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

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

BMJ Open ◽

10.1136/bmjopen-2021-049039 ◽

2021 ◽

Vol 11 (8) ◽

pp. e049039

Author(s):

Kou Xu ◽

Jiajie Wang ◽

Feng Hu ◽

Siying Lv ◽

Yanji Zhang ◽

...

Keyword(s):

Systematic Review ◽

Polycystic Ovary Syndrome ◽

Evaluation Method ◽

Polycystic Ovary ◽

Meta Analysis ◽

Biomedical Literature ◽

Reproductive Age ◽

Cochrane Library ◽

Ovary Syndrome ◽

Complementary And Alternative Therapy

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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The Role of the Brain in the Pathogenesis and Physiology of Polycystic Ovary Syndrome (PCOS)

Medical Sciences ◽

10.3390/medsci7080084 ◽

2019 ◽

Vol 7 (8) ◽

pp. 84 ◽

Cited By ~ 3

Author(s):

Coutinho ◽

Kauffman

Keyword(s):

Animal Models ◽

Polycystic Ovary Syndrome ◽

Neural Circuit ◽

Polycystic Ovary ◽

Pulse Frequency ◽

Reproductive Age ◽

Neuron Activity ◽

Ovary Syndrome ◽

Gnrh Neurons ◽

Reproductive Endocrine

Polycystic ovary syndrome (PCOS) is a common reproductive endocrine disorder, affecting at least 10% of women of reproductive age. PCOS is typically characterized by the presence of at least two of the three cardinal features of hyperandrogenemia (high circulating androgen levels), oligo- or anovulation, and cystic ovaries. Hyperandrogenemia increases the severity of the condition and is driven by increased luteinizing hormone (LH) pulse secretion from the pituitary. Indeed, PCOS women display both elevated mean LH levels, as well as an elevated frequency of LH pulsatile secretion. The abnormally high LH pulse frequency, reflective of a hyperactive gonadotropin-releasing hormone (GnRH) neural circuit, suggests a neuroendocrine basis to either the etiology or phenotype of PCOS. Several studies in preclinical animal models of PCOS have demonstrated alterations in GnRH neurons and their upstream afferent neuronal circuits. Some rodent PCOS models have demonstrated an increase in GnRH neuron activity that correlates with an increase in stimulatory GABAergic innervation and postsynaptic currents onto GnRH neurons. Additional studies have identified robust increases in hypothalamic levels of kisspeptin, another potent stimulator of GnRH neurons. This review outlines the different brain and neuroendocrine changes in the reproductive axis observed in PCOS animal models, discusses how they might contribute to either the etiology or adult phenotype of PCOS, and considers parallel findings in PCOS women.

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Quercetin and polycystic ovary syndrome, current evidence and future directions: a systematic review

Journal of Ovarian Research ◽

10.1186/s13048-020-0616-z ◽

2020 ◽

Vol 13 (1) ◽

Cited By ~ 3

Author(s):

Fatemeh Pourteymour Fard Tabrizi ◽

Fatemeh Hajizadeh-Sharafabad ◽

Maryam Vaezi ◽

Hamed Jafari-Vayghan ◽

Mohammad Alizadeh ◽

...

Keyword(s):

Systematic Review ◽

Polycystic Ovary Syndrome ◽

Polycystic Ovary ◽

Current Evidence ◽

Ovary Syndrome ◽

Future Directions

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Options for generating polycystic ovary syndrome based on experimental findings in animal models

Journal of obstetrics and women s diseases ◽

10.17816/jowd69489-100 ◽

2020 ◽

Vol 69 (4) ◽

pp. 89-100

Author(s):

Maria I. Yarmolinskaya ◽

Elena I. Abashova ◽

Olga L. Bulgakova

Keyword(s):

Animal Models ◽

Polycystic Ovary Syndrome ◽

Polycystic Ovary ◽

Reproductive Age ◽

Ovary Syndrome ◽

Indirect Methods ◽

Ovulatory Dysfunction ◽

Ovarian Morphology ◽

Genetic Interventions ◽

Experimental Findings

Polycystic ovary syndrome (PCOS) is a common endocrine pathology that affects 814% of women of reproductive age. The leading signs of the disease are hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology. Over the past decades, a variety of animal models have been developed to study the etiology and pathogenesis of PCOS, including chemical, hormonal, and genetic interventions. However, a large number of experimental techniques differ even in the framework of a single model. In this review article, we summarized PCOS animal models using both direct hormonal effects and indirect methods.

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Role of genetic and environmental factors in the development of polycystic ovary syndrome

Orvosi Hetilap ◽

10.1556/oh.2013.29589 ◽

2013 ◽

Vol 154 (17) ◽

pp. 650-657

Author(s):

László Ságodi ◽

Emőke Kiss-Tóth ◽

László Barkai

Keyword(s):

Environmental Factors ◽

Polycystic Ovary Syndrome ◽

Polycystic Ovary ◽

Reproductive Age ◽

Current Evidence ◽

Ovary Syndrome ◽

Genetic And Environmental Factors ◽

Endocrine Abnormality ◽

Ovarian Syndrome

Polycystic ovary syndrome is the most common heterogeneous endocrine abnormality in women in the reproductive age. The syndrome remains an enigmatic disorder because the aetiology is still unclear. Familial aggreagation is relatively common among patients with polycystic ovary syndrome suggesting a signiﬁcant genetic component, although the way of inheritance has not been established firmly. The authors review the relevant medical literature and suggest that genetic and environmental factors play a role in the development of polycystic ovary syndrome. To date, no gene has been identified that causes or contributes substantially to the development of a polycystic ovary syndrome phenotype. Polycystic ovarian syndrome is considered to be an oligogenic disorder in which the interaction of a number of genetic and environmental factors determines the heterogeneous clinical and biochemical phenotype. To summarize current evidence the authors conclude, that when we are able to identify and then modify environmental determinants, then we will be able to safeguard better the health of those patients who are predisposed to disease development due to genotype or previous environmental effects. Orv. Hetil., 2013, 154, 650–657.

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The potential role of incretin-based therapies for polycystic ovary syndrome: a narrative review of the current evidence

Therapeutic Advances in Endocrinology and Metabolism ◽

10.1177/2042018821989238 ◽

2021 ◽

Vol 12 ◽

pp. 204201882198923

Author(s):

Mohammed Altigani Abdalla ◽

Harshal Deshmukh ◽

Stephen Atkin ◽

Thozhukat Sathyapalan

Keyword(s):

Polycystic Ovary Syndrome ◽

Polycystic Ovary ◽

Narrative Review ◽

Reproductive Age ◽

Sex Hormone Binding Globulin ◽

Current Evidence ◽

Ovary Syndrome ◽

Glucagon Like Peptide ◽

Glucagon Like Peptide 1

Introduction: Polycystic ovary syndrome (PCOS) is a common endocrine disorder that affects women of reproductive age. Metabolic consequences associated with PCOS include, but are not limited to, insulin resistance (IR), type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). This narrative review aims to provide a comprehensive overview of the potential therapeutic roles of the incretin-based therapies in the management of PCOS. Methods: We performed a systematic search of databases including PubMed, MEDLINE and EMBASE up to 1 October 2020. We developed a search string of medical subject headings (MeSH) including the terms PCOS, incretin mimetics, glucagon-like peptide-1 (GLP-1), glucagon-like peptide-1 receptor antagonists (GLP-1 RAs), liraglutide, exenatide, semaglutide, dipeptidyl peptidase-4 (DPP-4) inhibitors, combined with IR, testosterone and sex hormone-binding globulin (SHBG). Results: We identified 854 relevant articles and, after the initial screening, eight interventional animal studies, one observational animal study, 14 interventional human studies, two case–control studies and one systematic review were included. These studies showed the potential significant roles of GLP-1 RAs and DPP-4 inhibitors in the management of PCOS, with significant improvements in the metabolic parameters, including substantial weight reduction and improved insulin sensitivity. These agents also improved the hormonal parameters through decreased free androgen and increased SHBG. Moreover, they improved menstrual regularity, increased fertility with enhanced ovulation and pregnancy in obese women with PCOS. Conclusion: GLP-1 RAs and DPP-4 inhibitors have a promising therapeutic role in PCOS; however, larger clinical trials are needed to establish the role of incretin-based therapies in the management of PCOS.

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Systematic Review of Black Cohosh (Cimicifuga racemosa) for Management of Polycystic Ovary Syndrome-Related Infertility

Journal of Pharmacy Practice ◽

10.1177/08971900211012244 ◽

2021 ◽

pp. 089719002110122

Author(s):

Chi Wai Fan ◽

Nicole E. Cieri-Hutcherson ◽

Timothy C. Hutcherson

Keyword(s):

Systematic Review ◽

Clinical Trials ◽

Polycystic Ovary Syndrome ◽

Polycystic Ovary ◽

Endometrial Thickness ◽

Pregnancy Rates ◽

Risk Of Bias ◽

Black Cohosh ◽

Hormone Regulation ◽

Ovary Syndrome

Polycystic ovary syndrome (PCOS) is a common cause of female infertility. To conduct a systematic review assessing the efficacy and safety of black cohosh for ovulation-induction through hormone regulation and increased endometrial thickness to improve pregnancy rates in women with PCOS-related infertility. Preferred Reporting Items for Systematic Reviews and Meta-Analyses was used. A search of Medline, Embase, International Pharmaceutical Abstracts, Science Direct, and Cumulative Index of Nursing and Allied Health Literature spanning origin to December 19, 2020 was conducted using keywords and permutations of “black cohosh” and “PCOS.” A search for “PCOS” in the National Clinical Trials database and International Clinical Trials Registry Platform was conducted in December 2020 to identify additional records. Eligibility criteria included reported efficacy or safety outcomes; studies in women with PCOS; English language; and primary literature. Eligible records were evaluated using applicable risk-of-bias tools. A total of 181 records were screened after deduplication from 207 results. Two randomized controlled trials (RCT) met inclusion criteria. Review of 1386 records from clinical trial registries and subsequent scoping searches resulted in identification of 4 additional records (3 published). Improvement in hormone regulation and endometrial thickness were found for black cohosh groups compared to clomiphene citrate (CC). Three RCTs reported improved pregnancy rates using black cohosh plus CC. There were no differences in adverse events. Studies demonstrated several risk-of-bias concerns. There is a lack of high-quality evidence supporting the effectiveness of black cohosh for improving pregnancy rates in PCOS-related infertility. Short-term use of black cohosh appears to be safe.

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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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