Die GnRH-Agonisten-Applikation zur Downregulation vor IvF ist "gold standard", überwiegend im sogenannten langen Protokoll. Die Behandlung soll den vorzeitigen LH-Anstieg mit vorzeitiger Ovulation verhindern. Die unerwünschten Wirkungen sind dosisabhängig und rechtfertigen die Suche nach der optimal niedrigen Dosis des GnRH-Agonisten. Mit dieser Fragestellung wurde eine prospektive randomisierte Dosisfindungsstudie durchgeführt. 200 sterile Frauen zwischen 18 und 38 Jahren erhielten vor der IvF-Behandlung im langen Protokoll die Standarddosis von 4,12 mg Triptorelinazetat-Depot (1 Amp. i.m. = Gruppe B: n = 100) versus 2,1 mg Triptorelinazetat Depot (1/2 Amp. i.m = Gruppe A. n = 100) zur Downregulation. Folgende Parameter wurden bestimmt: E2, LH, Progesteron. Die Behandlungsergebnisse wurden korreliert mittels der Anzahl der gewonnenen Oocyten, der fertilisierten Oocyten, der transferierten Embryonen und der Schwangerschaftsraten pro Embryotransfer. Abgebrochene IvF-Zyklen wurden einzeln analysiert. Bezüglich der Hormonwerte waren beide Gruppen ohne signifikanten Unterschied. In der Gruppe der Patientinnen mit der halbierten Dosis (A) kam es nur in einem Fall zu einer vorzeitigen Luteinisierung, in der Standartdosisgruppe (B) in keinem Fall. Wegen low response wurde in Gruppe A in 5 Fällen die Therapie abgebrochen, versus 3 Fälle in Gruppe B (ns). Ebenfalls vergleichbar war das IvF-outcome, nur die ET-Rate pro begonnener Stimulation zeigte einen signifikanten Unterschied: 88 % (A) versus 96 % (B), p / The GnRH agonist application for the downregulation prior to IVF is 'gold standard', mainly in the so-called long protocol. This should avoid premature ovulations. The dose-dependent, undesired effects justify the search for the optimal low dose of the GnRH agonist. A prospective randomised dose-finding study was carried out in this respect. Among 200 sterile women (18 and 38 years) for the planned IVF and/or IVF / ICSI treatment in the long protocol, n = 100 in group A received 2.1 mg Triptorelinacetate depot (1/2 amp., i.m.) and n = 100 in group B the standard dose of 4.12 mg (1 amp., i.m.) for the downregulation. The hormone values E2, LH, progesterone were determined. The treatment results were compared by means of the number and quality of the oocoytes, the embryo transfers and the pregnancy rates. Cancelled IVF cycles were analysed. With respect to the hormone values, neither of the two groups showed significant differences. A premature luteinization occurred in group A (reduced dose) in only one case; in the standard dose of group B, none occurred. Due to the low response, the therapy was cancelled in 5 cases in group A, in comparison to 3 cases in group B (ns). The IVF outcome showed a comparable result. The only significant difference was the ET rate per started stimulation (p

Introduction: Premenstrual Dysphoric Disorder (PMDD) is a condition that affects about 2-6% of women of reproductive age. The relation to ovarian steroids is apparent as symptoms are absent during anovulatory cycles. Neuroactive steroids like allopregnanolone have effect in the brain and on brain function and have been proposed to play an important role for the symptomatology of premenstrual symptoms and in the interaction between the GABAA receptor and alcohol. High doses of alcohol elevate allopregnanolone levels both in rats and humans. Allopregnanolone is a positive modulator of the GABAA receptor with sedative, anxiolytic and anticonvulsant effect in both human and animals. Aims: The aim was to investigate if a low dose (100μg) of GnRH agonist (buserelin) is effective for the treatment of PMDD and if allopregnanolone serum levels during treatment are associated to symptom severity. Furthermore, the studies aimed at investigating the effect of a low dose of alcohol upon saccadic eye movements in women with PMDD, and control subjects in different phases of the menstrual cycle, and to evaluate if there was a difference in response to alcohol between men and healthy women. We also wanted to see if this low dose of alcohol could have an effect on serum allopregnanolone levels in women with PMDD and control subjects in the follicular and luteal phases of the menstrual cycle. Methods: The effect of low dose (100μg) of GnRH agonist (buserelin) on premenstrual symptoms was evaluated in a randomized, placebo controlled, double-blinded cross-over trial. 27 PMDD patients were randomized to either GnRH agonist intranasally once a day or placebo for two months before the crossover. The main outcome measure was the daily symptom ratings for mood and physical symptoms made by the patients. In a subgroup of 12 women, grouped as buserelin responders and placebo responders, luteal phase serum progesterone, allopregnanolone, and pregnanolone was measured together with daily ratings for mood and physical symptoms. Alcohol responsiveness was measured in PMDD patients, female control subjects and men by comparing the effect of a low dose (0.2g/kg) of intravenous alcohol or placebo infusion upon saccadic eye movements. Blood samples for measurement of allopregnanolone and cortisol were taken throughout the alcohol/placebo challenges. Results: Low dose GnRH agonist was effective as treatment of premenstrual irritability and depression. Anovulatory cycles were confirmed in 56% of the subjects, particularly in older women. Buserelin as well as placebo responders displayed decreased allopregnanolone and progesterone levels in parallel with symptom improvement. PMDD patients displayed blunted saccadic eye movement response to alcohol infusion, especially in the luteal phase. Control subjects did not change their response to alcohol between cycle phases. We found no difference in saccadic eye movement sensitivity to alcohol between males and females. Allopregnanolone levels significantly decreased in the luteal phase following the alcohol infusion. Conclusions: Low dose GnRH agonist is effective in treatment of premenstrual depression and irritability but is likely to induce anovulation with increasing age. Independent of whether buserelin or placebo treatment was given decreased levels of allopregnanolone appear to be related to symptom improvement. Women with PMDD have altered saccadic eye movement sensitivity in response to alcohol, particularly in the luteal phase. The low dose of alcohol did not induce any difference in saccade measurements between males and females. Low dose of alcohol does not result in increased peripheral levels of allopregnanolone.

Šio darbo tikslas buvo nustatyti ovuliacijos pasireiškimo laiko priklausomybę nuo kalės veislės dydžio ir amžiaus bei metų laiko, bei palyginti GnRH agonisto Suprelorin implanto sukeltos ovuliacijos pasireiškimo laiką su natūraliai pasireiškusios rujos ovuliacijos laiku. Šiam tikslui pasiekti pirmiausiai buvo ištirta 194 kalių (51 skirtingos veislės) progesterono koncentracija kraujo serume. Iš šių kalių buvo atrinktos tos kalės, kurioms pagal progesterono koncentraciją pasireiškė ovuliacija (53 kalės). Nustatyta, kad progesterono koncentracija kraujo serume siekė 20-30 nmol/l. Kalės buvo suskirstytos į grupes: pagal amžių (2 grupės – iki 5 metų (n=41); 5 metų ir vyresnės (n=12) ), pagal veislės dydį (3 grupės – mažos (n=22), vidutinės (n=14) ir didelės (n=17) veislės), pagal sezoną (4 grupės – žiema (n=3), pavasaris (n=16), ruduo (n=11), vasara (n=23) ). Pagal kiekvieną požymį statistiškai buvo įvertinti ovuliacijos pasireiškimo laiko skirtumai tarp grupių, bei įvertinta ovuliacijos priklausomybė nuo kalės amžiaus, dydžio, metų laiko. Statistiškai patikimų skirtumų tarp grupių ir koreliacinių ryšių tarp ovuliacijos pasireiškimo laiko ir kalės amžiaus ir dydžio, bei metų laiko nebuvo nustatyta. Panašių tyrimų iki šiol buvo atlikta labai mažai, todėl informacija yra vertinga. Paskutiniame tyrimųetape4 kalėms buvo panaudoti GnRH agonisto Suprelorin implatai rujai sukelti. Implantas buvo įvedamas po oda, bambos srityje. Po įvedimo buvo imamas kraujas kelis kartus kas 3-5 dienas... [toliau žr. visą tekstą] / The main goal of this paper was to determine whether or not there is a significant influence of GnRH agonist, seasonality, age and size of the bitch on ovulation time, and to compare ovulation time induced by GnRH agonist Suprelorin implant and the ovulation time that occured naturally. To achieve this goal we tested the blood of 194 bitches (51 breeds) for progesterone levels in blood serum. Out of these 194 bitches we selected the ones (53 bitches) that ovulated. Meaning, the progesterone levels for these 53 bitches varied between 20-30 nmol/l. These 53 bitches were divided into groups: by age (2 groups – younger than 5 years (n=41); 5 years old and older (n=12),, by size (3 groups – small (n=22), medium (n=14), large (n=17), and by season (4 groups – winter (n=3), spring (n=16), summer (n=11), autumn (n=23). All the groups were statistically analyzed to determine whether or not there is a significant difference between the groups, and to determine if there are correlations between the ovulation time and the size and age of the bitch and time of year (season). No significant difference or correlations were determined. We have found a little information about influence of seasonality, and age and size of the bitch on ovulation time, so the information in this paper is valuable. For the last step to achieving the goal of the paper, GnRH agonist Suprelorin implant was used on 4 bitches. The agonist was implanted subcutaneously around the navel area. After the implantation... [to full text]

Premenstrual depressive symptoms and mood swings affect 3-8% of women in fertile age. The female hormones are believed to be the cause. Progesterone is well studied, but estrogen is not, and either are other causes such as intimate partner violence and chronic stress. The aim in this thesis was to investigate the influence of hormones as well as psychological aspects on the most common problems among women seeking care for premenstrual symptoms. In a cross-sectional study, four groups of women were included: ongoing users of oral contraceptives, with or without adverse mood symptoms and previous users, with or without experience of adverse mood. Depression and anxiety were significantly more common in both groups with reported adverse mood, in comparison with their control groups with no adverse mood. Self-reported PMS was significantly more common in those women who reported adverse mood, however, there was no difference in prospectively defined PMS or PMDD between the two groups of previous users. In a RCT with 25 women completing the study, GnRH treatment were tested in combination with two different HRT add-back doses of estradiol, in combination with progesterone and placebo. The higher dose of estrogen 1.5 mg in combination with progesterone induced significantly more pronounced symptoms than in combination with placebo. The lower dose, 0.5 mg gave less symptom recurrence in combination with progesterone. Exposure to violence was investigated among PMDD patients, healthy controls and gynecological patients. Among the participating women, gynecological patients, reported physical and/or emotional abuse significantly more often than did PMDD patients, as well as healthy controls. Chronic stress was investigated with diurnal cortisol, and low-dose dexamethasone test.  There was no difference in diurnal secretion of cortisol between PMDD patients and controls. No difference in the degree of dexamethasone suppression was found between PMDD patients and controls. According to the results from these studies, the main symptom provoking factor in women with PMDD appears to be the estradiol and progesterone fluctuations across the menstrual cycle, whereas chronic stress and intimate partner violence appears to be less relevant.

Submitted by Marlene Santos (marlene.bc.ufg@gmail.com) on 2014-12-19T18:38:39Z No. of bitstreams: 2 Tese - Jalsi Tacon Arruda - 2013.pdf: 4216712 bytes, checksum: ec49a9884c1f4b73b53a9b224c7c4aa1 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2014-12-22T11:01:46Z (GMT) No. of bitstreams: 2 Tese - Jalsi Tacon Arruda - 2013.pdf: 4216712 bytes, checksum: ec49a9884c1f4b73b53a9b224c7c4aa1 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Made available in DSpace on 2014-12-22T11:01:46Z (GMT). No. of bitstreams: 2 Tese - Jalsi Tacon Arruda - 2013.pdf: 4216712 bytes, checksum: ec49a9884c1f4b73b53a9b224c7c4aa1 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2013-07-01 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Infertility affects more couples and assisted reproduction techniques offer a possibility of treatment and the chance of having a child. Thus, the first attempt to ovulation induction is critical to the success of the cycle or even for future attempts is successful. Objective: To compare the protocols using GnRH agonist or antagonist for ovarian stimulation in normo-responders undergoing the first cycle of IVF/ICSI. Methods: we conducted a literature review on the history of ovulation induction controlled by medications. From the data available in the database of electronic medical records SISFERT used in the Laboratory of Human Reproduction (LabRep-HC-FM-UFG) a comparative retrospective observational study was conducted with 50 patients divided into two groups according to protocol: GnRH-agonist (leuprolide acetate 1 mg/day short protocol) or GnRHantagonist (Cetrorelix 0.25 mg/day), which received 150 IU/day of rFSH (follitropin alpha) and 250 µg of rhCG (alpha-coriogonadotrofina) in both groups. Results: Statistically significant differences were observed in the days of stimulation with rFSH, total dose of gonadotropin, days of use of GnRH, GnRH dose and total number of follicles (≥ 16 mm) on the day of the group rhCG GnRH agonist. There was no significant difference in other parameters, however, the number of oocytes retrieved was slightly higher in the GnRH agonist, but fertilization rate was higher in the GnRH-antagonist. Pregnancy rates and clinical chemistry were similar in both groups. Conclusions: although no significant differences in the results analyzed, the use of flexible antagonist protocol facilitates the handling and enables the patient using much lower doses of gonadotropins itself as the antagonist, reducing the cost of treatment when compared to the protocol with GnRH agonist. / A infertilidade afeta cada vez mais casais e as técnicas de reprodução assistida oferecem uma possibilidade de tratamento e a chance de ter um filho. Assim, a primeira tentativa de indução da ovulação é fundamental para o sucesso do ciclo ou, até mesmo, para que tentativas futuras sejam bem sucedidas. Objetivo: comparar os protocolos utilizando agonista ou antagonista do GnRH para estimulação ovariana em pacientes normo-respondedoras submetidas ao primeiro ciclo de FIV/ICSI. Métodos: foi realizada uma revisão da literatura sobre a história da indução da ovulação controlada por medicamentos. A partir dos dados disponíveis no banco de prontuários eletrônicos SISFERT utilizado pelo Laboratório de Reprodução Humana (LabRep–HC–FM–UFG), um estudo observacional retrospectivo comparativo foi conduzido com 50 pacientes distribuídas em dois grupos de acordo com o protocolo: GnRH-agonista (acetato de leuprolide 1 mg/dia protocolo curto) ou GnRH-antagonista (cetrorelix 0,25 mg/dia); e que receberam 150 UI/dia de rFSH (alfa-folitropina) e 250 µg de rhCG (alfa-coriogonadotrofina) em ambos os grupos. Resultados: foram observadas diferenças estatisticamente significativas nos dias de estimulação com rFSH, dose total de gonadotrofina, dias de uso do GnRH, dose total de GnRH e o número de folículos (≥ 16 mm) no dia do rhCG no grupo GnRH-agonista. Não houve diferença significativa nos outros parâmetros, no entanto, o número de oócitos recuperados foi ligeiramente maior no grupo GnRH-agonista, mas a taxa de fertilização foi maior no grupo GnRH-antagonista. As taxas de gravidez química e clínica foram similares nos dois grupos. Conclusões: embora não tenha havido diferenças significativas nos resultados analisados, o uso do protocolo flexível com antagonista facilita a manipulação pela paciente usuária e possibilita doses menores tanto de gonadotrofinas quanto do próprio antagonista, reduzindo o custo do tratamento quando comparado ao protocolo com agonista do GnRH

Thesis by publication -- 8 co-authored articles. / Thesis (PhD)--Macquarie University, Division of Environmental and Life Sciences, Department of Biological Sciences. / Includes bibliographical references. / Preface -- Management issues of urban common brushtail possums (Trichosurus vulpecula): a loved or hated neighbour -- Effects of deslorelin implants on reproduction in the common brushtail possum (Trichosurus vulpecula) -- Brushtail possums (Trichosurus vulpecula) in metropolotan Sydney: population biology and response to contraceptive implants -- Strategic survey for Toxoplasma gondii and Neospora caninum in the common brushtail possum (Trichosurus vulpecula) from urban Sydney, Australia -- Leptospirosis serology in the common brushtail possum (Trichosurus vulpecula) from urban Sydney, Australia -- Conclusions. / The common brushtail possum (Trichosurus vulpecula) is indeed a common inhabitant of many Australian citites, and one of the few marsupials that has adapted well to the urban environment. Their close proximity to people provides a great opportunity to experience native wildlife in the backyard, however, their utilization of house roofs, bold behaviour and appetite for garden plants often leads to conflict with householders. Population numbers are sufficiently high to require ongoing management to minimise negative impacts for humans and brushtail possums alike in a socially acceptable manner. The aim of this thesis was to identify current management issues and address the need for improved and novel management strategies. The potential of slow-release implants, containing the GnRH agonist deslorelin, as a contraceptive agent for brushtail possums was tested on a captive population. Males appeared resistant to treatment, but deslorelin was found to inhibit reproduction in female brushtail possums for at least one breeding season, making it a promising tool to control fertility in some wild populations. A further aim was to trial deslorelin implants on a wild urban population, to collect more information about the urban biology of this species and to point out issues which have previously not been addressed. Close proximity and interaction of urban brushtail possums with humans and their domestic animals can increase the risk of disease exposure and transmission and influence the health of wild populations. Serosurveys showed that animals were readily exposed to Leptospira spp. and Toxoplasma gondii. This thesis also provides the first data on brushtail possum dispersal in urban areas, knowledge which is highly relevant to the development of management strategies such as fertility control. The findings from this research broaden our knowledge about urban brushtail possums and should assist wildlife authorities in developing alternative or improved management procedures. / Mode of access: World Wide Web. / xxv, 287 p. ill., maps