Treatment Strategies for Unexplained Infertility
Semin Reprod Med DOI: 10.1055/s-0040-1719074Unexplained infertility is a common diagnosis among couples with infertility. Pragmatic treatment options in these couples are directed at trying to improve chances to conceive, and consequently intrauterine insemination (IUI) with ovarian stimulation and in vitro fertilization (IVF) are standard clinical practice, while expectant management remains an important alternative. While evidence on IVF or IUI with ovarian stimulation versus expectant management was inconclusive, these interventions seem more effective in couples with a poor prognosis of natural conception. Strategies s...
Source: Seminars in Reproductive Medicine - October 29, 2020 Category: Reproduction Medicine Authors: Wang, Rui van Eekelen, Rik Mochtar, Monique H. Mol, Femke van Wely, Madelon Tags: Review Article Source Type: research

Current and Future Medical Therapies for Adenomyosis
Semin Reprod Med DOI: 10.1055/s-0040-1719016There is no approved medical therapy for adenomyosis and limited evidence to guide treatments in part due to the complexity of nonhistologic diagnosis and the prevalence of concomitant gynecologic conditions. Most available evidence focuses on the treatment of heavy menstrual bleeding, painful menses, and pelvic pain. Data evaluating fertility outcomes, sexual function, and quality of life following treatment are lacking. Additionally, there is no disease-specific measure of quality of life for adenomyosis. The levonorgestrel-releasing intrauterine system appears to be the most e...
Source: Seminars in Reproductive Medicine - October 29, 2020 Category: Reproduction Medicine Authors: Cope, Adela G. Ainsworth, Alessandra J. Stewart, Elizabeth A. Tags: Review Article Source Type: research

Epidemiology of Adenomyosis
Semin Reprod Med DOI: 10.1055/s-0040-1718920Adenomyosis, characterized by the presence of endometrial glands and stroma within the myometrium, can have a substantial impact on the quality of women's lives. Despite this, the epidemiologic research on this condition lags considerably behind that of other noncancerous reproductive health conditions. The lack of progress and knowledge is due in part to the challenges in designing valid epidemiologic studies, since the diagnosis of adenomyosis historically has been limited to the examination of uterine specimens from hysterectomy. This review describes the available data on the...
Source: Seminars in Reproductive Medicine - October 26, 2020 Category: Reproduction Medicine Authors: Upson, Kristen Missmer, Stacey A. Tags: Review Article Source Type: research

Animal Models of Adenomyosis
Semin Reprod Med DOI: 10.1055/s-0040-1718741Adenomyosis is a nonmalignant uterine disorder in which endometrial tissue exists within and grows into the myometrium. Animal models have generated limited insight into the still-unclear pathogenesis of adenomyosis, provided a platform for preclinical screening of many drugs and compounds with potential as therapeutics, and elucidated mechanisms underlying the pain and fertility issues that occur in many women with the disease. Spontaneous adenomyosis has been studied in nonhuman primates, primarily in the form of case reports. Adenomyosis is routinely experimentally induced in ...
Source: Seminars in Reproductive Medicine - October 26, 2020 Category: Reproduction Medicine Authors: Marquardt, Ryan M. Jeong, Jae-Wook Fazleabas, Asgerally T. Tags: Review Article Source Type: research

The Male Is Significantly Implicated as the Cause of Unexplained Infertility
Semin Reprod Med DOI: 10.1055/s-0040-1718941Male infertility is recognized as a relatively common, complex condition, generated by a broad array of environmental and genetic factors. Historical reliance on the conventional semen profile has tended to underestimate the true contribution of “the male factor” to human infertility. This review highlights the importance of genetic and epigenetic factors in the etiology of male infertility, identifying a range of mutations responsible for primary testicular failure and impaired fertilizing potential. More than three quarters of all de novo mutations arise in the male...
Source: Seminars in Reproductive Medicine - October 21, 2020 Category: Reproduction Medicine Authors: Aitken, Robert John Tags: Review Article Source Type: research

Does Laparoscopy and Hysteroscopy Have a Place in the Diagnosis of Unexplained Infertility?
Semin Reprod Med DOI: 10.1055/s-0040-1718942The standard fertility workup includes assessment of ovulation, semen analysis, and evaluation of tubal patency. If the fertility workup is found to be normal, a diagnosis of unexplained infertility is made. The role of laparoscopy in fertility workup has been a matter of debate. The current review presents the evidence for and against laparoscopy and hysteroscopy during fertility workup and subsequently prior to fertility treatment. After appraising the literature, we found the role of diagnostic laparoscopy in fertility workup is limited and is dependent on factors like prevale...
Source: Seminars in Reproductive Medicine - October 20, 2020 Category: Reproduction Medicine Authors: Kamath, Mohan S. Rikken, Judith F.W. Bosteels, Jan Tags: Review Article Source Type: research

Pathology and Pathogenesis of Adenomyosis
Semin Reprod Med DOI: 10.1055/s-0040-1718922Adenomyosis represents a unique pathophysiological condition in which normal-appearing endometrial mucosa resides within myometrium and is thus protected from menstrual shedding. The resulting ectopic presence of endometrial tissue composed of glands and stroma is thought to affect normal contractile function and peristalsis of uterine smooth muscle, causing menometrorrhagia, infertility, and adverse obstetric outcomes. Since the first description of adenomyosis more than 150 years ago, pathologists have studied this lesion by examining tissue specimens, and have proposed multipl...
Source: Seminars in Reproductive Medicine - October 20, 2020 Category: Reproduction Medicine Authors: Antero, Maria Facadio Ayhan, Ayse Segars, James Shih, Ie-Ming Tags: Review Article Source Type: research

Interdisciplinary Teams in Endometriosis Care
Semin Reprod Med DOI: 10.1055/s-0040-1718943Endometriosis-associated chronic pelvic pain can at times be a complex problem that is resistant to standard medical and surgical therapies. Multiple comorbidities and central sensitization may be at play and must be recognized with the help of a thorough history and physical examination. If a complex pain problem is identified, most endometriosis expert reviews and guidelines recommend multidisciplinary care. However, there are no specific recommendations about what should be the components of this approach and how that type of team care should be delivered. There is evidence sh...
Source: Seminars in Reproductive Medicine - October 20, 2020 Category: Reproduction Medicine Authors: Allaire, Catherine Long, Alicia Jean Bedaiwy, Mohamed A. Yong, Paul J. Tags: Review Article Source Type: research

Impairment of Uterine Contractility Is Associated with Unexplained Infertility
Semin Reprod Med DOI: 10.1055/s-0040-1716409The uterine junctional zone represents the juncture between endometrium and myometrium. The junctional zone is hormonally dependent and displays continuous peristaltic activity throughout the menstrual cycle in the nonpregnant state which is concerned with sperm transport and embryo implantation. Peristalsis may be observed using various invasive and noninvasive modalities, of which ultrasound is the most readily applied in the clinical setting. Women with pelvic pathology display alterations in uterine peristalsis which may contribute to infertility. Characterization of peristal...
Source: Seminars in Reproductive Medicine - October 14, 2020 Category: Reproduction Medicine Authors: Hunt, Sarah Abdallah, Karim S. Ng, Ernest Rombauts, Luk Vollenhoven, Beverley Mol, Ben W. Tags: Review Article Source Type: research

How and Why to Define Unexplained Infertility?
Semin Reprod Med DOI: 10.1055/s-0040-1718709Unexplained infertility represents up to 30% of all cases of infertility. It is a diagnosis of exclusion, where no cause for infertility may be identified in the investigation of the couple, be it anovulation, fallopian tube blockage, or severe male factor. Unexplained infertility therefore cannot be considered a diagnosis to which a specific treatment is directed, rather that it indicates a failure to reach a diagnosis of the true cause of infertility. In this review, we explore the evidence base and potential limitations of the current routine infertility assessment. We also ai...
Source: Seminars in Reproductive Medicine - October 14, 2020 Category: Reproduction Medicine Authors: Abdallah, Karim S. Hunt, Sarah Abdullah, Sayed A. Mol, Ben W.J. Youssef, Mohamed A. Tags: Review Article Source Type: research

Adenomyosis: Mechanisms and Pathogenesis
Semin Reprod Med DOI: 10.1055/s-0040-1716687Adenomyosis is a common disorder of the uterus, and is associated with an enlarged uterus, heavy menstrual bleeding (HMB), pelvic pain, and infertility. It is characterized by endometrial epithelial cells and stromal fibroblasts abnormally found in the myometrium where they elicit hyperplasia and hypertrophy of surrounding smooth muscle cells. While both the mechanistic processes and the pathogenesis of adenomyosis are uncertain, several theories have been put forward addressing how this disease develops. These include intrinsic or induced (1) microtrauma of the endometrial&ndash...
Source: Seminars in Reproductive Medicine - October 8, 2020 Category: Reproduction Medicine Authors: Zhai, Junyu Vannuccini, Silvia Petraglia, Felice Giudice, Linda C. Tags: Review Article Source Type: research

Reproductive Health Needs of the Military and Veterans
Semin Reprod Med DOI: 10.1055/s-0040-1714120 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Seminars in Reproductive Medicine)
Source: Seminars in Reproductive Medicine - July 20, 2020 Category: Reproduction Medicine Authors: Christy, Alicia Y. Tags: Preface Source Type: research

Is Patient Advocacy the Solution to Physician Burnout?
Semin Reprod Med DOI: 10.1055/s-0040-1713428Physician burnout has been on the rise over the last several decades in a variety of specialties, leading to high rates of physician suicide and poor health outcomes for patients. As leaders in healthcare attempt to combat this issue through mental health initiatives and changes in medical training policies, we propose patient advocacy as a powerful technique to combat physician burnout and restore autonomy, purpose, and meaning into physicians' lives. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents &...
Source: Seminars in Reproductive Medicine - July 9, 2020 Category: Reproduction Medicine Authors: Jeelani, Roohi Lieberman, Daniel Chen, Serena H. Tags: Review Article Source Type: research

Reproductive Health Needs of the Military and Veterans, Part 3
Semin Reprod Med DOI: 10.1055/s-0040-1714767 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Seminars in Reproductive Medicine)
Source: Seminars in Reproductive Medicine - July 8, 2020 Category: Reproduction Medicine Authors: Segars, James H. Tags: Introduction Source Type: research

Obstetric Outcomes in Military Servicewomen: Emerging Knowledge, Considerations, and Gaps
Semin Reprod Med DOI: 10.1055/s-0040-1712929The number of women in the U.S. military is dramatically increasing. Similarly, the roles of active-duty women are greatly expanding, thus exposing them to new occupational risks. Determining the impact of pregnancy outcomes for women while in the military is difficult due to changing exposures over time, difficulty in utilizing appropriate comparison groups, and the lack of prospective investigations. Despite these limitations, it was concerning that the available data suggest that servicewomen delivering within 6 months of their first deployment have an increased preterm birth ...
Source: Seminars in Reproductive Medicine - June 24, 2020 Category: Reproduction Medicine Authors: Mezwa, Kathryn Adelsheim, Lee Markenson, Glenn Tags: Review Article Source Type: research

Postdeployment Fertility Challenges and Treatment in the Modern Era
Semin Reprod Med DOI: 10.1055/s-0040-1713430Current war-fighting environments have shifted dramatically over the past decade, and with this change, new types of injuries are afflicting American soldiers. Operative Enduring Freedom and Operation Iraqi Freedom have noted an increased use of sophisticated improvised explosive devices by adversaries. Injuries not frequently seen in previous conflict are dismounted complex blast injuries, which involve multiple proximal amputations, pelvic fractures, and extensive perineal wounds. Thus, an unforeseen consequence of the decreased mortality rate after these complex blast injuries...
Source: Seminars in Reproductive Medicine - June 24, 2020 Category: Reproduction Medicine Authors: Lentscher, Jessica A. Combs, Joshua C. Walker, Karrie Young, Christopher M. Chason, Rebecca Tags: Review Article Source Type: research

“Don't We Take Care of Our Veterans?” The Critical Need for Veteran's Health Services Infertility Services for Veterans: Policies, Challenges, and Opportunities
We describe the need for policy and expansion of services for infertility care in the Department of Defense and Veterans Health Administration, and the challenges and opportunities that exist. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Seminars in Reproductive Medicine)
Source: Seminars in Reproductive Medicine - May 7, 2020 Category: Reproduction Medicine Authors: Woodruff, Lee Mottla, Gilbert Tags: Review Article Source Type: research

Gynecologic Oncology in the Department of Defense
Semin Reprod Med DOI: 10.1055/s-0040-1709706Gynecologic oncology existed within the Department of Defense (DOD) prior to its recognition as a separate subspecialty of obstetrics and gynecology. Military gynecologic oncologists were among the founders of the specialty and continue a tradition of leadership and engagement within the field at the national and international level. The full range of gynecologic oncology services is located at the military's largest medical centers, acknowledging the team approach with multiple subspecialties necessary to provide the highest standard of modern gynecologic cancer care. Gynecologi...
Source: Seminars in Reproductive Medicine - April 30, 2020 Category: Reproduction Medicine Authors: Hamilton, Chad A. Maxwell, George L. Casablanca, Yovanni Tags: Review Article Source Type: research

Fertility Preservation Before Deployment: Oocyte and Sperm Freezing in Members of the Active Duty Military
Semin Reprod Med DOI: 10.1055/s-0040-1701633Active duty military service and deployment has the potential to compromise fertility through combat-related genitourinary injury, gonadotoxic exposures, and physical separation from a partner. Despite a growing interest among the military community as well as promising efficacy and safety data, fertility preservation remains an uncovered benefit for active duty soldiers. In 2016, the Pentagon proposed a program that would cover oocyte and sperm cryopreservation for any member of the active duty military desiring its use. Regrettably, that funding was not secured and predeploymen...
Source: Seminars in Reproductive Medicine - February 9, 2020 Category: Reproduction Medicine Authors: Martini, Anne E. Doyle, Joseph O. Tags: Review Article Source Type: research

Contraception and Unintended Pregnancy in the Military Healthcare System
Semin Reprod Med DOI: 10.1055/s-0039-3400461The number of women serving in the Armed Forces is growing and readiness has been decreed as the number 1 priority for the total Army. Provision of contraception and unintended pregnancy rates higher than the general population are two key factors in readiness of female soldiers. An in-depth review of women's healthcare in the military identified these two areas of women's health as greatly understudied. Long-acting reversible contraception provides effective and cost-efficient method for contraception and a proven way to decrease unintended pregnancy. Increased research and focu...
Source: Seminars in Reproductive Medicine - February 3, 2020 Category: Reproduction Medicine Authors: Heitmann, Ryan J. Tags: Review Article Source Type: research

Progesterone Elevation and Preventive Strategies to Avoid Implantation Failure
Semin Reprod Med DOI: 10.1055/s-0039-1700531Despite the wide utilization of gonadotropin-releasing hormone analogs, progesterone elevation (P4E) in the late follicular phase occurs in 5 to 30% of all ovarian stimulation (OS) cycles. Although the detrimental effect of P4E on pregnancy rates in fresh in vitro fertilization cycles is valid in all subsets of cases, higher levels of P4 and a longer duration of P4E may be needed in patients with a hyper-ovarian response in order for a negative impact on pregnancy rates to occur. Available preclinical and clinical data suggest that aggressive OS with high doses of follicle-stimul...
Source: Seminars in Reproductive Medicine - January 22, 2020 Category: Reproduction Medicine Authors: Bozdag, Gurkan Turkyilmaz, Esengul Yildiz, Sule Mumusoglu, Sezcan Yarali, Hakan Tags: Review Article Source Type: research

KISS1/KISS1R and Breast Cancer: Metastasis Promoter
Semin Reprod Med 2019; 37: 197-206 DOI: 10.1055/s-0039-3400968Kisspeptins (KPs), peptide products of the kisspeptin-1 (KISS1) gene, are the endogenous ligands for the KISS1 receptor, KISS1R, which is a G protein-coupled receptor. In many human tumors, KISS1 functions as a metastasis-suppressor gene and KISS1/KISS1R signaling has antimetastatic and tumor-suppressor roles. On the contrary, emerging evidence indicates that the KP/KISS1R pathway plays detrimental roles in triple negative breast cancer (TNBC), the most difficult type of breast cancer to treat. TNBC patients initially respond to chemotherapy, but tumors acquire ...
Source: Seminars in Reproductive Medicine - January 22, 2020 Category: Reproduction Medicine Authors: Guzman, Stephania Brackstone, Muriel Wondisford, Frederic Babwah, Andy V. Bhattacharya, Moshmi Tags: Review Article Source Type: research

Phoenixin and Its Role in Reproductive Hormone Release
Semin Reprod Med 2019; 37: 191-196 DOI: 10.1055/s-0039-3400964Phoenixin is novel neuropeptide, recently identified following the description of a peptide sequence highly conserved across several animal species, including humans, cows, and pigs. Expressed both centrally in the hypothalamus and arcuate nucleus and peripherally in cardiac and gastrointestinal tissue, it appears to modulate reproductive hormone secretion in a gonadotrophin-releasing hormone–dependent manner and may also influence anxiety and memory. While there remains much to be described regarding its signaling, this review assesses the currently avail...
Source: Seminars in Reproductive Medicine - January 22, 2020 Category: Reproduction Medicine Authors: Clarke, Sophie A. Dhillo, Waljit S. Tags: Review Article Source Type: research

Regulation of Pregnancy: Evidence for Major Roles by the Uterine and Placental Kisspeptin/KISS1R Signaling Systems
Semin Reprod Med 2019; 37: 182-190 DOI: 10.1055/s-0039-3400966Several studies provide strong evidence suggesting that in addition to central kisspeptin/KISS1R signaling, the peripheral uterine- and placental-based kisspeptin/KISS1R signaling systems are major regulators of pregnancy. Specifically, the evidence suggests that the uterine-based system regulates embryo implantation and decidualization, while both the uterine- and placental-based systems regulate placentation. Uterine kisspeptin and KISS1R regulate embryo implantation by controlling the availability of endometrial glandular secretions, like leukemia inhibitory ...
Source: Seminars in Reproductive Medicine - January 22, 2020 Category: Reproduction Medicine Authors: Radovick, Sally Babwah, Andy V. Tags: Review Article Source Type: research

DLK1, Notch Signaling and the Timing of Puberty
Semin Reprod Med 2019; 37: 174-181 DOI: 10.1055/s-0039-3400963The factors that trigger human puberty are among the central mysteries of reproductive biology. Several approaches, including mutational analysis of candidate genes, large-scale genome-wide association studies, whole exome sequencing, and whole genome sequencing have been performed in attempts to identify novel genetic factors that modulate the human hypothalamic–pituitary–gonadal axis to result in premature sexual development. Genetic abnormalities involving excitatory and inhibitory pathways regulating gonadotropin-releasing hormone secretion, repr...
Source: Seminars in Reproductive Medicine - January 22, 2020 Category: Reproduction Medicine Authors: Macedo, Delanie B. Kaiser, Ursula B. Tags: Review Article Source Type: research

Evolutionary Conservation of MKRN3 and Other Makorins and Their Roles in Puberty Initiation and Endocrine Functions
Semin Reprod Med 2019; 37: 166-173 DOI: 10.1055/s-0039-3400965Puberty is a critical period of development regulated by genetic, nutritional, and environmental factors. The role of makorin ring finger protein 3 (MKRN3) in the regulation of pubertal timing was revealed when loss-of-function mutations were identified in patients with central precocious puberty (CPP). To date, MKRN3 mutations are the most common known genetic cause of CPP. MKRN3 is a member of the makorin family of ubiquitin ligases, together with MKRN1 and MKRN2. The Mkrn genes have been identified in both vertebrates and invertebrates and show high evolution...
Source: Seminars in Reproductive Medicine - January 22, 2020 Category: Reproduction Medicine Authors: Naul é, Lydie Kaiser, Ursula B. Tags: Review Article Source Type: research

Neuropeptide Control of Puberty: Beyond Kisspeptins
Semin Reprod Med 2019; 37: 155-165 DOI: 10.1055/s-0039-3400967Puberty is a fundamental developmental event in the lifespan of any individual, when sexual and somatic maturation is completed, and reproductive capacity is achieved. While the tempo of puberty is under strong genetic determination, it is also modulated by a wide array of internal and environmental cues, including, prominently, nutritional and metabolic signals. In the last decade, our understanding of the neurohormonal basis of normal puberty and its perturbations has enlarged considerably. This is illustrated by the elucidation of the essential roles of kissp...
Source: Seminars in Reproductive Medicine - January 22, 2020 Category: Reproduction Medicine Authors: Barroso, Alexia Roa, Juan Tena-Sempere, Manuel Tags: Review Article Source Type: research

Kisspeptin, Neurokinin B and New Players in Reproduction
Semin Reprod Med 2019; 37: 153-154 DOI: 10.1055/s-0040-1701704 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Seminars in Reproductive Medicine)
Source: Seminars in Reproductive Medicine - January 22, 2020 Category: Reproduction Medicine Authors: Dhillo, Waljit S. Tags: Preface Source Type: research

Waljit S. Dhillo, MD
Semin Reprod Med 2019; 37: 151-152 DOI: 10.1055/s-0040-1701703 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Seminars in Reproductive Medicine)
Source: Seminars in Reproductive Medicine - January 22, 2020 Category: Reproduction Medicine Authors: Legro, Richard S. Tags: Introduction Source Type: research

Should We Make More Bone or Not, As Told by Kisspeptin Neurons in the Arcuate Nucleus
Semin Reprod Med 2019; 37: 147-150 DOI: 10.1055/s-0039-3400238Since its initial discovery in 2002, the neuropeptide Kisspeptin (Kiss1) has been anointed as the master regulator controlling the onset of puberty in males and females. Over the last several years, multiple groups found that Kiss1 signaling is mediated by the 7TM surface receptor GPCR54. Kiss1 mRNA is highly enriched in the basal medial and lateral subregions of the arcuate nucleus (ARC) in the medial basal hypothalamus. Thus, Kiss1ARC neurons reside in a unique anatomical location ideal for sensing and responding to circulating steroid hormones as well as nutr...
Source: Seminars in Reproductive Medicine - December 22, 2019 Category: Reproduction Medicine Authors: Herber, Candice B. Ingraham, Holly A. Tags: Review Article Source Type: research

Kisspeptin and Glucose Homeostasis
Semin Reprod Med 2019; 37: 141-146 DOI: 10.1055/s-0039-3400242Kisspeptin has well-established critical roles in the control of reproduction and fertility. Recently, evidence has emerged that suggests kisspeptin may have additional roles in the regulation of glucose homeostasis. Conflicting reports on the effects of kisspeptin on insulin secretion in animal models have been published, which cannot be fully accounted for by the different kisspeptin isoforms and range of kisspeptin doses used in these studies. Human studies have demonstrated associations between circulating kisspeptin levels and measures of insulin secretion ...
Source: Seminars in Reproductive Medicine - December 22, 2019 Category: Reproduction Medicine Authors: Izzi-Engbeaya, Chioma Hill, Thomas G. Bowe, James E. Tags: Review Article Source Type: research

Arcuate Kisspeptin Neurons Coordinate Reproductive Activities with Metabolism
Semin Reprod Med 2019; 37: 131-140 DOI: 10.1055/s-0039-3400251Hypothalamic control of fertility is the quintessential homeostatic function. However, fertility is metabolically demanding; so, there must be coordination between energy states and reproductive functions. Because gonadotropin-releasing hormone (GnRH) neurons are devoid of many of the critical metabolic hormone receptors for sensing nutrient levels, it has long been recognized that the sensing of energy stores had to be done by neurons presynaptic to GnRH neurons. Some of the obvious players have been the anorexigenic proopiomelanocortin (POMC) and orexigenic ne...
Source: Seminars in Reproductive Medicine - December 22, 2019 Category: Reproduction Medicine Authors: R ønnekleiv, Oline K. Qiu, Jian Kelly, Martin J. Tags: Review Article Source Type: research

Neurokinin B and Neurokinin-3 Receptor Signaling: Promising Developments in the Management of Menopausal Hot Flushes
Semin Reprod Med 2019; 37: 125-130 DOI: 10.1055/s-0039-3400241Vasomotor symptoms, including hot flushes and night sweats, pose a significant symptomatic burden to women undergoing menopause, and negatively impact on both their physical and psychological well-being. Management of these symptoms can be challenging, with the use of conventional hormone replacement therapy limited by duration of treatment and clinical contraindications. Recent advances in our understanding of the neuroendocrine regulation of the reproductive axis and thermoregulation postmenopause has helped identify a promising new therapeutic target to ameli...
Source: Seminars in Reproductive Medicine - December 22, 2019 Category: Reproduction Medicine Authors: Modi, Manish Dhillo, Waljit S. Tags: Review Article Source Type: research

Clinical Translational Studies of Kisspeptin and Neurokinin B
Semin Reprod Med 2019; 37: 119-124 DOI: 10.1055/s-0039-3400240Kisspeptin and neurokinin B (NKB) are hypothalamic neuropeptides that are vital for reproductive health. An absence of either kisspeptin or NKB signaling results in hypogonadotrophic hypogonadism and a failure to proceed through puberty. In recent years, several studies have demonstrated potential avenues for the clinical utility of medications that act through these pathways in the assessment and treatment of reproductive disorders. Kisspeptin acts to stimulate hypothalamic gonadotrophic-releasing hormone (GnRH) secretion from the hypothalamus. Kisspeptin induc...
Source: Seminars in Reproductive Medicine - December 22, 2019 Category: Reproduction Medicine Authors: Hunjan, Tia Abbara, Ali Tags: Review Article Source Type: research

Novel Biology of Tachykinins in Gonadotropin-Releasing Hormone Secretion
Semin Reprod Med 2019; 37: 109-118 DOI: 10.1055/s-0039-3400252The tachykinin family of peptides, composed of the neurokinins A and B (NKA, NKB) and substance P are involved in the central control of gonadotropin-releasing hormone (GnRH) release through a variety of neuronal circuitries that mediate the activation of Kiss1 neurons and the synchronization of their activity within the arcuate nucleus. The major outcome of this role is the precise regulation of the pulsatile pattern of GnRH release. In addition, tachykinins are involved in the maturation of the reproductive axis by determining the optimal timing of puberty ons...
Source: Seminars in Reproductive Medicine - December 22, 2019 Category: Reproduction Medicine Authors: Leon, Silvia Navarro, V íctor M. Tags: Review Article Source Type: research

Kisspeptin, Neurokinin B and New Players in Reproduction
Semin Reprod Med 2019; 37: 107-108 DOI: 10.1055/s-0039-3403461 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Seminars in Reproductive Medicine)
Source: Seminars in Reproductive Medicine - December 22, 2019 Category: Reproduction Medicine Authors: Dhillo, Waljit S. Tags: Preface Source Type: research

Waljit S. Dhillo, MD
Semin Reprod Med 2019; 37: 105-106 DOI: 10.1055/s-0039-3403460 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Seminars in Reproductive Medicine)
Source: Seminars in Reproductive Medicine - December 22, 2019 Category: Reproduction Medicine Authors: Legro, Richard S. Tags: Introduction Source Type: research

Kisspeptin and Prolactin
Semin Reprod Med 2019; 37: 093-104 DOI: 10.1055/s-0039-3400956The relationship between elevated prolactin and infertility has been known for a long time, but the specific mechanism by which prolactin inhibited reproduction had been uncertain. The discovery of kisspeptin has provided novel insights into how prolactin might cause infertility, with extensive evidence that elevated prolactin inhibits secretion of kisspeptin, resulting in hypogonadotropic hypogonadism, and infertility. More recent data suggest that a converse relationship might also exist, with evidence that kisspeptin influences prolactin secretion. This brief...
Source: Seminars in Reproductive Medicine - December 16, 2019 Category: Reproduction Medicine Authors: Grattan, David R. Szawka, Raphael E. Tags: Review Article Source Type: research

The Role of Kisspeptin in Sexual Behavior
Semin Reprod Med 2019; 37: 084-092 DOI: 10.1055/s-0039-3400992Sexual behavior is essential for the perpetuation of a species. In female rodents, mate preference and lordosis behavior depend heavily on the integration of olfactory cues into the neuroendocrine brain, yet its underlying neural circuits are not well understood. We previously revealed that kisspeptin neurons in the anteroventral periventricular nucleus/periventricular nucleus continuum (AVPv/PeN) are activated by male olfactory cues in female mice. Here, we further reveal that male-directed mate preferences and lordosis are impaired in kisspeptin knockout mice ...
Source: Seminars in Reproductive Medicine - December 16, 2019 Category: Reproduction Medicine Authors: Hellier, Vincent Brock, Olivier Bakker, Julie Tags: Review Article Source Type: research

Does the KNDy Model for the Control of Gonadotropin-Releasing Hormone Pulses Apply to Monkeys and Humans?
Semin Reprod Med 2019; 37: 071-083 DOI: 10.1055/s-0039-3400254There is now considerable evidence supporting the role of a subpopulation of neurons in the arcuate nucleus of the hypothalamus that coexpress kisspeptin, neurokinin B, and dynorphin (abbreviated as KNDy neurons) as the long sought-after gonadotropin-releasing hormone (GnRH) pulse generator. The “KNDy hypothesis” of pulse generation has largely been based on findings in rodents and ruminants, and there is considerably less information about the anatomical and functional organization of the KNDy subpopulation in the primate hypothalamus. In this revie...
Source: Seminars in Reproductive Medicine - December 16, 2019 Category: Reproduction Medicine Authors: Lehman, Michael N. He, Wen Coolen, Lique M. Levine, Jon E. Goodman, Robert L. Tags: Review Article Source Type: research

The Roles of the Amygdala Kisspeptin System
Semin Reprod Med 2019; 37: 064-070 DOI: 10.1055/s-0039-3400462The hypothalamic hormone kisspeptin (encoded by the KISS1/kiss1 gene) is the master regulator of the reproductive axis with its role in controlling gonadotrophin hormone secretion now well characterized. However, identification of kisspeptin and its cognate receptor expression within the amygdala, a key limbic brain region whose functions contribute to a broad range of physiological and behavioral processes, has heightened interest concerning kisspeptins' role in the broader aspects of reproductive physiology. In this review, we detail the important developments...
Source: Seminars in Reproductive Medicine - December 16, 2019 Category: Reproduction Medicine Authors: Mills, Edouard G. A. O'Byrne, Kevin T. Comninos, Alexander N. Tags: Review Article Source Type: research

Kisspeptin as a Behavioral Hormone
Semin Reprod Med 2019; 37: 056-063 DOI: 10.1055/s-0039-3400239Successful reproduction is dependent not only on hormonal endocrine responses but also on suitable partner selection, copulatory acts, as well as associated emotional, behavioral, and cognitive processes many of which are supported by the limbic system. The reproductive hormone kisspeptin (encoded by the KISS1/kiss1 gene) is now recognized as the key orchestrator of the reproductive axis. In addition to the hypothalamus, prominent kisspeptin neuronal populations have been identified throughout limbic and paralimbic brain regions across an assortment of species. ...
Source: Seminars in Reproductive Medicine - December 16, 2019 Category: Reproduction Medicine Authors: Mills, Edouard G.A. O'Byrne, Kevin T. Comninos, Alexander N. Tags: Review Article Source Type: research

Role of Kisspeptin and NKB in Puberty in Nonhuman Primates: Sex Differences
Semin Reprod Med 2019; 37: 047-055 DOI: 10.1055/s-0039-3400253To understand the roles of kisspeptin and neurokinin B (NKB) in puberty and sex differences in their involvement, we conducted a series of experiments measuring the release of gonadotropin-releasing hormone (GnRH) and kisspeptin in the median eminence of the hypothalamus in male and female monkeys throughout sexual development. Results indicate that kisspeptin-10 and the NKB agonist, senktide, stimulated GnRH release in males and females at the prepubertal and pubertal stages, but females are much more sensitive to kisspeptin signaling than males. Moreover, thro...
Source: Seminars in Reproductive Medicine - December 16, 2019 Category: Reproduction Medicine Authors: Garcia, James P. Keen, Kim L. Seminara, Stephanie B. Terasawa, Ei Tags: Review Article Source Type: research

Kisspeptin, Neurokinin B and New Players in Reproduction
Semin Reprod Med 2019; 37: 045-046 DOI: 10.1055/s-0039-3400487 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Seminars in Reproductive Medicine)
Source: Seminars in Reproductive Medicine - December 16, 2019 Category: Reproduction Medicine Authors: Dhillo, Waljit S. Tags: Preface Source Type: research

Waljit S. Dhillo, MD
Semin Reprod Med 2019; 37: 043-044 DOI: 10.1055/s-0039-3400463 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Seminars in Reproductive Medicine)
Source: Seminars in Reproductive Medicine - December 16, 2019 Category: Reproduction Medicine Authors: Legro, Richard S. Tags: Introduction Source Type: research

Reproductive Health Needs of the Military and Veterans, Part 2
Semin Reprod Med DOI: 10.1055/s-0039-1698793 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Seminars in Reproductive Medicine)
Source: Seminars in Reproductive Medicine - October 3, 2019 Category: Reproduction Medicine Authors: Segars, James H. Tags: Introduction Source Type: research

Reproductive Health Needs of the Military and Veterans
Semin Reprod Med DOI: 10.1055/s-0039-1698443 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Seminars in Reproductive Medicine)
Source: Seminars in Reproductive Medicine - September 24, 2019 Category: Reproduction Medicine Authors: Christy, Alicia Y. Tags: Preface Source Type: research

A Mentorship Program for Academic Obstetrician Gynecologists that Improved Publication and Overall Confidence for Success
This article aims to evaluate the impact of a mentorship program to enhance the training of clinical and research scientists in obstetrics and gynecology (OBGYN). A departmental course was developed for junior faculty and fellows based on their areas of interest. The research was IRB-approved. The curriculum consisted of monthly interactive workshops for an interdisciplinary group of trainees in OBGYN. Themes included research, education, and leadership in academic OBGYN. There was a strong emphasis on participatory exercises. Examples of curriculum topics included manuscript publication and review, grant writing, working ...
Source: Seminars in Reproductive Medicine - September 18, 2019 Category: Reproduction Medicine Authors: Nasab, Susan Rushing, John S. Segars, James H. Evers, Emily Handa, Victoria L. Lawson, Shari Miller, Colleen Yenokyan, Gayane Bienstock, Jessica Satin, Andrew J. Tags: Review Article Source Type: research

Infertility and the Military Male
Semin Reprod Med DOI: 10.1055/s-0039-1694027Male infertility is a condition that affects approximately 50% of infertile couples and about 30% of those couples have only male factor infertility identified. There has been speculation that male military service members may have an even greater lifetime prevalence of infertility as compared to the general population, but very few scientific publications focus on male factor infertility in the military population specifically. This review will discuss many of the unique considerations regarding male infertility in the military and highlight future opportunities for research. Th...
Source: Seminars in Reproductive Medicine - August 15, 2019 Category: Reproduction Medicine Authors: Reed-Maldonado, Amanda B. Madden, Kristin C. Tags: Review Source Type: research

Contraceptive Care in the Veterans Health Administration
Semin Reprod Med DOI: 10.1055/s-0039-1692201In recent years, the number of women Veterans obtaining care in the Veterans Affairs (VA) Healthcare System has grown, expanding the need for provision of contraceptive care. Women Veterans are a diverse group of women with complex sociodemographic and medical backgrounds, and meeting their needs presents a unique challenge for VA. Efforts including the establishment of comprehensive women's health clinics and training practitioners in women's health have greatly improved healthcare services for women Veterans over the last few decades. Recent data from a large cross-sectional su...
Source: Seminars in Reproductive Medicine - June 10, 2019 Category: Reproduction Medicine Authors: Yecies, Emmanuelle B. Judge-Golden, Colleen P. Callegari, Lisa Borrero, Sonya Tags: Review Article Source Type: research