Endocrine Abstracts

Background: Recurrent pregnancy loss (RPL) affects 1–2% couples, and is defined as ≧3 consecutive pregnancy losses before 20-weeks’ gestation. RPL is caused by foetal chromosomal abnormalities, or maternal factors such as thrombophilia. It was recently reported that men with RPL have high levels of sperm DNA fragmentation (a marker of infertility); however, the cause of this damage is currently not known. Seminal plasma has high levels of granulocyte-derived o...

Background: Recurrent pregnancy loss (RPL) affects 1–2% couples, and is defined as ≧3 consecutive pregnancy losses before 20-weeks’ gestation. RPL is caused by foetal chromosomal abnormalities, or maternal factors such as thrombophilia. It was recently reported that men with RPL have high levels of sperm DNA fragmentation (a marker of infertility); however, the cause of this damage is currently not known. Seminal plasma has high levels of granulocyte-derived o...

Introduction: Free ionised calcium is the biologically active component of total circulating calcium but is infrequently measured due to sampling requirements. Therefore, total calcium is ‘adjusted’ for albumin to provide a closer estimate of the biologically active ionised calcium level (e.g. James, Orell, Payne and Berry formulae). Here, we aim to derive a novel equation to estimate ionised calcium from readily available biochemical parameters and compare its perfo...

Background: Due to practical limitations, the diagnosis of hypogonadism is predominantly based on a single measure of reproductive hormones, often with confirmation on a second occasion. Factors associated with reproductive hormone variation include: pulsatile secretion, diurnal rhythm, and food intake, which can affect the accuracy of diagnosis of reproductive disorders. There is limited data quantitatively estimating the variability of reproductive hormone levels over the da...

Background: Non-alcoholic liver disease (NAFLD) affects up to 30% of adults worldwide. With the prevalence of NAFLD increasing after menopause, women aged >55 years are more likely to progress to advanced fibrosis than men. Moreover, liver decompensation secondary to NAFLD is more frequent in women compared to men. However, the causes of these differential outcomes are not fully understood.Methodology: We performed a retrospective cohort study utilis...

Introduction: Selective oestrogen receptor modulators (SERMs) and aromatase inhibitors (AIs) potentially increase endogenous gonadotrophin and testosterone secretion in men. They are used off-label in men with hypogonadism and/or infertility. There is a lack of guidance on using these agents in men with secondary hypogonadism, though these agents are widely used in these people as a cheaper alternative to gonadotrophins. Methods: Systematic search was co...

Section 1: Case history: A 19-year-old British-Asian man presented with a two-year history of gynaecomastia. He had no other symptoms of hypogonadism. He had an unremarkable past medical history, did not take any regular medications and denied the use of any illicit drugs. There was a family history of consanguinity, with his parents being first cousins. On examination, his BMI was 28 kg/m2 and he had post-pubertal-sized testes (20 ml) with normal secondary sexual c...

Background: Successful reproduction relies on integration of sensory cues of attraction with corresponding emotions and behaviours. However, the intrinsic factors integrating these fundamental aspects of human attraction with limbic and reproductive pathways have not been fully identified. Kisspeptin is a crucial activator of the reproductive axis and together with its receptor is widely expressed throughout the limbic and olfactory systems in humans suggesting a potential rol...

Case: A 19-year-old British-Asian man presented with a two-year history of gynaecomastia. He had no other symptoms of hypogonadism. On examination, BMI was 28 kg/m2 and he had post-pubertal-sized testes (20 ml) with normal secondary sexual characteristics. Hypogonadism was confirmed by two morning fasting total testosterone levels of 4.7 and 5.2 (RR 9.2–31.6 nmol/l). Haemoglobin was normal (152 g/l) and serum oestradiol was <100 pmol/l. He had inappropriate...

Background: During IVF treatment, a pharmacological dose of recombinant FSH (rFSH) is used to induce multi-follicular growth (controlled ovarian stimulation; COS). An insufficient dose of rFSH negatively impacts the number of oocytes retrieved, whereas an excessive dose risks the potentially life-threatening complication ‘ovarian hyperstimulation syndrome’. Hence, appropriate rFSH dosing is regarded as a key treatment decision affecting both the success and safety of...