Carina C.W. Chan

Effects of chinese green tea on weight, and hormonal and biochemical profiles in obese patients with polycystic ovary syndrome : A randomized placebo-controlled trial

Objectives: To study the effects of green tea on body weight, and biochemical and hormonal profiles in obese Chinese women with polycystic ovary syndrome (PCOS). Methods: Thirty-four obese Chinese women with PCOS were randomized into either treatment with green tea capsules or placebo for 3 months. The anthropomentric measurements, and biochemical and hormonal profiles before and after treatment in each group were compared. Results: The body weight of the green tea group decreased by a nonsignificant 2.4% after treatment; whereas the body weight, body mass index (BMI), and body fat content of the control group were significantly higher after 3 months. There were no differences in any of the hormone levels measured in either group. The biochemical profiles of the two groups were also similar except that there was a small but significant rise in the triglyceride level in the green tea group. Fewer patients in the green tea group remained amenorrhoeic, but this was not significantly different from the control group. Conclusions: Green tea supplementation did not significantly reduce body weight in obese women with PCOS, nor did it alter the glucose or lipid metabolism.

Comparison of three‐dimensional hysterosalpingo‐contrast‐sonography and diagnostic laparoscopy with chromopertubation in the assessment of tubal patency for the investigation of subfertility

Background.u2002 Two‐dimensional hysterosalpingo‐contrast‐sonography, as a screening test for tubal patency for subfertile patients, is limited by the difficulty in visualizing the entire Fallopian tube owing to its tortuosity. This major disadvantage can be overcome by means of the three‐dimensional hysterosalpingo‐contrast‐sonography (3D‐HyCoSy). The current study compared the efficacy of 3D‐HyCoSy with diagnostic laparoscopy and its feasibility as a screening test for tubal patency.

Ovarian changes after abdominal hysterectomy for benign conditions

Objectives: To investigate any change in the ovaries, including earlyfollicular serumfollicle-stimulating hormone (FSH) level, total ovarian volume, total antralfollicle count, and ovarian stromal bloodflow, in patients who had undergone abdominal hysterectomy for benign conditions. Methods: Fifteen women with abdominal hysterectomy and conservation of ovariesfor benign conditions and who were between 29 and 44 years old were recruited to undergo three-dimensional ultrasound examination with power Doppler to assess total ovarian volume, total antralfollicle count, and vascularization index (VI), flow index (FI), and vascularization flow index (VFI) of ovarian stromal blood flow. Serum FSH, estradiol, and progesterone levels were checked on the same day. The results of the assessments were considered taken during the early follicular phase if the estradiol and progesterone levels were basal. Fifteen age-matched healthy women underwent the same assessments on the second day of menstruation. Results: Women with hysterectomy had significantly elevated serum FSH level and lower ovarian stromal bloodflow indices, including VI, FI, and VFI, as compared with healthy women. The total antral follicle count and the total ovarian volume were similar between the two groups. Conclusion: These changes may suggest altered ovarian function after hysterectomy.

Antepartum hemorrhage of unknown origin - what is its clinical significance?

BACKGROUNDnAntepartum hemorrhage of unknown origin is a common antenatal complication, accounting for more than half of the cases of antepartum hemorrhage. Few investigators had reported the importance of this condition and the proper management.nnnMETHODnThe present study reviewed retrospectively 718 cases with singleton pregnancies diagnosed as having antepartum hemorrhage of unknown origin after 24 weeks from 1991 to 1996 and compared their pregnancy outcomes with controls who delivered during the same period of time as the study cases. Clinical and ultrasound examinations were performed in all recruited cases to exclude accidental hemorrhage, placenta previa or lower genital tract bleeding.nnnRESULTSnPatients with antepartum hemorrhage of unknown origin ran a higher risk of spontaneous preterm labor (p<0.001). The birthweight, when adjusted for gestation, did not differ between the two groups. Labor induction rate and cesarean section rates were significantly higher in the antepartum hemorrhage group. The incidences of major antepartum complications and neonatal complications did not differ between the two groups. There were more babies with congenital abnormalities in the antepartum hemorrhage group (p<0.001) and perinatal mortality rate was also higher, though this difference was not statistically significant.nnnCONCLUSIONnThe main fetal risks associated with antepartum hemorrhage of unknown origin is preterm labor and its subsequent fetal complications. A small but significant proportion of these pregnancies might be associated with fetal congenital abnormalities. Routine induction at term for this group of patients is of questionable value as adverse fetal outcomes are mostly associated with those that delivered prematurely, or with babies with congenital malformations. When gross fetal abnormalities could be reasonably excluded, labor induction at term should only be contemplated in the presence of other obstetric indications.

A pilot study on the effects of a Chinese herbal preparation on menopausal symptoms.

This study was conducted to determine whether a particular Chinese medicinal preparation is effective in alleviating menopausal symptoms. Chinese women with menopausal symptoms were recruited to receive treatment for 3 months followed by 3 months without treatment. The severity of menopausal symptoms and serum follicle-stimulating hormone (FSH), luteinizing hormone (LH) and estradiol levels were assessed at baseline, 3 and 6 months. Data from 97 women with a mean age of 52.3 years were analyzed. Sixty women (62%) were postmenopausal. The serum FSH level (interquartile range) was 58.0 (39.5–72.4) IU/l at baseline and rose significantly 3 months after treatment. The difference remained significant in the postmenopausal group while there was no significant difference in the perimenopausal women. The changes in serum LH and estradiol levels remained unchanged. The baseline menopausal symptom score was 8.9 ± 6.0. The menopausal symptom score improved markedly after treatment and remained at the same level at 6 months. All individual menopausal symptoms improved significantly after 3 months of treatment except dry eye. Most of these symptoms remained significantly improved at 6 months compared with the pre-treatment assessment. We observed that the Chinese medicinal preparation used in this study is effective in improving menopausal symptoms in healthy Chinese women. Further randomized controlled trial will be needed to confirm this observation.

The prevalence of polycystic ovaries in Chinese women with a history of gestational diabetes mellitus.

In the present study we aimed to define the prevalence of polycystic ovaries (PCO), using the revised ultrasound criterion, in Chinese women with previous gestational diabetes mellitus (GDM), as well as their associated clinical, hormonal and biochemical characteristics. Seventy Chinese women with previous GDM were recruited as the study group. The control group comprised women matched for age, parity and delivery year who had a normal oral glucose tolerance test during their index pregnancy. Two- and three-dimensional ultrasound scans were performed to study ovarian morphology and ovarian stromal blood flow. Anthropometric, hormonal and biochemical profiles were compared between women with and without ultrasound features of PCO. The prevalence of PCO in Chinese women was 23%. The group with a history of GDM had a higher but not statistically significant prevalence of PCO (34%). Compared with controls, they had significantly higher incidence of obesity, impaired glucose tolerance or diabetes, fasting insulin and leptin levels, and their lipid profile was less favorable. Also, their level of sex hormone-binding globulin was significantly lower and hence their free androgen index was higher, and so was their level of dehydroepiandrosterone sulfate. There was a trend for the study group to have higher ovarian stromal blood flow.

Circadian Changes in Uterine Artery and Ovarian Stromal Blood Flow After Pituitary Down-regulation

Objective: To investigate changes in the uterine artery and ovarian stromal blood flow in relation to the time of the day after pituitary down-regulation during in vitro fertilization treatment. Methods: Thirteen women were recruited. The uterine artery blood flow was studied using pulsed color Doppler ultrasonography and the ovarian stromal blood flow was measured using three-dimensional power Doppler ultrasonography. Ultrasound scan examinations and blood pressure measurements were performed in the morning and evening. Results: The diastolic and the mean arterial pressures were significantly higher in the evening. An increase in the uterine artery pulsatility index and resistance index in the evening was observed. The ovarian vascularization index, vascularization flow index, and right ovarian flow index were significantly lower in the evening. Conclusions: Despite the small sample size, we have demonstrated the presence of a diurnal change in uterine artery and ovarian stromal blood flow after pituitary down-regulation. Such changes may be related to the systemic change in the sympathetic system and hence vascular resistance. Future study regarding ovarian stromal blood flow should take into account the effect of the time of the day on the readings in order to avoid misleading interpretation of data.