Polycystic Ovaries In Women Research Articles

Impact of Metformin on Blood Levels of Thyroid Function Tests, and Some Biochemical Parameters Levels in Polycystic Ovarian Women

Polycystic ovary syndrome (PCOS) is the most common form of chronic female disease associated with androgen excess; perhaps occurring in 5-10% of the reproductive age group in women. PCOS is viewed as a heterogeneous disorder of multifactorial etiology. It is also associated with increased metabolic and cardiovascular risk factors. Objectives: The purpose of this study is to evaluate the serum level of hormones TSH, T3 and T4 in women with PCOS and to investigate the effect of metformin on hormones TSH, T3, and T4 levels in subjects with PCOS. Patients and methods: The present study was conducted at Kirkuk General Hospital and Azadi General Hospital from March 2023 to January 2024.One hundred forty-one women with PCOS were selected as the PCOS group, while 120 healthy women matched for age with the PCOS patients were selected as the control group. The body mass index is determined before and after therapy. They take metformin 850 mg twice daily for three months and provide fasting blood samples on the second day of menstruation before and after treatment. The data collection done through a designed closed and open-ended questionnaire, by using direct interviewing, and Ultrasound examination, Data were analyzed using SPSS for Windows 7. Results: Treatment resulted in a significant decrease in in body mass index at p-values 0.05. This study reveals that the thyroid hormones TSH, T3 and T4 were highly significantly increased (P < 0.001) in the serum of PCOS patients compared to the control group. Serum levels of TSH in women with PCOS were high significantly elevated compared to healthy control group. However, the study found no significant difference (p > 0.05) in TSH level in treated group with metformin compared with pre-treatment. Conclusion: Metformin can induce changes of TSH levels in patients with polycystic ovary syndrome.

Metformin Modulated Conventional and Biochemical Markers in Polycystic Ovarian Women

Metformin Modulated Conventional and Biochemical Markers in Polycystic Ovarian Women

The ameliorating effect of vitamin D supplementation on metabolic disturbances in polycystic ovary women

Our study aims to investigate the impact of Vitamin D supplementation on plasma glucose, lipids and other metabolic and endocrine parameters and evaluate the therapeutic effect of Vitamin D and how to improve insulin levels in patients with Polycystic ovarian syndrome (PCOS). A follow-up research was conducted in Kirkuk from January 5th through June 10th, 2022. There were 80 PCOS women in the research, both married and unmarried, ranging in age from 15 to 45 years old. These patients were hospitalized at Azadi Teaching Hospital's obstetrics and gynecology section. In the present study, 80 PCOS was diagnosed based on the presence of two of the Rotterdam criteria: oligo and anovulation, clinical and biochemical signs of hyperandrogenism, and polycystic ovaries in ultrasound, which were defined as the presence of 12 or more follicles measuring 2-9 mm in diameter in each ovary and ovarian volume more significant than 10 cm3. All 80 PCOS patients were given a comprehensive medical examination, anthropometric measurements, such as weight and height, and a generic questionnaire to fill out. The formula for calculating the Body Mass Index (BMI) was weight (kg)/height2 (m2 ). The mean BMI for PCOS patients was 28.2 (Kg /m²), and the mean for age 30. In our study, insulin level decreased significantly at P value (0.0045 ) with statically no correlation between vitamin D and insulin after three months of vitamin D administration, while insulin resistance level was reduced significantly at P value (< 0.0001) with a negative correlation between vitamin D and insulin resistance, while serum FSB level was raised significantly at P value < (0.0001).ConclusionThe majority of women with PCOS who enrolled in this study were within the childbearing age, and the majority of PCOS women were overweight. Vitamin D was most deficient in PCOS women. In PCOS women, hirsutism, acne, and irregular menstrual cycle were more frequent. Keywords: Polycystic ovarian syndrome; vitamin D; insulin Body Mass Index

Metformin Effects on Blood Levels of Myonectin in Polycystic Ovarian Women

Background: Polycystic ovary syndrome (PCOS) is a most prevalent endocrine diseases for females of childbearing age, and lead to an ovulatory infertility. It was shown that myonectin may be positively associated with insulin resistance parameters. Objectives: To evaluate serum myonectin levels and to determine the effects of metformin treatment on myonectin levels in patients with polycystic ovary syndrome. Patients and Methods: The Cross-Sectional Study carried out in the Department of Obstetrics and Gynecology Salahdeen general hospital in Tikrit city from 1st November 2022-30th January 2023. Patients diagnosed with PCOs depending based on the Rotterdam criteria. Participants were enrolled after all eligibility criteria were confirmed and informed consent completed. Sixty PCOS patients were selected as the PCOS group, while 30 healthy women matched for age with the PCOS patients were selected as the control group. Only 30 patients of them complete the follow up study and they agree to continue on metformin treatment during three months, the duration of the follow up. They take metformin 850 mg twice daily for three months and provide fasting blood samples on the second day of menstruation before and after treatment. The data collection done through: a designed closed and open-ended questionnaire, by using direct interviewing and Ultrasound examination, Laboratory examination. Myonectin, Luteinizing hormone (LH), Follicular Stimulating Hormone (FSH), and insulin were analysed by enzyme-linked immunosorbent assay (ELIZA) technique from Biomeriuex. Data were analyzed using SPSS for Windows 7. Results: The level of myonectin decreased significantly in PCOS patients compare to control group. The level of blood glucose, Insulin, and HOMA-IR, were increased significantly compared to the control. Serum LH levels were significantly higher, while the level of FSH were lowerin in women with PCOS than in controls. After metformin intake, all patients showed significant in decrease in gremlin concentration at p-values 0.05, but no significant difference (P>0.05) in myonectin level when compared to pre-treatment. Treatment resulted a significant decrease in in body mass index, Blood glucose, Insulin, HOMA-IR, testosterone and LH at p-values 0.05. However, the study found no significant difference (p > 0.05) in myonectin level between both groups in treated group with metformin compared with pre-treatment. Conclusion: Metformin testosterone and insulin resistance but can’t induce changes of myonectin level in patients with polycystic ovary syndrome.

Assessment of Erythropoietin, Testosterone, hepcidin and many hematological parameters in polycystic ovary women in Kirkuk city

This research was designed to assess the Testosterone, Erythropoietin and hepcidin concentrations and many hematological parameters (Hb, PCV, RBCs, Iron concentration and Ferritin concentration) in Women suffering poly cystic ovary, By which (55) blood sample were collected from women diagnosed with PCOs, at age (18-47) years with body mass index ≤ 30 kg/m2, whereas (25) blood samples were collected from healthy women regard as control group with body mass index ≥ 22 kg/m2,
 All samples were collected from external laboratories in Kirkuk city This study was done in the period from Sept 2016 to march 2017, so the results show significant increase at level (P≤ 0.01) in Testosterone concentration and hematological parameters (Hb, PCV, RBCs and Iron) in women suffering PCOs in comparison with control group, In other hand the study show significant decrease at level (P≤ 0.01) in Hepcidin concentration, ferritin concentration in women suffering PCOs in contrast with healthy group ,While the PCOs group showed no significant change in Erythropoietin concentration in comparison with healthy group.

Effect of aerobic exercise on inflammatory markers in polycystic ovary syndrome: a randomized controlled trial.

Chronic low-grade inflammation has emerged as a key contributor to the pathogenesis of Polycystic Ovary Syndrome (PCOS). In this regard, the present study examined the potential effects of aerobic exercise on interleukin-6 (IL6), tumor necrosis factor (TNF), and C-reactive protein (CRP) in PCOS women. This was a randomized clinical trial that included 40 females aged 25-35 years diagnosed with PCOS. The participants were divided into two groups equal in number: the aerobic exercise group (AEM), and the metformin group (M). The AEM group performed aerobic exercise three times a week for 12 weeks in addition to metformin treatment. The M group received metformin only. Participants were assessed for IL-6, TNF-α, and CRP at baseline and after 12 weeks of intervention. The findings showed a significant reduction in IL-6, TNF-α, and CRP values in both AEM and M groups (p=0.001, p=0.01, respectively) after the end of the 12 weeks of the intervention. However, the participants who received aerobic exercise plus metformin, group AEM, showed a greater reduction in IL-6, TNF-α, and CRP (p=0.01, p = 0.01 and p=0.001, respectively). Aerobic exercise is effective in lowering IL-6, TNF-α, and CRP in polycystic ovarian women. Further clinical trials are recommended to assess the potential effects of aerobic exercise on PCOS-associated risk factors.

Changes in Serum Irisin in Response to Metformin Treatment in Iraqi Women Patients with Polycystic Ovary Syndrome

Background: Polycystic ovary syndrome (PCOS) is the most prevalent endocrine condition in women, characterized by hyperandrogenism. Infrequent ovulation and multiple follicular cysts in hypertrophied sized ovaries, hyperinsulinemia and insulin resistance irisin a myokine play a vital role in the pathogenesis of many diseases characterized by insulin resistance. Objective: Assessment of the effect of metformin on the level of serum irisin in PCOS women compared to non– metformin-treated PCOS patients and healthy controls. Material and methods: This analytical cross-sectional included 88 females whose ages ranged from (18-to 40) years. All females were selected from the infertility treatment and IVF center of Kamal Al-Samarraey Hospital Baghdad/ Iraq from October 2020 to March 2021. Women were divided into three groups: group (a) involved 33 women with polycystic ovary syndrome metformin treatment, group (b) involved 37 women with polycystic ovary don't receive metformin group (c) involved (23) healthy women (act as controls). Each Serum specimen was analyzed to measure irisin, fasting insulin, fasting glucose, and homeostasis model assessment of insulin resistance (HOMA-IR). Results: significantly higher serum levels of irisin, fasting insulin and HOMA-IR were found in both groups of polycystic ovary women compared to healthy women. There was no significant difference in serum irisin levels between the two groups of polycystic ovary syndrome. Conclusion: It has been concluded that serum irisin levels did not change in response to metformin treatment.

English

BACKGROUND We wanted to analyse the clinical profile of polycystic ovarian syndrome (PCOS) women with history, examination and ultrasonogram and correlate hirsutism with biochemical markers as free testosterone, dehydro-epiandrosterone sulphate (DHEAS), sex hormone binding globulin (SHBG), free testosterone, DHEAS, and SHBG. METHODS This study is a prospective observational study conducted from 2011 to 2013 in the Department of Obstetrics and Gynaecology, Shree Balaji Medical College and Hospital, Chrompet in patients attending Gynaecology OPD. 100 women visiting the OPD were taken as control and 100 women were taken for PCOS study. RESULTS Hyperandrogenism was studied and all the biochemical markers were significantly higher in polycystic ovarian syndrome patients than in controls (P < 0.0001). The highest AUC-ROC was found for bioavailable testosterone (0.852) followed by free androgen index (0.847) and free testosterone (0.837). Lower AUC-ROC was found for androstenedione, total testosterone and SHBG (0.706, 0.799 and 0.76, respectively). When free androgen index of 4.97 was taken as a cut off value, sensitivity was 71.4 % and specificity was 85.2 %. A cut off of 0.78 nmol / L for bioavailable testosterone had even higher sensitivity of 75.9 %, but slightly lower specificity of 83.3 %. Bioavailable testosterone and free androgen index correlated significantly (all P < 0.05) with DHEAS, LH / FSH ratio, androstenedione and total testosterone. In addition, bioavailable testosterone, free androgen index, and free testosterone correlated significantly with follicle count, ovarian volume, and hirsutism scores. CONCLUSIONS White women have about 20 % of excess of dehydro-epiandrosterone sulphate (DHEAS) and black women have 30 % excess of dehydro-epiandrosterone sulphate (DHEAS) in those having poly cystic ovaries patients. There is an age-associated decline in DHEAS levels which is similar in both control and poly cystic ovaries women, regardless of the race which was seen in this study. KEY WORDS Free Testosterone, Dehydro–Epiandrosterone Sulphate (DHEAS), Sex Hormone Binding Globulin (SHBG)

Metformin effects on zonulin level in polycystic ovarian women.

Zonulin protein is a haptoglobin precursor and functions to modulate the permeability of tight junctions between enterocytes. Local inflammation or systemic inflammation can trigger zonulin expression. While the increased zonulin level causes an increase of intestinal permeability and entrance of foreign antigens, the latter can increase insulin resistance and inflammation. Polycystic ovarian syndrome affects women during their reproductive age characterized by hyperinsulinemia and/or hyperandrogenemia and associated with infertility problems. Changes in gut permeability such as irritable bowel syndrome are often found in PCOS patients. While metformin increases insulin mediates glucose uptake and, acts as an insulin-sensitizing drug used to treat PCOS patients is recently discovered to reshape intestinal bacteria and hence may affect intestinal action. This study was designed to find any association between zonulin level and other parameters in PCOS patients and to find metformin treatment effects on zonulin in PCOS patients. Thirty-one newly diagnosed PCOS women agree to take metformin 850 mg twice daily for three months and, and to give fasting serum samples to measure zonulin, FSH, LH, total testosterone, free testosterone, SHBG, fasting insulin, and fasting serum glucose before and after treatment. The free testosterone and zonulin are determined by the ELISA technique while the other parameters are determined by the Cobas technique. According to patients’ Homeostatic Model Assessment (HOMA-IR), the Patients were divided into two sub-groups: the first group consisting of those with initial HOMA-IR less than two and the second group was those of an initial HOMA-IR of between two to four. Whereas the first group showed no significant response to treatment, the second group showed a better response to metformin treatment, as demonstrated by their LH, total testosterone, free testosterone, fasting insulin, zonulin, and glucose levels. These parameters markedly improved after metformin treatment with p-values of 0.08, 0.09, 0.07. 0.04, 0.01 and 0.06, respectively.

Copeptin and Obestatin Levels in Polycystic Ovary women and their Relation to Obesity, insulin metabolism and Cardiovascular diseases

Objective: is to investigate the correlations between the serum levels of copeptin and obestatin, carotid artery intima-media thickness (CIMT), and brachial artery flow mediated dilatation (FMD) in obese and non-obese women with PCOS. Design: Prospective randomized study. Setting: Obstetrics and Gynecology Department, El-Hussein and Sayed Galal University Hospitals, Al-Azhar University. Patient(s): We analyzed 54 patients with PCOS and 20 normal women as controls. PCOS patients were divided into two groups based on body mass index (BMI): obese group (BMI > 30 kg/m2, n = 28) and non-obese group (BMI < 30 kg/m2, n = 26). Serum Copeptin and Obestatin levels, Insulin Homeostasis Model Assessment for Insulin Resistance (HOMA-IR), CIMT and brachial artery FMD were determined and compared among both groups. Result(s): Serum Obestatin levels were significantly lower in obese PCOS group than non-obese and control. While Serum Copeptin levels were significantly higher in obese PCOS group than non-obese and control. Brachial artery FMD was lower in the PCOS groups than control. Obestatin was positively correlated with cardiovascular risk factor (FMD), whereas Copeptin was negatively correlated with FMD Conclusion(s): Obestatin and Copeptin may provide useful information regarding future cardiovascular risk in PCOS patients as Obestatin was negatively correlated and Copeptin was positively correlated with cardiovascular risk factor (FMD). Keywords: Cardiovascular diseases, Copeptin, Insulin resistance, Obesity, Obestatin, Polycystic ovary

Concentration of anti-Mullerian hormone in the blood as a result of electrical stimulation of polycystic ovaries in women with infertility

This paper presents data on the effect of unilateral and bilateral electrical stimulation of the ovaries in 36 women of reproductive age with polycystic ovary syndrome and infertility on follicular reserve, estimated by the concentration of anti-Mullerian hormone in the blood serum. The results of surgical treatment showed that in the postoperative period in women, both with unilateral and bilateral ovarian cauterization, it does not lead to a critical decrease in the follicular reserve compared with indicators of healthy women.

Serum level evaluation of interleukin-18 in obese women with polycystic ovary syndrome

This study is designed to measure the level of interleukin (IL) 18 in polycystic ovary women and its association with obesity. In this study, blood samples from 50 women with PCOS and 30 healthy control women were collected from AL-Yarmouk Teaching, Baghdad Teaching hospitals During January 2018 - March 2018 for estimation of their serum level of IL18 by using enzyme-linked immunosorbent assay (ELISA) technique and evaluation serum levels of luteinizing hormone (LH), Follicle-stimulating hormone (FSH), Testosterone, prolactin (PRL) and Estradiol (E2) by using Electrochemiluminescence immunoassay (ECLIA). The results showed that there is a highly significant increase (P < 0.001) in serum level of IL18 in PCOS women than in healthy control group. As well as, the results of IL-18 value according to Body mass index (BMI) showed significant difference (P<0.05) between BMI and IL-18 level in all the PCOS patient subgroups (normal weight, overweight and obesity). Also, there was a significant increase in LH, FSH, PRL and T, and significant decrease in E2 was detected in PCOS patients.

PREGNANCY RATE FOLLOWING LUTEAL PHASE SUPPORT IN POLYCYSTIC OVARY WOMEN USING LETROZOLE WITH OR WITHOUT GONADOTROPIN AS OVULATION INDUCTION

Objective: The objective of the study was to evaluate the effect of luteal phase progesterone supplementation on pregnancy rates in anovulatory infertile polycystic ovary women using letrozole with or without gonadotropin as ovulation induction (OI).Method: A prospective randomized clinical study conducted in the infertility clinic - Al-Yarmouk Teaching Hospital, Baghdad/Iraq from June 2016 to January 2018. A total of 149 infertile polycystic ovary women who achieved ovulation using letrozole alone or with gonadotropin as OI protocol enrolled. Accordingly, the study group divided into two: Group A (letrozole group, no=99) and Group B (letrozole gonadotropin group, no=50). After triggering with human Chorionic Gonadotropin, the women in each group were randomly divided into two subgroup women with luteal phase support (LPS) and women without. The primary outcome measure was pregnancy rate.Results: The study shows that pregnancy rate was higher with letrozole group using LPS although the difference did not reach statistical significant (p=0.08). After adjustment of possible confounders; patients receiving letrozole with gonadotropin with LPS had significantly higher successful pregnancy rate.Conclusion: Administration of LPS after OI in infertile polycystic ovarian syndrome women may improve pregnancy rate.

LETROZOLE WITH OR WITHOUT GONADOTROPIN AS A FIRST-LINE OVULATION INDUCTION IN ANOVULATORY INFERTILE WOMEN DUE TO POLYCYSTIC OVARY SYNDROME

Objectives: The objective is to evaluate the clinical outcome of using letrozole alone or with gonadotropin as first-line ovulation induction in anovulatory infertile polycystic ovary women. Methods: A prospective single-arm study. 80 infertile polycystic ovarian syndrome (PCOS) women had been recruited between January and October 2017. Letrozole on day 2–3 of the cycle was given. The women are sorted into two groups according to the size of the dominant follicle on day 7 or 8, Group A (letrozole only group) and Group B (letrozole plus gonadotropin).Results: In our study, the overall pregnancy rate was (67.5%) and ovulation rate was 91.3%. The ovulation rate was significantly higher in Subgroup A than B (97.9% vs. 81.3%). Pregnancy rate was higher in Subgroup A (72.9% vs. 59.4%), but it was statistically not significant. The number of follicles was significantly higher in Subgroup B. Endometrial thickness, miscarriages, ovarian hyperstimulation syndrome, and multiple pregnancies were not statistically significant. Lower cycle number independently and significantly predict clinical pregnancy, while body mass index has a modest effect.Conclusions: Letrozole alone or in combination with gonadotropin as a first-line treatment in PCOS may be reasonable since this approach may improve the success rate and minimize the overall costs and risks.

Accuracy of anti-Müllerian hormone and total follicles count to diagnose polycystic ovary syndrome in reproductive women

ObjectiveRecently, there was a new recommendation of ultrasonographic criteria to diagnosis polycystic ovary syndrome (PCOS). In addition, serum anti-Müllerian hormone (AMH) was proposed as a surrogate marker for diagnosis of PCOS, but AMH cut-off level for diagnosis of PCOS is unclear. This study aimed to investigate the accuracy of serum AMH and evaluate new ultrasonographic criteria, follicle number per ovary (FNPO) threshold ≥ 25 follicles and ovarian volume (OV) > 10 mL, for diagnosis of PCOS. Materials and methodsA cross-sectional study was conducted. Fifty-five PCOS women and sixty-three normal ovulatory, non-hyperandrogenic women were recruited. Transvaginal or transrectal ultrasonography was performed in all participants to evaluate follicle number and OV. Serum AMH was evaluated in both study groups. ResultsThe mean age of the participants was 25.1 ± 5.3 years old in PCOS group and 29.7 ± 7.2 years old in control group. Mean AMH, FNPO and OV in PCOS women were significantly higher than those in non-PCOS women. The area under the receiver-operating characteristic (ROC) curve of AMH was 0.903. The threshold of AMH at 4.7 ng/mL offered the best compromise between 80% sensitivity and 77.8% specificity. The appropriated threshold values for FNPO, follicle number per cross-section (FNPS) and OV were 15 follicles, 7 follicles and 6.5 mL, respectively. Serum AMH level was significantly positively correlated with FNPO, FNPS and OV in both PCOS and control groups. In PCOS women, serum AMH showed strongly correlation with FNPO (r = 0.53, p < 0.001) and weakly correlation with total testosterone (r = 0.283, p = 0.036). ConclusionSerum AMH had a good diagnostic performance for diagnosis of PCOS presenting with oligo/anovulation and hyperandrogenism. AMH threshold at 4.7 ng/mL was the best compromise level for diagnosis of PCOS. FNPO ≥15, FNPS ≥7 and OV ≥ 6.5 mL were reliable threshold for detecting polycystic ovaries in women with frank manifestation of PCOS.

Levels of cytokines profile in polycystic ovary syndrome

Background: Polycystic ovary syndrome (PCOS) is one of the commonest endocrine disorder of female at reproductive age and it's prevalence in general population as 20%–33%. Objective: The aim of this study was to measure the level of interleukin (IL) 18, IL 6, and tumor necrosis factor (TNF) in polycystic ovary women and compare their levels with apparently healthy control group. Materials and Methods: case-control study was carried out in Basra. In this study, blood samples from 73 women with PCOS and 73 healthy control women were collected from outpatients and private gynecological clinics and primary health care centers from different area of Basra during August 2016–March 2017 for estimation of their serum levels of IL6, IL18, and TNF alpha by using enzyme-linked immunosorbent assay technique. Results: It is found that serum levels of IL6, IL18, and TNF alpha were elevated in PCOS women, and we conclude that serum levels of IL6, IL18, and TNF alpha are highly statistically significance in PCOS women than in healthy control group. Conclusion: Levels of IL6, IL18, and TNF alpha were highly statistically significant in PCOS comparing to normal women, and these high levels were related to PCOS independent on the presence of obesity or hyperandrogenism.

Impact of dexamethasone on pregnancy outcome in PCOs women candidate for IVF/ICSI, a single-blind randomized clinical trial study

Abstract Objective: Infertile women with polycystic ovary (PCOs) involve with anovulatory cycles. Various adjuvant treatments have been suggested to improve ovarian response in these patients. In this study, we aimed to evaluate the role of dexamethasone in the outcome of IVF/ICSI in PCOs infertile women. Study design: 129 PCOs infertile women undergone IVF/ICSI were enrolled for this single blind clinical trial study in 2012–2013. Setting: Fatemezahra Infertility and Reproductive Health Research Center, Babol University of Medical Sciences, Babol, Iran. Method: 43 patients who underwent IVF received dexamethasone (0.5 mg, 4 tab/day) in the treatment group and 74 patients were considered as the placebo group. Main outcome measure: Pregnancy rate was compared between the two groups. In addition, number of dominant follicle, oocytes retrieved, embryos transferred, and number of gonadotropin ampoule were evaluated. Results: The pregnancy rate in the group receiving dexamethasone was 17.5% significantly higher versus 4.3% in the placebo group (P

MEJORES TASAS DE ÉXITO DE FIV/ICSI CON EL USO DE METFORMINA EN MUJERES CON OVARIO POLIQUÍSTICO

Objetivo: Determinar el efecto de metformina en las tasas de éxito de fertilización in vitro (FIV) e inyección intracitoplasmática de espermatozoides (ICSI), en mujeres con ovario poliquístico. Diseño: Estudio retrospectivo. Institución: Centro de Fertilidad y Ginecología del Sur, Cusco. Participantes: Mujeres con infertilidad asociada a ovario poliquístico. Métodos: Se compara las tasas de éxito de FIV/ICSI de 7 mujeres con diagnóstico asociado de ovario poliquístico, usuarias de metformina, y de 9 mujeres con el mismo diagnóstico no usuarias del fármaco. Principales medidas de resultados: Embarazo. Resultados: La tasa de implantación fue 35%, la de embarazo bioquímico, 71,4%, y la de embarazo clínico, 57,1%, en las mujeres con ovario poliquístico usuarias de metformina. Las mujeres con ovario poliquístico no usuarias del fármaco tuvieron tasas de 0%, 11,1% y 0,0%, respectivamente. Conclusiones: El uso de metformina mejoro las tasas de éxito de FIV/ICSI en mujeres con ovario poliquístico.

The prevalence of polycystic ovary syndrome in a normal population according to the Rotterdam criteria versus revised criteria including anti-Mullerian hormone

What is the prevalence in a normal population of polycystic ovary syndrome (PCOS) according to the Rotterdam criteria versus revised criteria including anti-Müllerian hormone (AMH)? The prevalence of PCOS was 16.6% according to the Rotterdam criteria. When replacing the criterion for polycystic ovaries by antral follicle count (AFC) > 19 or AMH > 35 pmol/l, the prevalence of PCOS was 6.3 and 8.5%, respectively. WHAT IS KNOWN ALREADY?: The Rotterdam criteria state that two out of the following three criteria should be present in the diagnosis of PCOS: oligo-anovulation, clinical and/or biochemical hyperandrogenism and polycystic ovaries (AFC ≥ 12 and/or ovarian volume >10 ml). However, with the advances in sonography, the relevance of the AFC threshold in the definition of polycystic ovaries has been challenged, and AMH has been proposed as a marker of polycystic ovaries in PCOS. From 2008 to 2010, a prospective, cross-sectional study was performed including 863 women aged 20-40 years and employed at Copenhagen University Hospital, Rigshospitalet, Denmark. We studied a subgroup of 447 women with a mean (±SD) age of 33.5 (±4.0) years who were all non-users of hormonal contraception. Data on menstrual cycle disorder and the presence of hirsutism were obtained. On cycle Days 2-5, or on a random day in the case of oligo- or amenorrhoea, sonographic and endocrine parameters were measured. The prevalence of PCOS was 16.6% according to the Rotterdam criteria. PCOS prevalence significantly decreased with age from 33.3% in women < 30 years to 14.7% in women aged 30-34 years, and 10.2% in women ≥ 35 years (P < 0.001). In total, 53.5% fulfilled the criterion for polycystic ovaries with a significant age-related decrease from 69.0% in women < 30 years to 55.8% in women aged 30-34 years, and 42.8% in women ≥ 35 years (P < 0.001). AMH or age-adjusted AMH Z-score was found to be a reliable marker of polycystic ovaries in women with PCOS according to the Rotterdam criteria [area under the curve (AUC) 0.994; 95% confidence interval (CI): 0.990-0.999] and AUC 0.992 (95% CI: 0.987-0.998), respectively], and an AMH cut-off value of 18 pmol/l and AMH Z-score of -0.2 showed the best compromise between sensitivity (91.8 and 90.4%, respectively) and specificity (98.1 and 97.9%, respectively). In total, AFC > 19 or AMH > 35 occurred in 17.7 and 23.0%, respectively. The occurrence of AFC > 19 or AMH > 35 in the age groups < 30, 30-34 and ≥ 35 years was 31.0 and 35.7%, 18.8 and 21.3%, and 9.6 and 18.7%, respectively. When replacing the Rotterdam criterion for polycystic ovaries by AFC > 19 or AMH > 35 pmol/l, the prevalence of PCOS was 6.3 or 8.5%, respectively, and in the age groups < 30, 30-34 and ≥ 35 years, the prevalences were 17.9 and 22.6%, 3.6 and 5.6%, and 3.6 and 4.8%, respectively. The participants of the study were all health-care workers, which may be a source of selection bias. Furthermore, the exclusion of hormonal contraceptive users from the study population may have biased the results, potentially excluding women with symptoms of PCOS. AMH may be used as a marker of polycystic ovaries in PCOS. However, future studies are needed to validate AMH threshold levels, and AMH Z-score may be appropriate to adjust for the age-related decline in the AFC. None. Not applicable.

Weight Reduction Aids Antiepileptic Therapy to Restore Ovarian Functions of Epileptic Polycystic Ovary Women

Weight Reduction Aids Antiepileptic Therapy to Restore Ovarian Functions of Epileptic Polycystic Ovary Women