PCOS Patients Research Articles

PCOS and Role of Cumulus Gene Expression in Assessing Oocytes Quality.

The global infertility rate has been declining from year to year. PCOS is one of the treatable accountable causes contributing to anovulatory infertility. Nevertheless, the success rate of treatments and live-birth outcomes especially involving assisted reproductive techniques is still not very promising. There is a reduction in the development potential of oocytes and high-quality embryos in PCOS patients compared to non-PCOS patients. A critical step in IVF treatment is the assessment of oocyte and embryo competence before embryo transfer. Oocytes in metaphase II are very fragile. Repeated morphological assessment on these oocytes may directly impair the quality and affect the whole process. Identification of potential biomarkers especially in the cumulus cells oocytes complex will help to predict the outcome and may create space for improvement. This review has explored gene expression in cumulus cells with regards to oocytes quality in both normal and PCOS women. The gene expression was classified according to their physiological function such as the contribution on cumulus expansion, cumulus cells apoptosis, and glucose metabolism. Collectively, the review suggested that positive expression of HAS2, PTX3, GREM1, and VCAN may correlate with good quality oocytes and can be used as an indicator among PCOS women.

Evaluation of electrocardiographic repolarization parameters in patients with polycystic ovary syndrome

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Research, Development and Innovation Office Introduction Polycystic ovary syndrome (PCOS) is a multifactorial, endocrine disease associated with metabolic disturbances (e.g. hyperinsulinemia, insulin resistance) and increased cardiovascular risk. Recent data strongly suggest that different QT variability parameters characterizing cardiac repolarization instability represent novel markers in proarrhythmic risk assessment. Purpose In the present study we investigated ECG repolarization parameters, including QT variability parameters in patients with polycystic ovary syndrome. Methods Fifty-five PCOS patients (age: 29±6 years) and 55 age-matched healthy volunteers (age: 29±10 years) were enrolled in the study. Five-minute 12-lead resting electrocardiograms were recorded, the ECGs were digitized and evaluated off-line using the Cardiosys-A01 system (Cardiosys-A01). The following parameters were determined: the frequency corrected QT interval (QTc) using Bazett’s, Fridericia, Framingham and the Hodges formulas; QT dispersion (QTd) and T wave peak-to-end distance (Tpeak-Tend). Among QT variability parameters we analyzed the QT variance (QTv), the QT variability index (QTVI), the short-term beat-to-beat QT and RR interval variability (STV-QT, STV-RR) based on constructed Poincaré plots and the variability ratio (VR). Results The RR interval did not differ significantly in PCOS patients compared to controls (821±129 ms vs. 847±99 ms), however the QT interval (373±30 ms vs. 391±27 ms, p<0.01), the QTc calculated with Bazett’s, Framingham, Fridericia and Hodges correction formulas (QTc Bazett’s: 413±18 ms vs. 426±21 ms, p<0.01) and the Tpeak-Tend intervals were significantly shorter (76±10 ms vs. 83±12 ms, p<0.01). The QTd, QTv, and STV-RR did not differ significantly. However, the VR (0.3±0.4 vs. 0.2±0.2, p<0.05), the QTVI (-0,9±0.5 vs. -1,3±0.4, p<0.001), and importantly, the STV-QT were significantly higher in PCOS patients compared to controls (4.0±0.9 ms vs. 3.2±0.9 ms, p<0.0001). Conclusion Some of the alterations in repolarization parameters and the significant increase in the short-term beat-to-beat QT interval variability and the QT variability index may indicate increased repolarization instability in patients with polycystic ovary syndrome compared to age-matched controls, however, further studies are needed to establish the exact relation of this finding to increased arrhythmia propensity in this population.

Biphasic Effect of TNF-α on the Survival and Endocrine Function of Human Ovarian Granulosa Cells

Background: TNF-α has a wide range of functions in processes within the ovaries, including follicular development, ovarian hormones synthesis, ovulation, granulosa cell necroptosis, and follicular atresia. Innate immune response in the ovaries is the main source of TNF-α. The purpose of this study is to explore the dose- and time-dependent interactions between TNF-α and human granulosa cells. Methods: The follicular fluids (FF) were obtained from infertile patients undergoing IVF with PCOS (n = 20) and healthy women (n = 19). Granulosa cells were cultured and treated with varying concentration of recombinant human TNF-α. Cell viability was detected by CCK-8 method, the levels of TNF-α, estradiol, and inhibin were measured with ELISA, and cell apoptosis was detected by flow cytometry. Q-PCR and western-blot were used to evaluate the expression of TNFR1/2, P450, Inhibin α/βA, and caspase 3. Results: The level of TNF-α increased gradually with the development of follicles and was remarkably higher in the FF of PCOS patients than in that of healthy women. Treatment with TNF-α as low as 0.2 ng/mL promoted the proliferation of granulosa cells, thus upregulating P450 aromatase and inhibin A. On the other hand, a high concentration of TNF-α (0.4, 0.8, 2, and 8 ng/mL) showed dose- and time-dependent inhibitory effects on cell viability and E2 and inhibin A secretion. However, no marked differences in the expression of the two types of TNFR were observed in TNF-α-treated granulosa cells. Conclusions: The data presented here verify a biphasic effect of TNF-α on human ovarian endocrine and follicular development.

Effect of vitamin D supplementation on serum VEGF levels in vitamin d deficient polycystic ovarian syndrome patients

To estimate and compare serum VEGF levels before and after vitamin D supplementation in vitamin D deficient PCOS patients. The present study was conducted in Department of Obstetrics and Gynaecology in collaboration with Department of Biochemistry at University College of Medical Sciences (UCMS) and Guru Teg Bahadur Hospital (GTBH), Delhi from November 2017 to April 2019 (including enrollment of subjects, data analysis and thesis writing). Considering a standard deviation of 36.5 before supplementation and 42.7 after supplementation in VEGF levels in case of PCOS patients in study of Irani et al., to estimate an absolute difference of 31 units pg/ml decrease in VEGF levels, at α= 5% and power= 80%, a sample of 26 cases is required. Since there is a follow up of 3 months adding an attrition of 15%, the total sample size becomes 30 cases. Significant increase in serum vitamin D levels post supplementation was observed from pre supplementation 9.524±4.41 to post supplementation 32.07±12.40; p-value <0.001. We observed significant fall in angiogenesis marker, serum VEGF levels post vitamin D supplementation from 773.547±344.173 to 639.97±119.02, p value 0.004 which suggests negative correlation between serum Vitamin D and serum VEGF levels. Vitamin D supplementation in PCOS patients who are vitamin D deficient, leads to significant fall in angiogenesis marker serum VEGF, which is manifested as improvement in clinical and biochemical parameters in these patients.

IVF outcome with a high level of AMH: a focus on PCOS versus non-PCOS

BackgroundThe purpose of this research was to investigate whether high AMH levels in PCOS patients resulted in different IVF outcomes compared to those in non-PCOS patients.MethodsA retrospective cohort study was conducted involving 238 women undergoing IVF who had AMH levels > 4 ng/ml. Participants were divided into two groups: PCOS and non-PCOS.ResultsThe median AMH level was significantly higher in the PCOS group (7.59 ± 4.61 ng/ml vs. 5.91 ± 2.22 ng/ml, p < 0.001). The PCOS group required less gonadotropin but yielded more oocytes after stimulation. Significantly more participants from the PCOS group (41.5% [n = 39]) developed a hyperresponse to ovarian stimulation compared to the non-PCOS group (26.4% [n = 38]) (OR = 1.978, 95% CI 1.138–3.488; p = 0.015).ConclusionThere were significant differences in terms of total doses of gonadotropin and the number of oocytes retrieved in the PCOS and non-PCOS groups. Women with PCOS and high AMH levels have a higher risk of hyperresponse after ovarian stimulation than women without PCOS.

Molecular signature of immunological mechanism behind impaired endometrial receptivity in polycystic ovarian syndrome.

Despite the treatment of anovulation, infertility is still one of the main complications in PCOS women during reproductive age, which appears to be mainly due to impaired uterine receptivity. This study investigated the transcriptome profiles of endometrium in PCOS patients and healthy fertile individuals as the control group. Total mRNA was extracted from endometrial tissues of PCOS patients (n = 12) and healthy fertile individuals (n = 10) during the luteal phase. After cDNA synthesis, PCR array was performed using Human Female Infertility RT2 Profiler PCR Array kit (Qiagen, Cat.No: PAHS-164Z) for evaluating expression of 84 genes contributing to the female infertility. PCR Array data analysis identified significantly greater expression of CSF, IL11, IL15, IL1r1, IL1b, TNF, LIF, TNFRSF10B, TGFβ, C3, ITGA4 (Cd49d), SPP1, and Calca in PCOS women than in controls (P < 0.05). However, the expression of LIFR, C2, CD55, CFD, CALCA, LAM1, LAMC2, MMP2, MMP7, MMP9, ESR, SELL, ITGB3, and VCAM1 was significantly lower in PCOS group than in controls (P < 0.05). The results revealed dysregulation of immune-inflammatory molecules, complement activation and downregulation of IGF-I as well as adhesion molecules in PCOS group. The findings of this study indicated some potential causes of reduced receptivity of endometrium thus compromising the fertility in PCOS patients.

Evaluation of socio-demographic and clinical characteristics of PCOS patients attending a tertiary care institute in Colombo

Evaluation of socio-demographic and clinical characteristics of PCOS patients attending a tertiary care institute in Colombo

Hypothyroidism Incidence in Polycystic Ovarian Syndrome/ Subfertility

The association of polycystic ovarian syndrome (PCOS) and hypothyroidism is increasingly being recognised. Both syndromes share some common characteristics. In the patients of these two disorders, sub fertility appears frequently. Background and Objective: Hypothyroidism and PCOS are those syndromes that affects the women of child bearing age.These syndromes leads to subfertility. Risk of subfertility can be prevented in the patients of hypothyroidism by treatment at the onset of the disease. As hypothyroidism occurs more commonly in the patients of PCOS, so it is very important to explain its clinical impact. The objective of this study is to find out how hypothyroidism affects the patients who are suffering from polycystic ovarian syndrome. Study Design: The study design of this article is meta-analysis research. Material and Method: In last two months, we have studied many patients in our clinic.Out of these patients, some were diagnosed as patients of hypothyroidism and there were some patients of PCOS. All patients were females.Data including age and BMI was noted from their record sheets. We also noted the level of different hormones of their body.Venous blood samples were drawn and thyroid volumes was checked. Place and Duration: This study is conducted at Gynae and Obs department of Makran Medical College, Turbat and Teaching Hospital Kech, in the last two years in and outdoor from June 2019 to June 2021. Result: The values of triglycerides, cholesterol, fasting glucose , fasting insulin were significantly higher in the patients of PCOS. Levels of different hormones Including FSH, LH, TSH were also different in affected females as compared to control group.Women suffering from pcos are also unable to conceive.Total thyroid dysfunction was seen in almost 50% patients of pcos. Conclusion: Females who were suffering from hypothyroidism had higher volume of their ovaries and cystic ovaries as well.Meanwhile, females who suffered from pcos had more thyroid related diseases as well.Hypothyroidism changes the level of reproductive hormones in females and makes them unable to conceive (causes subfertility). Keywords: Hypothyroidism, Subfertility, Insulin resistance, PCOS, BMI, Hormones level.

Correlation of vitamin D with clinical, biochemical and anthropometrical parameters of PCOS patients

Objective: To find correlation of 25-hydroxy vitamin D (25OHD) levels with various clinical biochemicals, anthropometric parameters in patients of PCOS. Study design: Cross-sectional observational study. Materials and Methods: The study was conducted at Obstetrics and Gynaecological dept. of Jawaharlal Lal Nehru medical college, AMU, Aligarh, for a period of 2 years, 2018-2020. A total number of 100 PCOS patients satisfying inclusion criteria were enrolled for the study. Frequency of Vit-D deficiency in study group was estimated. Correlation of Vit-D levels with various clinical, anthropometrical, biochemical parameters was evaluated. Based on Vit –D levels the study population was divided in to Vit-D deficient and non-deficient individuals and Paired sample t-test was used to assess changes in quantitative variables. Pearson product moment co-relation analysis was used to see correlation among different variables. Qualitative variables were interpreted using Chi square test. Statistical analysis was performed using computer program SPSS version 25.0. Observations and Results: The results of 100 PCOS patients were analysed. Vit-D deficiency was found in 74% of PCOS population. Vitamin D correlated inversely with LH, FSH Prolactin and Testosteron levels (r=-0.213, p&lt;0.05,r=-0.176;p&gt;0.05,r=-0.101;p&gt;0.05; r = 0.246, p&lt;0.01).)Though significant correlation was found with LH and testosteron only.

A study on lipoprotein-a and PAI-1 in women with polycystic ovary syndrome.

PCOS is the most common endocrinological disorder amongst women of reproductive age. The consequences of PCOS extend beyond the reproductive axis and may lead to the development of metabolic syndrome leading to a high risk for hypertension and cardiovascular disease. Therefore, a more comprehensive evaluation of biochemical markers that reflect the cardiovascular risk is required for further understanding of pathophysiologic mechanisms, diagnosis and management. In this case-control study, women diagnosed with PCOS (n=100) in the age group (18-35 years) years were taken as cases and age matched healthy controls (n=100) were enrolled. Estimations of fasting plasma Glucose, serum total cholesterol (TC), triglycerides (TG) and High-density lipoprotein (HDL) concentrations were assayed while Low-density lipoprotein (LDL) was calculated by using Fredrickson Friedwald's formula. Serum Lipoprotein-a (Lp-a) was estimated using ELISA (Enzyme Linked Immunosorbent Assay). The quantitative data were expressed as Mean±Standard Deviation (SD). Unpaired Student's t-test was used to compare the values (PCOS vs Controls) and Pearson's correlation coefficient was used to elucidate the relationship between the variables. FBS and all lipid parameters were significantly increased in PCOS patients compared to control subjects. On the other hand, HDL-C was significantly decreased as compared to the control subjects. The hormones TSH, LH, FSH, PRL and LH/FSH ratio were significantly increased in PCOS patients compared to control subjects. Lipoprotein-a and PAI-1 was significantly increased in PCOS patients compared to the control subjects. Upon bivariate correlation analysis, Lp(a) had significant correlations with PAI-1 (r=0.35, p=0.000), WHR (r=0.25, p=0.000), LDL (r=0.52, p=0.000) and TSH (r=0.24, p=0.000). While the correlations with FBS (r=-0.008, p=0.91) and LH/FSH ratio (r=-0.004, p=0.95) were statistically insignificant. The evaluation of serum biomarkers such as Lp-a, PAI-1 and lipid profile routinely in PCOS patients may have diagnostic role in the early detection of metabolic abnormalities and endocrine derangements and timely management of comorbid Diabetes and Cardiovascular disease in PCOS females.

Association of FTO gene variant rs9939609 with hyperandrogenemia and fasting glucose\xa0levels in South Indian women with polycystic ovarian syndrome

BackgroundPolycystic ovary syndrome (PCOS) is a common endocrine–metabolic disorder due to genetic and environmental factors. Genetic variants located in intron 1 of Fat mass and obesity-associated (FTO) gene are associated with increased risk of obesity and metabolic disorders. This study aims to investigate the association of common FTO polymorphism rs9939609 in South Indian women with PCOS to assess its association with metabolic and endocrine parameters. FTO genotyping was done on 100 PCOS patients and 70 controls by Sanger sequencing.ResultsThe distribution of rs9939609 was observed between groups (28% TT, 57% TA, and 15% AA for PCOS and 37.1% TT, 51.4% TA, and 11.4% AA for the controls). In the PCOS group, across the carriers of different genotypes, a significant association was found between body mass index (BMI), fasting glucose levels, and testosterone with the presence of at least one risk allele of FTO rs9939609. Logistic regression analysis showed the association of fasting glucose levels and testosterone (OR 1.30 [1.03–1.63] and OR 5.83 [1.61–21.11], respectively) with FTO rs9939609.ConclusionsOur findings indicated that FTO SNP rs9939609 was not associated with PCOS, but suggested a significant association of rs9939609 with hyperandrogenemia, fasting glucose levels, and BMI in South Indian women with PCOS.

The Effect of Exercise Training on Body Composition, Insulin Resistance and High Sensitivity C-reactive Protein (Hs-CRP) in Women With Polycystic Ovary Syndrome: A Pilot Study From North India.

BackgroundPolycystic ovary syndrome (PCOS) is defined as clinical or biochemical hyperandrogenism, oligo/amenorrhea, and polycystic ovaries with or without increased ovarian volume. The goal of this study was to assess the effect of a 20-week home-based aerobic exercise programme on body composition, insulin resistance, and hs-CRP levels in women with PCOS.MethodsThis 12-month prospective study included 60 female patients diagnosed with PCOS, aged 20 to 40 years. The participants were divided into 2 groups, one for the experiment and the other for the control. For each participant, the 12-hour fasting blood samples were taken on two occasions i.e., 24 hours before the first session and 48 hours after the last session to measure the fasting glucose, fasting insulin, and hs-CRP. The Statistical Package for Social Sciences (SPSS) was used to conduct the analysis, and an association was considered significant when the p-value was less than 0.05.ResultsIn the present study, there was a dropout rate of 16.7% (5/30) in the study group and 23.3% (7/30) in the control group. The baseline characteristics were comparable (p>0.05) between the study group and the control group during the enrolment. The BMI (kg/m2) among the study group before the exercise programme was 22.8±1.8 and it was significantly reduced to 21.1±1.9 after the exercise programme (p<0.05). The HOMA-IR and hs-CRP (mg/L) levels among the study group before the exercise programme were 3.2±1.5 and 6.7±2.7 respectively, and these were significantly reduced to 1.9±1.6 and 4.2±1.3 respectively after the exercise programme (p<0.05). In contrast, paired T-test analysis showed no such significant difference (p<0.05) for all variables (Weight, BMI, Waist, Hip, fasting glucose, Fasting insulin, and hs-CRP) among the control group during the study period.ConclusionIn a group of female PCOS patients, a 20-week home-based aerobic exercise programme reduced weight, BMI, HOMA-IR, and hs-CRP. Although more research on the effects of aerobic exercises in PCOS is needed, these findings support aerobic exercise's effectiveness in reducing inflammation and enhancing insulin sensitivity in these patients.

Cinnamon, an effective anti-obesity agent: Evidence from an umbrella meta-analysis.

The evidence provided by meta-analyses on the beneficial impacts of cinnamon supplementation on anthropometric indices are still conflicting. Present study's aim was to evaluate the effects of cinnamon on obesity indices by an umbrella meta-analysis. The electronic databases including Web of Science, PubMed, EMBASE, Scopus were systematically searched up to March 2021. Data for the effects of cinnamon on anthropometric indices were collected from the meta-analyses. An umbrella meta-analysis was carried out using a random-effects model. The pooled effects of 7 meta-analyses showed that cinnamon supplementation significantly reduced body weight (ES: -0.67 kg; 95% CI: -0.99, -0.35, p˂.001), body mass index (ES: -0.45 kg/m2 ; 95% CI: -0.57, -0.33, p˂.001) in comparison to control group. However, the effects of cinnamon on waist circumference (ES: -1.05 cm; 95% CI: -2.26, 0.15, p= .087) were not considerable. According to results, cinnamon could be suggested as a complementary weight loss agent. Favorable results were obtained at a dose of ≥3 g/day. In this study, a comprehensive study was performed on meta-analyses performed on the effect of cinnamon on anthropometric indices. This study could be considered as a final conclusion about the effect of cinnamon on anthropometric indices. The results of this study showed that supplementation with cinnamon significantly reduces BMI and body weight. The impacts were greater in doses of ≥3 g/day and in PCOS patients. PRACTICAL APPLICATIONS: In this study, a comprehensive study was performed on meta-analyses performed on the effect of cinnamon on anthropometric indices. This study could be considered as a final conclusion about the effect of cinnamon on anthropometric indices. The results of this study showed that supplementation with cinnamon significantly reduces BMI and body weight. The impacts were greater in doses of ≥3 g/day and in PCOS patients.

Are Dioxins the Causative Agent of Polycystic Ovaries Syndrome?

Stein-Leventhal syndrome (Polycystic ovaries syndrome), represent one of the major obstacles facing reproductive medicine researchers, because there is no information about the etiology of it, and that made them fail to draw smile on faces of millions of women around the world, who are suffering from it. Scientists said that it is attributed to genetic and environmental factors, and we hypothesized that it was caused by environmental pollution by dioxins (specifically heavy metals), which disturb aryl hydrocarbon receptor and that lead to disturbing of nuclear receptors and then express genes which lead to hormonal, metabolic and immunological abnormalities appear in PCOS patients. And fortunately this hypothesis supports our hypothesis about the etiology of COVID-19 and its variants, clinically and epidemiologically. PCOS can be transmitted transmammry, sexually from Dixon exposed male partners, and due to direct exposure to Dixon either via explosion or by excessive use of makeup .Experimental studies is required to test our hypothesis.

Intrauterine Perfusion of Autologous Platelet-Rich Plasma Before Frozen-Thawed Embryo Transfer Improves the Clinical Pregnancy Rate of Women With Recurrent Implantation Failure.

ObjectiveTo evaluate whether the intrauterine perfusion of platelet-rich plasma (PRP) before frozen-thawed embryo transfer (FET) improves the pregnancy outcomes of patients with repeated implantation failure (RIF).MethodsThis retrospective study included 288 infertile women with RIF after undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatment from October 1, 2019, to January 1, 2021, at Qingdao Women and Children's Hospital. Patients were divided into two groups according to whether they received PRP intrauterine perfusion before embryo transfer in FET cycles. 138 women were in the PRP group, 150 women were in the control group. The primary outcome measure was live birth rates and the secondary outcome were clinical pregnancy, positive β hCG, miscarriage and implantation rates.ResultsNo significant differences in baseline demographic and clinical characteristics were observed between the two groups. Overall, significantly more women in the PRP group than in the control group achieved a live birth rate (41 women; 29.71% vs. 27 women; 18%) and a clinical pregnancy (50 women; 36.23% vs. 37 women; 24.67%). The PRP group had a higher implantation rate and lower spontaneous miscarriage rate than the control group, but these differences were not statistically significant. No pregnancy outcome difference between two groups in PCOS patients with RIF.ConclusionOur results showed that intrauterine perfusion of PRP before embryo transfer in FET cycles can significantly increase the live birth and clinical pregnancy rates in patients with RIF.

AN EXPLORATORY RESEARCH TO UNDERMINE THE KNOWLEDGE RELATED ATTRIBUTES OF POLYCYSTIC OVARY SYNDROME AMONG ADULT FEMALES

Polycystic ovary syndrome is a worldwide common syndrome of reproductive women described as reproductive, endocrine and metabolic abnormalities. PCOS is affecting 5-15% women all around the world. PCOS is defined as multifactorial pathology, determined by the association of many factors such as genetic, endocrine and environmental. Prevalence rate of PCOS in Pakistan is more than 50% and it is increasing day by day in young females. The objective of study is to access the females who are at risk of PCOS and relationship between PCOS and infertility in young females. The method of study was cross-sectional, done among female students of university. The respondents were asked about some physical signs and symptoms such as, oily skin, gain weight, darkened skin around their neck, excessive hair growth, and acne. In the end of the research, it is concluded that 20 percent of females out 100 have PCO’s and are unaware of their symptoms. 48% respondents said they do not have PCOS but the symptoms that they answered according to the questionnaire shows that they have PCOS. The respondents were asked about their periods regularity. 53.9% respondents have irregular periods 33.3% shows they have regular period 3.9% says that some time they have irregular periods and 6.9% says they never faced any irregularity in their periods. Results showed that 45% participants faced weight gain while the 15% does not know that they have gain any weight or not. Cravings percentage in PCOS patients increases from normal patients so the results shows that 39.2% participants have increase in cravings and 28.4% participants show they have no cravings and 30.4% don’t know about their cravings. The study concluded that adolescent girls were unaware of PCOS symptoms and their diet normally constitutes of junk food and beverages that effect their menstrual cycles.

Metformin, clomiphene citrate and flutamide effects on oocyte ultrastructure status and quality in PCOS mouse model

Research questionPolycystic ovary syndrome (PCOS) alters oocyte developmental competence and so the treatment of PCOS patients with assisted reproductive techniques is a major challenge for an infertility specialist. Does ovulation induction therapy with clomiphene citrate, metformin and flutamide affect abnormal PCOS follicle gene expression, its quality, and nuclear and cytoplasmic maturation in the oocyte matured in vitro? DesignFifty NMRI mice (7–8 weeks old) were randomly divided into five groups, including non-PCOS, PCOS and PCOS groups treated with clomiphene citrate (18 mg/kg body weight for 2 days), metformin (50 mg/100 g body weight for 30 days) and flutamide (10 mg/kg body weight injection for 15 days). The oocytes were collected for quantitative real-time polymerase chain reaction analysis (the evaluation of genes associated with oocyte maturation), transmission electron microscopy (the evaluation of cytoplasmic maturation) and in-vitro maturation (IVM) and IVF outcomes. ResultsThe dysregulated expression of some genes of insulin-like growth factor (IGF) families involved in oocyte competence and steroid metabolism (e.g. Cyp19a1 and Cyp11a1), transforming growth factor beta (TGF-β) family (e.g. Tgfb1, Gdf9, Bmp15, Inhbb and Bmpr1a), and oestrogen receptor signalling (e.g. Ncoa3, Pgr) was, to some extent, restored in the PCOS follicles following their with clomiphene citrate, metformin and flutamide. The improved cytoplasmic maturation was observed particularly in the PCOS mice treated with clomiphene citrate. The better IVM–IVF outcomes were also observed in the clomiphene citrate and metformin groups compared with the PCOS group. ConclusionsThis study opens up a new perspective on knowing the effect of ovulation induction therapy on not only nuclear maturation but also ultrastructural characteristics, IVM–IVF outcomes and PCOS oocyte developmental competence.

Insulin-like growth factor 2 mRNA-binding protein 2-regulated alternative splicing of nuclear factor 1 C-type causes excessive granulosa cell proliferation in polycystic ovary syndrome.

ObjectivesPolycystic ovary syndrome (PCOS) is a common reproductive endocrine disorder. Insulin‐like growth factor 2 mRNA‐binding protein 2 (IGF2BP2) serves as an HMGA2 target gene to promote the proliferation of granulosa cells (GCs). However, it is still unclear whether IGF2BP2 participates in the pathogenesis of PCOS as RNA binding protein (RBP). In this study, we aimed to elucidate IGF2BP2‐interacting transcripts, global transcriptome together with alternative splicing in GCs to eventually uncover potential mechanisms of PCOS pathogenesis.Materials and MethodsThe expression of IGF2BP2 in GCs from PCOS patients was detected using quantitative reverse transcription PCR (RT‐qPCR) and western blot. We captured IGF2BP2‐interacting transcripts, global transcriptome together with alternative splicing by RNA immunoprecipitation sequencing (RIP‐seq) and RNA sequencing (RNA‐seq). KGN cells transfected with IGF2BP2 overexpressing plasmids and nuclear factor 1 C‐type (NFIC) siRNAs, were applied to CCK‐8, EdU and TUNEL assays.ResultsIGF2BP2 was highly expressed in GCs from PCOS patients. As an RBP, it preferentially bound to the 3′and 5′UTRs of mRNAs with GGAC motif and a newly found GAAG motif. The overexpression of IGF2BP2 changed the transcriptome profile of KGN cells. IGF2BP2 functioned to regulate alternative splicing events and promote cell proliferation through inhibiting exon skipping events of NFIC.ConclusionIn conclusion, we demonstrated that IGF2BP2 promotes GC proliferation via regulating alternative splicing of NFIC in PCOS. The findings help to better understand the roles of IGF2BP2 in the pathogenesis of PCOS.

Clinical Correlates of PCOS in A Tertiary Health Care Centre

Aims: To study, analyze and find the correlation between different signs and symptoms of polycystic ovarian syndrome in a tertiary health care center. Settings and Design: (1) Type of study: Observational Study (2) Sample size: 150 (3) Study participants: All patients attending gynecology OPD diagnosed with PCOS. Study design: It was a Questionnaire based observational study. Methods and Material: This study was conducted on 150 patients with Polycystic Ovarian Syndrome. Diagnosis of Polycystic Ovarian Syndrome was done on the basis of 2003 Rotterdam diagnostic criteria. Ferriman Gallwey score was used for assessment of hirsutism and WHO cut-offs of Body Mass Index modified for Asian population was used for assessment of Body mass index, Statistical analysis used: Statistical Analysis: Data were compiled and analyzed using the site. Results: Percentages of Chief complaints: Irregular menses (89%), Obesity (41%), Hirsutism (37%), Acne (32% ), Infertility (10%). A Family History of Diabetes (45%), Hypertension(33%), Obesity (29%), Thyroid disorder (27%), PCOD (14%), and Cardiac Disorder (13%) were also analyzed. Polycystic changes in ultrasonographic findings were Present in 89% of the population and absent in 11% of the population. Only 33% of participants were regular with the exercise routine rest. Hirsutism was graded according to mild (22%), moderate (62%), and severe (16%).50 % had Acne on examination. Body Mass Index was measured and graded into Underweight (11.3%), Normal (28.60%), Overweight (9.30%), Pre-obese (31.30%), Obese type 1 (19.30 %). Acanthosis nigricans (AN) was present in 32% And absent in 68%. There was a significant Correlation between : ( p-value &lt;0.05) Irregular menses and infertility- 7%, Hirsutism and infertility- 3%, Ultrasonographic Findings, and Acne- 48%, Obesity, and Hirsutism- 45%, Irregular menses, and acne - 48% Irregular menses and hirsutism- 33%, Ultrasonographic findings, and acanthosis nigricans- 29.3%. Conclusions: There is a diversity in the presentation of chief complaints of PCOS patients. PCOS patients show a variety in the presentation of the history of metabolic syndromes and of PCOS in their families. They show cutaneous manifestations in the form of Acne, Hirsutism, and Acanthosis nigricans. PCOS patients mostly have moderate grades of hirsutism. Acne is present in almost half of PCOS patients even though most of them don't consider it as their chief complaint. Most of the participants who had increased BMI had Polycystic Ovarian Syndrome. Acanthosis is related to an increase in BMI. Very few patients include exercise in their daily routine. There is a significant correlation in PCOS patients between Irregular menses and infertility, Hirsutism and infertility, Ultrasonographic findings, and Acne as the chief complaint. Chief Complaints of Obesity and Chief Complaints of Hirsutism. Chief Complaints of irregular menses and Acne. Chief Complaints of Irregular menses and Hirsutism. Ultrasonographic findings and Acanthosis nigricans.

Fallopian tube patency diagnosed by laparoscopic chromopertubation in women with polycystic ovarian syndrome and non-subfertile controls: a retrospective case-control study

Background: Hyperandrogenism has been associated with tubal dysfunction. Previous studies have not used non-subfertile controls when assessing hyperandrogenic women through laparoscopic chromopertubation (LC), the gold standard for tubal patency testing. Methods: The objective of this retrospective study was to compare the results of LC between women with medication-resistant anovulatory polycystic ovary syndrome (PCOS, n = 202) and non-subfertile women with ovarian cysts (controls, n = 48). Results: There were no statistically significant differences between PCOS women and controls for the prevalence of bilateral tubal occlusion (2.5% versus 4.2%, respectively; p = 1.000) or overall rates for occlusion (7.4% of tubes assessed versus 6.3%, respectively; p = 0.828). More PCOS patients needed high pressure chromopertubation to demonstrate bilateral tubal patency than controls (12.4% versus 2.1%; p = 0.036). In the PCOS group, patients needing higher pressure to achieve patency demonstrated higher testosterone levels than women requiring typical pressure (0.66 ± 0.17 versus 0.47 ± 0.24 ng/mL; p = 0.001). Conclusions: For women with ovarian cysts and without subfertility, six percent of all Fallopian tubes are occluded. PCOS patients have similar rates of tubal occlusion, making these women a reasonable but more available control group for LC studies. Higher total testosterone levels were associated with higher LC pressures to demonstrate bilateral patency.