PCOS Patients Research Articles

Multiparametric arterial spin-labeling and diffusion-weighted imaging of phenotyping of polycystic ovaries

BackgroundPolycystic ovarian syndrome [PCO] is a worldwide endocrine disorder affecting women of reproductive age. Diagnosis and differentiation of PCO phenotypes are crucial for disease prognosis, fertility outcome, and treatment planning. This study aims to assess arterial spin labeling perfusion (ASL) and diffusion-weighted imaging (DWI) derived metrics in the diagnosis of PCO, differentiation of its phenotypes, and correlation of these metrics with laboratory measurements.ResultsASL and DWI of the pelvis were performed on 72 PCO patients and another 20 age-matched control group. Two observers measured the blood flow (BF) and ADC in the ovarian stroma. Serum levels of testosterone, dehydroepiandrosterone sulfate (DHEAS), and body mass index (BMI) were calculated. BF values were significantly higher in PCO patients than in control cases (P = 0.001), with area under the curve (AUC) of (0.94 and 0.89) and accuracy of (96% and 92%) for both observers, respectively. Also, BF values were significantly higher in classic than in non-classic PCO cases (P = 0.001), with AUC of (0.92 and 0.90) and accuracy of (91%) for both observers, respectively. ADC values were significantly lower in PCO patients than in control cases (P = 0.001), with AUC of (0.85 and 0.84) for the first observer and second observer, respectively. ADC values were significantly lower in classic PCO patients than in non-classic patients (P = 0.001), with AUC of (0.85 and 0.84) and accuracy of (77% and 81%) for both observers, respectively. Combined values of BF and ADC showed an accuracy of 91% and 86% for differentiating patient from control cases for both observers, respectively, and an accuracy of 92% for differentiating classic from non-classic PCO phenotypes. A significant correlation was found between ADC, BF metrics, and both serum testosterone and DHEAS levels (P < 0.05).ConclusionsCombination of ASL and ADC can be used in PCO diagnosis and can help in the differentiation of its phenotypes. Serum levels of testosterone and DHEAS have a significant correlation with ADC and BF metrics.

Prevalence of Subclinical Hypothyroidism in Untreated PCOS Patients and PCOS Patients on Metformin at a Tertiary Care Hospital of Eastern India

Prevalence of Subclinical Hypothyroidism in Untreated PCOS Patients and PCOS Patients on Metformin at a Tertiary Care Hospital of Eastern India

Effect of an Unani Formulation on Menstrual Cyclicity in Women With Polycystic Ovarian Syndrome—An Open Labelled Clinical Study

Background & ObjectivesPolycystic Ovarian Syndrome (PCOS) is one of the most common endocrinopathies among women of reproductive age affecting 2.2-26% of the population. The objective planned for the study was to evaluate the effect of an Unani formulation on menstrual cyclicity in women with PCOS. MethodologyAn open labelled clinical study was carried out in PCOS patients (n=30) aged between 20-38 years meeting the Rotterdam criteria and patients with thyroid dysfunction, hyperprolactinemia, systemic illnesses, malignancy, morbid obesity, pregnancy, lactation, and those treated with hormonal pills & insulin sensitizers within 3 months of study enrolment were excluded. Decoction of 25g of research drug formulation {consisting of Aneesūn (Pimpinella anisum Linn.), Ḥulba (Trigonella foenum graecum, Linn.), Suddāb khushk (Ruta graveolens Linn.), Majeeth (Rubia cordifolia Linn.) and Lobia surkh (Vigna Unguiculata (Linn.) Walp.)} was administered orally on an empty stomach once daily for 5 days/cycle for 3 consecutive cycles, 5 days prior to last menstrual period. The primary outcome measure was the improvement in menstrual cyclicity, and the secondary outcome measures were a reduction in BMI, waist circumference, ovarian volume, and serum insulin. Results were analyzed by Student’s test. ResultsMenstrual cyclicity was achieved in 73.33% of patients and 26.67% had persistent irregular menstruation. Reduction in BMI, waist circumference, ovarian volume, and serum insulin was achieved in 13.33%, 13.33%, 53.33%, and 36.67% of patients respectively. Interpretation & conclusionThis novel trial provides evidence of improved effectiveness and safety of the research drug formulation in PCOS. Hence it can be used as an alternate remedy in its management.

The possible regulatory role of miR-514 and miR-642b in cumulus cells on the oocyte maturation in patients with polycystic ovary syndrome

Polycystic ovary syndrome is a common endocrine disorder in reproductive-age women. Accordingly, abnormal microenvironment may negatively influence oocyte developmental competence as a result of the altered expression profile of cumulus cells (CCs), mainly the key players of oocyte maturation, such as epidermal growth factor receptor (EGFR) and prostaglandin E receptor-2 (PTGER2). This study aimed to examine the expression levels of miR-514, miR-642b, and their candidate target genes (EGFR and PTGER2, respectively) in CCs of immature and mature oocytes in patients with PCOS. A total of 40 oocytes at germinal vesicle (GV) and 40 oocytes at metaphase II (MII) stages were retrieved from 30 PCOS women. Quantitative real-time PCR was performed to analyze the expression level of miR-514, miR-642b, EGFR, and PTGER2 in cumulus cells (CCS) of each oocyte. The expression level of miRNAs and their candidate target genes were compared between CCs of GV and MII oocytes. Our study suggests an inverse relationship exists between the expression levels of miR-514 and EGFR, and miR-642b and PTGER2. Furthermore, we observed that CCs of GV oocytes had higher levels of EGFR and PTGER2 mRNA and lower levels of miR-514 and miR-642b expression compared to those of MII oocytes. The present study demonstrated that miR-514 and miR-642b can regulate oocyte development by targeting EGFR and PTGER2, respectively. Therefore, examination of these miRNAs in CCs could be promising parameters to predict oocyte competence in PCOS patients.

Contributing factors for pregnancy outcomes in women with PCOS after their first FET treatment: a retrospective cohort study

Objective We aim to explore the contributing factors of clinical pregnancy outcomes in PCOS patients undergoing their first FET treatment. Methods A retrospective analysis was conducted on 574 PCOS patients undergoing their first FET treatment at a private fertility center from January 2018 to December 2021. Results During the first FET cycle of PCOS patients, progesterone levels (aOR 0.109, 95% CI 0.018-0.670) and endometrial thickness (EMT) (aOR 1.126, 95% CI 1.043-1.419) on the hCG trigger day were associated with the clinical pregnancy rate. Similarly, progesterone levels (aOR 0.055, 95% CI 0.007-0.420) and EMT (aOR 1.179, 95% CI 1.011-1.376) on the hCG trigger day were associated with the live birth rate. In addition, AFC (aOR 1.179, 95% CI 1.011-1.376) was found to be a risk factor for preterm delivery. Conclusions In women with PCOS undergoing their first FET, lower progesterone levels and higher EMT on hCG trigger day were associated with clinical pregnancy and live birth, and AFC was a risk factor for preterm delivery. During FET treatment, paying attention to the patient’s endocrine indicators and follicle status may have a positive effect on predicting and improving the pregnancy outcome of PCOS patients.

GRIM19 deficiency aggravates metabolic disorder and ovarian dysfunction in PCOS

ContextPolycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women. Retinoid-interferon-induced mortality 19 (GRIM19) is a functional component of mitochondrial complex I that plays a role in cellular energy metabolism. However, the role of GRIM19 in the pathogenesis of PCOS is still unclear. ObjectiveTo investigate the role of GRIM19 in the pathogenesis of PCOS. DesignWe first measured the expression of GRIM19 in human granulosa cells (hGCs) from patients with and without PCOS (n = 16 per group), and then established a PCOS mouse model with WT and Grim19+/− mice for in vivo experiments. Glucose uptake-related genes RAC1 and GLUT4 and energy metabolism levels in KGN cells were examined in vitro by knocking down GRIM19 in the cell lines. Additionally, ovulation-related genes such as p-ERK1/2, HAS2, and PTX3 were also studied to determine their expression levels. ResultsGRIM19 expression was reduced in hGCs of PCOS patients, which was negatively correlated with BMI and serum testosterone level. Grim19+/− mice with PCOS exhibited a markedly anovulatory phenotype and disturbed glycolipid metabolism. In vitro experiments, GRIM19 deficiency inhibited the RAC1/GLUT4 pathway, reducing insulin-stimulated glucose uptake in KGN cells. Moreover, GRIM19 deficiency induced mitochondrial dysfunction, defective glucose metabolism, and apoptosis. In addition, GRIM19 deficiency suppressed the expression of ovulation-related genes in KGN cells, which was regulated by dihydrotestosterone mediated androgen receptor. ConclusionsGRIM19 deficiency may mediate ovulation and glucose metabolism disorders in PCOS patients. Our results suggest that GRIM19 may be a new target for diagnosis and treatment.

Higher Cumulative Live Birth Rate but Also Higher Late Miscarriage Risk in Non-Obese Women with Polycystic Ovary Syndrome Undergoing the First IVF/ICSI Cycle.

To determine the impact of polycystic ovary syndrome on in vitro fertilization/intracytoplasmic sperm injection and embryo transfer outcomes while analyzing the influencing factors. A retrospective cohort study comprised 4839 patients who underwent their first cycle of IVF/ICSI treatment from January 2016 to December 2021. Cumulative pregnancy rates, cumulative live birth rates, and late miscarriage rates compared between the PCOS group and control group. Subgroup analysis and binary regression were used to analyze the influence of BMI on clinical outcomes among individuals diagnosed with PCOS. Non-obese PCOS patients exhibited higher cumulative pregnancy rates, cumulative live birth rates, and late miscarriage rates compared to the control group with the normal BMI population (84.7% vs71.2%, P < 0.001; 74.1% vs 61.6%, P < 0.001; 4.1% vs 2.0%, P = 0.002), but there was no significant difference in early miscarriage rates between the two groups. Non-obese PCOS patients demonstrated a notably higher cumulative live birth rate but also a higher risk of late miscarriage compared to non-PCOS females with a normal BMI.

Comprehensive analysis of ovarian granulosa cell proteomics and phosphoproteomics in PCOS patients without insulin resistance.

PCOS is a complex and heterogeneous metabolic disorder that affects 6-20% of women of reproductive age. However, research on phosphorylation modification proteomics in PCOS remains lacking. PCOS can be divided into two groups based on the presence or absence of insulin resistance: PCOS with insulin resistance (PCOS-IR) and PCOS non-insulin resistant (PCOS-NIR). This study focused on the group without insulin resistance. Twenty-one PCOS-NIR and 39 control-NIR (Ctrl-NIR) patients were included in this study. All participants underwent ICSI or IVF-embryo transfer (IVF-ET) treatment in a reproductive center from July 2020 to November 2020. During oocyte retrieval, fresh follicular fluid was aspirated, collected, and sent to the laboratory for analysis of the granulosa cells. A 4D-label-free proteome quantification method was performed in this study; this was used to analyze protein enzymatic peptide fragments by liquid chromatography-mass spectrometry (LC-MS). Bioinformatic analysis was performed on differentially expressed proteins (DEPs) and differentially phosphorylated proteins (DPPs). A total of 713 DEPs were identified between the two groups, including 293 upregulated and 420 downregulated DEPs in the PCOS-NIR group. There were 522 and 159 proteins with increased and decreased phosphorylation, respectively, in the PCOS-NIR group. After analyzing the different phosphorylation modification sites, 933 sites with upregulated and 211 sites with downregulated phosphorylation were found in the PCOS-NIR group. In this study, we describe the quantitative protein expression profiles and phosphorylation-modified protein expression profiles of ovarian granulosa cells from patients with PCOS-NIR, providing a new research perspective for these patients. Further studies are required to elucidate the role of protein phosphorylation in PCOS.

Comparative effects of the antioxidant glutathione with metformin and Diane-35 on hormonal, metabolic, and inflammatory indicators in a DHEA-induced PCOS rat model

Objective Comparison of hormonal, metabolic and inflammatory markers of glutathione with metformin and Diane-35 in a rat model of PCOS induced by dehydroepiandrosterone. Methods Twenty-five female rats were randomized into four groups. Group 1 was administered a subcutaneous dose of 0.2 ml saline/day. Group 2 was given 0.2 ml of 1% carboxymethyl cellulose (CMC)/day orally for 28 days. A PCOS model was established with DHEA in rats. Group 3 was given 4.5 mg/kg/day of Diane-35 orally dissolved in 1% CMC for 28 days. Group 4 was given 300 mg/kg/day of metformin orally dissolved in 1 ml of saline for 28 days, and Group 5 was administered 100 mg/kg of glutathione intraperitoneally on days 35, 42, and 49. On day 56, the rats were sacrificed. Serum markers and follicle count were examined. Results Serum IL-6, hs-CRP, insulin, testosterone, SHBG, and MDA values were significantly lower in the glutathione group than in the PCOS group (p = 0.0006, p = 0.023, p = 0.0082, p = 0.0007, p = 0.0048, and p < 0.0001, respectively). The number of all follicles was similar between the control and glutathione groups (p < 0.05). When we compared the other groups with the PCOS group, the number of primary, secondary, atretic, and cystic follicles was significantly lower in the metformin and glutathione groups. The number of primordial and antral follicles was significantly higher than in the PCOS group. Conclusions Glutathione plays anti-inflammatory and antioxidant roles, similar to metformin, by lowering serum IL-6, insulin, testosterone, CRP, and MDA levels; decreasing atretic/cystic follicle count; and improving antral follicle count and folliculogenesis in PCOS patients.

The association of RBX1 and BAMBI gene expression with oocyte maturation in PCOS women

BackgroundPolycystic ovarian syndrome (PCOS) is a common endocrine disorder that affects 6–20% of women of reproductive age. One of the symptoms of PCOS is hyperandrogenism, which can impair follicular development. This disruption can cause issues with the development of oocytes and the growth of embryos. Although the exact cause of PCOS is not yet fully understood, studying the gene expression pattern of cumulus cells, which play a crucial role in the maturation and quality of oocytes, could help identify the genes associated with oocyte maturation in PCOS women. Through indirect activation of APC/Cdc20, RBX1 enables oocytes to bypass the GV (germinal vesicles) stage and advance to the MII (metaphase II) stage. our other gene is the BAMBI gene which stimulates WNT signaling, that is a crucial pathway for healthy ovarian function. This study aims to explore the expression level of the RBX1 and BAMBI genes between GV and MII oocytes of PCOS and non-PCOS groups.MethodsIn this experiment, we gathered the cumulus cells of MII (38 cases and 33 control) and GV (38 cases and 33 control) oocytes from women with/without PCOS. Besides, quantitative RT-PCR was used to assess the semi-quantitative expression of BAMBI and RBX1.ResultsAccording to our research, the expression level of RBX1 and BAMBI in MII and GV cumulus cells of PCOS patients was significantly lower than that in non-PCOS ones.ConclusionThis research raises the possibility of RBX1 and BAMBI involvement in oocyte quality in PCOS women.

Intra-ovarian inflammatory states and their associations with embryo quality in normal-BMI PCOS patients undergoing IVF treatment

BackgroundPolycystic ovary syndrome (PCOS) is the main cause of anovulatory infertility in women of reproductive age, and low-grade chronic inflammation plays a key role in the occurrence and development of PCOS. However, obesity, as a likely confounding factor, can affect the inflammatory state of PCOS patients.ObjectiveThe aim of this study was to comprehensively investigate intra-ovarian inflammatory states and their impact on embryo quality in PCOS patients with a normal BMI undergoing IVF treatment.MethodsDIA-mass spectrometry-based proteomics and bioinformatic analysis were combined to comprehensively profile the protein expression of granulosa cells (GCs) from 5 normal-BMI PCOS patients and 5 controls. Thirty-four cytokines were further systematically detected in follicular fluid (FF) from 32 age- and BMI-matched normal-BMI patients using Luminex liquid chip suspension technology. Next, the differentially expressed cytokines were evaluated by enzyme-linked immunosorbent assay (ELISA) in 24 newly recruited subjects, and the relationship between these cytokines and embryo quality in PCOS patients was analysed. Finally, these cytokine levels were compared and evaluated in PCOS patients with different androgen levels.ResultsProteomic analysis showed that the suppression of substance metabolism and steroid biosynthesis, more interestingly, resulted in an enhanced immune and inflammatory response in the GCs of normal-BMI PCOS patients and prompted the involvement of cytokines in this process. Luminex analysis further showed that FF macrophage inflammatory protein-1 beta (MIP-1β) and stromal cell-derived factor-1 alpha (SDF-1α) levels were significantly increased in normal-BMI PCOS patients compared to controls (P = 0.005; P = 0.035, respectively), and the ELISA results were consistent with these findings. Besides, FF MIP-1β showed an inverse correlation with the number of D3 good-quality embryos and the good-quality blastocyst rate in patients with PCOS (P = 0.006; P = 0.003, respectively), which remained significant after correction for multiple comparisons. Moreover, SDF-1α levels had no relationship with embryo development in PCOS patients. Additionally, SDF-1α levels were significantly lower in PCOS patients with high androgen levels than in controls (P = 0.031).ConclusionsLocal ovarian inflammation was present in normal-BMI PCOS patients, affecting follicular development, and FF MIP-1β may be a potential biomarker associated with embryo quality in normal-BMI PCOS patients.Graphical abstract

Frequency of Vitamin D deficiency in women with polycystic ovarian syndrome.

Introduction: Approximately 20% of women who are of reproductive age suffer from the common endocrine illness known as polycystic ovarian syndrome, or PCOS. Vitamin D insufficiency is common among PCOS-affected women. The symptoms of PCOS seem to be regulated by the vitamin D pathway. According to studies, women with PCOS had high frequencies of vitamin D insufficiency, ranging from 65.0% to 70.3%. Thus, we aimed to discover how common vitamin D deficiency was in women diagnosed with PCOS.&#x0D; Methodology: This cross-sectional study was conducted at the Department of Obstetrics &amp; Gynecology, CMH- Rawalpindi, from January to July 2022. A total of 90 women with polycystic ovarian syndrome diagnosed on Rotterdam criteria, 18 to 40 years of age, were included through a non-probability consecutive sampling technique. Pregnant female patients with chronic illnesses were excluded. After informed consent, data was collected from patients on a self-developed questionnaire. In all patients, a 3 ml blood sample was taken and sent to the institutional pathology laboratory to measure vitamin D levels. &#x0D; Results: The patients' average age was 28.91 ± 4.85 years—ages 18 to 30 comprised most of the 48 patients (53.33%). The average time a person had PCOS was 3.64 ± 1.58 years. The average body mass index was 29.02 ± 2.43 kg/m2. Forty-one (45.56%) of the PCOS patients had vitamin D insufficiency.&#x0D; Conclusion: As the frequency of vitamin D deficiency in women with PCOS is relatively high, we recommend that early identification through screening of the affected patients should be done.

Transcriptomic analysis identifies diagnostic genes in polycystic ovary syndrome and periodontitis

PurposeTo investigate underlying co-mechanisms of PCOS and periodontitis through transcriptomic approach.MethodsPCOS and periodontitis gene expression data were downloaded from the GEO database to identify differentially expressed genes. GO and KEGG pathway enrichment analysis and random forest algorithm were used to screen hub genes. GSEA analyzed the functions of hub genes. Correlations between hub genes and immune infiltration in two diseases were examined, constructing a TF-ceRNA regulatory network. Clinical samples were gathered from PCOS and periodontitis patients and RT-qPCR was performed to verify the connection.ResultsThere were 1661 DEGs in PCOS and 701 DEGs in periodontitis. 66 intersected genes were involved and were enriched in immune and inflammation-related biological pathways. 40 common genes were selected from the PPI network. RF algorithm demonstrated that ACSL5, NLRP12, CCRL2, and CEACAM3 were hub genes, and GSEA results revealed their close relationship with antigen processing and presentation, and chemokine signaling pathway. RT-qPCR results confirmed the upregulated gene expression in both PCOS and periodontitis.ConclusionThe 4 hub genes ACSL5, NLRP12, CCRL2, and CEACAM3 may be diagnostic genes for PCOS and periodontitis. The created ceRNA network could provide a molecular basis for future studies on the association between PCOS and periodontitis.

Long pentraxin 3 and vitamin D receptor mRNA expression pattern of cumulus granulosa cells isolated from PCOS oocytes at different stages of nuclear maturation

BackgroundA fine-tuned pro-inflammatory and anti-inflammatory balance in the follicular unit is essential for cumulus expansion and successful ovulation. While the long pentraxin 3 (PTX3) gene is required for the expansion of cumulus cells (CCs), ovulation, resumption of meiosis and fertilization, the vitamin D receptor gene (VDR-X2) is required for intra-follicle redox balance. This study was planned to determine the expression pattern of VDR-X2 and PTX3 mRNA in CCs isolated from germinal vesicle (GV), metaphase I (MI), and metaphase II (MII) oocytes of PCOS patients with ovulatory dysfunction.MethodsThe relative expression of CC-PTX3 and CC-VDR-X2 mRNA were evaluated using qRT-PCR in a total of 79 CC samples collected from individual cumulus-oocyte complex of 40 infertile patients (20 PCOS and 20 non-PCOS normal responders) who underwent ovarian stimulation with the GnRH antagonist protocol.ResultsRelative PTX3 mRNA expressions of CCMI-control and CCMII-control showed 3- and 9-fold significant upregulation compared to CCGV-control, respectively. The relative PTX3 mRNA expression of CCMII-control increased approximately three fold compared to CCMI-control. Compared to CCGV-pcos, a 3-fold increase was noted in the relative PTX3 mRNA expression of CCMI-pcos and an approximately 4-fold increase in the PTX3 mRNA expression of CCMII-pcos. Relative PTX3 mRNA expression values of CCMII-pcos and CCMI-pcos were similar. A 6-fold upregulation of relative PTX3 mRNA and a 4-fold upregulation of VDR-X2 mRNA were detected in CCMII-control compared to CCMII-pcos. CC-VDR-X2 expression patterns of the PCOS and control groups overlapped with the CC-PTX3 pattern. Fertilization rates of the PCOS group exhibiting failed transcript expression were similar to normal responders.ConclusionThe fact that relative CC-PTX3 and CC-VDR mRNA expression does not increase during the transition from MI to MII stage in PCOS as in normal responders suggests that PTX3 and VDR expression may be defective in cumulus cells of PCOS patients with ovulatory dysfunction.

PCOS in women with infertility and role of determinant genes of steroid hormones

We observed 125 women: group 1 - 45 women with primary PCOS and infertility; group 2 - 46 women with infertility and PCOS in preparation for ART; group 3 26 conditionally healthy women. Based on the foregoing, we presented the data of our own studies on the assessment of the state, the genes of steroid hormones (CYP17A1-rs743572, CYP19A1-rs247015) based on the analysis of laboratory data. CY17A1 polymorphism in patients with PCOS, it can be said that the GG mutant genotype was statistically significantly more common in patients compared to the control group. When dividing PCOS patients, they were divided into groups and compared with the control group, MS+ PCOS patients had a lower level of the mutant form (GG) genotype compared to the control group, but in MS- PCOS patients compared to the control group, the mutant gene was determined more.

Prevalence of Anxiety and Depression among PCOS Patients Seen in a Tertiary Government Hospital Using the Hospital Anxiety and Depression Scale - English/Pilipino Version (HADS/HADS-P).

PCOS is a common gynecologic disorder and recent studies have found that they are more prone in developing depression and anxiety compared to the general population. The Hospital Anxiety and Depression Scale (HADS) is a popular and simple self-administered instrument reliable for detecting states of anxiety and depression. Using this simple screening tool, it may lead to the identification of such mental disorders that may warrant timely psychiatric referral. The study aims to determine the prevalence of anxiety and depression among PCOS patients using the HADS-P questionnaire and to determine the association between depression and anxiety and disease characteristics. Convenience sampling was done to recruit PCOS patients >18 years old in Philippine General Hospital. Cross-sectional design was used for the prevalence of depression and anxiety, while nested case control design for the evaluation of the predictors of depression and anxiety. The HADS-P, a self-administered rating scale with independent subscales for anxiety and depression, was administered to the participants after securing consent. A cut-off score of >8 points on either of the depression and anxiety subscale was used to determine their respective prevalence. Logistic regression analysis was used to determine the association of clinical variables with anxiety or depression. A total of 253 patients with PCOS were recruited. On the basis of a HADS-P score of >8.0 per category, the prevalence of PCOS patients who were suggestive to have anxiety was 46.25% (n: 117, 95% CI: 39.98-52.60%), while 9.09% (n: 23, 95% CI: 5.85-13.33%) of them were suggestive to have depression. Crude logistic regression identified presence of depression, infertility, impaired glucose tolerance, and prominent acne as predictors of anxiety; whereas low parity, hirsutism, and presence of anxiety were predictors of depression. Adjusted logistic regression identified only presence of depression and infertility were significant predictors of anxiety (n: 116, LR χ2 (5): 15.46, p<0.01); while presence of anxiety increased the odds of depression by 2- to 13-fold, it was not statistically significant (n: 116, LR χ2 (5): 9.79, p: 0.08). There is a high prevalence of anxiety and depression among PCOS patients. The factors that were seen to be significantly associated with the development of anxiety were the presence of depression, impaired glucose tolerance, infertility and prominent acne, while for the development of depression were the presence of anxiety, hirsutism, and low parity. Screening for anxiety and depression is of paramount importance and physicians should be vigilant for the need of possible psychiatric intervention.

Comparative Study of High Sensitive C Reactive Protein (hsCRP) and Complete Hematogram Levels Among Early and Prolonged PCOS Patients

Comparative Study of High Sensitive C Reactive Protein (hsCRP) and Complete Hematogram Levels Among Early and Prolonged PCOS Patients

Laparoscopic Ovarian Drilling in Women with Anovulatory Infertility

Background: Polycystic ovaries are common condition mostly found in reproductive aged women. Conventionally clomiphene is used instead of letrozole as first line drug in patients presenting with infertility as later is off label. 20% women are clomiphene resistant, those can be treated with gonadotrophins, other ovulation induction drugs or laparoscopic ovarian drilling. Objective: As PCOS is one of the leading cause of anovulatory infertility among women of reproductive age group. We study different factors to speculate the effect of laparoscopic ovarian drilling. Study Design: Quasi experimental study. Setting: Department of Gynecology &amp; Obstetrics, Faisalabad Medical University, Faisalabad Pakistan. Duration: One year from August 2021 to August 2022. Methods: Our study includes 100 anovulatory PCOS patients resistant to conceive by medical treatment like clomiphene, later selected for LOD. Various clinical and biochemical parameters of PCOS were examined. Outcome was measured between different categories by using SPSS V 25 system. Results: Polycystic anovulatory women with BMI &gt;35kg/m2, serum testosterone concentration &gt; 4.5 and span of infertility &gt; 3 years showed lack of response to LOD. Whereas response was seen in patients with less BMI and testosterone concentration along with decrease span of infertility. Conclusion: Ovarian drilling by laparoscopy is an efficient second choice for infertile anovulatory patients resistant to clomiphene citrate, main benefits are single time treatment, as opposed to several trials of ovulation induction, cost effective and a method to replace gonadotrophins effectively for ovulation induction while maintaining pregnancy rate.

THE EMERGING ROLES OF AUTOPHAGY-RELATED MICRORNAS IN PCOS

Autophagy is a conserved catabolic process that involves the destruction and recycling of damaged bio macromolecules or organelles via lysosomal-dependent pathways and is essential for maintaining cell homeostasis. As a result, aberrant autophagy is linked to a variety of illnesses, including PCOS, neurological diseases, and cancer. Autophagy is involved in endocrine and anovulation disorders. However, the association between hyperandrogenism and autophagy in PCOS patients human granulosa cells remains unknown. MicroRNAs (miRNAs) are small non-coding RNA molecules that control gene expression at the post-transcriptional stage by silencing specific mRNA. MiRNAs offer significant regulatory potential for various essential biological processes, including autophagy. As a result, studying autophagy-related miRNAs expression in PCOS will provide insights into the disease and lead to the discovery of novel therapeutic targets in PCOS. We summarize current knowledge of miRNA dysregulation during autophagy in PCOS, with a focus on the link between autophagy and miRNAs, and address their role in PCOS treatment and diagnosis.

Comparison between Letrozole with and without Gonadotropins Injection on Pregnancy Rates in Infertile PCOS Patients: A Multicenter Randomized Observational Trial

Comparison between Letrozole with and without Gonadotropins Injection on Pregnancy Rates in Infertile PCOS Patients: A Multicenter Randomized Observational Trial