The primary outcome was the incidence of miscarriage. The summary measures were reported as relative risk (RR) with 95% confidence interval (CI).
A patient with extensive juvenile hypertrophy of the breasts has been presented. Several interesting facts in the case history are as follows: After pregnancy, the breasts did not regress with "hormone shots" to stop lactation. The patient took high-dosage estrogen birth control pills for 3 years before the breasts started to grow rapidly. Within 1 month after reduction mammaplasty and despite 20 mg dydrogesterone per day, the breasts started to enlarge. A total of 60 mg b.i.d. of dydrogesterone did not stop breast regrowth. Tamoxifen citrate did cause regression of the breasts. After two reductions, the breasts regrew with a subsequent pregnancy. The breast tissue regrew in the axilla with a subsequent pregnancy after simple mastectomy-subcutaneous mastectomy and free nipple transplants. Chronic marijuana use may have an effect on the breast tissue in certain susceptible females as well as in some males. Much needs to be learned about the control of growth of female breast tissue.
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To determine the effectiveness of both the progestagens and anti-progestagens in the treatment of painful symptoms ascribed to the diagnosis of endometriosis.
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Endometrial preparation in an oocyte donation program using orally administered synthetic estrogen and progestogen gives pregnancy rates comparable to those reported with natural products.
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This study is registered at ClinicalTrials.gov, NCT02128685 . Registered on 29 April 2014.
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Calibration curves were generated over the range of 5-150 ng/mL with values for coefficient of determination greater than 0.997 and by using a weighted (1/y) linear regression. The values of precision and accuracy were less than 12.5% and 7.5%, respectively, both for within- and between-run analysis. The mean recovery of the analyte was 99.8%. This is the first reported method for analysis dydrogesterone in human plasma that uses protein precipitation as sample processing procedure. The validated LC/MS method could be applied for determination of dydrogesterone in human plasma for therapeutic drug monitoring in gynecological disorders.
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One hundred and eighty women with a history of recurrent, unexplained spontaneous abortion (mean 3.5 abortions) were randomised to receive oral dydrogesterone (10 mg b.i.d.), intramuscular human chorionic gonadotrophin (hCG; 5000 IU every 4 days) or no additional treatment (controls). Treatment was started as soon as possible after confirmation of pregnancy and continued until the 12th gestational week. All women received standard supportive care. Abortions were significantly (p < or = 0.05) less common in the dydrogesterone group (13.4%) than in the control group (29%); there were no statistically significant differences between the hCG group and the control group. There were no differences between the groups with respect to pregnancy complications or congenital abnormalities. In conclusion, hormonal support with dydrogesterone can increase the chances of a successful pregnancy in women with a history of recurrent spontaneous abortion.
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Between September 1999 and March 2001, a total of 91 couples with infertility were recruited at Al-Hammadi Hospital, Riyadh, Kingdom of Saudi Arabia and Badeea Hospital, Jordan. In this prospective trial 46 couples were allocated to luteal phase support with hCG injections, while 45 couples were allocated to Duphaston (oral progestogens) as luteal support.
One hundred and two women entered the study and 95 women completed 6 months of hormone replacement therapy. Urinary incontinence was reported by 44.1% of the women, in 19.6% of the women it occurred more than twice a week. Both diurnal frequency and nocturnal frequency was reported by 28.4% of the women. For women with frequency or nocturia, the number of voids significantly decreased after 6 months hormone replacement therapy. Nocturia disappeared in 65.4% of the women after treatment and 23.3% reported to be cured of their urinary incontinence. Bacteriuria was present in the same seven women before and after hormone treatment. Dydrogesterone dose did not influence treatment outcomes.
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To investigate the difference in histopathology and cell cycle kinetics in the menopausal endometrium treated with sequential-combined hormone replacement therapy (HRT) using different types and doses of progestins.
Randomized, double-blind study.
Femoston had a neutral effect on blood coagulation factors and had no effect on plasma glucose concentrations. With Femoston, there was a positive change in the atherogenic index and the total cholesterol/HDL cholesterol ratio.
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To compare efficacy, satisfaction and tolerability of oral dydrogesterone and micronized vaginal progesterone gel used for luteal supplementation.
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To assess uterine artery blood flow and endometrial thickness in postmenopausal patients receiving sequential hormone replacement therapy (HRT) at different phases of the treatment.
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Guidelines recommend using the lowest effective dose of oestrogen for the management of vasomotor symptoms in postmenopausal women. The primary aim of this double-blind, multi-centre, randomised study was to assess the efficacy of oral ultra-low dose continuous combined hormone replacement therapy with 17β-oestradiol and dydrogesterone.
Although gestagens have been reported to influence bone metabolism, whether these contribute to the beneficial effects of hormone replacement therapy (HRT) on the skeleton of postmenopausal women is currently unclear. To address this question, we compared changes in bone turnover markers after commencing HRT in 26 postmenopausal women randomized to receive 8 weeks of treatment with 2 mg estradiol daily or 2 mg estradiol plus 10 mg dydrogesterone daily. Serum and second morning void urine samples were obtained at baseline (twice) and after 1, 2, 4, and 8 weeks. Serum estradiol was measured by RIA, urinary total deoxypyridinoline (DPD) excretion by high pressure liquid chromatography, and serum osteocalcin and C-terminal procollagen peptide by enzyme-linked immunosorbent assay. The increase in serum estradiol after treatment with estradiol alone was slightly, but significantly, greater than that in the combination group (P = 0.04). Although estradiol suppressed urinary DPD excretion to a greater extent when given alone (P = 0.02), osteocalcin levels were significantly higher in this group than in women receiving combination therapy (P = 0.04). To assess the effect of dydrogesterone on the balance between formation and resorption in more detail, we subsequently compared the ratio between formation and resorption markers in the two treatment groups. We found that osteocalcin/DPD and C-terminal procollagen peptide/DPD ratios were significantly higher in women treated with estradiol alone (P < 0.0001 and P = 0.002, respectively), suggesting that dydrogesterone may reduce formation relative to resorption. These results suggest that gestagens may reduce estrogen's beneficial effects on the skeleton of postmenopausal women, as assessed over the first 8 weeks of replacement therapy.
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The osteopontin: alphavbeta3 integrin complex has been proposed as a means of distinguishing receptive from non-receptive endometrium in clinical practice, thus offering new directions for the development of contraceptive approaches targeted to the endometrium as well as a better understanding of occult causes of infertility in women. Histological dating and immunohistochemical study were performed in control and study cycles in seven groups of women including 10 subjects per group and who received clomiphene citrate, ovarian stimulation for IVF, oral contraception, dehydrogesterone for endometrial luteal phase defect, two different regimens of hormone replacement therapy, or no treatment. Ten healthy fertile women served as a general control group. Osteopontin and alphavbeta3 integrin expression in the human endometrium was closely related to endometrial maturation and this was irrespective of the endometrium being in-phase or out-of-phase and the hormonal treatment (or no treatment) received. In conclusion, immunohistochemical assessment of the endometrium indicates that the use of osteopontin and alphavbeta3 integrin or the osteopontin: alphavbeta3 integrin complex as targets for the development of contraceptive approaches or the understanding of the pathogenesis of female infertility offer little benefit compared with simple histological dating.
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Dydrogesterone interacts with allopregnanolone levels (less with beta-endorphin), and it can be considered important modulator of the neuroendocrine function.
In Group A, the percentage of first transfer, average endometrial thickness on the day of using progesterone in FET cycles were all significantly higher than Group B. And the ratio of < 7 mm was significantly higher in Group B (8.8% vs 2.4%). However, no significant differences existed in clinical pregnancy rate (54.8% vs 52.9%) or embryo implantation rate (38.1% vs 35.8%). With endometrial thickening, both clinical pregnancy and embryo implantation rates increased. There was no significant difference in maximum E2 level. Clinical pregnancy rate, embryo implantation rate and live birth rate of the patients whose endometrial double thickness was thinner than 7 mm in Group B were all higher than those of similar endometrial thickness (all Progynova only) in 2011.
Oral continuous combined 0.5 mg/d estradiol valerate and 5 mg/d dydrogesterone as immediate add-back therapy during post-operative GnRH agonist treatment for severe endometriosis may be the most suitable regimen for Chinese women.
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The aim of this prospective, open, randomised study was to determine whether dydrogesterone was more effective than conservative management alone in preventing miscarriage in women with vaginal bleeding up to week 16 of pregnancy. Women were excluded if they had a history of recurrent miscarriage. A total of 191 women were randomised to dydrogesterone (40 mg stat followed by 10mg twice daily) or conservative management (control group). The treatment was considered successful if the pregnancy continued beyond 20 weeks of gestation.