Stratification of fertility potential according to cervical mucus symptoms: achieving pregnancy in fertile and infertile couples
Author: Marshell M., Corkill M., Whitty M., Thomas A. & Turner J. (2019)
Women wishing to conceive are largely unaware of fertility symptoms at the time of ovulation. This study investigated the effectiveness of fertility-awareness in achieving pregnancy, particu- larly fertile mucus pattern, in the context of infertility. The 384 eligible participants were taken from consecutive women desiring pregnancy who attended 17 Australian Billings Ovulation MethodVR clinics from 1999–2003. This cohort included couples with infertility !12 months (51%) and female age >35 years (28%). Under fertility-awareness instruction, pregnancy was achieved by 240 couples (62.5%) after maximum follow-up of two years. Mucus symptom observations effectively stratified ‘low pregnancy-potential’ (35.2%) and ‘high pregnancy-potential’ groups. Pregnancy rates were $30% higher in the latter group (44.4% versus 72.3%) in addition to con- sistent effects observed on pregnancy achievements within subgroups defined by prognostic factors such as duration of infertility (p1⁄40.001) and increasing female age (p1⁄40.04). Fertile symptoms were also associated with significantly shorter time to conception (4.2 versus 6.4 months) in a survival analysis (p1⁄40.003). Billings Ovulation MethodVR observations strongly pre- dicted successful conception. This has the capacity to provide a rapid, reliable and cost-effective approach to stratifying fertility potential, including directing timely and targeted investigations/ management, and is accessible for women who may be remote from primary or specialist care.
A Simple and Improved Predictor of Insulin Resistance Extracted From the Oral Glucose Tolerance Test: The I0*G60
Author: Contreras P.H., Salgado A.M., Bernal Y.A., Vigil P. (2019)
The objective of this study is to evaluate the diagnostic performance of several biochemical predictors of insulin resistance (IR). A total of 90 nondiabetic subjects were tested with both the pancreatic suppression test (PST) and the oral glucose tolerance test (OGTT). Of them, 53 were non–insulin-resistant (NIR) subjects and the remaining 37 were insulin resistant subjects.
Ovulation A Sign Of Health™: Understanding Reproductive Health In A New Way
Author: Pilar Vigil MD, PhD, FACOG, Contributors: Juan Pablo del Río MD, Natalia Molina BMed, Pedro Gutiérrez MD, Carolina Lyon Nrs, Yanara Bernal Nrs, Felipe G. Serrano BSc,. MSc (2019)
This text analyzes the anatomy of ovulation and the structures involved in this process. It reviews the role of the central nervous system and its communication through the neuroendocrine axis with the gonads and endocrine glands involved in ovulation. The concept of ovarian activity in the lifetime of women, the events that occur in intrauterine life, puberty, and during the reproductive age were discussed. It analyzes the concept of the fertile window and the processes that surround it, mentioning certain biomarkers. Special relevance was given to the role of cervical mucus as a tool for recognizing ovulation. Also, the relationship between hormones and the brain is mentioned. Finally, in relation to future perspectives, we expose the need for more research in order to improve women’s health and well-being, recognizing ovulation as a sign of health.
Steroid Hormones and Their Action in Women’s Brains: The Importance of Hormonal Balance
Author: Del Río J.P., Alliende M.I., Molina N., Serrano F.G., Molina S. and Vigil P. (2018)
Sex hormones significantly impact women’s lives. Throughout the different stages of life, from menarche to menopause and all stages in between, women experience dramatic fluctuations in the levels of progesterone and estradiol, among other hormones. These fluctuations affect the body as a whole, including the central nervous system (CNS). In the CNS, sex hormones act via steroid receptors. They also have an effect on different neurotransmitters such as GABA, serotonin, dopamine, and glutamate. Additionally, studies show that sex hormones and their metabolites influence brain areas that regulate mood, behavior, and cognitive abilities. This review emphasizes the benefits a proper hormonal balance during the different stages of life has in the CNS. To achieve this goal, it is essential that hormone levels are evaluated considering a woman’s age and ovulatory status, so that a correct diagnosis and treatment can be made. Knowledge of steroid hormone activity in the brain will give women and health providers an important tool for improving their health and well-being.
The ovarian continuum is a process that occurs during a woman’s lifetime. It begins during intrauterine life with fertilization and ends with menopause. This process can be greatly affected by different conditions such as changes in hormonal levels and illnesses. Therefore, understanding and promoting the knowledge and use of biomarkers of ovulation in women is a key aspect to consider when evaluating their health status. The knowledge and education about the ovarian continuum should be taken into account as a powerful tool for women and medical professionals.
Hormonal Abnormalities in Patients with Ovulatory Dysfunction are Associated with Changes in Mood States, IV Edition [International Workshop in Neuroendocrinology]
Author: Serrano F.G., Osorio T., and Vigil P. (2017)
The emotional states and hormones are an interesting field of study, where the changes associated with hormones could be related with possible implications in mental health. Additionally, ovulatory dysfunctions are a single most cause disorder and infertility by changes of sexual hormones levels in women with emotional tension that conduce to a psychosocial stress. Also, recent evidence which implicate the role of hormones and depressive states in patients that use contraceptives open a windows to understand the potential role of hormone as a new field of interest to evaluate possible markers as endocrine disorders and emotional states. However, exist a reduced research of these topics to understand a possible relationship between the role of hormones and their effects in emotional states. Here, we analyzed a data bank of a group of women with ovulatory dysfunction between 13 to 36 years old to evaluate changes in hormonal levels (Prolactin, Follicle-Stimulating Hormone (FSH), Thyroid-Stimulating Hormone (TSH), Estradiol and Testosterone) and a possible association with mood states by the use of 2 psychological test: POMS (Profile of Mood States) which evaluate 6 states: Tension, Depression, Anger, Vigor, Confusion and Fatigue, and as a control the use of FMPS (Frost Multidimensional Perfectionism Scale) which evaluate scales of perfectionism as concert to mistakes, pressure, order, organization, etc. As a result, we found that exist a positive correlation between levels of FSH and tension variable. Also, we found a negative correlation between estradiol with depression that is consistent with recent evidence. Additionally, the normal values considered for a population are not representative to use as a diagnostic, therefore these evidence need to be considered to future investigations. This is the first evaluation in the neuroendocrinology field that correlate moods states with hormonal level dysfunction suggesting potential implications in women health to the future.
Insulin Sensitivity and Testicular Function in a Cohort of Adult Males Suspected of Being Insulin-Resistant [Frontiers in Public Health]
Author: Contreras P., Vigil P., and Salgado A.M. (2017)
A cohort of 141 males (18-80 yo, 42.9±12.9) suspected of being Insulin Resistant (IR) was prospectively studied by determining their insulin sensitivity (Pancreatic Suppression Test, PST) and testicular function (total testosterone and SHBG). The subjects were considered IR when their Steady State Plasma Glucose (SSPG) was ≥ 150 mg/dL and Non-Insulin Resistant (NIR) when their SSPG was < 150 mg/dL; similarly, the subjects were labeled as Hypogonadal (HYPOG) when their total testosterone was ≤3.0 ng/mL and Eugonadal (EUG) when their total testosterone was > 3.0 ng/mL. Subjects n=141 IR n=94 (66.66%) NIR n=47 (33.33%) HYPOG n= 37 (26,24%) 30 7 EUG n=104 (73.76%) 64 40 Chi-square was 4.69 and p was 0.0303, indicating a significant interdependence between insulin resistance and hypogonadism. Age (>43 yo) predicted hypogonadism (AUROC 0.606, p=0.0308). Neither Weight nor BMI predicted hypogonadism, while Waist Perimeter (>110 cm) was a predictor of hypogonadism (AUROC 0.640, p=0.009). SSPG (>224 mg/dL) was a significant predictor of hypogonadism (AUROC 0.709, p=0.002). Age did not predict insulin resistance, while Weight (>99 kg), BMI (>29), and specially, Waist Perimeter (> 100 cm, AUROC 0.812, p< 0.0001) were all significant predictors of insulin resistance. In conclusion, Waist Perimeter predicted both insulin resistance (> 100 cm) and hypogonadism (> 110 cm), suggesting that the first hit of abdominal obesity is insulin resistance and the second hit is male hypogonadism.