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Sample records for anovulation

  1. The etiology analysis of anovulation in reproductive period%育龄期无排卵的病因分析

    Institute of Scientific and Technical Information of China (English)

    王艳; 刘晓燕; 任慕兰

    2014-01-01

    Chronic anovulation in reproductive period is defined as a pathological state of the women with failure of the ovary to release ova, which is one of the most common causes of infertility. Anovulation is typically associated with amenorrhea or severe oligomenorrhea. The WHO classification divides women with anovulation into three major groups:WHO GroupⅠ,Ⅱ,Ⅲ. The most common causes of anovulation in reproductive period are hypothalamic dysfunction,pituitary disease,and ovarian dysfunction. Other glands dysfunction such as thyroid disease and adrenal dysfunction can lead to anovulation. The common ovarian causes of anovulation are congenital ovarian dysplasia,resistant ovarian syndrome(ROS),premature ovarian failure(POF),polycystic ovary syndrome(PCOS), and luteinized unruptured follicle syndrome( LUFS) ,of which POF and PCOS are the most common. Systemic diseases may affect ovulation,resulting a vicious cycle. The harmful substances in environment,especially the environmental hormone,have been confirmed to induce adverse reproductive effects in human beings. The pathogenesis of anovulation is complicated,accurate evaluation and identification of the cause should be the pivotal issue of effective treatment.%育龄期无排卵是指育龄女性长期无卵子成熟排出的病理状态,是女性不孕症的主要原因之一。育龄期无排卵多伴随着闭经或严重的月经过少。世界卫生组织将无排卵分为WHOⅠ~Ⅲ类。育龄期无排卵主要病因可分为下丘脑功能紊乱、垂体疾病、卵巢功能异常;其他内分泌腺体如甲状腺和肾上腺功能异常亦可能导致无排卵。卵巢功能异常所致的无排卵病因包括:先天性卵巢发育异常、卵巢抵抗综合征(resistant ovarian syndrome,ROS)、卵巢早衰(premature ovarian failure,POF)、多囊卵巢综合征(polycystic ovary syndrome,PCOS)、未破裂卵泡黄素化综合征( luteinized unruptured follicle syndrome,LUFS),最常见者为POF和PCOS。

  2. Factors associated with nonresponse to ovulation induction using letrozole among women with World Health Organization group II anovulation

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    Thilina Sanjeewa Palihawadana

    2015-01-01

    Full Text Available Context: Letrozole, a third generation aromatase inhibitor is gaining importance in ovulation induction. Some prefer to use it as a second line agent in women who fail to respond to clomifene citrate. However, our knowledge about the predictors of response to letrozole is limited. Aims: The study was aimed at identifying the factors associated with letrozole resistance among women with World Health Organization (WHO group II anovulation. Subjects and Methods: Study was conducted at the infertility clinic at a tertiary care hospital in Sri Lanka. A case-control study design was used and included 50 subjects with WHO group II anovulation (25 clomifene responsive and 25 clomifene resistant. After a treatment cycle of letrozole, the factors were compared between the subjects who responded and those who failed to respond to treatment. Results: Ovulation was achieved in 76% (n = 19 of subjects who had responded to clomifene previously and in 24% (n = 6 with clomifene resistance. The factors associated with letrozole resistance included the presence of hirsutism (odds ratio [OR]: 3.89; 95% confidence interval [CI]: 1.2-12.3 and clomifene resistance (OR: 10.03; 95% CI: 2.81-35.7. The early follicular phase mean (standard deviation luteinizing hormone level was significantly higher among the nonresponders (9.75 [4.78] - 7.28 [2.3]; P = 0.02. Nonresponders showed significantly lower levels of oestradiol on the 5 th and 9 th days (28.50 [3.39] pg/mL vs. 7.49 [3.62] pg/mL; P = 0.0007 and 142.04 [76.22] pg/mL vs. 28.10 [12.8] pg/mL; P = 0.0001 of the menstrual cycle, respectively. Conclusions: The features associated with resistance to Letrozole at a dose of 2.5 mg show some overlap with those associated with clomifene resistance. However, some features do not show similar association. The effectiveness of letrozole at a dose of 2.5 mg in induction of ovulation among women with clomifene resistance is low and it does not seem to be a suitable treatment at a

  3. The effect of traditional Chinese medicine "Tian Gui Recipe (TGR)"on obesity and anovulation in androgen-sterilized rats (ASR)

    Institute of Scientific and Technical Information of China (English)

    俞瑾; 孙斐

    2002-01-01

    Objectives: A traditional Chinese medicine “Tian Gui Recipe (TGR)” has been used to effectively treat clomiphene resistant anovulatory disease and obesity, especially in polycystic ovary syndrome (PCOS) cases with hyperinsulinemia. The effect of TGR on obesity and anovulation was investigated in androgen-sterilized rats (ASR).Methods: Female SD rats at the age of 9 days were divided into 3 groups. Group ASR (n=15): anovulation was demonstrated at the age of 70 days by vaginal smear in rats while 1.25 mg of testosterone propionate was injected subcutaneously on its 9th neonatal day. Group A+H (n=25): TGR were administered to ASR at the age of 80 days for 3 weeks. Rats with regular estrous cycle and ovulation after herbal treatment were included in this group. Group C (n=15): normal ovulated rats were recruited. Around the age of 112 days or on proestrous day, all rats were sacrificed under anesthesia. Serum leptin, testosterone (T), estrogen (E2), follicular stimulating hormone (FSH), luteinizing hormone (LH) levels were measured with radioimmunoassay (RIA). Double immunofluorescent staining combined with confocal laser scanning microscope and dual in situ hybridization were carried out on sections through areas of arcuate nucleus (ARC) to determine whether estrogen receptor (ER) immunoreactivity (IR) or long form of leptin receptor (OB-Rb) mRNA were expressed in neuropeptide Y (NPY) immuno- and mRNA-containing neurons, and their relationship to proopiomelanocortin (POMC) mRNA-containing neurons. Immunohistochemistry and in situ hybridization were used to observe the levels of ER-, NPY-,gonadotrophin releasing hormone (GnRH)-IR and gene expression levels of NPY, OB-Rb, and POMC in ARC. Meanwhile, the criteria of energy state,including daily food intake, retroperitoneal fat depot pad and body weight,were measured and evaluated. Values of immunohistochemistry and in situ hybridization were expressed in mean optic density (MOD).Results:Seventeen out of the 25 rats

  4. The long-term complications of oligo-ovulation and anovulation%稀发排卵和无排卵的远期并发症

    Institute of Scientific and Technical Information of China (English)

    潘萍; 杨冬梓

    2014-01-01

    Ovulatory dysfunction is an important cause of female infertility with mainly characteristics of oligo-ovulation and anovulation. In addition to causing menstrual disorders and infertility,the long-term complications of oligo-ovulation and anovulation can not be ignored. Polycystic ovary syndrome( PCOS) is the most common clinical ovulation disorders with persisting pathophysiological changes, which causes a series of endocrinic/metabolic disorders, such as endometrial hyperplasia, endometrial cancer, insulin resistance, impaired glucose tolerance, diabetes,hypertension,dyslipidemia,metabolic syndrome,an increased risk of cardiovascular disease,et al. During the past 20 years, the long - term complications of PCOS were obtained sufficient researches, the long - term health situations of ovulation disorders patients and prevention of the complications have been paid more attentions.%排卵功能障碍是导致女性不孕症的一个重要原因,最显著的特征是稀发排卵或无排卵。稀发排卵和无排卵除了引起月经紊乱和不孕不育,其远期危害也不容忽视。多囊卵巢综合征( polycystic ovary syndrome,PCOS)是临床工作中最常见的排卵障碍性疾病,病理生理改变持续存在,远期常引起一系列内分泌/代谢紊乱,如子宫内膜增殖症、子宫内膜癌、胰岛素抵抗、糖耐量受损、糖尿病、高血压、血脂代谢异常、代谢综合征、心血管疾病风险增加等。近20年来,PCOS的远期并发症得到了较为充分的研究,排卵障碍患者的远期健康状况和并发症防治等问题日益受到重视。

  5. Infertility in Female Mice with a Gain-of-Function Mutation in the Luteinizing Hormone Receptor Is Due to Irregular Estrous Cyclicity, Anovulation, Hormonal Alterations, and Polycystic Ovaries1

    Science.gov (United States)

    Hai, Lan; McGee, Stacey R.; Rabideau, Amanda C.; Paquet, Marilène; Narayan, Prema

    2015-01-01

    The luteinizing hormone receptor, LHCGR, is essential for fertility in males and females, and genetic mutations in the receptor have been identified that result in developmental and reproductive defects. We have previously generated and characterized a mouse model (KiLHRD582G) for familial male-limited precocious puberty caused by an activating mutation in the receptor. We demonstrated that the phenotype of the KiLHRD582G male mice is an accurate phenocopy of male patients with activating LHCGR mutations. In this study, we observed that unlike women with activating LHCGR mutations who are normal, female KiLHRD582G mice are infertile. Mice exhibit irregular estrous cyclicity, anovulation, and precocious puberty. A temporal study from 2–24 wk of age indicated elevated levels of progesterone, androstenedione, testosterone, and estradiol and upregulation of several steroidogenic enzyme genes. Ovaries of KiLHRD582G mice exhibited significant pathology with the development of large hemorrhagic cysts as early as 3 wk of age, extensive stromal cell hyperplasia and hypertrophy with luteinization, numerous atretic follicles, and granulosa cell tumors. Ovulation could not be rescued by the addition of exogenous gonadotropins. The body weights of the KiLHRD582G mice were higher than wild-type counterparts, but there was no increase in the body fat composition or metabolic abnormalities such as impaired glucose tolerance and insulin resistance. These studies demonstrate that activating LHCGR mutations do not produce the same phenotype in female mice as in humans and clearly illustrate species differences in the expression and regulation of LHCGR in the ovary, but not in the testis. PMID:26040673

  6. Ovulation induction in normogonadotropic anovulation (PCOS)

    NARCIS (Netherlands)

    van Santbrink, Evert J. P.; Fauser, Bart C. J. M.

    2006-01-01

    Treatment of normogonadotropic anovulatory infertility (World Health Organization class 2, or WHO2) is by induction of ovulation using clomiphene citrate (CC), followed by follicle-stimulating hormone (FSH) in cases of treatment failure. Not all patients will become ovulatory or will conceive with t

  7. Neuroendocrine mechanisms of development of experimental hyperandrogen-induced anovulation.

    Science.gov (United States)

    Reznikov, A G; Sinitsyn, P V; Tarasenko, L V; Polyakova, L I

    2003-10-01

    An experimental model of hyperandrogen-induced anovulatory infertility (s.c. implantation of Silastic capsules containing testosterone into adult female rats) was used to study morphological, hormonal, and biochemical measures characterizing the state of the hypothalamo-hypophyseal-ovarian system. Impairments in functional androgen metabolism in the hypothalamus were seen, with decreases in the Luliberin sensitivity of the hypophysis, changes in the structure of estral cycles, and morphological changes in the ovaries; these findings are evidence for neuroendocrine disturbances in the control of ovulation. Flutamide, an experimental antiandrogen, led to partial normalization of the hormonal, biochemical, and morphological characteristics, as well as to recovery of fertility in females with anovulatory infertility.

  8. Anovulation with or without PCO, hyperandrogenaemia and hyperinsulinaemia as promoters of endometrial and breast cancer.

    Science.gov (United States)

    Papaioannou, Spyros; Tzafettas, John

    2010-02-01

    The relationship of infertility, endocrinology and cancer has become clearer in recent years. Polycystic ovaries (PCO) increase the risk of endometrial cancer. Prolonged amenorrhoea, therefore, should be prevented in such cases with the use of cyclical progestogens, in order for regular withdrawal bleeds to be induced and the endometrium protected from long-term unopposed oestrogen stimulation. There is no secure evidence base on which a relationship between PCO and breast cancer can be based. No specific breast screening for women with PCO is, therefore, recommended. Hyperandrogenaemia and hyperinsulinaemia are conditions whose significance in terms of increasing both endometrial and breast cancer risks is increasingly recognised. The exact mechanism with which they influence carcinogenesis is still far from clear. Whether they act in isolation or as expressions of the common background of the metabolic syndrome - in interaction with other components of this syndrome - is still the subject of research.

  9. Willingness to pay for ovulation induction treatment in case of WHO II anovulation: a study using the contingent valuation method

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    Poder TG

    2014-09-01

    Full Text Available Thomas G Poder,1 Jie He,2 Catherine Simard,3 Jean-Charles Pasquier4 1UETMIS and CRCHUS, CHUS, Sherbrooke, QC, Canada; 2Department of Economics, GREDI, University of Sherbrooke, QC, Canada; 3Department of Obstetrics and Gynecology, CH of Chicoutimi, affiliated to CHUS, QC, Canada; 4Department of Obstetrics and Gynecology, CHUS, Sherbrooke, QC, Canada Objective: To measure the willingness to pay (WTP of women aged 18–45 years to receive drug treatment for ovulation induction (ie, the social value of normal cycles of ovulation for a woman of childbearing age in order to feed the debate about the funding of fertility cares.Setting: An anonymous questionnaire was used over the general population of Quebec. Participants: A total of 136 subjects were recruited in three medical clinics, and 191 subjects through an online questionnaire.Method: The questionnaire consisted of three parts: introduction to the problematic, socioeconomic data collection to determine factors influencing the formation of WTP, and a WTP question using the simple bid price dichotomous choice elicitation technique. The econometric estimation method is based on the “random utility theory.” Each subject responding to our questionnaire could express her uncertainty about the answer to our WTP question by choosing the answer “I do not know.”Outcome measure: The WTP in Canadian dollars of women aged 18–45 years to receive drug treatment for ovulation induction.Results: Results are positive and indicate an average WTP exceeding 4,800 CAD, which is much more than the drug treatment cost. There is no evidence of sample frame bias or avidity bias across the two survey modes that cannot be controlled in econometric estimates.Conclusion: Medical treatment for ovulation induction is highly socially desirable in Quebec. Keywords: WTP, fertility, drug therapy 

  10. Willingness to pay for ovulation induction treatment in case of WHO II anovulation: a study using the contingent valuation method

    Science.gov (United States)

    Poder, Thomas G; He, Jie; Simard, Catherine; Pasquier, Jean-Charles

    2014-01-01

    Objective To measure the willingness to pay (WTP) of women aged 18–45 years to receive drug treatment for ovulation induction (ie, the social value of normal cycles of ovulation for a woman of childbearing age) in order to feed the debate about the funding of fertility cares. Setting An anonymous questionnaire was used over the general population of Quebec. Participants A total of 136 subjects were recruited in three medical clinics, and 191 subjects through an online questionnaire. Method The questionnaire consisted of three parts: introduction to the problematic, socioeconomic data collection to determine factors influencing the formation of WTP, and a WTP question using the simple bid price dichotomous choice elicitation technique. The econometric estimation method is based on the “random utility theory.” Each subject responding to our questionnaire could express her uncertainty about the answer to our WTP question by choosing the answer “I do not know.” Outcome measure The WTP in Canadian dollars of women aged 18–45 years to receive drug treatment for ovulation induction. Results Results are positive and indicate an average WTP exceeding 4,800 CAD, which is much more than the drug treatment cost. There is no evidence of sample frame bias or avidity bias across the two survey modes that cannot be controlled in econometric estimates. Conclusion Medical treatment for ovulation induction is highly socially desirable in Quebec. PMID:25328385

  11. PCOS according to the Rotterdam consensus criteria : change in prevalence among WHO-II anovulation and association with metabolic factors

    NARCIS (Netherlands)

    Broekmans, F. J.; Knauff, E. A. H.; Valkenburg, O.; Laven, J. S.; Eijkemans, M. J.; Fauser, B. C. J. M.

    2006-01-01

    Objective The current report aims to compare the prevalence of polycystic ovary syndrome (PCOS) diagnosed according to the new Rotterdam criteria (Rott-PCOS) versus the previous criteria as formulated by the National Institutes of Health (NIH) (NIH-PCOS) in women with normogonadotropic (WHO-II) anov

  12. Reproductive adaptations to a large-brained fetus open a vulnerability to anovulation similar to polycystic ovary syndrome.

    Science.gov (United States)

    Barnett, Deborah K; Abbott, David H

    2003-01-01

    During the ovarian or menstrual cycle, prior to ovulation, many female primates exhibit a relatively prolonged follicular phase and terminate the postovulatory luteal phase with menstrual bleeding. The prolonged follicular phase is a trait that distinguishes primate from nonprimate species. It enables extended estrogen-induced proliferation and growth of the uterine endometrium prior to progesterone-induced maturation during the luteal phase to accommodate a potential pregnancy with a rapidly invading placenta. Progressive development of both an extended duration of estrogen-induced, preimplantation endometrial proliferation and a rapidly invading placenta across the Primate order may well have been necessary to accommodate differentiation and growth of an increasingly large fetal brain. Prolongation of the follicular phase in primates has also led to the isolation of the final stages of follicle selection (growth deviation of the dominant follicle from its contemporaries) solely within the follicular phase and thus outside the protection of luteal phase progesterone inhibition of pituitary luteinizing hormone (LH) secretion. Such primate reproductive characteristics put the latter stages of ovarian follicle selection at risk of exposure to excessive pituitary secretion of LH. Excessive secretion of LH during follicle selection could result not only in impaired follicle development, excessive ovarian androgen secretion, and ovulation failure, but also in excessive estrogenic stimulation of the uterine endometrium without intervening menstrual periods. Such reproductive abnormalities are all found in a single, prevalent infertility syndrome afflicting women in their reproductive years: polycystic ovary syndrome (PCOS). We propose that successful female reproductive adaptations to accommodate the growth demands of large-brained primate fetuses have facilitated a particular vulnerability of higher primates to hypergonadotropic disruption of ovulatory function, as found in PCOS.

  13. Cost-effectiveness analysis on the use of rFSH + rLH for the treatment of anovulation in hypogonadotropic hypogonadal women

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    Papaleo E

    2014-06-01

    Full Text Available Enrico Papaleo,1 Carlo Alviggi,2 Giorgio Lorenzo Colombo,3,4 Claudio Pisanelli,5,6 Claudio Ripellino,7 Salvatore Longobardi,8 Pier Luigi Canonico91Centro Scienze della Natalità, Gynecological-Obstetrics Department, San Raffaele Hospital, Vita-Salute San Raffaele, Milan, Italy; 2Department of Neuroscience, Reproductive Sciences and Odontostomatology, University “Federico II” of Naples, Naples, Italy; 3Department of Drug Sciences, University of Pavia, Pavia, Italy; 4SAVE Studi Analisi Valutazioni Economiche, Milan, Italy; 5ACO San Filippo Neri, Rome, Italy; 6Società Italiana Di Farmacia Ospedaliera, Milan, Italy; 7CSD Medical Research Srl, Milan, Italy; 8Medical Department, Merck Serono SpA, Rome, Italy; 9Department of Pharmaceutical Sciences, University of Piemonte Orientale, Novara, Italy Background: Hypogonadotropic hypogonadal women are characterized by ovarian functionality deficiency, caused by low concentrations of follicle-stimulating hormone (FSH and luteinizing hormone (LH. To recover reproduction functionality, recommended therapies for ovarian induction involve injections of FSH and LH medications. Objective: Since important differences exist between recombinant and urinary gonadotropin therapies in terms of efficacy and cost, the objective of this study was to develop a cost-effectiveness model to compare recombinant FSH (rFSH + recombinant LH (rLH and highly purified human menopausal gonadotropin (HP-HMG. Methods: A Markov model was developed, considering three cycles of therapy; probability of pregnancy and miscarriage were considered, and the efficacy was evaluated in terms of pregnancy occurrence. The perspective of the model was that of the Italian Health Service, so only direct cost (drugs, specialist visits, patient examinations, and hospitalizations were included. Results: rFSH + rLH is associated with a higher total cost (€3,453.50 and higher efficacy (0.87 compared with HP-HMG (€2,719.70 and 0.50. rFSH + rLH generated an incremental cost effectiveness ratio equal to €2,007.30 compared to HP-HMG; the average cost per pregnancy is estimated to be €3,990.00 for recombinant strategy and €5,439.80 for urinary strategy. Results of probabilistic sensitivity analysis were consistent with the abovementioned findings. Conclusion: Despite the higher acquisition cost in comparison to HP-HMG, rFSH + rLH resulted in a higher pregnancy rate, which makes it the recommended choice when considering cost-effectiveness of LH in supporting FSH-induced follicular gonadotropins in hypogonadotropic hypogonadal women. Keywords: HP-HMG, hypogonadotropic hypogonadism, gonadotropin

  14. Síndrome da anovulação crônica hiperandrogênica e transtornos psíquicos Hyperandrogenic chronic anovulation and psychologic disturbances

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    José Arnaldo S. Ferreira

    2006-01-01

    Full Text Available Os autores fazem uma revisão da síndrome dos ovários policísticos (SOP com relação aos seus aspectos etiopatogênicos, clínicos, diagnósticos e terapêuticos, dando ênfase aos transtornos de ordem psíquica que freqüentemente acompanham esse distúrbiio. Tecem considerações sobre a importância não só de um efetivo tratamento médico, mas também de uma abordagem e um apoio psicológico, no sentido de melhorar ainda mais o bem-estar e a qualidade de vida dessas mulheres.The authors have reviewed the main aspects of the polycystic ovary syndrome (PCOS with respect to its etiopathogenic, clinical, diagnostic and therapeutic features, highlighting the psychological distresses that frequently arise in the syndrome. They also make considerations on the importance of an effective clinical treatment as well as on the approaches and psychological support, aiming to improve women’s well-being and quality of life.

  15. Standardization of androstenedione and estrone radioimmunoassay and profile of sex steroids, gonadotropins and prolactin - in patients with chronic anovulation due to inappropriate feedback (polycystic ovarian syndrome); Padronizacao do radioimunoensaio da androstenediona e da estrona e o perfil dos esteroides sexuais, gonadotrofinas e prolactina em pacientes com anovulacao cronica por retrocontrole improprio (sindrome dos ovarios policisticos)

    Energy Technology Data Exchange (ETDEWEB)

    Vilanova, Maria do Socorro Veras

    1992-12-01

    Full text. In order to evaluate the profile of the sex steroids gonadotropin and prolactin in polycystic ovarian syndrome (POS), 24 patients with POS were studied and compared with 20 normal women during the early follicular phase of the menstrual cycle. Radioimmunoassay techniques for androstenedione (A) and estrone (E{sub 1}) were standardized for the purpose of the study. Androstenedione and estrone were extracted from plasma with ethyl ether. The assays were maintained in equilibrium and the labelled hormone-antibody complex was then separated from the free hormone using dextran charcoal. The sensitivity of the method was 6.8 pg/tube for A and 3.7 pg/tube for E{sub 1}. Nonspecific binding ws 3.4 for A and 3.3 for E{sub 1}. The interessay error at the D50 level was 15.6 for A and 8.6 for E{sub 1}. Patients with POS had significantly higher basal levels of LH, A, T E{sub 1} and PRL and similar FSH and DHEA-S levels when compared with normal women. The LH/FSH ratio was significantly elevated and the A/T ratio was significantly decreased. The A/E{sub 1} and T/E{sub 2} ratios were elevated and the E{sub 1}/E{sub 2} was decreased, although the differences were not statistically significant. A positive correlation between A and E{sub 1} was observed in patients with POS. In view of the above data, it was concluded that: the quality control parameters of the radioimmunoassay for A and E{sub 1} standardized in the present study are considered satisfactory, and the assay could be used for diagnosis and research; the patients with POS have a different sex steroid and gonadotropin profile when compared normal women during the early follicular phase of the menstrual cycle

  16. Granulosa cell cycle regulation and steroidogenesis in a high androstenedione follicular microenvironment

    Science.gov (United States)

    Anovulatory infertility (either chronic or sporadic anovulation) affects up to 40% of infertile women. In fact, sporadic anovulation in humans may often go undetected. Recent literature has reported that 8-13% of normally menstruating women (250 total, two reproductive cycles) exhibit sporadic anovu...

  17. Effect of sustained released metformin therapy on phenotypic and biochemical markers of insulin resistance in polycystic ovary syndrome in South Indian women

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    Rama Nagendra Kumar

    2016-04-01

    Conclusions: Six months of metformin-SR therapy favorably altered markers of IR, TT, SHBG, anovulation and hyperandrogenism in normoglycemic women with PCOS. [Int J Reprod Contracept Obstet Gynecol 2016; 5(4.000: 1026-1030

  18. Thiazolinedione treatment in PCOS-an update

    DEFF Research Database (Denmark)

    Glintborg, Dorte; Andersen, Marianne

    2010-01-01

    Polycystic ovary syndrome (PCOS) is characterised by anovulation, hyperandrogenism, and polycystic ovaries. Fifty percent of patients fulfil the criteria for the metabolic syndrome. The pathogenesis of PCOS may be looked as a vicious cycle involving hyperandrogenemia, central obesity, and insulin...

  19. Polycystic ovary syndrome and hirsutism

    OpenAIRE

    Evliyaoğlu, Olcay

    2011-01-01

    Polycystic ovary syndrome is a multi factorial heterogenous disorder characterized by chronic anovulation and hyperandrogenism Diagnosis is based on clinical or laboratory evidence of nbsp; hyperandrogenism nbsp; For diagnosis at least two of the three Rotterdam criteria oligo anovulation clinical or biochemical signs of hyperandrogenism polycystic ovaries nbsp; should be ensured Clinical symptoms usually begin around menarche nbsp; Oligomenorrhea amenorrhea hirsutism acne alopecia can be ass...

  20. Polycystic ovary syndrome and risk of endometrial cancer: a mini-review.

    Science.gov (United States)

    Tokmak, Aytekin; Kokanali, Mahmut Kuntay; Guzel, Ali Irfan; Kara, Aydan; Topcu, Hasan Onur; Cavkaytar, Sabri

    2014-01-01

    The polycystic ovary syndrome is the most common endocrinological disorder of reproductive age women with a prevalence of 5 to 8 %. The most common diagnostic criteria used for polycystic ovary syndrome are oligo- or an-ovulation, clinical and/ or biochemical signs of hyperandrogenism and polycystic ovaries. Hyperandrogenism results in increased estrogen levels and lack of cyclic progesterone due to anovulation and persistent stimulation of the endometrium may lead to endometrial hyperplasia or adenocarcinoma development. In this mini review, we aimed to evaluate the possible relationship between polycystic ovary syndrome and endometrial cancer.

  1. Reproductive System Outcome Among Patients with Polycystic Ovarian Syndrome.

    Science.gov (United States)

    Carmina, Enrico

    2015-12-01

    Polycystic ovarian syndrome (PCOS) may present with different clinical patterns and the anovulatory phenotype may not be the most common. Data suggest that anovulation in PCOS is not the consequence of increased androgen ovarian secretion but rather of a severe derangement of early follicle development. Other mechanisms may be operative in subgroups of patients and may contribute to the arrest of follicle growth and anovulation. At least 50% of anovulatory patients with PCOS become ovulatory in their late reproductive age. There is also evidence that menopause may occur later in women with PCOS. Finally, a strategy for treatment of infertility in PCOS is presented.

  2. Prediction of ovulation induction outcome in normogonadotropic anovulatory infertility

    NARCIS (Netherlands)

    B. Imani (Babak)

    2002-01-01

    textabstractAnovulation is a major cause of female reproductive dysfunction and can be identified in approximately 18-25% of couples presenting with infertility (Hull et al., 1985). Oligomenorrhea (arbitrarily defined as menstrual periods occurring at intervals betvveen 35 days to 6 months) or ameno

  3. New paradigms in PCOS

    DEFF Research Database (Denmark)

    Ravn, Pernille

    2015-01-01

    Polycystic ovary syndrome (PCOS) is the most common endocrine disorder amongst women of reproductive age and is associated with various metabolic risk factors, in addition to chronic anovulation and factors related to androgen excess. Women with PCOS have a higher risk of insulin resistance...

  4. Women's Health Implications of Polycystic Ovary Syndrome

    NARCIS (Netherlands)

    Veltman-Verhulst, S.M.

    2012-01-01

    Polycystic Ovary Syndrome (PCOS) is a complex endocrine disorder of unknown etiology which affects approximately 12% of women. Principal features of PCOS are anovulation resulting in irregular or absent menstruation, excessive androgens (male sex hormones) and ovaries with multiple follicles (polycy

  5. Ovulatory disturbances. Causative factors among Japanese student nurses in a dormitory.

    Science.gov (United States)

    Nagata, I; Kato, K; Seki, K; Furuya, K

    1986-01-01

    The incidence of ovulatory disturbances in student nurses living in a restricted circumstance was evaluated by observing a basal body temperature (BBT) chart recorded for three to nine months by all of the student nurses in our medical college. The students were 18-21 years of age and were all living in a school dormitory. One hundred of the 154 students (64.9%) were anovulators during the school term. However, 40 of the anovulators showed ovulatory cycles with biphasic BBT patterns during their spring and/or summer holidays. The subjects' living conditions were investigated by questionnaire. Age of menarche, sport activity, self-perceived physical and mental work load, and native region did not appear to be related to their ovulatory disturbances. Weight-height-derived indices indicated that the anovulators had a tendency to corpulence as compared to the regular ovulators. Serum luteinizing hormone, follicle stimulating hormone, and prolactin levels of the anovulators were not significantly different from the regular ovulators.

  6. Health and fertility in World Health Organization group 2 anovulatory women

    NARCIS (Netherlands)

    Baird, D. T.; Balen, A.; Escobar-Morreale, H. F.; Evers, J. L. H.; Fauser, B. C. J. M.; Franks, S.; Glasier, A.; Homburg, R.; La Vecchia, C.; Crosignani, P. G.; Devroey, P.; Diedrich, K.; Fraser, L.; Gianaroli, L.; Liebaers, I.; Sunde, A.; Tapanainen, J. S.; Tarlatzis, B.; Van Steirteghem, A.; Veiga, A.; Evers, J. L. H.

    2012-01-01

    Disruption of ovulation occurs in different types of clinical infertility. The World Health Organization (WHO) has provided a classification of ovulation disorders. This review focuses on WHO group 2 anovulation. Searches were performed in Medline/PubMed and EMBASE. Each subject summary was presente

  7. Premature ovarian failure and ovarian autoimmunity

    NARCIS (Netherlands)

    J.A. Schoemaker (Joop); H.A. Drexhage (Hemmo); A. Hoek (Annemieke)

    1997-01-01

    textabstractPremature ovarian failure (POF) is defined as a syndrome characterized by menopause before the age of 40 yr. The patients suffer from anovulation and hypoestrogenism. Approximately 1% of women will experience menopause before the age of 40 yr. POF is a heter

  8. Elevated serum levels of free insulin-like growth factor I in polycystic ovary syndrome

    NARCIS (Netherlands)

    H.J. Thierry van Dessel; P.D.K. Lee (Philip); G. Faessen; B.C.J.M. Fauser (Bart); L.C. Giudice

    1999-01-01

    textabstractPolycystic ovary syndrome (PCOS) is the most common cause of anovulation in women. Previous studies suggest that the pathogenesis of PCOS may involve interrelated abnormalities of the insulin-like growth factor (IGF) and ovarian steroidogenesis systems. We i

  9. Bone morphogenetic proteins and the polycystic ovary syndrome

    NARCIS (Netherlands)

    E.L.A.F. van Houten (Leonie); J.S.E. Laven (Joop); Y.V. Louwers (Yvonne); A. McLuskey; A.P.N. Themmen (Axel); J.A. Visser (Jenny)

    2013-01-01

    textabstractBackground: Polycystic Ovary Syndrome (PCOS) is defined by two out of the following three criteria being met: oligo- or anovulation, hyperandrogenism, and polycystic ovaries. Affected women are often obese and insulin resistant. Although the etiology is still unknown, members of the Tran

  10. Obesity affects spontaneous pregnancy chances in subfertile, ovulatory women

    NARCIS (Netherlands)

    J.W. van der Steeg (Jan Willem); P. Steures (Pieternel); M.J.C. Eijkemans (René); J.D.F. Habbema (Dik); P.G. Hompes (Peter); J.M. Burggraaff (Jan); G.J.E. Oosterhuis (Jur); P.M.M. Bossuyt (Patrick); F. Veen (Fulco); B.W.J. Mol (Ben)

    2008-01-01

    textabstractBACKGROUND: Obesity is increasing rapidly among women all over the world. Obesity is a known risk factor for subfertility due to anovulation, but it is unknown whether obesity also affects spontaneous pregnancy chances in subfertile, ovulatory women. METHODS: We evaluated whether obesity

  11. Complementary Therapy in Polycystic Ovary Syndrome

    OpenAIRE

    Aquino, Carmen Imma; Nori, Stefania Lucia

    2014-01-01

    Polycystic Ovary Syndrome (PCOS) is an endocrine disease. PCOS afflicts 5 to 10 % of women of reproductive age. The symptoms are: amenorrhea, oligomenorrhea, hirsutism, obesity, infertility, chronic hyperandrogenic anovulation and acne. Other risk factors aggravate this condition: insulin resistance, obesity, hypertension, dyslipidemia, inflammation and subclinical cardiovascular disease. Anxiety, depression and reduced quality of life are also common. This review highlights the mechanisms an...

  12. Psychological well-being and sexarche in women with polycystic ovary syndrome

    NARCIS (Netherlands)

    J.E. de Niet; C.M. de Koning; H. Pastoor; H.J. Duivenvoorden (Hugo); O. Valkenburg (Olivier); M.J. Ramakers; J. Passchier (Jan); C. de Klerk (Cora); J.S.E. Laven (Joop)

    2010-01-01

    textabstractBackground The characteristics of polycystic ovary syndrome (PCOS) such as hyperandrogenism and anovulation can be highly stressful and might negatively affect psychological well-being and sexuality. The objective of this study was to evaluate the association between PCOS characteristics

  13. Polycystic ovary syndrome and acne.

    Science.gov (United States)

    Chuan, Sandy S; Chang, R Jeffrey

    2010-01-01

    Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in reproductive aged women. It is typically characterized by hyperandrogenism, chronic anovulation, and polycystic ovaries. Women with PCOS often experience dermatologic manifestations of hyperandrogenism, including hirsutism, acne vulgaris, and androgenic alopecia. This article will review the treatments for acne due to androgen excess in PCOS women.

  14. A review on treating PCOS in the integrative medicine%中西医结合对多囊卵巢综合征所致不孕症的研究进展

    Institute of Scientific and Technical Information of China (English)

    张瑞湘

    2015-01-01

    Polycystic Ovary Syndrome (PCOS) is a disease characterized with hyperandrogenism, anovulation and polycystic ovary-like changed. Polycystic Ovary Syndrome is the main reason of ovulatory disorder infertility. Anovulation and less ovulation are the key factors of PCOS patient’s reproductive dysfunction.%多囊卵巢综合征(PCOS)是一种以高雄激素血症、排卵障碍以及卵巢呈多囊样改变为特征的病变[1]。多囊卵巢综合征是引起排卵障碍性不孕的主要原因,无排卵和稀发排卵是导致PCOS患者生殖功能障碍的关键因素。

  15. The circadian variation in Anti-Müllerian hormone in patients with polycystic ovary syndrome differs significantly from normally ovulating women

    DEFF Research Database (Denmark)

    Bungum, Leif Johan; Franssohn, Florencia; Bungum, Mona Berger Håkonsen;

    2013-01-01

    To improve the biologic understanding of the Polycystic Ovarian Syndrome (PCOS) condition by examining the circadian variation and relationship between Anti Müllerian Hormone (AMH), gonadotropins and ovarian steroids in PCOS patients compared to normally ovulating and menstruating women....... By comparing the pattern of co-variation between AMH and Luteinizing Hormone, two compounds closely linked to hyperandrogenism and anovulation in PCOS, the involvement of the Hypothalamic-Pituitary-Ovarian axis in PCOS pathology could be elucidated....

  16. Endocrinology of Hirsutism

    OpenAIRE

    Kopera, Daisy; Wehr, Elisabeth; Obermayer-Pietsch, Barbara

    2010-01-01

    Hirsutism represents a primary clinical indicator of androgen excess. The most common endocrine condition causing hirsutism is polycystic ovary syndrome (PCOS). Diagnosing PCOS is not easy as the signs and symptoms are heterogenous. The newest diagnostic guideline made by the Androgen Excess and PCOS Society in 2006, claims the presence of hyperandrogenism, and ovarian dysfunction (oligo / anovulation and / or polycystic ovaries). Obesity associated reproductive and metabolic dysfunctions may...

  17. Polycystic Ovary Syndrome An Endocrine and Metabolic Disorder Throughout Life

    OpenAIRE

    Szilágyi A

    2015-01-01

    The etiology and pathogenesis of polycystic ovary syndrome (PCOS) is still a matter of controversies, but it is apparent that hyperinsulinism and insulin resistance (IR) are major determining factors in the development of ovarian hyperandrogenism and chronic anovulation. The consequences of the PCOS extend beyond the reproductive axis. Follow up studies have shown an increase in the incidence of type 2 diabetes mellitus and other elements of metabolic syndrome in PCOS and increased cardiov...

  18. Hormonal contraception in women with polycystic ovary syndrome: choices, challenges, and noncontraceptive benefits

    OpenAIRE

    Melo, Anderson; Reis,Rosana; Ferriani,Rui; Vieira,Carol

    2017-01-01

    Anderson Sanches de Melo, Rosana Maria dos Reis, Rui Alberto Ferriani, Carolina Sales Vieira Department of Gynecology and Obstetrics, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil Abstract: Polycystic ovary syndrome (PCOS) is an endocrine disorder among women of reproductive age characterized by chronic anovulation and polycystic ovary morphology and/or hyperandrogenism. Mana...

  19. Hormonal contraception in women with polycystic ovary syndrome: choices, challenges, and noncontraceptive benefits

    OpenAIRE

    de Melo AS; Reis RM; Ferriani RA; Vieira CS

    2017-01-01

    Anderson Sanches de Melo, Rosana Maria dos Reis, Rui Alberto Ferriani, Carolina Sales Vieira Department of Gynecology and Obstetrics, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil Abstract: Polycystic ovary syndrome (PCOS) is an endocrine disorder among women of reproductive age characterized by chronic anovulation and polycystic ovary morphology and/or hyperandrogenism. Management of clinical manifesta...

  20. Polycystic Ovary Syndrome and the Relationship of Cardiovascular Disease Risk

    Directory of Open Access Journals (Sweden)

    Evrim Çakır

    2013-06-01

    Full Text Available Polycystic ovary syndrome (PCOS is a common endocrine disorder affecting at least 5-10% of women of reproductive age. PCOS is characterized by hyperandrogenism, menstrual disturbance, anovulation, infertility and obesity and, also associated with increased number of cardiovascular risk factors and early atherosclerosis. Hyperinsulinemia is a frequent finding in PCOS patients and has cause-and-effect relationship with low-grade chronic inflammation and increased risk of cardiovascular disease. Turk Jem 2013; 17: 33-7

  1. The pineal gland - Its possible roles in human reproduction

    Science.gov (United States)

    Brzezinski, Amnon; Wurtman, Richard J.

    1988-01-01

    The paper discusses the role of the pineal gland in controlling mammalian reproduction, with particular attention given to the role of melatonin in polyestrus mammals, like humans and laboratory rodents. Evidence is cited indicating the influence of melatonin production and blood content on the age of puberty, the timing of the ovulatory cycle, gonadal steriodogenesis, and patterns of reproductive behavior. It is suggested that abnormal patterns of melatonin might be associated with amenorrhea, anovulation, unexplained infertility, premature menopause, and habitual abortions.

  2. Polycystic ovarian syndrome.

    Science.gov (United States)

    Trikudanathan, Subbulaxmi

    2015-01-01

    Women with PCOS present with signs of chronic anovulation, hyperandrogenism, and metabolic abnormalities. The NIH recently embraced the Rotterdam criteria to broadly identify all the phenotypes of PCOS. Women with PCOS are often obese with insulin resistance and hence have an increased susceptibility to glucose intolerance and type 2 diabetes. Future research should focus on the genetic, epigenetic, and environmental determinants of PCOS to develop new therapies to address the prevention of this disorder and its long-term complications.

  3. [Diagnosis and treatment of patients with primary "empty" sella turcica syndrome at the stage of sanatorium-and-spa rehabilitation].

    Science.gov (United States)

    Efimenko, N V; Akhkubekova, N K; Babiakin, A F; Kaĭsinova, A S

    2010-01-01

    The authors report the first attempt to develop the treatment strategy for patients with primary "empty" sella turcica syndrome based at a health resort facility. It is shown that combined therapy including radon baths and acupuncture at specific auricular points makes it possible to improve functioning of the pituitary-ovarian system, decrease body weight, normalize blood prolactin level, eliminate visceral obesity, enhance tissue sensitivity to insulin, reduce hyperinsulimenia and fertility problems (anovulation, hyperandrogenism, and hypoluteinism) associated with insulin resistance.

  4. The Diagnosis of Polycystic Ovary Syndrome in Adolescents.

    Science.gov (United States)

    Rosenfield, Robert L

    2015-12-01

    Consensus has recently been reached by international pediatric subspecialty societies that otherwise unexplained persistent hyperandrogenic anovulation using age- and stage-appropriate standards are appropriate diagnostic criteria for polycystic ovary syndrome (PCOS) in adolescents. The purpose of this review is to summarize these recommendations and discuss their basis and implications. Anovulation is indicated by abnormal uterine bleeding, which exists when menstrual cycle length is outside the normal range or bleeding is excessive: cycles outside 19 to 90 days are always abnormal, and most are 21 to 45 days even during the first postmenarcheal year. Continued menstrual abnormality in a hyperandrogenic adolescent for 1 year prognosticates at least 50% risk of persistence. Hyperandrogenism is best indicated by persistent elevation of serum testosterone above adult norms as determined in a reliable reference laboratory. Because hyperandrogenemia documentation can be problematic, moderate-severe hirsutism constitutes clinical evidence of hyperandrogenism. Moderate-severe inflammatory acne vulgaris unresponsive to topical treatment is an indication to test for hyperandrogenemia. Treatment of PCOS is symptom-directed. Cyclic estrogen-progestin oral contraceptives are ordinarily the preferred first-line medical treatment because they reliably improve both the menstrual abnormality and hyperandrogenism. First-line treatment of the comorbidities of obesity and insulin resistance is lifestyle modification with calorie restriction and increased exercise. Metformin in conjunction with behavior modification is indicated for glucose intolerance. Although persistence of hyperandrogenic anovulation for ≥2 years ensures the distinction of PCOS from physiologic anovulation, early workup is advisable to make a provisional diagnosis so that combined oral contraceptive treatment, which will mask diagnosis by suppressing hyperandrogenemia, is not unnecessarily delayed.

  5. Advanced Glycation End Products: Link between Diet and Ovulatory Dysfunction in PCOS?

    Directory of Open Access Journals (Sweden)

    Deepika Garg

    2015-12-01

    Full Text Available PCOS is the most common cause of anovulation in reproductive-aged women with 70% experiencing ovulatory problems. Advanced glycation end products are highly reactive molecules that are formed by non-enzymatic reactions of sugars with proteins, nucleic acids and lipids. AGEs are also present in a variety of diet where substantial increase in AGEs can result due to thermal processing and modifications of food. Elevation in bodily AGEs, produced endogenously or absorbed exogenously from high-AGE diets, is further exaggerated in women with PCOS and is associated with ovulatory dysfunction. Additionally, increased expression of AGEs as pro-inflammatory receptors in the ovarian tissue has been observed in women with PCOS. In this review, we summarize the role of dietary AGEs as mediators of metabolic and reproductive alterations in PCOS. Once a mechanistic understanding of the relationship between AGEs and anovulation is established, there is a promise that such knowledge will contribute to the subsequent development of targeted pharmacological therapies that will treat anovulation and improve ovarian health in women with PCOS.

  6. Health-Related Quality of Life and Primi-Gravid: A Comparative Study of Natural Conception and Conception by Assisted Reproduction Technologies (ARTs

    Directory of Open Access Journals (Sweden)

    Ashraf Kazemi

    2014-07-01

    Full Text Available Background: This study evaluated the impact of body mass index (BMI, total calorie intake and physical activity (PA as energy expenditure related factors on oxidative stress (OS in follicular fluid (FF. Materials and Methods: This prospective study conducted on 219 infertile women. We evaluated patients’ BMI, total calorie intake and PA in their assisted reproduction treatment cycles. Malondialdehyde (MDA and total antioxidant capacity (TAC in pooled FF at oocyte retrieval were additionally assessed. Results: There was no relation between OS biomarkers to total calorie intake and PA. The TAC levels in FF adjusted for age, duration of infertility, etiology of infertility, number of used gonadotrophin and PA showed a positive relation to BMI (p=0.001. The number of used gonadotrophin and PA had a negative relation to duration of infertility (p=0.03 and anovulation disorder as an etiology of infertility. The MDA level in FF had a positive association with anovulation disorder as the etiology of infertility (p=0.02. MDA in FF was unaffected by BMI. Conclusion: Increasing age, BMI and PA do not affect OS in FF. In women with longtime infertility and those with anovulation disorder as an etiology of infertility, decreased potent antioxidant defense in the follicular microenvironment may contribute to ovarian function. Therefore antioxidant supplements may be beneficial for these groups of women.

  7. Review of the safety, efficacy, costs and patient acceptability of recombinant follicle-stimulating hormone for injection in assisting ovulation induction in infertile women

    Directory of Open Access Journals (Sweden)

    Marleen Nahuis

    2009-11-01

    Full Text Available Marleen Nahuis1,2,3, Fulco van der Veen1, Jur Oosterhuis2, Ben Willem Mol1, Peter Hompes3, Madelon van Wely11Center for Reproductive Medicine, Department of Obstetrics and Gynaecology (H4-205, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; 2Department of Obstetrics and Gynaecology, Medisch Spectrum Twente, Enschede, The Netherlands; 3Department of Obstetrics and Gynaecology, Free Medical University, Amsterdam, The NetherlandsAbstract: Anovulation is a common cause of female subfertility. Treatment of anovulation is aimed at induction of ovulation. In women with clomiphene-citrate resistant WHO group II anovulation, one of the treatment options is ovulation induction with exogenous follicle-stimulating hormone (FSH or follitropin. FSH is derived from urine or is produced as recombinant FSH. Two forms of recombinant FSH are available – follitropin alpha and follitropin beta. To evaluate the efficacy, safety, costs and acceptability of recombinant FSH, we performed a review to compare recombinant FSH with urinary-derived FSH products. Follitropin alpha, beta and urinary FSH products appeared to be equally effective in terms of pregnancy rates. Patient safety was also found to be comparable, as the incidence of side effects including multiple pregnancies was similar for all FSH products. In practice follitropin alpha and beta may be more convenient to use due to the ease of self-administration, but they are also more expensive than the urinary products.Keywords: follitropin apha, follitropin beta, urinary gonadotropins, polycystic ovary syndrome

  8. Primenenie kombinirovannykh oral'nykh kontratseptivov u zhenshchin reproduktivnogo vozrasta s ozhireniem

    Directory of Open Access Journals (Sweden)

    E N Andreeva

    2009-06-01

    Full Text Available This article assesses the problem of obesity as a risk factor for development of severe metabolic complications and different disorders of reproductive function in women of childbearing age. It is pointed that obesity is associated with high prevalence of hyperandrogenemic and hyperplastic disorders, polycystic ovary syndrome, infertility, complications of pregnancy and childbirth. Article discusses the questions of integrated treatment approach of this category of patients, which include non-drug interventions (rational nutrition, lifestyle modification as well as the use of medications which lower the insulin resistance and hyperinsulinemia to restore ovary function and the possible use of combined oral contraceptives for correction of anovulation.

  9. The physiology and clinical utility of anti-Mullerian hormone in women

    DEFF Research Database (Denmark)

    Dewailly, Didier; Andersen, Claus Yding; Balen, Adam;

    2014-01-01

    is likely to be more reflective of different stages of follicle development. AMH shows limited short-term variability, but the influence of states such as prolonged oral contraceptive use need to be considered in clinical assessment. There are only very limited data on relationships between AMH and natural...... identify 'poor responders', but it seems inappropriate at present to withhold IVF purely on this basis. Women with PCOS show markedly raised AMH levels, due to both the increased number of small antral follicles and intrinsic characteristics of those granulosa cells, and this may contribute to anovulation...

  10. [Intrauterine programming of reproductive function--a valid concept?].

    Science.gov (United States)

    Schleussner, Ekkehard

    2009-01-01

    Early intrauterine fetal (mis)programming determines not only cardiovascular and metabolic regulation in later life, but also reproductive function. Intrauterine growth restriction may be associated with precocious maturation of gonadal function and an earlier onset of puberty and menarche. Especially prenatal androgen excess has negative effects on the development of the ovaries and female genital phenotype itself as well as on the neuroendocrine feedback regulation of the hypothalamic-pituitary-gonadal axis followed by a polycystic ovary syndrome with hyperandrogenism and anovulation in later life. These associations, which can be clearly demonstrated in animal experiments, need further confirmation by epidemiological and clinical trials in humans.

  11. 肥胖与育龄期女性生殖功能研究进展%Association between obesity and reproductive of women in childbearing age

    Institute of Scientific and Technical Information of China (English)

    宋荣

    2011-01-01

    The reproductive of women is dependent on many factors.Obesity is one of the most important factor which reduces the reproductive ability of women in childbearing age.Obese women of childbearing age may accompanied with menstrual disorders, oligo - anovulation or anovulation and even infertility.Obesity affects outcome of assisted reproductive technologies, higher risk of miscarriage and affects pregnancy outcome.We should appeal to avoid extra weight and improve fertility of obese women.%女性生殖功能受众多因素影响,肥胖是引起育龄期女性生殖能力降低的重要因素之一.育龄期肥胖女性可表现为月经紊乱,排卵障碍甚至不孕.肥胖与多囊卵巢综合征互为因果.肥胖影响辅助生殖技术的结局,使自然流产的风险增高,影响到妊娠的结局.避免超重及肥胖,积极控制多余体重,提高肥胖女性生育能力.

  12. What every physician should know about polycystic ovary syndrome.

    Science.gov (United States)

    Rosenfield, Robert L

    2008-01-01

    Polycystic ovary syndrome (PCOS) is the most common endocrine cause of hirsutism, acne, and pattern alopecia. It is a heterogeneous syndrome of hyperandrogenic anovulation that is typically due to intrinsic ovarian dysfunction, which is often aggravated by insulin-resistant hyperinsulinemia with its risks of diabetes mellitus and metabolic syndrome and their complications. Because there are many pitfalls to androgen assays, evaluation for hyperandrogenemia is suggested in women with moderate or severe hirsutism or hirsutism equivalents, menstrual irregularity, acanthosis nigricans, or intractable obesity. An endocrinologic work-up is necessary to rule out other hyperandrogenic disorders that require specific therapy (e.g., virilizing tumors, nonclassic congenital adrenal hyperplasia, hyperprolactinemia, and Cushing's syndrome). Ultrasonography helps in the differential diagnosis and may demonstrate the polycystic ovaries that have recently been vetted as an alternative to oligo-anovulation as a diagnostic criterion. Management of PCOS is determined by symptomatology. For those women not desiring pregnancy, the most common therapies are oral contraceptive pills, antiandrogens (contraindicated in the absence of adequate contraception), and insulin-lowering treatments (which have little effect on hirsutism).

  13. Incorporating patient preference into the management of infertility in women with polycystic ovary syndrome

    Directory of Open Access Journals (Sweden)

    Okoroafor UC

    2012-05-01

    Full Text Available Ugochi C Okoroafor, Emily S JungheimDepartment of Obstetrics and Gynecology, Washington University, St Louis, MO, USAAbstract: Polycystic ovary syndrome (PCOS is a heterogeneous condition characterized by anovulation, hyperandrogenism, and polycystic ovaries. Because of the heterogeneous nature of PCOS, women affected by the condition often require a customized approach for ovulation induction when trying to conceive. Treating symptoms of PCOS in overweight and obese women should always incorporate lifestyle changes with the goal of weight-loss, as many women with PCOS will ovulate after losing 5%–10% of their body weight. On the other hand, other factors must be considered including the woman’s age, age-related decline in fertility, and previous treatments she may have already tried. Fortunately, multiple options for ovulation induction exist for women with PCOS. This paper reviews specific ovulation induction options available for women with PCOS, the benefits and efficacy of these options, and the related side effects and risks women can anticipate with the various options that may affect treatment adherence. The paper also reviews the recommended evidence-based strategies for treating PCOS-related infertility that allow for incorporation of the patient’s preference. Finally, it briefly reviews emerging data and ongoing studies regarding newer agents that have shown great promise as first-line agents for the treatment of infertility in women with PCOS.Keywords: polycystic ovary syndrome, anovulation, clomiphene citrate, letrozole, metformin, obesity

  14. Drilling: medical indications and surgical technique

    Directory of Open Access Journals (Sweden)

    Cristina Kallás Hueb

    2015-12-01

    Full Text Available SUMMARY Introduction: anovulation is a major cause of female infertility, and polycystic ovary syndrome (PCOS is the leading cause of anovulation. While undergoing drug-induced ovulation, women with PCOS usually have a satisfactory response recruiting follicles, but some are unable to recruit follicles or often produce an excessive number of follicles, which can result in ovarian hyper-stimulation syndrome and/or multiple pregnancy. Surgical laparoscopy with ovarian "drilling" may prevent or reduce the need for drug-induced ovulation. Objective: to identify the current indications of laparoscopic ovarian drilling and the best surgical technique. Method: a review of the medical literature based on systematic search in the Medline, Lilacs and Cochrane databases, using as keywords laparoscopy, polycystic ovary syndrome, and drilling. Results: we found 105 articles in the literature, 27 of these highly relevant, describing findings on ovarian drilling. Conclusion: laparoscopic drilling is indicated for patients with polycystic ovary syndrome with ovulatory resistance to the use of clomiphene citrate, body mass index less than 30 kg/m2 and preoperative luteinizing hormone above 10 IU/L. The preferred surgical technique should be the realization of 5 to 10 perforations on the surface of each ovary bilaterally using monopolar energy.

  15. 中医对卵巢性不孕不育症状分析%An analysis of TCM in treating ovarian infertility symptom

    Institute of Scientific and Technical Information of China (English)

    黄先忠

    2013-01-01

    目的:对中医对卵巢性不孕不育症状分析。方法:了解卵巢性不孕不育症状,知道中医对卵巢性不孕不育症的治疗方法。结论:卵巢性不孕不育主要原因是因为:下丘脑性不排卵、垂体性不排卵、多囊卵巢综合征(PCOS)、黄素化未破裂卵泡综合征、黄体功能不足。%Objective: To analysis the symptom of ovarian infertility by TCM. Methods: Understanding of ovarian infertility symptom, know about ovarian infertility treatment method of TCM. Conclusion: Ovarian infertility main reason is that: Hypothalamic anovulation, pituitary anovulation, polycystic ovary syndrome (PCOS), luteinized unruptured follicle syndrome, inadequate luteal function.

  16. 肥胖型多囊卵巢综合征中西医治疗进展%Chinese and Western Medicine Treatment Progress of Obese - polycystic Ovary Syndrome

    Institute of Scientific and Technical Information of China (English)

    杜国华; 陈霞

    2011-01-01

    多囊卵巢综合征是以高雄激素血症、排卵障碍以及多囊卵巢为特征的症候群,是育龄期女性不排卵性不孕的主要原因之一,其中肥胖者约占50%,并有月经失调、不孕等近期困扰及出现多种远期并发症的风险,且患病人群日渐增多,治疗相对棘手.作者就目前从生活方式调整、中医药、西药、手术及联合治疗等方面治疗肥胖型PCOS的研究进展进行综述.%Polyeystic ovary syndrome is characterized by hyperandrogenism, anovulation, and polycystic ovaries. It's one of the main reasons for women's anovulation infertility of reproductive age, in which obesity accounts for about 50%. And it causes menstrual disorders, infertility and other problems and a variety of long-term complications. Treatment is relatively difficult, with the increasing number of patients. This is an overview of the treatment of obese PCOS based on lifestyle adjustment, traditional Chinese medicine, Western medicine, surgery and combined therapy.

  17. Fertility and contraception in end-stage renal disease.

    Science.gov (United States)

    Schmidt, R J; Holley, J L

    1998-01-01

    The hormonal aberrations that occur with end-stage renal disease (ESRD) are presented in this review in relation to fertility and conception among women on dialysis. The imbalance in gonadotropin production in dialysis-dependent men and women is characterized by elevations in luteinizing hormone (LH). In women dialysis patients, the normal estradiol-stimulated LH surge does not occur, resulting in anovulation. In men dialysis patients spermatogenesis is impaired, and low testosterone levels cause elevated LH. Infertility in those with ESRD is a culmination of many factors, including impotence and loss of libido, anovulation, and an altered hormonal milieu. Despite these inhibitors of conception, women on dialysis can conceive; pregnancy has been reported in 1% to 7% of women on dialysis in survey studies. The influence of dialysis mode (hemodialysis v peritoneal dialysis), recombinant human erythropoietin (EPO), and dialysis adequacy on the likelihood of conception among patients of either sex on dialysis is unknown. Reduced sexual activity and interest has consistently been reported in the ESRD population. The reasons for this are complex and likely involve the effects of comorbid illnesses, overall health status, body image factors, and hormonal alterations. Nephrologists rarely discuss conception and contraception with their women dialysis patients. Greater attention to these issues is needed.

  18. Evaluation and management of abnormal uterine bleeding in premenopausal women.

    Science.gov (United States)

    Sweet, Mary Gayle; Schmidt-Dalton, Tarin A; Weiss, Patrice M; Madsen, Keith P

    2012-01-01

    Up to 14 percent of women experience irregular or excessively heavy menstrual bleeding. This abnormal uterine bleeding generally can be divided into anovulatory and ovulatory patterns. Chronic anovulation can lead to irregular bleeding, prolonged unopposed estrogen stimulation of the endometrium, and increased risk of endometrial cancer. Causes include polycystic ovary syndrome, uncontrolled diabetes mellitus, thyroid dysfunction, hyperprolactinemia, and use of antipsychotics or antiepileptics. Women 35 years or older with recurrent anovulation, women younger than 35 years with risk factors for endometrial cancer, and women with excessive bleeding unresponsive to medical therapy should undergo endometrial biopsy. Treatment with combination oral contraceptives or progestins may regulate menstrual cycles. Histologic findings of hyperplasia without atypia may be treated with cyclic or continuous progestin. Women who have hyperplasia with atypia or adenocarcinoma should be referred to a gynecologist or gynecologic oncologist, respectively. Ovulatory abnormal uterine bleeding, or menorrhagia, may be caused by thyroid dysfunction, coagulation defects (most commonly von Willebrand disease), endometrial polyps, and submucosal fibroids. Transvaginal ultrasonography or saline infusion sonohysterography may be used to evaluate menorrhagia. The levonorgestrel-releasing intrauterine system is an effective treatment for menorrhagia. Oral progesterone for 21 days per month and nonsteroidal anti-inflammatory drugs are also effective. Tranexamic acid is approved by the U.S. Food and Drug Administration for the treatment of ovulatory bleeding, but is expensive. When clear structural causes are identified or medical management is ineffective, polypectomy, fibroidectomy, uterine artery embolization, and endometrial ablation may be considered. Hysterectomy is the most definitive treatment.

  19. HemoHIM improves ovarian morphology and decreases expression of nerve growth factor in rats with steroid-induced polycystic ovaries.

    Science.gov (United States)

    Kim, Sung Ho; Lee, Hae June; Kim, Joong Sun; Moon, Changjong; Kim, Jong Choon; Bae, Chun Sik; Park, Hae Ran; Jung, Uhee; Jo, Sung Kee

    2009-12-01

    Estradiol valerate (EV)-induced polycystic ovaries (PCOs) in rats cause the anovulation and cystic ovarian morphology. We investigated whether treatment with HemoHIM influences the ovarian morphology and the expression of nerve growth factor (NGF) in an EV-induced PCO rat model. PCO was induced by a single intramuscular injection of EV (4 mg, dissolved in sesame oil) in adult cycling rats. HemoHIM was either administered orally (100 mg/kg of body weight/day) for 35 consecutive days or injected intraperitoneally (50 mg/kg of body weight) every other day after EV injection. Ovarian morphology was almost normalized, and NGF was normalized in the PCO + HemoHIM group. HemoHIM lowered the high numbers of antral follicles and increased the number of corpora lutea in PCOs. The results are consistent with a beneficial effect of HemoHIM in the prevention and treatment of PCO syndrome.

  20. Current aspects of polycystic ovary syndrome: A literature review

    Directory of Open Access Journals (Sweden)

    VICTOR HUGO LOPES DE ANDRADE

    Full Text Available SUMMARY Polycystic ovary syndrome (PCOS is a heterogeneous endocrine disorder with variable prevalence, affecting about one in every 15 women worldwide. The diagnosis of polycystic ovary syndrome requires at least two of the following criteria: oligoovulation and/or anovulation, clinical and/or biochemical evidence of hyperandrogenism and morphology of polycystic ovaries. Women with PCOS appear to have a higher risk of developing metabolic disorders, hypertension and cardiovascular disorders. The aim of this article was to present a review of the literature by searching the databases Pubmed and Scielo, focusing on publications related to polycystic ovaries, including its pathogenesis, clinical manifestations, diagnosis and therapeutic aspects, as well as its association with cardiovascular and arterial hypertensive disorders.

  1. Polycystic Ovarian Syndrome: A Diagnostic and Therapeutic Challenge

    Directory of Open Access Journals (Sweden)

    Manmohan K Kamboj

    2010-01-01

    Full Text Available Polycystic ovarian syndrome (PCOS is the commonest endocrinopathy in women with a multi-factorial etiology, and presents not just a diagnostic dilemma but also a therapeutic challenge as well. The clinical features of the syndrome in adolescents result from hyperandrogenemia and oligo/anovulation. Most women presenting with non-pregnancy related secondary amenorrhea, oligomenorrhoea, acne, hirsutism, and infertility have PCOS. Consensus diagnostic criteria have been developed by the United States National Institutes of Health (NIH, and the European Society of Human Reproduction and Embryology and American Society of Reproduction (Rotterdam criteria. PCOS needs to be suspected, recognized, and treated to prevent some long term complications. Treatment modalities need to be individualized to address the specific concerns of each female presenting with this entity. This article reviews the diagnosis and principles of management of PCOS.

  2. Functional genomics of PCOS: from GWAS to molecular mechanisms.

    Science.gov (United States)

    McAllister, Jan M; Legro, Richard S; Modi, Bhavi P; Strauss, Jerome F

    2015-03-01

    Polycystic ovary syndrome (PCOS) is a common endocrinopathy characterized by increased ovarian androgen biosynthesis, anovulation, and infertility. PCOS has a strong heritable component based on familial clustering and twin studies. Genome-wide association studies (GWAS) identified several PCOS candidate loci including LHCGR, FSHR, ZNF217, YAP1, INSR, RAB5B, and C9orf3. We review the functional roles of strong PCOS candidate loci focusing on FSHR, LHCGR, INSR, and DENND1A. We propose that these candidates comprise a hierarchical signaling network by which DENND1A, LHCGR, INSR, RAB5B, adapter proteins, and associated downstream signaling cascades converge to regulate theca cell androgen biosynthesis. Future elucidation of the functional gene networks predicted by the PCOS GWAS will result in new diagnostic and therapeutic approaches for women with PCOS.

  3. A single early postnatal estradiol injection affects morphology and gene expression of the ovary and parametrial adipose tissue in adult female rats

    DEFF Research Database (Denmark)

    Alexanderson, Camilla; Stener-Victorin, Elisabet; Kullberg, Joel;

    2010-01-01

    expression related to follicular development and adipose tissue metabolism, and developed a non-invasive volumetric estimation of parametrial adipose tissue by magnetic resonance imaging. Estradiol reduced ovarian weight, increased antral follicle size and number of atretic antral follicles, and decreased......Events during early life can affect reproductive and metabolic functions in adulthood. We evaluated the programming effects of a single early postnatal estradiol injection (within 3h after birth) in female rats. We assessed ovarian and parametrial adipose tissue morphology, evaluated gene...... theca interna thickness in atretic antral follicles. Adult estradiol-injected rats also had malformed vaginal openings and lacked corpora lutea, confirming anovulation. Estradiol markedly reduced parametrial adipose tissue mass. Adipocyte size was unchanged, suggesting reduced adipocyte number...

  4. Role of Anti-Müllerian Hormone in pathophysiology, diagnosis and treatment of Polycystic Ovary Syndrome: a review.

    Science.gov (United States)

    Dumont, Agathe; Robin, Geoffroy; Catteau-Jonard, Sophie; Dewailly, Didier

    2015-12-21

    Polycystic ovary syndrome (PCOS) is the most common cause of chronic anovulation and hyperandrogenism in young women. Excessive ovarian production of Anti-Müllerian Hormone, secreted by growing follicles in excess, is now considered as an important feature of PCOS. The aim of this review is first to update the current knowledge about the role of AMH in the pathophysiology of PCOS. Then, this review will discuss the improvement that serum AMH assay brings in the diagnosis of PCOS. Last, this review will explain the utility of serum AMH assay in the management of infertility in women with PCOS and its utility as a marker of treatment efficiency on PCOS symptoms. It must be emphasized however that the lack of an international standard for the serum AMH assay, mainly because of technical issues, makes it difficult to define consensual thresholds, and thus impairs the widespread use of this new ovarian marker. Hopefully, this should soon improve.

  5. Restoration of Fertility after Removal of Extrauterine Mirena Coil: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Smriti R. C. Bhatta

    2011-01-01

    Full Text Available We present the case of a 27-year-old lady who was seen in the infertility clinic with a history of secondary infertility of a one-year duration. She had a hysteroscopy and Mirena insertion for heavy periods. Coil strings were not found by the GP during first coil check six weeks after insertion. A pelvic ultrasound scan did not show any coil, and it was not investigated further with a possible diagnosis of coil expulsion made. One year following that, she was seen in the infertility clinic. Initial investigations revealed anovulation, and HSG located the coil to be extrauterine. Mirena was removed laparoscopically, and a month following the removal she conceived. She is currently pregnant. This case highlights the effect of extrauterine mirena coils on fertility by possibly causing higher plasma levels of levonorgesterol and resulting suppression of ovulation. Laparoscopic removal of mirena coil can help in restoration of fertility.

  6. STANDARDIZATION OF DHANVANTARI TAILA: MEDICATED OIL FOR FEMALE INFERTILITY

    Directory of Open Access Journals (Sweden)

    Kamidi Vijaya Kumari

    2012-12-01

    Full Text Available Dhanvantari Taila is an Ayurvedic Herbal Oil prepared from the drugs Balamoola, Dasamoola, Yava, Devadaru, Manjista, Chandana, Sariba, Shilajit, Vacha, Agaru, Punarnava, Aswagandha, Satavari, Yasti, Triphala, Tila Taila and Cow milk etc.The drugs of Dhanvantari Taila are indicated in all vatarogas in various classical Ayurvedic Literatures. This drug acts like Lekhana, Brimhana, Srotoavarodha, Vedanastapana, Sothahara, Vranaropana etc. Based on these properties, oil was prepared with this group of drugs using Tila Taila as base. This Dhanvantari Taila was selected to study through Uttaravasthi, into uterine cavity on infertility patients including tubal block, Anovulation and Gynecological problems. Before conducting the clinical trails this oil was subjected to certain chemical studies to find out the iodine value, Saponification value, acid value, total fat, weight for ml and HPTLC finger printing for standardization of the drug.

  7. Switch to quetiapine in antipsychotic agent-related hyperprolactinemia.

    Science.gov (United States)

    Keller, R; Mongini, F

    2002-12-01

    Novel antipsychotics (clozapine, risperidone, olanzapine, quetiapine) are effective in treating psychotic symptoms, also in neurological disease. Hyperprolactinemia is a side effect related to antipsychotics that can cause galactorrhea, gynecomastia, amenorrhea, anovulation, impaired spermatogenesis, decreased libido and sexual arousal, impotence, and anorgasmia, consequent to removal of tonic dopaminergic inhibition of prolactin secretion via hypothalamic dopaminergic receptor blockade in the tuberoinfundibolar tract. Hyperprolactinemia occurs more frequently during treatment with risperidone and olanzapine compared with clozapine and quetiapine. The therapeutic algorithm to antipsychotic-relatedhyperprolactinemia is the following: reduction in antipsychotic dose, addition of cabergoline, bromocriptine, amantadine, and/or switch to another antipsychotic. We propose switching to quetiapine in symptomatic hyperprolactinemia related to antipsychotics and describe five cases.

  8. The rationale of the myo-inositol and D-chiro-inositol combined treatment for polycystic ovary syndrome.

    Science.gov (United States)

    Dinicola, Simona; Chiu, Tony T Y; Unfer, Vittorio; Carlomagno, Gianfranco; Bizzarri, Mariano

    2014-10-01

    PCOS is one of the most common endocrine disorders affecting women and it is characterized by a combination of hyper-androgenism, chronic anovulation, and insulin resistance. While a significant progress has recently been made in the diagnosis for PCOS, the optimal infertility treatment remains to be determined. Two inositol isomers, myo-inositol (MI) and D-chiro-inositol (DCI) have been proven to be effective in PCOS treatment, by improving insulin resistance, serum androgen levels and many features of the metabolic syndrome. However, DCI alone, mostly when it is administered at high dosage, negatively affects oocyte quality, whereas the association MI/DCI, in a combination reproducing the plasma physiological ratio (40:1), represents a promising alternative in achieving better clinical results, by counteracting PCOS at both systemic and ovary level.

  9. Endocrine-disrupting chemicals in polycystic ovary syndrome: an evidence-based minireview

    Directory of Open Access Journals (Sweden)

    Carmen E. Georgescu

    2012-12-01

    Full Text Available Polycystic ovary syndrome (PCOS is a plurifactorial endocrine disorder, affecting 5-10% of women of reproductive age to result inhyperandrogenia, anovulation and infertility, metabolic syndrome and enhanced cardiovascular risk. Animal experiments unraveled that preandearly postnatal exposure of female offspring to testosterone or bisphenol A (BPA, one synthetic, organic plasticizers component may inducea PCOS-like developmental pattern in adulthood. In contrast to other endocrine-disruption chemicals, information on BPA exposure inbiological indicators and wildlife is scarce. On the other hand, the ability of BPA to alter ovarian steroidogenesis has been demonstrated in severalcell culture models. In line with that, preliminary clinical studies demonstrated elevated serum and urinary BPA levels in PCOS patients.Nonetheless, a causative role of BPA in PCOS is still under debate and further studies on the topic are warranted.

  10. Ovulatory patterns in women with juvenile and late-onset/persistent acne vulgaris.

    Science.gov (United States)

    Noto, G; Pravatà, G; Aricò, M; Maneschi, F; Palisi, F

    1990-01-01

    The ovulatory patterns in women with acne vulgaris were evaluated in order to understand their relationship with androgenic levels. Ovulation disturbances were found in 58.3% of patients with prevalence of anovulation in the juvenile acne and of luteal insufficiency in the late-onset/persistent acne. Significant negative correlation was found between T free and P in the late-onset/persistent group (r: -0.629; p = 0.016): This may be interpreted as a rather steady endocrine status in which the raised androgenic levels, probably due to peripheral conversion, are concomitant to absent or insufficient ovulations. In the younger patients both the androgen excess and the ovulation disturbances could be due to an abnormal or delayed maturation of the hypothalamus-pituitary ovarian axis. The evaluation of the ovarian function in women with acne vulgaris may be useful to detect ovulatory disturbances in view of a possible resolution of both the problems by specific endocrine management.

  11. Polycystic ovary syndrome: current status and future perspective.

    Science.gov (United States)

    Barthelmess, Erin K; Naz, Rajesh K

    2014-01-01

    Polycystic ovary syndrome (PCOS) is a widespread reproductive disorder that encompasses many associated health conditions and has an impact on various metabolic processes. PCOS is depicted by hyperandrogenism, polycystic ovaries, and anovulation. It increases the risk of insulin resistance (IR), type 2 diabetes, obesity, and cardiovascular disease. The etiology of the disease remains unclear, and the subjective phenotype makes a united diagnosis difficult among physicians. It seems to be a familial genetic syndrome caused by a combination of environmental and genetic factors. It can be linked with metabolic disorders in first-degree family members. PCOS is the cause of up to 30% of infertility in couples seeking treatment. Currently, there is no cure for PCOS. Despite the growing incidence of this syndrome, limited research has been done that encompasses the entirety of PCOS spectrum. In this review, the current status and possible future perspective will be discussed.

  12. Treatment strategies for the infertile polycystic ovary syndrome patient.

    Science.gov (United States)

    Tannus, Samer; Burke, Yechiel Z; Kol, Shahar

    2015-11-01

    Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. Infertility is a prevalent presenting feature of PCOS, and approximately 75% of these women suffer infertility due to anovulation. Lifestyle modification is considered the first-line treatment and is associated with improved endocrine profile. Clomiphene citrate (CC) should be considered as the first line pharmacologic therapy for ovulation induction. In women who are CC resistant, second-line treatment should be considered, as adding metformin, laparoscopic ovarian drilling or treatment with gonadotropins. In CC treatment failure, Letrozole could be an alternative or treatment with gonadotropins. IVF is considered the third-line treatment; the 'short', antagonist-based protocol is the preferred option for PCOS patients, as it is associated with lower risk of developing ovarian hyperstimulation syndrome (specifically by using a gonadotropin--releasing hormone agonist as ovulation trigger), but with comparable outcomes as the long protocol.

  13. 多囊卵巢综合征的中西医结合治疗探讨

    Institute of Scientific and Technical Information of China (English)

    刘燕萍; 苗晓玲; 雷婕

    2011-01-01

    多囊卵巢综合征(Polycystic ovary syndrome,PCOS)是由多遗传因素、多基因和多环境因素引起的下丘脑一垂体一卵巢功能轴的紊乱、月经失调(月经稀发或闭经)、持续无排卵(chronic anovulation)、不孕(infertility)、胰岛素抵抗(Insulin resistance,IR)、高胰岛素血症(hyperinsulinemia,HI)、高雄激素血症( Hyperandrogenemia,HA)和卵巢多囊性改变为特征的异质性疾病[1].现将笔者对该病的认识及临床治疗报道如下.

  14. The role of anti-Müllerian hormone in the pathogenesis and pathophysiological characteristics of polycystic ovary syndrome.

    Science.gov (United States)

    Qi, Xinyu; Pang, Yanli; Qiao, Jie

    2016-04-01

    Polycystic ovarian syndrome (PCOS) is one of the major causes of anovulatory infertility. High levels of anti-Müllerian hormone (AMH) in the serum of PCOS patients participate in the major steps of the anovulation, and are related to pathogenesis and pathophysiological characteristic of PCOS, including the interactions of AMH with intra/extra ovarian factors like FSH, LH, androgen, and estrogen, as well as the role of AMH in folliculogenesis of PCOS. AMH promotes follicular atresia which may participate in the follicle pattern in PCOS patients. Recent years, the abnormally increased AMH in serum and follicle fluid of PCOS patients have attracted many scholars' attention. In this review, we summarized the role of AMH played in PCOS patients. It is of great significance for clarifying the role of AMH in the diagnosis and treatment of PCOS patients because AMH has the potential to increase our understanding of ovarian pathophysiology and to guide the clinical management of a broader range of conditions.

  15. Evidence-based management of infertility in women with polycystic ovary syndrome using surgery or assisted reproductive technology.

    Science.gov (United States)

    Costello, Michael F; Ledger, William L

    2012-05-01

    Polycystic ovary syndrome (PCOS) has been managed surgically since the development of wedge resection in the 1930s. Second-line surgical interventions for anovulation associated with PCOS include laparoscopic ovarian diathermy, which is as effective as medical induction of ovulation with gonadotropins, with a much reduced risk of multiple pregnancy. Bariatric surgery may be considered for morbidly obese patients with PCOS, although further research assessing such surgery specifically in PCOS patients is needed. Assisted reproduction, in the form of IVF with or without intracytoplasmic sperm injection, is usually indicated as third-line medical treatment or in the presence of other infertility factors. There is an ongoing debate concerning the relative merits of IVF and ovulation induction in PCOS, comparing the higher multiple pregnancy rate of ovulation induction with the greater cost and psychological stress of IVF.

  16. Ovarian Drilling in PCOS: is it really useful!?

    Directory of Open Access Journals (Sweden)

    ISSAM eLEBBI

    2015-07-01

    Full Text Available Polycystic ovary syndrome (PCOS is a frequent disorder, affecting approximately 5 to 10 % of infertile women. It can represent more than 80% of cases of infertility due to anovulation. The main goal of treatment is the induction of mono-ovulatory cycles. A pragmatic management of infertility in PCOS will allow most patients to conceive.Weight loss and clomiphene citrate (CC are the first-line components of patients treatment before gonadotropins are used. However, during gonadotropin administration, there is a high risk of ovarian hyper-stimulation (OHSS and multiple pregnancies. So, surgery with laparoscopic ovarian drilling (LOD is often used before gonadotropins in order to obtain normal ovulatory cycles.

  17. The prevalence of polycystic ovary syndrome in a normal population according to the Rotterdam criteria versus revised criteria including anti-Mullerian hormone

    DEFF Research Database (Denmark)

    Lauritsen, Mette Petri; Bentzen, J G; Pinborg, Anja Bisgaard;

    2014-01-01

    STUDY QUESTION: What is the prevalence in a normal population of polycystic ovary syndrome (PCOS) according to the Rotterdam criteria versus revised criteria including anti-Müllerian hormone (AMH)? SUMMARY ANSWER: The prevalence of PCOS was 16.6% according to the Rotterdam criteria. When replacing...... the criterion for polycystic ovaries by antral follicle count (AFC) > 19 or AMH > 35 pmol/l, the prevalence of PCOS was 6.3 and 8.5%, respectively. WHAT IS KNOWN ALREADY?: The Rotterdam criteria state that two out of the following three criteria should be present in the diagnosis of PCOS: oligo......-anovulation, clinical and/or biochemical hyperandrogenism and polycystic ovaries (AFC ≥ 12 and/or ovarian volume >10 ml). However, with the advances in sonography, the relevance of the AFC threshold in the definition of polycystic ovaries has been challenged, and AMH has been proposed as a marker of polycystic ovaries...

  18. Genetic investigation into ethnic disparity in polycystic ovarian syndrome

    DEFF Research Database (Denmark)

    Li, Shuxia; Zhu, Dongyi; Duan, Hongmei;

    2013-01-01

    Polycystic ovarian syndrome is universally the most common endocrinopathy in women of reproductive age. It is characterized by composite clinical phenotypes reflecting the reproductive impact of ovarian dysfunction (androgen excess, oligo-/anovulation, polycystic ovary) and metabolic abnormalities...... (insulin resistance, obesity) with widely varying symptoms among the affected. Studies have shown a clear pattern of disparity in clinical manifestations of its component phenotypes across ethnic populations. Recent genetic association studies suggested differential genetic background that could contribute...... to unravel the molecular basis of the interethnic difference in the pathogenesis of the syndrome. It is hoped that identification and characterization of population-specific structural genetic and functional genomic patterns could help to not only deepen our understanding of the aetiology but also develop...

  19. Revised criteria for PCOS in WHO Group II anovulatory infertility – a revival of hypothalamic amenorrhoea?

    DEFF Research Database (Denmark)

    Lauritsen, Mette Petri; Pinborg, Anja; Loft, Anne

    2015-01-01

    OBJECTIVE: To evaluate revised criteria for polycystic ovarian morphology (PCOM) in the diagnosis of polycystic ovary syndrome (PCOS) in anovulatory infertility. DESIGN: Prospective cohort study. PATIENTS: WHO Group II anovulatory infertile women (n = 75). MEASUREMENTS: Clinical, sonographic......% vs 41% (P = 0·003) had an LH/FSH ratio >2 and 19% vs 41% (P = 0·04) had hirsutism and/or elevated total testosterone, free testosterone, and/or androstenedione. The non-PCOM group included significantly more women with secondary infertility. The median AMH in the non-PCOM group was 47 pmol/l, which...... was twofold lower than in the PCOM group but above the upper limit of normo-ovulatory women. CONCLUSIONS: According to a revised threshold of 25 follicles, almost half the anovulatory infertile women do not have PCOM. The characteristics of these women may be compatible with hypothalamic anovulation...

  20. Metformin in obstetric and gynecologic practice: a review.

    Science.gov (United States)

    McCarthy, Elizabeth A; Walker, Susan P; McLachlan, Kylie; Boyle, Jacqui; Permezel, Michael

    2004-02-01

    Metformin is a common treatment for women who have insulin resistance manifesting as type 2 diabetes or polycystic ovarian syndrome (PCOS). With an increasing number of these patients conceiving, it is expected that the use of metformin in and around the time of pregnancy will increase. This article reassesses the mechanisms, safety, and clinical experience of metformin use in obstetrics and gynecology. Metformin is an attractive therapeutic option because administration is simple, hypoglycemia rare, and weight loss promoted. There is a large volume of research supporting the use of metformin treatment in diabetes mellitus, androgenization, anovulation, infertility, and recurrent miscarriage. Although metformin is known to cross the placenta, there is, as yet, no evidence of teratogenicity. Metformin has an array of complex actions, accounting for the varied clinical roles, many of which are still to be fully evaluated. Much research is still needed.

  1. Polycystic ovary syndrome: a dermatologic approach.

    Science.gov (United States)

    Moura, Heloisa Helena Gonçalves de; Costa, Dailana Louvain Marinho; Bagatin, Ediléia; Sodré, Celso Tavares; Manela-Azulay, Mônica

    2011-01-01

    Polycystic ovary syndrome (POS) is one of the most common endocrine abnormalities affecting women of reproductive age. It is a cause of significant social embarrassment and emotional distress. The pathogenesis of the disease is not yet fully understood, but it is thought to be a complex multigenic disorder, including abnormalities in the hypothalamic-pituitary axis, steroidogenesis, and insulin resistance. The main diagnostic findings of the syndrome are: hyperandrogenism, chronic anovulation and polycystic ovarian morphology seen on ultrasound. Hyperandrogenism is generally manifested as hirsutism, acne, seborrhea, androgenic alopecia and, in severe cases, signs of virilization. Treatment may improve the clinical manifestations of excess androgen production, normalize menses and ameliorate metabolic syndrome and cardiovascular complications. This article reviews the diagnosis, clinical manifestations, metabolic complications, and treatment of the syndrome. Early diagnosis and the consequent early treatment may prevent metabolic complications and emotional distress that negatively impact the patients' quality of life.

  2. Hirsutism and acne in polycystic ovary syndrome.

    Science.gov (United States)

    Archer, Johanna S; Chang, R Jeffrey

    2004-10-01

    Polycystic ovary syndrome (PCOS) is the most common endocrine abnormality affecting reproductive age women. Population-based studies estimate a prevalence of 5-10% [Obstet Gynecol 101 (2003) 995; Aust N Z J Obstet Gynaecol 41 (2001) 202]. The clinical characteristics of PCOS include hyperandrogenism, chronic anovulation, insulin resistance and infertility. Hyperandrogenism is generally manifested as hirsutism and acne. Both these clinical symptoms are treated with similar drug therapies, including oral contraceptive pills (OCPs), topical medications or antiandrogens such as spironolactone, flutamide and finasteride, as well as topical medications. Recent studies have shown that lower doses of these medications are as efficacious as high doses and have the advantage of decreased cost and an improved side-effect profile. Although hirsutism and acne can be considered cosmetic in nature, they cause significant social embarrassment and emotional distress. Physicians should be sensitive to these issues and approach patients in a caring and sympathetic manner.

  3. New adolescent polycystic ovary syndrome perspectives.

    Science.gov (United States)

    Alemzadeh, R; Kansra, A R

    2011-02-01

    Polycystic ovary syndrome (PCOS) is a common but heterogeneous disorder that usually arises during puberty. This endocrine disorder is associated with chronic anovulation and hyperandrogenemia with clinical manifestation of oligomenorrhea, hirsutism and acne. While the underlying etiology of PCOS remains unknown, it is commonly associated with obesity and insulin resistance leading to increased risk of cardiovascular disease, dyslipidemia and type 2 diabetes mellitus in hyperandrogenemic phenotypes. Menstrual irregularities and insulin resistance in obese adolescents are usually indistinguishable from the clinical manifestations of PCOS and pose a diagnostic dilemma due to higher circulating androgens during puberty. Consequently, a universal consensus on the definition of hyperandrogenemia in adolescents has been elusive. Nevertheless, hyperandrogenemia, independent of obesity, in postmenarchal adolescents is associated with increased risk of cardiometabolic syndrome. Therefore, treatment strategies including lifestyle changes and/or use of insulin-sensitizers, hormone replacement and antiandrogens should be utilized in order to delay long-term cardiovascular and metabolic complications of this endocrinopathy.

  4. Identification of altered microRNAs and mRNAs in the cumulus cells of PCOS patients: miRNA-509-3p promotes oestradiol secretion by targeting MAP3K8.

    Science.gov (United States)

    Huang, Xin; Liu, Chang; Hao, Cuifang; Tang, Qianqing; Liu, Riming; Lin, Shaoxia; Zhang, Luping; Yan, Wei

    2016-06-01

    Polycystic ovary syndrome (PCOS) is a common endocrine and metabolic disorder in women and is characterised by polycystic ovaries, hyperandrogenism and chronic anovulation. Although the clinical and biochemical signs of PCOS are typically heterogeneous, abnormal folliculogenesis is considered a common characteristic of PCOS. Our aim is to identify the altered miRNA and mRNA expression profiles in the cumulus cells of PCOS patients to investigate their molecular function in the aetiology and pathophysiology of PCOS. In this study, the miRNA expression profiles of the cumulus cell samples isolated from five PCOS and five control patients were determined by an miRNA microarray. At the same time, the altered mRNA profiles of the same cumulus cell samples were also identified by a cDNA microarray. From the microarray data, 17 miRNAs and 1263 mRNAs showed significantly different expression in the PCOS cumulus cells. The differentially expressed miRNA-509-3p and its potential target gene (MAP3K8) were identified from the miRNA and mRNA microarrays respectively. The expression of miRNA-509-3p was up-regulated and MAP3K8 was down-regulated in the PCOS cumulus cells. The direct interaction between miRNA-509-3p and MAP3K8 was confirmed by a luciferase activity assay in KGN cells. In addition, miRNA-509-3p mimics or inhibitor transfection tests in KGN cells further confirmed that miRNA-509-3p improved oestradiol (E2) secretion by inhibiting the expression of MAP3K8 These results help to characterise the pathogenesis of anovulation in PCOS, especially the regulation of E2 production.

  5. An Observational Study on 100 Patients with Polycystic Ovarian Syndrome (PCOS

    Directory of Open Access Journals (Sweden)

    Khaleda Khanam

    2014-09-01

    Full Text Available Background: Women with polycystic ovarian syndrome (PCOS have chronic anovulation and androgen excess not attributable to another cause. The fundamental pathophysiologic defect is unknown. Defects in LH secretion, LH/FSH ratio, amplitude of LH pulsations have been described; but the prevalence of these defects is not still clearly determined. Objective: To review the variable clinical presentations of polycystic ovarian syndrome. Materials and Methods: This observational study was carried out in Combined Military Hospitals of Jessore, Rangpur and Ghatail during November 2008 to June 2013. One hundred patients attending Gynaecology Outpatient Department (GOPD having at least two of the following criteria ––hyperandrogenism, chronic oligo- or anovulation and ultrasonographic findings were selected. In all selected women LH and FSH serum levels were determined and LH/FSH ratios were calculated. Body mass index (BMI was measured and was scored to classify their state of obesity. The collected data were compiled and arranged in tables and were subjected to analysis. Results: Most of the patients (92% were 20–30 years old. Chief complaint of the patients was infertility, either primary (72% or secondary (28%. Eighty percent women had menstrual irregularities, 30% were hirsute, 71% cases were overweight and 17% were obese. On pelvic ultrasonogram polycystic ovaries were found in 20% cases and 80% had normal ovaries. Thirty percent patients had LH/FSH ratio between 2.1–2.9, 32% had >3 and it was found normal in 38% of cases. Conclusion: PCOS cannot be diagnosed by a single clinical or laboratory finding. The diagnostic approach should be based largely on history and physical examination.

  6. Characterization of reproductive, metabolic, and endocrine features of polycystic ovary syndrome in female hyperandrogenic mouse models.

    Science.gov (United States)

    Caldwell, A S L; Middleton, L J; Jimenez, M; Desai, R; McMahon, A C; Allan, C M; Handelsman, D J; Walters, K A

    2014-08-01

    Polycystic ovary syndrome (PCOS) affects 5-10% of women of reproductive age, causing a range of reproductive, metabolic and endocrine defects including anovulation, infertility, hyperandrogenism, obesity, hyperinsulinism, and an increased risk of type 2 diabetes and cardiovascular disease. Hyperandrogenism is the most consistent feature of PCOS, but its etiology remains unknown, and ethical and logistic constraints limit definitive experimentation in humans to determine mechanisms involved. In this study, we provide the first comprehensive characterization of reproductive, endocrine, and metabolic PCOS traits in 4 distinct murine models of hyperandrogenism, comprising prenatal dihydrotestosterone (DHT, potent nonaromatizable androgen) treatment during days 16-18 of gestation, or long-term treatment (90 days from 21 days of age) with DHT, dehydroepiandrosterone (DHEA), or letrozole (aromatase inhibitor). Prenatal DHT-treated mature mice exhibited irregular estrous cycles, oligo-ovulation, reduced preantral follicle health, hepatic steatosis, and adipocyte hypertrophy, but lacked overall changes in body-fat composition. Long-term DHT treatment induced polycystic ovaries displaying unhealthy antral follicles (degenerate oocyte and/or > 10% pyknotic granulosa cells), as well as anovulation and acyclicity in mature (16-week-old) females. Long-term DHT also increased body and fat pad weights and induced adipocyte hypertrophy and hypercholesterolemia. Long-term letrozole-treated mice exhibited absent or irregular cycles, oligo-ovulation, polycystic ovaries containing hemorrhagic cysts atypical of PCOS, and displayed no metabolic features of PCOS. Long-term dehydroepiandrosterone treatment produced no PCOS features in mature mice. Our findings reveal that long-term DHT treatment replicated a breadth of ovarian, endocrine, and metabolic features of human PCOS and provides the best mouse model for experimental studies of PCOS pathogenesis.

  7. Nutrition and reproduction in women.

    Science.gov (United States)

    2006-01-01

    Malnutrition is a major problem in developing countries, and obesity and eating disorders are increasingly common in developing as well as developed countries. The reproductive axis is closely linked to nutritional status, especially undernutrition in the female, and inhibitory pathways involving detectors in the hind brain suppress ovulation in subjects with weight loss. Recovery may occur after minimal reacquisition of weight because energy balance is more important than body fat mass. Anorexia nervosa and bulimia nervosa affect up to 5% of women of reproductive age causing amenorrhoea, infertility and, in those who do conceive, an increased likelihood of miscarriage. Obesity can affect reproduction through fat cell metabolism, steroids and secretion of proteins such as leptin and adiponectin and through changes induced at the level of important homeostatic factors such as pancreatic secretion of insulin, androgen synthesis by the ovary and sex hormone-binding globulin (SHBG) production by the liver. WHO estimates that 9 to 25% of women in developed countries are severely obese, and obese mothers are much more likely to have obese children, especially if they have gestational diabetes. Obesity-associated anovulation may lead to infertility and to a higher risk of miscarriage. Management of anovulation with obesity involves diet and exercise as well as standard approaches to ovulation induction. Many obese women conceive without assistance, but pregnancies in obese women have increased rates of pregnancy-associated hypertension, gestational diabetes, large babies, Cesarean section and perinatal mortality and morbidity. Among contraceptors, the fear of weight gain affects uptake and continuation of hormonal contraceptives, although existing trials indicate that any such effects are small. For all methods of hormonal contraception, weight above 70 kg is associated with increased failure rates.

  8. Pathophysiology, risk factors, and screening methods for prediabetes in women with polycystic ovary syndrome

    Directory of Open Access Journals (Sweden)

    Gourgari E

    2016-08-01

    Full Text Available Evgenia Gourgari,1 Elias Spanakis,2 Adrian Sandra Dobs3 1Division of Pediatric Endocrinology, Georgetown University School of Medicine, Washington, DC, 2Division of Endocrinology, University of Maryland School of Medicine, 3Department of Endocrinology, Johns Hopkins University School of Medicine, Baltimore, MD, USA Abstract: Polycystic ovary syndrome (PCOS is a syndrome associated with insulin resistance (IR, obesity, infertility, and increased cardiometabolic risk. This is a descriptive review of several mechanisms that can explain the IR among women with PCOS, other risk factors for the development of diabetes, and the screening methods used for the detection of glucose intolerance in women with PCOS. Few mechanisms can explain IR in women with PCOS such as obesity, insulin receptor signaling defects, and inhibition of insulin-mediated glucose uptake in adipocytes. Women with PCOS have additional risk factors for the development of glucose intolerance such as family history of diabetes, use of oral contraceptives, anovulation, and age. The Androgen Society in 2007 and the Endocrine Society in 2013 recommended using oral glucose tolerance test as a screening tool for abnormal glucose tolerance in all women with PCOS. The approach to detection of glucose intolerance among women with PCOS varies among health care providers. Large prospective studies are still needed for the development of guidelines with strong evidence. When assessing risk of future diabetes in women with PCOS, it is important to take into account the method used for screening as well as other risk factors that these women might have. Keywords: IR, OGTT, obesity, hyperandrogenism, anovulation, BMI, insulin resistance, PCOS

  9. Effects of melatonin on the ovarian response to pinealectomy or continuous light in female rats: similarity with polycystic ovary syndrome

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    M.F. Prata Lima

    2004-07-01

    Full Text Available The current study was conducted to investigate the relationship between melatonin and chronic anovulation. Adult (3-4 months old female Wistar rats were submitted to pinealectomy: group I: pinealectomized ovariectomized melatonin-treated (N = 10; group II: pinealectomized ovariectomized placebo-treated (N = 12; group III: pinealectomized light-treated placebo-treated(N = 10 or maintained under continuous light; group IV: maintained under continuous light, ovariectomized melatonin-treated (N = 22; group V: maintained under continuous light, ovariectomized placebo-treated (N = 10; group VI: maintained under continuous light placebo-treated (N = 10. In order to assess ovarian modifications, unilateral ovariectomy was performed during the fourth month in groups I, II, IV, V and the other ovary was removed after 8 months. Ovariectomy was performed in groups III and VI only after eight months. Melatonin (200 µg/100 g body weight dissolved in 0.02 ml absolute ethanol was injected intramuscularly daily during the last 4 months into groups I and IV. The other groups were treated with placebo (NaCl. The ovarian cysts were analyzed and their area, perimeter and maximum diameter, as well as the thickness of the ovarian capsule were measured. Daily colpocytological smears were performed throughout the study. Persistent estrous condition and ovarian cysts were observed in all groups. In pinealectomized rats the ovarian and vaginal alterations disappeared at the end of the study and in rats maintained under continuous light the vaginal and ovarian polycystic aspect was reversed only in those treated with melatonin. We conclude that melatonin may act on the ovarian response reverting chronic anovulation induced by pinealectomy or continuous light.

  10. Medical management of clomiphene-resistant polycystic ovarian syndrome: an update

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    Sharonjeet Kaur

    2014-02-01

    Full Text Available Clomiphene citrate is the traditional first-line treatment for chronic anovulation that characterizes polycystic ovary syndrome (PCOS. A gold standard therapy has always been Clomiphene Citrate (CC. However, 20%-25% of PCOS women fail to ovulate with incremental doses of CC. A good body of evidence suggest that alternatives for PCOS women with CC-resistant anovulation include insulin sensitizers like metformin and pioglitazone. Insulin sensitizers improves pregnancy outcome and ovulation rate by and acts by ameliorating insulin sensitivity and hyperandrogenemia. Metformin is preferred in obese women. Gonadotropins induce ovulation and maintain optimal follicle growth via controlled administration of follicle stimulation hormone. Two regimens are used which includes high and low dose regimen. Low dose regimen is preferred but is associated adverse effects like ovarian hyperstimulation syndrome (OHSS and increased cost. Extending clomiphene therapy reduces cost and improves pregnancy outcome. Glucocorticoids are preferably used when serum Dehydroepiandrosterone levels are > 200µg/dL. Bromocriptine improves ovulation rate by decreasing prolactin levels. Human Chorionic Gonadotropin restores ovulation but its use is limited during intrauterine insemination. Tamoxifen acts in a similar way as CC but has lesser antiestrogenic effect on the endometrium, cervical mucus, and granulosa cells, hence an added advantage of monofollicular ovulation. Aromatase inhibitors block conversion androstenedione and testosterone to estrogen in ovary and improves ovulation rate. Added advantage includes lesser cost, simple to use, no danger of multiple pregnancies and convenient for patient. Combination of GnRH analogues and Gonadotropins are associated with increased risk of OHSS. D-chiro-inositol, N-Acetylcysteine, melatonin and acarbose are tried with little success. [Int J Basic Clin Pharmacol 2014; 3(1.000: 1-9

  11. Treatment options for polycystic ovary syndrome

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    Ahmed Badawy

    2011-02-01

    Full Text Available Ahmed Badawy1 Abubaker Elnashar21Department of Obstetrics and Gynecology, Mansoura University, Mansoura, Egypt; 2Department of Obstetrics and Gynecology, Benha University, Benha, EgyptAbstract: Polycystic ovary syndrome (PCOS is the most common endocrine disorder in women. The clinical manifestation of PCOS varies from a mild menstrual disorder to severe disturbance of reproductive and metabolic functions. Management of women with PCOS depends on the symptoms. These could be ovulatory dysfunction-related infertility, menstrual disorders, or androgen-related symptoms. Weight loss improves the endocrine profile and increases the likelihood of ovulation and pregnancy. Normalization of menstrual cycles and ovulation could occur with modest weight loss as little as 5% of the initial weight. The treatment of obesity includes modifications in lifestyle (diet and exercise and medical and surgical treatment. In PCOS, anovulation relates to low follicle-stimulating hormone concentrations and the arrest of antral follicle growth in the final stages of maturation. This can be treated with medications such as clomiphene citrate, tamoxifen, aromatase inhibitors, metformin, glucocorticoids, or gonadotropins or surgically by laparoscopic ovarian drilling. In vitro fertilization will remain the last option to achieve pregnancy when others fail. Chronic anovulation over a long period of time is also associated with an increased risk of endometrial hyperplasia and carcinoma, which should be seriously investigated and treated. There are androgenic symptoms that will vary from patient to patient, such as hirsutism, acne, and/or alopecia. These are troublesome presentations to the patients and require adequate treatment. Alternative medicine has been emerging as one of the commonly practiced medicines for different health problems, including PCOS. This review underlines the contribution to the treatment of different symptoms.Keywords: treatment, polycystic ovary

  12. Infertility: an approach to management in a district hospital in Ghana.

    Science.gov (United States)

    Fiander, A

    1990-07-01

    Up to 1/3 of women of child bearing age are infertile in certain African areas. Over 1000 patients registered at Bawku Hospital, Upper East Region, Ghana during an 18-month period, where a scheme for the investigation and treatment of infertile patients was established. The 5 main causes of infertility are: 1) tubal damage; 2) male factor; 3) anovulation; 4) uterine factor; and 5) unexplained. Special clinics are set up for infertility; outpatient staff are recruited. A preprinted questionnaire should be used for a uniform approach. The one used in Bawku is shown in the appendix. Health talks should be given. They should use the local language be at the right level, and use visual aids. In large clinics, numbers should be used to insure a 1st come, 1st served basis. A treatment protocol is important. When the patient 1st walks in, the infertility form is completed; appropriate investigations are done--hemoglobin, VDRL, seminal analysis, and cervical or high vagina swabs, and others--and the results are reviewed. The patient is encouraged to keep a menstrual calendar for 3 months. At the 2nd visit, the menstrual calendar is reviewed. A pelvic examination and a tubal patency test (TPT) are done. At the 3rd visit, abdominal and pelvic examinations are done and a TPT. Then patients can be diagnosed and counselled accordingly. At the last visit, further explanation is given, further TPTs are done if necessary, and anovulation is treated with clomiphene. The visits are spread out over 6 months. In unexplained fertility cases, the couple is told there is nothing wrong, they should keep trying. The idea that the man may be causing the infertility is foreign to many communities. This needs changing. 20% of infertility is due to male factor in Bawku. Male infertility is hard to cure. Cultural considerations prevent the clinician from telling the patient that her partner is infertile. They will tell her that there is nothing wrong with her. Approximately 15% become pregnant

  13. Metformin therapy in a hyperandrogenic anovulatory mutant murine model with polycystic ovarian syndrome characteristics improves oocyte maturity during superovulation

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    Sabatini Mary E

    2011-05-01

    Full Text Available Abstract Background Metformin, an oral biguanide traditionally used for the treatment of type 2 diabetes, is widely used for the management of polycystic ovary syndrome (PCOS-related anovulation. Because of the significant prevalence of insulin resistance and glucose intolerance in PCOS patients, and their putative role in ovulatory dysfunction, the use of metformin was touted as a means to improve ovulatory function and reproductive outcomes in PCOS patients. To date, there has been inconsistent evidence to demonstrate a favorable effect of metformin on oocyte quality and competence in women with PCOS. Given the heterogeneous nature of this disorder, we hypothesized that metformin may be beneficial in mice with aberrant metabolic characteristics similar to a significant number of PCOS patients. The aim of this study was to gain insight into the in vitro and in vivo effects of metformin on oocyte development and ovulatory function. Methods We utilized metformin treatment in the transgenic ob/ob and db/db mutant murine models which demonstrate metabolic and reproductive characteristics similar to women with PCOS. Results: Metformin did not improve in vitro oocyte maturation nor did it have an appreciable effect on in vitro granulosa cell luteinization (progesterone production in any genotype studied. Although both mutant strains have evidence of hyperandrogenemia, anovulation, and hyperinsulinemia, only db/db mice treated with metformin had a greater number of mature oocytes and total overall oocytes compared to control. There was no observed impact on body mass, or serum glucose and androgens in any genotype. Conclusions Our data provide evidence to suggest that metformin may optimize ovulatory performance in mice with a specific reproductive and metabolic phenotype shared by women with PCOS. The only obvious difference between the mutant murine models is that the db/db mice have elevated leptin levels raising the questions of whether their

  14. Effect of Ubiquinol on Serum Reproductive Hormones of Amenorrhic Patients.

    Science.gov (United States)

    Thakur, A S; Littaru, G P; Funahashi, I; Painkara, U S; Dange, N S; Chauhan, P

    2016-07-01

    In neuroendocrine system the increase in oxidative status is produced by a glucocorticoid-dependent and transcriptional increase in pro-oxidative drive, with concurrent inhibition of the antioxidant defense system, ultimately leading to increased neuronal cell death. Functional hypothalamic disturbances and neuroendocirne aberrations have both short and long term consequences for reproductive health. Understandably, an impaired or diminished hypothalamic-pituitary-ovarian axis leads to anovulation and hypoestrogenism. Anovulation is directly linked to the neurohormonal and hormonal background of Functional Hypothalamic Amenorrhea. Impairment of pulsatile Gonadotropin Releasing Hormone secretion causes the impairment of pulsatile Lutenizing Hormone (LH) and Follicle Stimulating Hormone (FSH) secretion. The importance of oxidative stress in various pituitary disorders suggesting a possible clinical usefulness of antioxidant molecules like the lipophilic antioxidant Ubiquinol. Coenzyme Q10 or Ubiquinol is an essential part of the cell energy-producing system of mitochondria. However, it is also a powerful lipophilic antioxidant, protecting lipoproteins and cell membranes from autooxidation. Due to these unique actions Ubiquinol is used in clinical practice as an antioxidants for neurodegenerative diseases. So to identify the role of Ubiquinol on reproductive hormones FSH and LH, we have included 50 infertile patients of age group of 20-40, which are mostly amenorrhic. Out of 50 only 30 patients were in continuous follow up after supplementing them with 150 mg of Ubiquinol every day for 4 months. The hormonal levels were estimated by Enzyme Linked Immuno Sorbent Assay technique at follicular phase. The result suggests that FSH concentration is increased up to three times (from 3.10 ± 2.70 to 10.09 ± 6.93) but remains within the normal limit (P  0.05). The supplementation of 150 mg of Ubiquinol may reduce the oxidative stress in neuroendocrine system which

  15. The RNA-binding protein, ZFP36L2, influences ovulation and oocyte maturation.

    Directory of Open Access Journals (Sweden)

    Christopher B Ball

    Full Text Available ZFP36L2 protein destabilizes AU-rich element-containing transcripts and has been implicated in female fertility. In the C57BL/6NTac mouse, a mutation in Zfp36l2 that results in the decreased expression of a form of ZFP36L2 in which the 29 N-terminal amino acid residues have been deleted, ΔN-ZFP36L2, leads to fertilized eggs that arrest at the two-cell stage. Interestingly, homozygous ΔN-Zfp36l2 females in the C57BL/6NTac strain release 40% fewer eggs than the WT littermates (Ramos et al., 2004, suggesting an additional defect in ovulation and/or oocyte maturation. Curiously, the same ΔN-Zfp36l2 mutation into the SV129 strain resulted in anovulation, prompting us to investigate a potential problem in ovulation and oocyte maturation. Remarkably, only 20% of ΔN-Zfp36l2 oocytes in the 129S6/SvEvTac strain matured ex vivo, suggesting a defect on the oocyte meiotic maturation process. Treatment of ΔN-Zfp36l2 oocytes with a PKA inhibitor partially rescued the meiotic arrested oocytes. Furthermore, cAMP levels were increased in ΔN-Zfp36l2 oocytes, linking the cAMP/PKA pathway and ΔN-Zfp36l2 with meiotic arrest. Since ovulation and oocyte maturation are both triggered by LHR signaling, the downstream pathway was investigated. Adenylyl cyclase activity was increased in ΔN-Zfp36l2 ovaries only upon LH stimulation. Moreover, we discovered that ZFP36L2 interacts with the 3'UTR of LHR mRNA and that decreased expression levels of Zfp36l2 correlates with higher levels of LHR mRNA in synchronized ovaries. Furthermore, overexpression of ZFP36L2 decreases the endogenous expression of LHR mRNA in a cell line. Therefore, we propose that lack of the physiological down regulation of LHR mRNA levels by ZFP36L2 in the ovaries is associated with anovulation and oocyte meiotic arrest.

  16. The estrogen-injected female mouse: new insight into the etiology of PCOS

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    Freeh Steven M

    2009-05-01

    Full Text Available Abstract Background Female mice and rats injected with estrogen perinatally become anovulatory and develop follicular cysts. The current consensus is that this adverse response to estrogen involves the hypothalamus and occurs because of an estrogen-induced alteration in the GnRH delivery system. Whether or not this is true has yet to be firmly established. The present study examined an alternate possibility in which anovulation and cyst development occurs through an estrogen-induced disruption in the immune system, achieved through the intermediation of the thymus gland. Methods, Results and Conclusion A putative role for the thymus in estrogen-induced anovulation and follicular cyst formation (a model of PCOS was examined in female mice by removing the gland prior to estrogen injection. Whereas all intact, female mice injected with 20 ug estrogen at 5–7 days of age had ovaries with follicular cysts, no cysts were observed in animals in which thymectomy at 3 days of age preceded estrogen injection. In fact, after restoring immune function by thymocyte replacement, the majority of thymectomized, estrogen-injected mice had ovaries with corpora lutea. Thus, when estrogen is unable to act on the thymus, ovulation occurs and follicular cysts do not develop. This implicates the thymus in the cysts' genesis and discounts the role of the hypothalamus. Subsequent research established that the disease is transferable by lymphocyte infusion. Transfer took place between 100-day-old estrogen-injected and 15-day-old naïve mice only when recipients were thymectomized at 3 days of age. Thus, a prerequisite for cyst formation is the absence of regulatory T cells. Their absence in donor mice was judged to be the result of an estrogen-induced increase in the thymus' vascular permeability, causing de facto circumvention of the final stages of regulatory T cell development. The human thymus has a similar vulnerability to steroid action during the fetal stage. We

  17. Phase 1 safety, tolerability, and pharmacokinetic study of single ascending doses of XM17 (recombinant human follicle-stimulating hormone in downregulated healthy women

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    Lammerich A

    2015-07-01

    Full Text Available Andreas Lammerich, Peter Bias, Beate Gertz Merckle GmbH, Ulm, Germany Background: XM17 is a recombinant human follicle-stimulating hormone (follitropin alfa for stimulation of multifollicular development in women undergoing controlled ovarian hyperstimulation during assisted reproductive therapy and for treatment of anovulation. Manufactured using Chinese hamster ovary cells transfected with the human follicle-stimulating hormone gene, XM17 has an identical amino acid sequence to that of the human protein as well as to those of the other approved recombinant human follicle-stimulating hormone products. Glycosylation patterns may differ slightly between products. The objectives of this first-in-human study were to assess the safety, tolerability, pharmacokinetics, and dose-proportionality of single ascending subcutaneous doses of XM17 in healthy young female volunteers.Methods: Endogenous follicle-stimulating hormone was downregulated by implanting a 1-month depot of goserelin acetate 3.6 mg on day 0 in eligible subjects. On day 14 of the experimental period, subjects received one of four ascending doses of XM17. Blood sampling to obtain the pharmacokinetic profile of XM17 was done at frequent intervals until 168 hours post-dose.Results: Following downregulation of endogenous follicle-stimulating hormone to <4 IU/L, 40 subjects (of mean age 29±5.4 years received single subcutaneous doses of 37.5 (n=4, pilot group, 75, 150, or 300 IU (n=12 each of XM17. The mean serum concentration-time profiles of XM17 revealed dose-related increases in maximum concentration (Cmax within 24 hours followed by monoexponential decay for the three higher dose levels. Slopes estimated by linear regression for Cmax and AUC0–168h were ~1.0 (0.9052 IU/L and 1.0964 IU·h/L, respectively. For each IU of XM17 administered, Cmax and AUC0–168h rose by 0.032 IU/L and 2.60 IU·h/L, respectively. Geometric mean elimination half-life ranged from 54 to 90 hours. No antibodies

  18. Treatment for polycystic ovary syndrome patients without fertility requirement%无生育要求多囊卵巢综合征患者无排卵的处理

    Institute of Scientific and Technical Information of China (English)

    李琳

    2014-01-01

    POlycystic Ovary syndrOme( PCOS)is a cOmmOn menstrual disOrder characterized by OligO - /anOvulatiOn. Patients usually cOmPlain Of menstrual disOrders Or endOmetrial PathOlOgy in the early stage. MetabOlic abnOrmalities are the main cOmPlicatiOns in the late stage,including tyPe 2 diabetes mellitus,cardiOvascular disease, metabOlic syndrOme( MS). TherefOre,it is necessary tO management anOvulatiOn in PCOS Patients withOut fertility requirement. Effective weight cOntrOl is imPOrtant. The aims in the early stage is tO cOntrOl menstrual cycles and Prevent endOmetrial PathOlOgy. Screening Of metabOlic abnOrmalities is needed tO lOwer the risk Of lOng - term cOmPlicatiOns.%多囊卵巢综合征(POlycystic Ovary syndrOme,PCOS)是一种常见的妇科内分泌疾病,稀发排卵或无排卵作为其重要的临床特征之一,在疾病早期主要引起月经异常和子宫内膜病变,在疾病后期可发生2型糖尿病、心血管疾病、代谢综合征(MetabOlic SyndrOme,MS)等,并与子宫内膜病变互为影响,形成恶性循环。因此,对于无生育要求 PCOS 患者无排卵的处理非常重要,长期有效的体重管理是 PCOS 患者最重要的基础治疗,在疾病早期阶段,主要是调整月经周期,预防子宫内膜病变,同时需要注意对患者的糖脂代谢异常进行筛查和早期治疗,预防糖尿病、心血管疾病、代谢综合征等远期并发症。

  19. [Impact of end-stage renal disease and kidney transplantation on the reproductive system].

    Science.gov (United States)

    Delesalle, A-S; Robin, G; Provôt, F; Dewailly, D; Leroy-Billiard, M; Peigné, M

    2015-01-01

    Chronic renal failure leads to many metabolic disorders affecting reproductive function. For men, hypergonadotropic hypogonadism, hyperprolactinemia, spermatic alterations, decreased libido and erectile dysfunction are described. Kidney transplantation improves sperm parameters and hormonal function within 2 years. But sperm alterations may persist with the use of immunosuppressive drugs. In women, hypothalamic-pituitary-ovarian axis dysfunction due to chronic renal failure results in menstrual irregularities, anovulation and infertility. After kidney transplantation, regular menstruations usually start 1 to 12 months after transplantation. Fertility can be restored but luteal insufficiency can persist. Moreover, 4 to 20% of women with renal transplantation suffer from premature ovarian failure syndrome. In some cases, assisted reproductive technologies can be required and imply risks of ovarian hyperstimulation syndrome and must be performed with caution. Pregnancy risks for mother, fetus and transplant are added to assisted reproductive technologies ones. Only 7 authors have described assisted reproductive technologies for patients with kidney transplantation. No cases of haemodialysis patients have been described yet. So, assisted reproductive technologies management requires a multidisciplinary approach with obstetrics, nephrology and reproductive medicine teams' agreement.

  20. Can anti-Mullerian hormone replace ultrasonographic evaluation in polycystic ovary syndrome? A review of current progress

    Directory of Open Access Journals (Sweden)

    Awadhesh Kumar Singh

    2015-01-01

    Full Text Available Several studies over the past decade have now consistently indicated that the serum anti-Mullerian hormone (AMH levels are at least 2–3-fold higher in the patients with polycystic ovary syndrome (PCOS, which also corresponds to the increased number of AMH producing preantral and small antral follicles. Moreover, AMH levels have been found to be associated in direct proportion to the follicle numbers per ovary or antral follicular count, assessed by the transvaginal ultrasound (TVS. Furthermore, AMH correlates directly with the rising serum testosterone and luteinizing hormone levels in PCOS. Hence, serum AMH in women with oligo-anovulation and/or hyperandrogenemia could indicate the presence of underlying PCOS, when reliable TVS is not feasible, or not acceptable, either due to the virginal status or psycho-social issue. In addition, the imaging quality of abdominal ultrasound is often impaired by obesity, which typically occurs in PCOS women. Indeed, PCOS occurs most commonly in young females who cannot be subjected to invasive TVS for various reasons; therefore, a desirable alternative to TVS is urgently required to diagnose the most prevalent endocrine abnormality of young women. This review will analyze the currently available evidence regarding the role of AMH in the diagnosis of PCOS.

  1. The role of insulin and selected adipocytokines in patients with polycystic ovary syndrome (PCOS) - a literature review.

    Science.gov (United States)

    Ozegowska, Katarzyna E; Pawelczyk, Leszek A

    2015-04-01

    Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women of reproductive age. It is manifested by hyperandrogenism, polycystic ovaries on ultrasound, oligomenorrhoea and anovulation. PCOS patients are more vulnerable to metabolic disorders: insulin resistance, obesity endothelium dysfunction, atherosclerosis, and activation of proinflammatory factors. This association shows that PCOS might be an ovarian manifestation of a metabolic syndrome. Insulin resistance is also strongly correlated with reproductive failure. Approximately 100 factors, secreted in adipose tissue, are responsible for its regulation. Adipocytokines have been found to play an important role in regulating insulin sensitivity Abnormal levels of adipokines are detected in patients with insulin resistance. Studies indicate that these factors, and their different activity in PCOS women, may affect changes observed in their metabolism and, especially may participate in the development of insulin resistance. There are several adipokines whose role has been thoroughly investigated and many that we still know very little about, for example apein and visfatin. Counseling PCOS patients about the possibility of developing metabolic syndrome, diabetes mellitus, and cardiovascular diseases should be a standard of care.

  2. Metabolism and Ovarian Function in PCOS Women: A Therapeutic Approach with Inositols

    Science.gov (United States)

    Rossetti, Paola; Buscema, Massimo; Condorelli, Rosita Angela; Gullo, Giuseppe; Triolo, Onofrio

    2016-01-01

    Polycystic ovary syndrome (PCOS) is characterized by chronical anovulation and hyperandrogenism which may be present in a different degree of severity. Insulin-resistance and hyperinsulinemia are the main physiopathological basis of this syndrome and the failure of inositol-mediated signaling may concur to them. Myo (MI) and D-chiro-inositol (DCI), the most studied inositol isoforms, are classified as insulin sensitizers. In form of glycans, DCI-phosphoglycan and MI-phosphoglycan control key enzymes were involved in glucose and lipid metabolism. In form of phosphoinositides, they play an important role as second messengers in several cellular biological functions. Considering the key role played by insulin-resistance and androgen excess in PCOS patients, the insulin-sensitizing effects of both MI and DCI were tested in order to ameliorate symptoms and signs of this syndrome, including the possibility to restore patients' fertility. Accumulating evidence suggests that both isoforms of inositol are effective in improving ovarian function and metabolism in patients with PCOS, although MI showed the most marked effect on the metabolic profile, whereas DCI reduced hyperandrogenism better. The purpose of this review is to provide an update on inositol signaling and correlate data on biological functions of these multifaceted molecules, in view of a rational use for the therapy in women with PCOS. PMID:27579037

  3. Metabolism and Ovarian Function in PCOS Women: A Therapeutic Approach with Inositols

    Directory of Open Access Journals (Sweden)

    Antonio Simone Laganà

    2016-01-01

    Full Text Available Polycystic ovary syndrome (PCOS is characterized by chronical anovulation and hyperandrogenism which may be present in a different degree of severity. Insulin-resistance and hyperinsulinemia are the main physiopathological basis of this syndrome and the failure of inositol-mediated signaling may concur to them. Myo (MI and D-chiro-inositol (DCI, the most studied inositol isoforms, are classified as insulin sensitizers. In form of glycans, DCI-phosphoglycan and MI-phosphoglycan control key enzymes were involved in glucose and lipid metabolism. In form of phosphoinositides, they play an important role as second messengers in several cellular biological functions. Considering the key role played by insulin-resistance and androgen excess in PCOS patients, the insulin-sensitizing effects of both MI and DCI were tested in order to ameliorate symptoms and signs of this syndrome, including the possibility to restore patients’ fertility. Accumulating evidence suggests that both isoforms of inositol are effective in improving ovarian function and metabolism in patients with PCOS, although MI showed the most marked effect on the metabolic profile, whereas DCI reduced hyperandrogenism better. The purpose of this review is to provide an update on inositol signaling and correlate data on biological functions of these multifaceted molecules, in view of a rational use for the therapy in women with PCOS.

  4. Studies on Androgen Receptor mRNA expression in Pancreas, Hypothalamus and Ovary of Androgen Sterilized Rats

    Institute of Scientific and Technical Information of China (English)

    Li WANG; Jing-wen HOU; Li-min LU; Jin YU; Sui-qi GUI

    2004-01-01

    Objective To investigate the androgen receptor (AR) mRNA expression in pancreas,hypothalamus and ovary of androgen sterilized rats (ASR)Methods ASR model was established by subcutaneous injection of testosterone propionate to SD female rats at the age of 9 days. Around the age of 106 days (proestrus),all rats were killed, serum △ 4-andronestedione (△ 4-A), total testosterone (TT), free testosterone (FT), insulin (Ins) and C-peptide (C-P)were measured by radioimmunoassay (RIA). Total RNA in pancreas, hypothalamus and ovary were extracted and the amount of AR mRNA was quantitatedly analyzed by RT-PCR with single base mutant template as inner standard. Results Serum concentrations of△ 4-A, TT, FT, Ins and C-P in ASR model rats were significantly higher than those in control group (P<0. 05, P<0. 01). The expression of AR mRNA in pancreas, hypothalamus and ovary increased significantly (P<0. 05,P<0. 01) of model rats as compared with control group. Conclusion The elevated serum androgen levels in ASR model could enhance the expression of AR mRNA levels in pancreas, hypothalamus and ovary, which further induce hyperinsulinemia and anovulation.

  5. A Combined Therapy with Myo-Inositol and D-Chiro-Inositol Improves Endocrine Parameters and Insulin Resistance in PCOS Young Overweight Women

    Science.gov (United States)

    Benelli, Elena; Del Ghianda, Scilla

    2016-01-01

    Introduction. We evaluated the effects of a therapy that combines myo-inositol (MI) and D-chiro-inositol (DCI) in young overweight women affected by polycystic ovary syndrome (PCOS), characterized by oligo- or anovulation and hyperandrogenism, correlated to insulin resistance. Methods. We enrolled 46 patients affected by PCOS and, randomly, we assigned them to two groups, A and B, treated, respectively, with the association of MI plus DCI, in a 40 : 1 ratio, or with placebo (folic acid) for six months. Thus, we analyzed pretreatment and posttreatment FSH, LH, 17-beta-Estradiol, Sex Hormone Binding Globulin, androstenedione, free testosterone, dehydroepiandrosterone sulphate, HOMA index, and fasting glucose and insulin. Results. We recorded a statistically significant reduction of LH, free testosterone, fasting insulin, and HOMA index only in the group treated with the combined therapy of MI plus DCI; in the same patients, we observed a statistically significant increase of 17-beta-Estradiol levels. Conclusions. The combined therapy of MI plus DCI is effective in improving endocrine and metabolic parameters in young obese PCOS affected women. PMID:27493664

  6. [Psychogenic amenorrhea].

    Science.gov (United States)

    Lachowsky, M; Winaver, D

    2007-01-01

    Any amenorrhoea noticed outside pregnancy, lactation and menopause periods might be of organic or functional origin. Today, non organic amenorrhoea are either called hypothalamic amenorrhoea, more exactly supra hypothalamic amenorrhoea; functional amenorrhoea--this definition being characterized by its lack of any anatomic substratum; or, psychogenic amenorrhoea--an etiologic definition. Like any amenorrhoea, functional or psychogenic amenorrhoea is the consequence of either anovulation or endometrial hypotrophy. Neuroendocrine sciences do open new exciting research perspectives but other ways all the more promising since hormonal mechanics would not be the explanation. Work on the unconscious is indeed the other road leading to these psychogenic amenorrhoea. The term "psychogenic"--of psychological origin--does not mean of unknown origin, provided we recognize the strong link between psyche and soma. Treatment for this kind of amenorrhoea is twofold: medical and psychotherapeutic. Even though psychological etiology is obvious, clinical examination must be rigorous and completed by complementary exams which will guide the therapeutics. This is reassuring to the patient for the gynaecologist she chose to consult is implied, and not the psychotherapist. This reassures us too, because what we care for, as doctors, is first of all the body. Psychotherapeutic support can be provided by the general practitioner or the gynaecologist, both with psychosomatics training, but a multidisciplinary approach must often be worked out.

  7. Discussion on Traditional Chinese Medicine With Artificial Cycle on Treating Irregular Menstruation Due to Polycystic Ovarian Syndrome%疏肝解郁配中药人工周期治疗多囊卵巢综合征引起月经不调初探

    Institute of Scientific and Technical Information of China (English)

    贾绍燕

    2012-01-01

    Polycystic ovarian syndrome is characteristed with hypomenorrhea, secondary amenorrhea, anovulation, infertility, hirsutism, obesity and enlarged Polycystic ovarian. It belongs to delayed menstruation, amenorrhea, metrorrhagia and metrostaxix, infertility, abdominal mass, and so on. This article explained the mechanism and clinical curative effect of traditional Chinese medicine with artificial cycle treating polycystic ovarian syndrome causing irregular menstruation based on the production mechanism of menstruation and its relationship between the liver.%多囊卵巢综合征是一种多以月经稀发、月经过少、继发闭经、无排卵、不孕、多毛、肥胖、卵巢多囊性增大为特征的综合征,属中医“月经后期”、“闭经”、“崩漏”、“不孕”、“癥瘕”等范畴,文章从月经产生的机理、与肝脏的关系,阐述疏肝解郁配中药人工周期治疗多囊卵巢综合征引起月经不调的机理及临床疗效.

  8. Neuroprotection via Reduction in Stress: Altered Menstrual Patterns as a Marker for Stress and Implications for Long-Term Neurologic Health in Women

    Science.gov (United States)

    Prokai, David; Berga, Sarah L.

    2016-01-01

    Individuals under chronic psychological stress can be difficult to identify clinically. There is often no outwardly visible phenotype. Chronic stress of sufficient magnitude not only impacts reproductive function, but also concomitantly elicits a constellation of neuroendocrine changes that may accelerate aging in general and brain aging in particular. Functional hypothalamic amenorrhea, a phenotypically recognizable form of stress, is due to stress-induced suppression of endogenous gonadotropin-releasing hormone secretion. Reversal of functional hypothalamic amenorrhea includes restoration of ovulatory ovarian function and fertility and amelioration of hypercortisolism and hypothyroidism. Taken together, recovery from functional hypothalamic amenorrhea putatively offers neuroprotection and ameliorates stress-induced premature brain aging and possibly syndromic Alzheimer’s disease. Amenorrhea may be viewed as a sentinel indicator of stress. Hypothalamic hypogonadism is less clinically evident in men and the diagnosis is difficult to establish. Whether there are other sex differences in the impact of stress on brain aging remains to be better investigated, but it is likely that both low estradiol from stress-induced anovulation and low testosterone from stress-induced hypogonadism compromise brain health. PMID:27999413

  9. Progress in Etiology,Diagnosis and Treatment of Hyperprolactinemia%高泌乳素血症的病因及诊疗进展

    Institute of Scientific and Technical Information of China (English)

    王佳宁

    2012-01-01

    高泌乳素血症(HPRL)为常见的内分泌紊乱性疾病,在临床症状上女性主要表现为闭经、溢乳、月经稀发、不孕等,该疾病影响了人们的健康及生活质量.目前治疗仍主要以溴隐亭为主,2011年HPRL诊疗指南中把卡麦角林作为首选用药,还有中药、手术、放射等治疗方法.现就HPRL的病因及诊疗进行综述,为高泌乳血症的治疗提供参考.%llyperprolactinaemia( 11PRL )is a common endocrine disorder characterized by amenorrhea, galactorrhea,anovulation and infertility. 11PRL have great impact on health-related quality of life( HRQoL ). The major treatment is still bromocriptine, while 2011 11PRL diagnosis and treatment guideline suggests cabergoline as the optimal medication, and traditional Chinese medicine, surgery and radiotherapy are also the options. Here is to make a review on the etiology, diagnosis and treatment of 11PRL.

  10. [Current diagnosis and treatment of hyperprolactinemia].

    Science.gov (United States)

    Melgar, Virgilio; Espinosa, Etual; Sosa, Ernesto; Rangel, María José; Cuenca, Dalia; Ramírez, Claudia; Mercado, Moisés

    2016-01-01

    Hyperprolactinemia is a frequent neuroendocrinological condition that should be approached in an orderly and integral fashion, starting with a complete clinical history. Once physiological causes such as pregnancy, systemic disorders such as primary hypothyroidism and the use of drugs with dopamine antagonistic actions such as metochlopramide have been ruled out, the most common cause of hyperprolactinemia is a PRL-secreting pituitary adenoma or prolactinoma. Prolactinomas are usually classified as microprolactinomas (less than 1 cm) or macroprolactinomas (larger than 1 cm), which can either be confined or invasive. The hormonal consequence of hypeprolactinemia is hypogonadism; in women, this is manifested as amenorrhea/oligomenorreha, anovulation and galactorrhea, whereas in men the main complaints are a diminished libido and erectile dysfunction. Macroprolactinomas can also present with symptoms and signs resulting form mass effect of the tumor, such as headaches and visual field defects. Other structural causes of hyperprolactinemia include non-functioning pituitary adenomas and infiltrative disorders, which can interrupt the inhibitory, descending dopaminergic tone. The primary treatment of prolactinomas is pharmacological with dopamine agonists such as cabergoline.

  11. Polycystic Ovary Syndrome – An Endocrine and Metabolic Disorder Throughout Life

    Directory of Open Access Journals (Sweden)

    Szilágyi A

    2015-01-01

    Full Text Available The etiology and pathogenesis of polycystic ovary syndrome (PCOS is still a matter of controversies, but it is apparent that hyperinsulinism and insulin resistance (IR are major determining factors in the development of ovarian hyperandrogenism and chronic anovulation. The consequences of the PCOS extend beyond the reproductive axis. Follow up studies have shown an increase in the incidence of type 2 diabetes mellitus and other elements of metabolic syndrome in PCOS and increased cardiovascular risk, too. It is possible that PCOS and type 2 diabetes mellitus are different clinical manifestations of the same IR syndrome, with their phenotypic differences. It is even more compound as PCOS is not a homogenous group of patients. It is reflected in the diagnostic criteria of PCOS by the Rotterdam PCOS Conference as the diagnostic criteria identify 4 phenotypes of PCOS. The PCOS phenotypes differ in the degree of hyperandrogenism, but differences in hyperinsulinism and obesity have not been studied yet. Management of PCOS depends on the principal goals of the patients (treatment of infertility, diminishing signs of hyperandrogensim, prevention of long term metabolic consequences, but the management should be individualized according to the phenotypes as well. The value of the insulin sensitizer therapy (e. g. metformin, myo-inositol, statins and/or lifestyle modification await further evaluation and it should be integrated in the spectrum of therapeutical options. A challenging task for the future is to assess the individul risk of PCOS patients according to phenotypes and to elaborate personal steps for prevention.

  12. [Hyperandrogenism: clinical aspects, investigation and treatment].

    Science.gov (United States)

    Beckers, A; Parotte, M C; Gaspard, U; Khalife, A

    1999-04-01

    Androgen excess (AE) is one of the most common endocrine disorders, affecting 10% of adult women before the menopause. The clinical picture varies widely depending on the etiology of AE. Most of these women are suffering from hirsutism, acne, menstrual disturbances, anovulation and obesity. Virilization is unusual, except in patients with ovary or adrenal cancer. Polycystic ovary syndrome (PCOS) and idiopathic hirsutism (IH) are the most frequent causes of androgen excess, accounting for more than 90% of the cases. The pathogenesis of PCOS is still an unresolved problem. A hereditary predisposition has been suggested. Enzymatic deficiency is a less frequent cause of AE, the most common deficiency being the non classic 21-OH deficiency (NCAH). AE has been implicated as a side effect of many drugs. Ovary and adrenal tumours are unusual, however, they must be considered especially in case of severe hirsutism or virilization. Complementary investigations are selected based on the result of clinical examination. Pharmacologic therapy, usually with anti-androgens, is the most widely used treatment for PCOS, IH and NCAH. Surgical therapy should be considered only when there is a particular indication such as Cushing's syndrome, ovary or adrenal tumours.

  13. Expression of matrix metalloproteinases and ovarian morphological changes in androgenized cyclic female guinea pigs.

    Science.gov (United States)

    Li, Jun-rong; Shen, Ting; Wang, Yan-li; Wei, Quan-wei; Shi, Fang-xiong

    2016-02-01

    This study was conducted to investigate expression of matrix metalloproteinases (MMPs) and ovarian morphological changes in androgenized cyclic female guinea pigs. Adult cyclic female guinea pigs were injected daily for 28 days with medium doses of testosterone propionate (TP; 1 mg/100g), high doses of TP (2 mg/100g), or saline (control). Serum concentrations of testosterone, estradiol (E2), and progesterone (P4) were measured. Histologic sections of ovaries were stained with hematoxylin-eosin and by immunohistochemistry. Expressions of steroidogenic acute regulatory protein, proliferating cell nuclear antigen, and MMP-2 and MMP-9 in the ovary were characterized by immunohistochemistry. After 28 days of TP injection, serum testosterone concentrations were increased dose-dependently. An appropriate dosage of TP could induce permanent anovulation in guinea pigs, making them a potential model for human polycystic ovary syndrome. MMP-2 and MMP-9 are jointly involved in the growth and atresia of ovarian follicles in cyclic guinea pigs. Increased numbers of atretic antral follicles in the ovary might be associated with the observed high expression of MMP-2 in androgenized cyclic guinea pigs.

  14. Phenotypes and enviromental factors: their influence in PCOS.

    Science.gov (United States)

    Diamanti-Kandarakis, Evanthia; Christakou, Charikleia; Marinakis, Evangelos

    2012-01-01

    Polycystic ovary syndrome (PCOS) is a complex syndrome of unclear etiopathogenesis characterized by heterogeneity in phenotypic manifestations. The clinical phenotype of PCOS includes reproductive and hormonal aberrations, namely anovulation and hyperandrogenism, which coexist with metabolic disturbances. Reflecting the crosstalk between the reproductive system and metabolic tissues, obesity not only deteriorates the metabolic profile but also aggravates ovulatory dysfunction and hyperandrogenism. Although the pathogenesis of PCOS remains unclear, the syndrome appears to involve environmental and genetic components. Starting from early life and extending throughout lifecycle, environmental insults may affect susceptible women who finally demonstrate the clinical phenotype of PCOS. Diet emerges as the major environmental determinant of PCOS. Overnutrition leading to obesity is widely recognized to have an aggravating impact, while another detrimental dietary factor may be the high content of food in advanced glycated end products (AGEs). Environmental exposure to industrial products, particularly Bisphenol A (BPA), may also exacerbate the clinical course of PCOS. AGEs and BPA may act as endocrine disruptors in the pathogenesis of the syndrome. PCOS appears to mirror the harmful influence of the modern environment on the reproductive and metabolic balance of inherently predisposed individuals.

  15. Contributions of androgen and estrogen to fetal programming of ovarian dysfunction

    Directory of Open Access Journals (Sweden)

    Dumesic Daniel A

    2006-04-01

    Full Text Available Abstract In female mammals, including humans, deviations from normal androgenic or estrogenic exposure during fetal development are detrimental to subsequent adult ovarian function. Androgen deficiency, without accompanying estrogen deficit, has little apparent impact on ovarian development. Fetal estrogen deficiency, on the other hand, results in impaired oocyte and follicle development, immature and abnormal adult ovaries, and excessive ovarian stimulation from endogenous gonadotropins ultimately generating hemorrhagic follicles. Complete estrogen deficiency lasting into adulthood results in partial ovarian masculinization. Fetal androgen excess, on the other hand, mediated either by direct androgen action or following androgen aromatization to estrogen, reprograms ovarian development and reproductive neuroendocrinology to mimic that found in women with polycystic ovary syndrome: enlarged, polyfollicular, hyperandrogenic, anovulatory ovaries with accompanying LH hypersecretion. Oocyte developmental competence is also compromised. Insulin is implicated in the mechanism of both anovulation and deficient oocyte development. Fetal estrogen excess induces somewhat similar disruption of adult ovarian function to fetal androgen excess. Understanding the quality of the fetal female sex steroid hormone environment is thus becoming increasingly important in improving our knowledge of mechanisms underlying a variety of female reproductive pathologies.

  16. Observation on human ovarian theca cell and granulosa cell interaction in polycystic ovary syndrome

    Institute of Scientific and Technical Information of China (English)

    焦泽旭; 周灿权; 庄广伦; 梁晓燕

    2002-01-01

    Objective: To investigate the role of human theca cell(TC) and granulo sa cell(GC) interaction and insulin(INS) in steroidogenesis in normal ovarian cy cle and in patients with PCOS. Methods: Ovarian theca and granulosa cells from eleven normal wo men and eight PCOS patients were co-cultured on opposite side of collagen with or without INS. The concentrations of estradiol(E2), progesterone(P) and andro stenedione (A) in the culture medium were examined by ELISA method.Results: When co-cultured with GC, TC in PCOS group produced mo re A and less P than those of normal group. When co-cultured with theca cells, granulosa cells in PCOS group produced more E2 than those of normal group. Add ition of INS increased the difference significantly.Conclusions: The GC and TC interaction from the normal and PCOS ovaries is different. There is a high A and high E2 intraovary loop of PC OS leading to premature arrest of follicle growth and anovulation. Insulin may p lay an important regulatory role.

  17. Management of psychotropic-induced hyperprolactinemia.

    Science.gov (United States)

    Marken, P A; Haykal, R F; Fisher, J N

    1992-10-01

    The effects of individual psychotropic medications on serum prolactin concentrations are described, and recommendations for dealing with adverse effects are provided. Hyperprolactinemia can result in galactorrhea, amenorrhea, irregular menses, and anovulation; in men, impotence and azoospermia, with or without lactation and gynecomastia, can occur. Antipsychotics may block dopamine receptors in the pituitary prolactin-secreting cells and prevent dopamine-induced reduction of prolactin release. The magnitude of the increase in prolactin concentration correlates with the amount of antipsychotic drug given. The treatment of choice is reduction of the antipsychotic dosage or discontinuation of therapy. If adjustments to the antipsychotic dosage fail to resolve symptoms, the dopamine agonists bromocriptine and amantadine may be tried. Antidepressants may produce elevated serum prolactin concentrations, especially with long-term administration. However, the frequency of antidepressant-induced hyperprolactinemia is much lower than that seen with antipsychotics, and serious adverse clinical effects are uncommon. Other psychotropic drugs such as lithium, valproic acid, buspirone, carbamazepine, and benzodiazepines either are only rarely associated with symptomatic hyperprolactinemia or do not produce clinically important changes in prolactin concentrations. Antipsychotic drugs are the psychotropic agents most likely to cause symptomatic hyperprolactinemia. Bromocriptine or amantadine may provide symptomatic relief if withdrawal or adjustment of the antipsychotic dosage does not eliminate the symptoms.

  18. The role of vitamin D and melatonin in the pathogenesis of polycystic ovary syndrome

    Directory of Open Access Journals (Sweden)

    J S Absatarova

    2014-03-01

    Full Text Available The article presents data on new possible mechanisms of pathogenesis of polycystic ovary syndrome. In the past years there have been a lot of studies on the effect of vitamin D on the development of insulin resistance and hyperandrogenism. The amount of evidence for of the correlation between vitamin D deficiency and obesity is growing. The search for genetic markers predisposing to polycystic ovary syndrome among vitamin D receptor gene polymorphisms seems quite premising. Considering of detected connections, therapy with vitamin D may be an effective treatment for this disease. In addition to the influence on reproductive function vitamin D is involved in the regulation of circadian rhythm, and it’s disturbance may lead to the development of anovulation. Another important factor in control of sleep and wakefulness cycles is melatonin. It’s participation in development and maturation of follicles by inhibiting of oxidative stress was proved, and the use of melatonin in women as a treatment for infertility helped to improve reproductive function. Thus, further studies of the role of vitamin D and melatonin may allow developing principally new approaches and medical guidelines for clinical practice.

  19. Updates on the myo-inositol plus D-chiro-inositol combined therapy in polycystic ovary syndrome.

    Science.gov (United States)

    Unfer, Vittorio; Porcaro, Giuseppina

    2014-09-01

    Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders affecting women of reproductive age. It is characterized by chronic anovulation, hyperandrogenism, and insulin resistance. It is the main cause of infertility due to the menstrual dysfunction and metabolic disorders. Women with PCOS also have an increased cardiovascular risk because of dyslipidemia and insulin resistance. So far, we have a lot of information about the etiology of PCOS, and many steps forward have been made about the diagnosis of this syndrome, but there is still no certainty about the therapy. Myo-inositol (MI) and D-chiro-inositol, two inositol stereoisomers, have been proven to be effective in PCOS treatment. However, only MI has been shown to have beneficial effects on reproductive function, whereas the administration of MI/D-chiro-inositol, in the physiological plasma ratio (i.e., 40:1) ensures better clinical results, such as the reduction of insulin resistance, androgens' blood levels, cardiovascular risk and regularization of menstrual cycle with spontaneous ovulation.

  20. Effect of myo-inositol and melatonin versus myo-inositol, in a randomized controlled trial, for improving in vitro fertilization of patients with polycystic ovarian syndrome.

    Science.gov (United States)

    Pacchiarotti, Alessandro; Carlomagno, Gianfranco; Antonini, Gabriele; Pacchiarotti, Arianna

    2016-01-01

    Polycystic ovarian syndrome (PCOS) induces anovulation in women of reproductive age, and is one of the pathological factors involved in the failure of in vitro fertilization (IVF). Indeed, PCOS women are characterized by poor quality oocytes. Therefore, a treatment for enhancing oocyte quality becomes crucial for these patients. Myo-Inositol and melatonin proved to be efficient predictors for positive IVF outcomes, correlating with high oocyte quality. We tested the synergistic effect of myo-inositol and melatonin in IVF protocols with PCOS patients in a randomized, controlled, double-blind trial. Five-hundred twenty-six PCOS women were divided into three groups: Controls (only folic acid: 400 mcg), Group A (Inofolic® plus, a daily dose of myo-inositol: 4000 mg, folic acid: 400 mcg, and melatonin: 3 mg), and Group B (Inofolic®, a daily dose of myo-inositol: 4000 mg, and folic acid: 400 mcg). The main outcome measures were oocyte and embryo quality, clinical pregnancy and implantation rates. The treatment lasted from the first day of the cycle until 14 days after embryo transfer. Myo-inositol and melatonin have shown to enhance, synergistically, oocyte and embryo quality. In consideration of the beneficial effect observed in our trial and on the bases of previous studies, we decided to integrate routinely MI and M supplementation in the IVF protocols. The same treatment should be taken carefully in consideration in all procedures of this kind.

  1. Bee venom treatment reduced C-reactive protein and improved follicle quality in a rat model of estradiol valerate-induced polycystic ovarian syndrome

    Directory of Open Access Journals (Sweden)

    L Karimzadeh

    2012-01-01

    Full Text Available Polycystic ovarian syndrome (PCOS is a low grade inflammatory disease characterized by hyperandrogenemia and chronic anovulation. C-reactive protein (CRP, released by adipocytes, plays a key role in PCOS. Apis mellifera honeybee venom (HBV contains a variety of biologically active components with various pharmaceutical properties. This study was designed to assess the possibility of HBV application as an anti-inflammatory therapeutic agent. To induce PCOS, 1 mg/100 g body weight estradiol valerate (EV was subcutaneously (SC injected into eight-week-old rats. After 60 days, 0.5 mg/kg HBV was administered SC for 14 consecutive days, and the results of PCOS treatment were investigated. Rats were then anesthetized with chloroform, and their ovaries and livers were surgically removed to determine histomorphometrical changes. Testosterone and 17-β-estradiol were detected by chemiluminescence immunoassay. In order to detect serum CRP, ELISA kit was used in three groups of EV-induced PCOS, HBV-treated PCOS and control animals. Thickness of the theca layer, number of cysts and the level of serum CRP significantly decreased in HBV group in comparison with PCOS group. Moreover, corpus luteum, as a sign of ovulation, was observed in HBV-treated ovaries which were absent in PCOS group. Our results suggest that the beneficial effect of HBV may be mediated through its inhibitory effect on serum CRP levels.

  2. [Polycystic ovary syndrome (PCOS)].

    Science.gov (United States)

    Torre, A; Fernandez, H

    2007-09-01

    Polycystic ovaries syndrome (PCOS) is one of the most common female hormonal disorders. Its multiple components--reproductive, metabolic, neoplasic and cardiovascular--have a major impact on the public health. Androgen excess and resistance to insulin, probably from genetic origin, are responsible for most of the clinical symptomatology. Resistance to insulin seems to be accompanied by a greater risk of glucose intolerance, type 2 diabetes, lipidic anomalies and can involve the development of cardiovascular diseases. In addition, sleep apnea syndrome is more progressively described in PCOS. Infertility, menses disorders and hirsutism often push these patients to consult their physician. A better understanding of the physiopathological mechanisms led to the emergence of new therapeutic options increasing the sensitivity to insulin. Besides the pregnancy wishes, cares aim to attenuate the marks of the hyper-androgenism (hormonal treatment and cosmetic) and to correct cardiovascular, respiratory and gynaecological risk factors. In case of infertility by anovulation, cares must be performed by trained experts to minimize the risk of ovarian hyper-stimulation syndrome and multiple pregnancies. A gradation from loose weight to clomiphene citrate ovulation induction, ovarian drilling, low dose gonadotropin, in vitro fertilisation, or in vitro maturation of oocytes should bring back good reproduction potential.

  3. Identification of influential factors on ovarian responsiveness with tamoxifen in type-2 WHO anovulatory patients

    Directory of Open Access Journals (Sweden)

    T. Madani

    2005-01-01

    Full Text Available Background and purpose: Chronic anovulation is a common cause of infertility in women. Most women with chronic anoulation have irregular menstural cycles and normal serum FSH concentration s(WHO-type 2.finding out influential factors on ovarian responsiveness is useful for managing the infertile patients. The objective of this study is to assess the relation of some factors on ovulation in infertile women referring to Royan institute between November 2002 to November 2003. Materials and Methods: A total of 74 normogonadotropic, oligomenorrhic, undergone ovulation induction using tamoxifen, were studied. The factors studied were pretreatment clinical sings (Hirsutism, BMI endocrine (FSH, LH, Insulin- testosterone and sonographic screening characteristics of these patients.Ovarian response and ovulation were monitored by ultrasound scans and measurement of mid-luteal progestron.Results: According to statistical analysis pretreatment Hirsutism- BMI – serum LH consentration, LH/FSH ratio and ovarian volume were identified as the significant parameters for prediction of ovulation with tamoxifen (P≤0.05.There was no statistically significant differences in age, duration of infertility, FBS/Fasting insulin ratio and ovulation between the groups. Conclusion: Ovarian responsiveness to tamoxifen in anovulatory infertile women can be predicted on the basis of some initial screening characteristics.The prediction model in this study may improve the outcome and make the treatment more safe and efficient.These approaches should be further evaluated in prospective comparative trial.

  4. Anorexia, bulimia, and the athletic triad: evaluation and management.

    Science.gov (United States)

    Fenichel, Rebecca M; Warren, Michelle P

    2007-12-01

    Caloric restriction caused by undernutrition or over-exercise is increasingly common and has significant health consequences such as hypothalamic amenorrhea, infertility, attainment of low peak bone mass, and bone loss leading to fracture. In these patients, the pathophysiology of amenorrhea and bone loss is multifactorial, involving hormones that integrate the nutritional state with the hypothalamic-pituitary-ovarian axis, including leptin and possibly ghrelin. The pathophysiology of bone loss includes nutritional deficiencies, possibly estrogen deficiency, and direct and indirect effects of leptin on bone. Identifying patients at risk for low bone mineral density and fracture is important, as is screening with dual energy radiograph absorptiometry. Treatment has focused on oral contraceptive use, yet improved bone mineral density is marked by nutritional recovery and anovulation reversal. Therefore, resolving the nutrition deficiency should be the cornerstone of treatment. Cognitive-behavioral therapy aims for weight recovery, which can lead to reversal of amenorrhea and improvement in other associated metabolic abnormalities. During treatment, estradiol levels can be followed to assess hypothalamic-pituitary-ovarian recovery because estradiol secretion may increase well before ovulation occurs. In patients failing the above interventions, hormone replacement should be considered, but bone mineral density should be followed because patients may continue to lose bone despite treatment with oral contraceptives if nutrition is not improved.

  5. Contributing Factors of Endometrial Receptivity in Polycystic Ovary Syndrome%多囊卵巢综合征子宫内膜容受性的影响因素

    Institute of Scientific and Technical Information of China (English)

    许榕倩

    2011-01-01

    多囊卵巢综合征(PCOS)是引起月经失调和不孕的常见内分泌障碍性疾病.PCOS不孕的主要原因有不排卵和卵母细胞质量差等.但经药物纠正排卵后,仍存在低妊娠率、高流产率的现象.其原因之一是PCOS患者内分泌及代谢的改变使其子宫内膜容受性降低.现从形态学、分子生物学和基因学角度探讨PCOS子宫内膜容受性降低的影响因素.%Polycystic ovary syndrome( PCOS) is a common endocrine disorder that causes menstrual dysregulation and irifertility. PCOS-associated infertility results mainly from anovulation and compromised oocytes.The medical treatment improves the ovulation , showing a low pregnancy rate and high abortion rate though. One of the caused underlying this problem is the reduced endometrial receptivity caused by the disruption of endocrine function and metabolism in PCOS patients. The article mainly reviews the contributing factors of reduction in endometrial receptivity in PCOS in the sense of morphology, molecular biology, and genetics.

  6. Mouse models to study polycystic ovary syndrome: a possible link between metabolism and ovarian function?

    Science.gov (United States)

    van Houten, E Leonie A F; Visser, Jenny A

    2014-03-01

    Polycystic ovary syndrome (PCOS) is the most common cause of female infertility affecting 6-8% of women worldwide. PCOS is characterized by two of the following three criteria: clinical or biochemical hyperandrogenism, oligo- or amenorrhea, and polycystic ovaries (PCO). In addition, women with PCOS are often obese and insulin resistant, and are at risk for type 2 diabetes and cardiovascular disease. The etiology of PCOS remains unknown. Therefore, several animal models for PCOS have been generated to gain insight into the etiology and development of the PCOS-associated phenotypes. Androgens are considered the main culprit of PCOS, and therefore, androgenization of animals is the most frequently used approach to induce symptoms that resemble PCOS. Prenatal or prepubertal androgen treatment results in many characteristics of human PCOS, including anovulation, cyst-like follicles, elevated luteinizing hormone (LH) levels, increased adiposity, and insulin insensitivity. However, PCOS has a heterogeneous presentation, and therefore it is difficult to generate a model that exactly reproduces the reproductive and metabolic phenotypes observed in women with PCOS. In this review, we discuss several mouse models for PCOS, and compare the reproductive and/or metabolic phenotypes observed in several androgen-induced models as well as in several genetic models.

  7. MLL2 Is Required in Oocytes for Bulk Histone 3 Lysine 4 Trimethylation and Transcriptional Silencing

    Science.gov (United States)

    Andreu-Vieyra, Claudia V.; Chen, Ruihong; Agno, Julio E.; Glaser, Stefan; Anastassiadis, Konstantinos; Stewart, A. Francis; Matzuk, Martin M.

    2010-01-01

    During gametogenesis and pre-implantation development, the mammalian epigenome is reprogrammed to establish pluripotency in the epiblast. Here we show that the histone 3 lysine 4 (H3K4) methyltransferase, MLL2, controls most of the promoter-specific chromatin modification, H3K4me3, during oogenesis and early development. Using conditional knockout mutagenesis and a hypomorph model, we show that Mll2 deficiency in oocytes results in anovulation and oocyte death, with increased transcription of p53, apoptotic factors, and Iap elements. MLL2 is required for (1) bulk H3K4me3 but not H3K4me1, indicating that MLL2 controls most promoters but monomethylation is regulated by a different H3K4 methyltransferase; (2) the global transcriptional silencing that preceeds resumption of meiosis but not for the concomitant nuclear reorganization into the surrounded nucleolus (SN) chromatin configuration; (3) oocyte survival; and (4) normal zygotic genome activation. These results reveal that MLL2 is autonomously required in oocytes for fertility and imply that MLL2 contributes to the epigenetic reprogramming that takes place before fertilization. We propose that once this task has been accomplished, MLL2 is not required until gastrulation and that other methyltransferases are responsible for bulk H3K4me3, thereby revealing an unexpected epigenetic control switch amongst the H3K4 methyltransferases during development. PMID:20808952

  8. MLL2 is required in oocytes for bulk histone 3 lysine 4 trimethylation and transcriptional silencing.

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    Claudia V Andreu-Vieyra

    Full Text Available During gametogenesis and pre-implantation development, the mammalian epigenome is reprogrammed to establish pluripotency in the epiblast. Here we show that the histone 3 lysine 4 (H3K4 methyltransferase, MLL2, controls most of the promoter-specific chromatin modification, H3K4me3, during oogenesis and early development. Using conditional knockout mutagenesis and a hypomorph model, we show that Mll2 deficiency in oocytes results in anovulation and oocyte death, with increased transcription of p53, apoptotic factors, and Iap elements. MLL2 is required for (1 bulk H3K4me3 but not H3K4me1, indicating that MLL2 controls most promoters but monomethylation is regulated by a different H3K4 methyltransferase; (2 the global transcriptional silencing that preceeds resumption of meiosis but not for the concomitant nuclear reorganization into the surrounded nucleolus (SN chromatin configuration; (3 oocyte survival; and (4 normal zygotic genome activation. These results reveal that MLL2 is autonomously required in oocytes for fertility and imply that MLL2 contributes to the epigenetic reprogramming that takes place before fertilization. We propose that once this task has been accomplished, MLL2 is not required until gastrulation and that other methyltransferases are responsible for bulk H3K4me3, thereby revealing an unexpected epigenetic control switch amongst the H3K4 methyltransferases during development.

  9. Menstrual and reproductive function repair in patients with polycystic ovary syndrome and obesity by correcting of glucose intolerance

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    O I Lineva

    2008-06-01

    Full Text Available The aim of the study was to investigate the effect of sibutramine on metabolic and hormonal parameters in women with PCOS and obesity. Materials and methods. The study included 53 women aged 18 to 35 years (mean age 31,3 ± 1,1 years with PCOS and obesity. All patients received therapy with sibutramine. The total treatment duration was 6 months. The treatment was evaluated monthly nature of the menstrual cycle, anthropometric parameters (body weight, BMI, ON, ON, ON / OF. The Results. The studies found that after 3 months of treatment with weight loss was 8,1 ± 0,31 kg, after 6 months - 13,1 ± 0,78 kg (p <0,05. Results of the survey of women included in this study strongly support the negative impact of obesity on the functional state of the reproductive system, evidenced by the high incidence of anovulation, rhythm disturbances of menstruation (amenorrhea up to, infertility. Conclusions. The obtained results once again confirm the high efficacy and safety of sibutramine to reduce body mass, suggest correction of metabolic, hormonal disorders and positive impact on women's reproductive health. This allows us to consider the use of sibutramine in women with PCOS and obesity as a way to restore the endocrine function of the reproductive system.

  10. [Hypercarotenemia, amenorrhea and a vegetarian diet].

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    Martin-Du Pan, R C; Hermann, W; Chardon, F

    1990-01-01

    In order to analyse the role of hypercarotenemia in amenorrhoea, we have studied the ovarian function of 20 patients presenting with hypercarotenemia (serum carotene greater than 5 mumol/l). 12 of these were complaining of secondary amenorrhoea (group I), 7 with a normal weight (group I A) and 5 with a weight below 85% of ideal weight (group I B). Another group of 8 patients had normal menstrual cycles and a body weight within normal limits (group II). Group I presented an ovarian insufficiency of hypothalamic origin with an increase in the FSH/LH ratio. The patients in group I A although of normal weight differed from group II by a history of important weight variations, strenuous sports activity and an essentially vegetarian diet, the most likely reason for their hypercarotenemia. The high carotene levels however do not seem to be directly responsible for the amenorrhoea, in view of the normal menstrual cycles of the patients in group II. Hypercarotenemia can be considered as a biologic marker of weight loss with fat mobilisation and low T3 levels. It can also be due to a vegetarian diet. The latter may be an aetiological factor in anovulation by increasing faecal excretion of oestrogens and thus decreasing blood levels of oestradiol particularly when associated with other compounding factors such as excessive physical activity, loss of weight or affective problems.

  11. Is ovarian surgery effective for androgenic symptoms of polycystic ovarian syndrome?

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    Johnson, N P; Wang, Kaye

    2003-11-01

    The effectiveness of laparoscopic ovarian drilling for treatment of anovulation in polycystic ovarian syndrome (PCOS) has been proved. The role of ovarian surgery in the treatment of symptoms related to hyperandrogenaemia, such as hirsutism and acne, has been less clear. This review sought to evaluate the effectiveness of ovarian surgery in the treatment of non-infertility symptoms related to PCOS. A systematic literature review was undertaken, by searching the Medline database for the years 1966-2002 inclusive. The search yielded 19 studies recording the outcomes of hirsutism, acne or androgen levels from surgical treatment for women with PCOS: three assessed unilateral oophorectomy; two ovarian wedge resection; and 14 ovarian drilling. There was no consensus of a clear improvement in hirsutism or acne in women undergoing surgery. There was a trend towards a decrease in serum androgen levels in most studies. We conclude that, while there is evidence that ovarian surgery may decrease androgen levels in some women with PCOS, the evidence that this translates into a clear improvement in hirsutism and acne is less clear. Further high quality clinical research, including data from randomisation, would be required to answer this question.

  12. Recent Progress of Diagnosis and Treatment in Polycystic Ovary Syndrome%多囊卵巢综合征诊断与治疗的新进展

    Institute of Scientific and Technical Information of China (English)

    周礼兰

    2012-01-01

    The pathogenesis of polycystic ovary syndrome( PCOS )is still not entirely clear at present; clinical manifestations include menstrual disorders,anovulation,obesity and so on. Diagnostic criteria for the disease are still controversial, most considering that Rotterdam criteria is more suitable for the diagnosis of PCOS in China. There are a variety of treatments as well, including non-surgical treatment adjusting menstrual cycle,ovulation induction treatment,insulin sensitizers and statins ),surgery( ovarian wedge resection,ultrasound-guided transvaginal ovarian interstitial hydrogel surgery )and integrated traditional Chinese and western medicine therapy.%多囊卵巢综合征(PCOS)的发病机制目前仍不完全清楚,临床主要表现为月经失调、排卵障碍、肥胖等.该病的诊断标准尚存争议,大多认为鹿特丹准则比较适用于我国PCOS的诊断.治疗方法 也繁多各异,包括非手术治疗(调整月经周期、促排卵治疗、应用胰岛素增敏剂和他汀类药物)、手术治疗(卵巢楔形切除术、经阴道超声引导的卵巢间质水凝术)和中西医结合治疗.

  13. MicroRNAs Related to Polycystic Ovary Syndrome (PCOS

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    Anja Elaine Sørensen

    2014-08-01

    Full Text Available Polycystic ovary syndrome (PCOS is the most common, though heterogeneous, endocrine aberration in women of reproductive age, with high prevalence and socioeconomic costs. The syndrome is characterized by polycystic ovaries, chronic anovulation and hyperandrogenism, as well as being associated with infertility, insulin resistance, chronic low-grade inflammation and an increased life time risk of type 2 diabetes. MicroRNAs (miRNAs are small, non-coding RNAs that are able to regulate gene expression at the post-transcriptional level. Altered miRNA levels have been associated with diabetes, insulin resistance, inflammation and various cancers. Studies have shown that circulating miRNAs are present in whole blood, serum, plasma and the follicular fluid of PCOS patients and that they might serve as potential biomarkers and a new approach for the diagnosis of PCOS. In this review, recent work on miRNAs with respect to PCOS will be summarized. Our understanding of miRNAs, particularly in relation to PCOS, is currently at a very early stage, and additional studies will yield important insight into the molecular mechanisms behind this complex and heterogenic syndrome.

  14. The management of infertility associated with polycystic ovary syndrome

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    Homburg Roy

    2003-11-01

    Full Text Available Abstract Polycystic ovary syndrome [PCOS] is the commonest cause of anovulatory infertility. Treatment modes available are numerous mainly relying on ovarian stimulation with FSH, a reduction in insulin concentrations and a decrease in LH levels as the basis of the therapeutic principles. Clomiphene citrate is still the first line treatment and if unsuccessful is usually followed by direct FSH stimulation. This should be given in a low dose protocol, essential to avoid the otherwise prevalent complications of ovarian hyperstimulation syndrome and multiple pregnancies. The addition of a GnRH agonists, while very useful during IVF/ET, adds little to ovulation induction success whereas the position of GnRH antagonists is not yet clear. Hyperinsulinemia is the commonest contributor to the state of anovulation and its reduction, by weight loss or insulin sensitizing agents such as metformin, will alone often restore ovulation or will improve results when used in combination with other agents. Laparoscopic ovarian drilling is proving equally as successful as FSH for the induction of ovulation, particularly in thin patients with high LH concentrations. Aromatase inhibitors are presently being examined and may replace clomiphene in the future. When all else has failed, IVF/ET produces excellent results. In conclusion, there are very few women suffering from anovulatory infertility associated with PCOS who cannot be successfully treated today.

  15. Impaired receptivity and decidualization in DHEA-induced PCOS mice

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    Li, Shu-Yun; Song, Zhuo; Song, Min-Jie; Qin, Jia-Wen; Zhao, Meng-Long; Yang, Zeng-Ming

    2016-01-01

    Polycystic ovary syndrome (PCOS), a complex endocrine disorder, is a leading cause of female infertility. An obvious reason for infertility in PCOS women is anovulation. However, success rate with high quality embryos selected by assisted reproduction techniques in PCOS patients still remain low with a high rate of early clinical pregnancy loss, suggesting a problem in uterine receptivity. Using a dehydroepiandrosterone-induced mouse model of PCOS, some potential causes of decreased fertility in PCOS patients were explored. In our study, ovulation problem also causes sterility in PCOS mice. After blastocysts from normal mice are transferred into uterine lumen of pseudopregnant PCOS mice, the rate of embryo implantation was reduced. In PCOS mouse uteri, the implantation-related genes are also dysregulated. Additionally, artificial decidualization is severely impaired in PCOS mice. The serum estrogen level is significantly higher in PCOS mice than vehicle control. The high level of estrogen and potentially impaired LIF-STAT3 pathway may lead to embryo implantation failure in PCOS mice. Although there are many studies about effects of PCOS on endometrium, both embryo transfer and artificial decidualization are applied to exclude the effects from ovulation and embryos in our study. PMID:27924832

  16. Infertility and pregnancy in women with polycystic ovary syndrome.

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    Nader, S

    2010-12-01

    Management of polycystic ovary syndrome (PCOS) usually spans a woman's reproductive years. While treatment of androgenic symptoms is often a primary concern, periodically, the regimen has to be modified because of a desire for pregnancy. At this time the couple should be evaluated for factors that may contribute to infertility and this should include semen analysis. However, for many, anovulation is likely to be the cause of infertility and ovulation induction is generally required. The premise on which ovulation induction in PCOS is based is two-fold: increasing ovarian exposure to follicle stimulating hormone (FSH) and/or correcting hormonal derangements. Potential differences in pathogenesis, evidenced clinically by phenotypic diversity, would suggest that treatment should be individualized. After a brief overview of factors relating to infertility, this paper outlines treatments available for ovulation induction in women with PCOS and provides a critical appraisal of management options. These options include the use of clomiphene citrate, insulin sensitizers, and the combination. Protocols for ovulation induction with FSH injections are outlined and the relative risks of multiple gestation and severe ovarian hyperstimulation syndrome of these various protocols discussed. The use of aromatase inhibitors and the occasional use of glucocorticoids are briefly reviewed, and indications for in vitro fertilization and laparoscopic ovarian diathermy outlined. Pregnancy outcome in this patient population is also discussed.

  17. Ovarian Drilling Efficacy, Estradiol Levels and Pregnancy Rate in Females With Polycystic Ovary Syndrome

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    Moramezi

    2015-02-01

    Full Text Available Background Polycystic ovary syndrome (PCOS is the most common cause of oligoovulation and anovulation in general population and in females with infertility. Objectives The purpose of this study was to compare the efficacy of ovarian laparoscopic drilling procedure (LOD in females with PCOS, resistant to treatment with estradiol (E2 level less than 40 pg/mL versus more than 40 pg/mL. Materials and Methods Females with PCOS, resistant to drug for ovary stimulation, were grouped based on the Estradiol levels of ≤ 40 pg/mL (n = 13 and > 40 pg/mL (n = 15. To survey the ovulation, continuing spontaneous ovulation and cumulative pregnancy rate, ovarian laparoscopic drilling was carried out after the analysis of serum E2. Results There was significant difference in the average starting time of ovulation and continuing spontaneous ovulation of cases with PCOS with E2 levels > 40 pg/mL, compared with ones with E2 ≤ 40 pg/mL (P = 0.029, P = 0.05, respectively. Significant differences were also found in pregnancy rates of cases with PCOS with E2 levels > 40 pg/mL compared with ones with E2 ≤ 40 pg/mL (P = 0.05. Conclusions This study revealed that LOD in females with PCOS with a serum E2 > 40 pg/mL was sufficient and safe to trigger development of ovarian follicles followed by clinical pregnancy.

  18. Uterine morphology and peristalsis in women with polycystic ovary syndrome

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    Leonhardt, Henrik; Hellstroem, Mikael [Department of Radiology, Institute of Clinical Sciences, Sahlgrenska University Hospital, Sahlgrenska Academy at the University of Gothenburg, Gothenburg (Sweden)], E-mail: henrik.leonhardt@vgregion.se; Gull, Berit; Nilsson, Lars; Janson, Per O. [Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska University Hospital, Sahlgrenska Academy at the University of Gothenburg, Gothenburg (Sweden); Kishimoto, Keiko [Department of Radiology, St Marianna University School of Medicine, Kanagawa (Japan); Kataoka, Masako [Department of Radiology, Kyoto University Hospital, Kyoto (Japan); Stener-Victorin, Elisabet [Institute of Neuroscience and Physiology, Department of Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg (Sweden)

    2012-12-15

    Background. Polycystic ovary syndrome (PCOS) is associated with chronic oligo-anovulation and high circulating sex hormone levels. Women with PCOS have an increased risk of developing endometrial cancer. In anovulatory women with PCOS a positive relationship between endometrial thickness and endometrial hyperplasia has been observed. Uterine peristalsis, which has been suggested to be of importance for female fertility, has not previously been studied in PCOS. Purpose. To assess whether women with PCOS have altered endometrial thickness, uterine wall morphology, and peristalsis. Material and Methods. In this prospective case-control study 55 women with PCOS (mean age, 29.5 years {+-} 4.5 SD) and 28 controls (27.6 {+-} 3.2) were examined using magnetic resonance imaging (MRI), assessing thickness of endometrium, junctional zone (JZ), and myometrium, and evaluating the occurrence, frequency (waves/min), strength (amplitude), pattern, and direction of peristalsis. Uterine morphology was also assessed by transvaginal ultrasonography (TVUS). Results. The endometrium was thinner in PCOS with oligo-amenorrhea compared to controls, also after adjustments for age and BMI (adjusted P = 0.043). There was no difference in thickness of the JZ or the myometrium in cases versus controls. Uterine peristalsis was less commonly observed in women with PCOS than in controls (adjusted P = 0.014). Conclusion. There were no differences in myometrial morphology between PCOS and controls, but the endometrium was thinner in PCOS with oligo-amenorrhea. Based on cine MRI, uterine peristalsis was less common in PCOS than in controls.

  19. [Polycystic ovary syndrome].

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    Vrbíková, Jana

    2015-10-01

    For diagnosing of polycystic ovary syndrome (PCOS) it is currently recommended to follow the ESHRE criteria. For diagnosis according to them two of the following three symptoms are sufficient: 1. morphology of polycystic ovaria, 2. clinical manifestations of hyperandrogenism or laboratory proof of hyperandrogenemia, and 3. oligo-anovulation. PCOS is a complex disorder in whose pathogenesis genetic and environmental effects interact. It is not a gynecological disorder alone, the syndrome is accompanied by insulin resistance which leads to increased incidence of type 2 diabetes mellitus and impaired glucose tolerance (4 times and twice, independently of BMI). Also gestational DM occurs more frequently. Dyslipidemia, arterial hypertension, elevated CRP and homocysteine levels, endothelial dysfunction and greater intima-media thickness are also more frequent. It is not quite clear, however, whether women with PCOS suffer cardiovascular events more frequently as well. More often than is accidental PCOS is associated with depression, anxiety and eating disorders, further with nonalcoholic steatohepatitis and with the sleep apnoea syndrome - especially in obese women. Therapeutic measures include non-pharmacological methods - lifestyle adjustments focused on weight reduction in obese individuals, cosmetic measures for dermatologic manifestation of hyperandrogenism, in particular laser and pharmacotherapy (combined hormonal contraceptives and antiandrogens). Menstrual irregularities can be treated with contraceptives or cyclical administration of gestagens, also metformin can be used.

  20. Adrenocortical steroid response to ACTH in different phenotypes of non-obese polycystic ovary syndrome

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    Cinar Nese

    2012-12-01

    Full Text Available Abstract Background Adrenal androgen excess is frequently observed in PCOS. The aim of the study was to determine whether adrenal gland function varies among PCOS phenotypes, women with hyperandrogenism (H only and healthy women. Methods The study included 119 non-obese patients with PCOS (age: 22.2 ± 4.1y, BMI:22.5 ± 3.1 kg/m2, 24 women with H only and 39 age and BMI- matched controls. Among women with PCOS, 50 had H, oligo-anovulation (O, and polycystic ovaries (P (PHO, 32 had O and H (OH, 23 had P and H (PH, and 14 had P and O (PO. Total testosterone (T, SHBG and DHEAS levels at basal and serum 17-hydroxprogesterone (17-OHP, androstenedione (A4, DHEA and cortisol levels after ACTH stimulation were measured. Results T, FAI and DHEAS, and basal and AUC values for 17-OHP and A4 were significantly and similarly higher in PCOS and H groups than controls (p  Conclusion PCOS patients and women with H only have similar and higher basal and stimulated adrenal androgen levels than controls. All three hyperandrogenic subphenotypes of PCOS exhibit similar and higher basal and stimulated adrenal androgen secretion patterns compared to non-hyperandrogenic subphenotype.

  1. Effects of phthalic acid esters on fetal health

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    Bajkin Ivana

    2014-01-01

    Full Text Available Introduction. Phthalates are synthetic industrial compounds capable of disrupting endocrine system. Effects of phthalates depend on dosage, duration of action and stage of development of the individual, thus making the fetus, newborn, and children at puberty the most vulnerable groups. Metabolism of Phthalates: Metabolism of these compounds consists of at least two steps: hydrolysis and conjugation. They are mainly excreted in urine, with a low percent being excreted through feces. Exposure to Phthalates. Exposure to the effects of phthalates begins at the intrauterine stage since the phthalates pass through the placental barrier. Phthalates may be found in plastic products, toys, medical equipment, industrial materials, food, and clothes. Determination of Phthalate Levels in Humans. Urine is the best sample for evaluating phthalate levels in humans because of rapid phthalate metabolism and high concentrations of metabolites in the urine. Fetal Testicular Dysgenesis Syndrome: Fetal testicular dysgenesis syndrome involves disorders of male genital tract such as shortened anogenital distance, hypospadia, cryptorchidism, malformations of seminal vesicles, prostate, epididymis and it results from the harmful effects of phthalates. Other Effects of Phthalates on Health. Negative effects of phthalates on female health are mostly reflected in anovulation, premature puberty, changes in duration of pregnancy. There is a possible effect on neurocognitive development, occurrence of allergies, asthma, testicular carcinoma, hepatic and renal damages, insulin resistance and obesity, thyroid dysfunction. Conclusion. Further studies are needed to establish the safe phthalate concentration in certain products and to determine more negative consequences of exposure to phthalate.

  2. Metabolic Disturbance in PCOS: Clinical and Molecular Effects on Skeletal Muscle Tissue

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    Wagner Silva Dantas

    2013-01-01

    Full Text Available Polycystic ovary syndrome is a complex hormonal disorder affecting the reproductive and metabolic systems with signs and symptoms related to anovulation, infertility, menstrual irregularity and hirsutism. Skeletal muscle plays a vital role in the peripheral glucose uptake. Since PCOS is associated with defects in the activation and pancreatic dysfunction of β-cell insulin, it is important to understand the molecular mechanisms of insulin resistance in PCOS. Studies of muscle tissue in patients with PCOS reveal defects in insulin signaling. Muscle biopsies performed during euglycemic hyperinsulinemic clamp showed a significant reduction in glucose uptake, and insulin-mediated IRS-2 increased significantly in skeletal muscle. It is recognized that the etiology of insulin resistance in PCOS is likely to be as complicated as in type 2 diabetes and it has an important role in metabolic and reproductive phenotypes of this syndrome. Thus, further evidence regarding the effect of nonpharmacological approaches (e.g., physical exercise in skeletal muscle of women with PCOS is required for a better therapeutic approach in the management of various metabolic and reproductive problems caused by this syndrome.

  3. Genetic rodent models of obesity-associated ovarian dysfunction and subfertility: insights into polycystic ovary syndrome

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    Isabel eHuang-Doran

    2016-06-01

    Full Text Available Polycystic ovary syndrome (PCOS is the most common endocrinopathy affecting women, and a leading cause of female infertility worldwide. Defined clinically by the presence of hyperandrogenemia and oligomenorrhoea, PCOS represents a state of hormonal dysregulation, disrupted ovarian follicle dynamics, and subsequent oligo- or anovulation. The syndrome’s prevalence is attributed at least partly to a well-established association with obesity and insulin resistance (IR. Indeed, the presence of severe PCOS in human genetic obesity and IR syndromes supports a causal role for IR in the pathogenesis of PCOS. The molecular mechanisms underlying this causality, however, as well as the important role of hyperandrogenemia, remain poorly elucidated. As such, treatment of PCOS is necessarily empirical, focusing on symptom alleviation. The generation of knockout and transgenic rodent models of obesity and IR offer a promising platform in which to address mechanistic questions about reproductive dysfunction in the context of metabolic disease. The impact of primary perturbations in rodent gonadotrophin or androgen signaling has been similarly interrogated. The insights gained from such models, however, have been limited by the relatively poor fidelity of rodent models to human PCOS. In this minireview we evaluate the ovarian phenotypes associated with rodent models of obesity and IR, including the extent of endocrine disturbance, ovarian dysmorphology and subfertility. We compare them to both human PCOS and other animal models of the syndrome (genetic and hormonal, explore reasons for their discordance and consider the new opportunities that are emerging to better understand and treat this important condition.

  4. An investigation of acarbose effects in PCOS women with postprandial hyperglycemia

    Institute of Scientific and Technical Information of China (English)

    郑建淮; 曹缵孙; 陈晓燕; 毛文军

    2002-01-01

    Objectives: To investigate the effects of insulin resistance on serum androgen level and ovulation of women with polycystic ovary syndrome (PCOS) and observe clinic role of acarbose in the treatment of hyperinsulinemia, postprandial hyperglycemia and anovulation. Methods: 14 women accompanied by postprandial hyperglycemia with PCOS were administrated by acarbose for 12 weeks.14 age-matched individuals who had similar body mass index and normal menstruation were served as controls. Results: Serum T levels declined significantly from 4.09±1.04 nmol/L to 1.71±0.54 nmol/L (P<0.001), after acarbose treatment for 12 weeks. 12 out of 14 cases restored ovulation and menstrual cycles after acarbose treatment, among which 4 got pregnant. Conclusion: Acarbose may play a role on reducing postprandial hyperglycemia and HbAic levels, increase ISI and FSG/FI, indirectly reduce serum androgen levels through reducing plasma insulin level and recover ovarian ovulation in PCOS women with postprandial hyperglycemia.

  5. Androgen circle of polycystic ovary syndrome.

    Science.gov (United States)

    Homburg, Roy

    2009-07-01

    Although the aetiology of polycystic ovary syndrome (PCOS) is still not known and the search for causative genes is proving elusive, it is generally agreed that hyperandrogenism is at the heart of the syndrome. Here, it is proposed that excess androgens are the root cause of PCOS starting from their influence on the female fetus in programming gene expression, producing the characteristic signs and symptoms which are then exacerbated by a propagation of excess ovarian androgen production from multiple small follicles, anovulation and insulin resistance in the reproductive life-span, thus setting up a vicious perpetual circle of androgen excess. This opinion paper, rather than being a full-scale review, is intentionally biased in support of this hypothesis that androgen excess is the 'root of all evil' in PCOS; in the hope that its acceptance could lead to more direct treatment of the syndrome in all its facets rather than the symptomatic treatment of side effects of androgen excess that we are addressing today.

  6. Determining menstrual phase in human biobehavioral research: A review with recommendations.

    Science.gov (United States)

    Allen, Alicia M; McRae-Clark, Aimee L; Carlson, Samantha; Saladin, Michael E; Gray, Kevin M; Wetherington, Cora Lee; McKee, Sherry A; Allen, Sharon S

    2016-02-01

    Given the volume and importance of research focusing on menstrual phase, a review of the strategies being used to identify menstrual phase and recommendations that will promote methodological uniformity in the field is needed. We conducted a literature review via Ovid Medline and PsycINFO. Our goal was to review methods used to identify menstrual phase and subphases in biobehavioral research studies with women who had physiologically natural menstrual cycles. Therefore, we excluded articles that focused on any of the following: use of exogenous hormones, the postpartum period, menstrual-related problems (e.g., polycystic ovarian syndrome, endometriosis), and infertility/anovulation. We also excluded articles on either younger (45 years old) study samples. We initially identified a total of 1,809 articles. After our exclusionary criteria were applied, 146 articles remained, within which our review identified 6 different methods used to identify menstrual phase and subphases. The most common method used was self-report of onset of menses (145/146 articles) followed by urine luteinizing hormone testing (50/146 articles) and measurement of hormones (estradiol and/or progesterone) in blood samples (49/146 articles). Overall, we found a lack of consistency in the methodology used to determine menstrual phase and subphases. We provide several options to improve accuracy of phase identification, as well as to minimize costs and burden. Adoption of these recommendations will decrease misclassification within individual studies, facilitate cross-study comparisons, and enhance the reproducibility of results.

  7. [Chronic inflammation and metabolic syndrome in comparison with other signs belonging to the image of polycystic ovary syndrome].

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    Marciniak, Aleksandra; Nawrocka-Rutkowska, Jolanta; Wiśniewska, Berenika; Brodowska, Agnieszka; Starczewski, Andrzej

    2013-04-01

    Polycystic ovary syndrome (PCOS) is a disorder which concern even 5-10% of women in reproductive age. PCOS is a cause of hyperandrogenism and menstrual disorders with chronic anovulation. The most common clinical symptoms observed in PCOS are hirsutism, acne and obesity. Patients with PCOS often suffer from metabolic disorders like insulin resistance, hyperinsulinemia, dyslipidemia, arteriosclerosis and other abnormalities of the metabolic syndrome. 35 to 60% of women with PCOS are obese and about 50% of them have insulin resistance and hyperinsulinemia. The pathogenesis of atherosclerosis emphasizes the role of inflammatory processes. There are a number of markers of the inflammation process. They are also observed in PCOS and may indicate an increased risk of cardiovascular disease in women. More than 46% of women with PCOS can be diagnosed with metabolic syndrome. Because of the fact that patients with PCOS are at higher risk group of the earlier development of complications such as diabetes t 2, atherosclerosis, hypertension and cardiovascular system diseases, it is important to carry out metabolic disorders diagnosis in every patient with PCOS. It will help to estimate the risk of complications and allow for the implementation of prevention or treatment of metabolic diseases belonging to the image of PCOS.

  8. Prevalence of metabolic syndrome in the family members of women with polycystic ovary syndrome from North India

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    Iram Shabir

    2014-01-01

    Full Text Available Background: Polycystic ovary syndrome (PCOS is the most complex and common endocrine disorder of women in reproductive years. In addition to irregular menstrual cycles, chronic anovulation and hyperandrogenism, it has many metabolic manifestations such as obesity, hyperlipidemia, hyperinsulinemia, insulin resistance, dysglycemia, increased risk of cardiovascular disease or possibly endometrial cancer. Familial clustering of PCOS in consistence with the genetic susceptibility has been described. Materials and Methods: The present study assessed the clinical, biochemical and hormonal parameters including prevalence of metabolic syndrome by two different criteria in the first- degree relatives of patients with PCOS. Results: The average age of 37 index patients was 23 ± 3.6 years, with the mean age of menarche as 13.3 ± 1.2 years. The mean age and age of menarche in mothers (n = 22 was 48.8 ± 5.1 and 13 ± 1.3 years, respectively, whereas as it was 23.5 ± 4.7 and 13.3 ± 1.2 years in sisters (n = 22, respectively. Metabolic syndrome (MS defined by International Diabetes Federation (IDF criteria was present in 10 index patients, 1 brother, 4 sisters, 17 mothers and 15 fathers while as by Adult Treatment Panel III (ATP III it was in 8 index patients, 5 sisters, 16 mothers and 11 fathers. Conclusion: The presence of MS or related metabolic derangements is high in the family members of women with PCOS.

  9. Clinical efficacy of Ayurveda treatment regimen on Subfertility with Poly Cystic Ovarian Syndrome (PCOS).

    Science.gov (United States)

    Dayani Siriwardene, S A; Karunathilaka, L P A; Kodituwakku, N D; Karunarathne, Y A U D

    2010-01-01

    Poly Cystic Ovarian Syndrome (PCOS) is the most common endocrinopathy in women of reproductive age, resulting from insulin resistance and the compensatory hyperinsulinemia. This results in adverse effect on multiple organ systems and may result in alteration in serum lipids, anovulation, abnormal uterine bleeding and infertility. According to Ayurvedic view PCOS can be correlated with Aarthava Kshaya. It was revealed that most of subfertility patients who were presented Osuki Ayurveda Centre suffered from the PCOS. Therefore the present study was carried out for the clinical evaluation of the efficacy of Ayurveda treatment regimen on subfertility with PCOS. Total 40 patients were selected by using purposive sampling method. According to the Ayurveda theories of Shodhana, Shamana and Tarpana, the treatment was conducted in 3 stages for the duration of 6 months. The response to the treatment was recorded and therapeutic effects were evaluated by symptomatic relief and through Trans Vaginal Scan and LH, FSH hormone levels. The results revealed that, subfertility due to PCOS can be cured successfully by using this Ayurveda treatment regimen.

  10. Potential use of durian fruit (Durio zibenthinus Linn) as an adjunct to treat infertility in polycystic ovarian syndrome.

    Science.gov (United States)

    Ansari, Reshma M

    2016-01-01

    Infertility due to polycystic ovarian syndrome (PCOS) is a worldwide problem that is increasing at alarming rates. Insulin resistance, the prime factor of PCOS, induces comorbid metabolic syndrome as well. Durian (Durio zibenthinus Linn), a fruit of Southeast Asia, is used as a natural supplement in healthy diets. This paper is a short literature review that examines the fruit's effects against various components of metabolic syndrome and its fertility-enhancing properties in PCOS. Various published literature was reviewed to learn of the anti-inflammatory, anti-oxidant, anti-obesity, anticholesterol, and antihypoglycaemic nature of the fruit. The literature search was done using PubMed, Google Scholar and library databases. The keywords used were polycystic ovarian syndrome, infertility, metabolic syndrome and Durian zibenthinus Linn. Reviewed studies showed that the fruit is effective against various components of metabolic syndrome, but the mechanisms of action against anovulation and menstrual disturbances in PCOS have yet to be studied. The traditional use of durian as a fertility-enhancing agent needs to be validated scientifically by isolating its various components and ascertaining its fertility enhancing properties.

  11. Defective CFTR-regulated granulosa cell proliferation in polycystic ovarian syndrome.

    Science.gov (United States)

    Chen, Hui; Guo, Jing Hui; Zhang, Xiao Hu; Chan, Hsiao Chang

    2015-05-01

    Polycystic ovarian syndrome (PCOS) is one of the most frequent causes of female infertility, featured by abnormal hormone profile, chronic oligo/anovulation, and presence of multiple cystic follicles in the ovary. However, the mechanism underlying the abnormal folliculogenesis remains obscure. We have previously demonstrated that CFTR, a cAMP-dependent Cl(-) and HCO3 (-) conducting anion channel, is expressed in the granulosa cells and its expression is downregulated in PCOS rat models and human patients. In this study, we aimed to investigate the possible involvement of downregulation of CFTR in the impaired follicle development in PCOS using two rat PCOS models and primary culture of granulosa cells. Our results indicated that the downregulation of CFTR in the cystic follicles was accompanied by reduced expression of proliferating cell nuclear antigen (PCNA), in rat PCOS models. In addition, knockdown or inhibition of CFTR in granulosa cell culture resulted in reduced cell viability and downregulation of PCNA. We further demonstrated that CFTR regulated both basal and FSH-stimulated granulosa cell proliferation through the HCO3 (-)/sAC/PKA pathway leading to ERK phosphorylation and its downstream target cyclin D2 (Ccnd2) upregulation. Reduced ERK phosphorylation and CCND2 were found in ovaries of rat PCOS model compared with the control. This study suggests that CFTR is required for normal follicle development and that its downregulation in PCOS may inhibit granulosa cell proliferation, resulting in abnormal follicle development in PCOS.

  12. Polycystic ovary syndrome: a transgenerational evolutionary adaptation.

    Science.gov (United States)

    Shaw, L M A; Elton, S

    2008-01-01

    Polycystic ovary syndrome has a common association with anovulatory infertility, while the physical symptoms are often associated with the increased androgens that are part of the endocrine profile. There is a well-recognised association with lipid and glucose metabolism anomalies and, when undergoing ovulation induction, ovarian hyperstimulation syndrome. This common condition is familial, but a contributory gene has yet to be found. The question of why a gene that predisposes to anovulation, diabetes and heart disease might have perpetuated so frequently is addressed. Three hypotheses for evolutionary advantage are discussed. The food deprivation hypothesis considers the role of the observed increase in ovulation when women with the condition lose weight in relation to seasonality. The refeeding hypothesis considers the androgenic and slightly enhanced anabolic metabolism in relation to periods of privation and the advantage of preferential early ovulation when refeeding after a period of privation. The transgenerational privation hypothesis considers the effect of persistent, severe, yet subfatal privation on individuals both in utero and throughout life. While an androgenic, anabolic state would improve efficiency in the use of food for protein synthesis and fat storage, benefiting the fetus both in relation to its in utero development and neonatal survival, survival and reproductive capacity as an adult benefits by a genotype expressing itself in women of successive generations.

  13. Acne - a potential skin marker of internal disease.

    Science.gov (United States)

    Pace, Joseph L

    2015-01-01

    Polycystic ovary syndrome (PCOS) is the most prevalent endocrine disorder in adult women. Hyperandrogenism is the crux of the pathogenesis of both acne and hirsutism, the most frequent clinical presentations of the syndrome. The chronic anovulation that may occur, often but not always associated with enlarged cystic ovaries, has long been recognized as an important feature of PCOS. In recent years major changes have occurred with regard to PCOS: Although management of the common cutaneous manifestations, mainly acne, hirsutism, alopecia, and acanthosis nigricans, remains strictly within the realm of daily dermatologic practice, the pendulum is shifting toward greater awareness of the longer-term systemic implications of PCOS, with emphasis on the unique opportunity and privileged position of the dermatologist to diagnose this potentially serious problem at an early stage, when effective long-term treatment can be instituted. Patients need to be advised that PCOS cannot be cured but can be controlled. Management should involve a multidisciplinary team with emphasis on lifestyle change, insulin sensitizing agents, androgen blockers, and attention to specific cutaneous manifestations.

  14. AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS, AMERICAN COLLEGE OF ENDOCRINOLOGY, AND ANDROGEN EXCESS AND PCOS SOCIETY DISEASE STATE CLINICAL REVIEW: GUIDE TO THE BEST PRACTICES IN THE EVALUATION AND TREATMENT OF POLYCYSTIC OVARY SYNDROME--PART 1.

    Science.gov (United States)

    Goodman, Neil F; Cobin, Rhoda H; Futterweit, Walter; Glueck, Jennifer S; Legro, Richard S; Carmina, Enrico

    2015-11-01

    Polycystic Ovary Syndrome (PCOS) is recognized as the most common endocrine disorder of reproductive-aged women around the world. This document, produced by the collaboration of the American Association of Clinical Endocrinologists (AACE) and the Androgen Excess and PCOS Society (AES) aims to highlight the most important clinical issues confronting physicians and their patients with PCOS. It is a summary of current best practices in 2015. PCOS has been defined using various criteria, including menstrual irregularity, hyperandrogenism, and polycystic ovary morphology (PCOM). General agreement exists among specialty society guidelines that the diagnosis of PCOS must be based on the presence of at least two of the following three criteria: chronic anovulation, hyperandrogenism (clinical or biological) and polycystic ovaries. There is need for careful clinical assessment of women's history, physical examination, and laboratory evaluation, emphasizing the accuracy and validity of the methodology used for both biochemical measurements and ovarian imaging. Free testosterone (T) levels are more sensitive than the measurement of total T for establishing the existence of androgen excess and should be ideally determined through equilibrium dialysis techniques. Value of measuring levels of androgens other than T in patients with PCOS is relatively low. New ultrasound machines allow diagnosis of PCOM in patients having at least 25 small follicles (2 to 9 mm) in the whole ovary. Ovarian size at 10 mL remains the threshold between normal and increased ovary size. Serum 17-hydroxyprogesterone and anti-Müllerian hormone are useful for determining a diagnosis of PCOS. Correct diagnosis of PCOS impacts on the likelihood of associated metabolic and cardiovascular risks and leads to appropriate intervention, depending upon the woman's age, reproductive status, and her own concerns. The management of women with PCOS should include reproductive function, as well as the care of hirsutism

  15. 多囊卵巢综合征胰岛素抵抗新进展%Molecular Mechanism and Management in Insulin Resistance in Polycystic Ovary Syndrome

    Institute of Scientific and Technical Information of China (English)

    沈文娟; 匡洪影; 张跃辉

    2011-01-01

    Polycystic ovary syndrome (PCOS)is one of the most common endocrine disorder with a variety of clinical manifestations among women of reproductive age. Its features include chronic anovulation, multicystic morphology of ovaries,hyperandrogenism. In recent years,insulin resistance (IR)has been regarded as one of the mechanisms of the development of PCOS,and is also associated with the hyperandrogenemia and dysfunction of ovaries. Many researches have been done on the molecular mechanism of IR in PCOS,which might provide a theory foundation for the treatment. This review thus focuses on the molecular mechanism and treatment of insulin resistance in patients with PCOS.%多囊卵巢综合征(PCOS)是一种常见的影响育龄期女性生殖和内分泌功能的特殊疾病,其临床表现异质性,以慢性无排卵、卵巢多囊样改变、高雄激素血症为主要临床表现.胰岛素抵抗是其发生、发展的重要病理生理机制之一,也是导致高雄激素血症和卵巢功能改变的重要原因.近年来,PCOS患者胰岛素抵抗的分子机制得到深入研究,为临床治疗提供了理论依据.综述PCOS胰岛素抵抗的分子机制研究和药物治疗进展.

  16. 中医药治疗多囊卵巢综合征的研究进展%Recent Research Progress in Traditional Chinese Medicine Treatment for Polycystic Ovarian Syndrome

    Institute of Scientific and Technical Information of China (English)

    沈喜萍

    2012-01-01

    多囊卵巢综合征(PCOS)是一组病因不明,临床表现以高度异质性、无排卵和高雄激素血症为主要特征的临床综合征.其发病机制较为复杂,目前尚无有效的治疗措施,成为目前妇科内分泌的研究热点.近年来,随着中医药研究的介入,PCOS治疗方面取得一些进展.现就中医脏腑辨证、中药周期、中医古方、中西医结合治疗及中药联合针灸等治疗方法予以综述.%Polycystic ovary syndrome( PC OS ) if a group oi rliniral syndrome oi unknown etiology, high-heterogeneity rliniral symptoms, and main features with anovulation and hyperandrogenism. Due to its complex pathogenesis,there is no effertive treatment so jar,making it a research hotspot in gynecologic endocri-nologye. In recent yeai-s,the treatment oi P(X)S has made some progress with the intervention oi the study oi traditional (Chinese medicine( TCM ). Heie is to make a review on the TCM treatment from the asperts oi the syndrome differentiation,the cycles oi Chinese medicine, the ancient Chinese medicine prescription,the inte-gi'ative medicine with western medicine,and the medicine combined with acupuncture treatment.

  17. Management von Endometriumhyperplasien. Gemeinsame Stellungnahme der DGGEF und des BVF e. V.

    Directory of Open Access Journals (Sweden)

    Römer T

    2014-01-01

    Full Text Available Blutungsstörungen, insbesondere bei Östrogendominanz im reproduktiven Alter, z. B. bei PCO-Syndrom (durch Anovulation fehlende Gestagenwirkung und starker Adipositas bzw. in höherem Lebensalter, können durch eine Endometriumhyperplasie bzw. durch ein Endometriumkarzinom bedingt sein. Das Endometriumkarzinom ist ein östrogenabhängiger Tumor, der überwiegend im höheren Lebensalter auftritt. Endometriumkarzinome entstehen in der Regel über Vorstufen (z. B. komplexe und atypische Hyperplasie bei überwiegender oder reiner Östrogen-Exposition, z. B. durch Östrogen-Monotherapie bei Frauen in der Postmenopause mit erhaltenem Uterus. Risikofaktoren: Histologische Subtypen der Endometriumhyperplasie und Entartungsrisiko nach traditioneller Klassifikation (1994 und 2003/WHO-Klassifikation (1994/2003: glandulär-zystische Hyperplasie/einfache Hyperplasie: 1–3 %, adenomatöse Hyperplasie (Grad 1 und Grad 2/komplexe Hyperplasie: 3 % (Grad 1, 8 % (Grad 2, adenomatöse Hyperplasie (Grad 3/atypische Hyperplasie: 30 % Diagnostik: Vaginalsonographie, Hysteroskopie und fraktionierte Curettage mit histologischer Begutachtung des Abradats. Therapieoptionen: Bei abgeschlossener Familienplanung, einem höheren Lebensalter und evtl. weiteren Zusatzindikationen ist die Hysterektomie die Therapie der Wahl. Bei Wunsch nach Erhalt des Uterus kann z. B. eine hoch-dosierte Gestagentherapie über 3–6 Monate erfolgen. Anschließend ist eine Recurettage zur Diagnostik erforderlich. Alternativ kann bei Frauen mit späterem Kinderwunsch in Abhängigkeit von der Histologie die vorübergehende Einlage eines LNG-IUS sinnvoll sein (off label. Gestagentherapie: – Behandlung der Endometriumhyperplasie: Bei einfacher aber auch komplexer Endometriumhyperplasie wurden Erfolge durch Einlage eines LNG-IUS beschrieben (off-label. – Behandlung von Frühformen des Endometriumkarzinoms bei Wunsch nach Uteruserhalt: Es gibt Einzelfallberichte über die erfolgreiche Therapie

  18. CORRELATION OF OBESITY, INSULIN RE SI S TANCE AND LIPID PROFILE IN WOMEN WITH PCOS IN KIMS HOSPITAL BANGALORE

    Directory of Open Access Journals (Sweden)

    Shashikala H

    2015-03-01

    Full Text Available BACKGROUND : Polycystic ovary syndrome is a condition associated with chronic anovulation, insulin resistance and androgen excess. Dyslipidemia, diabetes, obesity are all potent cardiovascular risk factors that tend to cluster in women with PCOD. These cannot be explained by obesity alone. Thus the need arises to study the effect of insulin resistance on these factors. This will help in assessing the long term cardiovascular morbidity in PCOD patients and take necessary preventive steps. OBJECTIVES : To analyze the infuence of obesity on lipid profile of PCOS women. To analyze the influence of insulin resistance on lipid profile in PCOS women. MATERIALS AND METHODS : In this prospective study done from December 2013 to September 2014, 50 women with PCOS had their body mass index and waist to hip ratio calculated. GTT, fasting and post prandial insulin, lipid profile was also done for each case. Insulin resistance was defined by fasting glucose to insulin ratio of less than or equal to 4.5. The association of obesity markers and insulin resistance with lipid markers was then studied. Statistical analysis using Student t test and ANOVA was done as indicated. Significance is assessed at 5% level of significance. RESULTS : Insulin resistance was seen in 56 percent of the cases. There was no correlation between markers of obesity (BMI and Waist to Hip ratio and the various lipid parameters. But in PCOS women with insulin resistance the lipid profile was significantly different (high triglycerides and lower high density lipoprotein compared to the insulin sensitive women. The difference between the two groups for triglycerides and HDL was statistically significant but that for LDL and total cholesterol was not statistically significant. CONCLUSION : Insulin resistance is associated with dyslipidemia in women with PCOS, independent of obesity.

  19. Application of human growth hormone to patients with polycystic ovary syndrome during in vitro fertilization

    Institute of Scientific and Technical Information of China (English)

    An Jin-xia; Liu Zhen

    2011-01-01

    Objective:To observe the effect of applying human growth hormone during in vitro fertilization to patients with polycystic ovary syndrome (PCOS)Methods:One hundred and twenty-one cycles of in vitro fertilization and embryo transfer in PCOS patients with anovulation from Dec.2008 to Nov.2010 were studied retrospectively.Of these 121 cycles,48 were with treatment of growth hormone (GH group),73 without GH treatment (control group).The dose of gonadotropin (Gn),the number of retrieved oocytes,good-quality embryo rate,implantation rate,frozen embryo rate,and pregnancy rate were compared.Results:The dosage of Gn was slightly higher in GH group than that in control group (29.18±8.33 vs.23.43±8.68 ampoullas,4U/ampoulla) and the number of retrieved oocytes in GH group were slightly less than that in control group (10.73±6.0vs.14.0±8.57),but there were no significant differences (P>0.05).The good-quality embryo rate (59.1% vs.33.3%),frozen embryo rate (87.5% vs.58.9%),pregnancy rate (56.5% vs.35.3 % ) and implantation rate (35.3 % vs.20.4 % ) in GH group were all significantly higher than those in control group (P<0.05).Conclusion:Early usage of GH in the ovarian hyperstimulation in PCOS patients could significantly improve good-quality embryo rate,implantation rate and pregnancy rate.

  20. Control of ovarian follicular and corpus luteum development for the synchronization of ovulation in cattle.

    Science.gov (United States)

    Thatcher, W W; Santos, J E P

    2007-01-01

    The objective of this review is to integrate strategies to optimize an ovulatory control program which then serves as a platform to improve the reproductive performance of lactating dairy cows. Programmed management of follicle growth, regression of the CL and induction of ovulation led to development of the Ovsynch program. Pre-synchronization of estrous cycles followed 12 to 14 days later with the Ovsynch program increased pregnancy rates to timed inseminations. Initiation of the Ovsynch program on day 3 of the estrous cycle reduced ovulation to GnRH and resulted in a smaller proportion of excellent and good quality embryos following timed insemination. The pregnancy rate to a timed insemination of Ovsynch was greater when cows ovulated to the first injection of GnRH. The Presynch-Ovsynch program provided a platform to identify factors regulating reproductive performance; such as, parity, body condition score and anovulation. Treatment with hCG at day 5 after insemination increased pregnancy rate in lactating dairy cows. Injection of bovine somatotropin at insemination increased pregnancy rate, conceptus length and interferon-tau content in uterine luminal flushings and altered endometrial gene expression at day 17 of pregnancy. During heat stress, timed embryo transfer increased pregnancy rate and using embryos cultured with IGF-I and transferred fresh resulted in a greater pregnancy rate. Induction of ovulation with estradiol cypionate, as a component of a timed insemination program, increased fertility. Manipulation of the estrous cycle to improve follicle/oocyte competence and management of the post-ovulatory dialogue between embryonic and uterine tissues should enhance embryo development and survival.

  1. Nuclear Progestin Receptor (Pgr Knockouts in Zebrafish Demonstrate Role for Pgr in Ovulation But Not in Rapid Nongenomic Steroid Mediated Meiosis Resumption

    Directory of Open Access Journals (Sweden)

    Yong eZhu

    2015-03-01

    Full Text Available Progestins, progesterone derivatives, are the most critical signaling steroid for initiating final oocyte maturation (FOM and ovulation, in order to advance fully-grown immature oocytes to become fertilizable eggs in basal vertebrates. It is well-established that progestin induces FOM via an elusive membrane receptor and a nongenomic steroid signaling process, which precedes progestin triggered ovulation that is mediated through a nuclear progestin receptor (Pgr and genomic signaling pathway. To determine whether Pgr plays a role in a nongenomic signaling mechanism during FOM, we knocked out Pgr in zebrafish using transcription activator-like effector nucleases (TALENs and studied the oocyte maturation phenotypes of Pgr knockouts (Pgr-KOs. Three TALENs-induced mutant lines with different frame shift mutations were generated. Homozygous Pgr-KO female fish were all infertile while no fertility effects were evident in homozygous Pgr-KO males. Oocytes developed and underwent FOM normally in vivo in homozygous Pgr-KO female compared to the wildtype controls, but these mature oocytes were trapped within the follicular cells and failed to ovulate from the ovaries. These oocytes also underwent normal germinal vesicle breakdown (GVBD and FOM in vitro, but failed to ovulate even after treatment with human chronic gonadotropin (HCG or progestin (17alpha,20beta-dihydroxyprogesterone or DHP, which typically induce FOM and ovulation in wildtype oocytes. The results indicate that anovulation and infertility in homozygous Pgr-KO female fish was, at least in part, due to a lack of functional Pgr-mediated genomic progestin signaling in the follicular cells adjacent to the oocytes. Our study of Pgr-KO supports previous results that demonstrate a role for Pgr in steroid-dependent genomic signaling pathways leading to ovulation, and the first convincing evidence that Pgr is not essential for initiating nongenomic progestin signaling and triggering meiosis resumption.

  2. Hyperprolactinemia after laparoscopic ovarian drilling: An unknown phenomenon

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    Omrani Gholamhossein R

    2005-08-01

    Full Text Available Abstract Background The effects of ovarian drilling on the serum levels of gonadotropins and androgens have been studied previously. The aim of this study is to evaluate the effects of ovarian drilling on the serum prolactin levels and its relation to ovulation in women with polycystic ovary syndrome. Methods This is a prospective controlled study. Thirty-six women with PCOS underwent ovarian electrocauterization in university hospitals. Control group consisted of 35 ovulatory women with unexplained infertility. Hormonal assessment performed in early follicular phase of spontaneous or induced cycle before operation in the two groups and repeated one week after operation. Hormonal assay was also performed in the early follicular phase of the first post-operative menstruation, folliculometry and progesterone assay were also performed in the same cycle. Data were analyzed by "repeated measurement design, discriminant analysis, correlation coefficient, and Fisher exact test". Results Six to ten weeks after operation the serum mean +/- SD prolactin levels increased from 284.41 +/- 114.32 mIU/ml to 354.06 +/- 204.42 mIU/ml (P = 0.011. The same values for the control group were 277.73 +/- 114.65 to 277.4 +/- 111.4 (P = 0.981 respectively. Approximately 45% of subjects in PCOS group remained anovulatory in spite of decreased level of LH and testosterone. Prolactin level remained elevated in 73.2% of women who did not ovulate 6–10 weeks after the procedure. Conclusion Hyperprolactinemia after ovarian cauterization may be considered as a possible cause of anovulation in women with polycystic ovaries and improved gonadotropin and androgen levels. The cause of hyperprolactinemia is unknown. Hormonal assay particularly PRL in anovulatory patients after ovarian cauterization is recommended.

  3. Different types of postpartum luteal activity affected by the exposure of heat stress and subsequent reproductive performance in Holstein lactating cows.

    Science.gov (United States)

    Kornmatitsuk, B; Chantaraprateep, P; Kornmatitsuk, S; Kindahl, H

    2008-10-01

    The aim of the present study was to determine the effect of heat stress on postpartum (PP) luteal activity and subsequent reproductive performance in lactating cows. Thirty Holstein-Friesian (HF, >or=75%) cows (hot season, n = 15 and cool season, n = 15) were studied over 60 days after calving. The changes of temperature-humidity index (THI) were monitored within both seasons. Body condition scores (BCS), uterine involution and the ovarian structures were recorded. Plasma samples were obtained three times a week for the analysis of progesterone (P4) and prostaglandin F(2 alpha) metabolite (PG metabolite). Subsequent reproductive performance of the cows, calved within the same period was also evaluated. The means of THI for hot and cool seasons varied between 84-87 and 78-83 respectively. A drop of the mean BCS was recorded at 5 weeks PP in the cows during hot season (p cows with normal PP ovarian cyclicity during hot and cool seasons were 4/15 (26.7%) and 9/15 (60.0%) respectively. A higher percentage of abnormal luteal activity was found in the cows during hot season (p = 0.07) and delayed luteal cyclicity/anovulation was the most pronounced atypical P4 profile. The levels of PG metabolite were not different between groups and the relationship between the levels of PG metabolite and the time of uterine involution was not evident (p > 0.05). The heat detection rates and the pregnancy rates were higher in the cows during cool season (p heat stress conditions had negative effects on BCS and altered a normal process of ovarian resumption PP, consequently resulted in lower reproductive performance in a tropical dairy herd.

  4. Norepinephrine stimulates progesterone production in highly estrogenic bovine granulosa cells cultured under serum-free, chemically defined conditions

    Directory of Open Access Journals (Sweden)

    Piccinato Carla A

    2012-11-01

    Full Text Available Abstract Background Since noradrenergic innervation was described in the ovarian follicle, the actions of the intraovarian catecholaminergic system have been the focus of a variety of studies. We aimed to determine the gonadotropin-independent effects of the catecholamine norepinephrine (NE in the steroid hormone profile of a serum-free granulosa cell (GC culture system in the context of follicular development and dominance. Methods Primary bovine GCs were cultivated in a serum-free, chemically defined culture system supplemented with 0.1% polyvinyl alcohol. The culture features were assessed by hormone measurements and ultrastructural characteristics of GCs. Results GCs produced increasing amounts of estradiol and pregnenolone for 144h and maintained ultrastructural features of healthy steroidogenic cells. Progesterone production was also detected, although it significantly increased only after 96h of culture. There was a highly significant positive correlation between estradiol and pregnenolone production in high E2-producing cultures. The effects of NE were further evaluated in a dose–response study. The highest tested concentration of NE (10 (−7 M resulted in a significant increase in progesterone production, but not in estradiol or pregnenolone production. The specificity of NE effects on progesterone productio n was further investigated by incubating GCs with propranolol (10 (−8 M, a non-selective beta-adrenergic antagonist. Conclusions The present culture system represents a robust model to study the impact of intrafollicular factors, such as catecholamines, in ovarian steroidogenesis and follicular development. The results of noradrenergic effects in the steroidogenesis of GC have implications on physiological follicular fate and on certain pathological ovarian conditions such as cyst formation and anovulation.

  5. Defining the Role of Bariatric Surgery in Polycystic Ovarian Syndrome Patients%减重手术在多囊卵巢综合征治疗中的作用

    Institute of Scientific and Technical Information of China (English)

    Shaveta M. Malik; Michael L. Traub; 王恺京; 徐安安

    2013-01-01

    Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in women. To meet PCOS criteria, women must have a combination of hyperandrogenism, anovulation and ultrasound findings. Almost 10% of all reproductive age women worldwide show signs of PCOS. Although women often seek care for gynecological or body image concerns, many PCOS women are at risk for metabolic syndrome (MS). Many of the metabolic consequences are overlooked and undertreated by physicians because these patients tend to be young, reproductive age women. MS and obesity coexist commonly with PCOS. These young women are predisposed to glucose abnormalities and ultimately diabetes mellitus, dyslipidemia and eventually cardiovascular disease. Bariatric surgery can be an effective means of weight loss in PCOS women. Surgical techniques have become safer and less invasive over time and have been found to be effective in achieving significant weight loss. Surgical options have also increased, giving patients more choices. Bariatric surgery may prevent or reverse metabolic syndrome. Bariatric surgery may also have reproductive benefits in PCOS patients. Although bariatric surgery has historically been performed in older, reproductive aged women, it has recently gained favor in adolescents as well. This is of particular importance due to the prevalence of both PCOS and MS in adolescents. Treatment of PCOS and MS certainly requires a combination of medical therapy, psychological support and lifestyle modifications. These treatments are difficult and often frustrating for patients and physicians. Bariatric surgery can be effective in achieving significant weight loss, restoration of the hypothalamic pituitary axis, reduction of cardiovascular risk and even in improving pregnancy outcomes. Ultimately, bariatric surgery should be considered part of the treatment in PCOS women, especially in those with MS.

  6. 青春期多囊卵巢综合征的诊疗进展%The Diagnosis Criteria and Treatment of Polycystic Ovary Syndrome in Adolescents

    Institute of Scientific and Technical Information of China (English)

    赵楠楠

    2013-01-01

    青春期多囊卵巢综合征(polycystic ovary syndrome,PCOS)的诊断标准仍存在争议,越来越多的学者赞成使用鹿特丹标准,前提是同时具备3个条件:稀发排卵或不排卵、高雄激素血症、超声下卵巢多囊样改变.对于青春期PCOS患者,如3个条件中只满足2个就做出诊断可能导致诊断过度.代谢综合征和睡眠障碍在青春期PCOS患者中发生率较高,并长期对患者健康造成影响.应采取综合治疗,包括调整生活方式,药物治疗是针对胰岛素抵抗及代谢功能障碍,常使用胰岛素增敏剂.综述青春期PCOS诊断与治疗的进展.%The diagnosis criteria of adolescent polycystic ovary syndrome (PCOS) remains controversial.There is growing support for the Rotterdam criteria,to fit all three criteria:oligoovulation or anovulation,hyperandrogenism and polycystic ovaries on pelvic ultrasonography.The adolescent PCOS may be over-diagnosed by the standard 'two of three' criteria.The rates of metabolic syndrome and sleep disorders are higher in those patients with the adolescent PCOS,which likely have implications on long-term health.The lifestyle modification should be included in the comprehensive treatment for the adolescent PCOS,such as diet,exercise and behavioral changes.Medicines are used to treat insulin resistance and metabolic dysfunction,such as insulin sensitizers.

  7. Effect of body mass index on in vitro fertilization outcomes in women

    Directory of Open Access Journals (Sweden)

    Anjali Sathya

    2010-01-01

    Full Text Available Background :Obesity has become a major health problem across the world. In women, it is known to cause anovulation, subfecundity, increased risk of fetal anomalies and miscarriage rates. However, in women going for assisted reproduction the effects of obesity on egg quality, embryo quality, clinical pregnancy, live birth rates are controversial. Objectives :To assess the effect of women′s body mass index (BMI on the reproductive outcome of non donor In vitro fertilization (IVF/Intracytoplasmic sperm injection (ICSI. The effects of BMI on their gonadotrophin levels (day 2 LH, FSH, gonadotrophin dose required for ovarian stimulation, endometrial thickness and oocyte/embryo quality were looked at, after correcting for age and poor ovarian reserve. Materials and Methods : Retrospective study of medical records of 308 women undergoing non donor IVF cycles in a University affiliated teaching hospital. They were classified into three groups: normal weight (BMI25 30 kg/m 2 . All women underwent controlled ovarian hyper stimulation using long agonist protocol. Results : There were 88 (28.6% in the normal weight group, 147 (47.7% in the overweight and 73 (23.7% in the obese group. All three groups were comparable with respect to age, duration of infertility, female and male causes of infertility. The three groups were similar with respect to day 2 LH/FSH levels, endometrial thickness and gonadotrophin requirements, oocyte quality, fertilization, cleavage rates, number of good quality embryos and clinical pregnancy rates. Conclusion :Increase in body mass index in women does not appear to have an adverse effect on IVF outcome. However, preconceptual counselling for obese women is a must as weight reduction helps in reducing pregnancy-related complications.

  8. Androgens and women's health.

    Science.gov (United States)

    Redmond, G P

    1998-01-01

    Androgenic disorders are those conditions in women characterized by excessive androgen action. They are the most common endocrinopathy of women, affecting from 10% to 20%. Signs are: persistent acne, hirsutism and androgenic alopecia, which is the female equivalent of male pattern baldness. A subgroup, those traditionally labeled as having polycystic ovary syndrome (PCOS), additionally have anovulation, as well as menstrual abnormalities and, often, obesity. Although women with androgenic disorders usually present themselves for help with the skin or menstrual changes, there are other important implications regarding their health. Women with PCOS have varying degrees of insulin resistance, and an increased incidence of Type II diabetes mellitus, as well as unfavorable lipid patterns. The presence of these risk factors is suggested by upper segment obesity, darkening of the skin, and the other skin changes that make up acanthosis nigricans. Diagnosis involves measurement of circulating androgens (of which free testosterone is most important), together with prolactin and FSH when menstrual dysfunction is present. Many women with androgenic skin changes have normal serum androgen levels, suggesting increased end organ sensitivity to androgens. Others have hyperandrogenism (of ovarian or adrenal origin). Treatment is usually successful in controlling acne, reducing hirsutism and stabilizing, or partially reversing, androgenic alopecia. Pharmacological approaches involve suppressing androgen levels, for example, the use of an appropriate oral contraceptive, or antagonizing androgen action with several medications that have this activity. Unfortunately, most women with androgenic disorders are frustrated in their efforts to obtain medical help. Understanding androgenic disorders will enable the physician to significantly help the majority of women with these conditions.

  9. Prevalence of polycystic ovary syndrome and its associated complications in Iranian women: A meta-analysis

    Science.gov (United States)

    Jalilian, Anahita; Kiani, Faezeh; Sayehmiri, Fatemeh; Sayehmiri, Kourosh; Khodaee, Zahra; Akbari, Malihe

    2015-01-01

    Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age and is the most common cause of infertility due to anovulation. There is no single criterion for the diagnosis of this syndrome. Objective: The purpose of this study was to investigate the prevalence of PCOS and its associated complications in Iranian women using meta-analysis method. Materials and Methods: Prevalence of PCOS was investigated from the SID, Goggle scholar, PubMed, Magiran, Irandoc, and Iranmedex, and weighting of each study was calculated according to sample size and prevalence of the binomial distribution. Data were analyzed using a random-effects model meta-analysis (Random effects model) and the software R and Stata Version 11.2. Results: 30 studies conducted between the years 2006 to 2011 were entered into meta-analysis. The total sample size was 19, 226 women aged between 10-45 years. The prevalence of PCOS based on National institute of child health and human disease of the U.S was, 6.8% (95 % CI: 4.11–8.5), based on Rotterdam was 19.5% (95 % CI: 2.24-8.14), and based on ultrasound was 4.41% (95% CI: 5.68-4.14). Also, the prevalence of hirsutism was estimated to be 13%, acne 26%, androgenic alopecia 9%, menstrual disorders 28%, overweight 21%, obesity 19%, and infertility 8%. Conclusion: The prevalence of PCOS in Iran is not high. However, given the risk of complications such as heart disease - cardiovascular and infertility, prevention of PCOS is important; we suggest that health officials must submit plans for the community in this respect. PMID:26644787

  10. Expression of Leptin Long-form Receptor mRNA in Luteinized Granulosa Cells of Obese Women with Polycystic Ovary Syndrome

    Institute of Scientific and Technical Information of China (English)

    YIN Jie; LIU Yi; LV Liqun; WANG Donghua; GONG Cheng; XIAO Wei; SHENG Hui

    2007-01-01

    To investigate the expression of mRNA of leptin long-form receptor (OB-Rb) in luteinized granulosa cells of obese women with polycystic ovary syndrome (PCOS), and to determine the role of leptin in the physiopathology of PCOS, luteinized granulosa cells were collected from the follicle fluid of 10 obese women who met the diagnostic criteria for PCOS and their BMI was equal to or greater than 25 kg/m2, and at the same time, granulosa cells were collected from 10 normal women undergoing IVF-ET who served as the control group. Some luteinized granulosa cells were taken from normal women for in-vitro culture, into which human leptin of different concentrations was added (0, 10, 100 and 1000 ng/mL). After stimulation with leptin for 48 h, RT-PCR was employed for the detection of the expression of OB-RLmRNA in the luteinized granulosa cells. Our results showed that the level of OB-RLmRNA in luteinized granulosa cells of obese PCOS women was higher than those in the control (P<0.05). In luteinized granulosa cells cultured in vitro and stimulated by human leptin for 48 h, the level of OB-RLmRNA was higher than those without leptin stimulation (P<0.01), and when leptin concentration was at 100 ng/mL, and the level of OB-RLmRNA reached a peak. It is concluded that in obese PCOS women, the level of serum leptin is increased, which promotes the expression of OB-RL in luteinized granulosa cells and increases the sensitivity of the granulosa cells to leptin. Leptin may contribute to anovulation in obese women with PCOS.

  11. Diagnostic and treatment characteristics of polycystic ovary syndrome: descriptive measurements of patient perception and awareness from 657 confidential self-reports

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    Genton Marc

    2001-08-01

    Full Text Available Abstract Background This investigation was undertaken to describe patient perception and awareness of the polycystic ovary syndrome (PCOS, the most common cause of anovulation/oligoovulation among women of reproductive age. Methods Fifteen parameters were evaluated by a computer-based research instrument accessed by a large, unscreened population. Incomplete questionnaires were not entered, and responses were electronically tabulated to block duplicate submissions. Results From 657 participants, the majority (63% were between 26–34 years old; mean BMI was 30.4 kg/m2. 343 of 657 had at least one pregnancy and 61% of the study group had taken fertility medicine (any type at least once. Physicians were the most common provider of PCOS information for all study participants, irrespective of age. Patient emotions associated with the diagnosis of PCOS included "frustration" (67%, "anxiety" (16%, "sadness" (10%, and "indifference" (2%. Self-reported patient aptitude regarding PCOS was scored as high or "very aware" in >60% of women. Respondents were also asked: "If your PCOS could be safely and effectively helped by something else besides fertility drugs or birth control pills, would that interest you?" Interest in alternative PCOS treatments was expressed by 99% of the sample (n = 648. Conclusions In our study population, most women associated negative emotions with PCOS although the self-reported knowledge level for the disorder was high. While these women regarded their obstetrician-gynecologist as integral to their PCOS education, traditional PCOS therapies based on oral contraceptives or ovulation induction agents were regarded as unsatisfactory by most women.

  12. 多囊卵巢综合征异常的内分泌激素改变对子宫内膜的影响%Endometrial abnormality in women with polycystic ovary syndrome

    Institute of Scientific and Technical Information of China (English)

    王辉; 张治芬

    2013-01-01

    多囊卵巢综合征(PCOS)是导致育龄期妇女不育及代谢异常的最常见内分泌疾病之一.PCOS患者的临床及生化表型各异,其最主要的临床表现包括稀发排卵/闭经及高雄激素表现(痤疮、多毛或高雄激素血症),且自然流产率及诱发排卵后的胚胎种植失败率均高于正常人,这些明显与PCOS子宫内膜本身异常相关,而不能仅归咎于其排卵障碍.本文对PCOS异常的内分泌激素改变对子宫内膜的影响作一综述.%Polycystic ovary syndrome(PCOS) is the most common endocrine disease associated with infertility and metabolic abnormality in women of child-bearing age.The clinical and biochemical features vary among individuals.The most widely accepted clinical characteristics of PCOS are oligo-ovulation or anovulation and hyperandrogenism.PCOS patients have a higher implantation failure rate after induction of ovulation,and they are more likely to suffer from spontaneous abortion.The infertility of PCOS patients should be attributed not only to ovulation disorders but also to endometrial dysfunction.Here we review the features of the endometrial abnormalities in women with PCOS.

  13. Tamoxifen: An alternative to clomiphene in women with polycystic ovary syndrome

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    Lakhbir Kaur Dhaliwal

    2011-01-01

    Full Text Available Background : Clomiphene citrate is commonly used for ovulation induction in women with anovulatory infertility. However, pregnancy rates with this drug are not as good as ovulation rates. Tamoxifen may be a better choice in some patients who fail to either ovulate or conceive with clomiphene due to its favorable effect on the cervical mucus and endometrium. This study was conducted to evaluate the role of tamoxifen in women with anovulatory infertility and find out the optimum dose needed for achieving the best outcome. Materials and Methods : 160 women attending the infertility clinic and suffering from anovulatory infertility were recruited for the study. Tamoxifen was administered in the dose of 40 mg daily and ovulation monitored. In case of anovulation, the dose was increased to 80 mg daily. Ovulation and pregnancy rates were calculated. Results : Twenty-three out of 160 women who received 40 mg of tamoxifen conceived, giving a pregnancy rate of 14.38% and pregnancy rate per ovulatory cycle as 14.94%. 32 out of 80 women who received 80 mg of tamoxifen conceived, giving a pregnancy rate of 40% and pregnancy rate per cycle as 33.68%. This difference in the pregnancy rate between the two groups was statistically significant. 35 women out of 90 with polycystic ovary syndrome (PCOS became pregnant with a pregnancy rate of 38.8% and 20 out of 70 women with clomiphene citrate failure conceived, giving a pregnancy rate of 28.5%. Conclusions : Tamoxifen is a good alternative to clomiphene in women with PCOS and clomiphene-resistant cases.

  14. Effect of Bumble Bee Venom in the Treatment of Polycystic Ovary Syndrome, the Relationship Between Tissue Factor Affecting the Level of TNFα in the Wistar Rat Model

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    M Nabiuni

    2013-04-01

    Full Text Available Abstract Background & aim: Polycystic ovary syndrome (PCOS is an endocrine failure leading to anovulation. TNFα is an effective factor in the regulation of normal functioning of the ovaries. High levels of TNFα causes PCOS is further. In this study, the effects of bumble bee venom (HBV on TNFα and other symptoms of ovarian PCOS were studied. Methods: In this experimental study, 60 female Wistar rats were divided into three groups: control, sham and experimental groups. The experimental group was injected with estradiol valerate-induced PCOS direction. Induced rats (PCOS were divided into two groups and treated with HBV. The treatment Group received 0.2mg of HBV for 10 consecutive days. Serum and ovarian tissue was collected from each of the four groups to compare the histological and changes in blood sugar levels. Results: A significant increase in ovarian PCOS weight was observed in the control group , whereas in the treated group with HBV rate fell (15.5 mg Glucose levels in PCOS was 256.5, the control group138, and the treatment group 158. Thickness of the theca layer of antral follicles in the treated group compared with PCOS showed a significant decrease (110 μm and 150 μm respectively. Immunohistochemical results showed increased TNFα factor in PCOS group than in the control group, whereas these levels in samples treated with HBV Reduced. Conclusion: The results of this study revealed that the beneficial effects of HBV in PCOS may be due to the inhibitory effect on factor TNFα. Key words: Polycystic ovary syndrome, Bumble bee venom, Tumor necrosis factor, Immunohistochemistry

  15. Alterations in Gut Microbiome Composition and Barrier Function Are Associated with Reproductive and Metabolic Defects in Women with Polycystic Ovary Syndrome (PCOS): A Pilot Study

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    Bashir, Mina; Münzker, Julia; Trummer, Christian; Zachhuber, Verena; Leber, Bettina; Horvath, Angela; Pieber, Thomas R.; Gorkiewicz, Gregor; Stadlbauer, Vanessa; Obermayer-Pietsch, Barbara

    2017-01-01

    Background Polycystic ovary syndrome (PCOS) is a common female endocrinopathy of unclear origin characterized by hyperandrogenism, oligo-/anovulation, and ovarian cysts. Women with PCOS frequently display overweight, insulin resistance, and systemic low-grade inflammation. We hypothesized that endotoxemia resulting from a leaky gut is associated with inflammation, insulin resistance, fat accumulation, and hyperandrogenemia in PCOS. In this pilot study, we compared the stool microbiome, gut permeability, and inflammatory status of women with PCOS and healthy controls. Methods 16S rRNA gene amplicon sequencing was performed on stool samples from 24 PCOS patients and 19 healthy controls. Data processing and microbiome analysis were conducted in mothur and QIIME using different relative abundance cut-offs. Gut barrier integrity, endotoxemia, and inflammatory status were evaluated using serum and stool markers and associations with reproductive, metabolic, and anthropometric parameters were investigated. Results The stool microbiome of PCOS patients showed a lower diversity and an altered phylogenetic composition compared to controls. We did not observe significant differences in any taxa with a relative abundance>1%. When looking at rare taxa, the relative abundance of bacteria from the phylum Tenericutes, the order ML615J-28 (phylum Tenericutes) and the family S24-7 (phylum Bacteroidetes) was significantly lower and associated with reproductive parameters in PCOS patients. Patients showed alterations in some, but not all markers of gut barrier function and endotoxemia. Conclusion Patients with PCOS have a lower diversity and an altered phylogenetic profile in their stool microbiome, which is associated with clinical parameters. Gut barrier dysfunction and endotoxemia were not driving factors in this patient cohort, but may contribute to the clinical phenotype in certain PCOS patients. PMID:28045919

  16. Identification of Differentially Expressed MicroRNAs in the Ovary of Polycystic Ovary Syndrome with Hyperandrogenism and Insulin Resistance

    Institute of Scientific and Technical Information of China (English)

    Lin Lin; Tao Du; Jia Huang; Li-Li Huang; Dong-Zi Yang

    2015-01-01

    Background:Polycystic ovary syndrome (PCOS) is the commonest endocrinopathy in women of reproductive age.The patients often develop insulin resistance (IR) or hyperinsulinemia despite manifesting anovulation and signs of hyperandrogenism.The cause and effect relationship of hyperinsulinemia and hyperandrogenemia (HA) is still debated.Micro-ribonucleic acids (miRNAs) have recently been shown to play a role in regulation of ovarian function.Our current study focused on the altered expression of miRNAs with PCOS.Methods:Ovarian theca intema tissues were obtained from 10 PCOS patients and 8 controls that were non-PCOS and had normal insulin sensitivity undergoing laparoscopy and/or ovarian wedge resection.Total RNA of all samples was extracted.We studied the repertoire of miRNAs in both PCOS and non-PCOS women by microarray hybridization.Bioinformatic analysis was performed for predicting targets of the differentially expressed miRNAs.Furthermore,selected miRNAs were validated by quantitative reverse transcriptase polymerase chain reaction (qRT-PCR).Results:A total of 27 miRNAs were differentially expressed in PCOS patients with respect to the controls in our discovery evaluationand two (miR-92a and miR-92b) of them were significantly downregulated in PCOS women in followed validation (P < 0.05).Targets prediction revealed that miR-92a targeted both GATA family of zinc finger transcription factor GATA-binding factor 6 (GATA6) and insulin receptor substrate proteins 2 (IRS-2).Conclusions:MiRNAs are differentially expressed between PCOS patients and controls.We identified and validated two miRNAs-miR-92a and miR-92b.They are significantly downregulated and may be involved in the pathogenesis of PCOS.

  17. Developmental programming by androgen affects the circadian timing system in female mice.

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    Mereness, Amanda L; Murphy, Zachary C; Sellix, Michael T

    2015-04-01

    Circadian clocks play essential roles in the timing of events in the mammalian hypothalamo-pituitary-ovarian (HPO) axis. The molecular oscillator driving these rhythms has been localized to tissues of the HPO axis. It has been suggested that synchrony among these oscillators is a feature of normal reproductive function. The impact of fertility disorders on clock function and the role of the clock in the etiology of endocrine pathology remain unknown. Polycystic ovarian syndrome (PCOS) is a particularly devastating fertility disorder, affecting 5%-10% of women at childbearing age with features including a polycystic ovary, anovulation, and elevated serum androgen. Approximately 40% of these women have metabolic syndrome, marked by hyperinsulinemia, dyslipidemia, and insulin resistance. It has been suggested that developmental exposure to excess androgen contributes to the etiology of fertility disorders, including PCOS. To better define the role of the timing system in these disorders, we determined the effects of androgen-dependent developmental programming on clock gene expression in tissues of the metabolic and HPO axes. Female PERIOD2::luciferase (PER2::LUC) mice were exposed to androgen (dihydrotestosterone [DHT]) in utero (Days 16-18 of gestation) or for 9-10 wk (DHT pellet) beginning at weaning (pubertal androgen excess [PAE]). As expected, both groups of androgen-treated mice had disrupted estrous cycles. Analysis of PER2::LUC expression in tissue explants revealed that excess androgen produced circadian misalignment via tissue-dependent effects on phase distribution. In vitro treatment with DHT differentially affected the period of PER2::LUC expression in tissue explants and granulosa cells, indicating that androgen has direct and tissue-specific effects on clock gene expression that may account for the effects of developmental programming on the timing system.

  18. Prevalence of metabolic syndrome in polycystic ovarian syndrome women in a hospital of Tehran

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    Ashraf Moini

    2012-01-01

    Full Text Available Background: Polycystic ovarian syndrome (PCOS is a condition associated with chronic anovulation, insulin resistance and androgen excess. Women with this syndrome are at increased risk of metabolic syndrome. Objective: The aim of the present study was to determine the prevalence of metabolic syndrome (MBS in women with PCOS referred to Arash Hospital in different ages and body mass index (BMI. Materials and Methods: A cross-sectional study was conducted in Gynecologic Clinic at Arash Hospital affiliated with Tehran University. A total of 282 women with PCOS ages between 15-40 years were included. The prevalence of Metabolic Syndrome and its components in this population were the main outcomes. Height, weight, waist circumference, blood pressure and laboratory tests (FBS, TSH, HDL-C, serum prolactin, triglycerides and total cholesterol were measured in this population. Results: The prevalence of MBS in PCOS women was 22.7% (64 cases. The rate of central obesity, FBS more than 110 mg/dl, triglycerides more than 150 mg/dl, high-density lipoprotein cholesterol levels (HDL-C less than 50 mg/dl, and blood pressure ≥130/85 mmHg in PCOS women was 31% (87, 3.2% (9, 33% (93, 68.8% (194, and 10.6% (30, respectively. The risk of MBS was increased in older and the obese women (BMI ≥30 kg/m2. Conclusion: The present sample showed women with PCOS have a high prevalence of MBS and its individual components, particularly decreased HDL-C.

  19. MicroRNAs related to androgen metabolism and polycystic ovary syndrome.

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    Sørensen, Anja E; Udesen, Pernille B; Wissing, Marie Louise; Englund, Anne Lis M; Dalgaard, Louise T

    2016-11-25

    Polycystic ovary syndrome (PCOS) is a frequent endocrine disorder in women. PCOS is associated with altered features of androgen metabolism, increased insulin resistance and impaired fertility. Furthermore, PCOS, being a syndrome diagnosis, is heterogeneous and characterized by polycystic ovaries, chronic anovulation and evidence of hyperandrogenism, as well as being associated with chronic low-grade inflammation and an increased life time risk of type 2 diabetes. A number of androgen species contribute to the symptoms of increased androgen exposure seen in many, though not all, cases of PCOS: Testosterone, androstenedione, dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEAS), where the quantitatively highest amount of androgen is found as DHEAS. The sulfation of DHEA to DHEAS depends on a number of enzymes, and altered sulfate metabolism may be associated with and contribute to the pathogenesis of PCOS. MicroRNAs (miRNAs) are small, non-coding RNAs that are able to regulate gene expression at the post-transcriptional level. Altered miRNA levels have been associated with diabetes, insulin resistance, inflammation and various cancers. Studies have shown that circulating miRNAs are present in whole blood, serum, plasma and the follicular fluid of PCOS patients and that these might serve as potential biomarkers and a new approach for the diagnosis of PCOS. In this review, recent work on miRNAs with respect to PCOS will be summarized. Our understanding of miRNAs, particularly in relation to PCOS, is currently at a very early stage, and additional studies will yield important insight into the molecular mechanisms behind this complex and heterogenic syndrome.

  20. The Impact of Androgen Excess on the Initiation and Development of Polycystic Ovary Syndrome%雄激素过多在多囊卵巢综合征发生发展中的作用

    Institute of Scientific and Technical Information of China (English)

    丁涛; 郑艳华; 谢军

    2012-01-01

    Although the aetiology of polycystic ovary syndrome (PCOS) is unknown and the search for causative genes is elusive,androgen excess is generally thought of an important triggers of PCOS.We known that excess androgens is the root cause of PCOS starting from the female fetus, producing the characteristic signs and symptoms which are then exacerbated by the excess ovarian androgen production from multiple small follicle,anovulation and insulin resistance in the reproductive life-span, thus setting up a vicious perpetual circle of excess androgen.The paper is biased in support of the hypothesis that androgen excess is the"root of all evil"'in PCOS.%目前多囊卵巢综合征(PCOS)的病因仍不十分明确,尚未发现其确切致病基因,不少研究表明雄激素过多与PCOS的发生密切相关,可能是促进其发生发展的重要因素.现普遍认为高雄激素血症是PCOS发病的根本原因之一,表现为特异性症状和并发症.然而,卵巢多小卵泡、不排卵和胰岛素抵抗的生育期妇女雄激素水平较高,使症状与并发症恶化,这就导致高雄激素血症的恶性循环.就高雄激素血症导致PCOS进行综述.

  1. Quality and quantity of infertility care in Bangladesh.

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    Fatima, P; Ishrat, S; Rahman, D; Banu, J; Deeba, F; Begum, N; Anwary, S A; Hossain, H B

    2015-01-01

    Infertility is an important health issue which has been neglected in the developing countries. First test-tube babies (triplet) in Bangladesh were born on 30th May, 2001. Although there is no tertiary level infertility center in the public sector, several private centers have come up with the facilities. The objective of the study was to find i) the quality and quantity of infertility care in Bangladesh and ii) the cause of infertility in the attending patients iii) the treatment seeking behaviors iv) and the reasons for not taking treatment among the attending patients. There are now 10 tertiary level Infertility centers in Bangladesh. The information was collected in a preformed datasheet about the facilities and the profile of the patients and the treatment seeking behavior of the attending patients. Out of the ten centers two centers refused to respond and did not disclose their data. Around 16700 new patients are enrolled in a year in the responsive clinics. Five percent (5%) of the patients underwent ART, 7% of the patients gave only one visit, 84% of the patients completed their evaluation, 76% of the patients took treatment. Causes of infertility in the patients taking treatment were male factor in 36.4%, bilateral tubal block in 20.2%, PCOS and anovulation in 31.7%, endometriosis in 19.6%, unexplained in 10.95, combined in 3.5%, ovarian failure in 1.4%, testicular failure in 0.33%, congenital anomaly in 0.3%. The main reason for not taking treatment was financial constrainment. The quality and quantity of infertility care is dependent on the available resources and on the use of the resources by the patients. In developing countries the resources are merging and confined to specified areas which cannot meet the demand of their population. The study gives us the idea of the need and the demand of the services in the country.

  2. Characterization of Serum MicroRNAs Profile of PCOS and Identification of Novel Non-Invasive Biomarkers

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    Wei Long

    2014-04-01

    Full Text Available Background: Polycystic ovary syndrome (PCOS, the most common endocrinopathy in women of reproductive age, is characterized by polycystic ovaries, chronic anovulation, hyperandrogenism and insulin resistance. Despite the high prevalence of hyperandrogenemia, a definitive endocrine marker for PCOS has so far not been identified. Circulating miRNAs have recently been shown to serve as diagnostic/prognostic biomarkers in patients with cancers. Our current study focused on the altered expression of serum miRNAs and their correlation with PCOS. Method and Results: We systematically used the TaqMan Low Density Array followed by individual quantitative reverse transcription polymerase chain reaction assays to identify and validate the expression of serum miRNAs of PCOS patients. The expression levels of three miRNAs (miR-222, miR-146a and miR-30c were significantly increased in PCOS patients with respect to the controls in our discovery evaluation and followed validation. The area under the receiver operating characteristic (ROC curve (AUC is 0.799, 0.706, and 0.688, respectively. The combination of the three miRNAs using multiple logistic regression analysis showed a larger AUC (0.852 that was more efficient for the diagnosis of PCOS. In addition, logistic binary regression analyses show miR-222 is positively associated with serum insulin, while miR-146a is negatively associated with serum testosterone. Furthermore, bioinformatics analysis indicated that the predicted targets function of the three miRNAs mainly involved in the metastasis, cell cycle, apoptosis and endocrine. Conclusion: Serum miRNAs are differentially expressed between PCOS patients and controls. We identified and validated a class of three serum miRNAs that could act as novel non-invasive biomarkers for diagnosis of PCOS. These miRNAs may be involved in the pathogenesis of PCOS.

  3. Metabolic profiles in ovulatory and anovulatory primiparous dairy cows during the first follicular wave postpartum.

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    Kawashima, Chiho; Sakaguchi, Minoru; Suzuki, Takahiro; Sasamoto, Yoshihiko; Takahashi, Yoshiyuki; Matsui, Motozumi; Miyamoto, Akio

    2007-02-01

    Metabolic hormones affect ovarian function in the cow. However, the relationship between metabolic factors and ovarian function is not clear in the postpartum primiparous cow because they are still growing. The aim of the present study was to investigate in detail the time-dependent profile of the metabolic hormones, metabolites, and milk yields of ovulatory and anovulatory primiparous cows during the first follicular wave postpartum. We used 16 primiparous Holstein cows and obtained blood samples for the profiles of metabolites (glucose; non-esterified fatty acid, NEFA; ketone body; total cholesterol; and aspartate aminotransferase), metabolic hormones (growth hormone, GH; insulin-like growth factor-I, IGF-1; and insulin), and progesterone every other day from 1 to 21 days postpartum. In addition, all ovaries were observed using ultrasound. Dairy milk yield was recorded during the experimental period. In all cows, the first follicular wave postpartum was observed and 6 of the cows ovulated. The plasma glucose (Pketone bodies (P<0.0001) concentrations and daily milk yield (P<0.0001) were higher in the anovulatory cows compared to the ovulatory cows. However, the GH levels, which enhance lipolysis for milk production, insulin and other metabolites did not differ between the two groups. In conclusion, the present study suggests that anovulation of the dominant follicle during the first follicular wave postpartum in primiparous cows is induced by low IGF-1 levels that are similar to those of multiparous cows. In addition, anovulatory cows are likely to mobilize body fat stores for milk production more easily than ovulatory cows.

  4. Evaluation of the Prevalence of Polycystic Ovarian Syndrome among Adolescent (15-18 Years Old Girls in Tehran during 2005-2006

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    Abbas Entezari

    2010-01-01

    Full Text Available Background: Polycystic ovarian syndrome (PCOS was first introduced by Leventhal and Steinin 1935. It has a wide range of manifestations such as hyperandrogenism, irregular menstruationand central body obesity. The lack of definite diagnostic criteria has made the diagnosis a difficulttask. Moreover, the disturbing aspects of the syndrome range from hirsutism in an adolescent girlto infertility in a young woman. Based on the Rotterdam 2003 Criteria, current diagnostic criteriamust include two of the following three symptoms:1. Either oligo-ovulation or anovulation,2. Clinical or laboratory manifestations of hyperandrogenism,3. Polycystic ovaries on sonographic examination (more than 12 follicles of less than 10 mm indiameter in each ovary.In this study, we have focused on the enrollment of a large sample size to assess the prevalence andclinical features of PCOS such that a wide range of basic information can be utilized for furtherinvestigations.Materials and Methods: This was a cross-sectional study with multi-stage random sampling.Subjects were selected from 15-18 years old girls from a number of high schools in Tehran. Afterinterview and clinical examination, those individuals with either menstrual irregularities, hirsutismor obesity were referred for further laboratory evaluations and abdominal sonography in order todiagnose PCOS and estimate its prevalence. We also aimed to assess the predominant features ofthis disorder among adolescents.Results: The overall prevalence of the syndrome was 3.42%. Out of the 1430 girls, 49 werediagnosed with PCOS.Conclusion: Despite its high prevalence, this syndrome has not been widely studied. Most of theconducted studies have enrolled small samples within a short time period. Thus, more accuratepolicy making in this regard can be achieved through definition of the prevalence of PCOS andaccurate estimation of its burden.

  5. Comparison clinical and metabolic effects of metformin and pioglitazone in polycystic ovary syndrome

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    Karoon Shahebrahimi

    2016-01-01

    Full Text Available Introduction: Polycystic ovary syndrome (PCOS is one of the most common endocrine disorders in women. PCOS comprises a broad spectrum of anomalies, including hyperandrogenism, chronic anovulation, obesity, and infertility. Insulin resistance and its compensatory hyperinsulinemia play a key role in the pathogenicity of PCOS. This study compares the effects of 2 types of insulin sensitizer drugs, metformin and pioglitazone, on clinical, metabolic, and endocrine characteristics of women with PCOS. Methods: In this randomized clinical trial, 56 women with PCOS (ages 20–49 years were treated orally with either metformin (500 mg 3 times daily or pioglitazone (30 mg daily for 3 months. Clinical (body weight, blood pressure [BP], and body mass index and laboratory indices (fasting blood sugar [FBS], serum triglyceride [TG], cholesterol, low-density lipoprotein, high-density lipoprotein, insulin, testosterone, and dehydroepiandrosterone [DHEA] were measured before and after therapy. Data were analyzed by Chi-square and McNemar's tests. Results: Significant decreases were seen after treatment with metformin in extent of hair loss (P = 0.008, wrist circle (P = 0.011, weight (P = 0.047, diastolic BP (P = 0.023, and DHEA (P = 0.035. A significant decrease in TG was seen with pioglitazone treatment (P = 0.047. In both groups, significant decreases in acne, menstrual disturbance, FBS, and serum insulin were seen. Conclusion: There is a significant amelioration of endocrine and metabolic indices with pioglitazone in PCOS patients. Although we were not able to recommend one treatment regime over the other, pioglitazone offers a useful, alternate treatment in women with PCOS who are not able to tolerate metformin.

  6. Prevalence of polycystic ovary syndrome and its associated complications in Iranian women: A meta-analysis

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    Anahita Jalilian

    2015-10-01

    Full Text Available Background: Polycystic ovary syndrome (PCOS is the most common endocrine disorder in women of reproductive age and is the most common cause of infertility due to anovulation. There is no single criterion for the diagnosis of this syndrome. Objective: The purpose of this study was to investigate the prevalence of PCOS and its associated complications in Iranian women using meta-analysis method. Materials and Methods: Prevalence of PCOS was investigated from the SID, Goggle scholar, PubMed, Magiran, Irandoc, and Iranmedex, and weighting of each study was calculated according to sample size and prevalence of the binomial distribution. Data were analyzed using a random-effects model meta-analysis (Random effects model and the software R and Stata Version 11.2. Results: 30 studies conducted between the years 2006 to 2011 were entered into meta-analysis. The total sample size was 19, 226 women aged between 10-45 years. The prevalence of PCOS based on National institute of child health and human disease of the U.S was, 6.8% (95 % CI: 4.11–8.5, based on Rotterdam was 19.5% (95 % CI: 2.24-8.14, and based on ultrasound was 4.41% (95% CI: 5.68-4.14. Also, the prevalence of hirsutism was estimated to be 13%, acne 26%, androgenic alopecia 9%, menstrual disorders 28%, overweight 21%, obesity 19%, and infertility 8%. Conclusion: The prevalence of PCOS in Iran is not high. However, given the risk of complications such as heart disease - cardiovascular and infertility, prevention of PCOS is important; we suggest that health officials must submit plans for the community in this respect.

  7. Comparison clinical and metabolic effects of metformin and pioglitazone in polycystic ovary syndrome

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    Shahebrahimi, Karoon; Jalilian, Nasrin; Bazgir, Nasrin; Rezaei, Mansour

    2016-01-01

    Introduction: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women. PCOS comprises a broad spectrum of anomalies, including hyperandrogenism, chronic anovulation, obesity, and infertility. Insulin resistance and its compensatory hyperinsulinemia play a key role in the pathogenicity of PCOS. This study compares the effects of 2 types of insulin sensitizer drugs, metformin and pioglitazone, on clinical, metabolic, and endocrine characteristics of women with PCOS. Methods: In this randomized clinical trial, 56 women with PCOS (ages 20–49 years) were treated orally with either metformin (500 mg 3 times daily) or pioglitazone (30 mg daily) for 3 months. Clinical (body weight, blood pressure [BP], and body mass index) and laboratory indices (fasting blood sugar [FBS], serum triglyceride [TG], cholesterol, low-density lipoprotein, high-density lipoprotein, insulin, testosterone, and dehydroepiandrosterone [DHEA]) were measured before and after therapy. Data were analyzed by Chi-square and McNemar's tests. Results: Significant decreases were seen after treatment with metformin in extent of hair loss (P = 0.008), wrist circle (P = 0.011), weight (P = 0.047), diastolic BP (P = 0.023), and DHEA (P = 0.035). A significant decrease in TG was seen with pioglitazone treatment (P = 0.047). In both groups, significant decreases in acne, menstrual disturbance, FBS, and serum insulin were seen. Conclusion: There is a significant amelioration of endocrine and metabolic indices with pioglitazone in PCOS patients. Although we were not able to recommend one treatment regime over the other, pioglitazone offers a useful, alternate treatment in women with PCOS who are not able to tolerate metformin. PMID:27867884

  8. Quality of life and marital sexual satisfaction in women with polycystic ovary syndrome.

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    Romana Pawlińska-Chmara

    2008-04-01

    Full Text Available Polycystic ovary syndrome affects 5-10% of women in the developed world, making it the most common endocrine disorder among women of reproductive age. The symptoms typically associated with polycystic ovary syndrome: amenorrhea, oligomenorrhea, hirsutism, obesity, subfertility, anovulation and acne can lead to a significant reduction in female life quality.The aim of the study was to evaluate the effect of polycystic ovary syndrome on quality of life and marital sexual satisfaction. Fifty women with polycystic ovary syndrome were qualified to the study as the research group. The control group consisted of fourty healthy women. A specific questionnaire was used as a research tool in this study. It included the socio-demographic part, polycystic ovary syndrome's symptomatology and validated scales: Polish version of Short Form-36 Health Survey (SF-36 and Index of Sexual Satisfaction (ISS. The mean age of researched women was 28.9+/-5.6 years, and in the control group - 30.5+/-5.3 years (p>0.05. Quality of life parameters for women with polycystic ovary syndrome were lower than for the controls in the aspect of: general health (p<0.01, limitations due to physical health (p<0.05, limitations due to emotional problems (p<0.001, social functioning (p<0.01, energy/fatigue (p<0.001 and emotional wellbeing (p<0.01. Studied women showed worse marital sexual functioning (p<0.05. Marital sexual dysfunctions were diagnosed in 28.6% of women with polycystic ovary syndrome and in 10.5% of healthy women (p<0.05. Polycystic ovary syndrome decreases quality of life and marital sexual functioning among women. A negative effect of hirsutism severity on general well-being and marital sexual life is also observed.

  9. Patients’ Knowledge about Causes and Solutions of Infertility in South West Nigeria

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    Olukunmi ‘Lanre OLAITAN

    2012-07-01

    Full Text Available Background: Infertility inability to conceive after exposure to continuous unprotected sex for twelve months, is a major cause of marriage conflict in south west Nigeria. Knowledge of causes and solutions to infertility among selected patients were assessed in 18 hospital/fertility centre across the 6 states in south west geo-political zone of Nigeria. Aims and objectives: To assess the knowledge of patients about causes and solutions to infertility in south west Nigeria. Methods/study Design: A survey of a consecutive sample of 390 cases of infertility were carried out in 18 hospital/fertility centers with a total of 65 cases of infertility evaluated in each of the 6 States centers between 2009 – 2012. Chi-square statistics was employed to test the hypotheses formulated at α=0.05 level of significance. Results/Findings: The knowledge of causes and solutions to infertility in the patients were established in all the States; (Lagos, Ogun, Oyo, Osun, Ondo and Ekiti. The commonest causes of infertility among these patients were, RTIs, damaged fallopian tubes, anovulation, poor semen analysis, distorted uterus. Low libido, previous use of IUCDs and uterine fibroids representing 81%, 70%, 68.7%, 65.9%, 65.9%, 65.7%, 65.3% and 62% respectively. The least common causes were taking of psychoactive drugs and working in hot condition/wearing of tight underclothing which was seen in 33.7% and 38.5% of the patients respectively. The patients also have knowledge about solutions of infertility in this order, that ART, regular sexual intercourse, taking hormonal drugs, antibiotics of choice, multivitamins and surgical removal of fibroids as follows; 72.3%, 69.2% 69%, 66.9%, 65.4% and 64.6% respectively. However, the least common solutions according to the patients are seen thus; engaging in varieties of sexual styles/positions, adoption of a child, corrective tubal surgery and wearing of loose/free underclothing representing 25.1%, 33.6%, 33.8% and 35

  10. Research progress in factors related metabolic syndrome in polycystic ovary syndrome%多囊卵巢综合征患者中导致代谢综合征改变的相关因子的研究进展

    Institute of Scientific and Technical Information of China (English)

    裴友娟; 王蔼明; 闫玲

    2012-01-01

    多囊卵巢综合征(PCOS)是常见的妇科内分泌紊乱性疾病,其发生发展不仅可以导致育龄妇女的月经紊乱、排卵障碍,而且其远期并发症,如:高血压、糖尿病等代谢紊乱也不容忽视.颈动脉内膜中层厚度(CIMT)是一种无创性早期反映动脉粥样硬化的指标;C反应蛋白(CRP)是机体或组织在损伤或炎症时,由白细胞介素(IL)-6、肿瘤坏死因子(TNF-a)等细胞因子刺激肝细胞合成的急性期反应蛋白;脂联素(ANP)是一种主要由白色脂肪组织细胞分泌和释放的肽类激素;非对称性二甲基精氨酸(ADMA)为内源性的一氧化氮(NO)合酶抑制剂,其增加可能减少NO的形成,与内皮功能损伤有关.上述因子的改变在一定程度上可引起PCOS患者代谢综合征的改变,本文就上述因子的改变对代谢综合征的影响作一综述.%Polycystic ovary syndrome(PCOS)is a common gynecological endocrine disorder. It could not only result in menstrual disorders and anovulation, but also metabolic problems, such as hypertension and diabetes. Carotid arterial intima-media thickness(CIMT) is an early and noninvasive index to reflect atherosclerosis. Oreactive protein (CRP) is an acute phase protein. CRP correlates with inflammatory disease or injury and is synthesized by hepatocytes in response to certain cytokines, for example, IL-1 and TNF alpha during the acute phase. Adiponectin is a peptide hormone secreted and released by white adipose tissue cells. Asymmetric dimethylarginine (ADMA) is synthetase inhibitor of endogenous nitric oxide (NO). Its increase could reduce the formation of NO, which related to endothelial function injury. The changes of the factors above could lead to metabolic syndrome in PCOS. This article reviews the influence of factors mentioned above to metabolic syndrome in PCOS.

  11. Anthropometric, clinical, and metabolic comparisons of the four Rotterdam PCOS phenotypes: A prospective study of PCOS women

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    Sujata Kar

    2013-01-01

    Full Text Available Aims: 1. To study the distribution of various Rotterdam classified phenotypes of polycystic ovarian syndrome (PCOS women, in our population. 2. To compare the four phenotypes with respect to anthropometric, clinical, and metabolic parameters. 3. To report the prevalence of insulin resistance (IR and metabolic syndrome in these women. Settings and Design: Private practice, Prospective cross-sectional comparative study. Materials and Methods: Women attending gynecology outpatient with the primary complains of irregular menses and/or infertility were evaluated. Each of them underwent detailed clinical examination, transvaginal sonography, and biochemical and hormonal assays. Four hundred and ten women with a clinical diagnosis of PCOS based on Rotterdam criteria were included in the study. The four phenotypes were 1 PCO complete, that is oligo/anovulation (O + polycystic ovaries (P + hyperandrogenism (H 2 P + O, 3 P + H, and 4 O + H. All women were also evaluated for metabolic syndrome (American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI, modified Adult Treatment Panel (ATP III 2005 guidelines and IR (homeostatic model assessment-IR (HOMA-IR. Statistical Analysis: Statistical Package for Social Sciences (SPSS version 18. Results: Largest group was PCOS complete (65.6% followed by P + O (22.2%; H + O (11.2%; and P + H (0.9%. Overall prevalence of metabolic syndrome was 35.07%. Hyperandrogenic phenotyptes; H + O (50% and P + H + O (37.04%, had significantly higher prevalence of metabolic syndrome than normoandrogenic P + O phenotype (10% (P ≤ 0.001. Body mass index (BMI ≥ 25 (P = 0.0004; odds ratio (OR = 3.07 (1.6574-5.7108, 95% CI, waist circumference (WC ≥ 80 cm (P = 0.001; OR = 3.68 (1.6807-8.0737, 95% CI and family history of diabetes (P = 0.019; OR 1.82 (1.1008-3.0194, 95% CI, were strongly associated with the presence of metabolic syndrome. The overall prevalence of IR in PCOS women was 30.44% (HOMA-IR cutoff

  12. Combined letrozole and clomiphene versus letrozole and clomiphene alone in infertile patients with polycystic ovary syndrome

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    Hajishafiha M

    2013-12-01

    Full Text Available Masomeh Hajishafiha,1 Meisam Dehghan,2 Nazila Kiarang,1 Nahideh Sadegh-Asadi,1 Seyed Navid Shayegh,3 Mohammad Ghasemi-Rad2 1Department of Gynecology, Reproductive Health Research Center, Urmia University of Medical Sciences, 2Urmia University of Medical Sciences, 3Gulf Medical University, Ajman, United Arab Emirates Background: Polycystic ovary syndrome (PCOS is the most common endocrine disorder in women of childbearing age (6.8%–18%, is among the most common causes of infertility due to ovulation factors, and accounts for 55%–70% of infertility cases caused by chronic anovulation. In this study, we used a combination of letrozole and clomiphene in patients resistant to both drugs individually, and studied the effects of this combination in ovulation and pregnancy in resistant PCOS patients. Methods: The study population included infertile couples diagnosed as PCOS in the wife. The women used clomiphene for at least six cycles in order to ovulate after failure to form the dominant follicle, and were then put on letrozole for four cycles. Patients who were unable to form the dominant follicle were enrolled on letrozole and clomiphene combination therapy. Results: One hundred enrolled patients underwent 257 cycles of a combination of letrozole and clomiphene, in which 213 were able to form the dominant follicle (82.9% and 44 were unable to do so (17.1%. The number of mature follicles was 2.3±1.1. The mean endometrial thickness in patients on the day of human chorionic gonadotropin administration was 8.17±1.3 mm. The pregnancy rate was 42%. Conclusion: According to the results of this study, it can be proposed that in PCOS patients resistant to clomiphene and letrozole used as single agents, a combination of the two drugs can be administered before using more aggressive treatment that may have severe complications or surgery. This combination may also be used as a first-line therapy to induce ovulation in severe cases of PCOS in order to

  13. Schildrüse: Reproduktionsmedizinische Aspekte - Update 2011

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    Janssen OE

    2011-01-01

    Full Text Available 1 Bei der Beratung von Frauen mit Fertilitätsproblemen sollte immer eine klinische und Laboratoriumsuntersuchung der Schilddrüsenfunktion erfolgen. Schilddrüsenerkrankungen sind in der Allgemeinbevölkerung häufig. Eine positive Familienanamnese oder Schilddrüsenerkrankungen in der früheren Anamnese sind stets verdächtig. 2 Das TSH sollte überprüft werden: a Bei unerfülltem Kinderwunsch als Screeninguntersuchung auch ohne konkreten Verdacht auf eine Erkrankung der Schilddrüse; b In der 4.–6. Schwangerschaftswoche, auch wenn TSH vor der Empfängnis normal war; c 4–6 Wochen nach Beginn einer Levothyroxintherapie, und nach jeder Änderung der Levothyroxindosierung; d Bei allen Frauen mit Schilddrüsenstörungen (oder Verdacht hierauf mindestens einmal im Trimenon (bei Hypo- und Hyperthyreosen können Kontrollen auch häufiger erforderlich sein. 3 TSH sollte im niedrig-normalen Bereich liegen ( 2,5 mIU/L – am besten schon vor der Konzeption. 4 Schwangere in Regionen mit grenzwertiger Jodversorgung (wie Deutschland sollten etwa 150 µg Jodid pro Tag erhalten. Autoimmunthyreoiditis ist keine Kontraindikation gegen eine Jodidsupplementation in Schwangerschaft und Stillzeit. Allerdings sollten Frauen mit Hyperthyreose unter Thyreostatika kein zusätzliches Jodid nehmen, da dies die erforderliche Dosis des Thyreostatikums erhöhen kann. 5 Da hCG die TSH-Spiegel senken kann, besonders im ersten Trimenon, ist das supprimierte TSH allein keine Indikation zur Behandlung mit einem Thyreostatikum. Manifeste Hyperthyreosen in der Schwangerschaft, auf der anderen Seite, erfordern eine Therapie, da die unkontrollierte Hyperthyreose ein Risikofaktor für Schwangerschaftskomplikationen bis hin zum Tod des Feten und zum Abort darstellt. Ausnahme ist die hCG-induzierte Hyperthyreose, die in der Regel zeitlich limitiert ist. 6 Unbehandelte Hypothyreosen – latent und manifest – sind Risikofaktoren für Anovulation; sie können in Verbindung mit dem

  14. Serum under-carboxylated osteocalcin levels in women with polycystic ovary syndrome: weight-dependent relationships with endocrine and metabolic traits

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    Pepene Carmen E

    2013-01-01

    Full Text Available Abstract Background Under-carboxylated osteocalcin (ucOC, the precursor substrate of bone biomarker OC is a potent regulator of energy metabolism by promoting insulin production and adiponectin synthesis and decreasing fat stores. The aim of the present study was to point out the potential role of ucOC in the physiopathology of polycystic ovary syndrome (PCOS, a common disorder defined by the constellation of anovulation, insulinresistance, hyperinsulinemia, obesity and androgen excess. Methods In this prospective case–control investigation, 78 young premenopausal women, i.e. 52 PCOS patients and 26 age- and body mass index (BMI-matched healthy controls, were successively enrolled. Recruitment of PCOS patients was performed according to Androgen Excess-Polycystic Ovary Syndrome (AE-PCOS Society 2006 criteria. All study participants were subjected to clinical examination, whole-body composition assessment and measurements of serum ucOC, OC (1-49, glucose and lipids, insulin, total testosterone (TT, estradiol, sex-hormone binding globulin (SHBG, high-sensitivity C-reactive protein (Hs-CRP and β-CrossLaps. Results BMI-stratified multivariate analysis revealed significantly higher ucOC levels in PCOS vs. controls in lean (p = 0.001 but not overweight and obese study participants (p = 0.456. Notably, a positive correlation between ucOC and TT (p = 0.018, calculated free testosterone (cFT, p = 0.028 and serum insulin (p = 0.036, respectively, was found to be confined to the lean analysis subgroup. Furthermore, in stepwise multiple regression models, β-CrossLaps and cFT were able to predict 46.71% of serum ucOC variability. (1-43/49OC failed to be significantly associated to any PCOS trait. Conclusions Circulating ucOC concentration is related to key endocrine PCOS characteristics in a weight-dependent manner. Within the bone-pancreas loop, high ucOC may favor insulin release in lean hyperandrogenic women to compensate for

  15. Prolactin regulation of kisspeptin neurones in the mouse brain and its role in the lactation-induced suppression of kisspeptin expression.

    Science.gov (United States)

    Brown, R S E; Herbison, A E; Grattan, D R

    2014-12-01

    by the administration of bromocriptine to block elevated levels of prolactin, suggesting that, although elevated prolactin contributes to lactational anovulation, additional non-neural factors must also contribute to the lactation-induced suppression of kisspeptin neurones.

  16. The mare as a model for luteinized unruptured follicle syndrome: intrafollicular endocrine milieu.

    Science.gov (United States)

    Bashir, S T; Gastal, M O; Tazawa, S P; Tarso, S G S; Hales, D B; Cuervo-Arango, J; Baerwald, A R; Gastal, E L

    2016-03-01

    Luteinized unruptured follicle (LUF) syndrome is a recurrent anovulatory dysfunction that affects up to 23% of women with normal menstrual cycles and up to 73% with endometriosis. Mechanisms underlying the development of LUF syndrome in mares were studied to provide a potential model for human anovulation. The effect of extended increase in circulating LH achieved by administration of recombinant equine LH (reLH) or a short surge of LH and decrease in progesterone induced by prostaglandin F2α (PGF2α) on LUF formation (Experiment 1), identification of an optimal dose of COX-2 inhibitor (flunixin meglumine, FM; to block the effect of prostaglandins) for inducing LUFs (Experiment 2), and evaluation of intrafollicular endocrine milieu in LUFs (Experiment 3) were investigated. In Experiment 1, mares were treated with reLH from Day 7 to Day 15 (Day 0=ovulation), PGF2α on Day 7, or in combination. In Experiment 2, FM at doses of 2.0 or 3.0 mg/kg every 12 h and human chorionic gonadotropin (hCG) (1500 IU) were administered after a follicle ≥32 mm was detected. In Experiment 3, FM at a dose of 2.0 mg/kg every 12 h plus hCG was used to induce LUFs and investigate the intrafollicular endocrine milieu. No LUFs were induced by reLH or PGF2α treatment; however, LUFs were induced in 100% of mares using FM. Intrafollicular PGF2α metabolite, PGF2α, and PGE2 were lower and the ratio of PGE2:PGF2α was higher in the induced LUF group. Higher levels of intrafollicular E2 and total primary sex steroids were observed in the induced LUF group along with a tendency for higher levels of GH, cortisol, and T; however, LH, PRL, VEGF-A, and NO did not differ between groups. In conclusion, this study reveals part of the intrafollicular endocrine milieu and the association of prostaglandins in LUF formation, and indicates that the mare might be an appropriate model for studying the poorly understood LUF syndrome.

  17. 青春期多囊卵巢综合征的诊断%Diagnosis of Polycystic Ovary Syndrome in Puberty

    Institute of Scientific and Technical Information of China (English)

    徐芳; 马明; 侯丽辉

    2013-01-01

    多囊卵巢综合征(PCOS)以稀发排卵或无排卵、临床和/或生化的高雄激素血症、卵巢的多囊样改变为特征.PCOS患者多于月经初潮前后出现症状,而正常青春期女孩也会出现月经变化和卵巢的多囊样改变,青春期因为环境改变如体重增加也会发生PCOS,目前国际上尚无青春期PCOS的诊断标准,这使得青春期PCOS的诊断困难,PCOS的结局既有生殖障碍,又有代谢异常,且容易发生糖尿病、心血管疾病、子宫内膜癌等远期并发症.所以早期诊断PCOS,进行相应治疗,可有效预防远期并发症的发生.文章认为应从排卵功能障碍和月经紊乱、临床的高雄激素血症、生化的高雄激素血症、卵巢的多囊样改变、促性腺激素异常、肥胖和代谢障碍、破坏性的睡眠呼吸暂停等方面考虑对PCOS的诊断.%Polycystic ovary syndrome( PCOS )is characterized as less ovulation or anovulation, clinical and/or biochemical hyperandrogenism and polycystic ovary changes. The symptoms of PCOS happen commonly around menarche.The healthy girls in puberty also have menstrual changes and polycystic ovary alternations. PCOS may also occur in puberty because of the environmental changes such as body weight gaining. Currently, the diagnostic standard on puberty PCOS has not been issued yet in the world, which brings the difficulty in the diagnosis. The consequences of PCOS include reproductive disturbance, metabolic abnormality and the long-term complications such as diabetes, cardiovascular diseases and endometrial cancer. Therefore , the early diagnosis of PCOS and treatment can effectively prevent the long-term complications. The paper believed that PCOS diagnosis should be considered in terms of ovulatory dysfunction,menstrual disorders, clinical hyperandrogenism, biochemical hyperandrogenism, polycystic ovary changes, gonadotropin abnormality , obesity, metabolic disturbance, destructive sleep apnea, etc.

  18. The local effects of ovarian diathermy in an ovine model of polycystic ovary syndrome.

    Science.gov (United States)

    Connolly, Fiona; Rae, Michael T; Butler, Mairead; Klibanov, Alexander L; Sboros, Vassilis; McNeilly, Alan S; Duncan, W Colin

    2014-01-01

    In order to develop a medical alternative to surgical ovarian diathermy (OD) in polycystic ovary syndrome (PCOS) more mechanistic information is required about OD. We therefore studied the cellular, molecular and vascular effects of diathermy on the ovary using an established ovine model of PCOS. Pregnant sheep were treated twice weekly with testosterone propionate (100 mg) from day 30-100 gestation. Their female offspring (n = 12) were studied during their second breeding season when the PCOS-like phenotype, with anovulation, is fully manifest. In one group (n = 4) one ovary underwent diathermy and it was collected and compared to the contralateral ovary after 24 hours. In another group a treatment PCOS cohort underwent diathermy (n = 4) and the ovaries were collected and compared to the control PCOS cohort (n = 4) after 5 weeks. Ovarian vascular indices were measured using contrast-enhanced ultrasound and colour Doppler before, immediately after, 24 hours and five weeks after diathermy. Antral follicles were assessed by immunohistochemistry and ovarian stromal gene expression by quantitative RT-PCR 24 hours and 5 weeks after diathermy. Diathermy increased follicular atresia (P<0.05) and reduced antral follicle numbers after 5 weeks (P<0.05). There was an increase in stromal CCL2 expression 24 hours after diathermy (P<0.01) but no alteration in inflammatory indices at 5 weeks. Immediately after diathermy there was increased microbubble transit time in the ovarian microvasculature (P = 0.05) but this was not seen at 24 hours. However 24 hours after diathermy there was a reduction in the stromal Doppler blood flow signal (P<0.05) and an increased ovarian resistance index (P<0.05) both of which persisted at 5 weeks (P<0.01; P<0.05). In the ovine model of PCOS, OD causes a sustained reduction in ovarian stromal blood flow with an increased ovarian artery resistance index associated with atresia of antral follicles.

  19. ABNORMAL UTERINE BLEEDING IN PERIMENOPAUSE

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    Shivaji

    2016-06-01

    Full Text Available BACKGROUND In the peri-menopausal and post-menopausal women, 70% of the gynaecological problems are due to AUB. In the United States, 11% of the hysterectomies are performed for AUB per year. During climacteric, ovarian activity declines leading to anovulation or irregular maturation of follicles. Therefore, the menstrual cycles are often anovulatory and irregular leading to AUB. Prolonged anovulatory periods with unopposed oestrogen stimulation lead to endometrial hyperplasia. This increases the risk of endometrial cancers. Over a decade the progression of endometrial hyperplasia to carcinoma is as follows: Simple hyperplasia - 1%, Complex hyperplasia - 3%, Simple hyperplasia with atypia - 8% and Complex hyperplasia with atypia 29% [Jeffcoate]. AIMS The objective of this study is to correlate the symptoms and the various menstrual patterns to the histopathological diagnosis, so that this knowledge can be applied for an early evaluation and diagnosis of the complications of AUB, and thus arrive at a timely and effective therapeutic strategies. METHODS This is a retrospective study of 314 patients of peri-menopausal age group presenting with AUB in the Department of Gynaecology at SVMCH and RC, Ariyur, Pondicherry, between 2011 and 2014. The study sample consisted of 314 samples of endometrium obtained by dilation and curettage as a day care procedure. RESULTS Menorrhagia is the predominant symptom, 128 cases [40.8%] and was associated with proliferative, secretory and hyperplastic endometrium. Metrorrhagia cases were 53 [16.9%], which predominantly showed secretory followed by proliferative histological pattern. There were 4 cases of Endometrial carcinoma [1.27%]. Simple hyperplasia with atypia were 10 cases [3.29%] and Complex hyperplasia with atypia cases were 7 [2.33%]. CONCLUSION AUB in perimenopausal period is very significant, as it accounts for about 70% of all gynaecologic outpatients. Endometrial hyperplasia is a precursor of

  20. The circadian variation in Anti-Mullerian hormone in patients with polycystic ovary syndrome differs significantly from normally ovulating women.

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    Leif Bungum

    Full Text Available OBJECTIVE: [corrected] To improve the biologic understanding of the Polycystic Ovarian Syndrome (PCOS condition by examining the circadian variation and relationship between Anti Müllerian Hormone (AMH, gonadotropins and ovarian steroids in PCOS patients compared to normally ovulating and menstruating women. By comparing the pattern of co-variation between AMH and Luteinizing Hormone, two compounds closely linked to hyperandrogenism and anovulation in PCOS, the involvement of the Hypothalamic-Pituitary-Ovarian axis in PCOS pathology could be elucidated. PATIENTS: Eight normal-weighted young, anovulatory PCOS-women as study group and ten normal menstruating and ovulating women as controls. INTERVENTIONS: Observational prospective study of the circadian variation in AMH, gonadotropins, sex steroids and androgens in a study and a control group. A circadian profile was performed in each study and control subject during a 24-h period by blood sampling every second hour, starting at 8:00 a.m. and continuing until 8:00 a.m. the following day. RESULTS: Significant differences in hormonal levels were found between the groups, with higher concentrations of AMH, LH and androgens in the PCOS group and lower amounts of FSH and progesterone. A distinct difference in the circadian variation pattern of AMH and LH between PCOS patients and normal controls was seen, with PCOS patients presenting a uniform pattern in serum levels of AMH and LH throughout the study period, without significant nadir late-night values as was seen in the control group. In PCOS women, a significant positive association between LH/ FSH and testosterone was found opposite to controls. MAIN OUTCOME MEASURES: Circadian variation in Anti-Müllerian Hormone, gonadotropins and ovarian steroids and the covariation between them. CONCLUSION: A significant difference in the circadian secretion of LH and AMH in PCOS women compared to normally ovulating women indicate an increased GnRH pulse

  1. Study of the Effects of Stachys Lvandulifolia Alcoholic Extract on Histomorphometry of Endometrium in Polycystic Ovarian Syndrome Rat Model

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    P. Pahlevani

    2016-04-01

    Full Text Available Introduction & Objective: Polycystic ovary syndrome (PCOS is the most common endocrinopathy affecting women. Chronic anovulation due to polycystic ovary syndrome predisposes women to endometrial changes. Stachys lavandulifolia is an aromatic plant belonging to the Labiatae family proven to have estrogenic properties. In this study, we evaluated the effects of Stachys lavandulifolia extract on endometrial histological parameters in a rat model of PCOS. Materials & Methods: Thirty-six adult female Sprague-Dawley rats, weighing between 17-200 g were used in this experimental study. PCOS was induced by a single intramuscular injection of 4 mg Estradiol Valerate. The rats were divided into six groups; control group with no treatment, the PCOS group receiving solvent, three PCOS groups treated by multiple doses (225, 450, 900 mg/kg of Stachys lvandulifolia extract, and PCOS group receiving clomiphene citrate (1.5 mg/kg. Extracts were injected intraperitoneally for a period of 4 estrous cycles (16 days. The endometrial biopsies were stained with Hematoxylin-Eosin and then the number of glands, endometrial glandular cell height, internal diameter of glands, height of epithelial cells and height of endometrium and pathological changes were examined. Results: The results showed that the height of surface epithelium and glandular epithelium increased and the endometrial thickness and internal diameter of glands insignificantly decreased in PCOS group compared to control (P>0.05 while the number of glands showed significant decrease (P=0.01. In addition, 40% of the rats in PCOS group showed endometrial hyperplasia. Treatment with clomiphen citrate and different concentrations of the Stachys lvandulifolia led height of glandular epithelium, internal diameter of glands, height of surface epithelium and endometrium and number of glands to become more similar to the control group, although they were not significant(P>0.05. Treatment with clomiphen citrate and

  2. The local effects of ovarian diathermy in an ovine model of polycystic ovary syndrome.

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    Fiona Connolly

    Full Text Available In order to develop a medical alternative to surgical ovarian diathermy (OD in polycystic ovary syndrome (PCOS more mechanistic information is required about OD. We therefore studied the cellular, molecular and vascular effects of diathermy on the ovary using an established ovine model of PCOS. Pregnant sheep were treated twice weekly with testosterone propionate (100 mg from day 30-100 gestation. Their female offspring (n = 12 were studied during their second breeding season when the PCOS-like phenotype, with anovulation, is fully manifest. In one group (n = 4 one ovary underwent diathermy and it was collected and compared to the contralateral ovary after 24 hours. In another group a treatment PCOS cohort underwent diathermy (n = 4 and the ovaries were collected and compared to the control PCOS cohort (n = 4 after 5 weeks. Ovarian vascular indices were measured using contrast-enhanced ultrasound and colour Doppler before, immediately after, 24 hours and five weeks after diathermy. Antral follicles were assessed by immunohistochemistry and ovarian stromal gene expression by quantitative RT-PCR 24 hours and 5 weeks after diathermy. Diathermy increased follicular atresia (P<0.05 and reduced antral follicle numbers after 5 weeks (P<0.05. There was an increase in stromal CCL2 expression 24 hours after diathermy (P<0.01 but no alteration in inflammatory indices at 5 weeks. Immediately after diathermy there was increased microbubble transit time in the ovarian microvasculature (P = 0.05 but this was not seen at 24 hours. However 24 hours after diathermy there was a reduction in the stromal Doppler blood flow signal (P<0.05 and an increased ovarian resistance index (P<0.05 both of which persisted at 5 weeks (P<0.01; P<0.05. In the ovine model of PCOS, OD causes a sustained reduction in ovarian stromal blood flow with an increased ovarian artery resistance index associated with atresia of antral follicles.

  3. Blood metabolites and hormone-based programmed breeding treatments in anovular lactating dairy cows.

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    El-Zarkouny, S Z; Shaaban, M M; Stevenson, J S

    2011-12-01

    The objectives were to (1) compare blood metabolites and reproductive outcomes in lactating dairy cows not inseminated before (early) and after (late) 100 d in milk (DIM) because of prolonged anovulation or anestrus; and (2) evaluate reproductive responses of cows ≤100 DIM to GnRH+PGF(2α) treatments after a fixed-time artificial insemination (AI; Ovsynch) or after induced estrus (Select Synch). In blood samples collected before initiating hormone-based breeding programs, anovular cows ≤ 100 DIM had the greatest serum total protein and globulin concentrations and the lowest tri-iodothyronine concentrations. Anovular and ovular cows >100 DIM had the greatest serum urea concentrations. Ovaries in cows (n=40) >100 DIM were examined by transrectal ultrasonography, and those without a detectable corpus luteum (CL; anovular) were given GnRH and then PGF(2α) 7 d later (Select Synch), whereas cows with a CL (ovular) were given 2 PGF(2α) injections 12 d apart. Cows were inseminated at observed estrus after the second or only PGF(2α) injection. More ovular (79%; 15/19) than anovular cows (24%; 5/21) were detected in estrus. No differences were detected between ovular and anovular cows in DIM at first AI, conception rate to first AI, cumulative pregnancy rates, number of services per conception, or days open. Cows (n=93) ≤100 DIM were assigned randomly to 3 treatments: (1) control (n=20) AI at estrus; (2) GnRH and then PGF(2α) on 7d (Select Synch; n=42) and monitored for signs of estrus for 5d and AI accordingly; or (3) 2 GnRH injections 9 d apart with PGF(2α) given 48 h before second GnRH injection and AI at 16h after the second GnRH injection (Ovsynch; n=31). Among cows ≤100 DIM, controls had more days to first service (149±16 d) than Select Synch cows (117±7 d). Ovsynch cows had the fewest days to first service (84±10 d) compared with control (149±16 d) and Select Synch (117±7 d) cows. Conception rates in control (25%) and Select Synch (26.2%) cows did

  4. Diagnosis and treatment for anovulatory abnormal uterine bleeding%无排卵型异常子宫出血的诊治

    Institute of Scientific and Technical Information of China (English)

    古健

    2014-01-01

    AnOvulatOry abnOrmal uterine bleeding is One tyPe Of abnOrmal uterine bleeding(AUB),alsO AUB -O fOr shOrt. AUB - O can be diagnOsed with medical histOry and labOratOry examinatiOn by excluding Organic factOrs Of systemic Or rePrOductive system. The Objective Of treatment fOr AUB - O includes twO asPects. One is tO inhibit endOmetrial hyPerPlasia,PrOlOnged menstruatiOn and menOrrhagia,which induced by chrOnic anOvulatiOn. The Other is tO PrOmOte the restOratiOn Of nOrmal menstrual functiOn,including nOrmal menstrual cycle and menstrual quantity. TheraPeutic regimen includes hemOstasis,menstruatiOn cycle adjustment and OPeratiOn. EstrOgen / PrOgestin PrOgestins are the mainstay Of treatment fOr AUB - O.%无排卵型异常子宫出血是异常子宫出血(abnOrmal uterine bleeding,AUB)中的一个类型,简称 AUB - O。通过病史及辅助检查排除全身或生殖系统器质性因素可诊断 AUB - O。AUB - O 的治疗目的包括两方面,一是抑制长期无排卵引起的子宫内膜过度增生、月经期延长和经量过多,二是促进正常月经功能恢复,包括正常月经周期和月经量的恢复。具体方案包括止血、调整月经周期及手术治疗。雌、孕激素尤其是孕激素是治疗 AUB - O 的主要药物。

  5. The Research Progress in Insulin Resistance in Polycystic Ovary Syndrome%多囊卵巢综合征胰岛素抵抗的新进展

    Institute of Scientific and Technical Information of China (English)

    李曌

    2011-01-01

    With the morbidity of 5%~10% in premenopausal women, polycystic ovary syndrome (PCOS) is an exceptionally commen disorder. Its features are chronic anovulation or few ovulations,polycystic ovaries increase in size and hyperandrogenism. In addition,it is also characterized by insulin resistance (IR) and β-cell dysfunction. The conception rate of patients with PCOS is fallen, and patient's prevalence rate of spontaneous abortion during pregnancy and gestatianal diabetes is higher than the normal persons. Besides,these patients are at higer risk of suffering from endometrial carcinoma .Some result from several recent studies, showed that patient's incidence of metabolic syndrome (MS) was increased. Metabolic syndrome has a significant relationship with cardiovascular diseases and IR. At present,many scholars have made extensive researches on the impact of IR and PCOS,pointing out that it is effective to improve PCOS patients'endocrine condition and their reproduction by ameliorate their insulin resistance. Lifestyle adjustment can be a efficient measure to achieve this aim,besides,oral hypoglycemic agents can also be an effective method to treat the insulin resistance in PCOS.%多囊卵巢综合征((PCOS)是青春期及育龄妇女最常见的内分泌和代谢紊乱性疾病,其发病率占育龄妇女的5%-10%.PCOS的基本特征为长期不排卵或稀发排卵、卵巢多囊性增大和高雄激素血症等,此外还表现有胰岛素抵抗(IR)及胰岛β细胞功能失调.PCOS患者妊娠率降低,妊娠期自然流产、妊娠期糖尿病的患病率亦较普通人群高,同时子宫内膜癌发病风险增高.PCOS患者代谢综合征的发病率升高,后者与心血管疾病风险紧密相连,并与IR有密切关系.目前许多学者对PCOS患者的IR做了大量的研究,提示改善PCOS 的IR可改善内分泌及生殖功能,而改善生活方式是改善患者IR的有效手段.口服降糖药已成为治疗PCOS 的IR的有效方法之一.

  6. Síndrome do ovário policístico: abordagem dermatológica Polycystic ovary syndrome: a dermatologic approach

    Directory of Open Access Journals (Sweden)

    Heloisa Helena Gonçalves de Moura

    2011-02-01

    Full Text Available A síndrome do ovário policístico (SOP é uma das endocrinopatias mais freqüentes nas mulheres em idade reprodutiva. Caracteriza-se por morbidade elevada devido aos aspectos estéticos e por repercussões metabólicas importantes. Embora a sua patogênese permaneça incompletamente conhecida, acredita-se numa desordem multigênica complexa, incluindo anormalidades no eixo hipotálamohipofisário, esteroidogênese e resistência insulínica. Os achados principais para o diagnóstico são: hiperandrogenismo, anovulação crônica e ovários policísticos à ultrassonografia. As manifestações dermatológicas do hiperandrogenismo incluem: hirsutismo, acne, seborréia, alopecia e, em casos mais graves, sinais de virilização. Existe considerável heterogeneidade nos achados clínicos e também pode haver variação na mesma paciente com o passar do tempo. O tratamento visa reduzir as manifestações do hiperandrogenismo, restaurar os ciclos ovulatórios regulares e corrigir a síndrome metabólica. Este artigo apresenta revisão da fisiopatologia, diagnóstico e tratamento da síndrome do ovário policístico. Enfatiza-se a importância do diagnóstico e tratamento precoces no intuito de prevenir as complicações metabólicas e a repercussão emocional que afeta a qualidade de vida das pacientes.Polycystic ovary syndrome (POS is one of the most common endocrine abnormalities affecting women of reproductive age. It is a cause of significant social embarrassment and emotional distress. The pathogenesis of the disease is not yet fully understood, but it is thought to be a complex multigenic disorder, including abnormalities in the hypothalamic-pituitary axis, steroidogenesis, and insulin resistance. The main diagnostic findings of the syndrome are: hyperandrogenism, chronic anovulation and polycystic ovarian morphology seen on ultrasound. Hyperandrogenism is generally manifested as hirsutism, acne, seborrhea, androgenic alopecia and, in severe

  7. Polimorfismos en los genes CYP11α y CYP17 y etiología del hiperandrogenismo en pacientes con poliquistosis ovárica Polymorphism in CYP11alpha and CYP17 genes and the etiology of hyperandrogenism in patients with polycystic ovary syndrome

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    María S. Pérez

    2008-04-01

    Full Text Available El síndrome de poliquistosis ovárica (PCOS es un desorden endocrino-metabólico de naturaleza multifactorial, con una marcada predisposición genética, que afecta al 6% de las mujeres en edad reproductiva. Se caracteriza por la presencia de hiperandrogenismo, oligo-anovulación y ovarios poliquísticos. Entre los genes candidatos se encuentran aquellos que codifican para enzimas que actúan en la síntesis de andrógenos. Dos de los genes candidatos son el CYP17 y el CYP11alfa que codifican para la 17alfa hidroxilasa (P45017alfa y para el P450scc (colesterol side chain cleavage respectivamente. Los polimorfismos en estos genes están asociados al desarrollo del fenotipo hiperandrogénico. Nuestro objetivo fue analizar las frecuencias alélicas de los polimorfismos de los dos genes mencionados en población con PCOS, compararla con población normal y analizar la relación de cada variante alélica con el fenotipo hiperandrogénico correspondiente. Se analizaron 65 pacientes y 58 controles sanos en los que se determinaron niveles de testosterona y frecuencia de polimorfismos en los genes mencionados. Se observó una diferencia estadísticamente significativa cuando se asoció el grupo de mayor nivel de androgenemia con la presencia del genotipo A2/A2 del gen CYP17, y se hallaron mayores niveles de andrógenos circulantes en las pacientes con PCOS portadoras del alelo 216- del gen CYP11alfa. Nuestros resultados sugieren que ambos alelos juegan un rol menor en el desarrollo de PCOS y podrían ser considerados como potenciales marcadores de riesgo genético para el desarrollo del fenotipo hiperandrogénico.The polycystic ovary syndrome (PCOS is a heterogeneous multifactorial endocrine metabolic disorder with genetic predisposition affecting 6% of women in the reproductive age. This syndrome is characterized by the presence of oligo-anovulation, hyperandrogenism and polycystic ovaries. Several genes have been postulated as responsible for the

  8. Manifestaciones clínicas del síndrome del ovario poliquístico

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    Donald Fernández-Morales

    2005-10-01

    and anovulation, but also had an associated metabolic risk. Polycystic ovary syndrome was redefined by a 2003 Holland consensus workshop. This condition is felt to be present if there are 2 of 3 possible diagnostic criteria: menstrual irregularities, biochemical o clinical signs of androgen excess and the presence of polycystic ovary morphology. The gynecologist frequentIy makes this diagnosis and has to have an adequate knowledge of the clinical signs and the possible long term risks. The evidence of a possible association with endometrial cancer and an increased cardiovascular disease risk is incomplete because the variety of definitions of polycystic ovary syndrome makes difficult the comparison of the studies. Dunaif claims that the prevalence of insulin resistance is a function of the studied population and the sensitivity and specificity of the method used to measure this parameter. She also mentions that women with polycystic ovary syndrome are hyperinsulinemic and insulin resistant, independentIy of obesity, compared with normal women. Legro demonstrated that 25 to 30% of the women with polycystic ovary syndrome have glucose intolerance and that Diabetes Mellitus occurs in 8% each year. He says that fasting glucose concentration is not a reliable predictor of the prevalence of diabetes in comparison with the 75 grams glucose tolerance test (American Society of Diabetes. He also says that the fasting deterrnination is a berter screening method, with the same predictive value for development of micro vascular complications.

  9. Mulheres com síndrome dos ovários policísticos apresentam maior frequência de síndrome metabólica independentemente do índice de massa corpóreo Women with polycystric ovary syndrome have a higher frequency of metabolic syndrome regardless of body mass index

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    Anderson Sanches Melo

    2012-01-01

    Full Text Available OBJETIVO: Avaliar a prevalência de síndrome metabólica e dos seus critérios definidores em mulheres com síndrome dos ovários policísticos do Sudeste brasileiro, estratificadas de acordo com o índice de massa corpóreo e comparadas com controles ovulatórias. MÉTODOS: Estudo transversal, realizado com 332 mulheres em idade reprodutiva, que foram divididas em dois grupo: Controle, constituído por 186 mulheres com ciclos menstruais regulares, sintomas ovulatórios e sem diagnóstico de síndrome dos ovários policísticos ou outra anovulação crônica; e Síndrome dos ovários policísticos, composto por 146 mulheres com o diagnóstico de síndrome dos ovários policísticos - Consenso de Rotterdam ASRM/ESHRE. Cada um destes grupos foi estratificado de acordo com o índice de massa corpóreo (PURPOSE: To assess the prevalence of metabolic syndrome and of its defining criteria in women with polycystic ovary syndrome from the Brazilian Southeast, who were stratified according to body mass index and compared to ovulatory controls. METHODS: This was a cross-sectional study conducted on 332 women of reproductive age, who were divided into two groups: Control, consisting of 186 women with regular menstrual cycles and ovulatory symptoms and without a diagnosis of polycystic ovary syndrome or other type of chronic anovulation, and the Polycystic ovary syndrome,Group, consisting of 146 women with a diagnosis of polycystic ovary syndrome (Rotterdam Consensus ASRM/ESHRE. Each group was stratified according to the body mass index, as follows: body mass index ( < 25 ≥25 and <30, and ≥ 30 kg/m². The frequencies of metabolic syndrome and of its defining criteria and the clinical and hormonal characteristics (follicle stimulating hormone, total testosterone, dehydroepiandrostenedione sulfate were analyzed. RESULTS: The frequency of metabolic syndrome was six times higher in the obese Polycystic ovary syndrome Group than among control women with the

  10. 卫爱武教授治疗因 PCOS 行 IVF - ET 的中医调治经验%Professor Wei Aiwu Experiences on PCOS IVF - ET with TCM

    Institute of Scientific and Technical Information of China (English)

    石少琦; 卫爱武

    2016-01-01

    多囊卵巢综合征(pCOS)是育龄妇女常见的内分泌疾病,临床以月经失调、不孕、多毛、肥胖、痤疮、卵巢多囊样改变为主要表现,而持续性无排卵及高雄激素是引起各种临床表现的主要原因。对于顽固性的排卵障碍患者,在经过反复(>3次)促排卵治疗及手术治疗(腹腔镜下卵巢打孔术)后仍失败者,多行体外受精-胚胎移植技术(IVF - ET),可解决无排卵问题。但仍存在许多问题,如取卵引起卵巢过度刺激的风险较大;取得的卵子质量较差,难以形成高质量胚胎;内膜不符合移植需要;妊娠率低;生化妊娠率高;抱婴回家率低等。导师卫爱武教授在临床工作中将中医药应用于该类患者的治疗,针对以上问题,在进入周期前整体调理月经周期,进入周期后养卵提高卵泡质量,滋肾养血准备内膜,移植后积极安胎,在临床上取得了良好的疗效。%Polycystic ovary syndrome(PCOS)was a common endocrine disorder in women of child-bearing age,clinical for menstrual disorders,infertility,hirsutism,obesity,acne and Polycystic ovarian changes as the main Performance which was caused by continued sex no ovulation and the Kaohsiung hormone. Pa-tients with intractable anovulation who not cured by treating with ovulation induction theraPy and surgery more than three times were given in vitro fertilization and embryo transfer technology(IVF - ET),which could solve the Problem of ovulation. However,there were still many Problems,such as greater risk of ovarian hyPerstimu-lation caused by eggs Pick - uP,difficulty to form a high quality embryo transPlantation due to the Poor quality of the eggs,unexPected the needs of endometrial,low Pregnancy rate,biochemical Pregnancy rate etc. . To solve the above Problems,Professor Wei Aiwu believed that this disease should be treated with overall regula-ting the menstrual cycle before menstrual cycle