Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
  1. Home
  2. Search

Refine search

Refine search

Access:
Content type:
Publication date:
Apply   From and To filters
Subject: Show more
Journals Show more
Publishers: Show more
Societies Show more
Series: Show more
Collections: Show more

Actions for selected content:

Select all | Deselect all
  • View selected items
  • Export citations
  • Download PDF (zip)
  • Save to Kindle
  • Save to Dropbox
  • Save to Google Drive

Save Search

You can save your searches here and later view and run them again in "My saved searches".

Please provide a title, maximum of 40 characters.
Cancel
×

7 results

  • Chapter 6 - The Relevance of the Anti-Müllerian Hormone in Polycystic Ovary Syndrome Diagnosis and Management

  • Edited by Gabor T. Kovacs, Bart Fauser, Richard S. Legro
  • Book:
    Polycystic Ovary Syndrome
    Published online:
    13 May 2022
    Print publication:
    02 June 2022, pp 52-57

  • Summary

    Anti-Müllerian hormone (AMH) has recently been proposed as a diagnostic marker for polycystic ovary syndrome (PCOS) instead of polycystic ovarian morphology (PCOM) seen on ultrasound. As serum AMH level reflects excess small follicles not visible on ultrasonography, AMH level would theoretically be more accurate than PCOM as a diagnostic marker. Its value is significantly higher in PCOS patients than in normal women; its high levels are also considered to play an important role in the pathogenesis of the disorder, accounting for anovulation in PCOS patients. Nevertheless, its use is still not recommended by the international guidelines as an alternative for detecting PCOM or as a single test result for the diagnosis of PCOS. Its potential clinical applications in PCOS patients are currently the characterization of the severity of the syndrome and in deciding hormone doses for ovarian stimulation treatments. An international standard is needed to standardize the existing assays for AMH calibration before diagnostic cutoffs can be determined and before AMH use as a diagnostic marker can be considered meaningful.

  • Chapter 15 - Female and Male Infertility

  • from Section 3 - Reproductive Endocrinology and Infertility
  • Edited by Tahir Mahmood, Charles Savona-Ventura, Ioannis Messinis, Sambit Mukhopadhyay
  • Book:
    The EBCOG Postgraduate Textbook of Obstetrics & Gynaecology
    Published online:
    24 November 2021
    Print publication:
    02 December 2021, pp 124-134

  • Summary

    Infertility is classified as a disease by the WHO and is recognized to have significant impact on the lives of the couples it affects. It is defined by the WHO as the failure of a couple to conceive after 12 months of regular, unprotected intercourse and is estimated to affect 1:7 couples. To determine the underlying cause of infertility, both the female and male should be investigated in parallel. In approximately 40% of couples there is a coexisting male and female factor contributing towards infertility. Assessments should begin after 12 months unless the female age is over 35 years or there are known risk factors, when investigations should be implemented sooner. There is a responsibility of the clinician to explore other avenues of parenthood for couples from the outset, as it is important to manage patient expectations and acceptance of childlessness if treatments fail.

  • Dietary minerals, reproductive hormone levels and sporadic anovulation: associations in healthy women with regular menstrual cycles

  • Keewan Kim, Jean Wactawski-Wende, Kara A. Michels, Karen C. Schliep, Torie C. Plowden, Ellen N. Chaljub, Sunni L. Mumford
  • Journal:
    British Journal of Nutrition / Volume 120 / Issue 1 / 14 July 2018
    Published online by Cambridge University Press:
    20 April 2018, pp. 81-89
    Print publication:
    14 July 2018
    • Article
      • You have access
    • PDF
    • HTML
    • Export citation

  • Although minerals are linked to several reproductive outcomes, it is unknown whether dietary minerals are associated with ovulatory function. We hypothesised that low intakes of minerals would be associated with an increased risk of anovulation. We investigated associations between dietary mineral intake and both reproductive hormones and anovulation in healthy women in the BioCycle Study, which prospectively followed up 259 regularly menstruating women aged 18–44 years who were not taking mineral supplements for two menstrual cycles. Intakes of ten selected minerals were assessed through 24-h dietary recalls at up to four times per cycle in each participant. Oestradiol, progesterone, luteinising hormone (LH), follicle-stimulating hormone (FSH), sex-hormone-binding globulin and testosterone were measured in serum up to eight times per cycle. We used weighted linear mixed models to evaluate associations between minerals and hormones and generalised linear models for risk of anovulation. Compared with Na intake ≥1500 mg, Na intake <1500 mg was associated with higher levels of FSH (21·3 %; 95 % CI 7·5, 36·9) and LH (36·8 %; 95 % CI 16·5, 60·5) and lower levels of progesterone (−36·9 %; 95 % CI −56·5, −8·5). Na intake <1500 mg (risk ratio (RR) 2·70; 95 % CI 1·00, 7·31) and Mn intake <1·8 mg (RR 2·00; 95 % CI 1·02, 3·94) were associated with an increased risk of anovulation, compared with higher intakes, respectively. Other measured dietary minerals were not associated with ovulatory function. As essential minerals are mostly obtained via diet, our results comparing insufficient levels with sufficient levels highlight the need for future research on dietary nutrients and their associations with ovulatory cycles.

  • 9 - Chronic pelvic pain

  • Mary Ann Lumsden, University of Glasgow, Margaret Rees, University of Oxford
  • Book:
    Menstrual Problems for the MRCOG and Beyond
    Published online:
    05 June 2014
    Print publication:
    27 February 2014, pp 103-114

  • Summary

    This introduction discusses the aetiology of menstrual problems, their presentation and investigation as well as medical and surgical management. Specific problems such as fibroid-associated bleeding, adolescent and perimenopausal bleeding and breakthrough bleeding are covered, as are other critically important problems such as premenstrual disorders, pelvic pain and dysmenorrhoea. The most common presenting menstrual problem is heavy menstrual bleeding (HMB). A woman's approach to her periods will vary through her reproductive life. After childbearing is completed, the view of the menses will alter dramatically. The longest intermenstrual interval occurs at the menarche. Menstrual irregularity is most likely to occur at the extremes of reproductive life, the incidence of anovulation increasing as the menopause approaches. Classical primary spasmodic dysmenorrhoea occurs at the onset of the menses and gets better after 1 or 2 days, whereas secondary dysmenorrhoea tends to start prior to the menses and worsens as it proceeds.

  • 10 - Definition of hyperandrogenism

  • Edited by Adam Balen, University of Leeds, Stephen Franks, Roy Homburg, Sean Kehoe
  • Book:
    Current Management of Polycystic Ovary Syndrome
    Published online:
    05 July 2014
    Print publication:
    01 October 2010, pp 117-124

  • Summary

    The diagnosis of hyperandrogenism is dependent on the accuracy and precision of measurement of the clinical features and the laboratory androgen assays. Hyperandrogenism in the context of polycystic ovary syndrome (PCOS) is a term used loosely to encompass both the clinical features of acne, hirsuties and androgenic alopecia and the laboratory evidence of hyperandrogenaemia. The relationship between acne and biochemical hyperandrogenaemia is well established but the number of women with acne in unselected populations is so great that it makes the link with PCOS unconvincing, particularly since the incidence of acne seems to be greater than that of PCOS. Anovulation is assessed by measuring the serum progesterone during the mid-luteal phase. Consecutive series of women with either a single symptom or various combinations of symptoms would be subjected to formal receiver operating characteristic (ROC) analysis to determine the optimal diagnostic characteristics.

  • 12 - Choices in the treatment of anovulatory polycystic ovary syndrome

  • Edited by Adam Balen, University of Leeds, Stephen Franks, Roy Homburg, Sean Kehoe
  • Book:
    Current Management of Polycystic Ovary Syndrome
    Published online:
    05 July 2014
    Print publication:
    01 October 2010, pp 143-152

  • Summary

    The majority of women with anovulation or oligo-ovulation due to polycystic ovary syndrome (PCOS) have clinical and/or biochemical evidence of hyperandrogenism. This chapter describes treatment with clomifene, aromatase inhibitors, gonadotrophins, and metformin. Weight loss has the undoubted advantages of being effective and cheap with no adverse effects and should be the first line of treatment in obese women with anovulatory infertility associated with PCOS. The aromatase inhibitors letrozole (Femara, Novartis) and anastrozole (Arimidex, AstraZeneca) have mainly been employed for the treatment of postmenopausal women with advanced breast cancer. In women with PCOS, metformin is said to lower fasting insulin concentrations but also probably acts directly on theca cells and attenuates androgen production. There is now sufficient evidence that low-dose step-up gonadotrophin therapy should be preferred to the now outdated conventional therapy for anovulatory patients and particularly for those with PCOS.

  • 1 - Genetic aetiology of infertility

  • Edited by Sean Kehoe, Lyn Chitty, Tessa Homfray
  • Book:
    Reproductive Genetics
    Published online:
    05 February 2014
    Print publication:
    01 November 2009, pp 1-14

  • Summary

    The main causes of female infertility are anovulation and anatomical causes such as obstruction in the genital tract. Many aspects of female reproductive function are strongly influenced by genetic factors. Androgen insensitivity syndrome is an X-linked disorder characterised by variable defects in virilisation of 46,XY individuals. A genetic contribution to spermatogenic failure is indicated by several families with multiple infertile or subfertile men. Klinefelter syndrome (47,XXY) is the most frequent cause of gonosomic anomalies, occurring in 0.1-0.2 % of newborn males. Chromosomal translocations are found with a frequency 8-10 times higher in infertile men and may be acrocentric Robertsonian translocations or reciprocal translocations. The prevalence among infertile men is high, from 5 % in those with severe oligozoospermia to 10 % in those with azoospermia. Understanding of the genetic basis of infertility is likely to increase dramatically in the future. New technologies are available that permit high-throughput detailed genetic analysis.