scholarly journals Polycystic Ovary Syndrome: Effect and Mechanisms of Acupuncture for Ovulation Induction

2013 ◽  
Vol 2013 ◽  
pp. 1-16 ◽  
Author(s):  
Julia Johansson ◽  
Elisabet Stener-Victorin
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Ovulation Induction ◽  
Polycystic Ovary ◽  
Experimental Studies ◽  
Cardiovascular Complications ◽  
Reproductive Age ◽  
Polycystic Ovaries ◽  
Ovary Syndrome ◽  
Menstrual Dysfunction ◽  
Beneficial Effects

Polycystic ovary syndrome (PCOS), the most common endocrine disorder among women of reproductive age, is characterized by the coexistence of hyperandrogenism, ovulatory dysfunction, and polycystic ovaries (PCO). PCOS also represents the largest part of female oligoovulatory infertility, and the management of ovulatory and menstrual dysfunction, comprises a third of the high costs of PCOS treatment. Current pharmacological and surgical treatments for reproductive symptoms are effective, however, associated with negative side effects, such as cardiovascular complications and multiple pregnancies. For menstrual irregularities and ovulation induction in women with PCOS, acupuncture has indicated beneficial effects. This review will focus on the results from randomized controlled acupuncture trials for regulation of menstrual dysfunction and for inducing ovulation in women with PCOS although there are uncontrolled trials with nonetheless interesting results. Animal experimental studies will be further discussed when they can provide a more mechanistic explanatory view.

scholarly journals Inflammation and reproductive function in women with polycystic ovary syndrome

2021 ◽  
Author(s):  
Leandro M Velez ◽  
Marcus Seldin ◽  
Alicia B Motta
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Chronic Inflammation ◽  
Polycystic Ovary ◽  
Essential Feature ◽  
Reproductive Function ◽  
Cardiovascular Complications ◽  
Reproductive Age ◽  
Metabolic Abnormalities ◽  
Ovary Syndrome ◽  
Inflammatory State

Abstract Polycystic Ovary Syndrome (PCOS) is one of the most frequent endocrinopathies, affecting 5–10% of women of reproductive age, and is characterized by the presence of ovarian cysts, oligo, or anovulation, and clinical or biochemical hyperandrogenism [1]. Metabolic abnormalities such as hyperinsulinemia, insulin resistance, cardiovascular complications, dyslipidemia, and obesity are frequently present in PCOS women [1]. Several key pathogenic pathways overlap between these metabolic abnormalities, notably chronic inflammation. The observation that this mechanism was shared led to the hypothesis that a chronic inflammatory state could contribute to the pathogenesis of PCOS [2]. Moreover, while physiological inflammation is an essential feature of reproductive events such as ovulation, menstruation, implantation, and labour at term [3], the establishment of chronic inflammation may be a pivotal feature of the observed reproductive dysfunctions in PCOS women [2]. Taken together, the present work aims to review the available evidence about inflammatory mediators and related mechanisms in women with PCOS, with an emphasis on reproductive function.

scholarly journals Letrozole-Induced Polycystic Ovary Syndrome Attenuates Cystathionine-β Synthase Gene Expression in the Ovaries of Female Sprague Dawley Rats

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1244-1244
Author(s):  
Amanda Bries ◽  
Joe Webb ◽  
Brooke Vogel ◽  
Claudia Carrillo ◽  
Aileen Keating ◽  
...  
Keyword(s):  
Gene Expression ◽  
Polycystic Ovary Syndrome ◽  
Mrna Expression ◽  
Polycystic Ovary ◽  
Elevated Serum ◽  
Reproductive Age ◽  
Sprague Dawley ◽  
Polycystic Ovaries ◽  
Ovary Syndrome ◽  
Sd Rats

Abstract Objectives Polycystic ovary syndrome (PCOS) is an endocrine disorder that affects 10% of reproductive age women and leads to hyperandrogenism, abnormal menstrual cycles, and polycystic ovaries. Moreover, PCOS has been associated with elevated serum homocysteine; however, the characterization of one-carbon metabolism (OCM) in PCOS remains incomplete. The aim of our research was to examine OCM in a genetic and chemically-induced rodent model of PCOS: 1) viable yellow Agouti (Avy) mice; and 2) letrozole (Let)-induced Sprague Dawley (SD) rats. Methods Five wk old female Avy mice (N = 18), their lean controls (N = 18), and SD rats (N = 36) were acclimated for one wk. Following acclimation, the animals were placed on a modified standard AIN93G diet (energy, %: 50.4, carbohydrate; 17.3, protein; and 32.3, fat). Rats were randomly assigned to Let (1 g/kg BW) treatment or vehicle (carboxymethylcellulose) control that was administered via a subcutaneously implanted slow-release pellet every 30-d. For both models, 12 animals were randomly assigned to be euthanized during proestrus at one of the following ages: 8, 16 or 24 wk. Bodyweight and estrous cycles were measured daily. Ovaries were collected to assess gene expression of OCM. These data were analyzed using linear mixed models to determine the main effects of age and treatment at a significance level of P < 0.05. Results Letrozole significantly reduced the occurrence of proestrus and estrus stages (P = 0.0001 and P = 0.006, respectively). Additionally, Let-induced rats had increased BW compared to control rats, across all age groups (P < 0.0001). In contrast, Avy mice weighed less than their controls by 24 wk of age (P < 0.0001). Cystathionine-β synthase (CBS) mRNA expression was downregulated in the Let-induced vs. control rats at 16 (59%; P < 0.05) and 24 (77%; P < 0.01) wk of age. As expected, Cyp19A1, aromatase mRNA was downregulated in the Let-induced rats (P = 0.02). Interestingly, betaine-homocysteine s-methyltransferase (BHMT) mRNA increased as a function of age in Let-induced rats (P = 0.03). Conclusions These data demonstrate that Letrozole-induced PCOS temporally decreases ovarian CBS mRNA expression; whereas, BHMT mRNA is upregulated as a function of age. Funding Sources This work was supported by the National Institute of Child Health and Human Development.

scholarly journals A Review of First Line Infertility Treatments and Supporting Evidence in Women with Polycystic Ovary Syndrome

2019 ◽  
Vol 7 (9) ◽  
pp. 95 ◽  
Author(s):  
Michael Costello ◽  
Rhonda Garad ◽  
Roger Hart ◽  
Hayden Homer ◽  
Louise Johnson ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Ovulation Induction ◽  
Polycystic Ovary ◽  
Clomiphene Citrate ◽  
Multiple Pregnancy ◽  
Reproductive Age ◽  
Supporting Evidence ◽  
First Line ◽  
Ovary Syndrome ◽  
Ultrasound Monitoring

Polycystic ovary syndrome (PCOS) is the most common cause of anovulatory infertility in women of reproductive age. Lifestyle change is considered the first line treatment for the management of infertile anovulatory women with PCOS, and weight loss for those who are overweight or obese. First line medical ovulation induction therapy to improve fertility outcomes is letrozole, whilst other less efficacious ovulation induction agents, such as clomiphene citrate, metformin, and metformin combined with clomiphene citrate, may also be considered. Metformin combined with clomiphene citrate is more effective than clomiphene citrate alone. In obese women with PCOS, clomiphene citrate could be used in preference to metformin alone whilst clomiphene citrate could be added to metformin alone in order to improve reproductive outcome in all women with PCOS. Gonadotrophins, which are more effective than clomiphene citrate in therapy naïve women with PCOS, can be considered a first line therapy in the presence of ultrasound monitoring, following counselling on the cost and the potential risk of multiple pregnancy.

Advances in Treatment Options for Polycystic Ovary Syndrome

2012 ◽  
Vol 08 (01) ◽  
pp. 57 ◽  
Author(s):  
Sanam Lathief ◽  
Lubna Pal ◽  
◽  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Ovulation Induction ◽  
Assisted Reproductive Technologies ◽  
Polycystic Ovary ◽  
Clomiphene Citrate ◽  
Reproductive Technologies ◽  
Reproductive Age ◽  
Comparable Efficacy ◽  
Hormonal Contraceptives ◽  
Ovary Syndrome

Polycystic ovary syndrome (PCOS) is the most common endocrinopathy seen in women of reproductive age. Clinical concerns relating to PCOS range from ovulatory infertility and menstrual disorders to risk of diabetes and cardiovascular disease. Hormonal contraceptives have been the mainstay of the management of common PCOS symptoms, such as menstrual irregularity and clinical stigmata of androgen excess (i.e., hirsutism and acne). An appreciation of the relevance of metabolic pathways in the pathophysiology of PCOS is relatively recent, and has translated into an expansion of the therapeutic strategies available for the management of PCOS. Insulin sensitizers were one of the first metabolic modulators to be incorporated in the clinical management paradigm, albeit with mixed results. Recognizing that insulin resistance is central to the pathophysiology of PCOS, newer agents—e.g., thiazolidinediones— followed, with almost comparable efficacy to metformin. Statins and most recently incretins constitute novel therapies with distinct metabolic targets that seem to hold promise in the management of PCOS. In tandem with the expansion in pharmaceuticals, a host of complementary and alternative medical therapies have generated interest for purported promise in the management of PCOS, including vitamin D, acarbose, and myo-inositol. The therapeutic options for managing PCOS-related infertility have also expanded. Clomiphene citrate (CC) has long been the first-line strategy for ovulation induction in the setting of anovulatory infertility; however, aromatase inhibitors are fast gaining acceptance as an ovulation induction strategy, with results comparable or even better than those seen with CC. An increasing level of therapeutic sophistication is reflected in ovarian stimulation protocols judiciously using gonadotropins, gonadotropin-releasing hormone antagonists, the procedure of ovarian drilling, and assisted reproductive technologies within vitrooocyte maturation.

scholarly journals Controversies in the diagnosis of polycystic ovary syndrome

2020 ◽  
Vol 14 ◽  
pp. 263349412091303
Author(s):  
Preetham Rao ◽  
Priya Bhide
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Reproductive Age ◽  
Polycystic Ovaries ◽  
Women Of Reproductive Age ◽  
Androgen Excess ◽  
Ovary Syndrome ◽  
Ultrasound Features

Polycystic ovary syndrome is a common endocrinological condition which is found to be prevalent in 5–10% of women of reproductive age. Historically, a combination of anovulation and androgen excess was considered a hallmark in the diagnosis of polycystic ovary syndrome. Addition of ultrasound features of polycystic ovary syndrome has improved the detection of variation in the polycystic ovary syndrome phenotype. Despite the widespread use of consensus diagnostic criteria, there remain several unresolved controversies in the diagnosis of polycystic ovary syndrome. Difficulty arises in methods of assessment and types of androgens to be measured to detect biochemical hyperandrogenism, setting a cut-off value for the diagnosis of clinical hyperandrogenism, setting an ultrasound threshold of antral follicle count to diagnose polycystic ovaries and also diagnosing this condition in adolescence where there is no clear definition for ‘irregular cycles’. This article looks at various controversies in the diagnosis of polycystic ovary syndrome.

scholarly journals Evidence-Based Lifestyle and Pharmacological Management of Infertility in Women with Polycystic Ovary Syndrome

2012 ◽  
Vol 8 (3) ◽  
pp. 277-290 ◽  
Author(s):  
Michael F Costello ◽  
William L Ledger
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Ovulation Induction ◽  
Polycystic Ovary ◽  
Pharmacological Therapy ◽  
Reproductive Age ◽  
First Line ◽  
Ovary Syndrome ◽  
Pharmacological Management ◽  
Medical Treatments ◽  
Laparoscopic Ovarian Drilling

Polycystic ovary syndrome (PCOS) is the most prevalent endocrine disorder in women of reproductive age and by far the most common cause of anovulatory infertility. Lifestyle change alone, and not in combination with pharmacological ovulation induction such as clomifene citrate or metformin, is generally considered the first-line treatment for the management of infertile anovulatory women with PCOS who are overweight or obese. Clomifene citrate should be considered as a first-line pharmacological therapy to improve fertility outcomes. Second-line medical treatments may include ovulation induction with gonadotropins (in clomifene citrate-resistant or clomifene citrate failure women) or laparoscopic ovarian drilling (in clomifene citrate-resistant women) or possibly with metformin combined with clomifene citrate (in clomifene citrate-resistant women). There is currently insufficient evidence to recommend aromatase inhibitors over that of clomifene citrate in infertile anovulatory women with PCOS in general or specifically in therapy-naive or clomifene citrate-resistant women with PCOS.

scholarly journals Specificities of the treatment for polycystic ovary syndrome and metabolic syndrome

2020 ◽  
Vol 3 (4) ◽  
pp. 254-259
Author(s):  
I.Yu. Il’ina ◽  
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Polycystic Ovary Syndrome ◽  
Metabolic Disorders ◽  
Negative Impact ◽  
Polycystic Ovary ◽  
Cardiovascular Complications ◽  
Polycystic Ovaries ◽  
Ovary Syndrome ◽  
Psychic Disorders

This paper discusses polycystic ovary syndrome (PCOS), a common endocrine disorder characterized by hirsutism, anovulation, and polycystic ovaries. Insulin resistance which is considered the major causative factor for both PCOS and metabolic syndrome is emphasized. The early diagnosis of metabolic disorders which increase the risk of cardiovascular complications and the complications of pregnancy (including gestational diabetes and hypertension which may result in preeclampsia and placental abruption) is of particular importance. The presence of metabolic syndrome in PCOS is associated with poor prognosis in terms of fertility and has a negative impact on the outcomes of in vitro fertilization in infertile women with PCOS. When describing treatment approaches, the role of metformin, inositol, folates, vitamin D, and statins in treating metabolic disorders in PCOS and metabolic syndrome, reducing the risks of cardiovascular complications, and realizing fertile function is highlighted. The course of PCOS is complicated by psychic disorders (i.e., depression, anxiety, bipolar disorder, or eating disorders) which are common in these women and should be considered when prescribing medications. KEYWORDS: polycystic ovary syndrome, insulin resistance, infertility, metabolic syndrome, cardiovascular complications, inositol, folates. FOR CITATION: Il’ina I.Yu. Specificities of the treatment for polycystic ovary syndrome and metabolic syndrome. Russian Journal of Woman and Child Health. 2020;3(4):254–259. DOI: 10.32364/2618-8430-2020-3-4-254-259.

scholarly journals A Study on Physical and Physiological Impact of Polycystic Ovary Syndrome

2021 ◽  
Vol 69 (2) ◽  
Author(s):  
Sathish Kumar B.P ◽  
Dr. Sayantan Ghosh ◽  
Dr. Lipika Das ◽  
Dr. Aksa Merin Jose
Keyword(s):  
Menstrual Cycle ◽  
Polycystic Ovary Syndrome ◽  
Healthy Lifestyle ◽  
Polycystic Ovary ◽  
Reproductive Organs ◽  
Reproductive Age ◽  
Therapeutic Interventions ◽  
Polycystic Ovaries ◽  
Ovary Syndrome ◽  
Metabolic Complications

Polycystic ovary syndrome is a relatively common hormonal disorder that causes a number of different symptoms in women of reproductive age. In such conditions, enlarged ovaries containing multiple small cysts (polycystic ovaries), are found. Although most women with PCOS have polycystic ovaries, some affected women do not. Common to all women with PCOS is an irregularity in menstrual cycle and the presence of excess male hormones (androgen). It disrupts the functioning of the reproductive organs that produce progesterone and estrogen, the hormones that regulate the menstrual cycle. A prospective observational study was carried out in 125 inpatients, after taking written informed consent from patients those who met the study criteria. A total of 125 patients were enrolled in the study, it was observed that 17.74% have experienced moderate depression, 18.54% patients experienced major irregular menstrual period problem, 2-25% of the patients were dealing with body weight, and 6.45% patients were identified that the growth of visible hair on the upper lip as a major problem. It was also found that 8.87% of patients experienced major menstrual cramps and patients were found worried about PCOS and hence disturbing their quality of life. Various long-term complication and co morbidities have been associated with PCOS and early diagnosed and therapeutic interventions are needed. PCOS is a chronic disease with manifestations across the life span and represents a major health and economic burden. Management should focus on support, education, addressing physiological factors and strongly emphasizing healthy lifestyle with targeted medical therapy as required. Addressing hyperandrogenism is clinically important and monitoring for and managing longer-term metabolic complications including dyslipidemia, IGT, DM2, cardiovascular risk factors, is crucial. Overall, further research is needed in this complex condition.

Effects of Metformin and Exercise in Polycystic Ovary Syndrome: Systematic Review and Meta-Analysis

2021 ◽  
Vol 53 (11) ◽  
pp. 738-745
Author(s):  
Yu Song ◽  
Huimin Wang ◽  
Zhengyan Zhu ◽  
Hongli Huang
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Exercise Intervention ◽  
Polycystic Ovary ◽  
Meta Analysis ◽  
Reproductive Age ◽  
China National Knowledge Infrastructure ◽  
Ovary Syndrome ◽  
Menstrual Cycles ◽  
Beneficial Effects ◽  
Knowledge Infrastructure

AbstractPolycystic ovary syndrome (PCOS) is a common endocrine disorder in women of reproductive age. Metformin is introduced for treatment of women with PCOS, and the beneficial effects of exercise in women with PCOS are found for a range of outcomes. Our aim is to compare the effects of metformin plus exercise with exercise intervention in PCOS on clinical, anthropometric, metabolic, and psychological parameters. MEDLINE, EMBASE, Web of Science and China National Knowledge Infrastructure were searched for studies. Nine studies were considered eligible for inclusion. The meta-analysis reveals that metformin offers additive benefits to exercise, leading to modest improvements in menstrual cycles, hyperandrogenism, and abdominal fat.

scholarly journals Polycystic Ovary Syndrome, Obesity and Reproductive Implications

2009 ◽  
Vol 5 (5) ◽  
pp. 529-542 ◽  
Author(s):  
Angelica Lindén Hirschberg
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Reproductive Function ◽  
Negative Influence ◽  
Reproductive Age ◽  
Polycystic Ovaries ◽  
Ovary Syndrome ◽  
Increased Risk ◽  
Important Challenge ◽  
Pharmacologic Treatments

Polycystic ovary syndrome (PCOS) is one of the most common causes of female infertility, affecting 5–10% of women of reproductive age. The syndrome is characterized by anovulation, hyperandrogenism and polycystic ovaries. Furthermore, PCOS is associated with insulin resistance and obesity, which is present in approximately 50% of women with PCOS. Reproductive function in women with PCOS is strongly dependent on bodyweight and metabolic status. Obesity is associated with an increased risk of infertility and may also have a negative influence on pregnancy outcome. Considering the worldwide epidemic of obesity, clinical problems relating to PCOS may worsen and increase in frequency. Lifestyle interventions resulting in weight loss comprise the most successful strategy to improve symptoms of PCOS. However, many patients fail to lose weight or may quickly regain weight. It is an important challenge to develop effective lifestyle programs and adjuvant pharmacologic treatments in order to improve reproductive and metabolic health among women with PCOS.

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