Appearance Of Polycystic Ovaries Research Articles

Polikistik Over Sendromlu (PKOS) Kadınlarda Anormal MiRNA Ekspresyonu

Polycystic ovary syndrome (PCOS) is a debilitating endocrine and metabolic disorder that affects a large proportion of women in their reproductive years. It differs by a range of symptoms including polycystic ovary appearance, hyperandrogenism, chronic anovulation, insulin resistance, and obesity. Despite years of research, the exact cause of PCOS remains elusive, but recent studies have suggested that epigenetic mechanisms may play a significant role in its pathogenesis. Of particular interest are micro-RNAs (miRNAs), short non-coding RNAs that are transcribed from DNA but not translated into protein. Recent research has demonstrated that abnormal expression of miRNAs is present in PCOS and may contribute to the development and progression of the disease. This review aims to provide an in-depth analysis of the current knowledge and challenges related to abnormal miRNA expression in PCOS, shedding light on a potential avenue for targeted therapies and improved management of this debilitating condition. The review summarizes the findings from various studies that have investigated the role of miRNAs in PCOS. It discusses the specific miRNAs that have been found to be dysregulated in PCOS and their potential impact on the pathophysiology of the disease. The review also highlights the challenges associated with studying miRNAs, including the complexity of their regulation and the need for standardized methodologies for miRNA profiling. Based on the available evidence, abnormal expression of miRNAs appears to be a significant contributor to the development and progression of PCOS. Targeting these dysregulated miRNAs could offer new therapeutic strategies for the management of PCOS. Biomarkers and gene therapies associated with miRNA may improve the accuracy and effectiveness of PCOS diagnosis and treatment. However, further research is needed to fully understand the functional roles of specific miRNAs and their potential as diagnostic or therapeutic targets.

Comprehensive Management of Polycystic Ovary Syndrome: Effect of Pharmacotherapy, Lifestyle Modification, and Enhanced Adherence Counseling.

Introduction Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women of childbearing age in India, which often presents as menstrual irregularities, infertility, acanthosis nigricans, etc. Metabolic disturbances associated with PCOSpredispose patients to cardiovascular diseases, which may be avoided by effective management. The aim of the current study was to evaluate the role of lifestyle modification (LSM) and metformin in PCOS management. Methods This is a retrospective cohort study conducted among 130 PCOS patients who attended the outpatient department of the tertiary care hospital in central India from October 2019 to March 2020. The study describes the effect of a combined package of LSM (physical exercise and dietary changes) and metformin on anthropometric, clinical, and biochemical parameters at three and six months. Results Out of the total 130 women, 12 were lost to follow-up and were omitted from further analysis. At six months of the treatment package (LSM, metformin, and enhanced adherence counseling (EAC)), a significant decrease was seen in body mass index, blood sugar,follicle-stimulating hormone,luteinizing hormone, and insulin. Following the intervention, the menstruation cycle became regular in 91% of the women while volume, theca, and appearance of polycystic ovaries on ultrasound decreased in 86% of women. Insulin resistance (IR) and hyperinsulinemia are the major causes of pathophysiological changes associated with PCOS. Metformin along with LSM primarily acts by decreasing IR, while EAC ensures treatment compliance. Conclusion Metformin along with LSM in the form of calories restricted, high-protein diet, and physical activity reduce IR and hyperandrogenaemia, resulting in improved anthropometric, glycemic indices, hormonal profiles, and features of hyperandrogenaemia. The combined therapy is beneficial to 85-90%of women with PCOS.

Ayurvedic Management of Infertility due to Anovulation-A Case Study

Background:Infertility is the failure to conceive even after one or more years of regular unprotected sexual intercourse. Due to improper life style ,incidence of infertility increases .PCOS is a life style disorder and very common among reproductive age group . Acharya Sushrutexplained about Bandhya Yonivya padawhere Nashtartava is mentioned as the one and only symptom. In Ayurveda text word Aartavahas been used extensively in different contexts; menstrual blood, ovum and ovarian hormones. Therefore Amenorrhea, anovulation, hormonal dysfunction can be considered as visible manifestations of Nashtartva. Material and method:Following is a case report of a female who was anxious to conceive after 3 years of active married life, she had irregular menses. Her USG reports showed polycystic appearance of ovaries .The treatment adopted were to balance vataand kapha. Result: the treatment patient was a known case of infertility due to PCOS and after treatment her PCOS was cured and she conceived . Discussion:Line of treatment was to enhance potency of ovum for ovulation and regularize vitiated Vata Dosha, Shrotoshuddhiand Aartava janan. Conclusion:Ayurvedatherapy can be used in patients of infertility due to PCOS for better outcome and no adverse drug effect was noticed

Adölesan Dönemde Polikistik Over Sendromu: Fiziksel, Metabolik ve Hormonal Özellikler

Aim: The Rotterdam criteria are used in the diagnosis of polycystic ovary syndrome (PCOS). However, since menstrual irregularities and acne are seen more frequently in adolescents, it is theoretically difficult to use the Rotterdam criteria. The aim of this study was to investigate whether the Rotterdam criteria are sufficient for the diagnosis of PCOS in adolescence. Material and Methods: Thirty patients and thirty healthy individuals between the ages of 16 and 18 years were included in the study. Anthropometric measurements, Ferriman Gallwey score (FGS), ultrasonographic ovarian volumes, androgens, and other hormone levels of the participants were recorded. Results: There was a statistically significant positive correlation between the homeostatic model assessment of insulin resistance (HOMA-IR) and waist circumference/hip circumference ratio in the patient group (r=0.656, p<0.001). The mean luteinizing hormone (LH) levels of the patient group were found to be statistically significantly higher than the control group (p=0.048). The median FGS of the patient group was statistically significantly higher than the control group (p<0.001). Serum total testosterone levels of adolescent girls who have polycystic ovaries were statistically significantly higher than the ones who have not (p=0.001). The median FGS of those with polycystic ovarian appearance on ultrasonography was found to be statistically significantly higher than those without (p=0.034). Conclusion: Among the Rotterdam diagnostic criteria, oligoanovulation, acne, and polycystic ovarian appearance on ultrasonography can be seen in healthy adolescents without PCOS. In this study, the most supportive finding for the diagnosis of PCOS was the appearance of polycystic ovaries accompanying moderate hirsutism.

A Detailed Cutaneous Manifestations Evaluation in Patients with Polycystic Ovary Syndrome

Background and Aim: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among women of reproductive age. The hypothalamus-pituitary-ovary axis dysregulates in PCOS, ultimately leading to hyperandrogenisms. Consequently, it is associated with hirsutism, dyslipidemia, obesity, infertility, menstrual disturbance, and insulin resistance. To our knowledge, there is no detailed investigation of these manifestations. That is why, this study aimed to evaluate manifestations of hyperandrogenism, hirsutism in particular. Methods: This study was performed on 39 women with an initial diagnosis of polycystic ovary syndrome. Rotterdam criteria including Oligo- or anovulation, hyperandrogenism clinical and/or biochemical signs, and ultrasound appearance of polycystic ovaries used as diagnostic criteria. Hirsutism scoring was carried out according to Freeman-Gallwey’s definition of hirsutism. The patients were analyzed for other skin problems including male pattern baldness, acanthosis nigricans, and acne as well as demographic features. Results: Hirsutism was observed in the majority of our patients (91%) ranging from mild to severe. Concerning the distribution of hirsutism on various parts of the body, severe hirsutism was observed more on the groin, abdominal area, and chin respectively. Male pattern baldness, acanthosis nigricans, and acne, and dysregulated menstruation were reported in these patients. Conclusion: This investigation found that skin manifestations, especially hirsutism, are highly frequent in patients with PCOS. *Corresponding Author: Hashem Nayeri; Email: hnaieri@gmail.com; nayeri@iaufala.ac.ir Please cite this article as: Masaeli A, Nayeri H, Mirzaei M. A Detailed Cutaneous Manifestations Evaluation in Patients with Polycystic Ovary Syndrome. Arch Med Lab Sci. 2021;7:1-6 (e10). https://doi.org/10.22037/amls.v7.30828

A Narrative Review of Current Understanding of the Pathophysiology of Polycystic Ovary Syndrome: Focus on Plausible Relevance of Vitamin D.

Polycystic ovarian syndrome (PCOS) is the most prevalent endocrinopathy of reproductive years. Salient features in presentation of patients PCOS include menstrual dysfunction, hyperandrogenism and/or polycystic appearance of ovaries on ultrasound. While the diagnosis of PCOS depends on presence of specified criteria, misdiagnoses are common. Despite years of extensive research, the exact aetiology of PCOS remains largely unknown. In the past decade, apart from insulin resistance and hyperandrogenemia, anti-mullerian hormone (AMH), an important marker of ovarian reserve, and vascular endothelial growth factor (VEGF), a crucial factor in angiogenesis, have been examined as plausible players of causative relevance for PCOS. Vitamin D, a sex-steroid hormone that is universally known for its relevance for skeletal health, has received increasing attention due to growing evidence supporting its pivotal in reproductive physiology and in PCOS. In this review we summarize our current understanding of the mechanisms relevant to the pathophysiology of PCOS and examine the role of vitamin D signalling in this context.

POLİKİSTİK OVER SENDROMUNDA (PKOS) ENDOTELYAL DİSFONKSİYONUN ERKEN SERUM BELİRTECİ: ENDOCAN

Objective: Polycystic ovary syndrome (PCOS) is a common endocrinological disease in women of reproductive age and has a wide range of metabolic effects. Chronic low-grade inflammation and endothelial dysfunction plays a key role in the pathogenesis of PCOS and they are associated with an increased risk of cardiovascular disease. Endocan, is an inflammatory marker showing endothelial dysfunction. The aim of our study, to compare serum endocan levels in PCOS and healthy control groups and to determine the relationship between some cardiovascular risk factors and serum endocan levels. Materials and Methods: This case-control study included 52 PCOS patients and 59 age-matched healthy controls. Patients were diagnosed as PCOS based on 2003 Rotterdam criteria. Demographic data, history of menstrual irregularity and infertility, polycystic ovary appearance in ultrasonography and hirsutism status were recorded. Endocan levels of PCOS patients and controls were compared. Data analysis was performed by using SPSS-22 for Windows (Statistical Package for Social Science, SPSS Inc. Chicago IL, USA®Z). Results: The median (IQR) value of serum endocan level was 420.7 ng/L (355.2-570.3) in the PCOS group and 320.0 ng/L (219.9-455.9) in the control group (p=0,003). While there was no significant correlation between serum endocan and some cardiovascular risk factors such as waist circumference, hip circumference, BMI, LDL, triglyceride, systolic and diastolic arterial tension but a positive correlation was found between homeostatic model assessment insulin resistance (HOMA-IR) (r= 0.276, p= 0,003). Conclusion: Serum endocan levels are higher in PCOS patients, in line with the literature. Endocan level shows a significant correlation with insulin resistance, one of the metabolic parameters. This may be a sign of early endothelial dysfunction in PCOS.

Clinical Presentation and Frequency of Metabolic Syndrome in Women With Polycystic Ovary Syndrome: An Experience From a Tertiary Care Hospital in Pakistan.

Introduction: Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting women of reproductive age. The aim of this study was to determine the variations in the clinical presentation and frequency of metabolic syndrome (MetS) in women with PCOS.Methods: This cross-sectional study was conducted at the Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Pakistan, from April 2019 to March 2020. Women attending the endocrine clinic who satisfied the Rotterdam criteria of PCOS and agreed to participate in the study were included. Detailed personal and family history of menstrual cycle, hirsutism, diabetes, hypertension, dyslipidemia and obesity was noted along with measurement of vitals, anthropometric measures and calculation of the body mass index. Physical examination performed for signs of hyperandrogenism, insulin resistance and biochemical and hormonal evaluation was also carried out in recruited participants. Statistical analysis was done using the Statistical Package for the Social Sciences (SPSS) version 20 (IBM Corp., Armonk, NY).Results: A total of 153 participants with mean age of 27.2±8.13 years were included in this study. Regarding clinical presentation, menstrual irregularity (oligomenorrhea 39.85%, amenorrhea 38.9%), followed by hirsutism 52.3%, was the most common presentation. Polycystic appearance of ovaries was noted in 33.3% of our study participants. MetS was identified in 46.4% participants (obesity was noted at the highest frequency at 82.4% followed by dyslipidemia at 56.2%).Conclusion: We observed a high frequency of MetS in females presenting with PCOS. There is a need to evaluate women with PCOS for various components of MetS to prevent potential complications.

Arterial stiffness measured by cardio-ankle vascular index is greater in non-obese young women with polycystic ovarian syndrome.

The association of metabolic abnormalities and polycystic ovarian syndrome (PCOS) has been documented, but few studies have focused on cardiovascular risk in these women. The aim of this study was to compare arterial stiffness by using the cardio-ankle vascular index (CAVI) in PCOS women with controls, and to evaluate whether any clinical or laboratory variables had independent associations with it. A group of 160 women, matched for age and body mass index were recruited. Diagnosis of PCOS was made according to the Rotterdam criteria. Arterial stiffness using CAVI was evaluated in non-obese young woman, with and without PCOS. In the PCOS group (n = 80), 60 cases (75%) had findings of hyperandrogenism, 59 (73.8%) had ovulatory dysfunction, and 70 (87.5%) had an ultrasonographic appearance of polycystic ovaries. Women with PCOS had significantly higher mean CAVI values when compared to subjects without PCOS (5.78 ± 0.64 vs 5.28 ± 0.77, P < 0.001). Multiple regression analysis revealed that androgen excess was associated with increased arterial stiffness, independent of ovulatory dysfunction, polycystic ovaries, body mass index and age. This data suggests that vascular compliance is decreased in young women with PCOS. Androgen excess is independently associated with increased arterial stiffness.

AYURVEDA INTERVENTION IN FEMALE INFERTILITY DUE TO OVARIAN FACTOR - A CASE REPORT

Infertility is defined as inability of a couple to conceive after one year of regular unprotected sexual intercourse. Incidence of ovarian dysfunction in the form of Polycystic ovarian disease (PCOD) has become a leading cause of female infertility in today’s era. Polycystic Ovarian disease (PCOD) is a heterogeneous, multifactorial and polygenic endocrinal disorder. Acharya Sushrut explained about Bandhya Yonivya pada where Nashtartava is mentioned as the one and only symptom. In Ayurveda text word Aartava has been used extensively in different contexts; menstrual blood, ovum and ovarian hormones. Therefore Amenorrhea, anovulation, hormonal dysfunction can be considered as visible manifestations of Nashtartva. So, here an attempt has been made to explore Samshodhan (Virechan) as a possible line of treatment for Bandhya (Nashtartava). Material and method: Following is a case report of a female who was anxious to conceive after 4 years of active married life, along with H/O delayed menses. Her USG reports showed polycystic appearance of ovaries and anovulation was noticed in follicular study. During this case study evaluation of Shodhan therapy (Virechan) and Shaman therapy in infertility due to ovulatory dysfunction was done. Result: Before the treatment patient was a known case of infertility due to PCOD and after treatment she conceived and delivered a healthy female baby. Discussion: Line of treatment was to enhance potency of ovum and with the help of Virechankarma, regularize vitiated Vata Dosha, Shrotoshuddhi and Aartava janan. Conclusion: Ayurveda therapy can be used in patients of infertility due to PCOD for better outcome and no adverse drug effect was noticed.

SUN-050 Isolated Hyperprolactinemia Caused by Chest Binding in a Transgender Male

Background: Prolactin levels are routinely measured in patients evaluated for PCOS. Compared with the general population, PCOS is more common among transgender men, with prevalence estimates as high as 30 to 50%1,2. Nipple stimulation is a recognized cause of hyperprolactinemia, and many transgender men engage in chest binding, which involves compressing the breast tissue to produce a more masculine appearance. Clinical Case: A 22-year old natal female with gender dysphoria, who presented to our clinic for initiation of masculinizing hormone therapy, revealed a history of irregular menstrual cycles, hirsutism, and moderate acne. The patient was on a combination OCP to regulate menstrual cycles but no other medications or supplements. Laboratory evaluation revealed normal TSH, creatinine, 24-hour urine cortisol, testosterone, 17 hydroxyprogesterone, and DHEA-S. LH was 2.4 mIU/mL, FSH was 6.0 mIU/mL, and prolactin was elevated at 55.6 ng/mL (4.8-23.3 ng/mL). Polycystic ovaries were not present on pelvic ultrasound. Pituitary MRI was ordered for further evaluation of hyperprolactinemia and no pituitary adenoma or other structural abnormality was seen. The patient denied nipple discharge and tenderness but endorsed chest binding. In the absence of another explanation, nipple stimulation through chest binding was hypothesized to be the cause of hyperprolactinemia. After withholding chest binding for one week, the patient’s prolactin level normalized to 13.95 ng/dL. The patient was diagnosed with PCOS according to Rotterdam criteria after exclusion of alternative etiologies. It was presumed that five years of consistent OCP use had normalized androgen levels and suppressed the appearance of polycystic ovaries on ultrasound. The patient was initiated on testosterone cypionate for gender affirmation. Prolactin increased again to 29.33 ng/mL one year later after resumption of continuous chest binding. Conclusion: This is the second reported case of hyperprolactinemia induced through chest binding.3 Transgender men are at increased risk for irregular periods due to underlying PCOS and therefore more likely to undergo an evaluation that includes prolactin measurement. By recognizing chest binding as a cause of isolated hyperprolactinemia, physicians can minimize unnecessary testing and anxiety in patients who engage in this practice.1. Baba, T. et al. Hum Reprod. 2007;22;1011-16. 2. Becerra-Fernandez, A. et al. Endorinol Nutr. 2014;61; 351-8.3. Patel, S., & Abramowitz, J. (2019, April). Hyperprolactinemia in a Transgender Male. Poster session presented at the Annual Scientific & Clinical Congress of the AACE, LA, CA.

Metabolic evaluation and measurement of ovarian volume in polycystic ovary sydrome: a cross-sectional observational study

Amac: Polikistik over sendromu (PKOS), hirsutizm veya laboratuvar degerlendirmesinde hiperandrojenemi bulgulari, adet duzensizligi ve anovulasyona bagli infertiliteye yol acabilen ve ureme cagindaki kadinlari etkileyen onemli bir hastaliktir. Beraberinde yer alan insulin direnci ve adipozite artisi kardiyometabolik risk artisina da neden olabilmektedir. Biz calismamizda PKOS dusunulen hastalarin muayene ve laboratuar bulgulari ile overlerin abdominal ultrasonografi ile degerlendirme sonuclarini sunmayi planladik. Gerec ve Yontem: Calismaya endokrinoloji poliklinigine hirsutizm, adet duzensizligi gibi semptomlarla basvuran ve PKOS tanisi dusunulen 22 kadin hasta alindi. Hastalarin yasi, aile oykusu, PKOS fenotipleri, ilk adet yasi, siklus uzunlugu ve fizik muayene bulgulari kaydedildi. Hirsutizm icin Ferriman&Gallwey skoru kullanildi. Biyokimyasal ve hormonal tetkikleri yapilarak HOMA-IR yontemi ile insulin direnci hesaplandi. Abdominal ultrasonografi ile over volumleri olculdu. Verilerin istatistiksel analizi icin SPSS-16 kullanildi. Bulgular: Yas ortalamasi 21.41±0.88 yil olan hastalarin %40.9’u B, %31.8’i C ve %27.3’u A PKOS fenotipik ozelliklerini gosteriyordu. Siklus uzunlugu degerlendirildiginde hastalarin %31.8’inde siklus normal (27-34 gun) bulundu. Hastalarin hepsinde Ferriman&Gallwey skoru ≥7 idi. Hirsutizm orani yuksek olmasina ragmen androjen duzeyleri genellikle normal bulundu (testosteron %72 normal, DHEAS %82 normal). Hastalarin 8’i (% 36) obez ve 3’u (%13.6) fazla kilolu idi. Hastalarin %40.9’unun birinci derece yakininda tip 2 diyabetes mellitus mevcuttu. Tum hastalarin aclik glukoz ve 75 gr OGTT sonrasi glukoz duzeyleri normaldi. HOMA-IR yontemi ile hastalarin %41’inde insulin direnci saptandi. Hastalarin LDL kolesterol ve trigliserid duzeyleri ile AST, ALT ve GGT duzeyleri normal bulunurken, 15 (%68) hastada HDL kolesterol 50 mg/dl altindaydi. Abdominal ultrasonografide over volumleri ortalama sagda 11.6±1.12ml, solda 11.5±1.01ml olculdu ve 13 hastada (%59.1) polikistik over gorunumu mevcuttu. Sonuc: Hastalarimizin tamaminda hirsutizm saptanirken, buyuk kisminda siklus duzensizligi, ultrasonografide over volumu artisi ve PKO gorunumu ile PKOS tanisi desteklenmistir. Ancak PKOS hastalarimizda laboratuar olarak hiperandrojenizm bulgulari, insulin direnci ve obezite daha az oranda gorulmustur

Difficulties in Diagnosis of Polycystic Ovarian Syndrome (PCOS) in Teens

Currently, the criterion used to diagnose the condition of PCOS is the same in women of all reproductive age group, which should not be the case. As teenage symptoms like irregular periods, acne and appearance of polycystic ovaries are commonly present in all adolescent girls after puberty, it is difficult to make an accurate diagnosis. Hence it will be better to wait for few years rather than making a hasty diagnosis of the teenage girls. The presence of metabolic syndrome should be targeted in the screening of these girls, who are suspected to have PCOS.

Polycystic ovary syndrome: reviewing diagnosis and management of metabolic disturbances.

Polycystic ovary syndrome (PCOS) is a common condition in women at reproductive age associated with reproductive and metabolic dysfunction. Proposed diagnosed criteria for PCOS include two out of three features: androgen excess, menstrual irregularity, and polycystic ovary appearance on ultrasound (PCO), after other causes of hyperandrogenism and dysovulation are excluded. Based on these diagnostic criteria, the most common phenotypes are the "classic PCOS"--hyperandrogenism and oligomenorrhea, with or without PCO; the "ovulatory phenotype"--hyperandrogenism and PCO in ovulatory women; and the "non-hyperandrogenic phenotype", in which there is oligomenorrhea and PCO, without overt hyperandrogenism. The presence of obesity may exacerbate the metabolic and reproductive disorders associated with the syndrome. In addition, PCOS women present higher risk for type 2 diabetes and higher prevalence of cardiovascular risk factors that seems to be associated with the classic phenotype. The main interventions to minimize cardiovascular and metabolic risks in PCOS are lifestyle changes, pharmacological therapy, and bariatric surgery. Treatment with metformin has been shown to improve insulin sensitivity, lowering blood glucose and androgen levels. These effects are more potent when combined with lifestyle interventions. In conclusion, besides reproductive abnormalities, PCOS has been associated to metabolic comorbidities, most of them linked to obesity. Confounders, such as the lack of standard diagnostic criteria, heterogeneity of the clinical presentation, and presence of obesity, make management of PCOS difficult. Therefore, the approach to metabolic abnormalities should be tailored to the risks and treatment goals of each individual woman.

Clinical and Metabolic Features of Polycystic Ovary Syndrome among Chinese Adolescents

ObjectivesTo explore the clinical and metabolic features exhibited by Chinese adolescents with polycystic ovary syndrome (PCOS) and to determine the differences between nonobese and obese adolescent patients with PCOS. DesignClinical cross-sectional study. SettingDepartment of Gynecology and Reproductive Center. Participants25 obese and 66 nonobese adolescents with PCOS and 26 age-matched controls. InterventionsFasting venous blood samples and an oral glucose tolerance test using 75 g of glucose were obtained from PCOS patients and controls. Main Outcome MeasuresClinical features were summarized. Serum levels of FSH, LH, E2, TT, SHBG, fasting insulin, and fasting glucose were measured. ResultsThe prevalence of obesity in adolescents with PCOS was 27% (25/91). 99% of these patients presented with menstrual disorders, 84% presented with clinical and/or biochemical hyperandrogenism, and 90% exhibited an ultrasonographic appearance of polycystic ovaries. The prevalence of hirsutism and acanthosis nigricans were higher in the obese PCOS group than in the nonobese PCOS group (72% vs 41% and 44% vs 5%, respectively). A total of 5 of 20 obese (25%) and 5 of 36 nonobese patients (14%) demonstrated impaired glucose tolerance levels. ConclusionsChinese adolescents with PCOS manifest clinical and metabolic features similar to those of adult Chinese women with PCOS except for the increased prevalence of hyperandrogenism and insulin resistance. Adolescents with high risk factors, especially those with menstrual disorders and hyperandrogenism, may need careful clinical screening.

Histological evaluation of rat larynx in experimental polycystic ovary syndrome model

This study aimed at studying the histopathological effects of hyperandrogenemia and estrogen deficiency on larynx mucosa in experimentally designed polycystic ovary syndrome of female rats. Two groups of experimental polycystic ovary syndrome model were composed in healthy female rats by per oral letrozole administration of for 21 and 42 days. Also a control group which only took vehicle (saline) for 42 days was designed. Laryngeal mucosa and ovaries of all animals were examined histopathologically by light microscopy and the serum hormone levels were analyzed using a solid-phase, two-site chemiluminescent enzyme immunometric assay. Statistically significant edema, vascular engorgement, inflammation, cilia loss and differentiation of goblet cell distribution were observed when the control group and study groups were compared (p < 0.01). In serum hormonal analysis there was a significant increase in levels of androgens and decrease in levels of estrogens. In addition, polycystic appearance of ovaries in letrozole-administered groups and normal appearance of ovaries in control group have been proven histopathologically. Polycystic ovary syndrome which causes estrogen deficiency and hyperandrogenemia in fertile ages resulted in histopathological changes in laryngeal mucosa.

Analysis of factors predicting success of metformin and clomiphene treatment for women with infertility owing to PCOS-related ovulation dysfunction in a randomised controlled trial

Metformin has failed to gain wide acceptance as a first-line treatment option for women with anovulatory infertility related to polycystic ovary syndrome. This study aimed to ascertain factors that predict fertility success with treatment that included metformin compared to standard (non-metformin) treatment. Randomised trial data analysis by logistic regression of factors likely to have a differential influence on the likelihood of success of metformin versus non-metformin treatment amongst women with ovulation dysfunction related to polycystic ovary syndrome. metformin versus those receiving placebo and those with lower BMI who received metformin were more likely to become pregnant than their lower BMI counterparts who received placebo (P=0.039). The subpopulation of women with BMI≤32 kg/m(2) had no factors showing a significantly different impact on the chance of pregnancy for women treated with metformin versus those receiving clomiphene treatment or combination metformin/clomiphene treatment versus clomiphene treatment. There were no significantly different effects of free testosterone, fasting insulin, duration of infertility or ultrasound appearance of polycystic ovaries in any treatment groups. This study provides preliminary evidence that BMI may be an important prognostic factor in response to metformin for women with ovulation dysfunction related to polycystic ovary syndrome, suggesting that women with a lower BMI may respond better to metformin treatment versus placebo amongst women with BMI>32 kg/m(2) . Individual patient data meta-analysis of existing randomised trials would clarify this further and would assess whether other factors might predict better response to metformin versus standard treatments.

Polycystic ovary syndrome (PCOS)

1. The Rotterdam classification should be used to define PCOS in the event of: menstrual cycle anomalies; amenorrhoea, oligomenorrhoea or long cycles, clinical and/or biochemical hyperandrogenism and ultrasound appearance of polycystic ovaries.2. The presence of two of these three criteria is sufficient once all other diagnoses have been ruled out.3. Diagnosis of hirsutism should not be based on the Ferriman-Gallway score.4. The ultrasound definition of PCOS contains precise criteria that must be included in the report: presence of at least 12 follicles in each ovary measuring 2–9mm in diameter, and/or increase in ovary size>10ml.5. Screening for elevated plasma LH no longer necessary. Testing for GnRH serves no purpose.6. Routine screening for metabolic abnormalities should be carried out systematically based on weight, height and BMI, waist circumference, blood pressure and laboratory parameters: plasma glucose, triglycerides, HDL cholesterol.7. In the case of obesity (BMI>30 kg/m2), oral glucose tolerance testing (OGTT) is recommended where fasting serum glucose is normal.8. Clomiphene citrate (CC) remains the first-line therapy for ovulation induction. In patients with BMI>30, it should be preceded by improvement of metabolic status through appropriate lifestyle modifications.

CYP1A1 gene polymorphism and polycystic ovary syndrome

The aim of this study was to assess the rates of variant alleles of cytochrome P4501A1 ( CYP1A1) in patients with polycystic ovary syndrome (PCOS). It was designed as a case–control study in Hacettepe University, Faculty of Medicine, Department of Obstetrics and Gynecology and Genetics. Forty-eight patients with PCOS served as the study group. Ninety-six regularly cycling women with no clinical and biochemical evidence of hyperandrogenism and polycystic ovary appearance served as the controls. The CYP1A1 variant alleles of all patients were determined via polymerase chain reaction. The rate of the CYP1A1 isoleucine (Ile)/valine (Val) allele was significantly higher in patients with PCOS than in the controls (OR: 7.8, 95% CI: 3.45–17.52, P < 0.001). However, there was no statistically significant difference in the distribution of Val/Val genotype (OR: 4.0, 95% CI: 0.60–26.73). The rate of any Val genotype (Ile/Val or Val/Val) was significantly higher in patients with PCOS compared with the control group (OR: 7.4, 95% CI: 3.33–16.46, P < 0.001). In conclusion, the patients with PCOS had a 7.8-fold higher frequency of CYP1A1 Ile/Val genotype and a 7.4-fold higher frequency of CYP1A1 of any Val genotype (Ile/Val or Val/Val).

Estrogenic ovulatory dysfunction or functional female hyperandrogenism: an argument to discard the term polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders seen among reproductive-age women, with a prevalence of 4%-9% depending on the criteria used to define the syndrome. The diagnostic criteria for PCOS have been surprisingly controversial and confusing for patients, clinicians, and researchers. We believe that the confusion surrounding PCOS arises almost entirely because its name refers to a trait that is inconsistently present and irrelevant to both the etiology and the treatment of the disorder. We suggest that merely abandoning the term PCOS will cure much of what has ailed us for decades and allow us to focus on the etiology and treatment of the causes of what the experts in this field have come to recognize as functional female hyperandrogenism.