Menstrual Cycle Length Research Articles

The role of serum progesterone induced blocking factor on unexplained infertility

ObjectiveThe aim of this study was to determine whether the progesterone-induced blocking factor (PIBF) level in women with unexplained infertility differed from that in fertile women. Study designVolunteers between 18 and 35 years old were included in this cross-sectional study and were divided into two groups—the unexplained-infertility group and the control group. Demographic data on all the women were collected using a detailed questionnaire. The infertile participants and their male partners received complete infertility examinations according to the protocol. Blood samples were taken from all participants after the examinations during regular clinic visits. Serum PIBF levels were measured using an enzyme-linked immunosorbent assay. ResultsOf the 46 healthy participants in the study, 22 had unexplained infertility. Age, body mass index, ethnicity, education level, age at first menarche, and length of menstrual cycles, serum follicle stimulating hormone, luteinizing hormone, estradiol, prolactin, thyroid stimulating hormone, and progesterone were similar between two groups. The mean right antral follicle count (AFC) was 6.6 ± 1.8 in the unexplained-infertility group and 6.5 ± 2.0 in the control group. The mean left AFC was 6.6 ± 2.0 in the unexplained-infertility group and 6.9 ± 1.5 in control group. The mean serum PIBF level was 6.92 ± 3.41 ng/mL in the unexplained-infertility group and 12.10 ± 10.47 ng/mL in the control group, which was a significant difference (p = 0.02). ConclusionThe present study showed that serum PIBF levels were significantly lower in unexplained-infertility group than in the fertile control group.

Menstrual Pattern, Reproductive Hormones, and Transabdominal 3D Ultrasound in 317 Adolescent Girls.

The knowledge of normal variation of reproductive hormones, internal genitalia imaging, and the prevalence of gynecological disorders in adolescent girls is limited. The study aimed to describe reproductive parameters in postmenarchal girls from the general population including the frequency of oligomenorrhea, polycystic ovary syndrome, and use of hormonal contraception. The Copenhagen Mother-Child Cohort is a population-based longitudinal birth cohort of 1210 girls born between 1997 and 2002. University hospital. A total of 317 girls were included, with a median age of 16.1 years and time since menarche of 2.9 years. Tanner stage, height, weight, age at menarche, menstrual cycle length and regularity, ovarian/uterine volume, and number of follicles were recorded. Serum concentrations of FSH, LH, anti-Müllerian hormone (AMH), inhibin B, estradiol, testosterone, SHBG, androstenedione, dehydroepiandrosterone sulfate, 17-OH-progesterone, and IGF-1 were measured. Twenty girls (6.3%) had oligomenorrhea and differed significantly in serum androgens and AMH, age at and time since menarche from girls with regular cycles. Twenty-seven girls were classified with PCOS (8.5%) and had significantly higher 17-OH-progesterone, estradiol, AMH, LH, and age at menarche than the reference group. Girls on oral contraception had significantly higher serum SHBG concentrations and lower serum concentrations of all hormones except AMH and IGF-1. Ovarian follicles 2 to 29.9 mm correlated positively with serum AMH (P < 0.0001). Most 16-year-old girls had regular menstrual cycles, normal reproductive hormones, and uterine and ovarian ultrasound. Serum AMH reflected ovarian follicle count and may be a useful biomarker of ovarian reserve.

Understanding menstrual characteristics from the perspective of reproductive energetics: a study on the adolescent Oraon tribal populations

The energetic costs of ovarian functions rely on the oxidizable fuels synthesized from carbohydrate, protein and fat that contribute to body’s fat storage. Energy deficient diet in association with low body fat may disrupt normal ovulatory function and lead to several menstrual irregularities. We examined the association of nutritional status with menstrual characteristics among a group of adolescent Oraon tribal population of West Bengal, India. We selected 301 adolescent girls, aged 10-19 years. Information on socio-demographic status, menstrual characteristics and assessment of the dietary intake and nutritional status were collected following standard protocol. ‘Healthy weight’ participants more likely reported irregularity in periods and skipping of menstrual cycle and shorter cycle length. Multivariate analysis revealed PBF has inverse association with PMS, duration of discharge and skipping of cycle (p&lt;0.05); carbohydrate intake has direct association with duration of menstrual discharge (p&lt;0.05); increased dietary fat intake has direct association with skipping of cycle, but not with BMI (p&lt;0.05); increase in MUAC has direct association with dysmenorrhoea (p&lt;0.05). Conclusion: Our study indicates energy deficiency does alter the menstrual characteristics of the Oraon adolescent girls.

Possible role of n-hexane as an endocrine disruptor in occupationally exposed women at reproductive age

Human exposure to n-hexane has been associated with subfertility and, experimentally, with a decrease in follicular development. In order to assess occupational exposure to n-hexane on ovarian function and gonadotropic hormones, we studied Mexican women labouring in a leather shoe factory (n = 34). Individual environmental levels for seven solvents, n-hexane included, were measured; also, urinary 2,5-hexanedione (2,5-HD) was determined. For ovarian function and hormonal status, FSH, LH, oestradiol and anti-Müllerian hormone (AMH) levels were determined. We performed all determinations also in a reference group, administrative workers with no exposure to solvents (n = 32). Results: N-hexane and urinary 2,5-HD levels were higher in exposed group (p < 0.001). More cases of oligomenorrhea as well as longer time for getting pregnant were observed in exposed women compared with controls; a positive association was found between menstrual cycle length and “time for getting pregnant” (p = 0.010); significant associations between FSH serum levels and 2,5-HD urinary levels (post-shift sample) were observed in non-smokers participants presenting oligomenorrhea from exposed group. Also, we found a trend for lower oestradiol levels in exposed participants with current smoking habit (p = 0.059). Conclusions: 2,5-HD urinary levels are associated with decreased gonadotropins levels; hence, n-hexane should be considered an endocrine disruptor in reproductive-age women.

Weekly Osteopathic Manipulative Treatment to Improve Measures of Sympathetic Tone in Women With Polycystic Ovary Syndrome: A Randomized, Controlled Pilot Study.

Polycystic ovary syndrome (PCOS), a common hormone disorder affecting reproductive and metabolic health of reproductive-age women, was shown in a previous study from these authors to be associated with increased sympathetic tone. Increased sympathetic tone contributes to long-term health risks for cardiovascular disease and promotes PCOS pathogenesis. To determine whether weekly osteopathic manipulative treatment (OMT) improves physiologic measures of sympathetic tone in women with PCOS. In the second phase of a larger study from this author group, 25 women with PCOS, aged 22 to 43 years, living in Erie, Pennsylvania, were recruited to participate in a randomized, controlled evaluation of OMT intervention. Participants were randomly assigned to either an OMT intervention or control group. The OMT group received weekly manipulation of Chapman points and rib-raising for viscerosomatic reflexes associated with the ovaries, adrenal glands, and heart for 12 consecutive weeks. Physiologic measures of sympathetic tone were collected, along with metabolic, endocrine, and reproductive measurements, both before the 3-month intervention and within 1 week of completing the intervention. Measurements included heart rate and blood pressure at rest and after 15 minutes of aerobic exercise, heart rate recovery after exercise, resting heart rate variability, serum androgen levels, body mass index, fasting blood glucose and insulin levels, and menstrual cycle length. Nineteen women completed the study. Comparing pre- and postintervention parameters, women with PCOS in the OMT intervention group experienced an improvement in postexercise systolic blood pressure (135.8 vs 129.1 mm Hg) and a trend toward heart rate recovery (23.2 vs 29.4 seconds). No significant improvements were found in the control group or in any other physiologic parameters measured. No significant improvements were found in the endocrine, metabolic, or reproductive parameters measured, although free testosterone was slightly lower after 3 months of weekly OMT (5.69 vs 4.64 pg/mL). Improvements in sympathetic tone after OMT suggest that weekly manipulation of Chapman points and viscerosomatic reflexes can be a useful adjunctive therapeutic option for women with PCOS. (ClinicalTrials.gov No. NCT03383484).

Nausea and Vomiting of Pregnancy and HG Risk Genes Associated With Blood Levels, Sleep, Stomach Pain, and Other Traits [23N

INTRODUCTION: Our genome-wide association study (GWAS) and replication study of nausea and vomiting of pregnancy (NVP) and Hyperemesis Gravidarum (HG) implicates the placenta and appetite hormone gene GDF15, its receptor GFRAL, PGR, and IGFBP7. The purpose of this study was to determine whether these genes and summary statistics overlap with other traits. METHODS: The GWAS catalog was searched for risk genes. The database and web interface platform, LD Hub, was used for genetic correlation analysis of summary statistics. RESULTS: Among 4220 GWASes, the HG risk locus GDF15 was associated with GDF15 protein levels, periodontitis, and lupus. GFRAL was associated with glomerular filtration rate, blood urea nitrogen levels, insomnia, body mass index, periodontal inflammation, blood protein levels, osteoporosis, and HIV-1 infection. IGFBP7 was associated with IGFBP7 protein levels, IgG glycosylation, diastolic blood pressure, brain volume in infants, heel bone mineral density, alcohol consumption, itch intensity from mosquitoes, and cotinine glucuronidation. PGR was associated with diastolic blood pressure, endometriosis/endometrial cancer, menstrual cycle length, lung adenocarcinoma, height, and adolescent idiopathic scoliosis. Among 855 pairs of traits, the leading findings showed variants increasing HG also increase stomach pain (P=.0004) and variants increasing NVP also increase sleeplessness/insomnia (P=1.37E-14). CONCLUSION: The finding that variants in GDF15 and IGFBP7 are associated with blood protein levels supports our study showing abnormal levels of GDF15 and IGFBP7 in women with HG. Overlap of the genes with other conditions provides biological insight. Associations with poor sleep and stomach pain may have implications for treatment strategies for NVP/HG.

Assessment of Presence of the Phenotypic Characteristics of Polycystic Ovarian Syndrome among Young Adult Girls in a Selected College, Kanchipuram District, Tamil Nadu, India

Assessment of presence of the phenotypic characteristic of Polycystic Ovarian Syndrome among youngadult girls in a selected college in Kanchipuram District, Tamil Nadu. The Objectives are to assess thephenotypic characteristics of polycystic ovarian syndrome among young adult girls. To determine theassociation between phenotypic characteristics with selected demographic variables. The conveniencesampling technique was used to select 295 sampling. Validity and Reliability data collection tools wereestablished. The data were collected by self-structured questionnaires. The collected data were tabulated andanalyzed. The findings of the present study Shows that the presence of phenotypic characteristics of PCOSbased on score of hirsutism was estimated to be (39.7%) and based on grading of acne was estimated tobe (66.8%) of young adult girls have mild acne characteristics of PCOS, (13.5%) of young adult girls havemoderate acne characteristics of PCOS.(11.9%) have severe acne characteristics of PCOS and (7.8%) havevery severe acne characteristics of PCOS.There is significant association between the demographic variables and the scoring of hirsutism of youngadult girls in their age, residence, age of menarche, regulation of menstrual cycle, length of menstrualcycle, BMI at p value= &lt;0.05 level of significant. And there is significant association between demographicvariables and the grading of acne among young adult girls in their residence, menstrual cycle, length ofmenstrual cycle, family history of PCOS, co-morbidities, BMI at p value= &lt;0.05% level of significant.

The Effect of Twin Sex on Menstrual Characteristics.

Background and objectives: The purpose of this project is to evaluate the association between twin sex discordance and menstrual characteristics. We hypothesize that sharing the uterus with a male twin can change ovulation programming, hence changing the menstrual cycle characteristics during adulthood. This project could be novel in discovering new physiological mechanisms of hormone exposure and menstrual cycles. Materials and methods: This is a cross-sectional study. We asked females from sex-concordant (n = 1290) and sex-discordant (n = 168) twin pairs in the Washington State Twin Registry about characteristics of menstrual cycles. Generalized Estimating Equation (GEE) analysis was used to compare groups. The main outcome measures included the amount of bleeding, duration of menstruation, the timing of menstruation, length of menstruation, and a number of periods per year. Results: We found a statistically significant association between the amount of menstrual period bleeding and twin sex discordance (0.42 (95% CI 0.18–0.94)). However, twin sex discordance was not associated with period duration, length of menstrual cycle, cycle regularity, or a number of periods per year. Conclusions: Twin sex discordance is not a predictor of clinical characteristics of menstruation during adulthood except for the amount of bleeding. Future studies should focus on the impact of male hormones on the amount of bleeding during menstruation.

A randomized controlled trial of a lifestyle intervention with longitudinal follow-up on ovarian dysmorphology in women with polycystic ovary syndrome.

Effects of lifestyle modification on reproductive function in polycystic ovary syndrome (PCOS) remain poorly elucidated. We compared the effects of a pulse-based diet (lentils, beans, split peas and chickpeas) with Therapeutic Lifestyle Changes (TLC) diet on ultrasonographic markers of ovarian morphology, hyperandrogenism and menstrual irregularity in PCOS. Randomized controlled trial. Women with PCOS (18-35years). Thirty women randomized to the pulse-based and 31 to TLC groups completed a 16-week intervention without energy restriction. Groups performed aerobic exercise (minimum of 5days/wk; 45minutes/d) and received health counselling (monthly) and longitudinal follow-up. Follicle numbers per ovary (FNPO, 2-9mm), ovarian volume (OV), free androgen index (FAI) and menstrual cycle length were measured pre- and postintervention. Follicle numbers per ovary (mean change±SD, -10±15), OV (-2.7±4.8mL), FAI (-3±2) and menstrual cycle length (-13±47days) decreased over time in both groups (All: P<.01), without group-by-time interactions (All: P≥.13). Attrition rate was 33.7% and comparable between groups (P=.94). Adherence to diet intervention negatively correlated with changes in FNPO (r=-0.54), OV (r=-0.35) and FAI (r=-.29) in pooled groups (All: P≤.04). Groups maintained reduced OV, FNPO, FAI and menstrual cycles 6months postintervention; however, decreased FNPO and FAI at 16weeks tended to revert to baseline levels 12months postintervention in both groups (All: P≤.05). Both interventions improved ovarian dysmorphology, hyperandrogenism and menstrual irregularity in PCOS, and no diet appeared to be superior at improving reproductive outcomes. Our observations highlight the importance of longitudinal surveillance for sustainable adherence to newly adopted healthy lifestyle behaviours and reproductive health in PCOS (ClinicalTrials.gov identifier, NCT01288638).

Menstrual patterns and self-reported hirsutism as assessed via the modified Ferriman-Gallwey scale: A cross-sectional study

ObjectiveHirsutism, the presence of excess terminal hair in a male pattern, is a clinical marker of androgen excess in women. We used cross-sectional data from a North American preconception cohort study to evaluate the association between menstrual cycle characteristics and hirsutism. Study DesignWomen aged 21–45 years were recruited to a North American cohort of pregnancy planners. On the baseline questionnaire, participants self-reported menstrual characteristics, which included menstrual regularity, cycle length, bleed length, and bleed heaviness. Participants provided a self-rating of hirsutism in nine distinct body areas using pictograms representing the modified Ferriman-Gallwey (mFG) score. Using their ratings, we calculated total mFG scores and defined hirsutism as mFG scores ≥8. We used log-binomial regression models to estimate prevalence ratios (PRs) for the association between menstrual characteristics and hirsutism assessed at baseline. ResultsWe included 5,542 women in the analytic cohort. Mean mFG score was 4.7, with 21.7 % reporting mFG scores ≥8. Compared with women with regular menstrual cycles, irregular cycles were positively associated with mFG ≥8 (PR 1.73, 95 % CI 1.56–1.91). Bleed lengths of ≥7 days compared with <3 days also showed a positive association with mFG score ≥8 (PR 1.59, 95 % CI 1.16–2.19), as did heavy bleeds (PR 1.42, 95 % CI 1.21–1.67) compared with moderate bleeds. Findings remained consistent when restricted to women without a prior diagnosis of polycystic ovary syndrome. ConclusionsIn a population-based cohort of North American women, menstrual irregularity, increased cycle and bleeds lengths, and heavier menstrual bleeds were associated with self-reported hirsutism.

Menstrual bleeding, cycle length, and follicular and luteal phase lengths in women without known subfertility: A pooled analysis of three cohorts.

There is variability between women for days of menstrual bleeding, cycle lengths, follicular phase lengths, and luteal phase lengths, related to age and parity. To describe total cycle length; anovulatory cycles; follicular and luteal phase lengths; and days and intensity of menstrual and non-menstrual bleeding in women without known subfertility over the course of 1year. 581 women (3,324 cycles) with no known subfertility (18-40years of age) were followed for up to 1year. Women recorded vaginal bleeding and mucus discharge daily. We used the peak day of cervical mucus as the estimated day of ovulation and the last day of the follicular phase. We used generalised linear mixed models stratified by age and parity to describe menstrual cycle parameters. The majority of women were <30years of age (74.5%), non-Hispanic White (88.6%), and nulliparous (70.4%). The mean menses length was 6.2 (1.5) days, median 6; cycle length 30.3 (6.7) days, median 29; follicular phase length 18.5 (6.5) days, median 17; and luteal phase length 11.7 (2.8) days, median 12. Nulliparous women aged ≥30years vs nulliparous women aged <30 had shorter cycles (29.2days, 95% confidence interval (CI) 27.8, 30.7 vs 31.5days, 95% CI 30.8, 32.2) and shorter follicular phases (17.6days, 95% CI 16.2, 18.9 vs 19.6days, 95% CI 18.9, 20.2). Among all women, within-woman differences between the longest and shortest menses length >3days, total cycle length >7days, follicular phase >7days, and luteal phase >3days were found in 11.6%, 43.0%, 41.7%, and 58.8% of women, respectively. Our findings confirm variability between women of menstrual cycle parameters related to age and parity, and also highlight within-woman variability in the follicular and luteal phases.

Real-life insights on menstrual cycles and ovulation using big data.

STUDY QUESTIONWhat variations underlie the menstrual cycle length and ovulation day of women trying to conceive?SUMMARY ANSWERBig data from a connected ovulation test revealed the extent of variation in menstrual cycle length and ovulation day in women trying to conceive.WHAT IS KNOWN ALREADYTiming intercourse to coincide with the fertile period of a woman maximises the chances of conception. The day of ovulation varies on an inter- and intra-individual level.STUDY DESIGN, SIZE, DURATIONA total of 32 595 women who had purchased a connected ovulation test system contributed 75 981 cycles for analysis. Day of ovulation was determined from the fertility test results. The connected home ovulation test system enables users to identify their fertile phase. The app benefits users by enabling them to understand their personal fertility information. During each menstrual cycle, users input their perceived cycle length into an accessory application, and data on hormone levels from the tests are uploaded to the application and stored in an anonymised cloud database. This study compared users’ perceived cycle characteristics with actual cycle characteristics. The perceived and actual cycle length information was analysed to provide population ranges.PARTICIPANTS/MATERIALS, SETTING, METHODSThis study analysed data from the at-home use of a commercially available connected home ovulation test by women across the USA and UK.MAIN RESULTS AND THE ROLE OF CHANCEOverall, 25.3% of users selected a 28-day cycle as their perceived cycle length; however, only 12.4% of users actually had a 28-day cycle. Most women (87%) had actual menstrual cycle lengths between 23 and 35 days, with a normal distribution centred on day 28, and over half of the users (52%) had cycles that varied by 5 days or more. There was a 10-day spread of observed ovulation days for a 28-day cycle, with the most common day of ovulation being Day 15. Similar variation was observed for all cycle lengths examined. For users who conducted a test on every day requested by the app, a luteinising hormone (LH) surge was detected in 97.9% of cycles.LIMITATIONS, REASONS FOR CAUTIONData were from a self-selected population of women who were prepared to purchase a commercially available product to aid conception and so may not fully represent the wider population. No corresponding demographic data were collected with the cycle information.WIDER IMPLICATIONS OF THE FINDINGSUsing big data has provided more personalised insights into women’s fertility; this could enable women trying to conceive to better time intercourse, increasing the likelihood of conception.STUDY FUNDING/COMPETING INTERESTSThe study was funded by SPD Development Company Ltd (Bedford, UK), a fully owned subsidiary of SPD Swiss Precision Diagnostics GmbH (Geneva, Switzerland). I.S., B.G. and S.J. are employees of the SPD Development Company Ltd.

The Menstrual Cycle and Risk of Breast Cancer: A Review.

Cyclic hormonal stimulation of the breast tissue plays a significant role in breast carcinogenesis. Current risk factor models do not include direct measures of cycle characteristics although the effects of possible surrogates of cycle activity such as age at menarche and menopause, parity, and nursing time have been investigated. Future risk models should also include menstrual cycle length, regularity, number of cycles before first full-term pregnancy, and life-time number of cycles. New risk factor models for pre- and postmenopausal breast cancer are proposed here. Furthermore, there is a need for more long-term, prospective studies investigating menstrual cycle characteristics as data currently available are primarily retrospective and collected at one time-point only.

Menstrual knowledge and practices of Pakistani girls: A multicenter, cross-sectional study

Information regarding the menstrual knowledge and practices of Pakistani girls is sparse. Therefore, we aimed to evaluate the knowledge and practices of Pakistani girls regarding menstruation. This cross-sectional study was conducted among four categories of university female students of medical, pharmacy, nursing, and arts & humanities during a period of 5 months (November 2016–March 2017). The data were acquired using a self-administered questionnaire from 3 medical institutes, 2 pharmacy institutes, 3 nursing institutes and 2 arts & humanities institutes at Lahore, Pakistan. The mean age of participants (N = 1777) was 20.38 ± 2.39 years. Overall 39.5%, 76.1% and 29.3% respondents’ provided correct answers to the questions concerning menstrual cycle length, duration of menstrual bleeding and source of bleeding, respectively. Regarding the understanding of menstruation, around 27% understood it as monthly bleeding happening with every woman, whereas 18% stated that it was a sign of adulthood. However, a small proportion believed that it was removal of dirt from the body. Regarding the practices-related to menstruation, there were some malpractices regarding diet and dietary intake (avoiding certain foods, eating less, and less fluid intake). However, the hygienic practices were found to be satisfactory. In conclusion, Pakistani university girls have some misconceptions, misperceptions and malpractices related to menstruation. Our findings draw attention to conduct awareness programs in order to eradicate these misconceptions, myths and malpractices.

Fertility awareness-based methods of family planning.

Fertility awareness-based methods (FABMs) of family planning involve monitoring various signs and symptoms of fertility during the menstrual cycle to identify the "fertile window," or the days of the cycle when unprotected intercourse is most likely to result in pregnancy. Signs and symptoms include menstrual cycle length, basal body temperature, urinary hormone measurements, and/or cervical fluid and may be used alone or in combination. Fertility signs reflect both physiological changes during the menstrual cycle and the life cycle of the ovum and sperm. Women learn to observe or measure and interpret these signs according to the instructions of their chosen FABM and avoid unprotected intercourse on fertile days. FABMs are appropriate for those who choose to use them, are able and willing to observe one or more fertility signs, and are in relationships that support the use of a coitus-related method such as a condom or abstaining from intercourse on fertile days.

Urinary Phytoestrogens and Relationship to Menstrual Cycle Length and Variability Among Healthy, Eumenorrheic Women.

Phytoestrogens may influence fecundability, although biological mechanisms remain elusive. Since it is hypothesized that phytoestrogens may act through influencing hormone levels, we investigated associations between phytoestrogens and menstrual cycle length, a proxy for the hormonal milieu, in healthy women attempting pregnancy. A population-based prospective cohort of 326 women ages 18 to 40 with self-reported cycles of 21 to 42 days were followed until pregnancy or for 12 months of attempting pregnancy. Urinary genistein, daidzein, O-desmethylangolensin, equol, enterodiol, and enterolactone were measured upon enrollment. Cycle length was determined from fertility monitors and daily journals. Linear mixed models assessed associations with continuous cycle length and were weighted by the inverse number of observed cycles. Logistic regression models assessed menstrual regularity (standard deviation > 75th vs ≤ 75th percentile). Models were adjusted for age, body mass index, race, creatinine, exercise, supplements, lipids, lead, cadmium, cotinine, parity, alcohol, and other phytoestrogens. Individual phytoestrogens were not associated with cycle length, although total phytoestrogens were associated with shorter cycles (-0.042 days; 95% confidence interval [CI], -0.080 to -0.003, per 10% increase). Each 1 nmol/L increase in enterolactone (odds ratio [OR] 0.88; 95% CI, 0.79-0.97) and total lignans (OR 0.85; 95% CI, 0.76-0.95) was associated with reduced irregularity, and each 1 nmol/L increase in genistein with irregularity (OR 1.19; 95% CI, 1.02-1.38). Phytoestrogens were not meaningfully associated with cycle length but may be associated with menstrual regularity, among women with self-reported regular cycles. These results highlight differences between isoflavones and lignans and are reassuring for women attempting pregnancy.

Effect of Omega-3 Fatty Acids on Hormonal Profile and Ovarian Stromal Blood Flow in Patients with Polycystic Ovary Syndrome

Background: In Polycystic ovary syndrome (PCOS) life style and dietary changes are recommended as the first line of management; however, the optimal nutritional management is not certain yet. Polyunsaturated fatty acids (PUFAs), particularly long-chain (omega-3) PUFAs, is known to improve overall human health and its widely used in managing infertility, but its role in PCOS management is still uncertain. Objective: The purpose of this study was to assess if omega-3 fatty acids supplementation for Polycystic ovary syndrome patients will have a positive effect on body weight, Hirsutism score, Menstrual cyclicity, hormonal status and Doppler flow to the Uterine and Ovarian stromal arteries.Study Design: A randomized prospective trial.Patients and Methods: A total of 67 patients with Polycystic ovary syndrome were randomized into two groups. Group I patients who received omega-3 fatty acid 1 gram daily capsules and group II patients who received no treatment for 3 months. Changes in weight, BMI, menstrual cycle length, modified Ferriman Gallway score, serum FSH, LH ,free Testosterone levels and Doppler of ovarian stromal and uterine arteries between baseline and the 3 months study period were compared between the 2 groups. Results: After 3 months supplementation with omega-3 fatty acid capsules, there was a statistically significant decrease in menstrual cycle length in the study group in comparison to the control group. Also, there was a statistically significant decrease in the pulsatility index (PI) of the uterine artery Doppler in the study group, but there was no change in the weight, BMI, ovarian stromal blood flow. Also, measures of FSH, LH and free testosterone did not show statistically significant changes for either group. Conclusion: Omega-3 fatty acids supplementation is effective in improving menstrual cyclicity and uterine artery blood flow in patients with PCOS and may be an helpful option for some patients with PCOS especially those who have defective endometrial receptivity and subsequent infertility or repeated miscarriages because of increased uterine artery resistance.

Anti-Müllerian hormone (AMH) in the Diagnosis of Menstrual Disturbance Due to Polycystic Ovarian Syndrome.

Introduction: Polycystic ovarian syndrome (PCOS) is a leading cause of female subfertility worldwide, however due to the heterogeneity of the disorder, the criteria for diagnosis remains subject to conjecture. In the present study, we evaluate the utility of serum Anti-Müllerian hormone (AMH) in the diagnosis of menstrual disturbance due to PCOS.Method: Menstrual cycle length, serum AMH, gonadotropin and sex-hormone levels, total antral follicle count (AFC), body mass index (BMI) and ovarian morphology on ultrasound were analyzed in a cohort of 187 non-obese women, aged 18–35 years, screened for participation in a clinical trial of fertility treatment between 2013 and 2016 at a tertiary reproductive endocrine center.Results: Serum AMH was higher in women with menstrual disturbance when compared to those with regular cycles (65.6 vs. 34.8 pmol/L; P < 0.0001). The odds of menstrual disturbance was increased 28.5-fold (95% CI 3.6–227.3) in women with serum AMH >60 pmol/L, in comparison to those with an AMH < 15 pmol/L. AMH better discriminated women with menstrual disturbance (area under ROC 0.77) from those with regular menstrual cycles than AFC (area under ROC 0.67), however the combination of the two markers increased discrimination than either measure alone (0.83; 95% CI 0.77–0.89). Serum AMH was higher in women with all three cardinal features of PCOS (menstrual disturbance, hyperandrogenism, polycystic ovarian morphology) when compared to women with none of these features (65.6 vs. 14.6 pmol/L; P < 0.0001). The odds of menstrual disturbance were increased by 10.7-fold (95% CI 2.4–47.1) in women with bilateral polycystic morphology ovaries than those with normal ovarian morphology. BMI was a stronger predictor of free androgen index (FAI) than either AMH or AFC.Conclusion: Serum AMH could serve as a useful biomarker to indicate the risk of menstrual disturbance due to PCOS. Women with higher AMH levels had increased rates of menstrual disturbance and an increased number of features of PCOS.

Effects of dynamical time scale mismatch on time series analysis using event intervals

The use of a sequence of inter-event time intervals as a proxy for time series measurements in state space reconstructions, used to compute correlation dimensions, is explored. In addition to testing the validity of the method in general, the effects of using time intervals that are much longer than the characteristic time scale of the system dynamics are examined. Two model systems for which copious information is available are employed: empirically measured data produced using a Chua circuit, and computed numerical values produced using a nonlinear model of the reproductive endocrine system. For time intervals well-matched to the dynamical time scale, the result of state space reconstructions using these time intervals is successful for both the Chua circuit data and the endocrine modeling results. Using longer time intervals, however, results in computed correlation dimensions that are considerably higher than the actual correlation dimensions of these systems. Similar results are also found using very long delay times in a standard time series analysis of the variables in both systems. Using parameter variations to induce changes in the correlation dimension of the endocrine model system, it is shown that these changes are similar in both the actual correlation dimension and the higher correlation dimension computed using very long time intervals. It is argued that this has important implications for studies in which the only available data consists of event intervals, as illustrated by comparisons between the endocrine modeling results presented here and empirical studies using menstrual cycle lengths as events intervals.

Menstrual cycle regularity and length and risk of mortality: a prospective cohort study

Menstrual cycle regularity and length and risk of mortality: a prospective cohort study