Effects of moxibustion on reproduction and metabolism of polycystic ovary syndrome: a protocol for meta-analysis and systematic review

IntroductionPolycystic ovary syndrome (PCOS) is one of the most common endocrinopathy in women of reproductive age. Recently, moxibustion, as a complementary and alternative therapy, has been commonly used in assisted reproduction and improvement of metabolic abnormalities in patients with PCOS. Currently, intervention efficacy of the use of moxibustion in PCOS treatment still remains controversial due to lack of high-quality evidence. Consequently, this study protocol was designed to objectively review and evaluate the effectiveness and safety of moxibustion treatment for PCOS.Methods and analysisElectronic searches will be carried out from inception to May 2021 in the online databases of The Cochrane Library, PubMed, EMBASE, Chinese Biomedical Literature, Chongqing VIP Chinese Science and Technology Periodical Database (VIP) and China National Knowledge Infrastructure. The Chinese Clinical Trial Registry Center and Clinical Trials will be used for searching ongoing trials. Randomised controlled trials and the first period in randomised cross-over trials involving any type of moxibustion for patients with PCOS will be included. Primary outcomes will be the ovulation rate, pregnancy rate and sex hormone levels, and secondary outcomes will be changes in clinical symptoms and metabolic indicators, total effective rate and the incidences of side effects and adverse events. Briefly, two reviewers will independently conduct study selection and data extraction, and the risk of bias will be assessed. Prior to the formal meta-analysis, the heterogeneity of included studies will be assessed. Review Manager Statistical Software (RevMan) V.5.3 will be used for data processing. Finally, the Grading of Recommendations Assessment, Development and Evaluation method will be applied to evaluate the quality of evidence.Ethics and disseminationEthical approval is not necessary since this study is designed as a systematic review. This study will be disseminated by a peer-review journal or conference presentation.

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Effect of Acupuncture on Polycystic Ovary Syndrome in Animal Models: Study Protocol for a Systematic Review and Meta-Analysis

10.21203/rs.3.rs-144670/v1 ◽

2021 ◽

Author(s):

Jinjin Gao ◽

Wei Li ◽

Yangyang Li ◽

Yan Li

Keyword(s):

Systematic Review ◽

Animal Models ◽

Polycystic Ovary Syndrome ◽

Polycystic Ovary ◽

Meta Analysis ◽

Risk Of Bias ◽

Reproductive Age ◽

Model Assessment ◽

Ovary Syndrome ◽

Complementary And Alternative Therapy

Abstract Background: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders among women of reproductive age. As a widely used complementary and alternative therapy, acupuncture is increasingly used to treat PCOS. However, the effect of acupuncture in treating PCOS is uncertain and the mechanisms are unclear. This systematic review aims to determine the efficacy of acupuncture on PCOS in animal preclinical models.Methods: We will search the following databases: PubMed, Web of Science, China National Knowledge Infrastructure and Chinese Science and Technology Periodical Database. We will only include animal experiments of acupuncture in treating PCOS. The primary outcome will be homeostatic model assessment- insulin resistance. The risk of bias will be assessed using the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE) risk of bias tool. Confidence in the cumulative evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. All meta-analyses will be conducted using Review Manager 5.4. Discussion: To the best of our knowledge, the use of acupuncture in treating PCOS has not yet been systematically reviewed in animal models. The evidence generated from this systematic review and meta-analysis could benefit future researches. Systematic review registration: OSF (Registration DOI: 10.17605/OSF.IO/FNM37)

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Association of Estrogen Receptor Genes Polymorphisms With Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis Based on Observational Studies

Frontiers in Endocrinology ◽

10.3389/fendo.2021.726184 ◽

2021 ◽

Vol 12 ◽

Author(s):

Siyu Zhou ◽

Shu Wen ◽

Yongcheng Sheng ◽

Meina Yang ◽

Xiaoyang Shen ◽

...

Keyword(s):

Systematic Review ◽

Estrogen Receptor ◽

Polycystic Ovary Syndrome ◽

Publication Bias ◽

Polycystic Ovary ◽

Meta Analysis ◽

Genetic Models ◽

Cochrane Library ◽

Ovary Syndrome ◽

Subgroup Analyses

PurposeControversial results existed in amounts of studies investigating the authentic association of estrogen receptor genes (ESR1 and ESR2) polymorphisms with the occurrence and progression of polycystic ovary syndrome (PCOS). The inconsistency might result from different loci, sample sizes, and ethnicities. To find the potential correlations between ESR1/ESR2 polymorphisms and PCOS risk, we conducted the first systematic review and meta-analysis to comprehensively summarize current studies in a large combined population.MethodsEligible studies were retrieved from PubMed, MEDLINE, EMBASE, Cochrane Library, CBM, CNKI, WANFANG, and VIP up to February 28, 2021. The quality of studies was assessed using the Newcastle–Ottawa Scale (NOS) scoring system. Odds ratios (ORs) and 95% confidence intervals (95%CIs) were calculated to synthesize data in five genetic models. Subgroup analyses were conducted by ethnicity. Heterogeneity and publication bias were also assessed. The protocol was registered in PROSPERO under the number CRD42021239200.ResultsA total of 8 studies involving 1,522 PCOS patients and 4,198 controls were included. No evidence demonstrated the association of ESR1 rs2234693 (OR=1.07 95%CI 0.98–1.18), ESR1 rs9340799 (OR=0.99 95%CI 0.69–1.43), or ESR2 rs4986938 (OR=1.06 95%CI 0.81–1.38) polymorphisms and PCOS risk in five genetic models. According to stratified subgroup analyses, ethnicity was considered the major source of heterogeneity. No publication bias was found in eligible studies.ConclusionThe present meta-analysis found no significant associations between the variants of ESR1 rs2234693, ESR1 rs9340799, ESR2 rs4936938, and individual PCOS susceptibility, even if ethnicity was taken into account.Systematic Review RegistrationThe protocol was registered in PROSPERO (available from https://www.crd.york.ac.uk/PROSPERO) with the ID number CRD42021239200.

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Treatment of Polycystic Ovary Syndrome-Related Infertility Using a Combination of Compound Xuanju Capsules and Hormone Therapy: A Meta-Analysis

10.21203/rs.3.rs-1038721/v1 ◽

2021 ◽

Author(s):

Qianwen Ma ◽

Yong Tan

Keyword(s):

Polycystic Ovary Syndrome ◽

Hormone Therapy ◽

Polycystic Ovary ◽

Therapy Group ◽

Meta Analysis ◽

Biomedical Literature ◽

Cochrane Library ◽

Therapeutic Effects ◽

Ovary Syndrome

Abstract Objective To compare the therapeutic effects of compound Xuanju capsules combined with hormone therapy versus hormone therapy alone on polycystic ovary syndrome (PCOS)-related infertility using a meta-analysis. Methods Electronic databases including PubMed, The Cochrane Library, Web of science, Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Wanfang Data, and VIP database were manually searched. The quality of included studies was evaluated based on the Cochrane systematic review standards, and the valid data were extracted for meta-analysis using Revman 5.3 software. Results A total of 14 randomized controlled trials accounting for 1249 patients were included. Meta-analysis showed that patients in the compound Xuanju capsule + hormone therapy group had higher estradiol levels and overall rates of effective treatment than those in the hormone therapy alone group. Moreover, they also exhibited lower levels of luteinizing hormone and follicle-stimulating hormone as well as lower Kupperman scores than the hormone therapy alone group. Conclusions The combination of compound Xuanju capsules and hormone therapy is more effective than hormone therapy alone in the treatment of PCOS-related infertility. However, the quality of current studies is low, and high-quality clinical trials are warranted.

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Effect of Acupuncture on Polycystic Ovary Syndrome in Animal Models: A Systematic Review

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2021/5595478 ◽

2021 ◽

Vol 2021 ◽

pp. 1-12

Author(s):

Yan Li ◽

Lijia Zhang ◽

Jinjin Gao ◽

Jun Yan ◽

Xue Feng ◽

...

Keyword(s):

Systematic Review ◽

Animal Models ◽

Polycystic Ovary Syndrome ◽

Polycystic Ovary ◽

Risk Of Bias ◽

Reproductive Age ◽

Current Evidence ◽

Manual Acupuncture ◽

Ovary Syndrome ◽

Complementary And Alternative Therapy

Background. Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders among women of reproductive age. As a widely used complementary and alternative therapy, acupuncture is increasingly used to treat PCOS. However, the effect of acupuncture in treating PCOS is uncertain, and the mechanisms are unclear. This systematic review aims to determine the efficacy of acupuncture on PCOS in animal preclinical models. Methods. Experimental animal studies of acupuncture in PCOS animal models were searched in PubMed, Web of Science, China National Knowledge Infrastructure, and the Chinese Science and Technology Periodical Database from inception to December 2020. The risk of bias was assessed using the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE) risk of bias tool. Results. A total of 358 studies were screened based on the title and abstract, and 31 studies were included. A total of 722 animals were involved, and all studies used either Wistar rats or SD rats. Twenty-six studies used electroacupuncture, 9 studies used manual acupuncture, and 5 of them employed both electroacupuncture and manual acupuncture. A total of 22 acupoints were involved; 7 studies followed the modern acupuncture pattern, and the rest followed classic acupuncture theory. Conclusions. The present review summarizes the current evidence of the effects of acupuncture on PCOS in animal models. Unfortunately, we could not draw a definite conclusion due to the methodological weakness of the included studies and the high heterogeneity. Well-designed studies are needed in the future to fill this gap.

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The Effects of Salvia miltiorrhiza on Reproduction and Metabolism in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2021/9971403 ◽

2021 ◽

Vol 2021 ◽

pp. 1-12

Author(s):

Wenjuan Shen ◽

Bao Jin ◽

Yaguang Han ◽

Hongwei Wang ◽

Huan Jiang ◽

...

Keyword(s):

Systematic Review ◽

Polycystic Ovary Syndrome ◽

Polycystic Ovary ◽

Salvia Miltiorrhiza ◽

Meta Analysis ◽

Density Lipoprotein ◽

Lipoprotein Cholesterol ◽

Cochrane Library ◽

Ovary Syndrome ◽

Significant Difference

Objective. Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. As a traditional medicine, Salvia miltiorrhiza (S. miltiorrhiza) has been widely used in the treatment of many gynecological diseases, but the efficacy of S. miltiorrhiza in women with PCOS has not been assessed. The purpose of this systematic review and meta-analysis was to evaluate the effectiveness and safety of S. miltiorrhiza in women with PCOS. Methods. We conducted searches in PubMed, Embase, the Cochrane Library, the China National Knowledge Infrastructure, the Wanfang Database, the Chinese Scientific Journal Database, and the Chinese BioMedical database from inception to December 23, 2020, to identify studies that met the inclusion criteria. The quality of the evidence was estimated using the Cochrane Reviewer Handbook 5.0.0, and the meta-analysis was performed using RevMan 5.3.5 software. Results. Six randomized controlled trials (RCTs) involving 390 patients with PCOS were included. The studies suggested that S. miltiorrhiza extract combined with letrozole (LET) was more effective in improving pregnancy rate (RR: 2.60, 95% CI: 1.06 to 6.39, P = 0.04 ) compared to LET alone. S. miltiorrhiza extract was associated with decreased fasting blood glucose (MD: –0.25, 95% CI: –0.37 to –0.13, P < 0.0001 ), fasting insulin (MD: –1.16, 95% CI: –1.74 to –0.58, P < 0.0001 ), total cholesterol (TC) (MD: –0.58, 95% CI: –0.72 to –0.43, P < 0.00001 ), and triglycerides (TG) (MD: –0.31, 95% CI: –0.35 to –0.26, P < 0.00001 ) compared with placebo, but not with improvements in body mass index or waist-to-hip ratio (MD: –1.41, 95% CI: –4.81 to 2.00, P = 0.42 ; MD: –0.02, 95% CI: –0.05 to 0.01, P = 0.16 , respectively). There was a significant difference between S. miltiorrhiza extract combined with cyproterone acetate (CPA) and CPA alone in terms of decreasing TC (MD: –0.77, 95% CI: –0.89 to –0.65, P < 0.00001 ), TG (MD: –0.43, 95% CI: –0.65 to –0.20, P < 0.0001 ), and low-density lipoprotein cholesterol (MD: –0.49, 95% CI: –0.66 to –0.33, P < 0.00001 ) and increasing high-density lipoprotein cholesterol (MD: 0.30, 95% CI: 0.20, 0.40, P < 0.00001 ). In addition, S. miltiorrhiza extract also decreased testosterone, follicle-stimulating hormone, and luteinizing hormone. The studies did not mention any adverse events with S. miltiorrhiza extract. Conclusion. The current studies indicate that S. miltiorrhiza has beneficial effects on reproduction and glucose and lipid metabolism in patients with PCOS, and it is generally safe for clinical application. However, more prospective RCTs with large samples, multiple centers, and longer intervention duration are needed in the future to obtain more reliable conclusions.

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Metabolic profile of women with PCOS in Brazil: a systematic review and meta-analysis

Diabetology & Metabolic Syndrome ◽

10.1186/s13098-021-00636-5 ◽

2021 ◽

Vol 13 (1) ◽

Author(s):

Poli Mara Spritzer ◽

Ramon Bossardi Ramos ◽

Lucas Bandeira Marchesan ◽

Monica de Oliveira ◽

Enrico Carmina

Keyword(s):

Systematic Review ◽

Polycystic Ovary Syndrome ◽

Metabolic Profile ◽

Polycystic Ovary ◽

Meta Analysis ◽

Reproductive Age ◽

Control Group ◽

Cochrane Central Register ◽

Ovary Syndrome ◽

Metabolic Traits

Abstract Background Polycystic ovary syndrome (PCOS) is a common endocrine disease affecting women of reproductive age and associated with reproductive and metabolic dysfunction. Few studies are available regarding metabolic traits in Brazilian women with PCOS. The aim of this systematic review and meta-analysis was to summarize the available evidence regarding metabolic traits and comorbidities in Brazilian women with polycystic ovary syndrome (PCOS). Methods We systematically searched PubMed, Cochrane Central Register of Controlled Trials, and Embase for cross-sectional, case–control, or cohort studies focusing on populations of different regions from Brazil, published until July 31, 2019. Studies were selected if they reported PCOS diagnostic criteria. Studies without a control group were included if they presented relevant metabolic data. Results Of 4856 studies initially identified, 27 were included in the systematic review and 12 were included in the meta-analysis, for a total of 995 women with PCOS defined by Rotterdam criteria and 2275 controls from different regions of Brazil. Obesity, metabolic syndrome and IGT were prevalent, and standard mean differences for BMI (SMD 0.67, 95% CI, 0.29, 1.05), waist circumference (SMD 0.22, 95% CI 0.02, 0.41), systolic (SMD 0.66, 95% CI 0.30, 1.01) and diastolic blood pressure (SMD 0.55, 95% CI 0.24, 0.87), glucose (SMD 0.21, 95% CI 0.04, 0.38) and HOMA (SMD 0.78, 95% CI 0.52, 1.04) were significantly higher in Brazilian women with PCOS compared to controls. Lipid profile was more adverse in PCOS vs. non-PCOS women. Between-study heterogeneities were low/moderate for glucose and HOMA and moderate/high for the other variables. Conclusions The data of this systematic review and meta-analysis indicate that Brazilian women with PCOS have a worse metabolic profile than women without PCOS with no important regional differences. The prevalence of metabolic changes is intermediate in Brazil vs. other countries.

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Elevated Anti-Müllerian Hormone Levels in Newborns of Women with Polycystic Ovary Syndrome: a Systematic Review and Meta-analysis Based on Observational Studies

Reproductive Sciences ◽

10.1007/s43032-021-00652-w ◽

2021 ◽

Author(s):

Siyu Zhou ◽

Danhua Lu ◽

Shu Wen ◽

Yongcheng Sheng ◽

Deying Kang ◽

...

Keyword(s):

Systematic Review ◽

Polycystic Ovary Syndrome ◽

Polycystic Ovary ◽

Meta Analysis ◽

Pooled Analysis ◽

Cochrane Library ◽

Maternal Body Mass Index ◽

Ovary Syndrome ◽

Random Effects Models ◽

Hormone Levels

AbstractWe performed this updated systematic review and meta-analysis to evaluate anti-Müllerian hormone levels (AMH) in newborns of mothers with polycystic ovary syndrome (PCOS) compared with healthy controls. A search of the literature was conducted in the PubMed, MEDLINE, EMBASE, Cochrane Library, CBM, CNKI, WANFANG, and VIP for articles to assess AMH levels in offspring of PCOS and non-PCOS mothers irrespective of language. These databases were searched from their inception to December 7, 2020. The quality of studies was assessed using the Newcastle-Ottawa Scale (NOS) scoring system. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were adopted to calculate the overall estimates with random-effects models. A total of 6 studies with 846 participants were included. The pooled analysis found an increased AMH level in the umbilical cord blood in newborns of PCOS mothers (SMD =0.62, 95% CI [0.28, 0.95]). Subgroup analyses revealed an elevation of AMH concentrations in female neonates, neonates born to American and Asian PCOS mothers. In addition, higher AMH levels were also found in studies diagnosed by the National Institute of Health (NIH) criteria, maternal clinical/biochemical hyperandrogenism, or maternal body mass index (BMI) >30 kg/m2. Meta-regression analysis suggested that diagnostic criterion contributed mostly to the high heterogeneity. We demonstrated that AMH levels in neonates born to PCOS mothers were essentially higher, which indicates that AMH may act as an enigmatic role in the pathogenesis of PCOS which inhibits folliculogenesis in the fetal stage.

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