P–129 Follicular extracellular vesicles of women with polycystic ovarian syndrome inhibit oocyte maturation

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
C Liu ◽  
M Wang ◽  
H Yao ◽  
M Cui ◽  
X Gong ◽  
...  

Abstract Study question Does follicular extracellular vesicles of women with polycystic ovarian syndrome (PCOS-EVs) interfere with the quality of oocytes? Summary answer PCOS-EVs induced oxidative stress in the oocytes and inhibited oocyte maturation by increasing the abnormal mitochondria distribution and abnormal spindle rates. What is known already Polycystic ovarian syndrome (PCOS) is a common endocrine disorder in women of reproductive age, with a prevalence up to 10%. Women with PCOS are characterized by a clustering of features, including hyperandrogenism, polycystic ovarian morphology, and notably, anovulation. Although international guidelines recommend assisted reproduction techniques to be an effective resort for PCOS patients to conceive. However, even after overcoming ovulatory dysfunction via ovulation induction, the pregnancy outcomes of patients with PCOS were far from satisfying with lower fertilization, cleavage, and implantation rates, implicating that theoocyte quality of these patients are affected. Whereas the mechanisms have not been elucidated yet. Study design, size, duration Follicular fluid of PCOS patients (n = 10) and healthy controls (n = 10) were collected and used for extracellular vesicles (EVs) isolation via ultracentrifugation. Germinal vesicle (GV) oocytes collected from female ICR mice were cocultured with RIF-EVs or FER-EVs, respectively, and PBS served as a blank control. GV breakdown (GVBD) rate and maturation rate were calculated at two-hour and fourteen-hour of co-culture, respectively. Besides, oocyte mitochondria distribution, meiosis spindle morphology, and oxidative status were assessed in different groups. Participants/materials, setting, methods EVs were determined by western blotting, nanoparticle tracking analysis, and transmission electron microscopy. Fluorescence labeled EVs were used to visualize internalization by oocytes. Oocytes mitochondria and mitosis spindles were stained with fluorescence, and abnormal mitochondria rate or abnormal spindle rate was calculated. Reactive oxygen species (ROS) level was detected in the differently treated oocytes. Moreover, the expression of CAT, GSS, and SOD was determined in the oocytes using quantitative reverse transcription polymerase chain reaction. Main results and the role of chance Both PCOS-EVs and CTRL-EVs are bilayered vesicles, ranging from 100 to 150 nm, and enriched in Alix, TSG101, and CD9. EVs could be internalized by oocytes within one hour. After coculture, the GVBD rate was similar among the three groups; whereas the maturation rate was significantly decreased in the PCOS-EV group compared with CTRL-EV group or PBS group. In addition, the abnormal mitochondria distribution rate or abnormal spindle rate were significantly increased in the PCOS-EV group compared with PBS or CTRL-EV group. The ROS level was increased in the PCOS-EV group compared with CTRL-EV group, and the expression of CAT, GSS, and SOD was increased in the PCOS-EV-treated oocytes. Limitations, reasons for caution Our study did not identify the contents of PCOS-EVs and CTRL-EVs, and the molecular mechanisms of dysregulations induced by PCOS-EVs need further researches to investigate. Wider implications of the findings: This work confirmed that EV-conducted cellular communication played an important role in oocyte development in women with PCOS. The dysregulation of oocytes induced by PCOS-EVs might be related to the poor oocyte quality of women with PCOS, which may provide a novel target to improve pregnancy outcomes of these patients. Trial registration number Not applicable

2019 ◽  
Author(s):  
Yana Naumenova ◽  
Elena Mahlina ◽  
Marya Rusalenko ◽  
Iryna Savasteeva ◽  
Tatyana Mokhort

Author(s):  
Jayshree J. Upadhye ◽  
Chaitanya A. Shembekar

Background: Polycystic ovarian syndrome (PCOS) is an endocrine disorder which affects the adolescent girls It affects 5% to 10% of women in their reproductive age. Awareness and accurate diagnosis is the first step in managing PCOS as it improves quality of life of the patient. The study was conducted to assess the knowledge on PCOS among the medical students.Methods: Survey of 200 girls was done to assess the knowledge on the polycystic ovarian syndrome among the medical students of different colleges studying in 1st, 2nd, and 3rd year. The data was collected from the students by using structured questionnaire.Results: In present study, 51% girls had normal BMI, 19.5% were overweight, 16.5% were obese while 13% were underweight. 33.5% females had acne, 16% had irregularity of menses, 5% had hirsutism while 2% had infertility. In present study, 33% adolescent and young girls had information about PCOS from teacher, 19% got information from friend, 11.5% got information from a doctor, 3.5% got information from newspaper while 5% got information from internet. 28% adolescent and young girls were unaware of PCOS.Conclusions: Thorough knowledge of the disorder and counseling for adolescents should be included in the curriculum which will provide awareness towards the disorder and lifestyle modification. Accurate diagnosis at a younger age may be a key.


2018 ◽  
Vol 25 (15) ◽  
pp. 1792-1804 ◽  
Author(s):  
Silvana R. Ferreira ◽  
Alicia B. Motta

Background: The endometrium is one of the most important female reproductive organs. Polycystic ovarian syndrome (PCOS) is a reproductive and endocrine pathology that affect women of reproductive age. PCOS negatively affects the endometrium, leading to implantation failure and proliferative aberrations. Methods: We conducted a search at the http://www.ncbi.nlm.nhi.gov/pubmed/electronic database using the following key words: endometrial steroid receptors, endometrium, uterine function, endometrium and PCOS, implantation window, implantation and PCOS, implantation markers, inflammation, oxidative stress. We selected the articles based on their titles and abstracts, then we analyzed the full text and classified the articles depending on the information provided according to the sections of the present review. Results: The endocrine and metabolic abnormalities displayed in women with PCOS promote complex effects on the endometrium, leading to a low rate of implantation and even infertility. Women with PCOS show alterations in the Hypothalamic-Pituitary- Ovarian axis, which results in constant circulating levels of estrogen, similar to those at the early follicular phase, and a deficiency in the withdrawal of estrogen and progesterone. Besides this deficiency in the withdrawal of estrogen and progesterone, the insulin/ glucose pathway, adhesion molecules, cytokines and the inflammatory cascade, together with the establishment of a pro-oxidative status, lead to an imbalance in the uterine function, which in turn leads to implantation failure or even endometrial cancer. Conclusion: Women with PCOS display a dysregulation of the Hypothalamic-Pituitary- Ovarian axis, which alters the steroid pathway. In addition, the deficiency in the withdrawal of estrogen and progesterone in the endometrium results in abnormal endometrial cellular proliferation. The imbalance in adipose tissue observed in PCOS patients reinforces the increase in circulating hormones. The present review describes the role of hormones, metabolites, cytokines, adhesion molecules and the insulin/glucose pathway related to the uterine endometrium in women with PCOS and their role in implantation failure and development of endometrial cancer.


2017 ◽  
Vol 9 (4) ◽  
pp. 336-340 ◽  
Author(s):  
Richa Singh ◽  
Meenal Jain ◽  
Poonam Yadav ◽  
Sarvesh Awasthi ◽  
Pallavi Raj

ABSTRACT Introduction The polycystic ovary syndrome (PCOS) is the most common condition associated with chronic anovulation affecting 4 to 6% of reproductive age women. Aim To compare the effectiveness of laparoscopic ovarian drilling (LOD) for ovulation induction with gonadotropins in clomiphene-resistant PCOS in terms of ovulation, pregnancy, live birth, abortion, multiple pregnancies, and complication like ovarian hyperstimulation syndrome (OHSS). Setting and design A prospective hospital-based randomized trial. Materials and methods It was a prospective study, which was carried out from January 2012 to May 2015. Totally, 89 women were evaluated in the study, out of which 44 women were in gonadotropin group and 45 were in LOD group. Statistical analysis Standard statistical analysis was done and significance of difference in results was tested by chi-square test. Results Ovulation rate in gonadotropin group was 75.0% at 6 months, whereas in LOD group, it was 20% at 3 months and was increased up to 66.66% after addition of clomiphene citrate and gonadotropin. The primary outcome in terms of pregnancy in gonadotropin group was 45.45% after 6 cycles and in LOD group was 11.11% after 3 cycles and 40.00% after 6 cycles with supplementation of clomiphene citrate and gonadotropin. Conclusion The ongoing pregnancy rate from ovulation induction with LOD alone was significantly less but if supplemented by clomiphene citrate and gonadotropin, it seems equivalent to ovulation induction with gonadotropin, but the former procedure carries a lower risk of multiple pregnancies. How to cite this article Yadav P, Singh S, Singh R, Jain M, Awasthi S, Raj P. To Study the Effect on Fertility Outcome by Gonadotropins vs Laparoscopic Ovarian Drilling in Clomiphene-resistant Cases of Polycystic Ovarian Syndrome. J South Asian Feder Obst Gynae 2017;9(4):336-340.


2020 ◽  
Vol 11 (4) ◽  
pp. 644-649
Author(s):  
Saroj Kumari ◽  
Sarvesh Kumar Singh ◽  
Kshipra Rajoria ◽  
Avadhesh Kumar

Polycystic ovarian syndrome (PCOS) is a probably fastest growing endocrinological disorder in females of reproductive age. In PCOS, follicular growth is influenced by hormonal imbalance during the ovarian cycle, leads to affected follicles remain in the ovary. The prevalence of PCOS is estimated 6-10% globally and 3.7% - 22.5% in Indian female population, which is relatively high. It is characterised by hyperandrogenism, anovulation and polycystic ovaries which clinically manifests in the terms of amenorrhea or oligomenorrhea, hirsutism, acne, infertility etc. In present scenario, incidence of this disease increasing exponentially due to sedentary lifestyle and faulty dietary habits. This particular disease is not described word to word in Ayurveda. Associated features of PCOS are closely resembling with Bandhya Yonivyapada, Artavavahasrotasa-Vidhha Lakshana, Nastartava and Ksheenaartava described by Acharya Sushruta and Pushpghani Jatharini and Vikuta Jatharini mentioned by Acharya Kashyap. Maximum congruence of PCOS can be established with Bandhya Yonivyapada. The purpose of this study is to understand Nastartava which is the cardinal feature of Bandhya. Word Artava has been used exclusively in Samhita in context of menstrual blood, ovum and ovarian hormones. Therefore Amenorrhea, anovulation, hormonal dysfunction is considered exposed manifestations of Nastartava. Possible line of treatment is stipulated with Nidanaparivarjan, herbal drugs and Panchakarma procedures. Keywords- Ayurveda, Artava, Nastartava, PCOS, Herbal drugs, Panchakarma


Author(s):  
Chaitali Maitra ◽  
Ramesh Chandra Gupta ◽  
Rishika Raj

Introduction: Polycystic Ovarian Syndrome (PCOS) is a common endocrine disorder in the women of reproductive age. Studies show that there is an intensive relationship between insulin and gonadal function. As per Rotterdam Criteria, there are four major phenotypes of PCOS with different presentation. Early detection of Insulin Resistance (IR) and consequential prevention of Metabolic Syndrome (MS) associated with PCOS may lead to better prospect for the disease. Aim: To find the pattern of IR in all the phenotypes of PCOS in relation to Waist Hip Ratio (WHR), Body Mass Index (BMI) and Testosterone and thereby, providing data for designing phenotype specific treatment of the disease. Materials and Methods: In this cross-sectional observational study, fasting insulin and fasting glucose were analysed to calculate Homeostasis Model Assessment (HOMA-IR) and Testosterone for total 144 female subjects of reproductive age group (18-40 years). Subjects were classified in to four groups as per Rotterdam Criteria. Complete PCOS (PCO-COM), PCO with Oligo/Anovulation (PCO-O), Anovulation with Hyperandrogenism (O-HA), and PCO with Hyperandrogenism (PCO-HA). Regression analysis was done to find the relation among the study variables. Analysis of Variance (ANOVA) was used to analyse the significant variance among the groups. Results: IR was found to be maximum among O-HA phenotype (2.4±0.37) and lowest among PCO-HA phenotypes (1.3±0.22). Regression analysis shows that there exist significant associations between IR and BMI (t=4.96, p=0.001) as well as between IR and WHR (t=2.97, p=0.003). No independent association between testosterone and IR was observed. Conclusion: Significant difference of IR, WHR, and BMI was observed among the four phenotypes of PCOS. Due to increased IR, O-HA and PCO-COM phenotypes are more predisposed to Cardiometabolic consequences of PCOS.


2019 ◽  
Vol 3 (5) ◽  

The Polycystic ovarian syndrome affects 6-15 % of reproductive age women worldwide. And recently the changing life styles and rising obesity worldwide have contributed to a rise in the incidence of PCOS. Though there are many issues with PCOS post conception. PCOS women are at increased risk of early pregnancy loss which is approx. three fold as compared to the women without PCOS. After successfully crossing the first trimester, they are at risk of developing pre- eclampsia, GDM, preterm birth and birth of small for gestational age infant. Also higher incidence of multiple pregnancies is there and the risks associated with them. All these leading to higher rate of c -section delivery. So, proper understanding of these risks, informing and counseling the patients regarding them facilitate closer maternal and fetal surveillance and help improving the outcome of pregnancy.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sultan Alghadeer ◽  
Alhanouf Algarawi ◽  
Faten Abu-Rkybah ◽  
Mashael M. Alshebly ◽  
Yazed Alruthia

Abstract Background Polycystic ovarian syndrome (PCOS) is a hormonal disorder that is prevalent in females of reproductive age with signs and symptoms that significantly reduce self-esteem and have a negative impact on their quality of life. The management of PCOS signs and symptoms should result in an improvement in the health-related quality of life (HRQoL) of patients. Polycystic ovarian syndrome questionnaire (PCOSQ) is a disease-specific scale. The PCOSQ has been translated into different languages and assessed in different populations. The validity and reliability of PCOSQ varied depending on the ethnicity and culture of the respondents. The objective of the study was to establish a valid and reliable version of the PCOSQ (AR-PCOSQ) in Arabic. Methods A cross-sectional study using the translated and validated AR-PCOSQ questionnaire was conducted by interviewing 117 women with PCOS. Results The mean age (years) and BMI (kg/m2) of subjects were 29.90 ± 6.33 and 27.21 ± 5.54, respectively. Most of the patients had ≥ 1-year long history of PCOS (73.5%) and a post-school degree (64.96%). The content validity index (CVI) for the AR-PCOSQ from 10 gynecologists was 0.9, indicating satisfactory validity content. The internal consistency for reliability confirmation measured by Cronbach’s alpha coefficient was applied. Alpha coefficients for all items together was 0.863, indicating good reliability. The intraclass correlation coefficients for each item for 30 participants were also acceptable, ranging from 0.911 to 0.986 with p value < 0.001. As far as the factor analysis is concerned, the overall Kaiser–Meyer–Olkin sampling adequacy measure was 0.772. The Bartlett sphericity test was significant (p ≤ 0.001), Indicating that there were interrelated variables. Conclusion Our results demonstrated the initial reliability and validity of the Arabic version of the PCOSQ as a measure of specific HRQoL in Saudi women with PCOS. This will fill an important gap in measuring the HRQoL for patients with PCOS in research and community settings in Saudi Arabia. The AR-PCOSQ can be used to help prioritize health-related concerns from the patient’s perspective.


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