No subject with free testosterone lower than .70% miscarried, all subjects with 1.30% and higher didTotal testosterone in patients with missed miscarriage was significantly lower than those in normal group, whereas % free testosterone (the total testosterone level divided by the SHBG level) was significantly higher. There was a significant negative correlation between % free testosterone and SHBG concentration in the normal group, but not in the missed miscarriage group. All the subjects in whom % free testosterone was 1.30% and higher subsequently miscarried, but no subject with % free testosterone less than 0.70% had a miscarriage.
SHBG level) was elevated in 14.6% of subjects with unexplained recurrent miscarriage.
Testosterone concentrations were higher in the women with recurrent miscarriages both with and without PCOS on days LH-7 and LH-4 of the cycle. Concentrations of androstenedione (precursor to testosterone and estrogen) also were higher in the women with recurrent miscarriages, but without PCOS on day LH-7. Testosterone/SHBG ratios were higher in the women with recurrent miscarriages, without PCOS compared with the controls on days LH-7, LH+0, and LH+7.
miscarriage in order to ascertain whether hyperandrogenaemia is a predictor of subsequent pregnancy outcome. We studied 571 women who attended the Recurrent Miscarriage Clinic in Sheffield and presented with ≥3 consecutive miscarriages. METHODS: Serum levels of total testosterone and sex hormone-binding globulin (SHBG) were measured in the early follicular phase and free testosterone (testosterone/SHBG) was then deduced. RESULTS: The prevalence of hyperandrogenaemia in recurrent miscarriage was 11% and in a subsequent pregnancy, the miscarriage rate was significantly higher in the raised free testosterone group (miscarriage rates of 68% and 40% for free testosterone > 5 and free testosterone ≤ 5 respectively). CONCLUSIONS: An elevated free testosterone index appears to be a prognostic factor for a subsequent miscarriage in women with recurrent miscarriage and is a more significant predictor of subsequent miscarriage than an advanced maternal age (≥40 years) or a high number (≥6) of previous miscarriages in this study.
The results suggest that androstenedione can inhibit human endometrial cell growth and secretory activity. Infertility and miscarriage associated with high androgen levels (e.g., that caused by the polycystic ovary syndrome) may be due to an adverse effect of high androgen levels on the endometrium.
Significant prolongation of the follicular phase and shortening of the luteal phase were demonstrated to be associated with clinical signs of hyperandrogenism and elevated plasma testosterone levels. Statistically significant correlations between plasma testosterone levels and duration of phases of the menstrual cycle were observed. Testosterone levels were directly related to the length of the follicular phase and inversely related to the length of the luteal phase. A significant inverse correlation between the lengths of the two phases of the menstrual cycle was also demonstrated.
training on 6 days a week in recreational atheletes. Cortisol release was reduced, follicle-stimulating hormone (FSH)-synthesis-secretion capacity was increased after training, and the luteinizing hormone (LH)-synthesis-secretion capacity reduced.
free testosterone among exercisers who lost between 0.5% and 2% body fat declined by 4.7% and 10.4%. In controls who lost this amount of body fat, concentrations of testosterone and free testosterone declined by only 2.8% and 4.3%.
calcium intake is linked to lower levels of adrenal androgens and higher levels of parathyroid hormones.
obese women with PCOS given 1200 mg/day of d-chiro-inositol for 6 to 8 weeks, the mean area under the plasma insulin curve after the oral administration of glucose decreased from 13,417 to 5158 µU/ml/min; glucose tolerance did not change significantly. The serum free testosterone concentration in these 22 women decreased from 1.1 to 0.5 ng/dL. The women's diastolic and systolic blood pressure decreased by 4 mm Hg, and their plasma triglyceride concentrations decreased from 184 to 110 mg per deciliter (2.1 to 1.2 mmol per liter). None of these variables changed appreciably in the placebo group. Nineteen of the 22 women who received d-chiro-inositol ovulated, as compared with 6 of the 22 women in the placebo group. Conclusions: d-Chiro-inositol increases the action of insulin in patients with PCOS, thereby improving ovulatory function and decreasing serum testosterone concentrations, blood pressure, and plasma triglyceride concentrations.
D-chiro-inositol (600 mg/day for 6 to 8 weeks), the mean area under the plasma insulin curve after oral administration of glucose decreased significantly from 8,343 mU/mL/min to 5,335 mU/mL/min. Concomitantly, the serum free testosterone concentration decreased significantly from 0.83 ng/dL to 0.22 ng/dL. Six of the 10 women (60%) in the D-chiro- inositol group ovulated in comparison with 2 of the 10 women (20%) in the placebo group. Systolic and diastolic blood pressures, as well as plasma triglyceride concentrations, decreased significantly in the D-chiro- inositol group . We conclude that, in lean women with PCOS, D-chiro-inositol reduces circulating insulin, decreases serum testosterone, and ameliorates some of the metabolic abnormalities (increased blood pressure and hypertriglyceridemia) of syndrome X.
Patients were treated for 5-6 weeks with N-acetyl cysteine at a dose of 1.8 g/day orally. A dose of 3 g/day was arbitrarily chosen for massively obese subjects. Six of 31 obese patients with PCOS were treated with placebo and served as controls. Fasting glucose, fasting insulin, and glucose area under curve were unchanged after treatment. Insulin area under curve after oral glucose tolerance test was significantly reduced, and the peripheral insulin sensitivity increased after N-acetyl cysteine administration, whereas the hepatic insulin extraction was unaffected. The N-acetyl cysteine treatment induced a significant fall in testosterone levels and in free androgen index values. In analyzing patients according to their insulinemic response to oral glucose tolerance test, normoinsulinemic subjects and placebo-treated patients did not show any modification of the above parameters, whereas a significant improvement was observed in hyperinsulinemic subjects. CONCLUSION(S): N-acetyl cysteine may be a new treatment for the improvement of insulin circulating levels and insulin sensitivity in hyperinsulinemic patients with polycystic ovary syndrome.
Adiponectin, Estrogen, FSH, GnRH, LH, PCOS, Progesterone, Prolactin, SHBG, Testosterone