Relationship between proinflammatory cytokines and clomiphene resistance in patients with polycystic ovary syndrome

AbstractThere is currently a dispute over the choice of ovulation induction treatment for infertile women with polycystic ovary syndrome (PCOS). The objective of this study is to compare the therapeutic effect of pulsed rhythmic administration protocol (PRAP) with conventional letrozole + human menopausal gonadotropin (HMG) in patients with clomiphene-resistance polycystic ovary syndrome (PCOS). A retrospective analysis of 821 intrauterine insemination (IUI) cycles between January 2015 and January 2020 was performed. Of these, 483 cycles were treated with a pulsed rhythmic administration protocol (PRAP), and 338 cycles were treated with conventional letrozole + HMG protocol (LHP). The therapeutic effect of the two protocols has been compared. The pregnancy rate was 18.07% in the LHP and 27.07% in the PRAP. The ongoing pregnancy rate in LHP was 14.46% and in PRAP was 22.73%. The research suggests that PRAP is more effective than LHP and could be an adequate ovulation induction strategy for the IUI cycle of patients with clomiphene-resistance PCOS.

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Association between metabolic and hormonal profile, proinflammatory cytokines in saliva and gingival health in adolescent females with polycystic ovary syndrome

BMC Oral Health ◽

10.1186/s12903-021-01553-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Natalia Wendland ◽

Justyna Opydo-Szymaczek ◽

Dorota Formanowicz ◽

Anna Blacha ◽

Grażyna Jarząbek-Bielecka ◽

...

Keyword(s):

Polycystic Ovary Syndrome ◽

Proinflammatory Cytokines ◽

Oral Hygiene ◽

Polycystic Ovary ◽

Control Group ◽

Study Group ◽

Ovary Syndrome ◽

Salivary Testosterone ◽

Gingival Health ◽

Tnf Α

Abstract Background Research studies indicate that polycystic ovary syndrome (PCOS) may increase susceptibility to periodontal disease. The mechanisms that link both conditions are not entirely understood. Thus, the study aimed to investigate the impact of hormonal and metabolic disturbances on the gingival health and salivary levels of tumor necrosis factor (TNF-α), interleukin 1β (IL1-β), and interleukin 6 (IL-6) in adolescent girls with PCOS. Methods Thirty-one patients with PCOS and twenty-eight healthy age-mates (as the control group) were enrolled in the study. Individuals with PCOS underwent blood tests for the determination of hormonal and metabolic parameters. Saliva samples were collected to measure salivary testosterone and proinflammatory cytokines in both studied groups. Calibrated dentist assessed oral hygiene and gingival health of all subjects. Results Salivary testosterone was significantly higher in the study group (p = 0.0007). The groups did not differ significantly concerning periodontal parameters. Patients with PCOS revealed higher levels of salivary cytokines (p < 0.0001). Gingival index (GI) and the percentage of sites bleeding upon probing (BOP%) were positively correlated with the plaque index (PI) in both groups (rs ≥ 0.60, p < 0.001), and negatively correlated with salivary testosterone level in the PCOS group (rs = − 0.44, p = 0.0138 and rs = − 0.37, p = 0.0424, respectively). BOP% was also positively correlated with body mass index (BMI) in the control group (rs = 0.40, p = 0.0368) and index of insulin resistance (HOMA-IR) in the study group (rs = 0.48, p = 0.0068). Salivary testosterone was positively correlated with TNF-α in the control group (rs = 0.41, p = 0.0321), while in the study group, total testosterone (TT) was positively correlated with IL-6 (rs = 0.37, p = 0.0400) and free androgen index (FAI) with TNF-α (rs = 0.36, p = 0.0491). Conclusions Gingival health of the examined population was associated primarily with oral hygiene and, to a lesser extent, with the hormonal and metabolic profile. Despite similar periodontal parameters in the both studied groups, patients with PCOS revealed significantly higher levels of proinflammatory cytokines in saliva, which might be the manifestation of the systemic low-grade inflammation associated with PCOS.

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Ovarian-adrenal cross-talk in polycystic ovary syndrome: evidence from wedge resection

Acta Endocrinologica ◽

10.1530/eje.0.1430383 ◽

2000 ◽

pp. 383-388 ◽

Cited By ~ 10

Author(s):

XK Wu ◽

SY Zhou ◽

K Sallinen ◽

P Pollanen ◽

R Erkkola

Keyword(s):

Polycystic Ovary Syndrome ◽

Polycystic Ovary ◽

Wedge Resection ◽

Sex Hormone Binding Globulin ◽

Acth Stimulation ◽

Adrenal Androgen ◽

Ovary Syndrome ◽

Glucose Ratio ◽

Clomiphene Resistance ◽

17 Hydroxyprogesterone

OBJECTIVE: To determine whether the ovary influences adrenal androgen secretion in women with polycystic ovary syndrome (PCOS). DESIGN: Six PCOS-affected patients with clomiphene resistance and gonadotrophin hyperresponsivity, and six controls with regular ovulatory cycles, matched for age and body mass index. METHODS: Bilateral ovarian wedge resection was performed to induce ovulation surgically for these refractory women with PCOS. The adrenal androgen secretions were evaluated in PCOS patients before and again 6 months after this surgery, and in the controls, using an ACTH stimulation test (0.25mg synthetic ACTH(1-24)). RESULTS: Biochemically, basal levels and the maximum net increases (Delta) of 17-hydroxyprogesterone (17-OHP) and androstenedione, Delta17-OHP/Delta progesterone and Delta androstenedione/Delta17-OHP ratios in response to exogenous ACTH were significantly higher in PCOS patients before operation than those of controls. This purely ovarian surgery in women with PCOS was found to significantly reduce their basal androstenedione, testosterone and LH levels, insulin/glucose ratio, and post-corticotrophic Delta17-OHP, Delta androstenedione, Delta17-OHP/Delta progesterone and Delta androstenedione/Delta17-OHP, without obvious changes in FSH, oestradiol, sex hormone-binding globulin, Delta dehydroepiandrosterone, Delta dehydroepiandrosterone sulphate, Delta aldosterone and Delta cortisol values. CONCLUSIONS: Ovarian hyperandrogenicity from polycystic ovary may contribute to the enhanced adrenal P450c17alpha activity and subsequent Delta(4) androgen reserve revealed by the pharmacological corticotrophin stimulation in our special PCOS cases.

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