Polycystic Ovaries Group Research Articles

Mesenchymal-Stem Cell-Derived Conditioned Media Versus Exosomes in the Treatment of Rat Model of Polycystic Ovary: An Attempt to Understand the Underlying Mechanisms (Biochemical and Histological Study).

Polycystic ovary syndrome (PCOS) is one of the most common endocrine and reproductive disorders throughout female reproductive age. Cell free therapy [conditioned media (CM) & exosomes (EXO)] is a promising approach in regenerative medicine. This study aimed to compare between the therapeutic effects of stem cell-derived CM and exosomes on induced animal model of polycystic ovary. Polycystic ovary (PCO) was induced in female rats (3-4 weeks old, weighing 70-80 g) by letrozole with a dose of 1 mg/kg/day dissolved in carboxymethylcellulose 1% orally once daily for 5 weeks. Animals were divided into four groups: control group, PCO group, EXO-treated group, and CM-treated group. Serum levels of testosterone hormone, leutinizing hormone, follicle stimulatimg hormone, and insulin hormone were estimated. Immunohistochemistry using anti-P53, anti-AMP-dependent protein kinase antibodies were done. Six rats/group were used for matting with adult male rats for testing fertility. The results showed that CM had significant superior therapeutic effects on exosomes in restoring the normal histological architecture of the ovary and fertility. In summary, cell free treatment is a safe approach for tissue regeneration. Stem cell-derived CM was more effective than exosomes in restoring normal histological structure of the ovaries and fertility in animal models of polycystic ovary.

Effect of Testosterone Enanthate Modeling of Polycystic Ovary on Liver Irs-2 mRNA Expression in Rats: A Brief Report

There are many animal models for polycystic ovary (PCO); using exogenous testosterone enanthate is one of the methods of induction of these models. However, induction of insulin resistance should also be studied in the modeling technics. Therefore, the present study aims to investigate the expression of insulin receptor substrate (Irs)-2 mRNA in the liver tissue of rat PCO model. Nineteen Wistar rats were divided into three groups; (1) PCO modeling group (N =7) received daily 1.0 mg/100g testosterone enanthate solved in olive oil along with free access dextrose water 5%, (2) vehicle group (N =6), which handled like the PCO group, but did not receive testosterone enanthate, (3) control group (N =6) with standard care. All the animals were administered via intra-peritoneal injection for 14 days. Expression of Irs-2 mRNA was studied with real-time PCR and fold changes (FC) were reported. The average of expression in the control group was considered as the calibrator. About 13.4% expression reduction was found in the PCO group (FC =0.874, P-value =0.043). No significant reduction was found in the vehicle group (FC =0.951, P-value =0.076). However, analysis of variance did not show a significant difference between all the groups of study (P-value =0.085). The present model of PCO might induce insulin resistance at liver level with a low effect size via reduction in the mRNA expression of Irs-2. Study of the involved genes and molecules in other tissues of PCO animal models is suggested.

Alteration of TGFB1, GDF9, and BMPR2 gene expression in preantral follicles of an estradiol valerate-induced polycystic ovary mouse model can lead to anovulation, polycystic morphology, obesity, and absence of hyperandrogenism.

ObjectiveIn humans, polycystic ovary syndrome (PCOS) is an androgen-dependent ovarian disorder. Aberrant gene expression in folliculogenesis can arrest the transition of preantral to antral follicles, leading to PCOS. We explored the possible role of altered gene expression in preantral follicles of estradiol valerate (EV) induced polycystic ovaries (PCO) in a mouse model.MethodsTwenty female balb/c mice (8 weeks, 20.0±1.5 g) were grouped into control and PCO groups. PCO was induced by intramuscular EV injection. After 8 weeks, the animals were killed by cervical dislocation. Blood serum (for hormonal assessments using the enzyme-linked immunosorbent assay technique) was aspirated, and ovaries (the right ovary for histological examinations and the left for quantitative real-time polymerase) were dissected. ResultsCompared to the control group, the PCO group showed significantly lower values for the mean body weight, number of preantral and antral follicles, serum levels of estradiol, luteinizing hormone, testosterone, and follicle-stimulating hormone, and gene expression of TGFB1, GDF9 and BMPR2 (p<0.05). Serum progesterone levels were significantly higher in the PCO animals than in the control group (p<0.05). No significant between-group differences (p>0.05) were found in BMP6 or BMP15 expression. ConclusionIn animals with EV-induced PCO, the preantral follicles did not develop into antral follicles. In this mouse model, the gene expression of TGFB1, GDF9, and BMPR2 was lower in preantral follicles, which is probably related to the pathologic conditions of PCO. Hypoandrogenism was also detected in this EV-induced murine PCO model.

LOW‐LEVEL LASER THERAPY DECREASED THE NUMBER OF OVARIAN FOLLICULAR CYSTS IN POLYCYSTIC OVARIES‐INDUCED RATS

Female rats induced to polycystic ovary (PCO) present ovarian alterations in both folliculogenesis and steroidogenesis. There are a reductions in the numbers of follicles and corpora lutea, in addition to the appearance of follicular cysts. Hyperandrogenemia is a consequence of steroidogenic alterations that induce irregular estral cycles and folliculogenesis. Low‐level laser therapy (LLLT) and light‐emitting diode (LEDs) therapy have been investigated and used in clinical practice concernig the biomodulation of cellular functions both in vivo and in vitro. The objective of this study was to analyze the effects of LLLT on the number of ovarian follicular cysts in PCO rats. Forty‐five female adult Wistar rats weighing 250–300 g were divided into control (n = 15), PCO (n = 15) and PCO/laser (n = 15) groups. PCO in the rats was induced by single injection of estradiol valerate (EV) (2 mg/kg/bw, i.m.). After PCO induction, the rats were divided into groups evaluated 30, 45, and 60 days after the injections. The animals were manually contained and irradiated with a laser (wavelength 808 nm, power 60 mW) using a dose of 3 Joules(J)/point for 18 seconds on the dorsal region, performing a transillumination on each ovary 3 times a week, totaling 6 J of energy per irradiated animal/per day of application. After sacrifice, the ovaries were collected for preparation and subsequent analysis of histological slides. The results were reported as means ± SEM. Statistically significant differences among the means for the treatment groups were identified using p&lt;0.05. This study was approved by the local Animal Care and Use Committee (CEUA–UNIARA, protocol n° 019/16). The findings showed that the highest number of follicular cysts (6.33 ± 1.52) occurred in the PCO group 60 days after EV injection, while the lowest number of follicular cysts was observed in the control group (0.33 ± 0.57). The PCO animals submitted to LLLT for 60 days presented fewer (3 ± 1) follicular cysts than the PCO animals, but more follicular cysts than the control animals. The highest number of follicles was observed in the control group after 30 days (8 ± 1), while the lowest number was observed in the PCO group after 60 days (1.66 ± 0.57). The number of follicles found for the 60‐days PCO/laser group (6.66 ± 0.57) was higher than for the PCO group and equal to the control group. It could be concluded that the use of LLLT decreased the number of follicular cysts and increased the number of ovarian follicles in the PCO/laser group, compared to the PCO group, apparently restoring the ovarian folliculogenesis activity.Support or Funding InformationGrant #2016/02811‐4. São Paulo Research Foundation (FAPESP).This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

INCREASED PLASMA IL‐1 CONCENTRATIONS IN POLYCYSTIC OVARYINDUCED RATS

Polycystic ovary syndrome (PCOS) is a clinical disorder that affects up to 15% of women of reproductive age, and is the most common endocrine disorder among pre‐menopausal women. PCOS is characterized by impairment of ovulation, reduced fertility, and imbalance of reproductive hormones. In addition, women with PCOS often exhibit obesity, metabolic syndrome, hyperinsulinemia, insulin resistance, and dyslipidemia. Adipose tissue secretes hormones that contribute to processes that regulate metabolism, inflammatory responses, immunity, and reproduction. In obesity, body fat deposits are hypertrophied, stimulated by androgens that influence the expression of enzymes and proteins involved in lipid and carbohydrate metabolism, oxidative stress, and differentiation of pre‐adipocytes into mature adipocytes. A consequence of hypertrophy and adipose hyperplasia is the expression of pro‐inflammatory cytokines. The goal of this study was to analyze the plasma variations of interleukin‐1 (IL‐1) in rats induced to polycystic ovary (PCO). Ten female adult Wistar rats weighing 200–340 g were divided into control (n = 5) and PCO (n = 5) groups. PCO was induced in the rats by single injection of estradiol valerate (EV) (2 mg/kg/bw, i.m.). The two groups of rats were then evaluated after 30 days. The results were reported as means ± SEM. Statistically significant differences among the means for the treatment groups were identified using p&lt;0.05. This study was approved by the local Animal Care and Use Committee (CEUA–UNIARA, protocol n° 031/16). The results showed that the body mass of the control group (344 ± 13.56 g) was higher than that of the PCO group (306.4 ± 32.35 g). The ovary mass of the control group (0.072 ± 0.004 g) was higher than for the PCO group (0.048 ± 0.005 g), and the gonadal somatic index of the control group (0.0257 ± 0.006) was also higher than for the PCO group (0.0166 ± 0.008). Finally, the plasma IL‐1 concentration of the PCO group (55.68 ± 13.15 pg/mL) was higher than for the control group (21.62 ± 5.78 pg/mL). The results were indicative of metabolic and inflammatory changes in the rats 30 days after the PCO induction.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

EFFECT OF PROGESTERONE ON SURVIVAL, IN VITRO GROWTH AND IN VITRO MATURATION OF FOLLICLE DERIVED FROM MOUSE POLYCYSTIC OVARY.

Polycystic ovarian syndrome is the most common endocrine disorder in women of reproductive age. The purpose of the present study is to investigate the role of progesterone on survival, in vitro growth and in vitro maturation of follicles and the maturation of oocytes derived from mouse polycystic ovary. To induce polycystic ovary (PCO) female NMRI mice 21 days old were injected daily with testosterone enanthate 1 mg/100g body weight dissolved in sesame oil for 4 weeks (PCO group), while non-PCO group were injected only with vehicle. Follicles were derived from both groups and cultured in MEM-α medium either with progesterone or without progesterone. Sizes of follicles were measured in days 1, 3, 6, 9 and 12. After 12 days follicles were transferred to mature medium, follicles from two groups were cultured for 24 and 48 h and the in vitro maturation of oocytes was assessed. In PCO groups with progesterone, survival and in vitro growth of follicles, significantly increased as compared with PCO groups without progesterone (p<0.05). The in vitro maturation rate in PCO group with progesterone was significantly higher than in those not treated by progesterone (p<0.05). This study demonstrated that progesterone can improve survival, in vitro growth and in vitro maturation of follicles derived from mouse polycystic ovary.

Clinical and metabolic characteristics of Turkish adolescents with polycystic ovary syndrome

The aim of this study was to investigate the clinical, endocrine, metabolic features and prevalence of metabolic syndrome (MBS) in Turkish adolescents with polycystic ovary syndrome (PCOS) and the differences in metabolic parameters between adolescent PCOS with or without the presence of polycystic ovaries (PCO) on ultrasound. Subjects (n = 77) were classified into two groups: oligomenorrhea (O) and clinical and/or biochemical hyperandrogenism (HA) (n = 38), without PCO and O + HA with PCO (n = 39). The control group consisted of 33 age-matched adolescents. Adolescents with PCOS had a significantly higher body mass index (BMI), waist circumference and levels of LH, LH/FSH ratio, triglyceride, insulin, HOMA-IR, free androgen index and lower levels of SHBG and FSH. After adjustment for BMI, LH, LH: FSH ratio remained significantly higher. Adolescents with PCOS had a higher prevalence of MBS. No significant differences in lipid profiles, insulin levels and insulin sensitivity in both the PCOS groups were seen. HDL-C levels were lower in the O + HA + PCO group compared to the controls. BMI may be the major contributing factor in the development of metabolic abnormalities in adolescents with PCOS. Impact statement Many studies have investigated the effect of PCOS on metabolic and cardiovascular risks. It is thought that PCOS increases metabolic and cardiovascular risks. Increase in metabolic and cardiovascular risks associated with PCOS may be handled with early diagnosis and early intervention of PCOS in adolescents, although the diagnosis of PCOS in adolescents could be hard because of the features of PCOS overlapping normal pubertal physiological events. However, early identification of adolescent girls with PCOS may provide opportunities for prevention of well-known health risks associated with this syndrome and reduction of long-term health consequences of PCOS by reducing androgen levels and improving metabolic profile. Our results also support that BMI may be the major contributing factor in the development of metabolic abnormalities in adolescents with PCOS.

Pelvic floor dysfunction and polycystic ovary syndrome

The purpose of this study was to compare the prevalence of pelvic floor dysfunction (PFD) symptoms in patients with and without polycystic ovary syndrome (PCOS) and among different PCOS phenotypes. This was a case–control study. All participants were assessed using ultrasonography to determine the presence or absence of polycystic ovaries (PCO) and allocated to the case or control group (having healthy females whose husbands were diagnosed with male infertility). The case group was then further subdivided into the three phenotypes according to the presence or absence of menstrual dysfunction (M), hyperandrogenism (HA) and PCO on ultrasonography. Pelvic floor dysfunction was assessed by the Pelvic Floor Distress Inventory-20 (PFDI-20). Briefly, the reported pelvic organ prolapse (POP) symptoms were higher in PCOS group (p = 0.05). The mean PFD score in the HA + M + PCO group was higher compared to other phenotypes although the difference did not reach significant level (p > 0.05). However, there was a significant positive correlation between luteinising hormone (LH) level and the POP symptom portion of the PFDI-20 (p < 0.05). The reported POP symptoms were higher in PCOS group especially in HA + M + PCO phenotype. The findings suggest that higher levels of LH might correlate to symptoms of POP.

Abnormally activated one-carbon metabolic pathway is associated with mtDNA hypermethylation and mitochondrial malfunction in the oocytes of polycystic gilt ovaries.

Polycystic ovarian syndrome (PCOS) is associated with hyperhomocysteinemia and polycystic ovaries (PCO) usually produce oocytes of poor quality. However, the intracellular mechanism linking hyperhomocysteinemia and oocyte quality remains elusive. In this study, the quality of the oocytes isolated from healthy and polycystic gilt ovaries was evaluated in vitro in association with one-carbon metabolism, mitochondrial DNA (mtDNA) methylation, and mitochondrial function. PCO oocytes demonstrated impaired polar body extrusion, and significantly decreased cleavage and blastocyst rates. The mitochondrial distribution was disrupted in PCO oocytes, together with decreased mitochondrial membrane potential and deformed mitochondrial structure. The mtDNA copy number and the expression of mtDNA-encoded genes were significantly lower in PCO oocytes. Homocysteine concentration in follicular fluid was significantly higher in PCO group, which was associated with significantly up-regulated one-carbon metabolic enzymes betaine homocysteine methyltransferase (BHMT), glycine N-methyltransferase (GNMT) and the DNA methyltransferase DNMT1. Moreover, mtDNA sequences coding for 12S, 16S rRNA and ND4, as well as the D-loop region were significantly hypermethylated in PCO oocytes. These results indicate that an abnormal activation of one-carbon metabolism and hypermethylation of mtDNA may contribute, largely, to the mitochondrial malfunction and decreased quality of PCO-derived oocytes in gilts.

Statistical Genomic Approach Identifies Association between FSHR Polymorphisms and Polycystic Ovary Morphology in Women with Polycystic Ovary Syndrome.

Background. Single-nucleotide polymorphisms (SNPs) in the follicle stimulating hormone receptor (FSHR) gene are associated with PCOS. However, their relationship to the polycystic ovary (PCO) morphology remains unknown. This study aimed to investigate whether PCOS related SNPs in the FSHR gene are associated with PCO in women with PCOS. Methods. Patients were grouped into PCO (n = 384) and non-PCO (n = 63) groups. Genomic genotypes were profiled using Affymetrix human genome SNP chip 6. Two polymorphisms (rs2268361 and rs2349415) of FSHR were analyzed using a statistical approach. Results. Significant differences were found in the allele distributions of the GG genotype of rs2268361 between the PCO and non-PCO groups (27.6% GG, 53.4% GA, and 19.0% AA versus 33.3% GG, 36.5% GA, and 30.2% AA), while no significant differences were found in the allele distributions of the GG genotype of rs2349415. When rs2268361 was considered, there were statistically significant differences of serum follicle stimulating hormone, estradiol, and sex hormone binding globulin between genotypes in the PCO group. In case of the rs2349415 SNP, only serum sex hormone binding globulin was statistically different between genotypes in the PCO group. Conclusions. Functional variants in FSHR gene may contribute to PCO susceptibility in women with PCOS.

Isolated polycystic morphology: Does it affect the IVF treatment outcomes?

The aim of the current study was to compare women who have normal ovarian ultrasonographic findings and women with ovulatory polycystic ovary (PCO), in terms of IVF treatment outcome. The study was conducted at a tertiary referral hospital and included 906 women who underwent IVF treatment. Of these, 224 of the women had PCO (24.7%) and 682 of the women had normal ovarian morphology (75.3%) at the time of ultrasonographic examination prior to IVF. The treatment outcomes were compared between the two groups. In the PCO group, the number of oocytes at the size of > 16 mm, the overall number of collected oocytes and the number of fertilised oocytes were found to be significantly higher. Furthermore, the rates of implantation, biochemical pregnancy and clinical pregnancy were significantly higher in the PCO group (p < 0.05). The detection of PCO morphology on baseline ultrasonography in IVF candidates may be associated with higher treatment success.

Obstetric outcomes in women with polycystic ovary syndrome and isolated polycystic ovaries undergoing in vitro fertilization: a retrospective cohort analysis

Objective: This retrospective cohort study evaluated the obstetric outcomes in women with polycystic ovary syndrome (PCOS) and isolated polycystic ovaries (PCO) undergoing in vitro fertilization (IVF) treatment.Methods: We studied 104 women with PCOS, 184 with PCO and 576 age-matched controls undergoing the first IVF treatment cycle between 2002 and 2009. Obstetric outcomes and complications including gestational diabetes (GDM), gestational hypertension (GHT), gestational proteinuric hypertension (PET), intrauterine growth restriction (IUGR), gestation at delivery, baby’s Apgar scores and admission to the neonatal intensive care unit (NICU) were reviewed.Results: Among the 864 patients undergoing IVF treatment, there were 253 live births in total (25 live births in the PCOS group, 54 in the PCO group and 174 in the control group). The prevalence of obstetric complications (GDM, GHT, PET and IUGR) and the obstetric outcomes (gestation at delivery, birth weight, Apgar scores and NICU admissions) were comparable among the three groups. Adjustments for age and multiple pregnancies were made using multiple logistic regression and we found no statistically significant difference among the three groups.Conclusion: Patients with PCO ± PCOS do not have more adverse obstetric outcomes when compared with non-PCO patients undergoing IVF treatment.

Correlation between ultrasound parameters and hormone level in patients with polycystic ovary and polycystic ovary syndrome

A total of 104 patients with polycystic ovarian changes on ultrasound were divided into polycystic ovary syndrome (PCOS) and polycystic ovaries (PCO) groups according to their clinical symptoms and endocrine examinations. And 40 women with normal ovulation served as the controls. Ovarian volume (OV), ovarian stroma area (SA), ovarian total area (TA) and SA/TA ratio were measured by transvaginal ultrasonography. Their endocrine hormone levels were determined. Patients with PCOS showed significantly higher OV, SA, TA and SA/TA than those of PCO and control groups. SA/TA was positively correlated with testosterone. The median serum levels of anti-Mullerian hormone (AMH) and inhibit B in the PCO group were intermediate between those in control and PCOS groups. AMH and inhibin B of PCOS were higher than the PCO and control groups. It indicated that the levels of AMH and inhibit B were associated with the degree of polycystic ovaries and they could be used to differentiate PCOS and PCO. SA/TA is associated with the elevated serum testosterone of PCO. And SA/TA is an important ultrasonic parameter for diagnosing PCOS. Key words: Polycystic ovary syndrome; Ultrasonograph, Doppler, color

Cumulative live-birth rate in women with polycystic ovary syndrome or isolated polycystic ovaries undergoing in-vitro fertilisation treatment

This retrospective cohort study evaluated the cumulative live birth rate in women with polycystic ovary syndrome (PCOS) and isolated polycystic ovaries (PCO) undergoing in-vitro fertilisation (IVF) treatment. We studied 104 women with PCOS, 184 with PCO and 576 age-matched controls undergoing the first IVF treatment cycle between 2002 and 2009. The main outcome measure was cumulative live birth in the fresh plus all the frozen embryo transfers combined after the same stimulation cycle. Women in both the PCOS (n = 104) and isolated PCO groups (n = 184) had higher ovarian response parameters compared to age-matched controls (n = 576), and higher rates of withholding fresh embryo transfer for risk of ovarian hyperstimulation syndrome (OHSS). The actual incidence of moderate to severe OHSS was significantly higher in the PCOS (11.5 %) but not the isolated PCO group (8.2%) compared to controls (4.9%). The live birth rates in the fresh cycle were comparable among the 3 groups, but the PCOS group had a significantly higher miscarriage rate compared to the other 2 groups. Cumulative live birth rate was significantly higher in the isolated PCO group (60.3%), but not the PCOS group (50.0%), compared to controls (47.5%). Women in the isolated PCO group, but not the PCOS group, had a significantly higher cumulative live birth rate compared to controls. This could be explained by the quantitative effect of the higher number of transferable embryos obtained per stimulation cycle, which is uncompromised by the unfavourable embryo competence otherwise observed in PCOS.

Study on the facial and body terminal hair growth in women in Guangdong by using modified Ferriman-Gallwey scoring system

To study growth of facial and body terminal hair of women in Guangdong province and its relationship with age, menstrual irregularities and polycystic ovary, and determine normative cut-off score of modified Ferriman and Gallwey (mFG). A cross-sectional study was conducted on 2988 women at age of 20-45 years from 16 communities of two urban and two rural regions in Guangdong province from June 2008 to July 2009. Terminal body hair growth was assessed by using the modified Ferriman and Gallwey (mFG) scoring system. The normative cut-off value of mFG were calculated by using the K-means cluster analysis (K=2). Those women were classified into following groups, including 982 women at group of ages of 20- years, 765 women at group of 26- years, 597 women at group of 31- years, 384 women at group of 36- years, 260 women at group of 41-45 years. Due to absence or errors of medical records, some cases were excluded from this study. Based on menses irregularities (MI), polycystic ovaries (PCO), there were 488 cases in MI group, 2413 cases in normal menses group, 568 cases in PCO group, and 2207 cases in non-PCO group finally. The incidences of acne, MI, acanthosis nigricans, and polycystic ovaries were also analyzed in all the hirsute groups. (1) among 2988 women, it was observed 149 women (5%) with mFG≥7,314 women (10.5%) with ≥5,747 women with mFG≥2. (2) Cluster analysis identified an mFG score of 5 as the cut-off value that define abnormal hirsute in the total population and all the sub-groups with/without MI or PCO; (3) Based on age classification, it was found that increased age was associated with decreased trends of the percentile and cut-off value of hirsutism. The value of hirsutism of mFG were 6 in group of 20- years, 5 in group of 26- years, 4 in groups of 31- years, 36- years and 41-45 years. (4) The prevalence of acne, menstrual irregularities and POC were 45.5% (143/314), 73.6% (231/314), 25.8% (81/314) in total population, 25.1% (671/2674), 16.1% (431/2674), 19.8% (529/2674) in normal hair women, which reached statistical difference (P<0.05). The prevalence of acne, menstrual irregularities and acanthosis nigricans were 44.4% (130/293), 23.2% (68/293), 4.1% (12/293) in those age hirsute groups, 25.3% (681/2695), 16.2% (437/2695), 1.9% (51/2695) in normal hair women, which reached statistical difference (P<0.05). (1) among women in Guangdong province, mFG scoring showed decreased trends in women with increasing age. (2) An mFG score≥5 was cut-off value in diagnosis of hirsutism. (3) The hirsute women exhibited higher incidence of acne, menses irregularity, and acanthosis nigricans than those of women with normal hair growth.

Polycystic ovaries at ultrasound: normal variant or silent polycystic ovary syndrome?

It is not known whether polycystic ovaries (PCO) are an ovarian appearance without pathological meaning or whether they share with polycystic ovary syndrome (PCOS) the same ovarian follicle abnormality. There are few studies including strictly selected women with PCO but without other criteria of PCOS. In order to address these issues, we compared hormonal, metabolic and ultrasound parameters obtained from patients with PCO only, patients with PCOS and controls. This was a comparative analysis including three age-matched groups of 95 patients, who were included consecutively in a database: controls, patients with sonographic PCO but no symptoms (PCO group) and patients with PCOS. A clinical examination, fasting serum sampling and pelvic ultrasound examination were performed between cycle days 2 and 5 and results were compared between groups. The median serum anti-Mullerian hormone (AMH) level in the PCO group was intermediate between that in controls and that in the PCOS group (33.6 pmol/L, 19.8 pmol/L and 63.3 pmol/L, respectively), the differences being significant after adjustment for follicle number (P < 0.05), while the mean androgen serum level in the PCO group was similar to that in the control group and significantly lower than that in the PCOS group (P < 0.05) (median serum testosterone levels: 0.90 nmol/L, 0.79 nmol/L and 1.39 nmol/L; median androstenedione levels: 5.25 nmol/L, 4.37 nmol/L and 6.09 nmol/L, respectively). Body mass index, waist circumference and insulin levels had no effect on these differences. PCO is an abnormal condition, affected women showing no evidence of hyperandrogenism but having higher AMH serum levels compared with controls, suggesting a granulosa cell abnormality in PCO similar to that observed in PCOS. The absence of hyperandrogenism in PCO does not seem linked to the metabolic status.

Comparison of anti-mullerian hormone and antral follicle count for assessment of ovarian reserve

AIM:This study aims to compare the efficacy of AFC and AMH, as markers for ovarian reserve.MATERIALS AND METHODS:75 patients with PCO (polycystic ovaries) undergoing IVF were randomized with 75 non-PCO patients. On day 3, volume of ovary was acquired, ovarian volume was defined by VOCAL, and Sono AVC was used to count the number of antral follicles. Sum total of antral follicles in both ovaries was taken as total antral follicle count (AFC). AMH was measured on the same day. Long agonist protocol with recombinant FSH (rFSH) was used for IVF stimulation till at least two follicles of 18 mm were seen. hCG 10,000 iu was given and ovum pick up was done after 34-35 h. Primary end point was number of follicles >12 mm seen on day of hCG. Final end point was number of ova retrieved on ovum pick up. Correlation of AFC and AMH was checked for both end points and with each other.RESULTS:Correlation of AFC and follicles >12 mm on day of hCG in PCO group is 0.56 and non-PCO group is 0.63,1 and for AMH and follicles >12 mm on day of hCG in PCO group is 0.42 and non-PCO group is 0.47. Correlation of AFC with number of ova retrieved on OPU in PCO group is 0.44 and for non-PCO group is 0.50. The value for AMH is 0.39 in PCO and 0.43 for non-PCO group. Comparing correlation of AFC and AMH for primary end point in PCO group has ‘z’ value 1.11(onetailed significance 0.1335, twotailed significance 0.267) and in non-PCO group comparison shows a ‘z’ value of 1.39 (one tailed significance 0.0823, two-tailed significance 0.1645). Therefore in both groups, AFC and AMH correlates with total number of follicles >12 mm on day of hCG, but both AFC and AMH have independent significance. Comparing correlation of AFC and AMH with number of ova retrieved on OPU, in non-PCO group has ‘z’ value of 0.54(one tailed 0.2946, two-tailed 0. 5892). In PCO group, this comparison shows, ‘z’ value of 0.36(one tailed 0.3594, two tailed 0.7188).CONCLUSION:AFC and AMH correlate with each other but have independent significance for estimating follicles >12 mm on day of hCG. For ova retrieved on OPU, in PCO group, AMH and AFC have similar significance. In non-PCO, AMH may increase accuracy of estimation of number of ova retrieved on OPU over AFC, but difference is not significant. AFC only may suffice for estimation of number of ova retrieved on OPU for all practical purposes.

Hyberbaric oxygen increases atresia in normal &amp; steroid induced PCO rat ovaries

BackgroundIn this study, we investigated the effect of hyperbaric oxygen therapy (HBOT) on the morphology of estradiol valerate (EV) induced polycystic ovary (PCO) to find a new treatment modality for improvement of PCO.MethodsThe rats were divided into four groups. Group1, control; group 2, PCO group; group 3, PCO with HBOT group and group 4, normal ovary with HBOT. PCO was induced by a single intramuscular injection of 4 mg EV in adult cycling rats. Other rats with normal ovaries had oil injection as placebo. HBOT was applied to third and fourth groups for six weeks. Histopathologic evaluation of ovaries of all groups were performed & compared.ResultsSix weeks of HBOT was resulted in increase in follicular atresia, decrease in the number of primary, secondary, tertiary follicles and decrease in the number of fresh corpus luteum in normal rat ovary. HBOT on polycystic rat ovary, resulted in significant increase in atretic follicles which were already present.ConclusionsHBOT of six weeks itself, changed ovarian morphology in favor of atresia both in PCO group and control group. This result of aggravated follicular atresia after HBOT on EV induced PCO may be due to long-term exposure in our protocol which with this state seems to be inapplicable in the improvement of PCO morphology.

P30.07: Clinical outcomes of IVF‐ET treatment in infertile patients with polycystic ovary syndrome or polycystic ovaries

To study the clinical features and outcomes of in vitro fertilization and embryo transfer (IVF-ET) in infertile patients due to polycystic ovary syndrome (PCOS) or polycystic ovaries (PCO). This study involved 189 infertile patients with polycystic ovary syndrome (PCOS), with 129 polycystic ovaries (PCO), and 142 without PCOS or PCO (control) undergoing IVF-ET. The dosage of gonadotrophin (Gn), sex hormone level on the day of HCG administration, clinical pregnancy rate, spontaneous abortion rate and ovarian hyperstimulation syndrome (OHSS) rate were analyzed and compared between the 3 groups. No significant differences were found in the clinical pregnancy rate between the PCOS group (202 cycles), PCO group (134 cycles) and control group (150 cycles) (51.0%, 53.0% and 46.0%, respectively). The levels of LH and T and early spontaneous abortion rates were significantly higher in PCOS group than in PCO group and control group (P < 0.05). The P level on HCG day was the highest in PCO group (P < 0.05). The early spontaneous abortion rates and clinical pregnancy rate showed no significant differences between PCO group and control group (P > 0.05). The dosage of Gn was significantly lower and OHSS rate higher in PCOS and PCO groups than in the control group (P < 0.05). The clinical pregnancy rate of infertile patients with PCOS is similar with that of PCO patients and control patients undergoing IVF-ET treatment. PCOS, however, is associated with increased spontaneous abortion rate, possibly due to abnormality of LH and T release. The clinical outcomes in PCO patients are similar with those in the control patients, and elevated P level in the late follicular phase does not obviously influence the outcomes of IVF. Both PCOS and PCO are associated with increased risk of OHSS.

Effects of Angelicae Gigantis Radix (AGR) on Polycystic Ovary induced by Estradiol Valerate in rats

Angelicae Gigantis Radix (AGR) is the most frequently used medicinal plats for patients with gynecological problems, especially pregnancy (1,2). This study was designed to investigate the effects of (AGR) on Polycystic Ovary (PCO) induced by Estradiol valerate (EV) in female rats. We investigated the effects of AGR on Changes in body weights and food and water uptake for 5 weeks. In addition, we examined the effects on ovary weights. Finally, we also observed histopathological changes in PCO rats. In our results, AGR administration group restored ovary/body weight ratio to normal levels, which were lowered by induction of PCO (3). In histopathological observation, formation of cysts was suppressed in AGR group compared with non-treated PCO group). In conclusion, these results suggest that AGR can be used for patients with PCO to prevent formation of cystic follicles and malfunction of ovary.