جستجوی مقالات مرتبط با کلیدواژه « Progesterone » در نشریات گروه « پزشکی »

Letrozole, an aromatase inhibitor, has recently been introduced as the preferred treatment option for ectopic pregnancy. To date, no study has investigated the effect of letrozole alone on placental tissue. The present study aimed to evaluate the effect of different doses of letrozole on the placenta of rats and to clarify the underlying mechanism. 

Sixty pregnant female rats were equally divided into three groups, namely the control group (GI), low-dose (0.5 mg/Kg/day) letrozole group (GII), which is equivalent to the human daily dose (HED) of 5 mg, and high-dose (1 mg/Kg/day) letrozole group (GIII), equivalent to the HED of 10 mg. Letrozole was administered by oral gavage daily from day 6 to 16 of gestation. Data were analyzed using a one-way analysis of variance followed by Tukey’s post hoc test and Chi square test. P<0.05 was considered statistically significant.

Compared to the GI and GII groups, high-dose letrozole significantly increased embryonic mortality with a high post-implantation loss rate (P<0.001) and significantly reduced the number of viable fetuses (P<0.001) and placental weight (P<0.001) of pregnant rats. Moreover, it significantly reduced placental estrogen receptor (ER) and progesterone receptor (PR) (P<0.001) and the expression of vascular endothelial growth factor (P<0.001), while increasing the apoptotic index of cleaved caspase-3 (P<0.001).

Letrozole inhibited the expression of ER and PR in rat placenta. It interrupted stimulatory vascular signals causing significant apoptosis and placental vascular dysfunction. Letrozole in an equivalent human daily dose of 10 mg caused a high post-implantation loss rate without imposing severe side effects.

A low progesterone level on the embryo transfer (ET) day significantly reduces the pregnancy rate. Therefore,the present study aims to investigate the effect of adding daily 50 mg intramuscular progesterone to a total of 800mg progesterone suppository on the in vitro fertilization (IVF) success rate in women with low progesterone levels. This parallel open-label clinical trial was performed on 218 IVF candidate infertile womenwho had <9.2 ng/ml progesterone levels on the ET day. These women were randomised to the intervention or controlgroup using the randomisation allocation rule. In the intervention group, 50 mg progesterone was prescribed intramuscularlyonce daily in addition to 400 mg of progesterone suppository every 12 hours from the day of ET. The controlgroup received only 400 mg of progesterone suppositories every 12 hours. In the case of pregnancy, the drugs abovewere continued until 12 weeks after the ET. Clinical pregnancy occurred in 54 (50.0%) women in the intervention group and in 39 (36.8%) women in thecontrol group, which was significantly different (P=0.035). Ongoing pregnancy occurred in 47 (43.5%) women in theintervention group, and 33 (31.1%) women in the control group, which was significantly different (P=0.042). Therewere no significant differences in terms of abortion and multiple pregnancy rates between the two groups. Intramuscular injection of 50 mg progesterone significantly increases the clinical and ongoing pregnancyrates (registration number: IRCT20150105020558N6).

Approximately two-thirds of infant mortality within the first year of life are caused by preterm labor (PL).

This study aimed to investigate the effects of progesterone-based compounds to prevent PL.

This randomized clinical trial study was conducted on 146 pregnant women admitted to Department of Obstetrics and Gynecology, Afzalipour hospital in Kerman University of Medical Sciences, Kerman, Iran in June 2019. The participants with PL received Tocolytic and 12 mg Betamethasone in 2 doses over 2 days to mature the fetus’s lungs. Stopping PL was considered a 12-hr period without any contractions after finishing the Tocolytic. Following the successful cessation of PL, the participants were monitored for 48 hr. Subsequently, the participants were divided into 2 groups. Participants received 200 mg Lutogel capsules orally per day in group A while group B received a weekly dose of 250 mg Proluton in the form of intramuscular injection, respectively. Treatment in groups continued until the 36th wk of delivery. The participants were followed-up weekly, and if any signs of PL were detected, an obstetrician carried out a vaginal examination.

The incidence of PL was the same in both groups. There was no significant difference in the latent phase, average birth weight, and the neonatal intensive care unit admission frequency (p = 0.07, 0.17, 0.58, respectively) between groups.

No difference in the results obtained from the neonatal outcomes evaluated in groups. Both medications similarly led to recovering pregnancy and neonatal outcomes caused by PL. Applying the oral form with similar beneficial effects were pointed out in this study, which can be a solution to the issues caused by numerous injections that are inevitable in the injected administration of this medicine.

 A significant number of pregnancies are at risk of threatened abortion (TA). Different types of progesterone are used to treat TA.

 In this study, the effects of 2 forms of progesterone on the continuation of pregnancy and TA-caused pregnancy outcomes were compared.

 A total of 190 women with a gestational age of 6 - 13 weeks presenting with uterine bleeding, closed cervix, and absence of fetal heart rate diagnosed by vaginal examination and ultrasound were allocated into 2 groups and treated with either (D) dydrogesterone (10 mg twice a day) or (M) micronized progesterone (200 mg, twice a day) for beyond 2 weeks after the cessation of uterine bleeding to ensure that bleeding would not recur. The participants were followed up and received prenatal care until the end of pregnancy. The outcomes of pregnancy were recorded and compared between the 2 groups.

 The incidence of preeclampsia, gestational diabetes, cesarean section, intrauterine fetal death (IUFD), placenta previa, and abortion was not significantly different between the 2 groups. However, the prevalence of preterm labor and low birth weight (LBW) was significantly lower in M-treated women (P < 0.001 and P = 0.007, respectively). The baby’s weight and gestational age at delivery were significantly higher in the M group than in the D group (P < 0.001). No serious drug side effects were observed in the 2 groups throughout the study.

 The results of this study showed that the incidence of preterm labor and LBW was significantly lower in the patients treated with micronized progesterone than in patients treated with dydrogesterone; however, the prevalence of preeclampsia, gestational diabetes, cesarean section, IUFD, and abortion was not significantly different between the 2 groups.

 A significant number of pregnancies are at risk of threatened abortion (TA). Different types of progesterone are used to treat TA.

 In this study, the effects of 2 forms of progesterone on the continuation of pregnancy and TA-caused pregnancy outcomes were compared.

 A total of 190 women with a gestational age of 6 - 13 weeks presenting with uterine bleeding, closed cervix, and absence of fetal heart rate diagnosed by vaginal examination and ultrasound were allocated into 2 groups and treated with either (D) dydrogesterone (10 mg twice a day) or (M) micronized progesterone (200 mg, twice a day) for beyond 2 weeks after the cessation of uterine bleeding to ensure that bleeding would not recur. The participants were followed up and received prenatal care until the end of pregnancy. The outcomes of pregnancy were recorded and compared between the 2 groups.

 The incidence of preeclampsia, gestational diabetes, cesarean section, intrauterine fetal death (IUFD), placenta previa, and abortion was not significantly different between the 2 groups. However, the prevalence of preterm labor and low birth weight (LBW) was significantly lower in M-treated women (P < 0.001 and P = 0.007, respectively). The baby’s weight and gestational age at delivery were significantly higher in the M group than in the D group (P < 0.001). No serious drug side effects were observed in the 2 groups throughout the study.

 The results of this study showed that the incidence of preterm labor and LBW was significantly lower in the patients treated with micronized progesterone than in patients treated with dydrogesterone; however, the prevalence of preeclampsia, gestational diabetes, cesarean section, IUFD, and abortion was not significantly different between the 2 groups.

Human epidermal growth factor 2 (HER2) is known to be an important prognostic factor in breast cancer. Numerous studies have shown HER2+ breast cancers have reduced overall survival and recovery time, as well as the efficacy of anti-HER2 therapies along with chemotherapy in improving disease outcomes. For this reason, it is recommended that all patients with breast cancer should be evaluated for HER2 status. This study aimed to assess the HER2 gene amplification by the CISH method in evaluating the HER2 status in patients with immunohistochemistry (IHC) 2+ (equivocal) results.

This retrospective cross-sectional study examined HER2 status based on the Chromogenic in situ hybridization (CISH) method in 280 breast carcinoma samples with an initial 2+ (equivocal) score in IHC. The relationship between HER2 amplification and hormone receptors (estrogen and progesterone) and Ki67 level was also investigated.

In sixty samples (21.4%), the HER2 gene was amplified based on the CISH method. The majority (215, 76.8%) of the samples were negative and 5 (1.8%) samples were indeterminate. No significant relationship was observed between HER2 amplification, estrogen receptor (p=0.143), and Ki-67 protein level (p=0.977). There was a significant inverse relationship between HER2 amplification and progesterone receptor positivity (p=0.007).

These results demonstrate that CISH is a helpful method to assess HER2 status in equivocal breast cancer and is positive (amplified) in about 21.4% of them.

Induction of ovulation results in changes in ovary including the tissue immune cells. Administration of progesterone following induction of ovulation may ameliorate some of these changes. The present study was conducted to examine the effect of this administration of progesterone on mast cell count and tissue histamine level in mice ovary at pre-implantation time.

An experimental study on 15 NMRI mice was carried out. The groups of study were control group, induction of ovulation group and a group for administration of progesterone after induction of ovulation. Mast cells count was through toluidine blue staining and tissue histamine level measure was through spectrophotometry. Analysis of variance (ANOVA) was used for data analysis.

The mean of mast cell count was significantly different between the groups (P <.001). Pairwise comparisons showed that induction group had significantly higher mast cells in comparison with control group (P =.039), indicating the effect of ovulation induction on mast cell count. The count was higher in progesterone group in comparison with induction group (P =.020). Mean of histamine level was significantly different between the groups (P <.001). Induction group had significantly higher histamine level in comparison with control group (P <.001). However, histamine level was not significantly different between induction and histamine groups (P =.998).

Ovulation induction raises ovary mast cell population and histamine level. However, progesterone could notimprove this change. Further studies should be conducted to find further roles of mast cells and histamine in ovary

Breast cancer is a multifactorial disease, and steroid hormones, especially estrogens and progesterone, are among the most important risk factors. Some conditions such as pregnancy, early menarche, late age at first full-term pregnancy, and use of oral contraceptive pills (OCPs), which increase the risk of estrogen exposure, also increase the risk of breast cancer. This study aimed to evaluate OCP use–related hormonal changes as a risk factor for breast cancer in young women in Najaf.

This cross-sectional study was conducted on 75 breast cancer patients and 25 healthy women between January and June 2021 at Al-Sader Teaching Hospital and the Middle Euphrates Cancer Center in Najaf city, Iraq. After obtaining written informed consent, the researchers drew 5 ml of venous blood from each participant and analyzed the samples using the cobas® e 411 analyzer. Estrogen and progesterone serum levels were measured to evaluate the relationship between the use of OCPs and breast cancer.

The mean serum level of estrogen in breast cancer patients with and without a history of OCP use (159.80 pg/ml 168.23 pg/ml, respectively) was significantly higher compared with the control group (95.48 pg/ml). The mean serum levels of progesterone in patients with and without a history of OCP use were 4.9 and 4.12 pg/ml, respectively, which in users was higher than in the control group (4.3 pg/ml, P = 0.01).

This study found that using OCPs was associated with a higher risk for breast cancer. This issue can be considered in health policies to control breast cancer incidence.

 Shereshevsky-Turner Syndrome is a chromosomal condition that affects females owing to full or partial missing of X-monosomy in all or part of the body's cells. Shereshevsky-Turner Syndrome is characterized by severe hormonal disorders and defects of the cardiovascular and urinary systems. With the advent of assisted reproductive technology (ART), pregnancy has become more accessible for this group of cases, often with donor eggs. In the available literature, it was not possible to find exact information during the time of selection of progestogen support, the duration of the appointment, and the term of withdrawal.

 This is the case of a 36-yr-old primigravid woman suffering from STs, mosaic karyotype comprising of 3 clones: 45X (69), 46XX (23), 47XXX (8), and 1000 interphase nuclei. In this case, we left high-maintenance doses of progesterone due to the application of ART and concomitant extragenital pathology, leading to a decrease in all functions of the placenta, including the endocrine. The woman was monitored before, during, and after the pregnancy. She was delivered at 37 wk and 6 days of gestation.

 ART increases the possibility of having a pregnancy and gestation in cases with a wide variety of genital and extragenital pathologies.

Changes in auditory function have been noted in post-menopausal women attributed in part to the lower levels of ovarian hormones. Decreased levels of ovarian hormones may alter auditory neurotransmission time, as evaluated by Auditory Brainstem Responses (ABR). Thus, the objective of this study was to compare the mean inter-peak ABR latencies and post-menopausal women compared to non-menopausal women.

In this cross-sectional study, research sample consisted of 60 women as case group in the age range of 45-55 years, who were post-menopausal and had normal hearing. The control group with similar characteristics were non-menopausal. Two groups were estimated by ABR and then the means of the variables that had a normal distribution were compared with each other by independent t-test.  

All differences between two groups were not significant, as follows; Mean I-III inter-peak ABR latencies (p-value=0.714), mean III-V inter-peak ABR latencies (p-value=0.691) and mean I-V inter-peak ABR latencies (p-value=0.483).

Menopause does not cause abnormal results in auditory brainstem responses.

Changes in auditory function have been noted in post-menopausal women attributed in part to the lower levels of ovarian hormones. Decreased levels of ovarian hormones may alter auditory neurotransmission time, as evaluated by Auditory Brainstem Responses (ABR). Thus, objective of this study was comparison of mean inter-peak ABR latencies in post-menopausal women compared to non-menopausal women.

In this cross-sectional study, research sample consisted of 60 women as case group in the age range of 45-55 years, who were post-menopausal and had normal hearing. The control group with similar characteristics were non-menopausal. Two groups were estimated by ABR and then the means of the variables that had a normal distribution were compared with each other by independent t-test.  

All differences between two groups were not significant, as follows; Mean I-III inter-peak ABR latencies (p-value=0.714), mean III-V inter-peak ABR latencies (p-value=0.691) and mean I-V inter-peak ABR latencies (p-value=0.483).

Menopause does not cause abnormal results in auditory brainstem responses.

Insufficient serum progesterone level in the implantation phase may reduce the rate of pregnancy during freeze embryo transfer (FET) cycles. The present study aimed to evaluate the impact of FET day serum progesterone level on pregnancy outcomes in patients receiving intramuscular plus vaginal progesterone administration for endometrial preparation.

Based on serum progesterone level on FET day, patients were divided into four quartiles: first ( < 25%), second (26–50%), third (51%–75%), and fourth ( > 75%). There was no significant difference among groups in basal characteristics.

No statistically significant difference was seen among groups concerning the mean number of retrieved and mature oocytes, embryos transferred, and endometrial thickness (EnT). The rate of implantation (P = 0.5), biochemical (P = 0.75), clinical (P = 0.54), and ongoing pregnancy (P = 0.5) were not associated with serum progesterone level on embryo transfer day.

We found that there is no association between serum progesterone level on ET day and pregnancy outcome during FET cycles. It seems that combination therapy using intramuscular and vaginal progesterone, keeps the serum progesterone on ET day high enough that eliminates the need for serum progesterone measurement.

Luteal phase deficiency is common in assisted reproductive technology and is characterized by inadequate progesterone production. Various studies have shown that administration of progesterone in fresh embryo transfer cycles increases the rate of clinical pregnancy and live birth rate. Progesterone administration has variable types: oral, vaginal, oil-based intramuscular, and subcutaneous.

This study aims to compare the effect of adding intramuscular progesterone to the vaginal progesterone for luteal phase support in the fresh embryo transfer cycle.

This study reviewed the information related to 355 women who had a fresh embryo transfer between March 2020 and February 2021 at the Yazd Reproductive Sciences Institute, Yazd, Iran. The participants population were divided into 2 groups based on the type of luteal phase support regime: group I (n = 173) received 400 mg vaginal progesterone alone twice a day from the day of ovum pick up; and group II (n = 182) received 50 mg IM of progesterone in addition to vaginal progesterone 400 mg twice a day from the day of ovum pick up. Chemical and clinical pregnancy rates were compared between groups.

The basic characteristics of groups were statistically similar. The rates of chemical and clinical pregnancy were higher in the vaginal plus IM progesterone group than in the vaginal progesterone group. Moreover, chemical pregnancy showed a significant difference between the groups (p = 0.011).

Our findings demonstrated that the addition of IM progesterone to the vaginal progesterone improves the chemical pregnancy rate in fresh embryo transfer.

The purpose of the current study was to assess if luteal support with intramuscular (IM) 17 alpha-hydroxyprogesterone caproate (17-OHPC) (Lentogest, IBSA, Italy) improves the pregnancy outcome in comparison to natural intramuscu-lar progesterone (Prontogest, AMSA, Italy) when administered to recipients in a frozen embryo transfer cycle.

A retrospective comparative study was performed to evaluate outcomes between two different intramuscular regimens used for luteal support in frozen embryo transfer cycles in patients underwent autologous in vitro fertilization (IVF) cycles (896 IVF cycles) and intracytoplasmic sperm injection (ICSI) who had a blastocyst transfer from February 2014 to March 2017 at the Centre for Reproductive and Genetic Health (CRGH) in London.

The live birth rates were significantly lower for the IM natural progesterone group when compared to 17-OHPC group (41.8% vs. 50.9%, adjusted OR of 0.63 (0.31-0.91)). The miscarriage rates were significantly lower in the 17-OHPC group compared to the IM natural progesterone group (14.5% vs. 19.2%, OR of 1.5, 95% CI of 1.13-2.11). The gestational age at birth and birth weight were similar in both groups (p=0.297 and p=0.966, respectively).

It is known that both intramuscular and vaginal progesterone preparations are the standard of care for luteal phase support in women having frozen embryo transfer cycles. However, there is no clear scientific consensus regarding the optimal luteal support. In this study, it was revealed that live birth rates are significantly higher in women who received artificial progesterone compared to women who received natural progesterone in frozen embryo transfer cycles.