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Today, serum antimullerian hormone (AMH) is considered as an interesting marker of fertility potential in women to determine follicular status and in men to evaluate testicular function. We study analytical and clinical characteristics of two AMH commercialized immunoassays: Immunotech and DSL methods. The detection limits (close to 0.13 ng/mL), functional sensitivities (close to 0.30 ng/mL) are equivalent, and imprecision results are acceptable for entirely manual assays. The Immunotech method is linear within the calibration range (up to 21 ng/mL) and the DSL method presents a lack of linearity making it accurate only up to 11 ng/mL (and not up to 14 ng/mL as it is indicated by the manufacturer). The two methods allow to measure human AMH, don't cross react with TGF-beta superfamily proteins and the DSL immunoassay recognize mouse (25%), rat (68%) and calf (100%) AMH. The comparison between the two methods (from 0.3 to 200 ng/mL) shows a good correlation (r = 0.979) with not statistically different results (p = 0.31). From a clinical point of view, the two methods allow the evaluation of follicular status in normo-ovulatory women and in women with polycystic ovary syndrome. Results are in agreement with studies showing that AMH serum concentration is strongly correlated with the number of antral follicles. In conclusion, the Immunotech method seems to be more efficient than the DSL method even if the two methods are suitable for clinical applications needing AMH measurements.

Our investigation includes two groups of subjects in which the relationships between ovarian growth, steroidogenesis and gonadotropin secretion were studied. The first group consists of premenarchal girls studied in a cross-sectional program; the second group includes girls after menarche with irregular cycles who were investigated with a long term follow up. In the first group an increase in ovarian volume and in the number of developing follicles were seen with increasing chronological age and pubertal stages. With advancing pubertal development, a progressive increase of LH pulse frequency and amplitude can be observed. These variables appear strongly linked to the ovarian morphological and functional development as the significant correlation between LH mean levels and pulsatile characteristics on the one hand, and ovarian volume and steroid production on the other hand demonstrate. In the maturational stage just before menarche, the ovaries may show increased volume and a very dishomogeneous structure; ovarian steroidogenesis may be often mainly directed towards the androgen synthesis. After menarche ovarian volume and structure continue to change and normal or enlarged ovaries, with homogeneous, multifollicular or polycystic structure can be frequently observed. However normal and homogeneous ovaries prevail in adolescents with regular and ovulatory cycles, while enlarged and dishomogeneous ovaries prevail in irregular anovulatory cycles. A trend towards normal adult ovarian morphology and structure is present in ovulatory subjects with normal gonadotropin pulsatile release and steroid synthesis. On the other hand, deranged gonadotropin profiles imply irregular cycles anovolation, hyperandrogenemia and enlarged polycystic ovaries during adolescence.(ABSTRACT TRUNCATED AT 250 WORDS)

Objective: To study the ferritin level in women using an intrauterine device., Methods: 104 women were enrolled before and during use of the intrauterine device. The subjects were divided into four groups according to whether or not they had used oral contraception previously., Results: There was a significant decrease in ferritin level, particularly in women who had not used contraception previously (Student's test)., Conclusion: Ferritin assay is a better test for measuring the effect of an intrauterine device on iron depletion than blood cell count or haemoglobin level.

A sequential treatment either with norethisterone or with oral natural micronized progesterone was administered, after randomization, to 80 women consulting for premenopausal disorders of the menstrual cycle. In all cases, the initial aspect of the endometrium showed a progesterone deficit with hyperplasia in 50 per cent of cases. At the third and sixth month of treatment, none of the biopsies presented hyperplastic characteristics whether after norethisterone or oral progesterone. However, three months after suspension of treatment, the proliferative or hyperplastic characteristics reappeared in 24 per cent of cases in the norethisterone group, and in 10 per cent of cases in the oral progesterone group. The administration of norethisterone induced a decrease in plasma levels of estradiol (E2), FSH and LH, and sex-hormone-binding globulin (SHBG) (p less than 0.001). No modification was observed during treatment with oral progesterone. The plasma levels of HDL-cholesterol and triglycerides were decreased by norethisterone (p less than 0.001-0.02). A slight decrease in phospholipids was also observed in this group. Treatment with oral natural micronized progesterone therefore offers an attractive alternative for the treatment of premenopausal menstrual disorders.

Delayed menarche, amenorrhea or at least luteal insufficiency are frequent in athletic women, when in intense athletic training. The origin of these disturbances seems to be plurifactorial. The main responsible parameters seem to be: the physical and psychological stresses; nutritional factors often associated with reduced food intake (specially reduced protein and increased vegetable fibers intake), and in some cases with loss of body fat; and affective problems responsible for eating disorders. The paper describes the acute effects of training upon hormones, and the hormonal profile of athletes when in intense training. The reduced or suppressed LH pulsatile secretion determines the ovulatory disturbances. Among the responsible factors, the rise of opioids, as beta-endorphin, and the corticotropin hyperactivity, which probably play an important role, even if other mechanisms will be demonstrated later.

It is important to diagnose hyperandrogenism in women. By disturbing ovulation, it is actually one of the most frequent causes of infertility. In this particular case, its diagnosis has specific implications: sometimes specific treatment is indicated, or the risk of fetal virilization should be prevented. There is always the possibility of a diagnosis of polycystic ovary, prompting precautionary measures to be taken that are likely to limit the risks linked to the multifollicular development that is so frequent with this disorder. In addition, hyperandrogenism exposes the patient to various gynecological and general complications: cancer of the endometrium, progressive increase in menstrual disturbances and infertility, obesity, metabolic disturbances and probably increase in cardiovascular risks. Certain types of hyperandrogenism give rise to diseases that expose the patient to specific risks: virilizing tumors, Cushing's syndrome, neonatal risks linked to congenital hyperplasia of the adrenal glands. Hyperandrogenism should be borne in mind not only when the clinical picture is that of virilization, but also when there is any disturbance in eugonadal ovulation, whether or not this is manifested as menstrual disturbances or as infertility, and especially whether or not it is accompanied by hirsutism.