Endocrine Abstracts

Androgen excess in women is most commonly caused by polycystic ovary syndrome (PCOS), but sinister ovarian and adrenal pathology requiring immediate action needs to be excluded. Here we examined whether the severity of androgen excess indicates the likely underlying pathology in women evaluated for androgen excess.We included all women undergoing assessment of serum DHEAS, androstenedione (D4) and testosterone (T) by liquid chromatogra...

Background: IVF is an effective treatment for infertility, however it may be complicated by the potentially life-threatening ‘ovarian hyperstimulation syndrome’ (OHSS). OHSS is an iatrogenic condition, resultant on the mode of triggering oocyte maturation. Kisspeptin safely triggers oocyte maturation in women at high risk of OHSS, but has yet to be compared with current triggers of oocyte maturation (hCG or GnRH agonist).Meth...

Background: Polycystic ovary syndrome (PCOS) is characterised by hyperandrogenism, oligo/amenorrhoea and subfertility but the effects on mental health outcomes are unclear. Offspring neurodevelopment might also be influenced by gestational androgen exposure.Aims: To determine if (i) there is an association between PCOS and psychiatric outcomes, and (ii) rates of autism spectrum disorder (ASD) and attention deficit hyperactivity disorde...

The female reproductive system provides several functions. These include ovulation, pregnancy and childbirth. The incidence of diabetes mellitus (DM) is increasing rapidly worldwide and it is associated with reproductive complications. Metformin is an oral hypoglycaemic drug used in the management of DM. The present study determined the effect of metformin on some reproductive function in alloxan-induced diabetic female Sprague-Dawley rats.<p class="abst...

Polycystic ovary syndrome (PCOS) is a common endocrinopathy that is associated with anovulatory infertility, menstrual disturbances and an adverse metabolic profile. Although the pathophysiology of PCOS remains unclear, dysregulation of gene expression has been previously shown in theca and granulosa cells. In this study, we used RNA-Sequencing to compare the transcriptomes of human granulosa cells from women with and without PCOS. Granulosa cells were retri...

Background: The Turner Syndrome Life Course Project, UCLH, has collected data on 810 women with TS, attending clinic for 20 years and has accumulated over 8000 clinic visits. We present an analysis of the effects of timing and type of exogenous oestrogen on health outcomes in adults.Methods: A cross- sectional analysis of 475 subjects with primary amenorrhoea with accurate age of pubertal induction data was performed using correlation coefficients contro...

Metabolic syndrome is a clustering of several cardiovascular risk factors including obesity, hypertension, diabetes, high triglyceride etc. Obesity has been shown to decreases key markers of uterine contractility during parturition in the rat and diabetes is associated with impairment of uterine contractility and high caesarean section rate. In this study, the effect of metabolic syndrome on gravid uterine muscle contractility in sprague-dawley rat was deter...

Vitamin D deficiency during pregnancy has been linked to adverse pregnancy outcomes such as pre-eclampsia (PET), but continues to be defined by serum measurement of a single metabolite, 25-hydroxyvitamin (25(OH)D). To identify broader changes in vitamin D metabolism during normal and PET pregnancies we developed a mathematical model using a reduced reaction network for vitamin D metabolism that allows for complete parametrisation by multiple vitamin ...

Background: Urinary concentrations of the major progesterone metabolite pregnanediol glucuronide (P3G) are used clinically and in research to monitor ovulation. This ELISA is laborious and costly. If it could be replaced by the automated sensitive chemiluminescence assays routinely used for serum this would be of great value.Objective: We aimed to determine the validity of urine progesterone as measured by two widely used automated assays in comparison t...

Genistein is an endocrine-disrupting chemical (EDC), derived from soya, with reported adverse effects on fetal development. The placenta regulates fetal environment for fidelity of organogenesis which can be compromised by several external factors including EDCs. This study examined the influence of genistein on the histomorphometry of the Giant Trophoblast Cells (GTC) of the placenta and the oxidative stress balance across the maternal serum, placenta and t...

Background: Despite new, albeit draft, international guidelines there remains limited data and guidance on the non-cardiac obstetric management and outcomes in women with Turner Syndrome (TS).AIMS: This retrospective single centre audit aimed to assess the maternal and fetal outcomes in a large single centre cohort.METHODS: We identified 110 women under our care with TS. Of these, 28 women had attempted to achiev...

Background: Leptin facilitates onset of puberty by impacting hypothalamic Kisspeptin, gonadotropin releasing hormone, follicle stimulating and luteinizing hormone. The link of peripheral Leptin-Kisspeptin in regulating the ovarian and endometrial tissue in relation to adiposity is unknown. Therefore, we wanted to identify their association with body mass index (BMI) and success of assisted reproductive treatments (ART) in infertile females.<p class="abst...

Background: Insulin resistance is a hallmark of Polycystic Ovary Syndrome (PCOS). Insulin sensitisers, most notably metformin, are thus used to treat the condition, but may be accompanied by gastrointestinal side-effects. The novel isomeric insulin sensitising agents D-chiro-inositol (DCI) and Myo-inositol (MI) improve insulin resistance by acting at the peripheral and ovarian level, respectively, whilst largely being devoid of adverse effects.<p class="...

Introduction: The risk of aortic dissection (AoD) is significantly increased (40 per 100,000/y) in women with Turner Syndrome (TS), but the clinical profile and management for those at risk are not well-established. To gain a better understanding, we present the experience of a single centre with multidisciplinary care, including dedicated cardiology, for management of TS in adulthood.Methods: Retrospective case-review of women develop...

Teddy is a highly proliferative goat breed, as females of this breed are famous for high twinning rates. Feed supplementation of olive oil has been shown to improve semen quality of goat bucks. In this study, the effects of feed supplementation with olive oil on serum testosterone, triiodothyronine (T3), thyroxine (T4) and some biochemical metabolites in Teddy goat bucks were investigated. For this purpose, 9 adult male goats, with clinically normal reproduc...

Background and Aims: Clinical management of women with hyperandrogenic symptoms varies widely and UK guidelines are lacking. Dependent on presentation, differential diagnoses may include thyroid dysfunction, hyperprolactinaemia, congenital adrenal hyperplasia (CAH), hypercortisolism, acromegaly and pregnancy. Women presenting with hyperandrogenic symptoms can have a normal or elevated testosterone. This study describes hormone requesting relevant to these co...

Introduction and aim: Turner Syndrome (TS) is associated with a variety of morbidities affecting nearly every body system, and necessitates multidisciplinary management. To facilitate care, the International Turner Syndrome Consensus Group have drafted Clinical Practice Guidelines that were disseminated to ESE members in April 2017. The aim of this audit was to assess whether current management of adolescent and adult TS women in our care is in accordance wi...

Introduction: Previous studies have shown that PCOS (first described 1935) increases the future risk of hypertension and coronary artery disease.Aims: We investigated in women with PCOS, the link between social disadvantage and markers of cardiometabolic risk and how weight gain over time related to social disadvantage.Methods: In a primary care-based study, 1797 women were identified from patients attending one ...

Introduction: Polycystic ovarian syndrome (PCOS) is one of the commonest endocrine disorders affecting women of reproductive age. We examined the specific tests that are done in primary care to lead to the diagnosis of PCOS, and to support the diagnosis once made.Methods: 1797 women were identified from a pooled GP practice database. The search included all patients defined with PCOS or related terms. Records included demographic infor...

Background: Multimorbidity, presence of 2 or more chronic conditions, is a growing issue for patients as well as health systems. Reported prevalence of multimorbidity in females in a UK study was 23%. Presence of an additional chronic condition adds challenges to an existing condition. The difficulties of living with polycystic ovary syndrome (PCOS) have been well described both in terms of dealing with the symptoms as well as the potential metabolic and men...

Background: Considering the high prevalence of metabolic and mental health issues associated with PCOS, it is important to screen for these routinely in clinic. We aimed to implement a standard approach to ensure we do this in our specialist PCOS clinic.Methods: We introduced a standard ‘PCOS clinic pack’ which included the following documents and data collected for analysis1. Checklist for doctors to e...

A 27 years old primigravida, with no significant past medical history, was referred to Endocrine clinic at 37 weeks gestation with hirsutism. She developed hirsute features during pregnancy and symptoms progressed with advancing gestation. Her physical examination revealed thick coarse dark hair growth in the midline of lower abdomen, between the breasts and forearms. She noted deepening of her voice but denied headaches, visual disturbance or clitromegaly.<...

Introduction: Infertility affects 15% of couples and a male factor accounts for 50% of cases. Adequate history taking, examination of both partners, hormone testing and semen analysis are required to ascertain a cause and treatment strategy. Gonadotropin therapy with Human Chorionic Gonadotropin (HCG) and recombinant Follicle Stimulating Hormone (rFSH) is indicated for use in men with reduced spermatogenesis due to hypogonadotropic hypogonadism (HH). We pres...

A 32 year old emirati patient is evaluated in the endocrine clinic because of symptoms of hypogonadism in the form of reduced sexual desire and erectile dysfunction. On further history taking he confenssed that he was abusing anabolic steroids over the last 3 years but has stopped 3 months prior to his evaluation. On physical exam he appears musculinized, his BMI is 27 kg/m2. He has acne on his face. Testicular size is around 15 ml bilateral. Has ...