Gynecology; Menopause; Polycystic Ovary Syndrome; Vitamin D; Premenopause; Reproductive Medicine
Women's Sleep Health Program
- Ovarian reserve refers to the number of eggs available in the ovaries at any given age. While a decline in ovarian reserve with aging is clinically appreciable from mid 30's, as reflected by reduced likelihood to achieve pregnancy and increased risk of pregnancy losses, this process may be accelerated in some women. Our preliminary data sugest that declining ovarian reserve in premenopausal women is accompanied by deterioration in certain health parameters including the skeleton and surrogate markers for risk of cardiovascular disease.
- Role of vitamin D insufficiency in reproductive physiology is suggested: Our preliminary data suggest that pregnancy rates following in vitro fertilization may be influenced by patient's vitamin D status.
- Vitamin D insufficiency may be contributory to the pathophysiology of polycystic ovary syndrome. Ongoing clinical trial will hopefully clarify this hypothesis
Specialized Terms: Decline in ovarian reserve and multisystem implications thereof; Polycystic Ovarian Syndrome (PCOS) and metabolic implications; Menopause; Vitamin D and Reproductive Function
Extensive Research Description
1. Ovarian reserve refers to the number of eggs available in the ovaries at any given age. While a decline in ovarian reserve with aging is clinically appreciable from mid 30's, as reflected by reduced likelihood to achieve pregnancy and increased risk of pregnancy losses, this process may be accelerated in some women. Our preliminary data sugest that declining ovarian reserve in premenopausal women is accompanied by deterioration in certain health parameters including the skeleton and surrogate markers for risk of cardiovascular disease.
2. Role of vitamin D insufficiency in reproductive physiology is suggested: Our preliminary data suggest that pregnancy rates following in vitro fertilization may be influenced by patient's vitamin D status.
3. Vitamin D insufficiency may be contributory to the pathophysiology of polycystic ovary syndrome. Ongoing clinical trial will hopefully clarify this hypothesis.1. Role of vitamin D in the pathophysiology of polycystic ovary syndrome (PCOS): Ongoing unblinded 3 month trial of vitamin D and Calcium supplementation to assess effects on glucose and insulin homeostasis.
2. Endometrial effects of Metformin in women with PCOS.
Characterizing the reproductive hormone milieu in infertile women with diminished ovarian reserve.
Pal L, Zhang K, Zeitlian G, Santoro N. Characterizing the reproductive hormone milieu in infertile women with diminished ovarian reserve.Fertil Steril. 2008 Dec 17. [Epub ahead of print]
Diminished ovarian reserve in a woman with a balanced 13;21 translocation.
Kummer N, Martin JR, Pal L.Diminished ovarian reserve in a woman with a balanced 13;21 translocation. Fertil Steril. 2009 Mar;91(3):931.e3-5. Epub 2008 Sep 30.
Full List of PubMed Publications
- Taylor HS, Tal A, Pal L, Li F, Black DM, Brinton EA, Budoff MJ, Cedars MI, Du W, Hodis HN, Lobo RA, Manson JE, Merriam GR, Miller VM, Naftolin F, Neal-Perry G, Santoro NF, Harman SM: Effects of Oral vs Transdermal Estrogen Therapy on Sexual Function in Early Postmenopause: Ancillary Study of the Kronos Early Estrogen Prevention Study (KEEPS). JAMA Intern Med. 2017 Oct 1. PMID: 28846767
- Cintron D, Lahr BD, Bailey KR, Santoro N, Lloyd R, Manson JE, Neal-Perry G, Pal L, Taylor HS, Wharton W, Naftolin F, Harman SM, Miller VM: Effects of oral versus transdermal menopausal hormone treatments on self-reported sleep domains and their association with vasomotor symptoms in recently menopausal women enrolled in the Kronos Early Estrogen Prevention Study (KEEPS). Menopause. 2017 Aug 21; 2017 Aug 21. PMID: 28832429
- Santoro N, Allshouse A, Neal-Perry G, Pal L, Lobo RA, Naftolin F, Black DM, Brinton EA, Budoff MJ, Cedars MI, Dowling NM, Dunn M, Gleason CE, Hodis HN, Isaac B, Magnani M, Manson JE, Miller VM, Taylor HS, Wharton W, Wolff E, Zepeda V, Harman SM: Longitudinal changes in menopausal symptoms comparing women randomized to low-dose oral conjugated estrogens or transdermal estradiol plus micronized progesterone versus placebo: the Kronos Early Estrogen Prevention Study. Menopause. 2017 Mar. PMID: 27779568
- Pau CT, Cheang KI, Modi BP, Kasippillai T, Keefe CC, Shulleeta M, Evans WS, Pal L, Strauss JF 3rd, Nestler JE, Welt CK: The role of variants regulating metformin transport and action in women with polycystic ovary syndrome. Pharmacogenomics. 2016 Oct 28; 2016 Oct 28. PMID: 27790932
- Owen CM, Pal L, Mumford SL, Freeman R, Isaac B, McDonald L, Santoro N, Taylor HS, Wolff EF: Effects of hormones on skin wrinkles and rigidity vary by race/ethnicity: four-year follow-up from the ancillary skin study of the Kronos Early Estrogen Prevention Study. Fertil Steril. 2016 Oct; 2016 Jul 5. PMID: 27393520
- Oktay K, Bedoschi G, Berkowitz K, Bronson R, Kashani B, McGovern P, Pal L, Quinn G, Rubin K: Fertility Preservation in Women with Turner Syndrome: A Comprehensive Review and Practical Guidelines. J Pediatr Adolesc Gynecol. 2016 Oct; 2015 Oct 17. PMID: 26485320
- Pal L, Zhang H, Williams J, Santoro NF, Diamond MP, Schlaff WD, Coutifaris C, Carson SA, Steinkampf MP, Carr BR, McGovern PG, Cataldo NA, Gosman GG, Nestler JE, Myers E, Legro RS, Reproductive Medicine Network.: Vitamin D Status Relates to Reproductive Outcome in Women With Polycystic Ovary Syndrome: Secondary Analysis of a Multicenter Randomized Controlled Trial. J Clin Endocrinol Metab. 2016 Aug; 2016 May 17. PMID: 27186859
- Ensari TA, Pal L: Update on menopausal hormone therapy. Curr Opin Endocrinol Diabetes Obes. 2015 Dec. PMID: 26512772
- Gressel GM, Parkash V, Pal L: Management options and fertility-preserving therapy for premenopausal endometrial hyperplasia and early-stage endometrial cancer. Int J Gynaecol Obstet. 2015 Dec; 2015 Sep 8. PMID: 26384790
- Pal L: Uterine stem cells--promise and possibilities. Maturitas. 2015 Nov; 2015 Aug 4. PMID: 26297687
- Santoro N, Pal L: Menopause and Perimenopause. Preface. Endocrinol Metab Clin North Am. 2015 Sep. PMID: 26316251
- Torrealday S, Pal L: Premature Menopause. Endocrinol Metab Clin North Am. 2015 Sep; 2015 Jun 22. PMID: 26316242
- Davis SR, Lambrinoudaki I, Lumsden M, Mishra GD, Pal L, Rees M, Santoro N, Simoncini T: Menopause. Nat Rev Dis Primers. 2015 Apr 23; 2015 Apr 23. PMID: 27188659
- Pal L, Kidwai N, Kayani J, Grant WB: Donor egg IVF model to assess ecological implications for ART success. J Assist Reprod Genet. 2014 Nov; 2014 Sep 2. PMID: 25179156
- Hossain N, Kanani FH, Ramzan S, Kausar R, Ayaz S, Khanani R, Pal L: Obstetric and neonatal outcomes of maternal vitamin D supplementation: results of an open-label, randomized controlled trial of antenatal vitamin D supplementation in Pakistani women. J Clin Endocrinol Metab. 2014 Jul; 2014 Mar 19. PMID: 24646102
- Lundsberg LS, Pal L, Gariepy AM, Xu X, Chu MC, Illuzzi JL: Knowledge, attitudes, and practices regarding conception and fertility: a population-based survey among reproductive-age United States women. Fertil Steril. 2014 Mar; 2014 Jan 30. PMID: 24484995
- Pal L: Systemic agents for focal symptoms: a promising pasture or a potential snare? Menopause. 2014 Mar. PMID: 24496087
- Ghazal S, Pal L: Perspective on hormone therapy 10 years after the WHI. Maturitas. 2013 Nov; 2013 Sep 10. PMID: 24094493
- Fischer C, Kallen AN, Pal L: Hormone therapy: A to Z. Menopause. 2013 Nov. PMID: 23921519
- Hughes JW, Guess MK, Hittelman A, Yip S, Astle J, Pal L, Inzucchi SE, Dulay AT: Clitoral epidermoid cyst presenting as pseudoclitoromegaly of pregnancy. AJP Rep. 2013 May; 2013 Feb 7. PMID: 23943712
- Kallen AN, Luk J, Pal L: Aberrant endocrinology and ovarian response to clomiphene citrate during the course of an undiagnosed early intrauterine pregnancy: a case report. J Reprod Med. 2013 May-Jun. PMID: 23763012
- Nardell M, Chhabra A, Pal L: Excluded, not dismissed: enhancing benefit in clinical research. Contemp Clin Trials. 2013 Jan; 2012 Sep 7. PMID: 22981957
- Pal L, Berry A, Coraluzzi L, Kustan E, Danton C, Shaw J, Taylor H: Therapeutic implications of vitamin D and calcium in overweight women with polycystic ovary syndrome. Gynecol Endocrinol. 2012 Dec; 2012 Jul 11. PMID: 22780885
- Luk J, Torrealday S, Neal Perry G, Pal L: Relevance of vitamin D in reproduction. Hum Reprod. 2012 Oct; 2012 Jul 23. PMID: 22824625
- Nejat EJ, Jindal S, Berger D, Buyuk E, Lalioti M, Pal L: Implications of blood type for ovarian reserve. Hum Reprod. 2011 Sep; 2011 Jun 26. PMID: 21708793
- Pal L, Hailpern SM, Santoro NF, Freeman R, Barad D, Kipersztok S, Barnabei VM, Wassertheil-Smoller S: Increased incident hip fractures in postmenopausal women with moderate to severe pelvic organ prolapse. Menopause. 2011 Sep. PMID: 21738078
- Kallen AN, Pal L: Cardiovascular disease and ovarian function. Curr Opin Obstet Gynecol. 2011 Aug. PMID: 21681091
- Wolff E, Pal L, Altun T, Madankumar R, Freeman R, Amin H, Harman M, Santoro N, Taylor HS: Skin wrinkles and rigidity in early postmenopausal women vary by race/ethnicity: baseline characteristics of the skin ancillary study of the KEEPS trial. Fertil Steril. 2011 Feb; 2010 Oct 25. PMID: 20971461
- Pal L, Bevilacqua K, Santoro NF: Chronic psychosocial stressors are detrimental to ovarian reserve: a study of infertile women. J Psychosom Obstet Gynaecol. 2010 Sep. PMID: 20718584
- Pal L: Menopause: demystifying management of common clinical challenges. Semin Reprod Med. 2010 Sep; 2010 Sep 15. PMID: 20845234
- Pal L, Zhang K, Zeitlian G, Santoro N: Characterizing the reproductive hormone milieu in infertile women with diminished ovarian reserve. Fertil Steril. 2010 Mar 1; 2008 Dec 18. PMID: 19100532
- Pal L: Pelvic organ prolapse and relationship with skeletal integrity. Womens Health (Lond). 2009 May. PMID: 19392617
- Kummer N, Martin JR, Pal L: Diminished ovarian reserve in a woman with a balanced 13;21 translocation. Fertil Steril. 2009 Mar; 2008 Sep 30. PMID: 18829026
- Pal L, Bevilacqua K, Zeitlian G, Shu J, Santoro N: Implications of diminished ovarian reserve (DOR) extend well beyond reproductive concerns. Menopause. 2008 Nov-Dec. PMID: 18791485
- Pal L, Parkash V, Chambers JT: Eosinophilia and uterine leiomyosarcoma. Obstet Gynecol. 2003 May. PMID: 12738126
- Pal L, Parkash V, Rutherford TJ: Omental trophoblastic implants and hemoperitoneum after laparoscopic salpingostomy for ectopic pregnancy. A case report. J Reprod Med. 2003 Jan. PMID: 12611098