menotropins and Leiomyoma

Due to the different pharmacological mode of action, GnRH-antagonists seem to open up new avenues to hormonal treatment in several indications. Although it may be still too early to speculate about the possible end of the era of GnRH-agonists, from what is known today, the advantages of GnRH-antagonists are most evident in our opinion. When the development of sustained delivery systems may continue and be completed, the antagonists will have a major potential within benign gynecological conditions and also in the treatment of malignancies such as prostatic, mammary, endometrial or ovarian cancer. Suitable sustained delivery systems and the development of GnRH-antagonists with sufficient oral bioavailability, represent the present and future challenge for these efforts.

Topics: Clinical Trials, Phase III as Topic; Endometriosis; Female; Follicle Stimulating Hormone; Gonadotropin-Releasing Hormone; Humans; Leiomyoma; Male; Menotropins; Neoplasms, Hormone-Dependent; Ovarian Neoplasms; Ovulation Induction; Pituitary Gland; Prostatic Neoplasms

Topics: Animals; Blastocyst; Chorionic Gonadotropin; Female; Gonadotropin-Releasing Hormone; Humans; Leiomyoma; Luteinizing Hormone; Menotropins; Pregnancy; Prolactin; Rabbits; Rats; Uterine Neoplasms

The relationship between fibroids and infertility remains an unsolved question, and management of intramural fibroids is controversial. During the implantation phase, uterine peristalsis is dramatically reduced, which is thought to facilitate embryo implantation. Our aims were to evaluate (i) the occurrence and frequency of uterine peristalsis in infertile women with intramural fibroids and (ii) whether the presence of uterine peristalsis decreases the pregnancy rate.. Ninety-five infertile patients with uterine fibroids were examined using magnetic resonance imaging (MRI). Inclusion criteria were as follows: (i) presence of intramural fibroids, excluding submucosal type; (ii) no other significant infertility factors (excluding endometriosis); and (iii) regular menstrual cycles, and MRI performed at the time of implantation (luteal phase day 5-9). The frequency of junctional zone movement was evaluated using cine-mode-display MRI. After MRI, patients underwent infertility treatment for up to 4 months, and the pregnancy rate was evaluated prospectively.. Fifty-one patients fulfilled the inclusion criteria, and 29 (57%) and 22 (43%) patients were assigned to the low (0 or 1 time/3 min) or high frequency (≥ 2 times/3 min) uterine peristalsis group, respectively. Endometriosis incidence was the same in both groups. Ten out of the 29 patients (34%) in the low-frequency group achieved pregnancy, compared with none of the 22 patients (0%) in the high-frequency group (P< 0.005). Comparing pregnant and non-pregnant cases, 4 of 10 patients (40%) and 9 of 41 patients (22%), respectively, had endometriosis (not significant).. A higher frequency of uterine peristalsis during the mid-luteal phase might be one of the causes of infertility associated with intramural-type fibroids.

Topics: Adult; Clomiphene; Endometriosis; Female; Fertility Agents, Female; Humans; Infertility, Female; Leiomyoma; Magnetic Resonance Imaging; Menotropins; Ovulation Induction; Peristalsis; Pregnancy; Pregnancy Complications, Neoplastic; Pregnancy Rate; Prospective Studies; Retrospective Studies; Uterine Neoplasms

Several studies have shown that gonadotrophin-releasing hormone analogue (GnRHa) offers a promising medical approach in the treatment of uterine leiomyomas. Medical management is very important especially when fertility is desired. We report on a case with mechanical infertility, in which the right tube was obstructed by cornual myoma and the left tube was resected due to a ruptured ectopic pregnancy. The myoma was reduced in size by GnRHa treatment and the patient subsequently conceived.

Topics: Adult; Chorionic Gonadotropin; Fallopian Tubes; Female; Humans; Leiomyoma; Menotropins; Pregnancy; Triptorelin Pamoate; Ultrasonography, Prenatal; Uterine Neoplasms