Abstracts selezionati – Bollettinoginendo

n3-2024

Letteratura scientifica 23 Gen 2025

Abstracts selezionati

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Carlos Rencoret, José L. Neyro, Santiago Palacios Menopausal hormone therapy and breast cancer risk: 21 years from the WHI clinical studies Gynecological and Reproductive Endocrinology and Metabolism 2024; 5(2):86-89
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Abstract

This article analyzes relevant studies that associate the relative risk of suffering from breast cancer with the use of menopausal hormone therapy, which have appeared since the publication of the Women’s Health Initiative (WHI) study in 2002
and have been in permanent discussion. Based on both the WHI study updated 20 years after its first publication, and
the 2019 meta-analysis published by the Collaborative Group on Hormonal Factors in Breast Cancer in The Lancet, the
authors conclude that up-to-date information shows that exogenous estrogens reduce the risk of breast cancer and
that today’s combined menopausal hormone therapy (which excludes medroxyprogesterone acetate) does not increase
the relative risk of breast cancer. Contemporary knowledge has revealed that not all progestins are the same, and that
natural progesterone and tibolone do not report a significant increase in the relative risk of breast cancer. The relative risk
of breast cancer is a partial aspect of the problem, with no real impact (absolute risk), and it is clinically not the most important issue for climacteric women who are on menopausal hormone therapy. Cardiovascular disease is the real cause
of death among climacteric women, and the protection against it (excluding strokes) provided by menopausal hormone
therapy when used during the window of opportunity is unquestionable. This therapy has proven to maintain and improve
the quality of life of the symptomatic women.
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Tommaso Simoncini , Mulan Ren, Tetiana Tatarchuk, Elke Kahler, Qi Yu, John C. Stevenson, Marcelo Graziano Custodio, Junyi Yang, Rossella E. Nappi
Impact of low and ultra-low dose estradiol and dydrogesterone on health-related quality of life of postmenopausal women: outcomes from two Phase 3 studies Gynecological and Reproductive Endocrinology and Metabolism 2024; 5(2):74-79
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Background and purpose: Oral low and ultra-low dose continuous combined estradiol (E) plus dydrogesterone (D) reduce vasomotor symptoms in postmenopausal women; this pooled analysis evaluated their impact on patient-reported
health-related quality of life.
Methods: In two Phase 3, double-blind studies, postmenopausal women were randomized 2:1:2 to receive E 0.5 mg/D
2.5 mg, E 1 mg/D 5 mg, or placebo for 13 weeks (European study) or 1:1 to receive E 0.5 mg/D 2.5 mg or placebo for 12
weeks (Chinese study). This post hoc analysis assessed changes in the scores of the Menopause Rating Scale (MRS)
from baseline to week 4 and end of treatment (EOT) in the total pooled population and for subgroups stratified by body
mass index (BMI; <25 and ≥25) or ethnicity (European and Chinese).
Results: The analysis included 640 women (E 0.5 mg/D 2.5 mg, n=288; E1 mg/D 5 mg, n=61; placebo, n=291). At EOT,
mean MRS scores for hot flushes/sweating, heart discomfort, sleep problems, anxiety and dryness of vagina were significantly improved with E 0.5 mg/D 2.5 mg versus placebo in the total population, as were total MRS scores and its
somato-vegetative, psychological, and urogenital subscale scores. These scores were all significantly improved by week
4, except for sleep problems and vaginal dryness and the urogenital subscale score. For E1 mg/D 5 mg versus placebo in
the total population, there were significant improvements in mean MRS scores for hot flushes/sweating, sleep problems,
depressive mood, anxiety, and joint and muscular discomfort as well as MRS total and somato-vegetative and psychological subscale scores. These scores were all significantly improved by week 4, except for sleep problems and anxiety,
and the psychological subscale score. The mean domain score for hot flushes/sweating was also significantly improved
with E 0.5 mg/D 2.5 mg versus placebo in all BMI and ethnicity subgroups.
Conclusions: In this pooled analysis, E 0.5 mg/D 2.5 mg and E 1 mg/D 5 mg improved in postmenopausal women
health-related quality of life across several clinically relevant domains compared to placebo.
espandi

Danielle Choucroun
Meningioma and levonorgestrel morning-after pillEuropean Gynecology and Obstetrics. 2024, 3: 137-141.
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Abstract
Meningiomas are typically benign tumors that arise from arachnoid cells, with the majority being intracranial and predominantly affecting women. These tumors are associated with certain conditions, such as neurofibromatosis and the exposure to ionizing radiation. Since the mid-20th century, a growing body of research has suggested a potential link between the development of meningiomas and female sex hormones, particularly progestogens. This article discusses the relationship of meningioma growth and gonadal steroids administration.
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Michał Kunicki, Natalia Rzewuska, Paulina Sopońska, Agata Pawłosek, Iwona Sowińska & Anna Kloska
Novel serum biomarkers for early diagnosis of gestational diabetes mellitus—a reviewGynecoloGical EndocrinoloGy 2025, Vol. 41, no. 1, 2455472
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Abstract

Gestational diabetes mellitus (GDM) affects 9–25% of pregnancies. Undiagnosed or poorly managed GDMis associated with both short- and long-term complications in the fetus and mother. the pathogenesis ofGDM is complex and has not yet been fully elucidated. Several biomarkers found in maternal serum havethe potential for the early diagnosis of GDM. the aim of this narrative review was to explore novelbiomarkers that have not been comprehensively described in previous reviews. we believe these biomarkersmay allow for the detection of GDM in the early stages of pregnancy, enabling timely proper treatmentand potentially preventing complications for both the mother and the fetus.
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Weiwei Fenga,Xianjing Xiea, Yan sua, Rong Jinb, and Wei shi
Relationship of adiponectin, leptin and reproductive endocrine hormones withinsulin resistance in polycystic ovary syndrome patients with normal BMIGynecological Endocrinology 2024, Vol. 40, no. 1, 2439886
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Abstract

Objective: this study aimed to analyze the correlation of adiponectin (aPN) and leptin (leP), reproductiveendocrine hormones with insulin resistance (iR) in polycystic ovary syndrome (PcOs) patients with normalbody mass index (BMi).
Methods: totally 160 PcOs patients were categorized into the Normal BMi (BMi: 18.5–25 kg/m2, n = 62) andhigh BMi (BMi > 25 kg/m2, n = 98) groups. Glucose indicators [fasting plasma glucose, fasting insulin andhomeostasis Model assessment of insulin Resistance (hOMa-iR)], lipid indicators [total cholesterol (tc),triglyceride (tG), high-density lipoprotein cholesterol (hDl-c) and low-density lipoprotein cholesterol(lDl-c)], adipokines [aPN and leP] and reproductive endocrine hormones [luteinizing hormone (lh), folliclestimulating hormone (Fsh), prolactin (PRl), total testosterone (tt), dehy-droepiandrosterone sulfate (Dheas)and estradiol (e2)] were collected, and their correlations were analyzed. the relationship of hOMa-iR withaPN, leP and reproductive endocrine hormones was subjected to multiple linear regression analysis.
Results: correlation analysis revealed positive correlations of hOMa-iR with tc, tG, lDl-c, leP, PRl, Dheasand tt and negative correlations with hDl-c, aPN, lh, Fsh and e2 in PcOs patients with normal BMi.Multiple linear regression analysis showed that lh, Fsh and e2 negatively affected hOMa-iR, while PRlpositively affected hOMa-iR.
Conclusion: there were strong correlations of HOMa-iR in PcOs patients with normal BMi with aPN, leP,and reproductive endocrine hormones. Besides, lh, Fsh, e2 and PRl expression had an important effecton iR in normal BMi PcOs patients, which provided a theoretical basis for the exploration of pathogenicmechanisms in normal BMi PcOs patients.
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Dominique de Ziegler, Sean Sokteang
Ovarian stimulation 2.0 Fertil Steril 2025 123: 8-9.
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Abstract

Ovarian stimulation (OS) has been the single most effective measure ever taken for enhancing assisted reproductive technology outcomes. In the past decade, we have seen a flurry of various new protocols used for OS in assisted reproductive technology In light of the important differences that characterize these new approaches for OS, we felt it was timely to review the relative merits of each and every new protocol.
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Sean Sokteang, Pichetra Ou, Chloe Tran, Dominique de Ziegler
Programming the onset of ovarian stimulation: from early follicular phase start to oral contraceptive pill, to luteal phase E2, Duostim, and random start oral contraceptive protocols Fertil Steril 2025;123:22–30.
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Abstract

Ovarian stimulation has been the single most efficient measure ever taken in assisted reproductive technology for improving outcomes by harvesting multiple oocytes and ultimately, embryos. Today, ovarian stimulation protocols consist of administrating exogenous gonadotropins to override the natural mechanisms that control the ovulatory quota to one in humans. For practicality issues, there have been numerous attempts to control, or ‘‘program,’’ when ovarian stimulation is initiated to improve functionality and in turn efficacy for assisted reproductive technology programs. The different options for controlling the onset of ovarian stimulation currently available are discussed here, as well as the novel possibility of using progestins for blocking premature ovulation.
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Machiel H.A. van Hooff, Mirte R. Caanen, Henrike E. Peters, Joop S.E. Laven , Cornelis B. Lambalk
Adolescent menstrual cycle pattern, body mass index, endocrine and ovarian ultrasound characteristics of PCOS and future fertility, cardiovascular-, and metabolic health: a 25-year longitudinal follow-up study Human Reproduction, 2025, 40(1), 138–147.
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STUDY QUESTION: What is the predictive value of oligomenorrhea and other PCOS diagnostic characteristics in adolescence (age 15–18 years) for future fertility and cardiovascular and metabolic health at adult age?
SUMMARY ANSWER: Adolescents with oligomenorrhea are more often treated to conceive but are as likely to have as much children as those with regular periods, while persisting oligomenorrhea may associate more often with cardiovascular or metabolic problems.
WHAT IS KNOWN ALREADY: Adolescents with oligomenorrhea have a high risk for adult PCOS associated with subfertility due to ovulatory disorders and long-term health risks. Longitudinal studies to estimate the extent of these risks with input starting at adolescence and covering the complete reproductive lifespan are lacking.
STUDY DESIGN, SIZE, DURATION: A 25-year prospective follow-up study based on a unique population-based adolescent study on menstrual irregularities performed between 1990 and 1997, the Pubertal Onset of Menstrual Cycle abnormalities, a Prospective study (POMP study). Of the 271 invited adults, 160 (59%) participated.
PARTICIPANTS/MATERIALS, SETTING, METHODS: We contacted stratified samples of the POMP study cohort two decades after the initial study for a questionnaire assessing PCOS features, fertility history, pregnancy outcome, metabolic, and cardiovascular health. One hundred and sixty subjects completed the questionnaire. The mean adolescent age was 15.3 years, and the women were 39.6 years at the time of follow-up. One hundred and eight subjects had a regular menstrual cycle as adolescents and 52 were oligomenorrheic.
MAIN RESULTS AND THE ROLE OF CHANCE: Of those with adolescent regular menstrual cycles 12 never tried to conceive, 4 tried but never conceived and 92 of 96 (96%) conceived, 89 of 96 (93%) delivering at least one living child. The median number of children was two. The mean time to pregnancy (TTP) was 8.4months in the women with regular periods as adolescents and 13.2months in case of oligomenorrhea (P ¼ 0.08) and subfertility was present in respectively 18% and 26%. 47 of 52 adolescents with oligomenorrhea tried to conceive and 45 succeeded to have at least one live birth. Twenty-eight per cent of the subjects reported a change over time of their menstruation pattern. Fifty per cent of the girls with adolescent oligomenorrhea developed a regular cycle and 16% of those with regular periods changed to oligomenorrhea with significantly more reported subfertility (40%, P ¼ 0.04). In case of persistent oligomenorrhea, a significant proportion (40%) underwent fertility treatment (P ¼ 0.04). Adult BMI did not differ between groups. The risk for pregnancy-induced hypertension or pre-eclampsia was comparable between the groups. Gestational diabetes developed in three subjects each with persistent oligo amenorrhea. Adult diabetes, hypertension, and hypercholesterolemia were also mostly reported in case of persistent oligomenorrhea. In this group, the prevalence of combined cardiovascular and metabolic problems was 14% compared to 7% in the case of regular menstrual cycles as adolescent.
LIMITATIONS, REASONS FOR CAUTION: The numbers in the study are small. However, the small difference between the percentage with a least one living child of those with adolescent oligomenorrhea versus those with adolescent regular menstrual cycles is reassuring. Time to pregnancy data may have been biased by early treatment of oligomenorrheic adults.
WIDER IMPLICATIONS OF THE FINDINGS: Oligomenorrheic adolescents may be reassured that their chance to have a live birth is comparable with those with a regular menstrual cycle.

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