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Vaginal progesterone

Siddhidatri Mishra, Rashmi Bagga, Jasvinder Kalra, Vanita Jain, Sourabh Dutta
Women (n = 300) at 'low risk' for a preterm birth (PTB), a singleton pregnancy and for a 16-24 week period of gestation (POG) were randomised to undergo cervical length (CL) measurement by transvaginal sonography (TVS) or not. The aim was to see if routine CL measurement and treatment of a short CL reduced the PTB rate. 'Low risk' was defined by an absence of a prior abortion or PTB of a singleton infant (>16 to <37 weeks) due to a spontaneous preterm labour (PTL) or a preterm pre-labour rupture of membranes (pPROM)...
March 14, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Athena P Souka, Ioannis Papastefanou, Athanasios Pilalis, Dimitrios Kassanos, George Papadopoulos
OBJECTIVES: To assess the feasibility and the results of introducing a policy of universal screening for preterm delivery. METHODS: Transvaginal sonography for cervical length (CL) measurement was performed at 20-24 weeks of gestation. Vaginal progesterone therapy was offered to women with CL ≤ 15mm. RESULTS: 10,969 singleton pregnancies were assessed. The decline rate was 1.32%. Spontaneous preterm delivery at less than 32 weeks (SPD32), less than 34 weeks (SPD34) and less than 37 weeks (SPD37) occurred in 0...
March 14, 2018: Ultrasound in Obstetrics & Gynecology
D A Davey
Major advances in menopause hormone therapy (MHT) hold promise in the future of better and safer care for women at and after the menopause. The principal advances are: (1) the critical window or 'window of opportunity' in the 10 years or so after the menopause, during which the benefits of MHT in healthy women exceed any risks; (2) use of transdermal instead of oral administration of estrogen to reduce the risk of venous thromboembolism; (c) investigation of the use of oral micronized progesterone (MP) and vaginal MP to prevent endometrial hyperplasia and carcinoma without any increased risk of breast cancer and venous thromboembolism in postmenopausal women receiving estrogens; vaginal MP prevents endometrial proliferation in the short term but the long-term effects in MHT remain to be established; (4) investigation into the use of intrauterine levonorgestrel-releasing devices (LNG-IUDs), which are an attractive form of MHT in perimenopausal women, providing contraception and reducing uterine bleeding, although the risk of breast cancer with LNG-IUDs requires clarification...
March 11, 2018: Climacteric: the Journal of the International Menopause Society
Jabbar Abbas Ahmed Al-Saaidi, Khalisa Khadim Khudair, Sura Safe Aubaes Al-Kafaji
Objective: The present study was conducted to investigate the impacts of active and passive immunization against synthetic inhibin and steroid-free bovine follicular fluid, respectively, on reproductive fecundity out of breeding season in Iraqi Awassi ewes. Methods: Follicular fluid was aspired from mature bovine follicles, treated with activated charcoal, and used for immunization of male rabbits for obtaining steroid free bovine follicular fluid (SFBFF) antiserum...
March 2, 2018: Asian-Australasian Journal of Animal Sciences
Marina Wanderley Paes Barbosa, Natália Paes Barbosa Valadares, Antônio César Paes Barbosa, Adelino Silva Amaral, José Rubens Iglesias, Carolina Oliveira Nastri, Wellington de Paula Martins, Hitomi Miura Nakagawa
OBJECTIVE: To identify, appraise, and summarize the evidence from randomized controlled trials (RCTs) comparing oral dydrogesterone to vaginal progesterone capsules for luteal-phase support (LPS) in women offered fresh or frozen embryo transfers following in vitro fertilization. METHODS: Two independent authors screened the literature for papers based on titles and abstracts, then selected the studies, extracted data, and assessed the risk of bias. Dydrogesterone and progesterone were compared based on risk ratios (RR) and the precision of the estimates was assessed through the 95% confidence interval (CI)...
February 28, 2018: JBRA Assisted Reproduction
Daniëlle Peterse, Katrien De Clercq, Chloë Goossens, M Mercedes Binda, F O Dorien, Philippa Saunders, Joris Vriens, Amelie Fassbender, Thomas M D'Hooghe
BACKGROUND: To induce endometrial decidualization in rodents, an intrauterine oil stimulus can be delivered via the nontraumatic vagina or via the traumatic laparotomy. However, there is considerable variation in amount of decidualization using these inducing methods. Therefore, we studied which oil delivery route could achieve the highest rate of endometrial decidualization along the full length of both uterine horns. METHODS: To induce decidualization, ovariectomized C57Bl/6J mice were injected with estrogen (100 ng/day; 3 days)...
January 1, 2018: Reproductive Sciences
M Christine Livergood, Amanda Trudell
No abstract text is available yet for this article.
November 1, 2017: American Family Physician
Marcelo H Santos, Marcos Vinicius C Ferraz Junior, Daniel M Polizel, José Paulo R Barroso, Alexandre A Miszura, André S Martins, Analisa V Bertoloni, Gabriela B Oliveira, Alexandre V Pires
This study aimed to evaluate the effects of decreasing permanence period of progesterone (P4) inserts from 9 (9d) to 7 (7d) days in timed-AI (TAI) protocol, as well as their reuse on pregnancy per AI (P/AI) during 7d protocol. At the beginning of all protocols, cows received 2 mg of estradiol benzoate (EB) and a vaginal insert containing 1.9 g of P4. In the 7d protocol, the P4 insert was removed, and cows were given 25 mg of prostaglandin F2α, 0.6 mg of estradiol cypionate and 300 IU of eCG 7 days later...
January 31, 2018: Theriogenology
Stuart Campbell
No abstract text is available yet for this article.
February 2018: American Journal of Obstetrics and Gynecology
Joann V Pinkerton, Andra H James
For women at elevated risk of thrombosis, clinicians are challenged to relieve menopausal symptoms without increasing the risk of thrombosis. Oral menopausal hormone therapy increases the risk of venous thromboembolism by 2-fold to 3-fold. Observational studies suggest less thrombotic risk with transdermal therapies and with progesterone over synthetic progestogens (progestins), but the data are limited. Beneficial nonpharmacologic therapies include cognitive behavioral therapy and clinical hypnosis, whereas beneficial nonhormonal pharmacologic therapies include selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors...
February 6, 2018: Clinical Obstetrics and Gynecology
Francis Brako, Bahijja Tolulope Raimi-Abraham, Suntharavathanan Mahalingam, Duncan Q M Craig, Mohan Edirisinghe
Recent evidence has continued to support the applicability of progesterone in preventing preterm birth, hence the development of an appropriate vaginal delivery system for this drug would be of considerable interest. Here, we describe the development of progesterone-loaded bioadhesive nanofibers using pressurized gyration for potential incorporation into a vaginal insert, with a particular view to addressing the challenges of incorporating a poorly water-soluble drug into a hydrophilic nanofiber carrier. Polyethylene oxide and carboxymethyl cellulose were chosen as polymers to develop the carrier systems, based on previous evidence of their yielding mucoadhesive nanofibers using the pressurized gyration technique...
February 2, 2018: International Journal of Pharmaceutics
Saumya RamaRao, Francis Obare, Salisu Ishaku, Babacar Mané, Heather Clark, Wilson Liambila, Godwin Unumeri, Harriet Birungi, Nafissatou Diop, Deepa Rajamani, John Townsend
The progesterone vaginal ring (PVR) is a contraceptive designed for use by breastfeeding women in the first year postpartum. This Report presents results of an acceptability study of the PVR in Kenya, Nigeria, and Senegal. Women seeking postpartum family planning services were offered various contraceptive options including the PVR. Of the 174 participating women, 110 (63 percent) used one ring and 94 (54 percent) completed the study by using two rings over a six-month period. Women were interviewed up to three times: at the time they entered the study, at 3 months (the end of the first ring cycle), and at 6 months (the end of the second ring cycle or when they exited if they had discontinued earlier)...
February 2, 2018: Studies in Family Planning
P Stute, L Wildt, J Neulen
Postmenopausal women with an intact uterus using estrogen therapy should receive a progestogen for endometrial protection. The debate on bioidentical hormones including micronized progesterone has increased in recent years. Based on a systematic literature review on the impact of menopausal hormone therapy (MHT) containing micronized progesterone on the mammary gland, an international expert panel's recommendations are as follows: (1) estrogens combined with oral (approved) or vaginal (off-label use) micronized progesterone do not increase breast cancer risk for up to 5 years of treatment duration; (2) there is limited evidence that estrogens combined with oral micronized progesterone applied for more than 5 years are associated with an increased breast cancer risk; and (3) counseling on combined MHT should cover breast cancer risk - regardless of the progestogen chosen...
January 31, 2018: Climacteric: the Journal of the International Menopause Society
Junhui Fu, Xiang Yu, Yiguang Jin
Vaginal rings are gynecological drug delivery devices with fixed shapes, sizes and drug doses. Here 3D printed personalized progesterone-loaded vaginal rings were prepared. Progesterone was mixed with polyethylene glycol (PEG) 4000 to form a solid dispersion that was cut into pieces. The mixture of poly(lactic acid) (PLA)/polycaprolactone (PCL) (8:2) and Tween 80 were mixed with the above pieces and hot-melted to form filaments. A fused deposition modeling (FDM) printer was used to prepare "O", "Y" or "M"-shaped vaginal rings with the filaments...
January 21, 2018: International Journal of Pharmaceutics
Jun-Mo Kim, Yoo Jin Park
Bacterial vaginosis (BV) and complicated vulvovaginal candidiasis (VVC) are frequently occurring vaginal infections in postmenopausal women, caused by an imbalance in vaginal microflora. Postmenopausal women suffer from decreased ovarian hormones estrogen and progesterone. A normal, healthy vaginal microflora mainly comprises Lactobacillus species (spp.), which act beneficially as a bacterial barrier in the vagina, interfering with uropathogens. During premenopausal period, estrogen promotes vaginal colonization by lactobacilli that metabolizing glycogen and producing lactic acid, and maintains intravaginal health by lowering the intravaginal pH level...
December 2017: Journal of Menopausal Medicine
Kate Devine, Kevin S Richter, Eric A Widra, Jeffrey L McKeeby
OBJECTIVE: To assess the noninferiority of vaginal P (Endometrin) compared with daily intramuscular P for replacement in programmed vitrified-warmed blastocyst transfer cycles and to assess the noninferiority of vaginal P in combination with intramuscular progesterone every third day compared with daily intramuscular P. DESIGN: Three-arm randomized controlled noninferiority study. To enable early recognition of inferiority if present, an a priori interim analysis was planned and completed once ongoing pregnancy data were available for 50% of the total enrollment goal...
January 12, 2018: Fertility and Sterility
Rodopiano S Florêncio, Melaynne S B Meira, Marcos V da Cunha, Mylena N C R Camarço, Eduardo C Castro, Marta C C F Finotti, Vinicius A de Oliveira
OBJECTIVE: To evaluate the predictive efficiency of serum estradiol (E2) concentration in the mid-luteal phase regarding chemical, clinical, and ongoing pregnancies, in patients subjected to IVF/ICSI with fresh embryo transfer. METHODS: One hundred and forty-three patients undergoing IVF/ICSI met all the inclusion criteria for the present study. Most of the patients used antagonists, final maturation was achieved with recombinant chorionic gonadotrophin (HCG), and embryo transfer took place on days 3 to 5, but mostly on day 4...
January 16, 2018: JBRA Assisted Reproduction
N G Shashikumar, R K Baithalu, S Bathla, S A Ali, P Rawat, A Kumaresan, S Kumar, B R Maharana, G Singh, D S Puneeth Kumar, S K Singh, S S Lathwal, L Jaiswal, T K Mohanty, A K Mohanty
Accurate and efficient detection of estrus is one of the major constraints for exploitation of the production potential of buffalo owing to its poor manifestation of estrus signs, seasonal differences in expression and higher incidences of silent estrus (29%). The current study focused on identification of estrus specific candidate proteins in saliva of buffaloes. Estrus was detected based on behavioral signs in response to the teaser and changes in reproductive organs and confirmed by per-rectal examination, trans-rectal USG of reproductive organs, cervico-vaginal mucus characteristics and blood serum progesterone estimation...
January 9, 2018: Theriogenology
Miha Lucovnik, Andreja Trojner Bregar, Lea Bombac, Ksenija Gersak, Robert E Garfield
AIM: The effectiveness of vaginal progesterone for maintenance tocolysis after arrested preterm labor remains controversial. Myometrial contractility can be assessed objectively and non-invasively after progesterone treatment by monitoring uterine electromyography (EMG). We examined the effects of vaginal progesterone on uterine EMG after successful acute tocolysis. METHODS: This was a randomized, double-blind, single-center study performed between 2012 and 2015...
January 3, 2018: Journal of Obstetrics and Gynaecology Research
Gabriele Saccone, Giuseppe Maria Maruotti, Antonia Giudicepietro, Pasquale Martinelli
Importance: Spontaneous preterm birth is a major cause of perinatal morbidity and mortality. It is unclear if a cervical pessary can reduce the risk of spontaneous preterm delivery. Objective: To test whether in asymptomatic women with singleton pregnancies and no prior spontaneous preterm birth but with short cervical length on transvaginal ultrasound, use of a cervical pessary would reduce the rate of spontaneous preterm birth at less than 34 weeks of gestation...
December 19, 2017: JAMA: the Journal of the American Medical Association
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