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Abstract Background There is conflicting evidence regarding an association between gonadotropin releasing hormone analogue (GnRHa) therapy and polycystic ovary syndrome (PCOS). This study aimed to compare the prevalence of endocrine disorders, primarily PCOS, between women who had been treated with GnRHa for central precocious puberty (CPP) and those who were not treated. Methods This was a retrospective cohort study, including women diagnosed with central precocious puberty between 1989 and 2011 in a university affiliated tertiary medical center. Data collected included demographic data, medical background, clinical presentation at diagnosis and duration of treatment (zero for non-treated). Gynecologic and endocrine long-term outcomes were compared by treatment group. Results Fifty-one women were included in the study, 27/51 had been treated with gonadotropin releasing hormone analogue (GnRHa). Overall prevalence of PCOS was 19.6%. No statistically significant difference in prevalence of PCOS was demonstrated between the treated and non-treated groups. Similarly, overall prevalence of either clinical or laboratory hyper-androgenism, was 29.4% and 33.3%, for the treatment and non-treatment groups respectively (p = non-significant). Conclusions GnRHa treatment for precocious puberty is not associated with increased risk of polycystic ovary syndrome.

Purpose: To investigate the effects and safety of gonadotropin releasing hormone analogue (GnRH-a) as an addition to progesterone luteal support in women who underwent in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) and achieved a clinical pregnancy.Methods: A retrospective analysis was conducted on 214 patients who underwent IVF/ICSI-ET procedures with standard long mid-luteal protocol, of which 123 received GnRH-a-free protocol and 91 received GnRH-a-added protocol. The patients' pregnancy and delivery course, and their neonates' status at birth and growth/development after birth were statistically compared.Results: There was no significant difference between both study groups regarding embryo risks and maternal complications during early pregnancy. as well as fetal risks during the middle and late stages and neonate risks during birth, except that the twin pregnancies of the GnRH-a-added group had a considerably greater male/female ratio, and a significantly higher rate of premature delivery and low birth weight than those of the GnRH-a-free group. In addition, there was no significant difference in neonate risks within 2 years after birth between both cohorts.Conclusion: With precautions taken to control the number of implanted embryos and reduce the incidence of twinning pregnancy, the addition of GnRH-a to luteal support is relatively safe and effective. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the improvement in catamenial chronic pelvic pain (CPP) after Gonadotropin Releasing Hormone analogue (GnRH-a) administration in women affected by adenomyosis or endometriosis. We retrospectively analysed clinical data of 63 premenopausal women with clinical suspect of adenomyosis (15 women, Group A) or endometriosis (48 women, Group B), which received GnRH-a in order to reduce CPP intensity during the time on surgery waiting list. Main outcome measures were variation of CPP intensity, numbers of days requiring analgesics and lost work productivity before and three months after GnRH-a administration. Compared to baseline, a significant decrease in CPP intensity ( p < 0.05) was observed in both groups, even if this reduction was significantly higher in Group A than in Group B ( p < 0.001). In both groups, moreover, a significant reduction in number of days requiring analgesics ( p < 0.05) and lost work productivity ( p < 0.05) was detected. In conclusion, GnRH-a administration in women with clinical suspect of adenomyosis induces a greater reduction in CPP when compared to women with endometriosis, thus representing a potential ex adiuvantibus criteria, helping TV-US in the clinical diagnosis of adenomyosis. [ABSTRACT FROM AUTHOR]

Context: Gonadotropin-releasing hormone (GnRH) has been the standard test for diagnosing central precocious puberty. Because GnRH is no longer available, GnRH analogues (GnRHa) are now used. Random LH concentration, measured by the third-generation immunochemiluminometric assay, is a useful screening tool for central precocious puberty. However, GnRHa stimulation test should be considered, when a basal LH measurement is inconclusive. However optimal sampling times for luteinizing hormone (LH) have yet to be established. Purpose: To determine the appropriate sampling time for LH post leuprolide challenge. Methods: A retrospective analysis of multi-sample GnRHa stimulation tests performed in 155 children (aged 1-9 years) referred for precocious puberty to Texas Children's Hospital. After 20 mcg/kg of SQ leuprolide acetate, samples were obtained at 0, 1, 3, and 6 hours. Results: Of 71 children with clinical evidence of central precocious puberty, fifty nine children had a peak LH >5 mIU/mL. 52 (88%) of these responders had positive responses at 1 hour (95% CI is 80-96%), whereas all 59 children (100%) had a peak LH response >5 mIU/mL at 3 hours (95% CI is 94-100%), P = 0.005. Conclusions: A single serum LH sample collected 3 hours post GnRHa challenge is the optimal sample to establish the diagnosis of central precocious puberty. [ABSTRACT FROM AUTHOR]

Abstract: The effects of a single intramuscular injection of gonadotropin releasing hormone analogue (GnRHa) alone or in combination with the dopamine antagonist domperidone (DOM) on ovulation induction of loach Misgurnus anguillicaudatus broodstocks collected from the wild were tested under routine hatchery conditions. The ovulation ratio, latency period, ovulation index, fertilization success and hatching rate were evaluated. The following hormone treatments were tested: 2 mg kg−1 BW of CPE as a positive control (PC), GnRHa alone at doses of 10 µg (G10), 20 µg (G20), 40 µg (G40) and 60 µg (G60) kg−1 BW and combinations of GnRHa and DOM at doses of 5 µg+2.5 mg (GD5), 10 µg+5 mg (GD10), 20 µg+10 mg (GD20) and 40 µg+20 mg (GD40) kg−1, respectively. Physiological saline injected fish were used as a negative control (NC). The results showed that the combination of 20 µg+10 mg (GD20) and 40 µg+20 mg (GD40) kg−1 of GnRHa and DOM, respectively, injection led to higher ovulation ratio and shorter latency periods in comparison with the control and the other hormone treatments (P <0.05), and there was no significant difference between the two ovulating groups with respect to ovulation ratio and latency period (P >0.05). There was a significant difference between the GnRHa alone groups and the GnRHa + DOM combined groups on the ovulation index (the former < the latter, P <0.05), while no significant differences in the fertilization success and hatching rate were found in any of the hormone treatments (P >0.05). Only 20% of the fish ovulated in group G10 and G20, and no fish ovulated in group NC, suggesting a dopaminergic inhibitory action on gonadotropin (GtH) secretion in this fish at the preovulatory stage. Therefore, it can be concluded that like many other cyprinids, dopamine inhibitory action was operating in loach and it was necessary to combine GnRHa with a dopamine antagonist for ovulation induction. As a result, ovulation can be induced successfully in loach broodstocks with 20 µg kg−1 GnRHa+10 mg kg−1 DOM treatment in a single injection without any negative effect on egg quality. Application of this combination could be beneficial for hatchery and broodstock management in loach culture. [Copyright &y& Elsevier]

: ObjectiveTo determine the profile of differentially expressed genes in leiomyoma and matched unaffected myometrium and to identify the genes whose expression are altered after gonadotropin releasing hormone analogue (GnRHa) therapy.: MethodsUsing total RNA isolated from untreated and GnRHa-treated leiomyoma and myometrium subjected to Clontech Atlas 1.2 K cancer microarray containing 1176 known genes, we found transcripts for many cytokines, growth factors and their receptors, adhesion molecules, extracellular matrix, proteases, signaling intermediates, and transcription factors in both tissues. Based on the overall normalization and reproducibility of the results, 328 differentially expressed and regulated genes with at least threefold change in their expression in untreated and GnRHa-treated tissues were chosen for further analysis.: ResultsThe expression value of the 328 genes subjected to significance analysis of microarray showed a total of 100 genes with relative significant change in expression. Of these genes, the expression of 18 was up-regulated and 82 down-regulated in untreated leiomyoma compared with myometrium. In GnRHa-treated tissues, the expression of 34 genes showed a significant decrease in leiomyoma, whereas 27 genes increased and 15 decreased in myometrium compared with their respective untreated tissues. There was no difference in the expression profile of these genes when comparing leiomyoma and myometrium from the GnRHa-treated group. Hierarchical cluster analysis revealed that these differentially expressed or regulated genes, classified based on their biologic functions, are involved in regulation of cell growth/cycle, signal transduction, transcription factors, and cell and tissue structure.: ConclusionMicroarray analysis allowed us to identify the profile expression of several specific genes in leiomyoma and myometrium whose expression appears to be differentially regulated after GnRHa therapy. [Copyright &y& Elsevier]

The present study demonstrates that acceleratedphotoperiod advances ovulation in Atlantic salmon, and that exposure to cold water prior to spawning further advances and synchronizes this process while improving egg-survival. High water temperature inhibited both sperm release and ovulation, whereas a GnRHa treatment overrode this temperature effect in most individuals. A decrease in water temperature seemed to accelerate both ovulation and sperm release, and water temperature modulated the plasma 17,20ßP profiles around ovulation and sperm release. The GnRHa treatment markedly increased the volume of strippable milt and the plasma 17,20ßP levels in males. [ABSTRACT FROM AUTHOR]

Although a clear role for estrogen receptor (ER) α has been established, the contribution of ERβ in estrogen-dependent development, growth and functions of the myometrium is not understood. As a first step towards understanding the role of ERβ, we have examined the expression of ERα and ERβ in the human myometrium. With competitive RT-PCR assays, the level of ERβ mRNA was 10–200 times lower than that of ERα mRNA in both premenopausal and postmenopausal myometrium. In premenopausal myometrium, the expression pattern of ERβ mRNA during the menstrual cycle was similar to that of ERα mRNA, with highest levels in peri-ovulatory phase. In postmenopausal myometrium, ERβ mRNA was significantly higher than it was in premenopausal myometrium, while the level of ERα mRNA was lower. The net result was a change in the ratio of ERβ to ERα mRNA expression. The ratio changed from 0.6–1.5 in premenopausal to 2.5–7.6 in postmenopausal myometrium. In premenopausal women, the gonadotropin releasing hormone analogue, leuprorelin acetate, elicited a decrease in ERα and an increase in ERβ mRNA expression to cause a postmenopausal receptor phenotype. Estradiol, on the other hand, reversed ERα and ERβ mRNA expression and their ratio in postmenopausal myometrium to those of premenopausal myometrium. Immunohistochemical staining and Western blot analysis of ERα and ERβ with semiquantitative analysis showed good agreement between mRNA and protein levels. The data indicate that coordinated expression of ERα and ERβ might be necessary for normal estrogen action in myometrium. Furthermore, estrogen appears a dominant regulator of both receptors in the myometrium. [Copyright &y& Elsevier]

Compared to control fish, gonadotropin releasing hormone-analogue (GnRHa) treatment delivered either by microspheres or cholesterol pellets successfully increased sperm production (cells kg−1) and milt volume (ml kg−1) in mature yellowtail flounder Pleuronectes ferrugineus during the spawning season. Spermatocrit decreased in both treated and control groups between 12 and 29 days post-implantation, indicating a seasonal decrease in sperm concentration, rather than an effect of the GnRHa treatments. Plasma levels of testosterone, 11-ketotestoterone and 17α,20βdihydroxy-4-pregnen-3-one (17α20βP) showed no clear pattern either across treatments or over days, however this does not exclude the possiblity that GnRHa had its effect on milt volumes via the stimulation of steroid production since the sampling protocol did not allow for the rapid clearance of steroids from the plasma. GnRHa treatment did not have a negative effect on sperm fertilizing ability, percentage hatch or larval morphology. Sperm motility and seminal plasma pH were increased by GnRHa treatment. [ABSTRACT FROM AUTHOR]

Background: Parental anxiety about the impact of puberty/menses, particularly in girls with severe disability leads to seeking therapeutic pubertal suppression. We aim to explore maternal attitudes and reasons for seeking pubertal suppression., Methods: Mothers of girls receiving gonadotropin -releasing hormone analogue therapy in Mafraq hospital, Abu Dhabi were enrolled in the study. A semistructured interview was conducted to ascertain possible reasons for delaying puberty. The study group was divided into girls with a disability with central precocious puberty (CPP) or normal puberty and girls without a disability presenting with CPP., Results: 42 mother-daughter pairs were enrolled and divided into two groups; group A: 15 girls with CPP with no disability; group B: 27 girls with disability (10 had CPP (group B1) and 17 had normal pubertal timing (group B2)). Mothers in group A aimed to delay puberty, while in group B, 13 (48%) mothers desired to halt puberty and 7 (26%) requested permanent surgical intervention. Fear of short stature (15, 100%), inability to cope psychologically (10, 67%) and fear of peer rejection (9, 60%) were the main concerns in group A. In group B, mothers were concerned about menstrual hygiene management (25, 92.5%), fear of child abuse or unwanted pregnancy (15, 55%) and fear of inability to express pain/discomfort with menstruation (8, 30%)., Conclusion: Mothers of girls with a disability commonly seek medical help to delay/halt puberty due to concerns about menstrual hygiene. Short final height was the main concern for girls without a disability. Culture and religion play an important role in puberty management in girls with a disability., Competing Interests: Competing interests: None declared.

Hypothalamic hamartoma (HH) is a congenital malformation diagnosed based on magnetic resonance imaging (MRI) and histological findings; it is often associated with central precocious puberty (CPP), gelastic seizures, abnormal behavior and mental retardation. In the present paper, we report our retrospective hypothesis that there is a relationship between symptoms and therapy, as well as the treatment for HH, and describe two cases of HH associated with CPP. Both cases had sessile masses located in the interpeduncular cistern, with extension to the hypothalamus on MRI (1.2 × 1.5 cm and 2.0 × 2.5 cm, respectively). The first case had intractable seizures, while the second had no seizures with paroxysmal discharge. In both patients, the hamartomas were partially removed, by γ-knife and surgical operation in the first case and surgically in the second, and a gonadotropin releasing hormone (GnRH) analogue was prescribed. One case showed improvement of both intelligence quotient (IQ) score and seizures, and the other showed improvements in IQ and abnormal behavior. It was difficult to determine any topology/symptom relationships. Surgery and GnRH analogue treatment can alleviate seizures, abnormal behavior and mental retardation associated with HH.