Progesterone use in assisted reproductive technology

Progesterone is the main hormone in the luteal phase. It plays a key role in preparing the uterus for a possible pregnancy, and in maintaining it after it has occurred. In assisted reproduction treatments, there is usually a luteal phase deficiency, so it is necessary to supplement this critical phase to obtain the best results, not only of implantation but also of ongoing pregnancy. Among all the available options, exogenously administered progestogens are the most used, as they have proven their efficacy and safety. This review will address the most relevant aspects of luteal phase support with progesterone in the different scenarios an embryo transfer can be performed, such as the stimulated cycle, the artificial cycle, or the natural cycle. Although there is no evidence of the perfect protocol for all patients, recent studies point to the need of individualizing luteal phase support according to the needs of each patient.     

Peptidoglycan inhibits progesterone and androstenedione production in bovine ovarian theca cells

Uterine bacterial infection perturbs uterine and ovarian functions in postpartum dairy cows. Peptidoglycan (PGN) produced by gram-positive bacteria has been shown to disrupt the ovarian function in ewes. The aim of this study was to determine the effect of PGN on steroid production in bovine theca cells at different stages of follicular development. Bovine theca cells isolated from pre- and post-selection ovarian follicles (<8.5 mm and >8.5 mm in diameter, respectively) were cultured in vitro and challenged with PGN. Steroid production was evaluated by measuring progesterone (P4) and androstenedione (A4) concentration in culture media after 48 h or 96 h of culture. Bovine theca cells expressed PGN receptors including Toll-like receptor 2 and nucleotide-binding oligomerization domain 1 and 2. Treatment with PGN (1, 10, or 50 μg/ml) led to a decrease in P4 and A4 production by theca cells in both pre- and post-selection follicles. The mRNA expression of steroidogenic enzymes were decreased by PGN treatment. Moreover, A4 production was further suppressed when theca cells of post-selection follicles were simultaneously treated by PGN and lipopolysaccharide (0.1, 1, or 10 μg/ml). These findings indicate that bacterial toxins may act locally on ovarian steroidogenic cells and compromise follicular development in postpartum dairy cows.     

Clinicopathological and Ultrasonic Features of Triple-Negative Breast Cancers: A Comparison with Hormone Receptor-Positive/Human Epidermal Growth Factor Receptor-2-Negative Breast Cancers

The purpose of this study was to analyze the clinicopathological and ultrasound characteristics of triple-negative breast cancers (TNBCs) and compare these findings with those for hormone receptor-positive (HR-positive)/human epidermal growth factor receptor-2-negative (HER-2-negative) tumors. Seventy-five TNBCs and 135 HR-positive/HER-2-negative breast cancers were reviewed. Data from conventional ultrasound, Doppler vascularity and elastography were included in the analysis. TNBCs had a higher histologic grade and Ki-67 level. On ultrasound, TNBCs often appeared as microlobulated, markedly hypo-echoic masses with an abrupt interface boundary, posterior acoustic enhancement, absence of calcifications and more characteristics of surrounding tissue. Results from multivariate regression analysis revealed that margin, posterior acoustic features and surrounding tissue features of tumors were independent predictive factors in differentiating TNBCs from HR-positive/HER-2-negative tumors. Our results suggest that a thorough evaluation of sonographic findings might be useful in discriminating between TNBCs and HR-positive/HER-2-negative tumors, which may provide accurate evidence for clinical early diagnosis.     

Irreversible Changes in Rat Erythrocyte Na+ Transport Systems with Progesterone and Estradiol Administration

In order to test whether alterations in Na⁺ transport systems occurring in women when the hormonal status is disturbed such as in pregnancy, under contraceptive or estradiol therapy are a direct result of hormonal action on these transport systems, Na⁺, K⁺-pump Na⁺, K⁺ outward cotransport and passive Na⁺ permeability were measured in erythrocytes of ovariectomized rats receiving estradiol or progesterone. No significant changes in Na⁺, K⁺-pump were observed in either conditions. Conversely, progesterone was found to decrease Na⁺, K⁺-cotransport and estradiol to increase this system, whereas both steroids increased passive Na⁺ permeability.     

孕酮诱导的封闭因子对妊娠免疫的调节

妊娠稳态受免疫细胞因子和免疫细胞的调节,母胎免疫异常可导致妊娠终止。孕激素可诱导淋巴细胞产生孕酮诱导的封闭因子(progesterone-induced blocking factor,PIBF),促使Th2型细胞因子分泌,诱导Th1/Th2平衡向Th2型细胞因子偏倚;抑制自然杀伤(NK)细胞活性;降低花生四烯酸分泌;促使不对称抗体产生等免疫机制维持妊娠。流产和早产患者PIBF水平明显低于正常妊娠妇女。采用酶联免疫吸附测定、免疫组化、蛋白质印迹和流式细胞术等方法能测定人外周血淋巴细胞、血清及尿液中PIBF水平。孕酮及其衍生物能增加PIBF的分泌维持妊娠,预防流产发生。综述PIBF在妊娠期的免疫调节功能以及研究进展。     

信号转导与转录活化因子3在老年子宫内膜癌发生及发展过程中的应用价值

目的：观察信号转导与转录活化因子3（ STAT3）在老年子宫内膜癌组织和子宫肌瘤患者中的表达情况。方法收集西平县人民医院2010年2月至2014年2月收治的48例老年子宫内膜癌患者（子宫内膜癌组）和30例子宫肌瘤患者（子宫肌瘤组）,全部患者均由手术切除组织标本后经病理检查确诊,对两组患者标本中的STAT3、孕激素受体（ PR）、雌激素受体（ ER）的阳性表达情况进行观察,并分析STAT3、PR、ER在老年子宫内膜癌病理表达情况。结果子宫内膜癌组患者标本中的STAT3的阳性表达率高于子宫肌瘤组（ P<0.01）,而PR、ER的阳性表达率低于子宫肌瘤组（P<0.01）,在子宫内膜癌患者标本中随着临床分级及组织学分级的增加,STAT3的阳性表达水平逐渐升高,而PR和ER的阳性表达水平则显著下降。结论 STAT3阳性表达水平能够在一定程度上反映老年子宫内膜癌的发生发展过程,可用于子宫内膜癌的临床治疗指导和预后评估。