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Reproductive biology in one other great ape (the gorilla)
Published in David J Cahill, Practical Patient Management in Reproductive Medicine, 2019
The simpler approach to ovulation induction was chosen, recognizing it was less effective, and she was started on clomifene citrate (Clomid; Sanofi, Guildford, UK). Because Salome's weight exceeded 150 kg, she was given 100 mg daily (twice the normal human starting dose). The effect of this administration is seen in Figure 11.2 – the upper slide shows the data for pregnanediol-3-glucuronide. Here oestrus is noted twice; progesterone levels do not rise after the first oestrus, clomifene is administered and shortly after the second oestrus, a major spike in progesterone levels was noted, indicating ovulation. Clearly gorilla physiology is not identical to human physiology, as the progesterone surge occurred immediately after oestrus whereas in humans, recall that the progesterone surge occurs a whole week after ovulation. Gorillas are similar to humans in many ways – but it is foolish to assume they are identical. Clomifene was then continued for several months, and she conceived. Unfortunately, there was an unexpected fetal death at 5 months, and Salome delivered a stillborn baby. After a period, the medication was commenced, and she again conceived in early 2006.
Steroid Δ4-Reductases: their Physiological Role and Significance
Published in Ronald Hobkirk, Steroid Biochemistry, 1979
One of the first urine steroid metabolites ever characterized was pregnanediol glucuronide.51 Pregnanediol commonly refers to 5β-pregnane-3α,20α-diol, which is quantitatively the most important of the various possible reduced isomers. Urine pregnanediol levels have long been used as an indicator or indirect measure of progesterone production.52 From a clinical point of view, this assay has in the past been very useful in the investigation of ovulatory disorders, i.e., the failure of a luteal phase peak of pregnanediol excretion suggests that ovulation and the formation of a corpus luteum have not occurred. This assay has been to a large extent replaced by the serum progesterone assay, which is a simpler assay to perform as well as being a more direct assay of progesterone production. The rise in the urine concentration of pregnanediol glucuronide parallels the rise in serum progesterone concentration following the time of predicted ovulation.53 While pregnanediol is considered to be quantitatively the important metabolite, only 14% of the radioactivity is excreted as this metabolite following the administration of 14C-progesterone to young men;54 this percentage decreases significantly to 10% in older men. The significance of this latter finding is unclear. The formation of pregnanediol from progesterone is similar in nature to the formation of tetrahydrometabolites from the corticoids.
Menstrual migraine: a review of current and developing pharmacotherapies for women
Published in Expert Opinion on Pharmacotherapy, 2018
G. Allais, Giulia Chiarle, Silvia Sinigaglia, Chiara Benedetto
The high prevalence of migraine among women and its correlation with the early follicular phase of the menstrual cycle suggest that the drop in estrogen, the hallmark of this phase, may be one of the mechanisms underlying attacks. Pavlovic et al. [18] found that the rate of estrogen decline can trigger the attack, especially during the 2 days following the luteal estrogen peak: migrainous women were noted to have a faster drop than controls. A clinical study measured hormone levels by dosing estrone-3-glucuronide and pregnanediol-3-glucuronide in urine in 38 women with MO for 3 months: attacks occurred more often during the falling phase of estrogen [19]. While a purely hormonal mechanism in PMM is relatively seldom, various other factors may trigger NMM. For estrogen deprivation to trigger an attack, a previous period of exposure to high hormone levels is necessary, as occurs during the late luteal phase or when combined hormonal contraceptives are used [20–22]. The drop in estrogen may increase susceptibility to such factors as prostaglandin levels, which are threefold higher in the central nervous system (CNS) and the endometrial system during the terminal phase of the menstrual cycle. Indeed, PGE2 levels in both plasma and saliva are significantly increased during the pain phase of PMM [23,24].
The impact of surgical treatment of obesity on the female fertility
Published in Gynecological Endocrinology, 2019
Radoslaw Slopien, Nikodem Horst, Jesse D. Jaremek, Demelza Chinniah, Robert Spaczynski
Rochester et al. [15] compared the hormonal levels in obese (BMI around 47 kg/m2) women aged 18–48 with regular menses, without polycystic ovarian syndrome (PCOS), before and 6 months after surgically induced weight loss. Following surgery, the urine levels of pregnanediol glucuronide in the daily luteal phase (but not of that in healthy women) were double the initial value. Along with the increase in pregnenediol glucuronide, it was noticed that there was a decrease in conjugated estrone with an increase of LH, almost twice the amount typical for a healthy woman.