Kisspeptin levels in idiopathic hypogonadotropic hypogonadism diagnosed male patients and its relation with glucose-insulin dynamic

Male hypogonadism is defined as the deficiency of testosterone or sperm production synthesized by testicles or the deficiency of both. The reasons for hypogonadism may be primary, meaning testicular or secondary, meaning hypothalamohypophyseal. In hypogonadotropic hypogonadism (HH), there is indeficiency in gonadotropic hormones due to hypothalamic or hypophyseal reasons. Gonadotropin-releasing hormone (GnRH) is an important stimulant in releasing follicular stimulant hormone (FSH), mainly luteinizing hormone (LH). GnRH omitted is under the effect of many hormonal or stimulating factors. Kisspeptin is present in many places of the body, mostly in hypothalamic anteroventral periventricular nucleus and arcuate nucleus. Kisspeptin has a suppressor effect on the metastasis of many tumors such as breast cancer and malign melanoma metastases, and is called “metastin” for this reason. Kisspeptin is a strong stimulant of GnRH. In idiopathic hypogonadotropic hypogonadism (IHH) etiology, there is gonadotropic hormone release indeficiency which cannot be clearly described.

A total of 30 male hypogonatropic hypogonadism diagnosed patients over 30 years of age who have applied to Haydarpasa Education Hospital Endocrinology and Metabolic Diseases Service were included in the study. Compared to the control group, the effect of kisspeptin on male patients with hypogonatropic hypogonadism and on insulin resistance developing in hypogonadism patients was investigated in our study.

A statistically significant difference was detected between average kisspeptin measurements of the groups (p?The reason for high kisspeptin levels in the patient group compared to the control group makes us consider that there may be a GPR54 resistance or GnRH neuronal transfer pathway defect. When patients and control groups were compared for HOMA-IR, the difference was not statistically significant. It is considered that kisspeptin is one of the reasons for hypogonatropic hypogonadism and has less effect on insulin resistance.     

Follicular fluid norepinephrine and dopamine concentrations are higher in polycystic ovary syndrome

The aim of the present study was to compare follicular fluid (FF) levels of norepinephrine (NE) and dopamine (DA) in polycystic ovary syndrome (PCOS) and non-PCOS patients who underwent in vitro fertilization (IVF). Forty-seven PCOS patients (study group) and 61 patients with male factor infertility (control group) who underwent IVF using GnRH agonist protocol were recruited. Concentrations of NE and DA were measured in FF specimens of all patients. Demographic characteristics were comparable between the groups. Significantly higher levels of NE were measured in FF of PCOS patients (median: 61.05?nmol/l) compared to those with male infertility (median: 49.82?nmol/l). Similarly, significantly higher levels of DA were measured in FF of PCOS patients (median: 23.70?nmol/l) compared to those with male infertility (median: 18.28?nmol/l). In conclusion, the FF concentrations of both catecholamine are increased in PCOS patients when compared to non-PCOS patients.     

Choroidal and macular thickness changes in type 1 diabetes mellitus patients without diabetic retinopathy

Objectives: To explore choroidal thickness (ChT) and retinal thickness (RT) changes in patients with type 1 diabetes mellitus (DM).

Methods: Sixty patients with Type 1 DM and 60 age- and sex-matched healthy controls were included in this prospective case–control clinical study. All patients underwent a complete ophthalmological examination. ChT of each participant was measured at the fovea and horizontal nasal and temporal quadrants at 500-µm intervals to 1500 µm from the foveola using spectral-domain optical coherence tomography (SD-OCT). Age, gender, disease duration, serum glycosylated hemoglobin (HbA1c), fasting glucose level, axial length (AL) and refractive error were noted and analyzed.

Results: Mean disease duration, mean HbA1c and mean fasting blood glucose in diabetic patients were 6.1±2.8 years, (8.9±0.9)% and 287.5±69.1 mg/dl, respectively. Age, gender, AL, spherical equivalent differences between the patients and subjects were insignificant (p>0.05). Subfoveal ChT, nasal quadrant ChT measurements, temporal 1500 µm and mean nasal ChT were significantly lower in diabetic patients (p<0.05 for all). Temporal 500 µm and 1000 µm ChT measurements, mean temporal ChT, average ChT, central macular thickness and average macular thickness did not differ significantly between the groups (p>0.05 for all).

Conclusion: This study showed that there is choroidal thinning in young Type 1 diabetic patients with early period of disease duration without diabetic retinopathy nor any other systemic diseases. Choroidal changes in type 1 DM seem to begin at nasal and distal temporal retina. These results need to be verified by larger and longitudinal studies.     

Artificial oocyte activation with calcium ionophore for frozen sperm cycles

Fertilization problems are the major problems that may be faced in 30–55% of the patients during an intracytoplasmic sperm injection (ICSI) cycle. A successful oocyte activation depends on factors related to both sperm and oocyte, and one of the important factors that mediates the process is Ca²⁺ concentration within the oocyte. Artificial oocyte activation (AOA) is a method used for fertilization problems that commonly involve the usage of Ca²⁺ ionophores and is usually used in problems such as total fertilization failure (TFF) and globozoospermia. The aim of the present study was to investigate possible effects of AOA for different groups of patients with fertilization failure. Four groups of patients (previous TFF, low oocyte number, severe sperm quality, and frozen sperm (FS) group) that underwent ICSI with AOA were included in the study. All groups had similar control groups with same indications except TFF, where AOA was not performed. Fertilization rates were significantly higher in the TFF group than those observed in other AOA groups. Fertilization rates and quality of embryos observed in the remaining AOA groups were higher than those of the controls, which were statistically insignificant. Prgenancy rates were higher in all AOA groups compared to the controls, although the differences were significant in FS group only. Quality of embryos and pregnancy rates were lower in the TFF group compared to the remaining AOA groups indicating possible concomitant problems. Fertilization rates, quality of embryos and pregnancy rates seemed to be increased in all indication groups suggesting that not only TFF patients but also a wide variety of patients with different indications may benefit from AOA.

Abbreviations: ICSI: Intracytoplasmic sperm injection; ARTs: Assisted reproductive techniques; Ca: Calcium; AOA: Artificial oocyte activation; TFF: Total fertilization failures; OAT: Oligoasthenoteratozoospemia; IVF: In vitro fertilization; SOAT: Severe OAT; LON: Low ooctye number; FS: Frozen sperm; hCG: human chorionic gonadotrophin; PVP: polyvinylpyrrolidone; HSA: human serum albumin