scholarly journals Age-specific cut-off levels of anti-Müllerian hormone can be used as diagnostic markers for polycystic ovary syndrome

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Fahimeh Ramezani Tehrani ◽  
Maryam Rahmati ◽  
Fatemeh Mahboobifard ◽  
Faezeh Firouzi ◽  
Nazanin Hashemi ◽  
...  
Keyword(s):  
Bayesian Method ◽  
Polycystic Ovary ◽  
Characteristic Curve ◽  
Generalized Additive Models ◽  
Additive Models ◽  
Control Group ◽  
Age Group ◽  
Predictive Values ◽  
Pcos Group

Abstract Background The majority of available studies on the AMH thresholds were not age-specific and performed the receiver operating characteristic curve (ROC) analysis, based on variations in sensitivity and specificity rather than positive and negative predictive values (PPV and NPV, respectively), which are more clinically applicable. Moreover, all of these studies used a pre-specified age categorization to report the age-specific cut-off values of AMH. Methods A total of 803 women, including 303 PCOS patients and 500 eumenorrheic non-hirsute control women, were enrolled in the present study. The PCOS group included PCOS women, aged 20–40 years, who were referred to the Reproductive Endocrinology Research Center, Tehran, Iran. The Rotterdam consensus criteria were used for diagnosis of PCOS. The control group was selected among women, aged 20–40 years, who participated in Tehran Lipid and Glucose cohort Study (TLGS). Generalized additive models (GAMs) were used to identify the optimal cut-off points for various age categories. The cut-off levels of AMH in different age categories were estimated, using the Bayesian method. Main results and the role of chance Two optimal cut-off levels of AMH (ng/ml) were identified at the age of 27 and 35 years, based on GAMs. The cut-off levels for the prediction of PCOS in the age categories of 20–27, 27–35, and 35–40 years were 5.7 (95 % CI: 5.48–6.19), 4.55 (95 % CI: 4.52–4.64), and 3.72 (95 % CI: 3.55–3.80), respectively. Based on the Bayesian method, the PPV and NPV of these cut-off levels were as follows: PPV = 0.98 (95 % CI: 0.96–0.99) and NPV = 0.40 (95 % CI: 0.30–0.51) for the age group of 20–27 years; PPV = 0.96 (95 % CI: 0.91–0.99) and NPV = 0.82 (95 % CI: 0.78–0.86) for the age group of 27–35 years; and PPV = 0.86 (95 % CI: 0.80–0.94) and NPV = 0.96 (95 % CI: 0.93–0.98) for the age group of 35–40 years. Conclusions Application of age-specific cut-off levels of AMH, according to the GAMs and Bayesian method, could elegantly assess the value of AMH in discriminating PCOS patients in all age categories.

scholarly journals Antioxidant status in relation to heavy metals induced oxidative stress in patients with polycystic ovarian syndrome (PCOS)

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Manal Abudawood ◽  
Hajera Tabassum ◽  
Atheer H. Alanazi ◽  
Fatmah Almusallam ◽  
Feda Aljaser ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Heavy Metals ◽  
Polycystic Ovary ◽  
Reproductive Age ◽  
Health Concern ◽  
Control Group ◽  
Polycystic Ovaries ◽  
Strong Negative Correlation ◽  
Pcos Group

AbstractPolycystic ovary syndrome (PCOS) is a global health concern for women of reproductive age, as 6.5% of women worldwide are affected by this syndrome. PCOS is marked by hyperandrogenism, anovulation, menstrual abnormalities, and polycystic ovaries. Metals such as arsenic, cadmium, lead and mercury are considered to be systemic toxicants/human carcinogens and seem to have devastating effects on humans, even at minimal exposures. One of the probable aetiological factors for PCOS has been identified as oxidative stress. In view of the probable associations among oxidative stress, metal toxicity and PCOS, the present study examined the role of heavy metals in the generation of oxidative stress among females. This prospective study included 106 women (56 women diagnosed with PCOS and 50 women who were not diagnosed with PCOS as control women). There were no significant differences in the sociodemographic characteristics between the two groups except for the irregularity of menses and the presence of acne. The serum As, Cd, Pb, and Hg levels increased and the serum glutathione (GSH) and superoxide dismutase (SOD) levels diminished significantly in the PCOS group compared to the control group at P < 0.001. The SOD levels were negatively correlated with the As and Pb levels at P < 0.05. Additionally, the PCOS group exhibited a strong negative correlation between the GSH and As levels (P < 0.01), GSH and Pb levels (P < 0.05) and GSH and Hg levels (P < 0.01). Furthermore, the As levels were positively correlated with increased levels of Cd, Pb and Hg among PCOS women. Significant positive correlations were observed between Pb and Cd and between Cd and Hg at P < 0.001. The outcome of the study provides clear insight into the role of metal-induced oxidative stress, which plays a vital role in the pathophysiology underlying PCOS and suggests the use of these markers as prognostic tools to reduce the consequences of high-risk exposure to these metals among females.

Evaluation of Ovaries in Patients with Polycystic Ovary Syndrome using Shear Wave Elastography

2020 ◽  
Vol 16 (5) ◽  
pp. 578-583
Author(s):  
Aysegul Altunkeser ◽  
Zeynep Ozturk Inal ◽  
Nahide Baran
Keyword(s):  
Shear Wave ◽  
Large Scale ◽  
Polycystic Ovary ◽  
Shear Wave Elastography ◽  
Left Ovary ◽  
Control Group ◽  
Tissue Elasticity ◽  
Group I ◽  
Pcos Group ◽  
The Right

Background: Shear wave electrography (SWE) is a novel non-invasive imaging technique which demonstrate tissue elasticity. Recent research evaluating the elasticity properties of normal and pathological tissues emphasize the diagnostic importance of this technique. Aims: Polycystic ovarian syndrome (PCOS), which is characterized by menstrual irregularity, hyperandrogenism, and polycystic overgrowth, may cause infertility. The aim of this study was to evaluate the elasticity of ovaries in patients with PCOS using SWE. Methods: 66 patients diagnosed with PCOS according to the Rotterdam criteria (PCOS = group I) and 72 patients with non-PCOS (Control = group II), were included in the study. Demographic and clinical characteristics of the participants were recorded. Ovarian elasticity was assessed in all patients with SWE, and speed values were obtained from the ovaries. The elasticity of the ovaries was compared between the two groups. Results: While there were statistically significant differences between the groups in body mass index (BMI), right and left ovarian volumes, luteinizing hormone and testosterone levels (p<0.05), no significant differences were found between groups I and II in the velocity (for the right ovary 3.89±1.81 vs. 2.93±0.72, p=0.301; for the left ovary 2.88±0.65 vs. 2.95±0.80, p=0.577) and elastography (for the right ovary 36.62±17.78 vs. 36.79±14.32, p=0.3952; for the left ovary 36.56±14.15 vs. 36.26±15.10, p=0.903) values, respectively. Conclusion: We could not obtain different velocity and elastography values from the ovaries of the patients with PCOS using SWE. Therefore, further large-scale studies are needed to elucidate this issue.

scholarly journals Association between Luteinizing Hormone/Choriogonadotropin Receptor Ins18LQ Gene Polymorphism and Polycystic Ovary Syndrome

2020 ◽  
Vol 8 (A) ◽  
pp. 517-520
Author(s):  
Hilma Putri Lubis ◽  
Muhammad Fidel Ganis Siregar ◽  
Ichwanul Adenin ◽  
Binarwan Halim ◽  
Henry Salim Siregar ◽  
...  
Keyword(s):  
Luteinizing Hormone ◽  
Polycystic Ovary Syndrome ◽  
Gene Polymorphism ◽  
Polycystic Ovary ◽  
Control Group ◽  
Control Groups ◽  
Ovary Syndrome ◽  
Significant Difference ◽  
Pcos Group ◽  
And Control

BACKGROUND: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders of women in the childbearing period. However, its pathophysiology is still unclear. Certain polymorphisms of the luteinizing hormone/choriogonadotropin receptor (LHCGR) genes may lead to changes in the bioactivity of this hormone. The important functional role of LHCGR in the metabolism of androgen and ovulation, the LHCGR gene variant, may be related to the risk of PCOS. AIM: The aim of this study was to evaluate the association between LHCGR Ins18LQ gene polymorphism and PCOS. METHODS: A case–control study was performed in women with PCOS and non-PCOS from May 2019 to October 2019 in HFC IVF Center. We included 50 women with PCOS and 50 healthy controls. Polymorphism of the LHCGR (ins18LQ) gene was genotyped using polymerase chain reaction-restriction fragment length polymorphism. RESULTS: From this study, we found that there was no significant difference in the proportion of ages between the groups (p > 0.05). There were significant differences in the characteristics of body mass index, FSH level, LH level, and LH/FSH ratio between the PCOS and control groups (p < 0.05). We also found that the proportion of heterozygote variant non-ins/ins was higher in the PCOS group compared to the control group, but there was no significant difference between the polymorphisms of the non-ins and non-nonins variants between the PCOS and control groups (p = 0.269). The frequency of ins alleles was higher in the PCOS group compared to the control group. CONCLUSION: There was no significant association between LHCGR ins18LQ gene polymorphism and PCOS.

scholarly journals Role of Anti-mullerian Hormone (AMH), As A Prediction of Clinical Pregnancy Outcome in Women with Polycystic Ovarian Syndrome with Sub Fertility

2018 ◽  
Vol 9 (1) ◽  
pp. 3-5
Author(s):  
Ashia Khatun ◽  
Afroza Kutubi ◽  
Khairun Nahar ◽  
Israt Jahan ◽  
Hasina Begum ◽  
...  
Keyword(s):  
Polycystic Ovarian Syndrome ◽  
Polycystic Ovary ◽  
Clinical Pregnancy ◽  
Age Group ◽  
Serum Samples ◽  
Ovary Syndrome ◽  
Randomized Sampling ◽  
Ovarian Syndrome ◽  
Good Linear Correlation

Background: Anti-mullerian hormone (AMH) in largely expressed throughout folliculogenisis (by granulosa cells in ovarian follicles) but highest in pre-antral and small antral steges (<4mm) drameter of development.Objective: To analyse the usefulness of plasma anti-mullerian hormone (AMH) measurement as a test for assessing ovarian reserve in Polycystic ovary syndrome with sub fertility,Methodology: Women with PCOS and sub fertility, were included in this study with age group 18-35yrs. This Prospetive cohort study done in 30 cases in ShSMC with purposive randomized sampling, from January 2015 to December 2015. Serum, plasma & for evaluation of PCOS, preferably TV-USG was done.Result: In this study we analyze 30 serum samples from patient aged between 18-35 years and transvaginal ultrasonography was done simultaneously. Mean age group of my patient was 25.2±4.7 years which correlates with AMH level in PCOS which is statistically significant (p<0.001). Mean level of AMH is 5.7±4.9 mg/ml which is also correlate with transvaginal USG scan with the feature of PCOS (p<.0.001). More than 50% woman presents with features of subfertility with PCOS and 46.7% are normal ovaries. Mean menstrual day 7.6 (4-12 days) which have a good linear correlation with irregularities of menstrual cycle and PCOS (p<0.05).Conclusion: To conclude AMH appears to have a major inhibiting role during folliculogenesis, which may contribute to anovulation in PCOS. The reason for the raised AMH in PCOS may give clues as to the mechanism os anovulation.J Shaheed Suhrawardy Med Coll, June 2017, Vol.9(1); 3-5

Determine Cyp17a1 and Ki67 Expressions in Pcos Induced Rat Model Treated with Sepia pharaonis Ink Extract Proves Effective

2020 ◽  
Author(s):  
J. Leonoline Ebenezer ◽  
R. Gunapriya ◽  
K. Ranganathan ◽  
R. Vijayaraghavan ◽  
M. Karthik Ganesh
Keyword(s):  
Rat Model ◽  
Polycystic Ovary ◽  
Clomiphene Citrate ◽  
Drug Effects ◽  
Female Rats ◽  
Therapeutic Drug ◽  
Control Group ◽  
Vaginal Smears ◽  
Sepia Pharaonis ◽  
Pcos Group

Background: The present study aims to evaluate the therapeutic action of Sepia pharaonis ink extract in experimentally induced polycystic ovary syndrome (PCOS) rat model and perform Immunohistochemistry to confirm the findings.Methods: The female rats were grouped into 5 consisting of six animals each. Only water was given to the control group. For inducing PCOS, Letrozole 1mg/kg.b.wt was administered to the subsequent four groups for 21 days. To the third group, an allopathic drug, clomiphene citrate 1mg/kg was given for 19 days after PCOS induction. The SPIE was subjected to lyophilisation to make a black powder and next two groups were administered orally with two different dosages of SPIE (100mg and 200mg respectively) mixed with water after PCOS induction. Vaginal smears were taken from all groups till 21 days and then treatment was started with clomiphene citrate (CC) and SPIE. After 21 days, vaginal smears were taken from all groups till ovulation was induced. The test drug effects were studied using ovary weight both right and left, body weight, hormonal levels, histopathology of ovary and Immunohistochemistry. Result: PCOS group showed rapid increase in the ovarian weight when compared to control and was reduced by CC and SPIE treatment. The levels of progesterone and estradiol were found lower and testosterone levels were found higher in PCOS rats which were favourably altered. Vaginal smears coincided with the histopathology and immunohistochemistry findings. SPIE can be used as a therapeutic drug for PCOS in future, reduce infertility complaint of females and prevent early inception of diabetes mellitus.

scholarly journals Endocrine Disruptors and Polycystic Ovary Syndrome (PCOS): Elevated Serum Levels of Bisphenol A in Women with PCOS

2011 ◽  
Vol 96 (3) ◽  
pp. E480-E484 ◽  
Author(s):  
Eleni Kandaraki ◽  
Antonis Chatzigeorgiou ◽  
Sarantis Livadas ◽  
Eleni Palioura ◽  
Frangiscos Economou ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Bisphenol A ◽  
Body Mass ◽  
Polycystic Ovary ◽  
Elevated Serum ◽  
Hospital Setting ◽  
Metabolic Parameters ◽  
Control Group ◽  
Blood Levels ◽  
Pcos Group

Context: Bisphenol A (BPA) is a widespread industrial compound used in the synthesis of polycarbonate plastics. In experimental animals, neonatal exposure to BPA results in a polycystic ovary-like syndrome (PCOS) in adulthood. A bidirectional interaction between androgens and BPA levels has been disclosed. Objective: To determine BPA levels in PCOS women as well as the association between BPA and hormonal/metabolic parameters compared to a control group. Design, Setting, and Participants: Cross-sectional study of 71 PCOS (National Institutes of Health criteria) and 100 normal women, age- and body mass index–matched, in a University hospital setting. Main Outcome Measures: Anthropometric, hormonal, metabolic parameters and BPA blood levels were determined. Patients (PCOS) and controls (C) were further subdivided according to body mass index into lean and overweight subgroups, respectively. Results: BPA levels were significantly higher in the total PCOS group compared with the controls (1.05±0.56 vs. 0.72±0.37ng/ml, P &lt; 0.001). PCOS women, lean (PCOS-L) and overweight (PCOS-OW), had higher BPA levels compared to the corresponding control group lean (C-L) and overweight (C-OW): (PCOS-L = 1.13±0.63 vs. C-L = 0.70±0.36, P &lt; 0.001) (PCOS-OW = 0.96 ± 0.46 vs. C-OW = 0.72 ± 0.39, P &lt; 0.05). A significant association of testosterone (r = 0.192, P &lt; 0.05) and androstenedione (r = 0.257, P &lt; 0.05) with BPA was observed. Multiple regression analysis for BPA showed significant correlation with the existence of PCOS (r = 0.497, P &lt; 0.05). BPA was also positively correlated with insulin resistance (Matsuda index) in the PCOS group (r = 0.273, P &lt; 0.05). Conclusions: Higher BPA levels in PCOS women compared to controls and a statistically significant positive association between androgens and BPA point to a potential role of this endocrine disruptor in PCOS pathophysiology.

scholarly journals PREVALENCE OF NON-ALCOHOLIC FATTY LIVER DISEASE IN WOMEN WITH POLYCYSTIC OVARY SYNDROME AND ITS CORRELATION WITH METABOLIC SYNDROME

2015 ◽  
Vol 52 (2) ◽  
pp. 117-123 ◽  
Author(s):  
Mariana Drechmer ROMANOWSKI ◽  
Monica Beatriz PAROLIN ◽  
Alexandre C T FREITAS ◽  
Mauri J PIAZZA ◽  
Jorgete BASSO ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Liver Disease ◽  
Fatty Liver Disease ◽  
Polycystic Ovary ◽  
International Diabetes Federation ◽  
Control Group ◽  
Ovary Syndrome ◽  
Alcoholic Fatty Liver ◽  
Pcos Group ◽  
Alcoholic Fatty Liver Disease

Background The polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women at childbearing age. Metabolic syndrome is present from 28% to 46% of patients with PCOS. Non-alcoholic fatty liver disease (NAFLD) is considered the hepatic expression of metabolic syndrome. There are few published studies that correlate PCOS and NAFLD. Objective To determine the prevalence of NAFLD and metabolic syndrome in patients with PCOS, and to verify if there is a correlation between NAFLD and metabolic syndrome in this population. Methods Study developed at Gynecology Department of Clinical Hospital of Federal University of Parana (UFPR). The sessions were conducted from April 2008 to January 2009. One hundred and thirty-one patients joined the analysis; 101 were diagnosed with PCOS and 30 formed the control group. We subdivided the PCOS patients into two subgroups: PCOS+NAFLD and PCOS. All the patients were submitted to hepatic sonography. For hepatoestheatosis screening, hepatic ecotexture was compared do spleen’s. For diagnosis of metabolic syndrome, we adopted the National Cholesterol Education Program/Adult Treatment Panel III (NCEP/ATP III) criteria, as well as the criteria proposed by International Diabetes Federation. Statistical analysis were performed with t of student and U of Mann-Whitney test for means and chi square for proportions. Results At PCOS group, NAFLD was present in 23.8% of the population. At control group, it represented 3.3%, with statistical significance (P=0.01). Metabolic syndrome, by NCEP/ATP III criteria, was diagnosed in 32.7% of the women with PCOS and in 26.6% of the women at control group (no statistical difference, P=0.5). At PCOS+DHGNA subgroup, age, weight, BMI, abdominal circumference and glucose tolerance test results were higher when compared to PCOS group (P<0.01). Metabolic syndrome by NCEP/ATPIII criteria was present in 75% and by International Diabetes Federation criteria in 95.8% of women with PCOS+NAFLD with P<0.01. Insulin levels at SOP+DHGNA were higher than at PCOS group with P<0.01. Conclusion Almost 25% of the patients with PCOS were diagnosed for NAFLD. Metabolic syndrome was present between 32.7% and 44.6% of patients with PCOS. At subgroup PCOS+NAFLD, metabolic syndrome is highly prevalent. These patients are more obese, with higher BMI and higher glucose levels.

scholarly journals The role of left atrial strain in patients with functional tricuspid regurgitation before and after annuloplasty: a long-term follow-up study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Qing-long Meng ◽  
Hong Meng ◽  
Jia Tao ◽  
Shu Yang ◽  
Hao Wang
Keyword(s):  
Tricuspid Regurgitation ◽  
Mitral Stenosis ◽  
Left Atrial ◽  
Pearson Correlation ◽  
Characteristic Curve ◽  
Control Group ◽  
Rheumatic Mitral Stenosis ◽  
Functional Tricuspid Regurgitation

Abstract Background Functional tricuspid regurgitation (TR) is common among patients with left heart disease and may recur during the follow-up period after selective tricuspid valve annuloplasty (TVA). This study aims to analyse the relationship between left atrial (LA) strain and the degree of preoperative functional TR and to explore the role of LA strain in predicting TR recurrence. Methods This study included 63 patients with rheumatic mitral stenosis who underwent mitral valve replacement and concomitant TVA. Additionally, 20 healthy controls were enrolled. Preoperative conventional LA echocardiographic parameters and LA strain were measured. The association between LA strain and preoperative functional TR severity was analysed by Pearson correlation. Predictors of recurrent TR were determined by multivariate logistic regression analyses. Results Compared with the control group, the mitral stenosis group developed a significant impairment in terms of LA strain. The degree of preoperative functional TR exhibited moderate correlations with LA reservoir strain (r = − 0.57) and LA conduit strain (r = 0.48). During a median follow-up period of 66.4 ± 36.4 months, TR recurred in 18 patients. Preoperative LA reservoir strain and the mean transmitral gradient were predictors of postoperative TR recurrence. When the two indexes were combined to establish a prediction, the sensitivity and specificity of prediction increased. The area under the receiver operating characteristic curve of the combined indicator was higher than those of the single indicators (0.90 vs. 0.70 and 0.72). Conclusions LA strain correlates with preoperative functional TR severity in patients with rheumatic mitral stenosis. The LA reservoir strain and preoperative mean transmitral gradient are independent predictive factors for recurrent TR after TVA.

scholarly journals Novel predictor of the occurrence of DKA in T1DM patients without infection: A combination of neutrophil/lymphocyte ratio and white blood cells

2021 ◽  
Vol 16 (1) ◽  
pp. 1365-1376
Author(s):  
Yiping Cheng ◽  
Wenhao Yu ◽  
Yuping Zhou ◽  
Tao Zhang ◽  
Haiyan Chi ◽  
...  
Keyword(s):  
Blood Cells ◽  
Low Cost ◽  
Characteristic Curve ◽  
White Blood Cells ◽  
Area Under The Curve ◽  
Control Group ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio

Abstract The role of inflammation has been identified in the pathogenesis of diabetic ketoacidosis (DKA). The neutrophil/lymphocyte ratio (NLR) and white blood cells (WBC) can be used to predict a systemic inflammatory response. Changes in NLR and WBC levels have never been explored in type 1 diabetes mellitus (T1DM) patients with DKA and an uninfected state. This retrospective study included a total of 644 participants. NLR and WBC were measured in the control group (n = 316) and in T1DM patients with mild-DKA (n = 92), severe-DKA (n = 52), and non-DKA (n = 184) in an uninfected state. Then, we assessed the independent predictors of DKA occurrence in T1DM patients in an uninfected state. The diagnostic performance of variables was determined by receiver operating characteristic curve analysis. Serum NLR of T1DM patients is significantly higher than that of normal controls, and if DKA occurs, NLR increases further and increases with the severity of DKA. In addition to diastolic blood pressure, blood urea nitrogen, glycated hemoglobin (HbA1c), and WBC, NLR was also independently associated with DKA in T1DM patients with an uninfected state (OR = 1.386, 95% CI: 1.127–1.705, p = 0.002). Furthermore, the diagnosis analysis showed that except for NLR and WBC, the area under the curve (AUC) of indicators with a statistical difference in patients with and without DKA were 0.747 for DKA diagnosis, and after the addition of NLR and WBC, the AUC was 0.806. The increased NLR level represents a low-cost and highly accessible predictor for DKA in T1DM patients with an uninfected state. The addition of inflammation indicators can play a statistically significant role in the prediction model of the DKA occurrence.

scholarly journals Evaluation the levels of some hormones in women with polycystic ovary syndrome

2019 ◽  
Vol 24 (5) ◽  
pp. 25
Author(s):  
Namareq Ata allah Mohemeed1 ◽  
Firas Shawki Abdul-razzak2
Keyword(s):  
Menstrual Cycle ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Follicle Stimulating Hormone ◽  
Control Group ◽  
Age Group ◽  
Ovary Syndrome ◽  
Blood Samples ◽  
Healthy Women ◽  
Stimulating Hormone

This study was conducted on 40 Samples of Patients with polycystic ovary syndrome (PCOS) after their diagnosis, The study aimed to identify the most important  hormonal disorders associated  with  this syndrome . The study begins from Octobar 2017 to March 2018 , the age from(19-45) years .Blood samples were taken during the (2-4( days of menstrual cycle and the selected samples were compared with 20 healthy women as control group ,and the following hormones were evaluated Luteninzing hormone (LH), Follicle Stimulating Hormone (FSH), Prolactin (PRL),Testosterone (Testo) and Oxytocin (OX) ,the study showed a high significant in the concentrations of OX ,Testo and LH (P≤0.01) , a high significant in the PRL concentration (P≤0.05) and a high significant in the FSH concentration (P≤0.05(,the results were distributed to three groups according to BMI ,age and treatment, in term BMI it was divided into three groups, BMI(18.5-24.9)(25.0-29.9) (≥30)kg/m2 the results showed a high significant (P≤0.05)  in the LH and OX concentration in  group BMI (18.5-24.9)kg/m2 and in both PRL and Testo in group BMI(≥30)kg/m2. in term age, it was divided into three groups (19-26) (27-35) (36-45)years, the results showed a high significant (P≤0.05) in LH  and Testo concentration at age group (36-45)years ,compared to other groups, and a high significant (P≤0.05) in both PRL and OX, between three group of age , treatment it was divided  into three groups of metformin, progesterone contraceptive used and non-used of the treatment .the results showed a high significant (P≤0.05) in LH, PRL, OX and Testo concentrations, and a high significant (P≤0.05) of FSH in women treated compared with non-used  .   http://dx.doi.org/10.25130/tjps.24.2019.085

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