Disorder In Women Of Reproductive Age Research Articles

Association of metabolic and inflammatory markers with polycystic ovarian syndrome (PCOS): an update.

Polycystic ovarian syndrome (PCOS) is the most prevalent metabolic disorder in reproductive-age women. It is indeed a multifactorial condition evidenced by ovarian dysfunction, hyperandrogenaemia, infertility, hormonal imbalance and chronic anovulation. Experimental evidence infers that PCOS women are prone to cardiovascular problems and insulin resistance. To furnish the details about the association of inflammatory markers in PCOS. An extensive literature search on PubMed, science direct and google scholar has been performed for articles about PCOS and inflammation in PCOS. A comprehensive analysis using original articles, reviews, systemic and meta-analysis was conducted for better understanding the relationship between inflammatory cytokines and PCOS. The inflammatory markers perform a substantial part in managing the functions of the ovary. Any disturbances in their levels can lead to ovarian dysfunction. Inflammatory markers are associated with PCOS pathogenesis. The interplay between inflammatory cytokines in the PCOS ovary strongly implies that inflammation is one of the most potent risk factors of PCOS. Inflammatory markers have a significant role in regulating the ovary. This manuscript highlights the significance of metabolic and inflammatory markers with PCOS. Since PCOS is always considered as a metabolic disorder, researchers can also consider focusing on the relationship between the inflammatory markers in PCOS to establish a new treatment or management of the disease and to improve women's health.

Comparison of dietary micronutrient intake in PCOS patients with and without metabolic syndrome

BackgroundPolycystic ovarian syndrome (PCOS) is the most common endocrine disorder in reproductive-age women. It is one of the risk factors of metabolic syndrome (MetS). These two syndromes have an inflammatory etiologic foundation along with oxidative stress. The present study aimed to compare the dietary intake of antioxidant micronutrients in PCOS women with and without MetS.Materials and methodsOverall, 42 participants eligible for this nested case control study were selected by the convenience sampling method. The case group included 14 PCOS patients with MetS and the control group included 28 PCOS patients without MetS. The dietary intake assessment of selenium, chromium, zinc, carotenoids, vitamin D and vitamin E was carried out by a 147-item Food Frequency Questionnaire (FFQ). PCOS and MetS were diagnosed using the Rotterdam criteria and NCEP ATP III, respectively. Statistical analysis was performed using SPSS16 software, T-test and Mann Whitney. Significant P-value was considered 0.05.ResultsDietary intake of antioxidant micronutrients (selenium, zinc, chromium, carotenoids and vitamin E) was significantly lower in the PCOS women with MetS than in the control group (P < 0.05).ConclusionSince the PCOS patients without MetS had more intake of the aforementioned micronutrients than those with MetS, it is assumed that the dietary intake of these nutrients could probably have a protective effect on MetS.

Reproductive disorders in women with different pcos phenotypes

The article presents data on the study of reproductive disorders in women with PCOS, depending on the phenotype of the disease. Anamnesis was studied, clinical and hormonal studies were conducted in 133 patients with PCOS. The frequency of reproductive disorders and pregnancy outcomes were determined depending on the clinical form of the disease.

Long non-coding RNAs: novel players in the pathogenesis of polycystic ovary syndrome.

Long non-coding RNAs (lncRNAs) are a class of transcripts (>200 nucleotides) lacking protein-coding capacity. Based on the complex three-dimensional structure, lncRNAs are involved in many biological processes and can regulate the expression of target genes at chromatin modification, transcriptional and post-transcriptional levels. LncRNAs have been studied in multiple diseases but little is known about their role(s) in polycystic ovary syndrome (PCOS), the most common endocrinological disorder in reproductive-aged women around the world. In this review, we characterized and explored the potential mechanisms of lncRNAs in the pathogenesis of PCOS. We found that lncRNAs play a molecular role in PCOS mainly by functioning as the competitive endogenous RNA (ceRNA) and are significantly correlated with some clinical phenotypes. We summarized in detail regarding aberrant lncRNAs in different specimens of women with PCOS [i.e., granulosa cells (GCs), cumulus cells (CCs), follicular fluid (FF), peripheral blood] and various PCOS rodent models [i.e., dehydroepiandrosterone (DHEA) and letrozole induced models]. In clinical practice, detection of lncRNAs in serum might enable early diagnosis. Furthermore, new lncRNA-based classifications might be emerging as potent predictors of a particular phenotype in PCOS. Overall, we proposed new insights for the application of precision medicine approaches to the management of PCOS.

Lifestyle Intervention for Overweight/Obese Pregnant Women with Polycystic Ovarian Syndrome: Lessons and Challenges

Introduction and Objective: Polycystic ovary syndrome (PCOS) is the most common reproductive disorder in women of reproductive age, and overweight and obesity are highly prevalent in women with PCOS. This study aims to explore whether lifestyle intervention can improve gestational weight gain (GWG), glucolipid metabolism, and perinatal outcomes in overweight/obese pregnant women with PCOS. Methods: This study is a randomized controlled trial that included overweight and obese pregnant women with PCOS who met the inclusion criteria of 8–12 gestational weeks. They were randomly allocated to the intervention group and the control group. Women in the intervention group were given individualized counseling on diet and exercise from a trained dietitian and followed up regularly by a trained dietitian. Women in the control group received guidance on diet and exercise in the form of group education. Results: A total of 296 pregnant women were enrolled in the study, including 164 in the intervention group and 132 in the control group. GWG was 11.93 ± 5.67 kg in the intervention group and 11.86 ± 5.35 kg in the control group and did not differ between the 2 groups. According to the per-protocol analyses, women with good compliance had a lower weight gain (10.11 ± 5.56 vs. 12.70 ± 5.31, p = 0.0042). The incidence of gestational diabetes mellitus and other perinatal outcomes did not differ between the 2 groups. For the lipid profile, we did not find significant improvement in the intervention group. Conclusions: Our study showed that lifestyle intervention of diet and exercise did not affect GWG, glucolipid metabolism, and perinatal outcomes of overweight/obese pregnant women with PCOS. However, women with good compliance can benefit from the lifestyle intervention for GWG. We believe that future studies should focus on trial design and increasing compliance to improve the quality of the study.

Endocrine disrupting chemicals and reproductive disorders in women, men, and animal models.

This chapter covers the known effects of endocrine disrupting chemicals (EDCs) on reproductive disorders. The EDCs represented are highly studied, including plasticizers (bisphenols and phthalates), chemicals in personal care products (parabens), persistent environmental contaminants (polychlorinated biphenyls), and chemicals in pesticides or herbicides. Both female and male reproductive disorders are reviewed in the chapter. Female disorders include infertility/subfertility, irregular reproductive cycles, early menopause, premature ovarian insufficiency, polycystic ovarian syndrome, endometriosis, and uterine fibroids. Male disorders include infertility/subfertility, cryptorchidism, and hypospadias. Findings from both human and animal studies are represented.

In utero exposure to maternal stressful life events and risk of polycystic ovary syndrome in the offspring: The Raine Study

BackgroundPCOS is the most common endocrine disorder in reproductive age women. The origins of PCOS are unknown but experimental and limited human evidence suggests that greater prenatal exposure to androgens may predispose to PCOS. Experimental evidence suggests that maternal stressors may affect reproductive function in the offspring via changes in prenatal androgen exposure. In this present study, we aim to investigate whether maternal stressful life events during pregnancy are associated with polycystic ovary morphology (PCOM) or polycystic ovary syndrome (PCOS) in adolescent offspring. MethodIn a large population-based pregnancy cohort study (The Raine Study) continuously followed from prenatal life through to adolescence we examined the association between maternal stressful life events during pregnancy in both early and late gestation, and subsequent circulating concentrations of ovarian and adrenal androgens, PCOM and PCOS in the normal menstrual cycle of offspring age 14–16 years. Maternal stressful life events were prospectively recorded during pregnancy at 18 and 34 weeks using a 10-point questionnaire. Female offspring (n = 223) completed a questionnaire about their menstrual cycles, underwent a clinical examination for hirsutism (Ferriman-Gallwey score) and transabdominal pelvic ultrasound examination to determine ovarian morphology according to standardized criteria for classification of PCOM. Plasma samples were obtained at day 2–6 of the normal menstrual cycle for measurement of androgens. PCOM was defined according to the international consensus definition, 2003 and the evidence-based guideline for the assessment and management of PCOS, 2018. PCOS was diagnosed according to Rotterdam criteria and National Institute of Health (NIH) criteria. Multivariate linear and logistic regression analyses were used to examine the associations between maternal stressful life event exposure and ovarian morphology (PCOM), circulating ovarian and adrenal androgens (clinical and biochemical hyperandrogenism (hirsutism)) and presence of PCOS. ResultsOf 223 recruited adolescent girls, 78 (35.9%) and 68 (31.3%) had PCOM by the 2003 and 2018 criteria respectively, while 66 (29.6%) and 37 (16.6%) had PCOS, using Rotterdam and NIH criteria, respectively. Most girls (141/223, 63.2%) were exposed to at least one stressful life event in early gestation and around half (121/223, 54.3%) were exposed to at least one stressful life event in late gestation. Maternal stressful life events in early gestation were associated with a statistically significant lower prevalence of PCOM when applying the 2003 criteria [adjusted odds ratio [aOR] and 95% confidence intervals (CI): 0.74 (95% CI: 0.55; 0.99)], and a similar association was detected when applying the 2018 PCOM criteria (aOR, 0.69, 95% CI: 0.50; 0.95)]. Maternal stressful life events in early gestation were also associated with lower circulating concentrations of testosterone (β = −0.05, 95% CI: −0.09; −0.004) and androstenedione (β = −0.05, 95% CI: −0.10; −0.002) in the offspring. No similar effects for PCOM or circulating androgens were detected in late gestation. No statistically significant associations between maternal stressful life events in early or late gestation with PCOS (neither Rotterdam nor NIH criteria) in adolescence were detected. The prospective collection of maternal stressful life events during both early and late gestation and direct measurement of PCOM, PCOS and circulating androgens in adolescence and key co-variates implies minimal possibility of recall, information bias and selection bias. ConclusionMaternal exposure to stressful life events in early gestation is associated with significantly reduced circulating ovarian and adrenal androgen concentrations in adolescence (testosterone and androstenedione), and an indication of fewer cases of polycystic ovary morphology (PCOM) defined by the 2003 international consensus definition and by the 2018 international evidence-based guideline, but has no effect on polycystic ovary syndrome (PCOS), diagnosed using either Rotterdam or NIH criteria.

The AMPK-mTOR axis requires increased MALAT1 expression for promoting granulosa cell proliferation in endometriosis.

Endometriosis is a common reproductive disorder in women, with a global prevalence of 10-15%. Long noncoding RNAs (lncRNAs) are critical to gene transcription, cell cycle modulation and immune response. The lncRNA metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) reportedly mediates autophagy of endometrial stromal cells in endometriosis. The present study aimed to evaluate the role and mechanism of MALAT1 in granulosa cells (GCs) in endometriosis. Consequently, MALAT1 expression was upregulated in GCs obtained from patients with endometriosis and in the steroidogenic human granulosa-like tumor cell line KGN. However, MALAT1 knockdown consequently decreased the proliferation and viability of these cells, as determined by MTT and 5-ethynyl-2'-deoxyuridine staining assays. Both Annexin V-fluorescein isothiocyanate/propidium iodide flow cytometry and western blotting performed to detect proapoptotic factors indicated that MALAT1 depletion might promote KGN cell apoptosis. Furthermore, MALAT1 knockdown increased GC autophagy, as evidenced by microtubule-associated protein 1A/1B-light chain 3 (LC3) cleavage upregulation and p62 degradation. In addition, although 5'-AMP-activated protein kinase (AMPK) mRNA expression and protein levels decreased in GCs obtained from patients with endometriosis and KGN cells, MALAT1 knockdown restored AMPK levels. However, addition of BML-275 (MALAT1 inhibitor) to MALAT1-knockdown KGN cells recovered their viability and proliferative capacity and simultaneously reduced their apoptotic and autophagic capacity. Therefore, MALAT1 may regulate GC proliferation via AMPK-mTOR-mediated cell apoptosis and autophagy.

Novel role of CXCL14 in modulating STAR expression in luteinized granulosa cells: implication for progesterone synthesis in PCOS patients

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in reproductive-age women. Reduced progesterone levels are associated with luteal phase deficiency in women with PCOS. The levels of C-X-C motif chemokine ligand-14 (CXCL14) were previously reported to be decreased in human-luteinized granulosa (hGL) cells derived from PCOS patients. However, the function of CXCL14 in hGL cells and whether CXCL14 affects the synthesis of progesterone in hGL cells remain unclear. In the present study, the levels of CXCL14 were reduced in follicular fluid and hGL cells in PCOS patients, accompanied by decreased progesterone levels in follicular fluid and decreased steroidogenic acute regulatory (STAR) expression in hGL cells. CXCL14 administration partially reversed the low progesterone production and STAR expression in hGL cells obtained from PCOS patients. In primary hGL cells, CXCL14 upregulated STAR expression and progesterone production. CXCL14 activated the phosphorylation of cyclic adenosine monophosphate response element-binding protein (CREB) and CREB inhibitor attenuated the modulation of StAR expression by CXCL14. P38 and Jun N-terminal kinase (JNK) pathways were also activated by CXCL14 and inhibition of p38 and JNK attenuated the increase of phosphorylation of CREB, STAR expression and progesterone production caused by CXCL14. Our findings revealed the novel role of CXCL14 in upregulation of STAR expression and progesterone synthesis through CREB phosphorylation via activation of p38 and JNK pathways in hGL cells. This is likely contributing to the dysfunction in steroidogenesis in granulosa cells from PCOS patients.

A Review of the Impact of Bariatric Surgery in Women With Polycystic Ovary Syndrome.

Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in reproductive-age women that causes infertility. Obesity and insulin resistance are closely tied to the pathophysiology of PCOS. Current first-line treatments include lifestyle modifications, hormone modulators, and laparoscopic ovarian drilling, but little attention has been given to bariatric surgery as a viable option. A detailed review of the literature regarding the outcomes of obese women with PCOS after bariatric surgery is necessary. All studies were found in the PubMed database, limited to females and humans, and selected due to relevancy and quantitative data. Bariatric surgery promotes significant weight loss within one year, which is associated with amelioration of insulin resistance, hyperandrogenism, menstrual irregularity, and ovulatory dysfunction. Surgery successfully mediates the regression of PCOS and promotes successful pregnancy. Thus, we recommend the consideration of bariatric surgery as part of the main treatment considerations in obese patients with PCOS. However, more focused and comprehensive research with better study designs are still needed in the future to investigate PCOS and bariatric surgery.

A NOVEL DIAGNOSTIC APPROACH FOR POLYCYSTIC OVARY SYNDROME DIAGNOSIS USING GONADOTROPIN RELEASING HORMONE RECEPTOR AUTOANTIBODY ACTIVITY AND ANTIMULLERIAN HORMONE

Despite being the most common endocrinological disorder of reproductive aged women, polycystic ovary syndrome (PCOS) remains a complex disease of unknown etiology. Patients spend an average of two years of clinical evaluation with at least three health professionals before diagnosis. As PCOS remains a diagnosis of exclusion, there is room for improvement in diagnostic classification. Although the use of Antimullerian hormone (AMH) as a diagnostic test has shown promise, it has limitations. Our laboratory has identifiedvariation in levels of activating autoantibody (AAb) to the second extracellular loop of the gonadotropin-releasing hormone receptor (GnRHR) associated with PCOS in infertile patients.

Effects of vitamin D supplementation on serum lipid profile in women with polycystic ovary syndrome: A protocol for a systematic review and meta-analysis.

Background:Polycystic ovary syndrome (PCOS) is the commonest endocrine disorder in reproductive-aged women. In addition to the reproductive consequences, PCOS is also characterized by a metabolic disorder, which may play a part in the etiology of anovulation and has important implications for long-term health as well. Vitamin D deficiency is prevalent in PCOS and there is a close relationship between metabolic dysfunction and vitamin D status in women with PCOS. The purpose of this systematic analysis is to evaluate the effect of vitamin D supplementation on serum lipid profiles in patients with PCOS.Methods:We will search five databases for relative studies: Medline, the Cochrane Library, EMBASE, Web of Science, and ClinicalTrials.gov and identified all reports of randomized controlled trials published prior to July 2020. Two authors will independently scan the articles searched, extract the data from articles included, and assess the risk of bias by Cochrane tool of risk of bias. Disagreements will be resolved by discussion among authors. All analysis will be performed based on the Cochrane Handbook for Systematic Reviews of Interventions. Fixed-effects model or random-effects model was used to calculate pooled estimates of weighted mean difference (WMD) with 95% confidence intervals.Results:This review will be to assess the effect of vitamin D supplementation on serum lipid profiles in patients with PCOS. The results of the study will be published in a scientific journal after peer-review.Conclusions:These findings will provide guidance to clinicians and patients on the use of vitamin D for PCOS with dyslipidemia.Ethics and dissemination:This study is a protocol for a systematic review of vitamin D as a treatment of dyslipidemia in PCOS patients.Systematic review registration:INPLASY202050007.

Anomalous expression of miR-103 in polycystic ovary syndrome influenced by hormonal, and metabolic variables

BackgroundPolycystic ovary syndrome (PCOS), a common endocrine disorder in reproductive-aged women, is correlated with obesity and insulin resistance (IR), androgens excess, chronic anovulation, and infertility. MicroRNAs (miRNAs) are small, single-stranded, noncoding RNA molecules that participate in inflammation, reproduction and metabolism, may contribute to PCOS. Current study aiming to manifest the correlation of body mass index (BMI) and testosterone (T) with miR-103 expression before and after fat loss. Methods46 controls (N = 23 with BMI < 24 kg/m2, N = 23 with BMI ≥ 28 kg/m2) and 46 patients with PCOS (N = 23 with BMI < 24 kg/m2, N = 23 with BMI ≥ 28 kg/m2) aged between 20 and 30 were recruited. Waist-to-hip (WHR) and Body fat% (BF%) was measured and calculated. Serum hormones, serum lipid, metabolism parameters, and serum miR-103 were measured. All the assessments were measured before and after fat loss in a three-month intervention period. ResultsmiR-103 was correlated with BMI rather than testosterone (T), and there was a significant difference between the non-obese and obese groups in miR-103 expression. Compared to before fat loss, miR-103 expression showed a slight downward trend. ConclusionsSerum miR-103 differentially expressed between controls and PCOS subjects, miR-103 was positively correlated with BMI. There was significant difference between the non-obese and obese groups in miR-103 expression.

SUN-LB50 Increased In Vivo Pulsatile LH Secretion and Hypothalamic Kisspeptin, NKB, and Dynorphin RNA Levels in a PCOS-Like Mouse Model

Polycystic ovary syndrome (PCOS) is a reproductive disorder in women characterized by hyperandrogenemia, anovulation, cystic ovaries, and LH hyper-pulsatility, but the mechanisms causing the pathophysiology remain incompletely understood. We recently reported a novel mouse model that recapitulates the majority of PCOS phenotypes in adulthood. Females given constant, long-term letrozole to reduce aromatase activity demonstrate PCOS-like phenotypes, including polycystic ovaries, anovulation, elevated circulating testosterone, and increased LH. In vivo LH pulsatile secretion, which is greatly elevated in PCOS women, was not previously studied, nor were possible changes in reproductive neurons known to control GnRH/LH secretion. Here, we used recent technical advances in the field to examine in vivo LH pulse dynamics of freely-moving LET female mice versus control and ovariectomized (OVX) mice. We also studied whether hypothalamic gene expression of several important reproductive regulators, kisspeptin, neurokinin B (NKB), and dynorphin, is altered in LET females. Compared to controls, LET females exhibited very rapid, elevated in vivo LH pulsatility, with increased pulse frequency, amplitude, and basal levels, similar to PCOS women. LET mice also had markedly elevated Kiss1, Tac2, and Pdyn expression along with increased Kiss1 neuron activation in the hypothalamic arcuate nucleus. Although elevated, most hyperactive LH pulse parameters and increased arcuate mRNA measures of LET mice were significantly lower than in OVX littermates. Our findings demonstrate that LET mice, like PCOS women, have markedly elevated LH pulsatility which likely drives increased ovarian androgen secretion. Increased arcuate kisspeptin and NKB levels may be fundamental contributors to the enhanced stimulation of LH pulse secretion in this PCOS-like condition, and perhaps, in some PCOS women.

MON-322 The Characteristic of Reproductive Disorders in Women with ACTH-Dependent Cushing Syndrome in the Republic of Uzbekistan (RUz) and Republic of Karakalpakstan (RKK)

The aim- to study the characteristic of the reproductive function in patients with ACTH-dependent Cushing Syndrome in (CS) in all regions of the RUz and RKK. Material and methods. Under our supervision in the all regions of RUz and Tashkent-city there are 120 women of fertile age with ACTH-dependent Cushing Syndrome were observed in the framework of project. Middle age of patients was 27,6 ± 3, 4 years.The complex of researches, including clinical, biochemical hormonal (ACTH, LH, FSH, cortizol, prolactin), ultrasound investigations, pituitary and adrenals CT/MRI was executed all patients. Results. The patients were divided into 2 groups: 1 group - patients with conservative treatment - 47 cases (39,1%), 2 group -patients with pituitary surgery - 65 cases.(54,1%), 3 group - combined therapy - 8 patients (6,6%).The reproductive disorders had 63 women from 120 (52,5%): amenorrhoea -35%), oligomenorrhoea (30%), polimenorrhoea (7,5%). It was found that with ACTH - dependent Cushing’s syndrome, primary infertility was 17,6%, secondary 23.5%,We found hyperandrogenemiya and hypercortizolemiya in patients of all groups before treatment. Estradiol levels were significantly inversely correlated with cortisol levels. One year after surgery we established normal range of LH, FSH, ACTH, cortizol, prolactin in all women of 2 group, but in 1 and 3 group we didn’t achieve compensation yet.After 1 year only 1 (2,1)% women from 1 group can pregnant. After 1 year 30 women from 65 patients of second group after pituitary surgery (46,1%) achieved pregnancy without stimulation therapy. There are 2 (25%) women of 3 group achieved pregnancy.The restoration of reproductive function in women with CS was observed in 3,5% of cases in patients treated with medical therapy, 33,3% in patients with adrenalectomy and combination therapy, and 50% after transsphenoidal adenomectomy of pituitary tumor. Conclusions. The fertility function in women with ACTH-dependent CS can improve after pituitary surgery without stimulation therapy. In 46,1% of cases, in patients with combined therapy -in 25%and in women after conservative therapy - in 2,1%.

Assessment of Anti-Mullerian Hormone and Anti Ovarian Antibody in the Sera of Patients with Polycystic Ovarian Syndrome in AL-Najaf Al-Ashraf Province

Polycystic ovarian syndrome(PCOS)is the most common endocrinopathy,that affects 5 to 20% of women in age of(12-45year)and cause a widespread of reproductive disorder in women and it is a major cause of hirsutism,acne,hormonal disturbance and infertility. Women with PCOS may associated with health conditions obesity,amenorrhea, oligomenorrhea,hyperandrogenemia and insulin resistance.The PCOS patients are with increased risk for type 2diabetes mellitus,diabetic complications,dyslipidemia and cardiovascular disease .Objective: Aim of the study to investigate the pathogenicity,disease severity and early diagnosis roles anti-Mullerian hormone and anti-ovarian antibody in ladies with PCOS.Conclusion: Polycystic ovarian syndrome was related to the increase level of AMH in different age of PCOS patients,which comprised 55.0% in PCOS patients that cause defect in ovulation and resulting fertility problem,while no relationship between anti-ovarian antibody and patients with PCOS.

Knowledge of PCOS in physicians-in-training: identifying gaps and educational opportunities

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in reproductive-aged women. A recent study found that many obstetrics and gynecology (ObGyn) practicing physicians are unaware of the Rotterdam criteria recommended for diagnosis. Our objective was to identify gaps in trainee knowledge of PCOS diagnostic criteria and management. An online survey was sent out to US ObGyn physicians-in-training in 2018. The primary outcomes were identification of at least one component of each Rotterdam criteria (Rot-3): (1) oligomenorrhea/amenorrhea, (2) clinical or biochemical hyperandrogenism, and (3) ovarian volume or antral follicle count, and identification of all five components (Rot-5). Secondary outcomes were identification of comorbidities and management of PCOS. Multivariable logistic regression was used controlling for gender, seniority (PGY) status, program type, completion of an REI rotation, and number of PCOS patients seen. 85.4% of 347 trainees completing the survey reported using Rotterdam criteria to diagnose PCOS. However, only 55% identified Rot-3 and less than 10% identified Rot-5. Seniority (PGY4 OR 2.2; 95% CI: 1.2–4.1; p = .01) and completion of REI rotation (OR 1.8 95% CI: 1.2, 1.8; p = .006) were associated with identifying Rot-3. Similar findings were noted with identifying Rot-5. Our study identified significant gaps in knowledge regarding PCOS, suggesting an urgent need for improving strategies for trainee education to increase patient satisfaction and provide comprehensive care.

Effects of metformin alone and in combination with spironolactone on hyperandrogenism in polycystic ovarian syndrome

Objective To evaluate the efficacy of combined therapy with metformin and low-dose spironolactone as compared with metformin alone on the clinical and endocrine-metabolic alterations of patients with polycystic ovarian syndrome (PCOS). Background PCOS is the most common endocrinological disorder in reproductive-age women. Thus, at least theoretically, metformin plus spironolactone therapy may be an effective and safe combination for PCOS. Patients and methods A prospective randomized comparative study was carried out on 48 patients with the PCOS in Obstetrics and Gynecology Department, Menoufia University Hospital, and Al-Shohadaa Hospital, Egypt, from the period of May 2016 till January 2018. Detailed history, laboratory investigations, obstetric examination, and follow-up were done. Results Mean hirsutism score and BMI (kg/m2) were 10.8 ± 3.9 and 26.8 ± 2.2, respectively, before treatment, which decreased significantly to 7.6 ± 2.4 and 22.10 ± 1.92, respectively, after 6 months of treatment. Luteinizing hormone, follicle-stimulating hormone, free testosterone, dehydroepiandrosterone sulfate, fasting glucose, fasting insulin, and homeostasis model assessment of insulin resistance were decreased significantly after 6 months of treatment as compared with before treatment among women who received metformin + hypocaloric diet and received metformin + spironolactone + hypocaloric diet before treatment. Free testosterone was decreased in group B (58.2 ± 9.1) more than group A (73.6 ± 12. 9). Conclusion The results confirm the beneficial effects of metformin in patients with PCOS. It also proves that the addition of low-dose spironolactone induces a more marked reduction of clinical and biochemical hyperandrogenism in patients with PCOS present with hyperandrogenic conditions.

Male Offspring of Hyperandrogenemic Female (HAF) Rats Develop Hypertension Beginning at 16 Weeks of Age

Polycystic ovary syndrome (PCOS) is the most common reproductive disorder in women. It is characterized by hyperandrogenemia, oligo/anovulation, and polycystic ovaries. Children born to women with PCOS often have intrauterine growth restriction (IUGR) or are small for gestational age. This present study was conducted to test the hypothesis that maternal hyperandrogenemia will affect blood pressure (mean arterial pressure (MAP)) in male offspring.Hyperandrogenemia was produced by implantation of 5α‐dihydrotestosterone pellets (DHT; 7.5 mg/90 days, sc) in SD female rats at 4 wks of age (hyperandrogenemic females (HAF)). Control females received placebo pellets. Females were mated with SD males at 10–12 wks of age. Approximately 60% of HAF rats became pregnant, compared to 100% of controls. At 48 hrs, offspring were weighed and measured, and litters were culled to 4 males and 4 females. DHT and control dams were allowed to nurse offspring for 3 wks. Offspring (F1) were left untreated and studied at 4–6 mos (adult) and ≥16 mos (aging).Despite similar litter sizes (n=10–12±2 for HAF and control dams; p=NS), male offspring from HAF dams (F1HAF) weighed significantly less than offspring from control dams (F1contr.): (male F1HAF vs. F1contr: (PN 12 hrs :6.4±0.1 vs. 7.0±0.2g; n=13–15; p&lt;0.05; PN 48 hrs: 7.4±0.3 vs. 8.1±0.1 g; n=13–15; p&lt;0.05). Male F1HAF were also significantly shorter in length (6.2±0.6 vs. 6.8±0.2 cm; n= 15–18, p&lt;0.05) and had smaller head circumference (4.4±0.1 vs. 4.6±0.1 cm; n=12–15) at 48hrs than male F1contr. At 16 wks, fat mass (normalized to BW) was significantly higher in male F1HAF than F1contr (0.07±0.01 vs. 0.06±0.01; p&lt;0.05). MAP (radiotelemetry) was significantly elevated in adult male F1HAF compared to F1contr (121± 3 vs. 113 ± 3 mmHg; n=4–5/grp, p&lt;0.05). DHT levels were significantly lower in male F1HAF than F1contr (57.4±34.9 vs 136.4±55.7 ng/ml; n=7–11/grp; p&lt;0.01). With aging, male F1HAF had higher levels of proinflammatory cytokines than did male F1contr (by Bioplex; n=3–7/grp; all p&lt;0.05): IL‐17a (149.5±39 vs. 32.1±5 pg/ml; p&lt;0.05), IL‐1α (426±159 vs. 138±33 pg/ml), IL‐1β (122.6±36 vs. 36±6 pg/ml), and PAI‐1 (1690±386 vs. 590±63 pg/ml).Male offspring of HAF dams are born with IUGR compared to offspring of control females. As adults, male offspring of HAF dams have lower levels of androgens, increased fat mass, and develop hypertension. With aging, HAF male offspring have higher levels of inflammation than control offspring. These data are important since physicians rarely ask their middle‐aged, hypertensive, overweight male patients with androgen deficiencies if their mothers had PCOS during their pregnancy. With this knowledge, physicians may not only be able to predict which men will suffer from these complications, but may also provide the best therapeutic options for these men.Support or Funding InformationStudies were supported by NIH R01HL135089, R01HL66072, P01HL05971, P20GM121334

Herbal concoctions used in the management of some women-related health disorders in Ibadan, Southwestern Nigeria

Objectives: The health conditions of women are broad, and range from pregnancy, gynaecological conditions to overall health/wellness. Ethnomedicinal investigation on plants used in the management of women-related health disorders was conducted in Bode herbal market, Ibadan, Southwestern Nigeria to further emphasize the role of herbal medicine in reproductive health. Methodology and Results: Ten herb sellers (all females; age range, 35 – 57; mean, 45.80; SD, 7.41) were interviewed in the local language (Yoruba) and their responses recorded. Recipes used in the management of arthritis, fibroid (uterine and menopausal), and obesity/overweight were documented. Thirty (38) plant species belonging to 24 plant families are profiled. The family Fabaceae had the highest number of species (n=7) while stem bark was the most frequently used (37%) plant part. Methods of preparations were mainly decoction and steeping of botanicals in alcohol. Administration includes taking one tot/half-a-glass cup, 2 (morning and night) to 3 times daily. Conclusion and Application of Findings: This study documents and further emphasizes the role of medicinal plants in female reproductive health. Although some of the plants reported here have been cited for the management of diseases such as skin infections and malaria/yellow fever, published reports on their use for women-related health disorders are limited. This research finds application in reproductive disorders in women and alternative approach to health care systems. These plants are presented for experimentation and scientific validation. Efforts should be made to conserve these plants, especially those that show promising bioactivity. Key words: Women, Arthritis, Fibroid, Obesity, Medicinal plant, Nigeria