Objective To examine the impact of hormones used for controlled ovarian hyperstimulation (COH) on normal and malignant breast cell growth and proliferation. Design In vitro study of cultured normal ...and malignant breast cell lines. Setting Academic medical center. Patient(s) None. Intervention(s) Normal and malignant breast cell lines cultured in two- and three-dimensional (2D and 3D) systems and treated with follicle-stimulating hormone (FSH), luteinizing hormone (LH), or FSH with LH or human chorionic gonadotropin (hCG). Main Outcome Measure(s) Effects of treatment on cell proliferation in 2D culture using the MTS assay and on colony growth in 3D culture. Result(s) Compared with untreated cells, normal MCF-10A cells showed a decrease in proliferation and colony size when exposed to a combination of FSH and hCG. The HCC 1937 cells treated with FSH and LH also showed a decrease in colony growth but no change in proliferation. None of the treatments had an effect on the proliferation or colony size of the MCF-7 cells. Conclusion(s) Follicle-stimulating hormone, LH, and hCG do not appear to cause an increase in cell proliferation or colony growth in either normal or malignant mammary epithelial cell lines. The potential risk for mammary cell transformation associated with these agents may be related to indirect endocrine effects on breast cell physiology.
Unlike in men, a very limited number of studies were focused on the specificity of ART management of cystic fibrosis (CF) in women. The purpose of this study was to determine the causes of ...infertility in patients, the appropriate ART treatment, and their prognosis in terms of pregnancy.
We conducted a multicentre analytical case-control study including CF women who were age-matched to non-CF women. We reported the causes of infertility, the ART management type and pregnancy outcomes.
17 cases were compared to 34 controls. There was no significant difference between the groups concerning cause infertility. There was a non-statistically significant trend with a lower antral follicle count in CF compared to controls (19.5 versus 26.8, p=0.08). IUI seemed to be as successful as IVF/ICSI in CF as opposed to controls where the IVF/ICSI was the most effective (in CF group for HCG >100 UI/L: 38.8% vs. 36.8%, p=0.4175). There were more embryos obtained in CF than in controls (3.1 versus 1.6, p=0.02). The number of oocytes and embryos obtained and pregnancy outcomes remained similar between DF508 homozygous group and others CFTR mutations group. The results of ART procedures and pregnancy evolution were not influenced by FEV1.
In absence of any other pathology, IUI may be first option for CF women. If insemination fails, IVF with a low dose of gonadotropins may be more appropriate to prevent the risk of hyperstimulation syndrome. FEV1 and genetic do not seem to be contributing factors in the prognosis of ART.
To study the impact of hematopoietic stem cell transplantation (HSCT) on the uterine volume of childhood acute leukemia (AL) survivor depending on age at HSCT and the type of myeloablative ...conditioning regimen.
Thirteen French University Teaching Hospitals.
Prospective cohort study.
Eighty-eight women who underwent HSCT during childhood or adolescence for AL compared to a control group.
A multicentric prospective national study compared the uterine volume in a cohort of childhood AL survivor adult women treated with HSCT, matched 1:1 to control women. Pelvic magnetic resonance imaging scans included diffusion-weighted imaging sequences. Scans were centralized for a double-blinded reading by 2 radiologists.
Uterine volume, uterine body-to-cervix ratio, and apparent diffusion coefficient.
The mean age at HSCT was 9.1 ± 0.3 years with a mean follow-up duration of 16.4 ± 0.5 years. The cohort of 88 HSCT survivor women was composed of 2 subgroups depending on the myeloablative conditioning regimen received: an alkylating agent–based regimen group (n = 34) and a total body irradiation (TBI)–based regimen group (n = 54). Among the 88 women, 77 were considered as having a “correct hormonal balance” with estrogens supplied by hormone replacement therapy (HRT) for premature ovarian insufficiency (POI) or because of a residual ovarian function. In the control group (n = 88), the mean uterine volume was 79.7 ± 3.3 mL. The uterine volume significantly decreased in all HSCT survivor women. After the alkylating agent–based regimen, the uterine volume was 45.3 ± 5.6 mL, corresponding to a significant volume reduction of 43.1% (28.8–57.4%) compared with that of the control group. After TBI, the uterine volume was 19.6 ± 1.9 mL, corresponding to a significant volume reduction of 75.3% (70.5%–80.2%) compared with that of the control group. After the alkylating agent–based regimen, the uterine volume dramatically decreased in women with POI without HRT compared with that in those with a correct hormonal balance (15.2 ± 2.6 vs. 49.3 ± 6 mL). In contrast, after TBI, the uterine volume was similar in all women, with no positive effect of hormonal impregnation on the uterine volume (16.3 ± 2.6 vs. 20.1 ± 2.2 mL, respectively).
The uterine volume was diminished after HSCT, regardless of the conditioning regimen. The physiopathology needs to be further investigated: specific impact of a high dose of an alkylating agent; impact of hormone deprivation around puberty; poor compliance to HRT; or different myometrial impact of HRT compared with endogenous ovarian estrogens?
ClinicalTrials.gov/NCT 03583294 (enrollment of the first subject, November 11, 2017; enrollment of the last subject, June 25, 2021).
El volumen uterino se ve drásticamente reducido después de un transplante de células madre hematopoyéticas durante la infancia independientemente del régimen de acondicionamiento previo.
Estudiar el impacto del transplante de células madre hematopoyéticas (HSCT) sobre el volumen uterino en las supervivientes de leucemia aguda infantil (AL) según la edad en que se realizó el HSCT y el tipo de régimen de acondicionamiento mieloablativo.
Trece hospitales universitarios franceses.
Estudio prospectivo de cohortes.
Ochenta y ocho mujeres sometidas a HSCT durante su infancia o adolescencia por AL comparadas con un grupo control.
Se comparó el volumen uterino en una cohorte de mujeres adultas supervivientes de AL infantil tratada mediante HSCT en un estudio nacional prospectivo multicéntrico, emparejadas 1:1 con mujeres control. Las imágenes de las resonancias magnéticas pélvicas incluyeron secuencias de imágenes ponderadas por difusión. Las pruebas se centralizaron para una lectura doble-ciego realizada por 2 radiólogos.
Volumen uterino, relación cuerpo-cérvix uterino y coeficiente de difusión aparente.
La edad media en la realización del HSCT fue de 9.1+/- 0.3 años, con una media de duración del seguimiento de 16.4 +/- 0.5 años. La cohorte de 88 mujeres supervivientes de HSCT estaba compuesta por 2 subgrupos dependiendo del régimen de acondicionamiento mieloablativo recibido: un grupo con régimen basado en agentes alquilantes (n=34) y otro con régimen basado en irradiación corporal total (TBI) (n=54). Entre las 88 mujeres, se consideró que 77 tenían un “balance hormonal correcto” con aporte de estrógenos mediante tratamiento hormonal sustitutivo (HRT) por insuficiencia ovárica prematura (POI) o por una función ovárica residual. En el grupo control (n=88), el volumen uterino medio fue de 79.7 +/- 3.3 mL. El volumen uterino estaba significativamente reducido en todas las mujeres supervivientes de HSCT. Tras el régimen basado en agentes alquilantes, el volumen uterino era de 45.3 +/- 5.6 mL, correspondiente a una reducción significativa del volumen del 43.1% (28.8-57.4%) comparada con las del grupo control. Después de TBI, el volumen uterino fue de 19.6 +/- 1.9 mL, correspondiente a una reducción significativa del volumen del 75.3% (70.5%-80.2%) comparadas con las del grupo control. Tras el régimen basado en agentes alquilantes, el volumen uterino disminuyó drásticamente en mujeres con POI sin HRT comparadas con aquellas que tenían un balance hormonal correcto (15.2 +/- 2.6 vs. 49.3 +/- 6 mL). Por el contrario, después de TBI, el volumen uterino fue similar en todas las mujeres, sin efecto positivo de la impregnación hormonal sobre el volumen uterino (16.3 +/- 2.6 vs 20.1 +/-2.2 mL respectivamente).
Después de HSCT se produjo una reducción del volumen uterino independientemente del régimen de acondicionamiento. Son necesarios más estudios para conocer la fisiopatología: impacto específico de altas dosis de agentes alquilantes, impacto de la deprivación hormonal en la pubertad, bajo cumplimiento del HRT o diferente impacto miometrial de la HRT comparada con los estrógenos ováricos endógenos?
Útero, transplante de células madre hematopoyéticas, MRI, quimioterapia, irradiación corporal total.
Abstract Background/Purpose Isolated tubal torsion associated with hydrosalpinx is a rare pathology. Our goal was to analyze the clinical and imaging features and discuss the different treatment ...options available. Methods We retrospectively reviewed all the cases of adnexal torsion treated in our department of pediatric surgery over a 10-year period. We searched 2 electronic databases (Medline and Sciencedirect) and targeted reports published during the same period using the key words tubal torsion and hydrosalpinx. Results A total of 13 cases, 6 from our hospital and 7 in the medical literature, were identified and analyzed. In 9 (69%) of 13 cases (n = 9/13), torsion and hydrosalpinx occurred on the left fallopian tube. Salpingectomy was performed in 11 of the patients. The resected tubes showed the persistence of ciliated cells associated with signs of moderate ischemic infarction in 50% (n = 3/6) of the cases. Conclusions Isolated tubal torsion associated with hydrosalpinx is too often misdiagnosed and treated by salpingectomy regardless of the negative impact on the future reproductive potential of our young patients. As is commonly advocated for ovarian salvage in adnexal torsions, tubal conservation should be favored when possible.
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