Effects of synthetic conjugated estrogens A on sleep quality in postmenopausal women with nocturnal diaphoresis and/or hot flushes: a pilot study

In a single-center, double-blind, placebo-controlled pilot study, patients who received 0.625 mg daily of synthetic conjugated estrogens A experienced a statistically significant reduction in the average number of hot flushes and galvanic skin responses. The polysomnographic change in sleep measures did not reach statistical significance, but the data suggest an overall improvement in sleep quality in the treatment group.     

来曲唑、他莫昔芬和氯米芬治疗多囊卵巢综合征不孕疗效比较

目的比较多囊卵巢综合征(PCOS)不孕患者经纠正内分泌代谢紊乱后应用3种不同促排卵药物的效果及对子宫内膜的影响。方法选择2009年3月至2010年1月中山大学孙逸仙纪念医院妇产科生殖中心128例PCOS不孕患者,于本院行第1次促排卵,有高雄激素或胰岛素抵抗者经预处理至少3个月。随机分为3组,来曲唑44个周期、他莫昔芬40个周期和氯米芬44个周期。结果月经第10天的子宫内膜厚度,他莫昔芬组[(6.4±1.2)mm]高于来曲唑组[(5.4±1.7)mm]和氯米芬组[(5.4±1.3)mm](P=0.01);HCG日血雌二醇(E2)水平,来曲唑组[(838.6±678.2)pmol/L]低于他莫昔芬组[(2629.2±1931.5)pmol/L]和氯米芬组[(1971.2±1222.8)pmol/L](P<0.001);3组间加用尿促性腺激素(HMG)周期数,HCG日子宫内膜厚度、血黄体生成素及孕酮、直径≥18mm成熟卵泡数,妊娠率和早期流产率,差异无统计学意义(P>0.05);HCG日子宫内膜的厚度与注射HCG的月经周期日及月经第10天的子宫内膜厚度呈正相关(P<0.05),与药物的种类及HCG日血E2水平等无显...     

Hormone replacement therapy in postmenopausal women with Alzheimer's disease: a randomized,prospective study

OBJECTIVE: To compare the therapeutic efficacy of hormone replacement therapy (HRT) and tacrine in Alzheimer's disease. DESIGN: Six-month, randomized, open-label study. SETTING: University hospital. PATIENT(S): Fifty-five women with mild to moderate Alzheimer's disease were randomly assigned to tacrine (n = 26) or HRT (n = 29). INTERVENTION(S): In the tacrine group, an initial dose of 40 mg/day was increased up to 160 mg/day. In the HRT group, conjugated equine estrogen was given to patients without uteri (n = 3) or together with micronized progesterone to patients with uteri (n = 26). MAIN OUTCOME MEASURE(S): Mini-Mental State Examination (MMSE), Hopkins Verbal Learning Test, Boston Naming Test, Controlled Oral Word Association Test, Geriatric Depression Scale, Hamilton Depression Scale (HDS), and Instrumental Activities of Daily Living (IADL). RESULT(S): Thirty-three patients who completed the outcome measures (tacrine, 17; HRT, 16) were included in an intent-to-treat analysis. The results did not differ between groups except for IADL, which rated more highly after HRT. Apolipoprotein E genotype effects were assessed. MMSE and HDS scores were improved after tacrine treatment in epsilon 4-negative patients. CONCLUSION(S): Overall efficacy of estrogen plus progesterone combination was similar to tacrine for cognition and mood, but greater for ADL. In epsilon 4-negative patients, tacrine is preferable for cognition and mood.     

A randomized comparison of ovulation induction and hormone profile between the aromatase inhibitor anastrozole and clomiphene citrate in women with infertility

Background. In the present study we evaluated and compared the effects of ovulation and hormonal dynamics induced by anastrozole and clomiphene citrate in women with infertility.

Materials and methods. Thirty-three infertile patients, aged 25–41 years, were enrolled. Patients received either anastrozole 1 mg daily (AI group) or clomiphene citrate 100 mg daily (CC group) from cycle day 3 to day 7. Number of mature follicles (≥18 mm), endometrial thickness, pregnancy rate and serial hormone profiles (follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E₂), testosterone and progesterone) were measured on cycle day 3, day 8, day 10, the day of intrauterine insemination (IUI), day 7 after IUI and day 14 after IUI.

Results. Baseline parameters were similar in the two groups, including age, body mass index, infertility duration and day-3 serum hormones except FSH. The mean FSH value on day 3 was significantly different (4.3 mIU/ml in the AI group vs. 6.3 mIU/ml in the CC group; p < 0.05). The women receiving anastrozole had fewer ovulatory follicles (1.2 in the AI group vs. 1.8 in the CC group; p < 0.05) and a thicker endometrium (10.6 mm in the AI group vs. 7.8 mm in the CC group; p < 0.05). The levels of progesterone and testosterone were similar during ovulation stimulation cycles in both groups. On the other hand, the AI group had a significantly higher LH level but a significantly lower E₂ level in the stimulation cycle.

Conclusion. Anastrozole has a high pregnancy rate, although it induces fewer ovulatory follicles compared with clomiphene citrate. The two drugs gave different responses of FSH, LH and E₂ during stimulation cycles.     

Effects of metformin on body mass index,menstrual cyclicity,and ovulation induction in women with polycystic ovary syndrome

OBJECTIVE: Metformin has been used as a treatment in many studies of the infertility associated with polycystic ovary syndrome (PCOS). We will review the literature on this topic as it specifically relates to changes in body mass index (BMI), improvement in menstrual cyclicity, and effects on ovulation and pregnancy rates. DESIGN: Review of studies addressing biochemical and clinical changes in women with PCOS on metformin. MAIN OUTCOME MEASURE(S): Changes in BMI, menstrual cyclicity, ovulation rate, and pregnancy rate. RESULT(S): Metformin has been shown to produce small but significant reductions in BMI. Multiple observational studies have confirmed an improvement in menstrual cyclicity with metformin therapy. The studies addressing the concomitant use of metformin with clomiphene citrate initially predicted great success, but these have been followed by more modest results. There is little data in the literature concerning the use of metformin and hMGs. CONCLUSION(S): Some (but not all) women with PCOS have improvements in their menstrual cycles while on metformin. The data supporting the use of metformin in ovulation induction with clomiphene citrate and hMG remain to be confirmed by large, randomized, prospective studies.     

Hyperbaric oxygen and ovarian follicular stimulation for in vitro fertilization: a pilot study

Our objective was to assess the safety and tolerability of hyperbaric oxygen therapy (HBO) as an adjunct to IVF therapy in women with a poor prognosis for pregnancy in a prospective observational pilot study. We conclude that HBO is well tolerated by women undergoing IVF treatment and that further study is required to determine whether this is an efficacious adjuvant therapy for women being treated by IVF.     

A pilot study evaluating a telephone-based exercise intervention for pregnant and postpartum women

Introduction: Exercise during pregnancy is associated with reduced rates of preeclampsia, gestational diabetes, anxiety, insomnia, and excessive weight gain. Continued exercise during the postpartum period is important for healthy weight loss and reduced anxiety. Unfortunately, pregnant and postpartum women are significantly less active than nonpregnant women. The purpose of this pilot study was to evaluate a telephone‐based exercise intervention designed for pregnant and postpartum women. Methods: Healthy women (N = 37) who were pregnant (16 weeks’ gestation or less) or postpartum (6 months or less) participated in a 3‐month, telephone‐based exercise intervention based on the transtheoretical model and social cognitive theory. Exercise was assessed by using the 7‐Day Physical Activity Recall Interview. Results: Pregnant participants significantly increased their exercise from a mean (standard deviation [SD]) of 60.47 (63.1) minutes per week at baseline to 132.9 (82.3) minutes at 3 months, F(1,13) = 9.96, P < .01. Postpartum participants significantly increased their exercise from a mean (SD) of 68.9 (63.5) minutes per week at baseline to 123.8 (48.8) minutes at 3 months, F(1,15) = 6.56, P < .05. Discussion: Participants responded positively to the intervention by significantly increasing their exercise levels. There is a need for a large, randomized controlled trial examining the efficacy of telephone‐based exercise interventions for pregnant and postpartum women.     

A comparison of letrozole to gonadotropins for ovulation induction in subjects with advanced maternal age: a retrospective pilot study

This retrospective study was performed to compare the success of ovulation induction using letrozole versus gonadotropins in women at least 38 years of age, with normal ovarian reserve. Pregnancy and clinical pregnancy rates (PR) were statistically higher with gonadotropin than with letrozole stimulation.     

女性不孕症患者焦虑、抑郁状况和生活质量调查

目的调查女性不孕症患者焦虑、抑郁状况和生活质量,以探讨影响不孕症患者生活质量的因素。方法对182例女性不孕症患者进行焦虑、抑郁和生活质量测评,分析患者不同精神状况的特征,确定对其生活质量的影响因素。结果 182例不孕症患者中,有焦虑者46例(25.3%),有抑郁者20例(11.0%)。焦虑患者伴肥胖症、中等及以下教育程度、单纯女方不孕分别为15例(32.6%)、32例(69.6%)和26例(56.5%),高于无焦虑者的13例(9.6%)、70例(51.5%)和50例(36.8%),两组各因素比较,差异有统计学意义(P均0.05)。抑郁患者伴肥胖症、单纯女方不孕分别为11例(55.0%)和13例(65.0%),高于无抑郁患者的17例(10.5%)和63例(38.9%),两组各因素比较,差异有统计学意义(P均0.05)。焦虑或抑郁患者的躯体健康评分分别为(88±15)分和(89±12)分,精神状况正常者为(90±15)分和(89±15)分,差异无统计学意义(P0.05);而评价生活质量的其他评分比较,差异有统计学意义(P0.05)。多元回归分析显示,焦虑是影响生活质量危险因素(t=-5.665,P0.001)。结论女性不孕症患者的精神障碍发病率高,精神障碍影响患者生活质量。     

A pilot feasibility study of mindfulness childbirth education for women with a history of sexual trauma

Backgroundand purpose: Pregnant women with a history of sexual trauma are at increased risk for mood disorders. Mindfulness interventions delivered prenatally may reduce risk of mood disorders. The purpose of this pilot was to examine the feasibility and acceptability of Mindfulness-Based Childbirth and Parenting (MBCP) for women with a history of sexual trauma.Materials and methodsA one-group repeated measures design was employed, involving three assessments: baseline, post-intervention and at eight weeks postpartum. Twelve pregnant women were recruited and enrolled. Self-report measures and open-ended written questionnaires were used to assess health outcomes and intervention acceptability.ResultsResults show high satisfaction with the program, an immediate reduction in prenatal anxiety, and longitudinal increase in interoceptive awareness skills.ConclusionThe results suggest the feasibility and acceptability of the MBCP approach for women with a history of sexual trauma.