Galectins are a phylogenetically conserved family of soluble β-galactoside binding proteins, consisting of 15 different types, each with a specific function. Galectins contribute to placentation by regulating trophoblast development, migration, and invasion during early pregnancy. In addition, galectins are critical players regulating maternal immune tolerance to the embedded embryo. Recently, the role of galectins in angiogenesis during decidualization and in placenta formation has gained attention. Altered expression of galectins is associated with abnormal pregnancies and infertility. This review focuses on the role of galectins in pregnancy-associated processes and discusses the relevance of galectin-glycan interactions as potential therapeutic targets in pregnancy disorders.

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Pregnancy Galectinology: Insights Into a Complex Network of Glycan Binding Proteins

Endometriosis is a prevalent chronic disease in up to 10% of women of reproductive age and often causes pain symptoms. In some patients, these symptoms negatively affect quality of life for a long time. Dienogest is an oral progestin that was recently approved for the treatment of endometriosis. It is allowed for long-term administration with a favorable safety and tolerability profile. Dienogest 2mg/day was superior to placebo in relieving pain symptoms in patients with endometriosis, equivalently effective to gonadotropin releasing hormone agonist (GnRHa). The size of endometriomas was reduced by use of dienogest. Postoperative administration of dienogest showed the efficacy in relieving pain and suppressing recurrence of endometrioma in patients with endometriosis. Dienogest was also effective in relieving symptoms in women with deep infiltrating endometriosis (DIE) or extragenital endometriosis. Dienogest is an alternative for the treatment of endometriosis because of its efficacy, safety and tolerability.

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Dienogest in the Treatment of Endometriosis

In the past 10–15 years, paediatric transgender care has emerged at the forefront of several general practice and subspecialty guidelines and is the topic of continuing medical education for various medical disciplines. Providers in specialties ranging from family medicine, paediatrics and adolescent medicine to endocrinology, gynaecology and urology are caring for transgender patients in increasing numbers. Current and evolving national and international best practice guidelines recommend offering a halt of endogenous puberty for patients with early gender dysphoria, in whom impending puberty is unacceptable for their psychosocial health and wellness. Pubertal blockade has implications for fertility preservation, transgender surgical care and psychosocial health, all of which must be considered and discussed with the patient and their family and/or legal guardian before initiation. For transgender people who experience gender dysphoria as children, in whom impending puberty is unacceptable for their psychosocial health and wellness, pubertal blockade is a therapeutic option. In this Review, the authors discuss pubertal blockade and its implications for fertility preservation, surgical care and psychosocial health, all of which must be considered and discussed with the patient and their family and/or legal guardian before initiation.

The effect of early puberty suppression on treatment options and outcomes in transgender patients

Vaginal micronized progesterone versus the levonorgestrel‐releasing intrauterine system for treatment of non‐atypical endometrial hyperplasia: A randomized controlled trial

To compare the effectiveness of dienogest (DIE) and norethisterone acetate (NETA) regimens in the treatment of endometrial hyperplasia (EH) without atypia.Participants were premenopausal women with irregular uterine bleeding, and endometrial hyperplasia without atypia on endometrial biopsy. Enrolled patients were randomly allocated into two groups: group I got DIE 2 mg/day (orally Visanne) for 14 days (10th to the 25th day of cycle) while group II received between the 16th and 25th day of the cycle, norethisterone acetate (NETA) 15 mg/d (orally Primolut Nor) was administered for 10 days. Both groups continued the therapy for six months.The DIE group showed a higher resolution (32.7%) and regression (57.7%) than NETA group (31% & 37.9%, respectively) with significant regression (p = 0.039). No progression in DIE group while four (6.9%) women in NETA group were recorded a progression to complex type without a significance. Also, NETA group showed a significant persistence rate (22.5%) than DIE group (3.8%) (p = 0.005). Also number in NETA group managed by hysterectomy with significant difference (p = 0.042).If used as first-line treatment, Dienogest produces a better rate of regression and a lower incidence of hysterectomy than Norethisterone Acetate does when used in EH without atypia. 

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Dienogest versus norethisterone acetate in management of endometrial hyperplasia without atypia

Aim: The aim of the study was to compare the effectiveness of dienogest (DIE), depo medroxyprogesterone 17-acetate (MPA), and micronized progesteron (MP) regimens for treatment of simple endometrial hyperplasia (EH) without atypia. Methods: One hundred and twenty premenopausal patients aged between 35 and 55, with simple EH without atypia, were offered 3 types of progestins (MPA, MP, and DIE) and were randomized to one of them. After 6 months of treatment, patients were reevaluated. The efficacy of different progestins in treatment of EH was compared with regard to resolution and regression rates. We classified the terms of resolution and regression as “complete response” and persistence as “no response”. Results: A total of 99 patients continued the study (31 in MP, 35 in MPA, and 33 in the DIE group). None of the results of endometrial pathology were progressed to atypia or complex hyperplasia. The complete response resolution rate was 93.5% in the MP, 88.5% in the MPA, and 96.9% in the DIE group. The highest complete response rate was in the DIE group, although there was no statistically significant difference between groups (p = 0.39). The efficacy of progestins was similar between the groups. Conclusion: DIE is an effective and convenient method for thinning the endometrium.

The Efficacy of Dienogest in the Treatment of Simple Endometrial Hyperplasia without Atypia.

Objective: Galectins are animal lectins that bind to surface glycoproteins expressed at the fetal-maternal interface. The aim of this prospective case–control study was to investigate the possible ...

Eda Ulku Karakilic

Papers

The Efficacy of Dienogest in the Treatment of Simple Endometrial Hyperplasia without Atypia.

Serum Galectin 7 is Not Useful to Predict Abortion in the First Trimester.

The efficacy of haematologic parameters in the diagnosis of missed abortus