scholarly journals A Systematic Review of Endocrine Therapy for Improved Reproductive and Metabolic Outcomes in PCOS Women

2021 ◽  
Vol 7 (2) ◽  
pp. 65
Author(s):  
Nur Aini Lutfi Rahmawati ◽  
Esti Yunitasari ◽  
Ni Ketut Alit Armini ◽  
Padoli Padoli ◽  
Suharyono Suharyono
Keyword(s):  
Live Birth ◽  
Clomiphene Citrate ◽  
Outcome Data ◽  
Endocrine Treatment ◽  
Obese Women ◽  
Metabolic Outcomes ◽  
Evidence Quality ◽  
Data Imprecision ◽  
Ovarian Syndrome

Introduction: Polycystic ovarian syndrome (PCOS) is characterized by infrequent or absent ovulation as well as elevated levels of androgens and insulin (hyperinsulinaemia). The purpose of this study was to determine the efficacy of endocrine treatment in improving reproductive and metabolic outcomes in women with PCOS.Methods: We searched the following databases from inception to Maret 2020: PubMed, Proquest, ScienceDirect, Scopus and CINAHL. We investigated at metformin, clomiphene citrate, metformin plus clomiphene citrate, D-chiro-inositol, statins, and resveratrol as treatments. We compared them to each other, as well as to a placebo or no therapy. The quality of the evidence ranged from extremely low to moderate. The risks of bias (poor reporting of technique and inadequate outcome data), imprecision, and inconsistency were the limitations.Results: Although the evidence quality was low, our latest evaluation indicated that metformin alone may be superior to placebo for live birth. Data for live birth were equivocal when metformin was compared to clomiphene citrate, and our conclusions were hampered by a paucity of evidence. Body mass index (BMI) varies in the results, emphasizing the need of stratifying data by BMI.Conclusion: Clinical pregnancy and ovulation improvements demonstrate that clomiphene citrate is still preferred to metformin for ovulation induction in obese women with PCOS.

scholarly journals EFFECTIVENESS OF LIFESTYLE MODIFICATION ON WEIGHTLOSS AND QUALITY OF LIFE IN OBESE WOMEN WITH POLYCYSTIC OVARIAN SYNDROME

2018 ◽  
Vol 11 (9) ◽  
pp. 333
Author(s):  
Vinaya Rajendra Patil ◽  
Poovishnu Devi Thangavelu ◽  
Vaishali Krishnat Jagtap
Keyword(s):  
Quality Of Life ◽  
Weight Loss ◽  
Polycystic Ovarian Syndrome ◽  
Lifestyle Modification ◽  
Obese Women ◽  
Group A ◽  
Conventional Physiotherapy ◽  
Group B ◽  
Ovarian Syndrome

Objectives: (1) The objectives of this study were to determine the effectiveness of lifestyle modification on weight loss and the quality of life in obese women with the polycystic ovarian syndrome and (2) to determine the effectiveness of conventional physiotherapy on weight loss and the quality of life in obese women with polycystic ovarian syndrome.Methods: Ethical clearance was obtained from the Institutional Ethical Committee. A total of 40 obese women with the polycystic ovarian syndrome (PCOS) were selected and divided into two groups, Group A (N=17) received conventional physiotherapy alone, and Group B (n=15) received lifestyle modification along with conventional physiotherapy. The preassessment of body weight is measured by body mass index (BMI); the waist-hip ratio (W-H ratio) and body fat percentage and the quality of life were scored as per the PCOS questionnaire (PCOSQ); and postinterventional assessment was taken for the same after 9 months.Result: Intergroup statistical analysis for BMI revealed extremely significant in postintervention for Group B (P<0.0001). W-H ratio and PCOSQ were extremely significant for Group B (P<0.0001). While postintervention analysis showed extremely significant difference between Group A and Group B (P<0.0001). Group B treated with lifestyle modification, and conventional physiotherapy was extremely significant.Conclusion: Lifestyle modification with conventional physiotherapy helped in reducing weight and showed the increased quality of life in women with PCOS.

Evaluation of endothelial function in obese and non obese women with polycystic ovarian syndrome

Authorea ◽  
2020 ◽  
Author(s):  
Gita Radhakrishnan ◽  
Anshuja Singla ◽  
Mamta Jakhar ◽  
Rachna Agarwal ◽  
Anupama Tandon ◽  
...  
Keyword(s):  
Endothelial Function ◽  
Polycystic Ovarian Syndrome ◽  
Obese Women ◽  
Ovarian Syndrome

scholarly journals When and why do people act on flawed science? Effects of anecdotes and prior beliefs on evidence-based decision-making

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Audrey L. Michal ◽  
Yiwen Zhong ◽  
Priti Shah
Keyword(s):  
Educational Interventions ◽  
Evidence Based ◽  
Prior Beliefs ◽  
Learning Experiment ◽  
Apply Research ◽  
Evidence Quality ◽  
The Media ◽  
The Impact ◽  
Learning Interventions

AbstractToday’s citizens are expected to use evidence, frequently presented in the media, to inform decisions about health, behavior, and public policy. However, science misinformation is ubiquitous in the media, making it difficult to apply research appropriately. Across two experiments, we addressed how anecdotes and prior beliefs impact readers’ ability to both identify flawed science and make appropriate decisions based on flawed science in media articles. Each article described the results of flawed research on one of four educational interventions to improve learning (Experiment 1 included articles about having a tidy classroom and exercising while learning; Experiment 2 included articles about using virtual/augmented reality and napping at school). Experiment 1 tested the impact of a single anecdote and found no significant effect on either participants’ evidence evaluations or decisions to implement the learning interventions. However, participants were more likely to adopt the more plausible intervention (tidy classroom) despite identifying that it was unsupported by the evidence, suggesting effects of prior beliefs. In Experiment 2, we tested whether this intervention effect was driven by differences in beliefs about intervention plausibility and included two additional interventions (virtual reality = high plausible, napping = low plausible). We again found that participants were more likely to implement high plausible than low plausible interventions, and that evidence quality was underweighed as a factor in these decisions. Together, these studies suggest that evidence-based decisions are more strongly determined by prior beliefs than beliefs about the quality of evidence itself.

scholarly journals Acupuncture and Clomiphene Citrate for Live Birth in Polycystic Ovary Syndrome: Study Design of a Randomized Controlled Trial

2013 ◽  
Vol 2013 ◽  
pp. 1-11 ◽  
Author(s):  
Hongying Kuang ◽  
Yan Li ◽  
Xiaoke Wu ◽  
Lihui Hou ◽  
Taixiang Wu ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Polycystic Ovary Syndrome ◽  
Live Birth ◽  
Polycystic Ovary ◽  
Controlled Trial ◽  
Clomiphene Citrate ◽  
Fertility Treatment ◽  
Ovary Syndrome ◽  
Randomized Controlled ◽  
Multicenter Randomized Controlled Trial

Acupuncture is an alternative therapy to induce ovulation in women with polycystic ovary syndrome (PCOS), but there is no study reporting the live birth rate following ovulation induction by acupuncture or its potential as an adjuvant treatment to clomiphene citrate (CC). We assess the efficacy of acupuncture with or without CC in achieving live births among 1000 PCOS women in Mainland China. This paper reports the methodology of an ongoing multicenter randomized controlled trial. The randomization scheme is coordinated through the central mechanism and stratified by the participating sites. Participants will be randomized into one of the four treatment arms: (A) true acupuncture and CC, (B) control acupuncture and CC, (C) true acupuncture and placebo CC, and (D) control acupuncture and placebo CC. To ensure the quality and integrity of the trial we have developed a unique multinational team of investigators and Data and Safety Monitoring Board. Up to the end of April 2013, 326 subjects were recruited. In conclusion, the success of this trial will allow us to evaluate the additional benefit of acupuncture beyond the first line medicine for fertility treatment in PCOS women in an unbiased manner.

scholarly journals Time associations between U.S. birth rates and add-Ons to IVF practice between 2005–2016

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Norbert Gleicher ◽  
Lyka Mochizuki ◽  
David H. Barad
Keyword(s):  
Live Birth ◽  
Outcome Data ◽  
Single Embryo Transfer ◽  
Additional Treatment ◽  
Birth Rates ◽  
Preimplantation Genetic Testing ◽  
Vitro Fertilization ◽  
Live Births ◽  
Live Birth Rates

AbstractUntil 2010, the National Assisted Reproductive Technology Surveillance System (NASS) report, published annually by the Center for Disease Control and Prevention (CDC), demonstrated almost constantly improving live birth rates following fresh non-donor (fnd) in vitro fertilization (IVF) cycles. Almost unnoticed by profession and public, by 2016 they, however, reached lows not seen since 1996–1997. We here attempted to understand underlying causes for this decline. This study used publicly available IVF outcome data, reported by the CDC annually under Congressional mandate, involving over 90% of U.S. IVF centers and over 95% of U.S. IVF cycles. Years 2005, 2010, 2015 and 2016 served as index years, representing respectively, 27,047, 30,425, 21,771 and 19,137 live births in fnd IVF cycles. Concomitantly, the study associated timelines for introduction of new add-ons to IVF practice with changes in outcomes of fnd IVF cycles. Median female age remained at 36.0 years during the study period and center participation was surprisingly stable, thereby confirming reasonable phenotype stability. Main outcome measures were associations of specific IVF practice changes with declines in live IVF birth rates. Time associations were observed with increased utilization of “all-freeze” cycles (embryo banking), mild ovarian stimulation protocols, preimplantation genetic testing for aneuploidy (PGT-A) and increasing utilization of elective single embryo transfer (eSET). Among all add-ons, PGT-A, likely, affected fndIVF most profoundly. Though associations cannot denote causation, they can be hypothesis-generating. Here presented time-associations are compelling, though some of observed pregnancy and live birth loss may have been compensated by increases in frozen-thawed cycles and consequential pregnancies and live births not shown here. Pregnancies in frozen-thawed cycles, however, represent additional treatment cycles, time delays and additional costs. IVF live birth rates not seen since 1996–1997, and a likely continuous downward trend in U.S. IVF outcomes, therefore, mandate a reversal of current outcome trends, whatever ultimately the causes.

Effect of Sildenafil in Endometrial Ripening with Induction of Ovulation by Clomiphene Citrate in Polycystic Ovarian Syndrome; Double Blinded; Randomized Controlled Trial

2019 ◽  
Vol 2 (3) ◽  
pp. 01-10
Author(s):  
Dalia Mohammed Mohammed El-Khaldy ◽  
Mohamed Saeed Khallaf ◽  
Ahmed Mohamed Nour Eldin Hashad ◽  
Ibrahim Shazly Mohamed Amen Elshazly
Keyword(s):  
Randomized Controlled Trial ◽  
Polycystic Ovarian Syndrome ◽  
Controlled Trial ◽  
Clomiphene Citrate ◽  
Clinical Pregnancy ◽  
Sildenafil Citrate ◽  
Control Group ◽  
Induction Of Ovulation ◽  
Randomized Controlled ◽  
Ovarian Syndrome

Back ground: World Health Organization (WHO) defines infertility as a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse. Worldwide, 8 to 12 percent of couples experience fertility problems. Causes of infertility in women were as follows: menstrual disorders (disorders of cycle length and flow) 62.6%, diseases (obesity, thyroid diseases, diabetes) 58.7%, impaired ovulation (hormonal disorders, oligoovulation and anovulation) 50.3%, uterine causes 16.7%, tubal factor 15.4%, and cervical causes 7.9%. In the male factor fertility there was semen abnormalities (44.6%), genetic factors (29.8%), anti-spermatogenesis agents (11%), and vascular disorders (17.2%). Aim of the Study: The purpose of this study is to evaluate the effect of sildenafil in endometrial ripening with induction of ovulation by clomiphene citrate in polycystic ovarian syndrome. Patients and methods: It is a randomized controlled trial on 65 infertile women with polycystic ovarian syndrome; patients were randomly divided into two equal groups. In control group, 31 patients were given oral sildenafil, one tablet every 12 hrs. From 2nd day of the cycle till 12th day and clomiphene citrate, one tablet every 12 hours, for 5 days from 3rd day of the menstrual cycle. In study group, 34 patients were given oral placebo, one tablet every 12 hrs. From 2nd day of the cycle till 12th day and clomiphene citrate, one tablet every 12 hours, for 5 days from 3rd day of the menstrual cycle. A transvaginal ultrasound was performed to evaluated the endometrial thickness before and after treatment, the follicularometeric was measured on day 11 and day13. Uterine artery Doppler was then measured. Qualitative serum B-hCG level was checked 14 days after ovulation to assess clinical pregnancy rate. Design: Prospective, Double blinded randomized controlled trial. Setting: Obstetrics & Gynecology outpatient clinic, Ain Shams University Hospital. Study duration: 3 months. Results: The present study was a double-blind, randomized, controlled study that was conducted on 65 women with PCOS who underwent induction of ovulation by Clomiphene citrate in outpatient clinic of Ain Shams University hospital. Conclusion: Our systematic review and meta-analysis showed that follicular supplementation of sildenafil citrate (oral or vaginal), alone or adjuvant therapy can be used for improving the EM and clinical pregnancy rate in women undergoing assisted reproduction. However, given the methodological limitations the current evidence does not support its use in clinical practice yet. Future high-quality RCT with large sample size to evaluate the sildenafil citrate effect in women undergoing assisted reproduction are needed. Future RCTs should focus on type of processing, stage of embryo, embryo quality, dosage, time of administration, type of control group, in order to identify the groups of patients who would benefit the most from this intervention and the most appropriate dosage, time, and type of sildenafil citrate which would have the most positive effect and the less possible side effects.

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