITY, OXIDOREDUCTASES, PREGNANCY complications, RADIOIMMUNOASSAY, POLYCYSTIC ovary syndrome, DISEASE complications
Abstract

The relationship between insulinaemia and obesity and glucose tolerance and the impact of pregnancy as risk factor for carbohydrate abnormalities were investigated in 91 consecutive patients with polycystic ovary syndrome (PCOS) aged 26-32 years. Fifteen normoglycaemic patients became pregnant within 6 months of the pregestational study using pharmacological induction of ovulation. Plasma concentrations of insulin and glucose after an oral glucose tolerance test (OGTT) were determined by immunoradiometric assay and glucose oxidase technique respectively. OGTT patients were classified according to their response as normoinsulinaemic (n = 46) or hyperinsulinaemic (n = 45). Impairment of glucose metabolism occurred in 12.1% (n = 11, 10 obese and one lean) of all PCOS subjects. Based on insulin secretion, 6.5% of normoinsulinaemic and 13.3% of hyperinsulinaemic patients had an impaired glucose tolerance and 2.3 and 2.2% respectively a non-insulin-dependent diabetes mellitus. Obese patients had higher values for area under the curve for insulin response to OGTT (I-AUC values) than lean patients, and the percentage above ideal body weight was greater in hyperinsulinaemic than in normoinsulinaemic patients. All hyperinsulinaemic (7/15) subjects who became pregnant developed an impairment of glucose metabolism during pregnancy. It is concluded that the PCOS population was at higher risk of developing carbohydrate abnormalities than the normal population of a similar reproductive age. Furthermore, those with abnormal insulin secretion at the pregestational stage may, during pregnancy, develop an impaired gestational glucose tolerance or gestational diabetes. [ABSTRACT FROM AUTHOR]

Published
1996
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14. Effect of opioid blockade on insulin metabolism in polycystic ovarian disease.

Author

Fulghesu, A M, Ciampelli, M, Fortini, A, Cucinelli, F, Guido, M, Caruso, A, Lanzone, A, and Mancuso, S

Abstract

A total of 17 women affected by polycystic ovarian disease (PCOD) were studied to evaluate the involvement of endogenous opioids in the pathophysiology of the hyperinsulinism in PCOD by administering naltrexone, an oral opioid antagonist. An oral glucose tolerance test (OGTT) was performed at baseline (on day 5 of the cycle) and repeated after 6 weeks of naltrexone administration. Plasma glucose, insulin and connecting peptide (c-peptide) concentrations were evaluated in all samples. Based on their insulinaemic response to OGTT, patients were classified as hyperinsulinaemic or normoinsulinaemic. Naltrexone treatment significantly (P < 0.007) reduced the insulin response to OGTT in the hyperinsulinaemic group without affecting the c-peptide incremental area; in the normoinsulinaemic group there was a slight, but not significant, increase in both c-peptide and insulin incremental areas. The two groups showed similar c-peptide incremental areas after naltrexone treatment. There was no significant difference in the c-peptide:insulin incremental areas molar ratio between the two groups; after treatment, a significant increase in this ratio was observed in both groups. When we considered the data as an expression of the fractional hepatic extraction of insulin, we found a lower value for hyperinsulinaemic in comparison with normoinsulinaemic patients (not significant), and a significant (P < 0.01) improvement of this parameter in the hyperinsulinaemic group after naltrexone administration. In conclusion, we suggest that the contribution to hyperinsulinaemia in PCOD patients may be at least in part due to both increased pancreatic secretion and reduced hepatic removal of insulin. Chronic pharmacological inhibition of opioid tone could improve the insulin plasma concentration by acting chiefly on the liver metabolism of insulin in hyperinsulinaemic patients.

Published
1995
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