The notion that estrogens play a meaningful role in ovarian folliculogenesis stems from a large body of in vitro and in vivo experiments carried out in certain rodent models, (e.g., rats) wherein the stimulatory role of estrogen on granulosa cell growth and differentiation is undisputed. However, evidence derived from these polyovulatory species may not be readily generalizable to the monoovulatory subhuman primates, let alone the human. Only recently, significant observations on the ovarian role(s) of estrogen have been reported for the primate/human. It is thus the objective of this communication to review the evidence for and against a role for estrogens in primate/human ovarian follicular development with an emphasis toward the application of the concepts so developed to contemporary reproductive physiology and to the practice of reproductive medicine. The role(s) of estrogens will be examined not only by analyzing the physiological evidence to the effect that these hormones control ovarian function and follicular growth, but also by summarizing the molecular evidence for the existence and distribution of the cognate receptors.

Background Zika virus (ZIKV) infection during pregnancy has severe consequences on the new-born. The World Health Organization declared the Zika outbreak to be a Public Health Emergency of International Concern (PHEIC) in 2016. Health facilities in the regions most affected by Zika lacked the capacity to respond to the increased demand for contraception. The objectives were to explore healthcare users’ perceptions regarding contraception, Zika prevention during pregnancy and post-abortion care (PAC) services in the context of a Zika outbreak in Tegucigalpa, Honduras, and to follow these services over time. Methods This study was part of a broader implementation research study. We used qualitative research consistent with grounded theory approach. Semi-structured interviews and focus groups were performed with women and their partners who used contraceptive services or received PAC services. Data were collected in two stages from December 2017 to July 2018. Themes explored included contraception, Zika and PAC services. Results Participants had positive attitude towards the use of contraceptive methods and demanded more information on safety, efficacy and on side effects. Health care services were inconsistent in the provision of information on Zika and contraception services. ZIKV vector transmission was known but fewer participants were aware of risk of sexual transmission of Zika. Barriers to access healthcare services included contraceptive and PAC services included distance to healthcare facilities, disorganized admission process, long waiting times and out-of-pocket expenditure to purchase medicines. Furthermore, poor quality, mistreatment and abuse of women seeking PAC was prevalent. Some positive changes were noted over time, such as improvements in infrastructure including improved privacy and cleanliness, removal of fees, requisite to bring clean water to hospital. Conclusions Our results highlight the challenges and areas for improvement in policy and practice related to contraceptive services and PAC in the context of ZIKV infection. Public policies to prevent epidemics should focus more on providing proper sanitation; removing barriers to access and use of effective contraception as human rights priority. Zika epidemic has highlighted weaknesses in health systems that obstruct access to and use of sexual and reproductive health services. The study results call for increased efforts to improve access, especially for women of low socio-economic status and intervene at different levels to eradicate discrimination and improve equity in the provision of health care. Qualitative methods can capture the community perspectives and can provide useful information to develop interventions to improve services.

Objective: To investigate the association between sarcopenia, sarcopenic obesity and muscle strength and variables related to quality of life in elderly women. Method: The sample consisted of 56 female volunteers who underwent body composition analysis (BMI and x-ray absorptiometry dual-energy DXA). Handgrip strength was measured using a Jamar dynamometer. We used the SF-36 health questionnaire to analyze quality of life. The data were analyzed with descriptive statistics and the Pearson correlation coefficient; SPSS 15.0 was used to perform the statistical analysis. Results: The mean age of the subjects was 64.92±5.74 years; of the 56 volunteers evaluated, 19.64% (n=11) were classified as sarcopenic obese and 45 (80.36%) were not. Thirteen volunteers (23.21%) were classified as sarcopenic while 43 (76.78%) were not. Although there were no statistically significant differences between the studied parameters and quality of life among those with sarcopenia or sarcopenic obesity, the values were lower in affected individuals. Interestingly, handgrip strength correlated positively and significantly with all of the SF-36 dimensions except VIT (P=0.08) and SM (P=0.25). Conclusions: Seeing that handgrip strength is a determining factor in quality of life aspects in this population, the screening and identification of small functional changes using simple clinical measures may facilitate early intervention and help prevent disability. In contrast, neither sarcopenia nor sarcopenic obesity were found to be associated with quality of life.Keywords: sarcopenia; sarcopenic obesity; aging; muscle strength; rehabilitation; quality of life. ResumoObjetivo: Verificar a associação entre sarcopenia, obesidade sarcopênica e força muscular com variáveis relacionadas à qualidade de vida em idosas. Método: A amostra foi composta por 56 voluntárias do sexo feminino que se submeteram à análise de composição corporal (IMC e absortometria de raios-x de dupla energia DXA). A força de preensão palmar (FPP) foi mensurada pelo dinamômetro Jamar. Para análise de qualidade de vida, usou-se o questionário SF-36; para análise estatística, os dados foram apresentados por meio da estatística descritiva

Compelling evidence exists displaying that the intrafollicular IGF-I system constitutes an obligatory mediator of FSH action in the murine ovary. Within this system, the ovarian IGF binding protein-4-directed protease (IGFBP-4ase) may have a critical role. Human IGFBP-4ase has been proved identical to the previously well-characterized pregnancy-associated plasma protein-A (PAPP-A). This communication reports the cloning and sequencing of the mouse PAPP-A cDNA as well as its expression and cellular localization in the mouse ovary. PAPP-A mRNA was undetectable in ovaries of untreated immature 25-d-old mice. Treatment with PMSG led to a marked time-dependent increase in PAPP-A expression in well-defined subsets of granulosa cells and follicles. Specifically, PAPP-A expression was detectable exclusively in centrifugally residing membrana granulosa cells of antral follicles during a 3- to 36-h period post PMSG. PAPP-A expression then fell to nondetectable levels in dominant preovulatory follicles at 48 h post PMSG. Treatment of PMSG-primed mice with human CG caused a rapid reinduction of PAPP-A expression in granulosa cells of dominant follicles and was sustained at relatively high levels throughout the ovulation and luteinization. These results suggest a role for gonadotropin-stimulated PAPP-A gene expression in the physiologic processes of dominant follicle development, ovulation, and luteogenesis in the mammalian ovary. The early onset and extended duration of gonadotropin-dependent PAPP-A expression in granulosa cells may serve to degrade the antigonadotropin IGFBP-4. Accordingly, successful antral follicle development, ovulation, and corpus luteum formation may be contingent on an IGFBP-4-deplete/PAPP-A-replete circumstance, hence resulting in an IGF-I-replete intrafollicular microenvironment.

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