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  • 1. Aghajanova, L.
    et al.
    Altmae, S.
    Stavreus-Evers, Anneli
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Giudice, L. C.
    Stanniocalcin-1 in Human Endometrium2015Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 103, nr 2, s. E6-E7Artikel i tidskrift (Övrigt vetenskapligt)
  • 2.
    Aghajanova, Lusine
    et al.
    Univ Calif San Francisco, Dept Obstet Gynecol & Reprod Sci, 550 16th St,7th Floor,Box 0132, San Francisco, CA 94158 USA..
    Altmae, Signe
    Competence Ctr Hlth Technol, Tartu, Estonia.;Univ Granada, Sch Med, Dept Pediat, Granada, Spain..
    Kasvandik, Sergo
    Competence Ctr Hlth Technol, Tartu, Estonia.;Univ Tartu, Inst Technol, Prote Core Facil, Tartu, Estonia.;Univ Tartu, Womens Clin, Tartu, Estonia..
    Salumets, Andres
    Competence Ctr Hlth Technol, Tartu, Estonia.;Univ Tartu, Womens Clin, Tartu, Estonia..
    Stavreus-Evers, Anneli
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Giudice, Linda C.
    Univ Calif San Francisco, Dept Obstet Gynecol & Reprod Sci, 550 16th St,7th Floor,Box 0132, San Francisco, CA 94158 USA..
    Stanniocalcin-1 expression in normal human endometrium and dysregulation in endometriosis2016Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 106, nr 3, s. 681-691Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To determine expression of stanniocalcin-1 (STC1) in human endometrium with and without endometriosis and its regulation by steroid hormones. Design: Laboratory study. Setting: University. Patient(s): Nineteen women with endometriosis and 33 control women. Intervention(s): Endometrial biopsy and fluid sampling. Main Outcome Measure(s): Analysis of early secretory (ESE) and midsecretory (MSE) endometrial secretomes from fertile women with the use of nano-liquid chromatography-dual mass spectrometry;real-time quantitative polymerase chain reaction, and immunohistochemistry for STC1 and its receptor calcium-sensing receptor (CASR) mRNA and proteins in endometrium with and without endometriosis; evaluation of STC1 and CASR mRNA expression in endometrial stromal fibroblasts (eSF) from women with and without endometriosis decidualized with the use of E2P or 8-bromo-cyclic adenosine monophosphate (cAMP). Result(s): STC1 protein was strongly up-regulated in MSE versus ESE in endometrial fluid of fertile women. STC1 mRNA significantly increased in MSE from women with, but not from those without, endometriosis, compared with proliferative endometrium or ESE, with no significant difference throughout the menstrual cycle between groups. STC1 mRNA in eSF from control women increased >230-fold on decidualization with the use of cAMP versus 45-fold from women with endometriosis, which was not seen on decidualization with E-2/P. CASR mRNA did not exhibit significant differences in any condition and was not expressed in isolated eSF. STC1 protein immunoexpression in eSF was significantly lower in women with endometriosis compared with control women. Conclusion(s): STC1 protein is significantly up-regulated in MSE endometrial fluid and is dysregulated in eutopic endometrial tissue from women with endometriosis. It is likely regulated by cAMP and may be involved in the pathogenesis of decidualization defects.

  • 3. Aghajanova, Lusine
    et al.
    Altmäe, Signe
    Bjuresten, Kerstin
    Hovatta, Outi
    Landgren, Britt-Marie
    Stavreus-Evers, Anneli
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Disturbances in the LIF pathway in the endometrium among women with unexplained infertility2009Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 91, nr 6, s. 2602-2610Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To study the expression of leukemia inhibitory factor (LIF), its receptors LIFR and gp130, and its inhibitor SOCS1 in endometria from fertile women and infertile women with unexplained infertility. Signaling through the LIF pathway is involved in maintenance of a receptive state of human endometrium. Impaired endometrial receptivity may be a cause of female infertility. DESIGN: Prospective clinical study. SETTING: Hospital-based IVF unit and university-affiliated reproductive research laboratories. PATIENT(S): Twenty-six healthy fertile women and 14 women with unexplained infertility. INTERVENTION(S): Endometrial biopsy. MAIN OUTCOME MEASURE(S): Pinopode formation, expression of LIF, LIFR, gp130, and SOCS1 protein and mRNA in endometrial biopsies. RESULT(S): The expression of LIFR in the endometrium was negatively correlated to the expression of SOCS1 and positively correlated to the formation of pinopodes. In control fertile women, simultaneous intense apical staining of LIFR and gp130 together with faint SOCS1 staining was observed in epithelial cells, whereas the opposite was seen in most women with unexplained infertility. CONCLUSION(S): Unexplained infertility in some women might be explained by disturbances in the LIF pathway in midsecretory-phase endometrium.

  • 4.
    Aghajanova, Lusine
    et al.
    Dept of Clinical Science, Karolinska Institutet, Stockholm, Sweden.
    Stavreus-Evers, Anneli
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Lindeberg, Maria
    Dept of Clinical Science, Karolinska Institutet, Stockholm, Sweden.
    Landgren, Britt-Marie
    Dept of Clinical Science, Karolinska Institutet, Stockholm, Sweden.
    Skjöldebrand Sparre, Lottie
    Hovatta, Outi
    Dept of Clinical Science, Karolinska Institutet, Stockholm, Sweden.
    Thyroid-stimulating hormone receptor and thyroid hormone receptors are involved in human endometrial physiology2011Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 95, nr 1, s. 230-237Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To study the expression, distribution, and function of thyroid-stimulating hormone receptor (TSHR) and thyroid hormone receptors (TR) alpha1, alpha2, and beta1 in human endometrium. DESIGN: Experimental clinical study. SETTING: University hospital. PATIENT(S): 31 fertile women. INTERVENTION(S): Endometrial biopsy samples obtained throughout the menstrual cycle. MAIN OUTCOME MEASURE(S): Real-time reverse transcriptase polymerase chain reaction, immunohistochemistry and Western blot to study the expression of TSHR, TRalpha1, TRalpha2, and TRbeta1 messenger RNA (mRNA) and proteins in human endometrium. RESULT(S): We found TSHR, TRalpha1, TRalpha2 and TRbeta1 mRNA and proteins expressed in human endometrium. Immunostaining for TSHR in the luminal epithelium and TRalpha1 and beta1 in the glandular and luminal epithelium increased statistically significantly on luteinizing hormone (LH) days 6 to 9, coinciding with appearance of pinopodes. Endometrial stromal and Ishikawa cells expressed mRNA for TSHR, TR, and iodothyronine deiodinases 1-3. After 48 hours, TSH significantly increased leukemia inhibitory factor (LIF) and LIF receptor (LIFR) messenger RNA (mRNA) in endometrial stromal cells, but decreased their expression in Ishikawa cells. Glucose transporter 1 mRNA was up-regulated by TSH in Ishikawa cells. We found that TSH statistically significantly increased secretion of free triiodothyronine (T(3)) and total thyroxin (T(4)) by Ishikawa cells compared with nonstimulated cells. CONCLUSION(S): Thyroid hormones are directly involved in endometrial physiology.

  • 5.
    Almen-Christensson, Anna
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Neurologi. Linköpings universitet, Hälsouniversitetet.
    Hammar, Mats
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Lindh-Åstrand, Lotta
    Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Brynhildsen, Jan
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Landtblom, Anne-Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Neurologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Neurologiska kliniken. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland, Medicinska specialistkliniken .
    Prevention of menstrual migraine with perimenstrual transdermal 17-beta-estradiol: a randomized, placebo-controlled, double-blind crossover study2011Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 96, nr 2, s. 498-500Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    he effect of treatment with percutaneous E(2) (100 mu g/24 h) during 2 weeks perimenstrually on the number and severity of menstrual migraine attacks was studied in 27 women in a randomized, placebo-controlled, double-blind, crossover trial. We were not able to demonstrate any difference between E(2) supplementation and placebo on the number or severity of migraine attacks, but both regimens showed significant effects compared with before treatment.

  • 6.
    Altmae, Signe
    et al.
    Div Obstet & Gynecol,Karolinska Inst, Stockholm, Sweden; Dept Clin Sci Intervent & Technol, Huddinge Hosp, Karolinska Univ, Huddinge, Sweden.
    Stavreus-Evers, Anneli
    Dept Womens & Childrens Hlth, Akad Sjukhuset, Uppsala Univ, Uppsala, Sweden.
    Ruiz, Jonatan R.
    Dept Biosci & Nutr, Unit Prevent Nutr, Karolinska Inst, Stockholm, Sweden.
    Laanpere, Margit
    Inst Mol & Cell Biol, Dept Biotechnol, Univ Tartu, Tartu, Estonia.
    Syvanen, Tiina
    Dept Womens & Childrens Hlth, Akad Sjukhuset, Uppsala Univ, Uppsala, Sweden.
    Yngve, Agneta
    Dept Biosci & Nutr, Karolinska Inst, Stockholm, Sweden.
    Salumets, Andres
    Inst Mol & Cell Biol, Dept Biotechnol, Univ Tartu, Tartu, Estonia; Dept Obstet & Gynecol, Univ Tartu, Tartu, Estonia.
    Nilsson, Torbjorn K.
    Dept Clin Chem, Orebro Univ Hosp, Orebro, Sweden.
    Variations in folate pathway genes are associated with unexplained female infertility2010Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 94, nr 1, s. 130-137Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To investigate associations between folate-metabolizing gene variations, folate status, and unexplained female infertility. Design: An association study. Setting: Hospital-based IVF unit and university-affiliated reproductive research laboratories. Patient(s): Seventy-one female patients with unexplained infertility. Intervention(s): Blood samples for polymorphism genotyping and homocysteine, vitamin B12, and folate measurements. Main Outcome Measure(s): Allele and genotype frequencies of the following polymorphisms: 5,10-methylenetetra-hydrofolate reductase (MTHFR) 677C/T, 1298A/C, and 1793G/A, folate receptor 1 (FOLR1) 1314G/A, 1816delC, 1841G/A, and 1928C/T, transcobalamin II (TCN2) 776C/G, cystathionase (CTH) 1208G/T and solute carrier family 19, member 1 (SLC19A1) 80G/A, and concentrations of plasma homocysteine, vitamin B12, and serum folate. Result(s): MTHFR genotypes 677CT and 1793GA, as well as 1793 allele A were significantly more frequent among controls than in patients. The common MTHFR wild-type haplotype (677, 1298, 1793) CAG was less prevalent, whereas the rare haplotype CCA was more frequent in the general population than among infertility patients. The frequency of SLC19A1 80G/A genotypes differed significantly between controls and patients and the A allele was more common in the general population than in infertile women. Plasma homocysteine concentrations were influenced by CTH 1208G/T polymorphism among infertile women. Conclusion(s): Polymorphisms in folate pathway genes could be one reason for fertility complications in some women with unexplained infertility. (Fertil Steril (R) 2010;94:130-7. (C) 2010 by American Society for Reproductive Medicine.)

  • 7.
    Altmäe, Signe
    et al.
    Dept of Clinical Science, Inervention and Technology, Division of Obstetrics and Gynecology, karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.
    Stavreus-Evers, Anneli
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Ruiz, Jonatan R.
    Dept of Biosciences and Nutrition, Unit for Preventive Nutrition, Karolinska Institutet, Stockholm, Sweden.
    Laanpere, Margit
    Syvänen, Tiina
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Yngve, Agneta
    Salumets, Andres
    Nilsson, Torbjörn K.
    Dept of Clinical Chemistry, Örebro University Hospital, Örebro, Sweden.
    Variations in folate pathway genes are associated with unexplained female infertility2010Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 94, nr 1, s. 130-137Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To investigate associations between folate-metabolizing gene variations, folate status, and unexplained female infertility. DESIGN: An association study. SETTING: Hospital-based IVF unit and university-affiliated reproductive research laboratories. PATIENT(S): Seventy-one female patients with unexplained infertility. INTERVENTION(S): Blood samples for polymorphism genotyping and homocysteine, vitamin B12, and folate measurements. MAIN OUTCOME MEASURE(S): Allele and genotype frequencies of the following polymorphisms: 5,10-methylenetetrahydrofolate reductase (MTHFR) 677C/T, 1298A/C, and 1793G/A, folate receptor 1 (FOLR1) 1314G/A, 1816delC, 1841G/A, and 1928C/T, transcobalamin II (TCN2) 776C/G, cystathionase (CTH) 1208G/T and solute carrier family 19, member 1 (SLC19A1) 80G/A, and concentrations of plasma homocysteine, vitamin B12, and serum folate. RESULT(S): MTHFR genotypes 677CT and 1793GA, as well as 1793 allele A were significantly more frequent among controls than in patients. The common MTHFR wild-type haplotype (677, 1298, 1793) CAG was less prevalent, whereas the rare haplotype CCA was more frequent in the general population than among infertility patients. The frequency of SLC19A1 80G/A genotypes differed significantly between controls and patients and the A allele was more common in the general population than in infertile women. Plasma homocysteine concentrations were influenced by CTH 1208G/T polymorphism among infertile women. CONCLUSION(S): Polymorphisms in folate pathway genes could be one reason for fertility complications in some women with unexplained infertility.

  • 8. Altmäe, Signe
    et al.
    Stavreus-Evers, Anneli
    Ruiz, Jonatan R
    Laanpere, Margit
    Syvänen, Tiina
    Yngve, Agneta
    Salumets, Andres
    Nilsson, Torbjörn K
    Department of Clinical Chemistry, Örebro University Hospital.
    Variations in folate pathway genes are associated with unexplained female infertility2010Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 94, nr 1, s. 130-137Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To investigate associations between folate-metabolizing gene variations, folate status, and unexplained female infertility.

    DESIGN: An association study.

    SETTING: Hospital-based IVF unit and university-affiliated reproductive research laboratories.

    PATIENT(S): Seventy-one female patients with unexplained infertility.

    INTERVENTION(S): Blood samples for polymorphism genotyping and homocysteine, vitamin B12, and folate measurements.

    MAIN OUTCOME MEASURE(S): Allele and genotype frequencies of the following polymorphisms: 5,10-methylenetetrahydrofolate reductase (MTHFR) 677C/T, 1298A/C, and 1793G/A, folate receptor 1 (FOLR1) 1314G/A, 1816delC, 1841G/A, and 1928C/T, transcobalamin II (TCN2) 776C/G, cystathionase (CTH) 1208G/T and solute carrier family 19, member 1 (SLC19A1) 80G/A, and concentrations of plasma homocysteine, vitamin B12, and serum folate.

    RESULT(S): MTHFR genotypes 677CT and 1793GA, as well as 1793 allele A were significantly more frequent among controls than in patients. The common MTHFR wild-type haplotype (677, 1298, 1793) CAG was less prevalent, whereas the rare haplotype CCA was more frequent in the general population than among infertility patients. The frequency of SLC19A1 80G/A genotypes differed significantly between controls and patients and the A allele was more common in the general population than in infertile women. Plasma homocysteine concentrations were influenced by CTH 1208G/T polymorphism among infertile women.

    CONCLUSION(S): Polymorphisms in folate pathway genes could be one reason for fertility complications in some women with unexplained infertility.

  • 9.
    Bjuresten, Kerstin
    et al.
    Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm.
    Landgren, Britt-Marie
    Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm.
    Hovatta, Outi
    Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm.
    Stavreus-Evers, Anneli
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Luteal phase progesterone increases live birth rate after frozen embryo transfer2011Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 95, nr 2, s. 534-537Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To see if progesterone support has a beneficial effect on live birth rate after frozen embryo transfer in natural cycles. DESIGN: Prospective randomized controlled trial. SETTING: University-based hospital. SUBJECT(S): Four hundred thirty-five women undergoing embryo transfer in natural cycles. INTERVENTION(S): The women received either vaginal progesterone, 400 mg twice a day from the day of embryo transfer in natural cycles, or no progesterone support. MAIN OUTCOME MEASURE(S): Live birth rate, biochemical pregnancy rate, pregnancy rate, and spontaneous abortion rate. RESULT(S): Live birth rate were significantly greater in women receiving vaginal progesterone as luteal phase support after frozen-thawed embryo transfer in natural cycles compared with those who did not take progesterone. There were no differences in biochemical pregnancy rate, pregnancy rate, or spontaneous abortion rate. CONCLUSION(S): Progesterone supplementation improves live birth rate after embryo transfer in natural cycles.

  • 10. Borry, Pascal
    et al.
    Rusu, Olivia
    Dondorp, Wybo
    De Wert, Guido
    Knoppers, Bartha Maria
    Howard, Heidi Carmen
    Anonymity 2.0: direct-to-consumer genetic testing and donor conception.2014Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 101, nr 3, s. 630-2Artikel i tidskrift (Refereegranskat)
  • 11.
    Bourlev, Vladimir
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Ilyasova, Natalia
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Adamyan, Leyla
    Research Centre of Obstetrics, Gynecology and Perinatology, Russian Academy of the Medical Sciences, Moscow, Russia.
    Larsson, Anders
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk kemi.
    Olovsson, Matts
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Signs of reduced angiogenic activity after surgical removal of deeply infiltrating endometriosis2010Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 94, nr 1, s. 52-57Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To study the concentrations of vascular endothelial growth factor A (VEGF-A), soluble vascular endothelial growth factor receptors-1 and -2 (sVEGFR-1 and -2), angiogenin, and angiopoietin-2 (Ang-2) in serum and peritoneal fluid from healthy controls and women with advanced endometriosis. Further, we addressed the question of whether surgical removal of endometriotic lesions was associated with normalization of the serum concentrations of the same markers. DESIGN: Patients with endometriosis before and after surgery were compared with control patients. SETTING: University Hospital. PATIENT(S): Twenty-one healthy controls and 32 women with advanced endometriosis. INTERVENTION(S): In women with endometriosis we performed surgical removal of endometriotic lesions using laparoscopy. MAIN OUTCOME MEASURE(S): Data on serum and peritoneal fluid concentrations of selected markers in healthy controls and women with endometriosis before surgery and in serum 5 to 7 days after surgery. RESULT(S): Women with endometriosis had elevated levels of VEGF-A, sVEGFR-1, and Ang-2 in serum and all studied markers in peritoneal fluid compared with healthy controls. Surgical removal of endometriotic lesions resulted in decreased serum levels of pro-angiogenic VEGF-A and increased levels of sVEGFR-2 that negatively regulates the action of VEGF. CONCLUSION(S): Women with advanced endometriosis have serum and peritoneal fluid concentrations of several factors involved in the regulation of angiogenesis that differ from those in healthy women, and these changes at least partly normalize within a week after surgical removal of the endometriotic lesions.

  • 12.
    Brodin, Thomas
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Bergh, Torbjorn
    Berglund, Lars
    Hadziosmanovic, Nermin
    Holte, Jan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Menstrual cycle length is an age-independent marker of female fertility: results from 6271 treatment cycles of in vitro fertilization2008Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 90, nr 5, s. 1656-1661Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To investigate whether menstrual cycle length correlates with success rates at IVF/intracytoplasmic sperm injection (ICSI) and could be used as a marker of ovarian reserve. DESIGN: Prospective observational study. SETTING: Private infertility centre. PATIENT(S): A total of 6271 IVF/ICSI treatment cycles. INTERVENTION(S): Self-reported mean number of menstrual days during the last year was recorded before initiation of IVF/ICSI treatment. MAIN OUTCOME MEASURE(S): Relations between menstrual cycle length and pregnancy and delivery rates. RESULT(S): Increasing age was associated with a subtle shortening of mean menstrual cycle length. Menstrual cycle length correlated linearly with pregnancy and delivery rates, even after age adjustment. The chance of delivery after IVF/ICSI was almost doubled for women with a menstrual cycle length >34 days compared with women with a menstrual cycle length <26 days. Menstrual cycle length was also significantly associated with ovarian response to FSH/hMG stimulation and embryo quality. CONCLUSION(S): Mean menstrual cycle length is highly related to success rates in assisted reproduction, independently of age. A precise menstrual cycle history could be used as a simple marker of ovarian reserve.

  • 13. Bryman, Inger
    et al.
    Sylvén, Lisskulla
    Berntorp, Kerstin
    Innala, Eva
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Bergström, Ingrid
    Hanson, Charles
    Oxholm, Marianne
    Landin-Wilhelmsen, Kerstin
    Pregnancy rate and outcome in Swedish women with Turner syndrome2011Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 95, nr 8, s. 2507-2510Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Pregnancies occurred in 57 (12%) of 482 Swedish women with Turner syndrome with a liveborn rate of 54% in 124 pregnancies. Spontaneous pregnancies occurred in 40%, mainly in women with 45,X/46,XX mosaicism, and oocyte donation in 53% where miscarriages were less frequent, odds ratio = 0.43 (95% confidence interval 0.17-1.04).

  • 14. Cesta, Carolyn E
    et al.
    Viktorin, Alexander
    Olsson, Henrik
    Johansson, Viktoria
    Sjölander, Arvid
    Bergh, Christina
    Skalkidou, Alkistis
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Nygren, Karl-Gösta
    Cnattingius, Sven
    Iliadou, Anastasia N
    Depression, anxiety, and antidepressant treatment in women: association with in vitro fertilization outcome2016Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 105, nr 6, s. 1594-U285Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To investigate associations between depression, anxiety, and antidepressants before in vitro fertilization (IVF) and IVF cycle outcomes, including pregnancy, live birth, and miscarriage.

    DESIGN: Nationwide register-based cohort study.

    SETTING: Not applicable.

    PATIENT(S): Nulliparous women undergoing their first IVF cycle recorded in the Swedish Quality Register of Assisted Reproduction, January 2007 to December 2012 (n = 23,557).

    INTERVENTION(S): Not applicable.

    MAIN OUTCOME MEASURE(S): Associations between diagnoses of depression/anxiety, antidepressants, and IVF cycle outcome evaluated using logistic regression to produce adjusted odds ratios (AOR) and 95% confidence intervals (CI).

    RESULT(S): In total, 4.4% of women had been diagnosed with depression/anxiety and/or dispensed antidepressants before their IVF first cycle. The odds for pregnancy and live birth were decreased (n = 1,044; AOR = 0.86; 95% CI, 0.75-0.98; and AOR = 0.83; 95% CI, 0.72-0.96, respectively). For women with a prescription for a selective serotonin reuptake inhibitor (SSRI) only (n = 829), no statistically significant associations were found. Women with non-SSRI antidepressants (n = 52) were at reduced odds of pregnancy (AOR = 0.41; 95% CI, 0.21-0.80) and live birth (AOR = 0.27; 95% CI, 0.11-0.68). Women with a depression/anxiety diagnosis with no antidepressant (n = 164) also had reduced odds of pregnancy (AOR = 0.58; 95% CI, 0.41-0.82) and live birth (AOR = 0.60; 95% CI, 0.41-0.89). Among the women who became pregnant (39.7%), there were no statistically significant associations between exposure and miscarriage except for the women taking non-SSRI antidepressants (AOR = 3.56; 95% CI, 1.06-11.9).

    CONCLUSION(S): A diagnosis of depression/anxiety and/or treatment with antidepressants before IVF was slightly associated with reduced odds of pregnancy and live birth. Women with the presence of depression/anxiety without antidepressants had a more pronounced reduction in odds, implying that the underlying disorder is important for the observed association.

  • 15.
    Dennerstein, Lorraine
    et al.
    Department of Psychiatry, The University of Melbourne, Parkville, Victoria, Australia.
    Lehert, Philippe
    Department of Psychiatry, The University of Melbourne, Parkville, Victoria, Australia.
    Bäckström, Torbjörn
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Heinemann, Klaas
    Women's Health Care, Bayer Schering Pharma, Berlin, Germany.
    The effect of premenstrual symptoms on activities of daily life2010Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 94, nr 3, s. 1059-1064Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To assess impact of premenstrual symptoms on activities of women's daily lives (ADL). DESIGN: Cross-sectional population-based survey. SETTING: Market research company. PATIENT(S): A total of 4,085 women aged 14-50 years recruited by random telephone digit dialing in France, Germany, Hungary, Italy, Spain, the United Kingdom, Brazil, and Mexico. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): A telephone interview checklist of 23 premenstrual symptoms, sociodemographic and lifestyle variables, and ADL effects (global question and seven areas). Stepwise regression measured the effect of premenstrual symptoms and sociodemographic factors on ADL. RESULT(S): Symptoms and symptom domains (physical and mental) had similar negative effects on ADL. Activities of daily life were predominantly affected by symptom severity. Income level, age, and country also significantly affected ADL. In all, 2,638 women (64.6%) were minimally affected in ADL, 981 (24%) were moderately affected, and 454 (11.1%) were severely affected. CONCLUSION(S): Both physical and mental premenstrual symptoms have significant impact on quality of life, assessed as ADL. Up to 35% of women of reproductive age in Europe and Latin America were moderately or severely affected in ADL by cyclical premenstrual symptoms.

  • 16.
    Gambadauro, Pietro
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa. Karolinska Inst, Dept Learning Informat Management & Eth LIME, Stockholm, Sweden.
    Iliadis, Stavros I
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Gynekologisk endokrinologi.
    Bränn, Emma
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Obstetrisk forskning.
    Skalkidou, Alkistis
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Obstetrisk forskning.
    Conception by means of in vitro fertilization is not associated with maternal depressive symptoms during pregnancy or postpartum2017Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 108, nr 2, s. 325-332Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To study whether conception by means of in vitro fertilization (IVF) is associated with maternal depressive symptoms during pregnancy or postpartum.

    Design: Longitudinal observational study. Setting: University hospital.

    Patient(s): A total of 3,283 women with singleton pregnancies receiving antenatal care and delivering in Uppsala from 2010 to 2015.

    Intervention(s): A web-based self-administered structured questionnaire including sociodemographic, clinical and pregnancy-related items, and the Edinburgh Postnatal Depression Scale (EPDS) was delivered at 17 and 32 gestational weeks and at 6 weeks and 6 months postpartum.

    Main Outcome Measure(s): Prevalence of significant depressive symptoms (EPDS >= 12) and EPDS scores.

    Result(s): A total of 167 women (5%) had conceived via IVF and 3,116 (95%) had a spontaneous pregnancy. IVF mothers were more frequently >= 35 years of age (46.1% vs. 22.6%) and primiparous (71.7% vs. 49.9%) and had a higher cesarean delivery rate (22.4% vs. 14.2%). Demographic and clinical characteristics were otherwise similar between the two groups. Significant depressive symptoms were reported by 12.8%, 12.4%, 13.8%, and 11.9% of women at 17 and 32 gestational weeks and 6 weeks and 6 months postpartum, respectively. The prevalence of depressive symptoms and the EPDS scores during pregnancy and postpartum were similar between women conceiving spontaneously or through IVF. The mode of conception was not associated with significant depressive symptoms at any time point, even when adjusting for several possible confounders in multivariable logistic regression analysis.

    Conclusion(s): Despite the psychologic distress characterizing subfertility and its treatment, conception by means of IVF is not associated with maternal depressive symptoms during pregnancy or postpartum.

  • 17.
    Gambadauro, Pietro
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Magos, Adam
    Endoscopic loops for laparoscopic myomectomy2011Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 95, nr 2, s. E12-E12Artikel i tidskrift (Refereegranskat)
    Abstract
  • 18.
    Hambiliki, Fredwell
    et al.
    Department of Clinical Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
    Hanrieder, Jörg
    Uppsala universitet, Teknisk-naturvetenskapliga vetenskapsområdet, Kemiska sektionen, Institutionen för kemi - BMC. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Bergquist, Jonas
    Uppsala universitet, Teknisk-naturvetenskapliga vetenskapsområdet, Kemiska sektionen, Institutionen för kemi - BMC. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Hreinsson, Julius
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Stavreus-Evers, Anneli
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Wånggren, Kjell
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Glycoprotein 130 promotes human blastocyst development in vitro2013Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 99, nr 6, s. 1592-U444Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To investigate the efficacy of leukemia inhibitory factor (LIF) and/or glycoprotein 130 (gp130) on in vitro growth of human embryos. Design: Laboratory study. Setting: University hospital-based IVF clinic. Patient(s): A total of 164 frozen embryos that survived thawing were cultured in media supplemented with LIF and/or gp130 or control media. Intervention(s): Morphological development was evaluated by light microscopy. Protein expression profiles of single blastocysts were evaluated using matrix-assisted laser desorption/ionization time of flight-based intact cell mass spectrometry. Main Outcome Measure(s): Embryo development and protein content. Result(s): Addition of gp130 to culture media improved blastocyst formation (73% vs. 43%). Addition of LIF to the culture media did not improve embryo development. Protein fingerprint spectra were obtained that revealed significant intensity changes for multiple molecular species including thymosin beta-10, thymosin beta-4, histone H2A, histone H2B, histone H4, ubiquitin, ubiquitin-T, and acyl-CoA binding protein. Conclusion(s): Glycoprotein 130, but not LIF, seems to be beneficial for preimplantation embryo development, implicating a physiological role in regulating preimplantation development in humans and thus ought to be included in culture media designed for embryo culture to the blastocyst stage. Furthermore, these findings highlight the great potential of matrix-assisted laser desorption/ionization time of flight mass spectrometry and intact cell mass spectrometry as a versatile tool in reproductive medicine research.

  • 19.
    Hambiliki, Fredwell
    et al.
    Dept of Clinical Science, Intervention and Technology, Div of Obstetrics and Gynaecology, Karolinska Institutet, Stockholm, Sweden.
    Ljunger, Elisabeth
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Karlström, Per-Olof
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Stavreus-Evers, Anneli
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Hyaluronan-enriched transfer medium in cleavage-stage frozen-thawed embryo transfers increases implantation rate without improvement of delivery rate2010Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 94, nr 5, s. 1669-1673Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To investigate the efficacy of hyaluronan-enriched transfer media in cleavage-stage frozen embryo transfer cycles. DESIGN: Two commercially available transfer media were prospectively compared in an observational study. SETTING: Hospital-based in vitro fertilization clinic. PATIENT(S): Patients (n = 425) undergoing frozen-thawed embryo transfer (FET). The embryos transferred were included in either a study group (high hyaluronic acid [HA], n = 199) or a control group (low HA, n = 226). INTERVENTION(S): Delivery rate per FET; positive hCG rate, biochemical pregnancy rate, clinical pregnancy rate, implantation rate, and clinical abortion rate were secondary outcomes. RESULT(S): The use of HA in the transfer media significantly increased the positive hCG rate (37.2% vs. 25.2%) and implantation rate (23.1% vs. 15.8%) without increasing the delivery rate (21.6% vs. 21.2%). More subjects in the study group with a positive hCG test experienced biochemical pregnancy (28.4% vs. 8.9%). CONCLUSION(S): Addition of HA to transfer media seems to favor attachment of early embryos in FETs without increasing the delivery rate.

  • 20.
    Hellberg, Dan
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Nilsson, Staffan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    IVF and HPV2007Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 87, nr 6, s. 1498-1498s. 1498-1498Artikel i tidskrift (Refereegranskat)
  • 21.
    Holmqvist, Per
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Brynhildsen, Jan
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Letter: Estrogen-vitamin D interaction in multiple sclerosis Reply2011Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 95, nr 1, s. E4-E4Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    n/a

  • 22.
    Holmqvist, Per
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Hammar, Mats
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Landtblom, Anne-Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Neurologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Neurologiska kliniken. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland, Medicinska specialistkliniken .
    Brynhildsen, Jan
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Age at onset of multiple sclerosis is correlated to use of combined oral contraceptives and childbirth before diagnosis2010Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 94, nr 7, s. 2835-2837Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study was to evaluate whether age of onset of multiple sclerosis is related to use of combined oral contraceptives and/or timing of childbirth. The results showed that use of combined oral contraceptives and childbirth before the first multiple sclerosis symptom was correlated to a higher mean age at the onset of the disease.

  • 23.
    Holte, Jan
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Brodin, Thomas
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Berglund, Lars
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Uppsala kliniska forskningscentrum (UCR).
    Hadziosmanovic, Nermin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Uppsala kliniska forskningscentrum (UCR).
    Olovsson, Matts
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Bergh, Torbjörn
    Carl von Linné Clinic, Uppsala Science Park.
    Antral follicle counts are strongly associated with live-birth rates after assisted reproduction, with superior treatment outcome in women with polycystic ovaries2011Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 96, nr 3, s. 594-599Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To evaluate the association of antral follicle count (AFC) with in vitro fertilization/intracytoplasmic sperm injection (IVF-ICSI) outcome in a large unselected cohort of patients covering the entire range of AFC. Design: Prospective observational study. Setting: University-affiliated private infertility center. Patient(s): 2,092 women undergoing 4,308 IVF-ICSI cycles. Intervention(s): AFC analyzed for associations with treatment outcome and statistically adjusted for repeated treatments and age. Main Outcome Measure(s): Pregnancy rate, live-birth rate, and stimulation outcome parameters. Result(s): The AFC was log-normally distributed. Pregnancy rates and live-birth rates were positively associated with AFC in a log-linear way, leveling out above AFC similar to 30. Treatment outcome was superior among women with polycystic ovaries, independent from ovulatory status. The findings were significant also after adjustment for age and number of oocytes retrieved. Conclusion(s): Pregnancy and live-birth rates are log-linearly related to AFC. Polycystic ovaries, most often excluded from studies on ovarian reserve, fit as one extreme in the spectrum of AFC; a low count constitutes the other extreme, with the lowest ovarian reserve and poor treatment outcome. The findings remained statistically significant also after adjustment for the number of oocytes retrieved, suggesting this measure of ovarian reserve comprises information on oocyte quality and not only quantity.

  • 24. Huber, Malin
    et al.
    Hadziosmanovic, Nermin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Uppsala kliniska forskningscentrum (UCR).
    Berglund, Lars
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Uppsala kliniska forskningscentrum (UCR).
    Holte, Jan
    Using the ovarian sensitivity index to define poor, normal, and high response after controlled ovarian hyperstimulation in the long gonadotropin-releasing hormone-agonist protocol: suggestions for a new principle to solve an old problem2013Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 100, nr 5, s. 1270-1276.e3Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To explore the utility of using the ratio between oocyte yield and total dose of FSH, i.e., the ovarian sensitivity index (OSI), to define ovarian response patterns. Design: Retrospective cross-sectional study. Setting: University-affiliated private center. Patient(s): The entire unselected cohort of 7,520 IVF/intracytoplasmic sperm injection treatments (oocyte pick-ups [OPUs]) during an 8-year period (long GnRH agonist-recombinant FSH protocol). Intervention(s): None. Main Outcome Measure(s): The distribution of the OSI (oocytes recovered x 1,000/total dose of FSH), the cutoff levels for poor and high response, set at +/- 1 SD, and the relationship between OSI and treatment outcome. Result(s): OSI showed a log-normal distribution with cutoff levels for poor and high response at 1.697/IU and 10.07/IU, respectively. A nomogram is presented. Live-birth rates per OPU were 10.5 +/- 0.1%, 26.9 +/- 0.6%, and 36.0 +/- 1.4% for poor, normal, and high response treatments, respectively. The predictive power (C-statistic) for OSI to predict live birth was superior to that of oocyte yield. Conclusion(s): The OSI improves the definition of ovarian response patterns because it takes into account the degree of stimulation. The nomogram presents evidence-based cutoff levels for poor, normal, and high response and could be used for unifying study designs involving ovarian response patterns.

  • 25.
    Hudecova, Miriam
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Holte, Jan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Moby, Lena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Olovsson, Matts
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Stridsberg, Mats
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Biokemisk endokrinologi.
    Larsson, Anders
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Biokemisk struktur och funktion.
    Berglund, Lars
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Uppsala kliniska forskningscentrum (UCR).
    Berne, Christian
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Endokrin diabetes och metabolism.
    Sundström Poromaa, Inger
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Androgen levels, insulin sensitivity, and early insulin response in women with polycystic ovary syndrome: a long-term follow-up study2011Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 95, nr 3, s. 1146-1148Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Thirty-four women with polycystic ovary syndrome who previously had participated in studies with intravenous glucose tolerance test and hyperinsulinemic, euglycemic clamp between 1987 and 1995 underwent anthropometric, endocrine (T and sex-hormone binding globulin serum concentration), and metabolic (intravenous glucose tolerance test, hyperinsulinemic, euglycemic clamp, and androgens) measurements. Free androgen levels and β-cell function decreased over time in women with polycystic ovary syndrome, but insulin sensitivity remained unaltered.

  • 26.
    Hudecova, Miriam
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Holte, Jan
    Olovsson, Matts
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Larsson, Anders
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Berne, Christian
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Sundstrom-Poromaa, Inger
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Prevalence of the metabolic syndrome in women with a previous diagnosis of polycystic ovary syndrome: long-term follow-up2011Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 96, nr 5, s. 1271-1274Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To examine the prevalence of the metabolic syndrome (MetS) according to the scientific statement of the American Heart Association and the US National Cholesterol Education Program/Adult Treatment Panel III in middle-aged Swedish women previously diagnosed with polycystic ovary syndrome (PCOS) in comparison with age-matched healthy controls.

    DESIGN: Long-term follow-up study.

    SETTING: Department of Obstetrics and Gynecology, Uppsala University.

    PATIENT(S): Eighty-four women diagnosed with PCOS between 1987 and 1995; and 87 controls randomly selected from the general population.

    INTERVENTION(S): Anthropometric measurements and blood tests.

    MAIN OUTCOME MEASURE(S): Body mass index, waist circumference, blood pressure, lipids, and glucose.

    RESULT(S): The prevalence of MetS in women with PCOS (mean ± SD age, 43.0 ± 5.8 years) was 23.8% and in controls was 8.0%, and it did not differ according to PCOS phenotype at the index assessment (polycystic ovaries [PCO], oligomenorrhea, and hirsutism: 10 [22.7%]; PCO and oligomenorrhea: 8 [22.2%]) or according to the persistence of PCOS features at follow-up (persisting PCOS: 25.8%; resolved PCOS: 16.7%).

    CONCLUSION(S): The MetS occurred more often in patients with PCOS than in controls and did not depend on phenotypic presentation at the index assessment or the persistence of PCOS at follow-up.

  • 27.
    Hudecova, Miriam
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Holte, Jan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Olovsson, Matts
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Lind, Lars
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Medicin.
    Poromaa, Inger Sundström
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Endothelial function in patients with polycystic ovary syndrome: a long-term follow-up study2010Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 94, nr 7, s. 2654-2658Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To investigate pulse wave reflection and endothelial-dependent vasodilatation (EDV) in PCOS patients and age-matched healthy controls. Design: Long-term follow-up study. Setting: Department of Women’s and Children’s Health, Uppsala University, Sweden. Patient(s): Sixty-seven PCOS patients with a mean age of 43.3 years at the follow-up investigation and 66 age-matched controls. Intervention: Aplanation tonometry before and after b-2 receptor agonist (terbutaline) challenge. Main outcome measure(s): Baseline augmentation index (AI) aorta, baseline AI-radial, and change in AI-radial following terbutaline administration as a measure of EDV. Result(s):  There was no difference in baseline AI-aorta between PCOS patients and control subjects. Change in AI-radial following terbutaline administration was less pronounced in PCOS patients in comparison to control subjects. This difference remained when adjusted for use of combined oral contraceptives/hormone replacement therapy and postmenopausal status but not after adjustment for BMI. Conclusion(s): Middle-aged PCOS patients display signs of endothelial dysfunction in comparison to age-matched controls, but this is largely due to the increased prevalence of independent risk factors for cardiovascular disease found in this group.

  • 28.
    Inzunza, Jose
    et al.
    Department of Biosciences and Nutrition, Karolinska Institute, Sweden.
    Danielsson, Olle
    Lalitkumar, Parameswaran Grace
    Larsson, Olle
    Axelson, Magnus
    Töhönen, Virpi
    Danielsson, Kristina Gemzell
    Stavreus-Evers, Anneli
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Selective insulin-like growth factor-I antagonist inhibits mouse embryo development in a dose-dependent manner2010Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 93, nr 8, s. 2621-2626Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To study the role of a synthetic insulin-like growth factor-I receptor (IGF-IR) antagonist, picropodophyllin, for mouse preimplantation embryo development in vivo and in vitro. DESIGN: In vitro and in vivo study. SETTING: Hospital-based research unit. ANIMALS: FVB/N mice and mouse embryos. INTERVENTION(S): The effect of picropodophyllin in mouse embryo development in vivo and in vitro, immunohistochemistry, ELISA, polymerase chain reaction. MAIN OUTCOME MEASURE(S): Embryo development, presence of IGF-IR, messenger RNA expression, IGF-I synthesis. RESULT(S): The effect of picropodophyllin on embryo development in vitro and in vivo was not reversible. Mice treated with picropodophyllin 1 to 3 days after mating had a reduced number of blastocysts, 40.5% versus 78.8%, and a higher number of embryos with delayed development, 48.6% versus 11.5%. Insulin-like growth factor-IR protein is present in both phosphorylated and nonphosphorylated form at all stages of embryo development. The relative IGF-IR messenger RNA expression was highest in the oocyte and reduced during development to blastocyst stage. Insulin-like growth factor-I in culture media was reduced after picropodophyllin treatment. CONCLUSION(S): We conclude that IGF-I has an important role in normal mouse embryo development and that its receptor plays an essential role in the embryonic genome activation process.

  • 29.
    Isaksson, Stina
    et al.
    Uppsala University, Sweden.
    Sydsjö, Gunilla
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Skoog Svanberg, Agneta
    Uppsala University, Sweden.
    Lampic, Claudia
    Karolinska Institute, Sweden.
    Preferences and needs regarding future contact with donation offspring among identity-release gamete donors: results from the Swedish Study on Gamete Donation2014Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 102, nr 4, s. 1160-1166Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To investigate the attitudes and preferences regarding future contact with donation offspring among identity-release donors of oocytes or sperm. Design: Longitudinal cohort study. Setting: University-based fertility clinics in Sweden. Patient(s): A total of 210 women and men were questioned 5-8 years after their donation of oocytes or sperm. Intervention(s): Questionnaires given to donors prior to their donation and 5-8 years after donation. Main Outcome Measure(s): Donors attitudes and preferences regarding future contact with their donation offspring. Result(s): A majority of identity-release oocyte (65%) and sperm (70%) donors were positive toward being contacted by an offspring of mature age. More than half wanted to be notified by the clinic when an offspring requested information about them, but about a third were negative toward receiving this information. One in four reported a need for counseling regarding future contact with an offspring. Conclusion(s): Several years after donation, a majority of identity-release oocyte and sperm donors show positive attitudes toward future contact with their offspring. Donors appear to have different preferences for information and support regarding such contact. Fertility clinics and health-care services should provide counseling regarding contact with an offspring to the donors who express a need for this.

  • 30.
    Isaksson, Stina
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Sydsjö, Gunilla
    Division of Obstetrics and Gynaecology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University.
    Skoog Svanberg, Agneta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Lampic, Claudia
    Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Huddinge.
    Preferences and needs regarding future contact with donation offspring among identity-release gamete donors: results from the Swedish Study on Gamete Donation2014Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 102, nr 4, s. 1160-1166Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective

    To investigate the attitudes and preferences regarding future contact with donation offspring among identity-release donors of oocytes or sperm.

    Design

    Longitudinal cohort study.

    Setting

    University-based fertility clinics in Sweden.

    Patient(s)

    A total of 210 women and men were questioned 5–8 years after their donation of oocytes or sperm.

    Intervention(s)

    Questionnaires given to donors prior to their donation and 5–8 years after donation.

    Main Outcome Measure(s)

    Donors' attitudes and preferences regarding future contact with their donation offspring.

    Result(s)

    A majority of identity-release oocyte (65%) and sperm (70%) donors were positive toward being contacted by an offspring of mature age. More than half wanted to be notified by the clinic when an offspring requested information about them, but about a third were negative toward receiving this information. One in four reported a need for counseling regarding future contact with an offspring.

    Conclusion(s)

    Several years after donation, a majority of identity-release oocyte and sperm donors show positive attitudes toward future contact with their offspring. Donors appear to have different preferences for information and support regarding such contact. Fertility clinics and health-care services should provide counseling regarding contact with an offspring to the donors who express a need for this.

  • 31.
    Joelsson, Lana Salih
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Berglund, Anna
    Uppsala universitet, Nationellt centrum för kvinnofrid (NCK).
    Rosenblad, Andreas
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Västerås.
    Tydén, Tanja
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap.
    Preconception Lifestyles And Lifestyle Modification Among Women Seeking For Infertility2015Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 104, nr 3, s. E182-E183Artikel i tidskrift (Övrigt vetenskapligt)
  • 32. Jung, Seungyoun
    et al.
    Allen, Naomi
    Arslan, Alan A.
    Baglietto, Laura
    Brinton, Louise A.
    Egleston, Brian L.
    Falk, Roni
    Fortner, Renee T.
    Helzlsouer, Kathy J.
    Idahl, Annika
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Kaaks, Rudolph
    Lundin, Eva
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Patologi. Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Näringsforskning.
    Merritt, Melissa
    Onland-Moret, Charlotte
    Rinaldi, Sabina
    Sanchez, Maria-Jose
    Sieri, Sabina
    Schock, Helena
    Shu, Xiao-Ou
    Sluss, Patrick M.
    Staats, Paul N.
    Travis, Ruth C.
    Tjonneland, Anne
    Trichopoulou, Antonia
    Tworoger, Shelley
    Visvanathan, Kala
    Krogh, Vittorio
    Weiderpass, Elisabete
    Zeleniuch-Jacquotte, Anne
    Zheng, Wei
    Dorgan, Joanne F.
    Demographic, lifestyle, and other factors in relation to antimullerian hormone levels in mostly late premenopausal women2017Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 107, nr 4Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To identify reproductive, lifestyle, hormonal, and other correlates of circulating antimullerian hormone (AMH) concentrations in mostly late premenopausal women. Design: Cross-sectional study. Setting: Not applicable. Patient(s): A total of 671 premenopausal women not known to have cancer. Intervention(s): None. Main Outcome Measure(s): Concentrations of AMH were measured in a single laboratory using the picoAMH ELISA. Multivariable-adjusted median (and interquartile range) AMH concentrations were calculated using quantile regression for several potential correlates. Result(s): Older women had significantly lower AMH concentrations (>= 40 [n = 444] vs. < 35 years [n = 64], multivariable-adjusted median 0.73 ng/mL vs. 2.52 ng/mL). Concentrations of AMH were also significantly lower among women with earlier age at menarche (< 12 [n = 96] vs. >= 14 years [n = 200]: 0.90 ng/mL vs. 1.12 ng/mL) and among current users of oral contraceptives (n = 27) compared with never or former users (n = 468) (0.36 ng/mL vs. 1.15 ng/mL). Race, body mass index, education, height, smoking status, parity, and menstrual cycle phase were not significantly associated with AMH concentrations. There were no significant associations between AMH concentrations and androgen or sex hormone-binding globulin concentrations or with factors related to blood collection (e.g., sample type, time, season, and year of blood collection). Conclusion(s): Among premenopausal women, lower AMH concentrations are associated with older age, a younger age at menarche, and currently using oral contraceptives, suggesting these factors are related to a lower number or decreased secretory activity of ovarian follicles.

  • 33. Karypidis, Anna-Helena
    et al.
    Söderström, Torbjörn
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk farmakologi.
    Nordmark, Anna
    Granath, Fredrik
    Cnattingius, Sven
    Rane, Anders
    Association of cytochrome P450 1B1 polymorphism with first-trimester miscarriage2006Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 86, nr 5, s. 1498-1503Artikel i tidskrift (Refereegranskat)
    Abstract [en]
    Objective: To determine whether the cytochrome P450 1B1 (CYP1B1) Val432Leu polymorphism and caffeine intake. Design: The population-based case-control study included 507 women with miscarriage in the first trimester of pregnancy and 908 controls with a normal first trimester pregnancy. The controls were frequently matched to cases. The material was analyzed taking maternal age, smoking habits, alcohol intake, caffeine intake, fetal karyotype, nausea, and vomiting into consideration. Setting: University hospital and primary care facility. Main Outcome Measure(s): CYP1B1 Val432Leu genotype frequencies in cases and controls. Result(s): Carriers of the CYP1B1 432 Val/Val genotype were at a higher risk of miscarriage in the first trimester of pregnancy (odds ratio = 1.46; 95% confidence interval 1.02-2.08). We also found a significant interaction between genotype and caffeine intake. Conclusion(s): CYP1B1 Val432Leu polymorphism is associated with first-trimester miscarriage, and it may also modify the risk among coffee drinkers.
  • 34.
    Källén, Bengt
    et al.
    Tornblad Institute, Lunds universitet.
    Finnström, Orvar
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Pediatrik. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Linköping.
    Nygren, K-G
    Fertility Clinic, Sofiahemmet, Stockholm.
    Otterblad Olausson, Petra
    Centre for Epidemiology, Stockholm.
    In vitro fertilization in Sweden: Child morbidity including cancer risk2005Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 84, nr 3, s. 605-610Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To study long-term morbidity among children conceived by IVF. Design: A register study in Sweden of IVF infants compared with all infants born. Setting: National health registers. Patient(s): More than 16,000 children born after IVF (30% of them after intracytoplasmic sperm injection) were studied with national health registers. Main Outcome Measure(s): Total number of days in hospital care at different ages, hospitalization for specific diagnoses, childhood cancer. Result(s): An overuse of hospital care was found among IVF children up to 6 years of age, which was partly explained by maternal characteristics. Discharge diagnoses indicating brain damage (mental retardation, cerebral palsy, epilepsy, behavioral problems) occurred in excess and seemed to be completely explained by preterm births. In addition, other discharge diagnoses were overrepresented, some of them linked to preterm birth. There were 29 children with cancer (21 expected), 5 of them had Langerhan's histiocytosis. Conclusion(s): Long-term morbidity among children conceived by IVF is higher than among naturally conceived infants. This was partly explained by an excess of preterm and multiple births but might also mirror different parental attitudes toward medical care for their children. No general increase in cancer risk was seen, but unexpectedly many children with histiocytosis were noted. ©2005 by American Society for Reproductive Medicine.

  • 35.
    Källén, Bengt
    et al.
    Tornblad Institute, Lunds Universitet.
    Finnström, Orvar
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Pediatrik. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Linköping.
    Nygren, K-G
    Fertility clinic Sofiahemmet, Stockholm.
    Otterblad-Olausson, Petra
    Centre for Epidemiology Stockholm.
    In vitro fertilization (IVF) in Sweden: Infant outcome after different IVF fertilization methods2005Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 84, nr 3, s. 611-617Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To compare infant outcome after different IVF techniques. Design: A register study in Sweden of IVF infants compared with all infants born. Setting: National health registers. Patient(s): We studied 16,280 IVF infants, 30% of whom were conceived by intracytoplasmic sperm injection (ICSI). Intervention(s): None. Main Outcome Measure(s): Multiple births, infant sex, preterm birth, low birth weight, and small for gestational age among singletons, mortality, low Apgar score, neonatal diagnoses. Result(s): Twinning was less frequent after frozen standard IVF (18.1%) and after ICSI (21.8%) than after fresh standard IVF (24.4%). The male/female ratio was significantly increased in infants conceived after standard IVF. No significant differences were seen between singleton infants conceived after different IVF methods with respect to preterm birth, low birth weight, or infant mortality, with the possible exception of frozen standard IVF, for which some of these rates were lower than after fresh standard IVF. Infants born after ICSI had an indicated lower risk of respiratory problems than infants born after standard IVF. Conclusion(s): Little difference in outcome was seen after different IVF methods. The differences observed might be due to dissimilar characteristics of the treated women (e.g., because ICSI was mainly used in connection with male infertility). ©2005 by American Society for Reproductive Medicine.

  • 36.
    Lindahl, Magnus S.
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Olovsson, Matts
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Nyberg, Sigrid
    Thorsen, Kim
    Olsson, Tommy
    Sundström Poromaa, Inger
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Increased cortisol responsivity to adrenocorticotropic hormone and low plasma levels of interleukin-1 receptor antagonist in women with functional hypothalamic amenorrhea2007Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 87, nr 1, s. 136-142Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To assess the hypothalamic-pituitary-adrenal (HPA) axis at all levels, to determine the origin of the previously reported hypercortisolism in patients with functional hypothalamic amenorrhea. A secondary aim was to evaluate factors outside the central nervous system which are known to affect the HPA axis, i.e., circulating levels of interleukin-6 (IL-6), interleukin-1 receptor antagonist (IL-1Ra), and fat mass-adjusted leptin levels, in patients with functional hypothalamic amenorrhea and healthy controls. DESIGN: Cross-sectional study. SETTING: Umeå University Hospital, Umeå, Sweden. PATIENTS: Fifteen subjects with hypothalamic amenorrhea, and 14 age- and weight-matched controls. INTERVENTIONS: None. MAIN OUTCOME MEASURES: We collected blood samples four times during a 24-hour interval for analysis of cortisol, leptin, IL-1Ra, and IL-6 levels. We performed a low-dose oral dexamethasone test and a low-dose ACTH test. We measured body-fat percentage using a dual-energy X-ray absorptiometer. RESULTS: Patients with hypothalamic amenorrhea had increased diurnal cortisol levels (P<.001). The cortisol response to intravenous low-dose ACTH was increased in functional hypothalamic amenorrhea patients compared to control subjects (P<.01), but they had similar rates of dexamethasone suppression. Patients with hypothalamic amenorrhea also had decreased diurnal leptin (P<.05), and decreased diurnal IL-1Ra levels (P<.05), compared to controls. Body-fat percentage was the main predictor of leptin levels. CONCLUSION: The present study suggests novel links for the development of functional hypothalamic amenorrhea, including increased adrenal responsiveness and impairments in proinflammatory cytokine pathways.

  • 37.
    Lindholm, Åsa
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Bixo, Marie
    Björn, Inger
    Wölner-Hanssen, Pål
    Eliasson, Mats
    Larsson, Anders
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk kemi.
    Johnson, Owe
    Sundström Poromaa, Inger
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Effect of sibutramine on weight reduction in women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial2008Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 89, nr 5, s. 1221-1228Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To examine the efficacy of sibutramine together with brief lifestyle modification for weight reduction in obese women with polycystic ovary syndrome (PCOS). DESIGN: Investigator-initiated, multicenter, double-blind, randomized, parallel-group clinical trial. SETTING: Departments of Obstetrics and Gynecology in primary care, referral centers, and private practice. PATIENT(S): Forty-two patients with confirmed PCOS were included in the study, and 34 patients completed the study. INTERVENTION: Sibutramine 15 mg once daily together with brief lifestyle modification was compare with placebo together with brief lifestyle modification. MAIN OUTCOME MEASURE(S): The primary endpoint was to assess weight loss. Secondary endpoints included the efficacy of sibutramine for treatment of menstrual pattern and cardiovascular risk factors. RESULT(S): After 6 months the sibutramine group had lost 7.8 +/- 5.1 kg compared with a weight loss of 2.8 +/- 6.2 kg in the placebo group. Sibutramine treatment resulted in significant decreases in apolipoprotein B, apolipoprotein B/apolipoprotein A ratio, triglycerides, and cystatin C levels. CONCLUSION(S): Sibutramine in combination with lifestyle intervention results in significant weight reduction in obese patients with PCOS. In addition to the weight loss, sibutramine seems to have beneficial effects on metabolic and cardiovascular risk factors.

  • 38.
    Ljunger, Elisabeth
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Stavreus-Evers, Anneli
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Cnattingius, Sven
    Clinical Epidemiology Unit, Dept of Medicine, Karolinska Institutet, Stockholm, Sweden.
    Ekbom, Anders
    Lundin, Catarina
    Annerén, Göran
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Medicinsk genetik.
    Sundström-Poromaa, Inger
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Ultrasonographic findings in spontaneous miscarriage: relation to euploidy and aneuploidy2011Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 95, nr 1, s. 221-224Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To evaluate a possible correlation between transvaginal ultrasound findings in miscarriages and cytogenetic analyses from chorionic villi obtained by dilatation and curettage. DESIGN: Prospective, population-based study. SETTING: University-based hospital. PATIENT(S): Five hundred seventy-six women with spontaneous miscarriage diagnosed between 6 and 12 completed pregnancy weeks. INTERVENTION(S): Transvaginal ultrasonography and dilatation and curettage. MAIN OUTCOME MEASURE(S): Cytogenetic analyses and ultrasound measurement of embryonic pole. RESULT(S): The mean gestational age was 9.5 weeks. Chromosomal analyses were successful in 259 cases, 159 with cytogenetic abnormalities and 100 euploidy. Empty gestational sacs were equally often found in euploidy and aneuploidy, whereas small embryonic or fetal poles were significantly more often associated with aneuploidy. CONCLUSION(S): A smaller than expected fetal size when a miscarriage is diagnosed during the first trimester is significantly associated with a chromosomal aberration.

  • 39.
    Marin-Briggiler, Clara I.
    et al.
    Instituto de Biologia y Medicina Experimental, National Research Council of Argentina (CONICET), University of Buenos Aires, Buenos Aires, Argentina.
    Gonzalez-Echeverria, Maria F.
    Centro Medico Fertilab, Buenos Aires, Argentina.
    Munuce, Maria J.
    Laboratorio de Estudios Reproductivos, Area de Bioquimica Clinica, Facultad de Ciencias Bioquimicas y Farmaceuticas, Universidad Nacional de Rosario, Rosario, Argentina.
    Ghersevich, Sergio
    Laboratorio de Estudios Reproductivos, Area de Bioquimica Clinica, Facultad de Ciencias Bioquimicas y Farmaceuticas, Universidad Nacional de Rosario, Rosario, Argentina.
    Caille, Adriana M.
    Laboratorio de Estudios Reproductivos, Area de Bioquimica Clinica, Facultad de Ciencias Bioquimicas y Farmaceuticas, Universidad Nacional de Rosario, Rosario, Argentina.
    Hellman, Ulf
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Ludwiginstitutet för cancerforskning.
    Corrigall, Valerie M.
    Department of Rheumatology, King’s College London School of Medicine, Guy’s Hospital, London, United Kingdom.
    Vazquez-Levin, Monica H.
    Instituto de Biologia y Medicina Experimental, National Research Council of Argentina (CONICET), University of Buenos Aires, Buenos Aires, Argentina.
    Glucose-regulated protein 78 (Grp78/BiP) is secreted by human oviduct epithelial cells and the recombinant protein modulates sperm zona pellucida binding2010Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 93, nr 5, s. 1574-1584Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To determine the secretion of Grp78 by human oviduct epithelial cells, its association to spermatozoa, and its involvement in gamete interaction. Design: Prospective study. Setting: Basic research laboratory. Subject(s): Semen samples obtained from normozoospermic volunteers. Tubal tissue provided by patients undergoing hysterectomies. Oocytes collected from women undergoing IVF-ET. Intervention(s): Analysis of Grp78 expression and secretion by oviductal tissue. Gamete incubation with recombinant Grp78 (rec-Grp78). Main Outcome Measure(s): Assessment of protein expression and secretion by immunohistochemistry and Western immunoblotting, respectively. Evaluation of rec-Grp78 binding to human spermatozoa by immunocytochemistry, and analysis of its effect upon gamete interaction using the hemizona assay. Result(s): Grp78 was found in the surface of oviduct epithelial cells. Soluble Grp78 was detected in oviductal fluids from women in the periovulatory period and in oviductal tissue conditioned medium. Rec-Grp78 was able to bind to the sperm acrosomal cap, and its presence during gamete interaction led to a decrease in the number of spermatozoa bound to the zona pellucida (ZP). When calcium ions from the incubation medium were replaced by strontium, rec-Grp78 enhanced sperm ZP interaction. Conclusion(S): Grp78 is expressed and secreted by oviduct epithelial cells. The protein would bind to the gametes and may modulate their interaction in a calcium-dependent manner.

  • 40.
    Naessén, Tord
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Kushnir, Mark M.
    Uppsala universitet, Teknisk-naturvetenskapliga vetenskapsområdet, Kemiska sektionen, Institutionen för fysikalisk och analytisk kemi, Analytisk kemi.
    Chaika, Andrey
    Donetsk State Medical University, Ukraine.
    Nosenko, Jelena
    Donetsk State Medical University, Ukraine.
    Mogilevkina, Iryna
    Donetsk State Medical University, Ukraine.
    Rockwood, Alan L.
    ARUP Institute for Clinical and Experimental Pathology, Utah.
    Carlström, Kjell
    Karolinska Institute.
    Bergquist, Jonas
    Uppsala universitet, Teknisk-naturvetenskapliga vetenskapsområdet, Kemiska sektionen, Institutionen för fysikalisk och analytisk kemi, Analytisk kemi.
    Kirilovas, Dmitrijus
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Steroid profiles in ovarian follicular fluid in women with and without polycystic ovary syndrome, analyzed by liquid chromatography-tandem mass spectrometry.2010Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 94, nr 6, s. 2228-2233Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE

    To compare steroid concentrations and steroid product-to-precursor ratios in ovarian follicular fluid (FF) from women with polycystic ovary syndrome (PCOS) and from regularly menstruating women in their early follicular phase, using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Polycystic ovary syndrome involves abnormal regulation of the steroidogenic enzymes, leading to arrest of follicle development.

    DESIGN

    Case-control study.

    SETTING

    University hospital clinic.

    PATIENT(S)

    Follicular fluid from size-matched ovarian follicles (5-8 mm) in 27 nonstimulated women with PCOS and in 21 women without PCOS was sampled. Thirteen steroids were quantitated from 40 muL of FF, using LC-MS/MS.

    INTERVENTION(S)

    None.

    MAIN OUTCOME MEASURE(S)

    Concentrations of steroids in the FF and product-to-precursor ratios (enzyme activity) were compared between the groups.

    RESULT(S)

    In women with PCOS, ovarian FF contained higher concentrations of individual and total androgens, lower individual and total estrogens (E), and a lower total E-to-androgen ratio, compared with regularly menstruating women. The product-to-precursor concentration ratios indicated higher CYP17-linked and lower CYP19-linked (aromatase) enzyme activity. Receiver operating characteristic plots indicated the early CYP17 step (17-OH5P/5P) being highly important for the prevalence of PCOS (c = 0.95).

    CONCLUSION(S)

    The women with PCOS had higher ovarian CYP17-linked and lower CYP19-linked (aromatase) enzyme activity, confirming previous data. Multiple steroid assessments from minute volumes including FF from nonstimulated ovaries, using LC-MS/MS, might be useful in research, clinical endocrinology, and in IVF.

  • 41. Nybacka, Asa
    et al.
    Carlstrom, Kjell
    Fabri, Fredrika
    Hellström, Per Martin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Gastroenterologi/hepatologi.
    Hirschberg, Angelica Linden
    Serum antimullerian hormone in response to dietary management and/or physical exercise in overweight/obese women with polycystic ovary syndrome: secondary analysis of a randomized controlled trial2013Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 100, nr 4, s. 1096-1102Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To investigate whether randomized diet and/or physical exercise influence serum levels of antimullerian hormone (AMH) in obese women with polycystic ovary syndrome (PCOS). Design: Randomized, 4-month trial with three interventions. Setting: Women's health clinical research unit at a university hospital. Patient(s): Fifty-seven overweight/obese women with PCOS. Intervention(s): Diet, physical exercise, or both, using programs individually adapted and supervised by a dietician and/or a physiotherapist. Main Outcome Measure(s): Serum AMH levels before and after the interventions and correlations to reproductive function, body composition, and endocrine and metabolic variables. Result(s): After intervention, serum levels of AMH were significantly decreased only in the diet group, and the levels were significantly lower than in the exercise group. The strongest predictor of decreased AMH was a decrease in free T, whereas weight loss had no significant influence. Normalized levels of AMH were associated with improvements in menstrual cyclicity and hyperandrogenism but not in metabolic variables. Conclusion(s): This randomized study supports that diet reduces serum AMH in association with decreased androgen levels in obese women with PCOS. Increased serum AMH may be used as a marker of ovulatory dysfunction and hyperandrogenism but not as a marker of insulin resistance.

  • 42. Nybacka, Asa
    et al.
    Carlstrom, Kjell
    Stahle, Agneta
    Nyren, Sven
    Hellström, Per Martin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Hirschberg, Angelica Linden
    Randomized comparison of the influence of dietary management and/or physical exercise on ovarian function and metabolic parameters in overweight women with polycystic ovary syndrome2011Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 96, nr 6, s. 1508-1513Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective:

    To compare the influence of dietary management and/or physical exercise on ovarian function and metabolic variables in women with polycystic ovary syndrome (PCOS).

    Design:

    Randomized 4-month trial with three interventions and a long-term follow-up.

    Setting:

    Women's health clinical research unit at a university hospital.

    Patient(s):

    Fifty-seven overweight/obese women with PCOS.

    Intervention(s):

    Dietary management, physical exercise, or both, using programs individually adapted and supervised by a dietician and/or a physical therapist. Main

    Outcome Measure(s):

    Ovarian function, endocrinologic, and metabolic status and body composition.

    Result(s):

    On average, body mass index was reduced 6% by the dietary management, 3% by the exercise, and 5% by the combined interventions. Lower body fat and lean body mass were significantly decreased in the dietary groups, whereas upper body fat was lowered and lean body mass maintained by exercise alone. The menstrual pattern was significantly improved in 69% and ovulation confirmed in 34% of the patients, with no differences among the groups. The strongest predictor of resumed ovulation was a high serum level of insulin-like growth factor-binding protein 1 after the intervention. Follow-up of one-half of the patients for a median of 2.8 years revealed sustained weight reduction and improvement in menstrual pattern.

    Conclusion(s):

    Dietary management and exercise, alone or in combination, are equally effective in improving reproductive function in overweight/obese women with PCOS. The underlying mechanisms appear to involve enhanced insulin sensitivity. Supportive individualized programs for lifestyle change could exert long-term beneficial effects.

  • 43.
    Ottander, Ulrika
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Solensten, Nils Gunnar
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Bergh, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Patologi.
    Olofsson, Jan I
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Intraovarian blood flow measured with color doppler ultrasonography inversely correlates with vascular density in the human corpus luteum of the menstrual cycle2004Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 81, nr 1, s. 154-159Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective

    To evaluate the morphologic characteristics underlying the ultrasonographic appearance and blood flow dynamics in the human corpus luteum (CL) of the menstrual cycle.

    Design

    Cross-sectional study.

    Setting

    Umeå University Hospital, Umeå, Sweden.

    Patient(s)

    Twenty-six otherwise healthy women with proven fertility and a history of regular menstrual cycles, scheduled for elective hysterectomy or tubal sterilization.

    Intervention(s)

    An ovulatory LH rise in urine was established and the CL age was determined according to the day after the LH rise. Before surgery, a standardized ultrasonographic examination of the CL, including B-mode and color Doppler ultrasonography measurements, was performed. Upon commencing the minilaparotomy, the CL was excised and measured using a digital slide-caliper. The volume density (percentage of CL volume occupied by blood vessels) of factor VIII–related antigen immunostained endothelial cells was determined.

    Main outcome measure(s)

    Pulsatility index obtained from intraovarian blood vessels supplying the CL and volume density of blood vessels in CL tissue. The CL maximal and minimal outer and inner dimensions were measured in vivo by ultrasonography and ex vivo by a digital slide caliper.

    Result(s)

    A statistically significant decrease of blood vessel density and an increased resistance to blood flow, as indicated by pulsatility index, was established during the course of corpus luteum development. An inverse correlation between pulsatility index and volume density of blood vessels was found. A high degree of agreement between ultrasonographic and anatomic measurements of surgically removed CL was found.

    Conclusion(s)

    Transvaginal ultrasonography in combination with intraovarian color Doppler flow measurements is a simple and reliable method to evaluate the size and vascularization of the human CL.

  • 44.
    Piltonen, Terhi T.
    et al.
    Univ Oulu, Oulu Univ Hosp, Dept Obstet & Gynecol, PEDEGO Res Unit,Med Res Ctr, Aapistie 5,Box 5000, Oulu 90014, Finland.
    Giacobini, Paolo
    INSERM, Jean Pierre Aubert Res Ctr, Lab Dev & Plast Neuroendocrine Brain, Lille, France;Univ Lille, Sch Med, Federat Hosp Univ, Lille, France.
    Edvinsson, Åsa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Reproduktiv hälsa.
    Hustad, Steinar
    Univ Bergen, Dept Clin Sci, Bergen, Norway;Univ Bergen, Core Facil Metabol, Bergen, Norway.
    Lager, Susanne
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Obstetrisk och reproduktiv hälsoforskning.
    Morin-Papunen, Laure
    Univ Oulu, Oulu Univ Hosp, Dept Obstet & Gynecol, PEDEGO Res Unit,Med Res Ctr, Aapistie 5,Box 5000, Oulu 90014, Finland.
    Tapanainen, Juha S.
    Univ Oulu, Oulu Univ Hosp, Dept Obstet & Gynecol, PEDEGO Res Unit,Med Res Ctr, Aapistie 5,Box 5000, Oulu 90014, Finland;Univ Helsinki, Dept Obstet & Gynecol, Helsinki, Finland;Helsinki Univ Cent Hosp, Helsinki, Finland.
    Sundström-Poromaa, Inger
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Reproduktiv hälsa.
    Arffman, Riikka K.
    Univ Oulu, Oulu Univ Hosp, Dept Obstet & Gynecol, PEDEGO Res Unit,Med Res Ctr, Aapistie 5,Box 5000, Oulu 90014, Finland.
    Circulating antimüllerian hormone and steroid hormone levels remain high in pregnant women with polycystic ovary syndrome at term2019Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 111, nr 3, s. 588-596.e1Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To investigate plasma antimullerian hormone (AMH) concentration and its relation to steroid hormone levels in pregnant women with polycystic ovary syndrome (PCOS) and controls at term.

    Design: Case-control study.

    Setting: University-affiliated hospital.

    Patient(s): A total of 74 pregnant women at term: 25 women with PCOS (aged 31.6 ± 3.9 years [mean ± standard deviation], body mass index 24.0 ± 3.9 kg/m2, mean gestational length 279 ± 9 days) and 49 controls (aged 31.7 ± 3.3 years, body mass index 24.0 ± 3.3 kg/m2, mean gestational length 281 ± 9 days).

    Intervention(s): None.

    Main Outcome Measure(s): Plasma AMH and steroid hormone levels.

    Result(s): Antimullerian hormone, T, and androstenedione levels were higher in women with PCOS at term compared with controls, whereas estrogen and P levels were similar. The differences were pronounced in women carrying a female fetus. Testosterone and AMH levels correlated positively in both groups, but E2 levels only in women with PCOS.

    Conclusion(s): Pregnant women with PCOS present with elevated AMH and androgen levels even at term, suggesting a hormonal imbalance during PCOS pregnancy. Differences were detected especially in pregnancies with a female fetus, raising the question of whether female pregnancies are more susceptible to AMH and steroid hormone actions.

  • 45.
    Pinola, Pekka
    et al.
    Oulu Univ Hosp, Dept Obstet & Gynecol, Oulu, Finland.;Univ Oulu, Oulu, Finland.;Med Res Ctr Oulu, Oulu, Finland..
    Puukka, Katri
    Univ Oulu, Oulu, Finland.;Med Res Ctr Oulu, Oulu, Finland.;Oulu Univ Hosp, Nordlab Oulu, Oulu, Finland.;Univ Oulu, Dept Clin Chem, Oulu, Finland..
    Piltonen, Terhi T.
    Oulu Univ Hosp, Dept Obstet & Gynecol, Oulu, Finland.;Univ Oulu, Oulu, Finland.;Med Res Ctr Oulu, Oulu, Finland..
    Puurunen, Johanna
    Oulu Univ Hosp, Dept Obstet & Gynecol, Oulu, Finland.;Univ Oulu, Oulu, Finland.;Med Res Ctr Oulu, Oulu, Finland..
    Vanky, Eszter
    Norwegian Univ Sci & Technol, Inst Lab Med Childrens & Womens Hlth, Trondheim, Norway.;St Olavs Univ Hosp Trondheim, Dept Obstet & Gynecol, Trondheim, Norway..
    Sundström-Poromaa, Inger
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Stener-Victorin, Elisabet
    Karolinska Inst, Dept Physiol & Pharmacol, Stockholm, Sweden..
    Hirschberg, Angelica Linden
    Karolinska Univ Hosp, Dept Obstet & Gynecol, Stockholm, Sweden..
    Ravn, Pernille
    Odense Univ Hosp, Dept Obstet & Gynecol, Odense, Denmark..
    Andersen, Marianne Skovsager
    Odense Univ Hosp, Dept Endocrinol & Metab, Odense, Denmark..
    Glintborg, Dorte
    Odense Univ Hosp, Dept Endocrinol & Metab, Odense, Denmark..
    Mellembakken, Jan Roar
    Oslo Univ Hosp, Sect Reprod Med, Dept Gynecol, Womens Div, Oslo, Norway..
    Ruokonen, Aimo
    Univ Oulu, Oulu, Finland.;Med Res Ctr Oulu, Oulu, Finland.;Oulu Univ Hosp, Nordlab Oulu, Oulu, Finland.;Univ Oulu, Dept Clin Chem, Oulu, Finland..
    Tapanainen, Juha S.
    Univ Oulu, Oulu, Finland.;Med Res Ctr Oulu, Oulu, Finland.;Univ Helsinki, Dept Obstet & Gynecol, Helsinki, Finland.;Helsinki Univ Hosp, Helsinki, Finland..
    Morin-Papunen, Laure C.
    Oulu Univ Hosp, Dept Obstet & Gynecol, Oulu, Finland.;Univ Oulu, Oulu, Finland.;Med Res Ctr Oulu, Oulu, Finland..
    Normo- and hyperandrogenic women with polycystic ovary syndrome exhibit an adverse metabolic profile through life2017Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 107, nr 3, s. 788-+, artikel-id 795.e2Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To compare the metabolic profiles of normo- and hyperandrogenic women with polycystic ovary syndrome (PCOS) with those of control women at different ages during reproductive life. Design: Case-control study. Setting: Not applicable. Patient(s): In all, 1,550 women with normoandrogenic (n = 686) or hyperandrogenic (n = 842) PCOS and 447 control women were divided into three age groups: < 30, 30-39, and > 39 years). Interventions(s): None. Main Outcome Measure(s): Body mass index (BMI), waist circumference, blood pressure, glucose, insulin, cholesterol, lipoproteins, triglycerides and high-sensitivity C-reactive protein. Result(s): Both normo- and hyperandrogenic women with PCOS were more obese, especially abdominally. They had increased serum levels of insulin (fasting and in oral glucose tolerance tests), triglycerides, low-density lipoprotein, and total cholesterol, higher blood pressure, and lower high-density lipoprotein levels independently from BMI compared with the control population as early as from young adulthood until menopause. The prevalence of metabolic syndrome was two-to fivefold higher in women with PCOS compared with control women, depending on age and phenotype, and the highest prevalence was observed in hyperandrogenic women with PCOS at late reproductive age. Conclusion(s): When evaluating metabolic risks in women with PCOS, androgenic status, especially abdominal obesity and age, should be taken into account, which would allow tailored management of the syndrome from early adulthood on.

  • 46. Rickenlund, Anette
    et al.
    Carlström, Kjell
    Ekblom, Björn
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Björn Ekbloms forskningsgrupp.
    Brismar, Torkel B
    von Schoultz, Bo
    Hirschberg, Angelica Lindén
    Hyperandrogenicity is an alternative mechanism underlying oligomenorrhea or amenorrhea in female athletes and may improve physical performance.2003Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 79, nr 4, s. 947-55Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To evaluate endocrine mechanisms underlying oligomenorrhea or amenorrhea in female athletes. DESIGN: Cross-sectional study. SETTING: Women's health clinical research unit at a university hospital. PATIENT(S): Age- and BMI-matched groups of athletes active in endurance sports with and without menstrual disturbances and regularly cycling sedentary controls. INTERVENTION(S): Groups were compared with respect to endocrine status, body composition, and physical performance. MAIN OUTCOME MEASURE(S): Identification of a subgroup of oligomenorrheic or amenorrheic athletes with increased androgen levels and anabolic body composition. RESULT(S): A subgroup of 8 of 25 athletes with menstrual disturbances had significantly higher serum levels of free and total testosterone, androstenedione, LH-FSH ratio, and lower SHBG levels than did all other groups. Other oligomenorrheic or amenorrheic athletes had normal values comparable to those in regularly menstruating athletes and controls. The hyperandrogenic subgroup showed a more anabolic body composition, with higher total bone mineral density and upper-lower fat mass ratio than did oligomenorrheic or amenorrheic athletes with normal androgen levels. The hyperandrogenic subgroup had the highest VO2 max and the highest performance values in general. CONCLUSION(S): Menstrual disturbances in female athletes are often explained as a consequence of hypothalamic inhibition and caloric deficiency. We suggest that essential hyperandrogenism is an alternative mechanism underlying oligomenorrhea or amenorrhea in some female athletes and may imply an advantage for physical performance.

  • 47. Saha, Rama
    et al.
    Pettersson, Hans Järnbert
    Svedberg, Pia
    Olovsson, Matts
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Bergqvist, Agneta
    Marions, Lena
    Tornvall, Per
    Kuja-Halkola, Ralf
    Heritability of endometriosis2015Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 104, nr 4, s. 947-952Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To estimate the relative contribution of genetic influences and prevalence on endometriosis.

    DESIGN: Analysis of self-reported data from a nationwide population-based twin registry.

    SETTING: Not applicable.

    PATIENT(S): A total of 28,370 women, female monozygotic (MZ) or dizygotic (DZ) twins, who participated in either of two surveys (1998-2002 or 2005-2006).

    INTERVENTION(S): None.

    MAIN OUTCOME MEASURE(S): Self-reported endometriosis, validated by medical records.

    RESULT(S): A history of endometriosis was reported by 1,228 female twins. The probandwise concordance was 0.21 for MZ and 0.10 for DZ twins. Higher within-pair (tetrachoric) correlation was observed among MZ (0.47) compared with DZ (0.20) twins. The best-fitting model revealed a contribution of 47% by additive genetic factors and the remaining 53% attributed to unique environmental effects.

    CONCLUSION(S): Our findings suggest both genetic and unique (nonshared) environmental influences on the complex etiology of endometriosis and support the hypothesis that genes have a strong influence on phenotypic manifestations of endometriosis.

  • 48.
    Sanner, Karin
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Conner, Peter
    Dept of Obstetrics and Gynecology, Karolinska University Hospital, Stockholm, Sweden.
    Bergfeldt, Kjell
    Dickman, Paul
    Sundfeldt, Karin
    Bergh, Torbjörn
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Hagenfeldt, Kerstin
    Janson, Per Olof
    Nilsson, Staffan
    Persson, Ingemar
    Dept of Medical Epi and Bio, Karolinska Institute, Stockholm, Sweden.
    Ovarian epithelial neoplasia after hormonal infertility treatment: long-term follow-up of a historical cohort in Sweden2009Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 91, nr 4, s. 1152-1158Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To study the association between hormonal infertility treatment and ovarian neoplasia. DESIGN: Historical cohort study. SETTING: Three university hospitals in Sweden. PATIENT(S): A total of 2,768 women assessed and treated for infertility and infertility-associated disorders between 1961 and 1975. INTERVENTION(S): Exposed women received clomiphene citrate and/or gonadotropins. MAIN OUTCOME MEASURE(S): Incidence of ovarian neoplasia. RESULT(S): No overall excess risk of invasive ovarian cancer emerged compared with the general population. In women with gonadotropin treatment for non-ovulatory disorders, the risk was elevated (standardized incidence ratio [SIR] = 5.89; 95% confidence interval [CI] 1.91-13.75); four of the five cases reported hCG treatment only, rendering the biological plausibility uncertain. Multivariate analysis within the cohort indicated that treatment with gonadotropins only was associated with an increased risk of invasive cancer (relative risk = 5.28; 95% CI 1.70-16.47). For borderline tumors, a more than threefold overall increase of tumors (SIR = 3.61; 95% CI 1.45-7.44) was noted; women exposed to clomiphene because of ovulatory disorders showed the highest risk (SIR = 7.47; 95% CI 1.54-21.83). CONCLUSION(S): Our findings of increased risk of ovarian cancer after gonadotropins and of borderline tumors after clomiphene treatment need to be interpreted with caution. However, concern is raised, and further research on the long-term safety particularly of modern hormonal infertility treatment in IVF programs is warranted.

  • 49. Stener-Victorin, Elisabet
    et al.
    Baghaei, Fariba
    Holm, Göran
    Janson, Per Olof
    Olivecrona, Gunilla
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Fysiologisk kemi.
    Lönn, Malin
    Mannerås-Holm, Louise
    Effects of acupuncture and exercise on insulin sensitivity, adipose tissue characteristics, and markers of coagulation and fibrinolysis in women with polycystic ovary syndrome: secondary analyses of a randomized controlled trial2012Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 97, nr 2, s. 501-508Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To investigate the possible effects of low-frequency electroacupuncture (EA) and physical exercise on markers of coagulation and fibrinolysis, insulin sensitivity, and adipose tissue characteristics in women with polycystic ovary syndrome (PCOS). Design: Secondary analyses of a prospective, randomized controlled clinical trial. Setting: Department of Physiology and Department of Obstetrics and Gynecology, University of Gothenburg. Patient(s): Eighty-four women with PCOS were randomized. Intervention(s): Women with PCOS were randomized to 16 weeks of low-frequency EA (14 treatments), physical exercise (at least 3 times/wk), or no intervention. Main Outcome Measure(s): Anthropometrics, circulating coagulation and fibrinolytic markers, insulin sensitivity (euglycemic hyperinsulinemic clamp), hemodynamics, and adipose tissue morphology/function recorded at baseline, after 16 weeks of intervention, and after a 16-week follow-up. Result(s): In the low-frequency EA group, circulating plasminogen activator inhibitor 1 activity decreased by 21.8% after 16 weeks of intervention and by 31.1% at the 16-week follow-up and differed from the physical exercise and the no intervention groups. The EA group had decreases in circulating fibrinogen and tissue plasminogen activator (t-PA), sagittal diameter, and diastolic blood pressure after treatment, and fibrinogen remained lower at the 16-week follow-up. In the physical exercise group, lipoprotein lipase activity increased and diastolic blood pressure decreased after treatment, and both diastolic and systolic blood pressure were lower at follow-up. No other variables were affected. Conclusion(s): Low-frequency EA counteracted a possible prothrombotic state in women with PCOS, as reflected by a decrease in plasminogen activator inhibitor 1 activity. Despite within-group improvements, there were no between-group differences in anthropometric, metabolic, or hemodynamic variables after 16 weeks of EA or physical exercise at the dose/intensity studied. (Fertil Steril(R) 2012;97:501-8. (C) 2012 by American Society for Reproductive Medicine.)

  • 50. Svalander, P C
    et al.
    Holmes, P V
    Olovsson, Matts
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Wikland, M
    Gemzell-Danielsson, K
    Bygdeman, M
    Platelet-derived growth factor is detected in human blastocyst culture medium but not in human follicular fluid--a preliminary report.1991Ingår i: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 56, nr 2Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The content of PDGF in human blastocyst culture medium (n = 8), serum (n = 12), and FF (n = 17) from natural IVF cycles was determined by an RIA specific for PDGF B-chain. The blastocysts were cultured under serum-free conditions throughout development. The findings show that PDGF B-chain is released into the culture medium of human blastocysts and that serum is positive, whereas FF is negative for PDGF.

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