This document summarizes several clinical studies that evaluated the effects of red clover isoflavone supplements on menopausal symptoms. A randomized, double-blind, placebo-controlled trial of 113 menopausal women in Austria found that 80 mg of red clover isoflavones per day significantly reduced hot flashes, improved sleep, and improved mood after 12 weeks compared to placebo. A separate randomized crossover trial of 60 menopausal women in Ecuador also found 80 mg of red clover isoflavones daily for 3 months significantly reduced menopausal symptoms measured by the Kupperman index compared to placebo. Both studies found the supplements were well-tolerated with few side effects. In vitro studies further suggest the isoflavones do not
Improving Success by Tailoring Ovarian StimulationSandro Esteves
This document summarizes a presentation given by Dr. Sandro Esteves on improving IVF success through tailored ovarian stimulation. The presentation covered factors that determine ovarian response, strategies for high and poor responders, and evidence for different stimulation protocols. For high responders, low starting doses of rFSH, GnRH antagonists, and GnRH agonist triggering were recommended based on evidence from randomized controlled trials and observational studies. For poor responders, GnRH antagonists were suggested to potentially improve outcomes based on data from 14 RCTs.
The document discusses changing protocols for in vitro fertilization (IVF) from gonadotropin-releasing hormone (GnRH) agonists to GnRH antagonists. Some key points discussed include:
1) GnRH antagonists are associated with a lower risk of ovarian hyperstimulation syndrome (OHSS) compared to GnRH agonists.
2) While efficacy outcomes like live birth and pregnancy rates are similar between the two protocols, GnRH antagonists require fewer gonadotropin ampoules and have a shorter duration of stimulation.
3) Based on multiple randomized controlled trials and meta-analyses, it is justified to shift from GnRH agonists to GnRH antagonists for IVF
This lecture discusses the role of LH in reproductive cycles. It notes that both FSH and LH are essential for normal estrogen biosynthesis and optimal follicular development occurs within an 'LH window' above a certain threshold but below a ceiling. The lecture also reviews evidence that 75IU of recombinant LH is sufficient to promote optimal follicular and endometrial growth in most hypogonadotropic hypogonadism patients. The central paradigm is to maximize beneficial effects of treatment while minimizing complications and risks.
GnRH antagonist in Ovarian stimulation for IVF/ET, Prof. Usama M.Fouda umfrfouda
GnRH antagonists provide an alternative to GnRH agonists for ovarian stimulation in IVF by causing immediate suppression of gonadotropin release. Advantages include avoiding the initial flare effect seen with agonists and a lower risk of OHSS. Antagonists are given in either single or multiple dose protocols when follicles reach a certain size. While antagonists require less gonadotropin and have a shorter duration, asynchronous follicle development and higher early cycle estrogen levels are disadvantages. Pregnancy rates are now comparable between antagonist and agonist protocols, though the risk of OHSS is about half with antagonists.
1) The document discusses the evolution of using GnRH antagonists in IVF treatment instead of agonists. Antagonists allow for a shorter, less invasive treatment with fewer injections and side effects like ovarian hyperstimulation syndrome (OHSS).
2) Clinical trials and Cochrane reviews have found antagonist protocols to be as effective as agonist protocols with comparable live birth rates but significantly reduced risk of OHSS. This makes antagonists the preferred protocol especially for high risk groups like PCOS patients.
3) The antagonist approach creates a safer, less stressful IVF experience for patients and allows treatments that were not possible with agonists, such as protocols for cancer patients needing immediate fertility preservation. The document predicts antagonists
Evolution of ovarian stimulation for ART - towards an individualized approachSandro Esteves
The presentation discusses the evolution of ovarian stimulation for assisted reproductive technology (ART). It begins with a historical perspective of gonadotropin development from urinary sources to recombinant products. It then examines primary factors affecting IVF success like age, ovarian reserve markers, and cause of infertility. The presentation concludes by exploring more individualized clinical strategies like tailoring gonadotropin doses, flexible GnRH antagonist protocols, and LH supplementation to improve IVF outcomes.
Improving Success by Tailoring Ovarian StimulationSandro Esteves
This document summarizes a presentation given by Dr. Sandro Esteves on improving IVF success through tailored ovarian stimulation. The presentation covered factors that determine ovarian response, strategies for high and poor responders, and evidence for different stimulation protocols. For high responders, low starting doses of rFSH, GnRH antagonists, and GnRH agonist triggering were recommended based on evidence from randomized controlled trials and observational studies. For poor responders, GnRH antagonists were suggested to potentially improve outcomes based on data from 14 RCTs.
The document discusses changing protocols for in vitro fertilization (IVF) from gonadotropin-releasing hormone (GnRH) agonists to GnRH antagonists. Some key points discussed include:
1) GnRH antagonists are associated with a lower risk of ovarian hyperstimulation syndrome (OHSS) compared to GnRH agonists.
2) While efficacy outcomes like live birth and pregnancy rates are similar between the two protocols, GnRH antagonists require fewer gonadotropin ampoules and have a shorter duration of stimulation.
3) Based on multiple randomized controlled trials and meta-analyses, it is justified to shift from GnRH agonists to GnRH antagonists for IVF
This lecture discusses the role of LH in reproductive cycles. It notes that both FSH and LH are essential for normal estrogen biosynthesis and optimal follicular development occurs within an 'LH window' above a certain threshold but below a ceiling. The lecture also reviews evidence that 75IU of recombinant LH is sufficient to promote optimal follicular and endometrial growth in most hypogonadotropic hypogonadism patients. The central paradigm is to maximize beneficial effects of treatment while minimizing complications and risks.
GnRH antagonist in Ovarian stimulation for IVF/ET, Prof. Usama M.Fouda umfrfouda
GnRH antagonists provide an alternative to GnRH agonists for ovarian stimulation in IVF by causing immediate suppression of gonadotropin release. Advantages include avoiding the initial flare effect seen with agonists and a lower risk of OHSS. Antagonists are given in either single or multiple dose protocols when follicles reach a certain size. While antagonists require less gonadotropin and have a shorter duration, asynchronous follicle development and higher early cycle estrogen levels are disadvantages. Pregnancy rates are now comparable between antagonist and agonist protocols, though the risk of OHSS is about half with antagonists.
1) The document discusses the evolution of using GnRH antagonists in IVF treatment instead of agonists. Antagonists allow for a shorter, less invasive treatment with fewer injections and side effects like ovarian hyperstimulation syndrome (OHSS).
2) Clinical trials and Cochrane reviews have found antagonist protocols to be as effective as agonist protocols with comparable live birth rates but significantly reduced risk of OHSS. This makes antagonists the preferred protocol especially for high risk groups like PCOS patients.
3) The antagonist approach creates a safer, less stressful IVF experience for patients and allows treatments that were not possible with agonists, such as protocols for cancer patients needing immediate fertility preservation. The document predicts antagonists
Evolution of ovarian stimulation for ART - towards an individualized approachSandro Esteves
The presentation discusses the evolution of ovarian stimulation for assisted reproductive technology (ART). It begins with a historical perspective of gonadotropin development from urinary sources to recombinant products. It then examines primary factors affecting IVF success like age, ovarian reserve markers, and cause of infertility. The presentation concludes by exploring more individualized clinical strategies like tailoring gonadotropin doses, flexible GnRH antagonist protocols, and LH supplementation to improve IVF outcomes.
In ART, GnRH antagonists are effective in preventing a premature LH surge and induce a shorter and more cost-effective ovarian stimulation compared to the long agonist protocol.
N-acetyl cysteine (NAC) may be an effective adjuvant to clomiphene citrate (CC) therapy for inducing ovulation in women with polycystic ovary syndrome (PCOS) resistant to CC alone. A randomized controlled trial assigned 150 such women to receive either NAC plus CC or placebo plus CC for 5 days. The results showed significantly higher ovulation and pregnancy rates in the NAC group compared to the placebo group, demonstrating NAC's potential as a novel adjuvant to CC therapy for PCOS patients. NAC appears to be a safe and inexpensive addition that could help more women with PCOS achieve ovulation and pregnancy when standard CC treatment is ineffective.
GnRH Agonist vs GnRH Antagonist what to choose?DrRitu Santwani
This document summarizes information about GnRH agonists and antagonists used for pituitary suppression during IVF treatment. It discusses that both drugs are used to suppress LH levels and prevent a premature LH surge, but that GnRH agonists have been used longer with more studies and experience. While meta-analyses have found no significant differences in live birth or pregnancy rates between the two protocols, some studies found advantages of agonists for certain patient groups like poor responders or those with previous IVF failures. The document provides details on long and short agonist protocols and reviews several studies comparing outcomes of agonist versus antagonist protocols.
This document summarizes research on the effects of alternative hormonal treatments, including bazedoxifene, on various tissues in humans. It discusses preclinical and clinical data on the effects of ospemifene, tamoxifen, raloxifene, and bazedoxifene on the endometrium, vagina, breast, and bone. It then summarizes results from several clinical trials, known as the SMART trials, that evaluated the efficacy and safety of a combination of conjugated estrogens and bazedoxifene for vasomotor symptoms, quality of life, vaginal health, and bone mineral density and fracture risk reduction.
This document summarizes strategies for individualizing ovarian stimulation protocols in ART based on patient factors. It discusses how a "one size fits all" approach can lead to poor responses, OHSS, and low patient satisfaction. Biomarkers like AMH, AFC, and genetic profiles can help predict ovarian response and tailor protocols. The document also reviews gonadotropin options including urinary vs recombinant drugs and their differences in purity and dosing precision. Finally, it discusses LH surge prevention with GnRH agonists and antagonists.
The document discusses estrogens and progestogens, including their sources, receptors, mechanisms of action, pharmacokinetics, therapeutic uses, and side effects. Natural estrogens include estradiol, estrone and estriol, while synthetic estrogens include ethinyl estradiol, stilbestrol and mestranol. Progesterone is a natural progestogen, while synthetic progestogens include medroxyprogesterone acetate, allylestrenol and levonorgestrel. Estrogens and progestogens act through nuclear receptors and have genomic and non-genomic effects. Their therapeutic uses include hormone replacement therapy, contraception and treatment of gynecological conditions.
This document summarizes various adjuvant therapies used in IVF/ICSI and their evidence and effectiveness. It discusses assisted hatching, which helps the embryo hatch from the zona pellucida, and preimplantation genetic screening, which screens embryos for genetic abnormalities. It also reviews maternal factors like aspirin, glucocorticoids, growth hormone, and their effects on IVF outcomes. The evidence and roles of additional treatments including heparin, immunoglobulin, antibiotics, acupuncture, and endometrial biopsy are summarized.
The Need of LH in ART and Differences Between Sources of LH ActivitySandro Esteves
This document discusses the role of luteinizing hormone (LH) in reproductive cycles and ovarian stimulation. It summarizes that LH is essential for normal ovarian steroidogenesis and follicular development. Certain patient groups, such as older women, poor responders, and those with less sensitive ovaries may benefit from LH supplementation during controlled ovarian stimulation cycles to help maximize pregnancy rates. The document reviews several randomized controlled trials comparing recombinant follicle-stimulating hormone alone versus in combination with recombinant LH, finding improved outcomes with LH addition in some patient populations.
1. The document discusses the evolution of gonadotropins used in assisted reproduction, including their development from urinary sources to recombinant products.
2. It describes how recombinant gonadotropins provide higher purity and more consistent dosage compared to earlier urinary products, with clinical trials demonstrating similar or improved outcomes.
3. The use of recombinant gonadotropins can offer benefits to patients through features such as pre-filled pens, which may improve compliance and reduce stress associated with treatment.
This document discusses the management of infertility through non-surgical and surgical methods. It covers various medical treatments for different infertility causes like varicocele, hormonal imbalances, infections etc. It also discusses assisted reproduction techniques like IVF. Key surgical interventions covered are varicocelectomy for varicocele and testicular biopsy/sperm retrieval for azoospermia evaluation. Guidelines for varicocele treatment from organizations like ASRM are also summarized. The document appears to be slides from an academic presentation on evaluation and management of male infertility.
Role of LH supplementation in reproductive medicine - Aspire 2013Sankalp Singh
To add or not to add LH is a highly contentious issue.Here,i would be discussing role of LH supplementation in IVF cycle as per present day evidence.
Also,will be scrutinising the available studies for their reliability or lack of it.
This document summarizes research on mild versus standard ovarian stimulation protocols for in vitro fertilization (IVF) in patients with polycystic ovary syndrome (PCOS). Standard IVF protocols for PCOS patients often result in excessive ovarian response, high miscarriage rates, and risk of ovarian hyperstimulation syndrome (OHSS). Mild stimulation protocols aim to limit the number of oocytes retrieved to reduce risks, while various studies have found mild protocols achieve comparable pregnancy rates to standard protocols and have additional benefits like lower costs and greater patient comfort. The document reviews definitions of mild versus standard IVF, various mild stimulation medication options and regimens, and clinical trial results comparing outcomes between mild and standard stimulation protocols.
GnRH analogues work by initially causing a flare effect before downregulating the pituitary gland and reducing sex hormone production. They are used to treat conditions like endometriosis but can cause side effects from estrogen deficiency. Addback therapy aims to prevent these side effects by maintaining adequate estrogen levels while still treating the underlying condition. Common addback options include low-dose estrogen-progestin combinations, tibolone, bisphosphonates, and raloxifene. Ongoing research continues to explore new uses and better tolerated options for GnRH analogues and addback therapies.
GnRH agonist versus antagonist and impact on cycle outcomeSandro Esteves
This document summarizes a lecture on using GnRH agonists versus antagonists in ICSI cycles and the impact on cycle outcomes. It discusses that LH suppression is desirable in controlled ovarian stimulation to prevent premature ovulation and luteinization. While GnRH agonists were initially used for this starting in 1984, GnRH antagonists introduced in 1999 provide LH suppression without an initial flare effect and allow for a flexible treatment protocol. The summary reviews the findings that GnRH antagonists have no negative impact on estradiol levels, endometrial receptivity, or cycle parameters compared to agonists and provide a better safety profile with shorter treatment duration.
The document discusses luteal phase support (LPS) in assisted reproductive technology (ART) cycles. It notes that abnormal luteal function can occur after controlled ovarian stimulation, necessitating LPS. It reviews various LPS options including human chorionic gonadotropin and progesterone administered via different routes. Vaginal progesterone is found to effectively increase endometrial levels while intramuscular progesterone yields the highest serum levels. The document concludes that LPS is necessary to optimize ART outcomes and that intramuscular or vaginal progesterone are equally effective options.
Effective interventions in ART An overview of Cochrane Reviews 2015Aboubakr Elnashar
This document summarizes the key findings from 95 Cochrane systematic reviews on interventions for assisted reproductive technology published up to July 2015. 32 reviews identified interventions that were effective (19 interventions) or promising (13 interventions) in improving live birth or pregnancy rates. 14 reviews found interventions that were ineffective (2 interventions) or possibly ineffective (12 interventions). The reviews assessed interventions for various steps of ART including pre-ART strategies, ovarian stimulation, embryo transfer, and luteal phase support. Effective interventions included use of growth hormone, metformin, endometrial injury, and single embryo transfer. Ineffective interventions included follicular flushing and preimplantation genetic screening.
GnRH Antagonists in Controlled Ovarian StimulationSandro Esteves
This document provides an overview of a lecture on LH suppression in controlled ovarian hyperstimulation (COH) using GnRH antagonists. The key points covered include:
1) The importance of LH suppression in COH to prevent premature luteinization and improve outcomes.
2) How GnRH antagonists can be used for LH suppression compared to agonists. Clinical trials show antagonists reduce OHSS risk and duration of stimulation compared to agonists without impacting live birth rates.
3) Flexible or fixed antagonist protocols, use of oral contraceptives, and timing of hCG administration do not significantly impact outcomes. LH supplementation is generally not needed.
This document discusses subfertility, or reduced fertility, and treatments. It notes that about 25-30% of healthy couples conceive per month, with 50% conceiving within 3 months, 75% within 6 months, and 90% within a year. Subfertility is defined as no pregnancy after 12 months of unprotected sex. About 5% of couples have fertility problems and 10% may need medical treatment. Treatments discussed include tracking ovulation, hormonal therapy, treating infections, ovarian stimulation, and less than 3-5% need IVF. Male fertility can be improved with micronutrients like L-carnitine, L-arginine, and antioxidants. Better sperm quality may reduce the need for
Therapy - Intention to reestablish a physiological situation of the vagina.
How does the optimal therapy look? Reduces the sensible quantity of germs AND represses the subjective disturbances. General antimicrobial (Bacteria, Fungal, Virus). Vaginal equilibrium is established and keep alive itself. Shouldn’t cause Resistance and should be applicable as Prophylaxes.
Antibacterial mechanism of action of Propolis: DNA dependant on RNA Polymerase as follows: Bacteria are spited slowly Penetrability of cell membrane increased as follows: Bacteria get more sensitiv. The Hydroxy-cinnamon-acid inhibits reversible the Motility of Bacteria s follows: slow dissermination
Visit our Website: www.imi.co.at
In ART, GnRH antagonists are effective in preventing a premature LH surge and induce a shorter and more cost-effective ovarian stimulation compared to the long agonist protocol.
N-acetyl cysteine (NAC) may be an effective adjuvant to clomiphene citrate (CC) therapy for inducing ovulation in women with polycystic ovary syndrome (PCOS) resistant to CC alone. A randomized controlled trial assigned 150 such women to receive either NAC plus CC or placebo plus CC for 5 days. The results showed significantly higher ovulation and pregnancy rates in the NAC group compared to the placebo group, demonstrating NAC's potential as a novel adjuvant to CC therapy for PCOS patients. NAC appears to be a safe and inexpensive addition that could help more women with PCOS achieve ovulation and pregnancy when standard CC treatment is ineffective.
GnRH Agonist vs GnRH Antagonist what to choose?DrRitu Santwani
This document summarizes information about GnRH agonists and antagonists used for pituitary suppression during IVF treatment. It discusses that both drugs are used to suppress LH levels and prevent a premature LH surge, but that GnRH agonists have been used longer with more studies and experience. While meta-analyses have found no significant differences in live birth or pregnancy rates between the two protocols, some studies found advantages of agonists for certain patient groups like poor responders or those with previous IVF failures. The document provides details on long and short agonist protocols and reviews several studies comparing outcomes of agonist versus antagonist protocols.
This document summarizes research on the effects of alternative hormonal treatments, including bazedoxifene, on various tissues in humans. It discusses preclinical and clinical data on the effects of ospemifene, tamoxifen, raloxifene, and bazedoxifene on the endometrium, vagina, breast, and bone. It then summarizes results from several clinical trials, known as the SMART trials, that evaluated the efficacy and safety of a combination of conjugated estrogens and bazedoxifene for vasomotor symptoms, quality of life, vaginal health, and bone mineral density and fracture risk reduction.
This document summarizes strategies for individualizing ovarian stimulation protocols in ART based on patient factors. It discusses how a "one size fits all" approach can lead to poor responses, OHSS, and low patient satisfaction. Biomarkers like AMH, AFC, and genetic profiles can help predict ovarian response and tailor protocols. The document also reviews gonadotropin options including urinary vs recombinant drugs and their differences in purity and dosing precision. Finally, it discusses LH surge prevention with GnRH agonists and antagonists.
The document discusses estrogens and progestogens, including their sources, receptors, mechanisms of action, pharmacokinetics, therapeutic uses, and side effects. Natural estrogens include estradiol, estrone and estriol, while synthetic estrogens include ethinyl estradiol, stilbestrol and mestranol. Progesterone is a natural progestogen, while synthetic progestogens include medroxyprogesterone acetate, allylestrenol and levonorgestrel. Estrogens and progestogens act through nuclear receptors and have genomic and non-genomic effects. Their therapeutic uses include hormone replacement therapy, contraception and treatment of gynecological conditions.
This document summarizes various adjuvant therapies used in IVF/ICSI and their evidence and effectiveness. It discusses assisted hatching, which helps the embryo hatch from the zona pellucida, and preimplantation genetic screening, which screens embryos for genetic abnormalities. It also reviews maternal factors like aspirin, glucocorticoids, growth hormone, and their effects on IVF outcomes. The evidence and roles of additional treatments including heparin, immunoglobulin, antibiotics, acupuncture, and endometrial biopsy are summarized.
The Need of LH in ART and Differences Between Sources of LH ActivitySandro Esteves
This document discusses the role of luteinizing hormone (LH) in reproductive cycles and ovarian stimulation. It summarizes that LH is essential for normal ovarian steroidogenesis and follicular development. Certain patient groups, such as older women, poor responders, and those with less sensitive ovaries may benefit from LH supplementation during controlled ovarian stimulation cycles to help maximize pregnancy rates. The document reviews several randomized controlled trials comparing recombinant follicle-stimulating hormone alone versus in combination with recombinant LH, finding improved outcomes with LH addition in some patient populations.
1. The document discusses the evolution of gonadotropins used in assisted reproduction, including their development from urinary sources to recombinant products.
2. It describes how recombinant gonadotropins provide higher purity and more consistent dosage compared to earlier urinary products, with clinical trials demonstrating similar or improved outcomes.
3. The use of recombinant gonadotropins can offer benefits to patients through features such as pre-filled pens, which may improve compliance and reduce stress associated with treatment.
This document discusses the management of infertility through non-surgical and surgical methods. It covers various medical treatments for different infertility causes like varicocele, hormonal imbalances, infections etc. It also discusses assisted reproduction techniques like IVF. Key surgical interventions covered are varicocelectomy for varicocele and testicular biopsy/sperm retrieval for azoospermia evaluation. Guidelines for varicocele treatment from organizations like ASRM are also summarized. The document appears to be slides from an academic presentation on evaluation and management of male infertility.
Role of LH supplementation in reproductive medicine - Aspire 2013Sankalp Singh
To add or not to add LH is a highly contentious issue.Here,i would be discussing role of LH supplementation in IVF cycle as per present day evidence.
Also,will be scrutinising the available studies for their reliability or lack of it.
This document summarizes research on mild versus standard ovarian stimulation protocols for in vitro fertilization (IVF) in patients with polycystic ovary syndrome (PCOS). Standard IVF protocols for PCOS patients often result in excessive ovarian response, high miscarriage rates, and risk of ovarian hyperstimulation syndrome (OHSS). Mild stimulation protocols aim to limit the number of oocytes retrieved to reduce risks, while various studies have found mild protocols achieve comparable pregnancy rates to standard protocols and have additional benefits like lower costs and greater patient comfort. The document reviews definitions of mild versus standard IVF, various mild stimulation medication options and regimens, and clinical trial results comparing outcomes between mild and standard stimulation protocols.
GnRH analogues work by initially causing a flare effect before downregulating the pituitary gland and reducing sex hormone production. They are used to treat conditions like endometriosis but can cause side effects from estrogen deficiency. Addback therapy aims to prevent these side effects by maintaining adequate estrogen levels while still treating the underlying condition. Common addback options include low-dose estrogen-progestin combinations, tibolone, bisphosphonates, and raloxifene. Ongoing research continues to explore new uses and better tolerated options for GnRH analogues and addback therapies.
GnRH agonist versus antagonist and impact on cycle outcomeSandro Esteves
This document summarizes a lecture on using GnRH agonists versus antagonists in ICSI cycles and the impact on cycle outcomes. It discusses that LH suppression is desirable in controlled ovarian stimulation to prevent premature ovulation and luteinization. While GnRH agonists were initially used for this starting in 1984, GnRH antagonists introduced in 1999 provide LH suppression without an initial flare effect and allow for a flexible treatment protocol. The summary reviews the findings that GnRH antagonists have no negative impact on estradiol levels, endometrial receptivity, or cycle parameters compared to agonists and provide a better safety profile with shorter treatment duration.
The document discusses luteal phase support (LPS) in assisted reproductive technology (ART) cycles. It notes that abnormal luteal function can occur after controlled ovarian stimulation, necessitating LPS. It reviews various LPS options including human chorionic gonadotropin and progesterone administered via different routes. Vaginal progesterone is found to effectively increase endometrial levels while intramuscular progesterone yields the highest serum levels. The document concludes that LPS is necessary to optimize ART outcomes and that intramuscular or vaginal progesterone are equally effective options.
Effective interventions in ART An overview of Cochrane Reviews 2015Aboubakr Elnashar
This document summarizes the key findings from 95 Cochrane systematic reviews on interventions for assisted reproductive technology published up to July 2015. 32 reviews identified interventions that were effective (19 interventions) or promising (13 interventions) in improving live birth or pregnancy rates. 14 reviews found interventions that were ineffective (2 interventions) or possibly ineffective (12 interventions). The reviews assessed interventions for various steps of ART including pre-ART strategies, ovarian stimulation, embryo transfer, and luteal phase support. Effective interventions included use of growth hormone, metformin, endometrial injury, and single embryo transfer. Ineffective interventions included follicular flushing and preimplantation genetic screening.
GnRH Antagonists in Controlled Ovarian StimulationSandro Esteves
This document provides an overview of a lecture on LH suppression in controlled ovarian hyperstimulation (COH) using GnRH antagonists. The key points covered include:
1) The importance of LH suppression in COH to prevent premature luteinization and improve outcomes.
2) How GnRH antagonists can be used for LH suppression compared to agonists. Clinical trials show antagonists reduce OHSS risk and duration of stimulation compared to agonists without impacting live birth rates.
3) Flexible or fixed antagonist protocols, use of oral contraceptives, and timing of hCG administration do not significantly impact outcomes. LH supplementation is generally not needed.
This document discusses subfertility, or reduced fertility, and treatments. It notes that about 25-30% of healthy couples conceive per month, with 50% conceiving within 3 months, 75% within 6 months, and 90% within a year. Subfertility is defined as no pregnancy after 12 months of unprotected sex. About 5% of couples have fertility problems and 10% may need medical treatment. Treatments discussed include tracking ovulation, hormonal therapy, treating infections, ovarian stimulation, and less than 3-5% need IVF. Male fertility can be improved with micronutrients like L-carnitine, L-arginine, and antioxidants. Better sperm quality may reduce the need for
Therapy - Intention to reestablish a physiological situation of the vagina.
How does the optimal therapy look? Reduces the sensible quantity of germs AND represses the subjective disturbances. General antimicrobial (Bacteria, Fungal, Virus). Vaginal equilibrium is established and keep alive itself. Shouldn’t cause Resistance and should be applicable as Prophylaxes.
Antibacterial mechanism of action of Propolis: DNA dependant on RNA Polymerase as follows: Bacteria are spited slowly Penetrability of cell membrane increased as follows: Bacteria get more sensitiv. The Hydroxy-cinnamon-acid inhibits reversible the Motility of Bacteria s follows: slow dissermination
Visit our Website: www.imi.co.at
The document discusses declining sperm quality and increasing DNA damage in sperm. It presents several studies that show decreases in sperm density and quality in the US, Europe and other Western countries. DNA fragmentation in sperm can negatively impact fertility, the ability to fertilize eggs, and increase risks of miscarriage. The document then summarizes a study that found supplementing with various micronutrients including L-carnitine, L-arginine, vitamin E, folic acid, zinc, selenium, glutathione and coenzyme Q10 for 3 months decreased DNA fragmentation in sperm and improved sperm quality parameters and pregnancy rates compared to a control group without supplements.
This document discusses AMH (anti-Müllerian hormone) as a marker of ovarian function for patients undergoing ovarian tissue banking for fertility preservation prior to cancer treatment. It presents results from a study measuring AMH levels in patients before and after oncological therapy. The study found a significant decrease in AMH levels after treatment in all patients. Lower post-treatment AMH levels were associated with premature ovarian failure, receipt of chemotherapy before tissue banking, lack of menstruation, and menopausal symptoms. The preliminary findings suggest AMH is a useful marker for assessing ovarian damage from cancer treatment in these patients.
This document summarizes research on cryopreserving and reimplanting whole ovaries and ovarian tissue in sheep. It describes two experiments: 1) cryopreserving and analyzing whole porcine ovaries, finding good structure preservation; and 2) cryopreserving and reimplanting whole sheep ovaries, resulting in pregnancy and live birth. The document concludes that while technically possible, whole ovary transplantation is a major procedure, but ovarian tissue or slice transplantation is easier surgically with a reduced follicle pool.
The document discusses making positive choices and good sportsmanship. It encourages choosing what will positively affect your life and not following crowds committing crimes. Good sportsmanship means thinking of your opponent with respect, while bad sportsmanship means disrespecting the opponent. The document contrasts good and bad choices, good and bad kids, and choosing right versus wrong.
Chronic of Umbilical Stem Cell Collection in Austria - Sources of stem cells - Umbilical cord blood - Quality standardsat the University Clinic Vienna PRO - Motivations for collection of umbilical cord blood
FAQ of parents: How can we use it?, How long can the cells be stored?, Can they be used for other family members?, How safe is storage ?, Where are the cells stored?
- Collection of umbilical cord blood - Einfluss der Transport- und Prozessdauer auf
die Funktionalität der Stammzellen (CFU-GM ) -
Visit our Website: www.imi.co.at
The document discusses making positive choices and good sportsmanship. It encourages choosing what will positively affect your life and not following crowds committing crimes. Good sportsmanship means thinking of your opponent with respect, while bad sportsmanship means disrespecting the opponent. The document contrasts good and bad choices, good and bad kids, and choosing right versus wrong.
This document describes a study that evaluated the effect of intravesical instillation of hyaluronic acid (HA) on the recurrence rate of uncomplicated urinary tract infections (UTIs) in women. Twenty women with a history of recurrent UTIs received weekly then monthly HA instillations for one year. Urine cultures were taken before, during, and after treatment. The results showed a reduction in both UTI recurrence rate and average number of UTIs per year after HA treatment. The recurrence rate was 35%, with most patients experiencing either one or two UTIs over the study period compared to three to five UTIs previously. This suggests intravesical HA instillation may be an effective way to prevent recurrent UT
This document discusses a study on the effects of micronutrient supplementation on male subfertility. It notes that sperm quality and male fertility have been declining. The study examined 132 men who took a daily supplement of various micronutrients for 3 months, finding a 25.8% pregnancy rate. This was higher than the 14.8% rate among the 73 men in a control group who did not take supplements. The document concludes that a lack of micronutrients may cause declining sperm quality and quality can be improved with micronutrient supplementation based on this study and others discussed.
Implementing strategic projects - A business leader's viewHendon Group, Inc.
A copy of the presentation Ira Hendon delivered to local business leaders at an Early Morning Networking Breakfast sponsored by the Illinois Lake County Chamber of Commerce on Friday, June 21, 2013.
Get the best out of your finance organisation, an introduction to Finance-For...Finance-Force AG
An introduction into Finance-Force AG, finance support from hands on individuals with experiences in both industry and big 4.
Finance-Force AG supports its clients in establishing or developing a successful financial organization. The business is divided into five divisions aligned with its offerings: Finance and Controlling, Recruitment, Corporate Finance, Board Services and Corporate Services.
A practical and implementation-oriented activity is one of the strengths of Finance-Force AG. All the staff bring a wealth of experience in leadership positions in finance functions.
Benefit from our know-how.
RCT of the effects of Metformin Vs COCs in adolescent PCOS women through a 2...Aboubakr Elnashar
This randomized controlled trial compared the effects of metformin and combined oral contraceptives (COCs) in adolescent women with polycystic ovary syndrome (PCOS) over 24 months. 119 adolescent girls were randomly assigned to receive metformin, COCs, or no treatment (control group). Both metformin and COCs significantly improved cycle regularity and hirsutism compared to the control group. However, metformin was associated with significant improvement in insulin sensitivity, while COCs deteriorated insulin sensitivity. The study concludes that metformin and COCs have comparable effects on symptoms, but metformin may have metabolic advantages in adolescent PCOS patients.
This document summarizes key developments in the history of gonadotropin-releasing hormone (GnRH) and its clinical applications:
1. Major milestones from the 1920s-1980s include the discovery and extraction of pituitary hormones, the isolation of GnRH, and the development of in vitro fertilization.
2. GnRH analogs like leuprolide and cetrorelix are now used for conditions like endometriosis, uterine fibroids, and fertility treatment to suppress hormone levels. GnRH antagonists allow shorter IVF cycles but currently have lower pregnancy rates than agonists.
3. Continuous GnRH agonist/antagonist administration produces an anti-reproductive
This document summarizes the history and development of gonadotropin-releasing hormone (GnRH) and its analogues used in fertility treatment and other medical conditions. Key events include the isolation of GnRH in 1971, development of GnRH agonists and antagonists in the 1970s, and first uses of GnRH analogues for in vitro fertilization in the 1980s. The document also describes the structure, function and clinical uses of follicle-stimulating hormone, luteinizing hormone, and various GnRH analogues.
Medical management of dub – new modalities dr. jyoti bhaskar lecture 4Lifecare Centre
This document discusses treatment options for dysfunctional uterine bleeding (DUB). It begins by defining heavy menstrual bleeding and noting the goals of treatment. It recommends a woman-centered approach. The NICE guidelines recommend levonorgestrel-releasing intrauterine system (LNG-IUS) as first-line treatment, followed by tranexamic acid or NSAIDs as second-line options. Third-line includes oral or injected progestogens. It also discusses the use of oral contraceptives, progestational agents like medroxyprogesterone acetate, and the potential role of selective estrogen receptor modulators like ormeloxifene. Surgical and medical management are compared.
This document discusses the 25-year treatment of a patient with metastatic carcinoid tumor to the liver through various interventions including surgery, chemotherapy, radiation therapy, and more. It provides details on the progression of the disease and treatments over time, highlighting that interventional oncology can provide durable therapies to control liver metastases when integrated with other treatments. Combining liver-directed and systemic therapies may further improve long-term outcomes but requires additional study.
This document discusses medical management options for dysfunctional uterine bleeding (DUB). It begins by defining DUB and outlining treatment goals of controlling bleeding, correcting related conditions, preventing recurrence, and improving quality of life. First line treatment is recommended to be a levonorgestrel-releasing intrauterine system. Other options discussed include tranexamic acid, NSAIDs, combined oral contraceptives, and various progestogen therapies. Ormeloxifene is presented as an ideal selective estrogen receptor modulator for DUB due to its tissue-specific effects and safety profile. Studies demonstrate its effectiveness in reducing bleeding and improving outcomes for women with DUB.
IVF stimulation protocol- Agonist and antagonistpayalagrawal57
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Dr. Sharda Jain, Dr. Jyoti Agarwal, and Dr. Jyoti Bhaskar presented an interactive session on the medical management of dysfunctional uterine bleeding (DUB) in 2014. Ormeloxifene, a selective estrogen receptor modulator, was discussed as a non-steroidal treatment option for DUB that has shown efficacy in several pilot studies and randomized controlled trials. Ormeloxifene has advantages of a convenient dosing schedule and few side effects, and has been used to successfully treat over 700 patients with DUB. Feedback was encouraged from participants on experiences treating DUB.
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1. Clinical Action and Safety of
Red Clover Isoflavones
Martin Imhof
General Public Teaching Hospital
Korneuburg/Vienna
Medical University - Vienna
2. • Million Women Study Collaborators.
Breast cancer and hormone-
replacement therapy in the Million
Women Study. Lancet 2003; 362:419-
27
• Women´s Health Initiative (WHI) Study
– Interrupted due to severe side
effects
5. Are Red Clover Isoflavones
Effective ?
A Double Blind, Randomized,
Placebo-controlled
Cross-Over Study
6. Week 12Week 4 Week 8
-25
-20
-15
-10
-5
0
PercentageReductioninHot
Flushes
Placebo
Active
Baber RJ, et al. Climacteric 1999
Effect of 40 mg red clover extracts over No.
Daily hot flashes and Greene Scores (n=51
postmenopausal)*
*RDBPC study
7. Tice JA, et al. JAMA 2003
Effect of 80 mg vs. 57 mg red clover extracts vs
placebo over No. hot flashes freq and Greene
Scores (n=252 postmenopausal)*
*ICE study (RDBPC)
After 12 weeks:After 12 weeks:
80 mg RCE (n=84): 41% reduction80 mg RCE (n=84): 41% reduction
57 mg RCE (n=83): 34%.57 mg RCE (n=83): 34%.
Placebo (n=85): 36% (p > 0.05).Placebo (n=85): 36% (p > 0.05).
8. Van Weijer PH, et al. Maturitas 2002
Effect of 80 mg red clover extracts vs
placebo over hot flashes frequenz and
Greene Scores (n=30 postmenopausal)*
4 weeks placebo run in phase4 weeks placebo run in phase
(16% reduction).(16% reduction).
After 12 weeks:After 12 weeks:
Red clover reduced hot flashesRed clover reduced hot flashes
freq 44%.freq 44%.
Placebo no further reduction.Placebo no further reduction.
*RDBPC study
9. • Placebo-controlled, cross-over, double-blind, randomized
• 113 menopausal women, 109 finished this study
• 25 weeks
• 80 mg isoflavones daily (2 capsules of menoflavon)
• Within the 25 weeks 4 examinations
• Start: November 2002 - End: February 2005
Menoflavon Study 80mg isoflavones /d
of red clover – clinical trial Austria
10. Examinations and questionnaires
Kupperman scoreKupperman score (index before start >15)(index before start >15)
Changes inChanges in blood serum levelsblood serum levels (T, E2, FSH, LH,(T, E2, FSH, LH,
SHBG, HDL, LDL, Triglycerides, Lpa, Cholesterol)SHBG, HDL, LDL, Triglycerides, Lpa, Cholesterol)
Effects on theEffects on the endometriumendometrium Vaginal smearVaginal smear
(cytodiagnosis)(cytodiagnosis)
Urine-analysisUrine-analysis (urinary excretion of isoflavones)(urinary excretion of isoflavones)
Depressions scaleDepressions scale after Zerssenafter Zerssen
Hospital Anxiety and Depression Scale (Hospital Anxiety and Depression Scale (HADS-DHADS-D))
Observation studyObservation study: effects of menoflavon on skin, hair,: effects of menoflavon on skin, hair,
nails and libido, vaginal atrophy….nails and libido, vaginal atrophy….
11. Demographic and anamnestic data
Group A
(n=50)
Group B
(n=59)
Overall
(n=109)
Mean age (yrs.) 54.5 ± 6.2 53.7 ± 7.8 53.5 ± 7.1
Mean BMI 24.5 ± 3.9 24.9 ± 3.9 24.7 ± 3.9
Hysterectomy (%) 18.0 13.6 15.6
14. Hot flushes, Boxplots-comparison
Hot flushes were reduced significantly
with MF11RCE (p<0,001)
No effect under Placebo
before after
MF11RCE
before after
Placebo
16. Sleeping behavior - Boxplots-comparison
before after
MF11RCE Placebo
afterbefore
Sleeping behavior improved high
significantly with MF11RCE (p<0,001)
No effect under Placebo
18. Baseline measures
Group A
(n=50)
Group B
(n=59)
Overall
(n=109)
E2
(pg/ml) 36.30 38.31 37.39
T (ng/ml) 0.43 0.63 0.54
LH (mIU/ml) 30.64 29.92 30.25
FSH (mlU/ml) 60.31 60.45 60.38
SHBG (nmol/l) 61.44 57.69 59.41
Group A
(n=41)
Group B
(n=51)
Overall
(n=92)
Endometrium
(mm)
4.3 3.4 3.8
Data are presented as mean values.
19. Wilcoxon-test MF11RCE vs. placebo
N Negative
Ranks
Positive
Ranks
p
E2 109 40 43 0,8610,861
T 109 61 36 0.003
LH 109 64 44 0.861
FSH 109 62 47 0.069
SHBG 109 58 51 0.824
ET 92 15 45 0.001
23. Maturitas. 2006 Aug 20;55(1):76-81.
Effects of a red clover extractEffects of a red clover extract (MF11RCE(MF11RCE))
onon endometriumendometrium and sex hormones inand sex hormones in
postmenopausal women.postmenopausal women.
Martin Imhof, Anca Gocan, Franz Reithmayr, Markus Lipovac,Martin Imhof, Anca Gocan, Franz Reithmayr, Markus Lipovac,
Claudia Schimitzek4, Johannes HuberClaudia Schimitzek4, Johannes Huber
24. Results clinical study - 80 mg
isoflavones – 113 women Austria
Testosterone levels increasedTestosterone levels increased significantly (p=0,021) Wilcoxon testsignificantly (p=0,021) Wilcoxon test
with MF11RCE, no significant change with placebowith MF11RCE, no significant change with placebo
Endometrium thicknessEndometrium thickness waswas reducedreduced withwith MF11RCE (p<0.001)MF11RCE (p<0.001)
Climacteric symptomsClimacteric symptoms as evaluated withas evaluated with Kupperman index wasKupperman index was
reducedreduced in general (p<0.001) with MF11RCE treatment.in general (p<0.001) with MF11RCE treatment.
o Hot flushes and sweating were reducedHot flushes and sweating were reduced statistically significantlystatistically significantly
(p<0.001)(p<0.001)
o Sleeping behavior improvedSleeping behavior improved highly significanthighly significant (p<0.001)(p<0.001)
o DepressionDepression andand nervousnessnervousness were significantly reduced (p<0.001)were significantly reduced (p<0.001)
o Lack of concentrationLack of concentration was significantly reduced (p<0.001)was significantly reduced (p<0.001)
EstradiolEstradiol,, FSHFSH andand LHLH plasmaplasma levels did not change significantlylevels did not change significantly
comparing both groupscomparing both groups
25. Design clinical study - 80 mg
isoflavones – 60 women Ecuador
Double-blind, placebo controlled, randomized, cross-overDouble-blind, placebo controlled, randomized, cross-over
90 days 2 capsules menoflavon/day - wash out - 90 days90 days 2 capsules menoflavon/day - wash out - 90 days
Placebo resp. vice versaPlacebo resp. vice versa
60 women, average age: 51,3 years60 women, average age: 51,3 years
Inclusion criteria: Kupperman-Index ≥15, no HRT,..Inclusion criteria: Kupperman-Index ≥15, no HRT,..
3 examinations (at the beginning, after 90 days, end)3 examinations (at the beginning, after 90 days, end)
Kupperman-Index, lipids, hormone levels (E2, FSH, LH,Kupperman-Index, lipids, hormone levels (E2, FSH, LH,
Testosterone, SHBG, Lipoprotein a), vaginal cytologyTestosterone, SHBG, Lipoprotein a), vaginal cytology
26. Effect of 80 mg red clover extracts over
Kupperman scoring after 3 months (n=53
postmenopausal)
Hidalgo L, Chedraui P, et al. Gynecol Endocrinol, 2005, In press
0
5
10
15
20
25
30
baseline red clover placebo
baseline red clover placebo
27. The effect of red clover supplementation over lipid profile
a
vs. baseline; b
vs. red clover phase; * p < 0.05;
Parameter
Baseline
n=53
After isoflavone
supplementation n=53
After placebo
n=53
Total cholesterol
(mg/dL)
223.9 ± 37.6
214 ± 32.2 a
* 220.4 ± 34.1 b
HDL-C (mg/dL)
39.7 ± 11.5
40 ± 9.6 a
41.1 ±10 b
LDL-C (mg/dL)
146.8 ± 29.9
129.7 ± 39.4 a
* 140 ± 35.2 b
Triglycerides
(mg/dL)
199.6 ± 77.8
181.1 ± 72.3 a
* 242.7 ± 166.9 b
*
Lipoprotein A
(mg/dL)
41.2 ± 36.9
22.8 ± 26.9 a
* 20.5 ± 25.8 b
Hidalgo L, Chedraui P, et al. Gynecol Endocrinol, 2005, In press
28. The effect of red clover supplementation over hormonal profile
Parameter
Baseline
n=53
After isoflavone
supplementation n=53
After placebo
n=53
SHBG (nmol/L) 50.1 ± 23.7 46.9 ± 21.9 a
49 ± 22 b
FSH (mIU/mL)
63.7 ± 22.6 63.3 ± 26.1 a
62.6 ± 22.1 b
LH (mIU/mL) 27.7 ± 13.8 30.8 ± 13.4 a
28.7 ± 14 b
17 β estradiol
(pg/mL)
23.8 ± 8.8 22.4 ± 7.2 a
20.9 ± 4.6 b
Testosterone
(ng/dL)
24.8 ± 11.2
21.4 ± 5 a
23.2 ± 11.3 b
Hidalgo L, Chedraui P, et al. Gynecol Endocrinol, 2005, In press
29. Results clinical study - 80 mg
isoflavones – 60 women Ecuador
No significant effect on BMI, weight and blood pressure inNo significant effect on BMI, weight and blood pressure in
both groupsboth groups
significant effect on Kupperman-Index, lipidssignificant effect on Kupperman-Index, lipids
Compared to placebo menoflavon significantly decreased:Compared to placebo menoflavon significantly decreased:
• menopausal symptoms, like:menopausal symptoms, like:
• hot flushes, night sweats, sleeping disorders,hot flushes, night sweats, sleeping disorders,
nervousness, depression, dizziness, ....nervousness, depression, dizziness, ....
• Triglyceride levelTriglyceride level
menoflavon had a positive effect over the vaginamenoflavon had a positive effect over the vagina
30. CONCLUSIONS
80 mg (MF11RCE) Red Clover does80 mg (MF11RCE) Red Clover does
significantly decrease menopausal complaintssignificantly decrease menopausal complaints
80 mg (MF11RCE) Red Clover significantly80 mg (MF11RCE) Red Clover significantly
influences Testosterone level andinfluences Testosterone level and
Endometrium thicknessEndometrium thickness
The action of MF11RCE on MCF 7 and HumanThe action of MF11RCE on MCF 7 and Human
Endothelial Breast Cells does not show a riskEndothelial Breast Cells does not show a risk
of tumour induction in analysis of geneof tumour induction in analysis of gene
activationactivation
34. Experiment 1
Cells:
- MCF-7 mamma carcinoma cell line
Phytohormones:
- Red clover - Trifolium pratense, (MF11RCE)
- “synthetic” Genistein and Daidzein (Indofine).
Technology:
- 20K Chip arrays (Affymetrix)
35. Experimental design:
MCF-7 were examined after
12 and 24 hours.
Experimental groups:
- untreated cells
- combination of genistein plus daidzein
(2,5 µg/ml each)
- red clover extract (5 µg/ml)
36.
37. Flowchart of experimental analysis
c-DNA
Scan Hybridize
(16 hours)
mRNA
IVT
(Biotin-UTP
Biotin-CTP)
Labeled fragments
L L
L
L
Cells
38. Comparison of the mRNA expression pattern in MC-F7
cells stimulated with red-clover extract with that of
daidzin and genestin stimulated cells.
22.000 genes were screened by DNA array and for each gene 11 oligos for
perfect match and 11 oligos for mismatch are analyzed. Therefore a total of
500.000 spots were quantitatively analyzed.
39. Results
A significant increase (>2times) in mRNA expression
induced by phytohormones was seen for 117 genes.
The functional repertoire of these genes cover
-Growth arrest genes
-DNA repair genes
(GADD34)
-Growth factors
(insulin-like growth factor binding protein 4)
42. Results
THE GENES DIFFERENTIALLLY UP-REGULATED BY
SYNTHETIC PHYTOESTROGENS ARE
“METALLOTHIONEINS” (MT)
AND ARE BELIVED TO PLAY AN ROLE IN
TUMORGENESIS.
44. Conclusion
Application of red clover and synthetic
phytohormones causes a transcriptional
regulation of 117 genes in MCF-7.
The effect of synthetic Daidzein/Genistein differs
significantly from that of red clover by
upregulation of transcription of 10 genes
(Metallothionins).
This first results do not implicate a major
influence of red clover on the proliferation or
differentiation of MCF-7 cells.
46. Experiment 2
Pooled sera of 5 menopausal women . Before and
after intake of MF11RCE (menoflavon) for 3 month
• Control group = before intake of MF11RCE
• Treatment group = after intake of MF11RCE
48. Regulation of Transcription
• MF11RCE inhibits the expression of
transcriptional genes
(TCF4,TCF7L2,MAFB,MXI1,ID4,HOP,BTF3,BAZ1A)
and genes in relation to ribosomal subunit
joining and the initiation of translation
(EIF3S5, EIF4EBP, RPL29,RPS16)
= MF11RCE can influence cell proliferation and
differentiation by down regulation of cellular
transcription and translation
49. Genes involved in regulation
of DNA
0
100
200
300
400
500
600
G
M
N
N
H
2AFV
H
IST1H
2
H
M
G
B2
M
C
M
5
PC
N
A
PR
K
D
C
PR
M
1
Gene
Estimat
control
treatment
50. Genes involved in regulation of
DNA
• MF11RCE down regulates genes
involved with DNA replication.
(GMNN,H2AFV,HIST1H2,HMGB2,MC5,PCNA,PRKDC
,RM1)
= MF11RCE has an anti-proliferative
effect through inhibition of DNA
replication
52. Apoptosis
• MF11RCE induces Expression of
(AFURS1, ENC1/PIG10 p53 induced gene 10)
and inhibits Porimin
= MF11RCE can rise the p53 level
(ENCI/PIG10) and activate
apoptosis.
= MF11RCE can induce senescence
(AFURS1)
53. Regulation of cell proliferation
0
200
400
600
800
1000
1200
JAG
1
RARR
ES
VEG
F
M
ET
genes
signalestimates
control
treatment
54. Regulation of cell
proliferation
• MF11RCE inhibits JAG1,RARRES,
VEGF,MET. (cell proliferation)
and cell differentation (Keratin 10,
Keratin 19).
= MF11RCE inhibits genes of
cell-proliferation and cell-
differentation
55. In a culture of primary mammae epithelial
cells MF11RCE down regulates genes for
–Transcription and translation
–Protein synthesis
–DNA replication
–Cell proliferation
and up regulates genes for
–Apoptosis
56. Conclusion
MF11RCE seems not to be
inductive for tumor and/or tumor
growth in a healthy mamma
epithelial cells culture.
Further study are necessary to
improve if Isoflavones can
protect against tumor
development an/or tumor growth
57. • Georg Steiner
• Michael Loeffler
• Anka Gocan
• Marianne Imhof
• Kristian Hrachowitz
• Sylvia Molzer
• Markus Lipovac
• Johannes Huber
Editor's Notes
Ladies and Gentlemen, dear Chairman
Recently two major studies Point out the risk
Baber: Climacteric 1999 : randomized double blind placebo controlled crossover trial 51 women placebo or 40mg red clover isoflavone for 12 weeks percentage reduction in hot flashes measured at 4 weeks, 8 weeks and 12 weeks initial reduction in hot flashes at 4 and 8 weeks, no difference at 12 weeks negative result or ?
Baber: Climacteric 1999 : randomized double blind placebo controlled crossover trial 51 women placebo or 40mg red clover isoflavone for 12 weeks percentage reduction in hot flashes measured at 4 weeks, 8 weeks and 12 weeks initial reduction in hot flashes at 4 and 8 weeks, no difference at 12 weeks negative result or ?
Baber: Climacteric 1999 : randomized double blind placebo controlled crossover trial 51 women placebo or 40mg red clover isoflavone for 12 weeks percentage reduction in hot flashes measured at 4 weeks, 8 weeks and 12 weeks initial reduction in hot flashes at 4 and 8 weeks, no difference at 12 weeks negative result or ?