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Background:Serum Anti-Mullerian hormone (AMH) levels in women with polycystic ovary syndrome (PCOS) are two- to threefold higher than in ovulatory women with normal ovaries, corresponding to the two- to threefold increase in the number of small follicles in PCOS. The increased AMH has been hypothesized to reduce follicle sensitivity to follicle stimulating hormone (FSH) and estradiol production, thus preventing follicle selection, resulting in follicular arrest at the small antral phase with failure of dominance.Objective:The study was undertaken to test the hypothesis that high AMH level is associated with poor response to ovulation induction in PCOS women.Methods:This was a cross-sectional comparative study of 50 infertile women with PCOS, grouped into those with AMH level <8 ng/mL and those with AMH level ≥8 ng/mL. All participants received an initial dose of 100 mg/day of clomiphene citrate from 2nd to 6th day of menstrual cycle. Ovarian response (follicle size) was assessed by transvaginal monitoring on 12th day of cycle.Results:A total of 50 women were recruited, of which 4 dropped out. Women with AMH ≥8 ng/mL comprised only 23.91% of the PCOS women. AMH and day 12 follicle size had a statistically significant association. Adjusting for other confounding variables in linear, logarithmic, and logistic analysis, serum AMH had significant negative relationship with follicle size (r = 0.511, p < 0.001). AMH was also positively correlated with serum LH, testosterone and negatively correlated with serum follicle stimulating hormone (FSH), serum TSH and BMI.Conclusion:We observed that higher AMH level women had poor response to ovulation induction compared to women with low AMH level.

Background:New vessel formation or neovascularization has been recognized as a feature of endometriosis. Treatment with cabergoline suppresses cell proliferation and vascular-endothelial-growth-factor-mediated angiogenesis, thereby promoting regression of endometriotic lesions. Dienogest, a fourth-generation progestin currently in use for the treatment of endometriosis significantly decreases the volume of endometrial implants.Objective:The objective of the study was to see if cabergoline is as effective as dienogest in reducing the size of endometriomas and pelvic pain in women with endometriosis.Methods:The prospective comparative study was carried out on 56 women with endometrioma (diagnosed by ultrasound), divided by odd and even numbers into two groups. Cabergoline, 0.5 mg tablet twice weekly, was given to 28 women for 3 months. Dienogest, 2 mg tablet daily, was given to 28 women for the same duration. Pre- and post-treatment assessment of endometrioma size by transvaginal sonography and pelvic pain using the 10-cm visual analog scale (VAS) were recorded.Results:The percentage reduction in endometrioma size in women given dienogest was twice that compared to the women given cabergoline. Mean VAS score after 3 months was significantly lower in the cabergoline group compared to dienogest (p¡ 0.05). The incidence of nausea, vomiting, and headache were similar in cabergoline and dienogest group. There was polymenorrhea in the cabergoline group and irregular spotting in the dienogest group.Conclusions:Reduction of the size of endometrioma is less apparent with cabergoline than dienogest after 3 months of treatment. Cabergoline yields better results in decreasing pelvic pain compared to dienogest.

This study was carried out to assess the levels of trace metals (Fe, Zn, Mn and Cu) in the macroalgae and sediment of the Sundarban mangrove estuary in Bangladesh. In this connection, macroalgae, water and sediment samples were collected seasonally (pre-monsoon, monsoon and post-monsoon) for a year from the study area. The surface water of the estuary was found to be quite rich in NO3, PO4and NH4, which is more than that of the sediment pore water. Trace elements were determined using an atomic absorption spectrophotometer. The amount of trace metals in the samples were found in the order of Fe > Mn > Zn > Cu. Enrichment factor was done for trace metals in sediment and showed non-crustal origin of Zn and Cu in the monsoon period. Analysis of variance revealed the seasonal variation of trace metal concentration in sediment (except Mn; p> 0.05) and macroalgae (except Zn; p> 0.05). Iron in sediment showed significant positive correlation both with Fe (r= 0.84, p< 0.05) and Mn (r= 0.87, p< 0.01) in macroalgae. Similarly, Cu in sediment demonstrated a significant positive correlation with Cu in macroalgae (r= 0.81, p< 0.01). The findings reveal a significant communication of metals in sediment and macroalgae.