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P880 The impact of oral contraceptives and metformin on antimüllerian hormone serum levels in women with polycystic ovary syndrome
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Poster presentations / International Journal of Gynecology & Obstetrics 107S2 (2009) S413–S729
Conclusions: PTEN may influence the proliferation of human granulosa cells as well as disturbance of follicular growth in PCOS patients. P879 Effect of cinnamon (Cinnamomum zeylanicum) on reproductive system in male mice M. Modaresi1 , M. Mesripour2 , R. Rajaii3 . 1 Department of Animal Science, Islamic Azad University (Khorasgan Branch), Isfahan, Iran, 2 Department of Physiology, Islamic Azad University (Khorasgan Branch), Isfahan, Iran, 3 Department of Animal Science, Payam Noor University (Esfahan Center) Cinnamon (Cinnamomum zeylanicum) has many pharmaceutical effects which one of the best important uses is increasing of sexuality. In this research considered the effect of cinnamon bark extract on male Balb/c mice reproductive system. At first, samples separated full casually, as six groups and in any of group eight samples, respectively as, experimental groups 1, 2, 3, 4 and two groups, control and placebo which kept in the same conditions. Cinnamon hydro-ethanolic extract provided in different dose (50, 100, 200 and 400 mg/kg/2 day) and injected intraperitonealy for 20 days. These groups compared with control group. The best important parameters in this research included: the testicles weight changes, probably histological changes in testis, change in number of sexual cells and density of LH, FSH and testosterone in blood of samples. The hormonal experiments were measured by RIA technique. The results indicated that cinnamon significantly can be increase the level of LH and FSH in dose of 200, 400 mg/kg. The density of testosterone increased in dose of 50, 100 mg/kg also the number of sperms and primary spermatocytes raise in 200, 400 cinnamon extract but no significant differences were observed in weight of testicles and histological changes. The finding of this research indicated the positive effect of cinnamon extract on male reproductive system and hormone change in pituitary-gonad axis because sperm count and secretion of FSH hormone meaningful improve in dose of 200, 400 mg/kg. P880 The impact of oral contraceptives and metformin on antimullerian ¨ hormone serum levels in women with polycystic ovary syndrome J. Mousatat1 , A. Piouka2 , A. Karkanaki1 , I. Katsikis2 , N. Georgopoulos2 , D. Panidis2 . 1 Obstetrics and Gynecology Department, Giannitsa General Hospital, Giannitsa, Greece, 2 Division of Endocrinology and Human Reproduction, 2nd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Thessaloniki, Greece The aim of the present study was to assess the impact of metformin and of two different regimens of oral contraceptives containing different progestins, namely cyproterone acetate and drospirenone, on serum antimullerian ¨ hormone (AMH) levels in a well characterized cohort of women with polycystic ovary syndrome (PCOS), recruited on the base of the more strict criteria. The study included forty five (45) women with PCOS diagnosed according to the criteria proposed in 1990 by the National Institute of Child Health and Human Development Conference on PCOS. Women with PCOS were divided into three groups: Group A was treated for 6 months with an oral contraceptive (OC) containing 35 mg ethinylestradiol plus 2 mg cyproterone acetate, Group B was treated for 6 months with an OC containing 30 mg ethinylestradiol plus 3 mg drospirenone, and Group C was treated for 6 months with metformin 850 mg ×2. AMH serum levels were significantly decreased under treatment with an oral contraceptive containing 35 mg ethinylestradiol plus 2 mg cyproterone acetate both after 3 and after 6 months (p < 0.001 and p = 0.002, respectively). This effect was achieved
through the decrease in serum androgens, the suppression of pituitary gonadotropins and the amelioration of insulin resistance under treatment with an OC containing cyproterone acetate. Treatment with an OC containing 30 mg ethinylestradiol plus 3 mg drospirenone, as well as treatment with metformin 850 mg×2 did not significantly affect serum AMH levels. P881 Enlargement of thyroid nodule in pregnancy: A case report S. Pankaja, V. Stamelos, R. Indusekhar. University Hospital of North Staffordshire, Stoke-on-Trent, UK Objective: To make clinicians aware of the pitfalls in the diagnosis and management of thyroid disorders in pregnancy. Patient and Methods: A 40 year old gravida 4 para 3 (one caesarean section followed by two normal deliveries), booked in the antenatal clinic at 14 weeks gestation. She had longstanding thyroid nodules confirmed by FNAC and USS to be colloid nodules with normal thyroid function tests. At 34 weeks, free T4 was towards lower side of normal range and she was started on low dosage of thyroxine supplement. She presented to antenatal clinic at 39 weeks gestation with the complaint of sudden increase in the size of thyroid swelling over 3 weeks, significant biphasic stridor and shortness of breath. Physical examination revealed massive multinodular goitre with tracheal deviation to the right. She was admitted and seen by the Endocrinologist, ENT specialists and anaesthetists. USS and CT scan revealed grossly enlarged thyroid with multiple nodules with retrosternal extension and narrowing and displacement of trachea to the right. To reduce respiratory effort of delivery, elective CS was performed along with total thyroidectomy. Results: She was started on full thyroxine replacement therapy and at 3 months follow up her calcium and thyroid function tests were found to be normal. Conclusion: Pregnancy itself is an iodine deficiency state and could result in formation or rapid enlargement of pre existing thyroid nodules. Even small increase in size of thyroid nodules can have profound impact on respiratory effort in pregnancy. A multidisciplinary approach is essential for optimal management. P882 Klippel-Feil anomaly associated, Rokitansky-Kustner ¨ syndrome, pelvic kidneys and bilateral gonadal dysgenesis: A case report N. Atakul, L. Senturk, B. Bulut, S. Sahmay. Reproductive Endocrinology division, Department of Obstetrics and Gynecology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey Objective: Klippel-Feil syndrome is a rare disorder caused by failure of the division of the bones in the cervical spine during embryonic development.We describe a patient with established Klippel-Feil syndrome and multiple genital anomalies. Case report: A 16-year old girl with primary amenorrhea admitted to our deparment was evaluated initally with physical examination. Vaginal vestibule was oblitareted, there was only 2 cm depth of blind pouch. She has Turner phenotype with webbed neck, short stature and low hairline on the neck.Her MR of cervical spine show fusion of the C2–7 caudally, consistent with Klippel-Feil syndrome.Her abdominal MR showed biletarel pelvic kidney, uterus and bilateral ovaries were not visualized.FSH, LH, E2 values are 4.8, 3.2 and 35 mIU/ml respectively.The karyotype was 46 XX. Conclusion: The association between Kleippel-Feil and genital anomalies is very rare. Although there are few published cases with absent vagina, Mayer-Rokitansky or agenesis of uterine cervix with this syndrome.Presence of bilateral ovarian dysgenesis and MayerRokitansky unusual.An association between these two conditions is very exceptional and appears to be coincidental. The incidence of renal anomalies in Feil’s and Rokitanski-Kustner ¨ are not rare, unilateral renal agenesis being the most common in both.A We
Poster presentations / International Journal of Gynecology & Obstetrics 107S2 (2009) S413–S729
Conclusions: PTEN may influence the proliferation of human granulosa cells as well as disturbance of follicular growth in PCOS patients. P879 Effect of cinnamon (Cinnamomum zeylanicum) on reproductive system in male mice M. Modaresi1 , M. Mesripour2 , R. Rajaii3 . 1 Department of Animal Science, Islamic Azad University (Khorasgan Branch), Isfahan, Iran, 2 Department of Physiology, Islamic Azad University (Khorasgan Branch), Isfahan, Iran, 3 Department of Animal Science, Payam Noor University (Esfahan Center) Cinnamon (Cinnamomum zeylanicum) has many pharmaceutical effects which one of the best important uses is increasing of sexuality. In this research considered the effect of cinnamon bark extract on male Balb/c mice reproductive system. At first, samples separated full casually, as six groups and in any of group eight samples, respectively as, experimental groups 1, 2, 3, 4 and two groups, control and placebo which kept in the same conditions. Cinnamon hydro-ethanolic extract provided in different dose (50, 100, 200 and 400 mg/kg/2 day) and injected intraperitonealy for 20 days. These groups compared with control group. The best important parameters in this research included: the testicles weight changes, probably histological changes in testis, change in number of sexual cells and density of LH, FSH and testosterone in blood of samples. The hormonal experiments were measured by RIA technique. The results indicated that cinnamon significantly can be increase the level of LH and FSH in dose of 200, 400 mg/kg. The density of testosterone increased in dose of 50, 100 mg/kg also the number of sperms and primary spermatocytes raise in 200, 400 cinnamon extract but no significant differences were observed in weight of testicles and histological changes. The finding of this research indicated the positive effect of cinnamon extract on male reproductive system and hormone change in pituitary-gonad axis because sperm count and secretion of FSH hormone meaningful improve in dose of 200, 400 mg/kg. P880 The impact of oral contraceptives and metformin on antimullerian ¨ hormone serum levels in women with polycystic ovary syndrome J. Mousatat1 , A. Piouka2 , A. Karkanaki1 , I. Katsikis2 , N. Georgopoulos2 , D. Panidis2 . 1 Obstetrics and Gynecology Department, Giannitsa General Hospital, Giannitsa, Greece, 2 Division of Endocrinology and Human Reproduction, 2nd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Thessaloniki, Greece The aim of the present study was to assess the impact of metformin and of two different regimens of oral contraceptives containing different progestins, namely cyproterone acetate and drospirenone, on serum antimullerian ¨ hormone (AMH) levels in a well characterized cohort of women with polycystic ovary syndrome (PCOS), recruited on the base of the more strict criteria. The study included forty five (45) women with PCOS diagnosed according to the criteria proposed in 1990 by the National Institute of Child Health and Human Development Conference on PCOS. Women with PCOS were divided into three groups: Group A was treated for 6 months with an oral contraceptive (OC) containing 35 mg ethinylestradiol plus 2 mg cyproterone acetate, Group B was treated for 6 months with an OC containing 30 mg ethinylestradiol plus 3 mg drospirenone, and Group C was treated for 6 months with metformin 850 mg ×2. AMH serum levels were significantly decreased under treatment with an oral contraceptive containing 35 mg ethinylestradiol plus 2 mg cyproterone acetate both after 3 and after 6 months (p < 0.001 and p = 0.002, respectively). This effect was achieved
through the decrease in serum androgens, the suppression of pituitary gonadotropins and the amelioration of insulin resistance under treatment with an OC containing cyproterone acetate. Treatment with an OC containing 30 mg ethinylestradiol plus 3 mg drospirenone, as well as treatment with metformin 850 mg×2 did not significantly affect serum AMH levels. P881 Enlargement of thyroid nodule in pregnancy: A case report S. Pankaja, V. Stamelos, R. Indusekhar. University Hospital of North Staffordshire, Stoke-on-Trent, UK Objective: To make clinicians aware of the pitfalls in the diagnosis and management of thyroid disorders in pregnancy. Patient and Methods: A 40 year old gravida 4 para 3 (one caesarean section followed by two normal deliveries), booked in the antenatal clinic at 14 weeks gestation. She had longstanding thyroid nodules confirmed by FNAC and USS to be colloid nodules with normal thyroid function tests. At 34 weeks, free T4 was towards lower side of normal range and she was started on low dosage of thyroxine supplement. She presented to antenatal clinic at 39 weeks gestation with the complaint of sudden increase in the size of thyroid swelling over 3 weeks, significant biphasic stridor and shortness of breath. Physical examination revealed massive multinodular goitre with tracheal deviation to the right. She was admitted and seen by the Endocrinologist, ENT specialists and anaesthetists. USS and CT scan revealed grossly enlarged thyroid with multiple nodules with retrosternal extension and narrowing and displacement of trachea to the right. To reduce respiratory effort of delivery, elective CS was performed along with total thyroidectomy. Results: She was started on full thyroxine replacement therapy and at 3 months follow up her calcium and thyroid function tests were found to be normal. Conclusion: Pregnancy itself is an iodine deficiency state and could result in formation or rapid enlargement of pre existing thyroid nodules. Even small increase in size of thyroid nodules can have profound impact on respiratory effort in pregnancy. A multidisciplinary approach is essential for optimal management. P882 Klippel-Feil anomaly associated, Rokitansky-Kustner ¨ syndrome, pelvic kidneys and bilateral gonadal dysgenesis: A case report N. Atakul, L. Senturk, B. Bulut, S. Sahmay. Reproductive Endocrinology division, Department of Obstetrics and Gynecology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey Objective: Klippel-Feil syndrome is a rare disorder caused by failure of the division of the bones in the cervical spine during embryonic development.We describe a patient with established Klippel-Feil syndrome and multiple genital anomalies. Case report: A 16-year old girl with primary amenorrhea admitted to our deparment was evaluated initally with physical examination. Vaginal vestibule was oblitareted, there was only 2 cm depth of blind pouch. She has Turner phenotype with webbed neck, short stature and low hairline on the neck.Her MR of cervical spine show fusion of the C2–7 caudally, consistent with Klippel-Feil syndrome.Her abdominal MR showed biletarel pelvic kidney, uterus and bilateral ovaries were not visualized.FSH, LH, E2 values are 4.8, 3.2 and 35 mIU/ml respectively.The karyotype was 46 XX. Conclusion: The association between Kleippel-Feil and genital anomalies is very rare. Although there are few published cases with absent vagina, Mayer-Rokitansky or agenesis of uterine cervix with this syndrome.Presence of bilateral ovarian dysgenesis and MayerRokitansky unusual.An association between these two conditions is very exceptional and appears to be coincidental. The incidence of renal anomalies in Feil’s and Rokitanski-Kustner ¨ are not rare, unilateral renal agenesis being the most common in both.A We