scholarly journals Infertility Riding on Polycystic Ovarian Syndrome (PCOS): A Review of Treatment Modalities

2021 ◽  
pp. 1-14
Author(s):  
Reenoo Jauhari ◽  
Prashant Mathur ◽  
Vineeta Gupta
Keyword(s):  
Polycystic Ovarian Syndrome ◽  
Follicular Development ◽  
Reproductive Age ◽  
Fertility Treatment ◽  
Response To Treatment ◽  
Lipid Lowering ◽  
Treatment Modalities ◽  
Comprehensive Treatment ◽  
Lifestyle Modifications ◽  
Ovarian Syndrome

Polycystic ovarian syndrome (PCOS) is the commonest cause of anovulatory infertility. Depending on the population studied between 5 and 18% of women of reproductive age suffer from PCOS, however not all of them are anovulatory or experience subfertility. PCOS has been associated with numerous reproductive and metabolic abnormalities. Despite enormous advances in the management of reproductive dysfunction, insight into the metabolic implications of PCOS is limited by the lack of uniform diagnostic criteria, the heterogeneity of the condition and the presence of confounders including obesity. Obesity clearly has a role in long term health and may best predict both reproductive and metabolic dysfunction as well as negatively affect the response to treatment in women with PCOS. Diabetes, cardiovascular disease and cancer are also at the forefront of any risk assessment or comprehensive treatment strategy for these women. Lifestyle modifications including dietary changes, increased exercise and weight loss are appropriate first line interventions for many women with PCOS. Pharmaceuticals including metformin, lipid lowering agents and oral contraceptives should be tailored to the individual’s risk profile and treatment goals. The fertility treatment in women with subfertility and PCOS aimed to safely induce monofollicular ovulation resulting in the birth of a singleton child. Women with PCOS undergoing fertility treatment are at risk of multi-follicular development as well as ovarian hyper-stimulation syndrome (OHSS), so they must be carefully counselled and monitored during fertility treatment. It is imperative that prior to embarking on fertility treatment, a patient’s health and weight is optimised. This chapter will explore the latest evidence for fertility treatments for women with PCOS.

scholarly journals Assisted Reproductive Technologies for Women with Polycystic Ovarian Syndrome

2021 ◽  
Vol 14 (3) ◽  
pp. 1305-1308
Author(s):  
Muhjah Falah Hassan ◽  
Pallav Sengupta ◽  
Sulagna Dutta
Keyword(s):  
Polycystic Ovarian Syndrome ◽  
Assisted Reproductive Technologies ◽  
Polycystic Ovary ◽  
Fetal Loss ◽  
Reproductive Technologies ◽  
Fertilization Rate ◽  
Reproductive Age ◽  
Treatment Modalities ◽  
Reproductive Techniques ◽  
Ovarian Syndrome

Polycystic ovarian syndrome (PCOS) is the most common cause of anovulatory fertility problems in women of reproductive age, with a prevalence as high as 40% to 75%. There are different treatment modalities for increasing the chance of pregnancy in PCOS patients. Since most of the PCOS patients suffer from ovulatory problems, therapeutic efforts are focused mainly towards restoring normal ovulation. However, even after pharmacological interventions to ameliorate ovulatory irregularities, women with polycystic ovary are still at high risk of fetal loss. Thus, assisted reproductive techniques (ARTs) have become popular approaches which significantly increase the chances of successful pregnancy in these women, bypassing the conditions of PCOS. The present mini-review ‘pinpoints’ on the suitability of ARTs for PCOS patients who fail to ovulate following the conventional infertility treatment. The article also briefly explains how intracytoplasmic sperm injection (ICSI), the most effectiveART, correlates with better biological parameters, fertilization rate and better quality of embryos in PCOS women.

scholarly journals Prevalence, Symptomatology and Herbal Management of Polycystic Ovarian Syndrome

2020 ◽  
Author(s):  
Sabira Sultana ◽  
Naheed Akhter ◽  
Muhammad Akram ◽  
Syed Muhammad Ali Shah ◽  
Naveed Munir ◽  
...  
Keyword(s):  
Polycystic Ovarian Syndrome ◽  
Scientific Information ◽  
Pituitary Hormones ◽  
Mature Female ◽  
Reproductive Age ◽  
Tinospora Cordifolia ◽  
Treatment Modalities ◽  
Asparagus Racemosus ◽  
Lepidium Meyenii ◽  
Ovarian Syndrome

Polycystic Ovarian Syndrome (PCOS) is multi-organ syndrome that affects 6–25% of females during reproductive age. It disrupts normal hormone levels of females and affects adrenal hormone and sex hormones along with pituitary hormones including adrenocorticotropic, growth hormone and gonadotropins hormones. It results in several secondary characteristics in females such as infertility, hormonal imbalance, oligomenorrhea, amenorrhea, obesity and hirsutism. Polycystic ovarian syndrome is associated with mental and reproductive disorder and almost 4–18% mature female students are affected by polycystic ovarian syndrome. Female affected by polycystic ovarian syndrome have increased risk of infertility, ovarian cancer, skin problems and psychological problems such as anxiety, depression and changes in sleep along with mood swings. This chapter discusses the Prevalence, Symptomatology and Management of Polycystic Ovarian Syndrome. For the management of PCOS, the role of some medicinal plants including Asparagus racemosus, Tinospora cordifolia, Foeniculum vulgare, Ocimum tenuiflorum, Actaea racemosa, and Lepidium meyenii have also been discussed in addition to other treatment modalities. The literature data was searched out and compiled using relevant original research articles and reviews published and indexed in Google Scholar, Scientific Information Database, Elsevier, PubMed and Science Direct.

scholarly journals “Polycystic Ovarian Syndrome Benefitted by Yoga.”

2020 ◽  
Vol 8 (04) ◽  
Author(s):  
Gayatri Patil
Keyword(s):  
Weight Reduction ◽  
Polycystic Ovarian Syndrome ◽  
Therapeutic Potential ◽  
Reproductive Age ◽  
Lifestyle Modifications ◽  
Hormonal Imbalance ◽  
Dietary Regime ◽  
Ovarian Syndrome

Now a days PCOS is one of the commonest problems of reproductive age caused by hormonal imbalance. Aims and Objects: To Study PCOS. To assess the effectiveness of Yoga in management of PCOS. To highlight the key messages. Conclusion : Weight reduction is main preventive and therapeutic potential to combat with this. It can be achieved by incorporating lifestyle modifications. Ayurveda dietary regime the wholesome food (Pathya Ahar) and Yoga interventions mentioned in Ayurveda literature are main key  

scholarly journals COMPARISON BETWEEN DIETARY INTAKE AND AGE IN RELATION TO BODY MASS INDEX AMONG POLYCYSTIC OVARIAN SYNDROME WOMEN – A CASE–CONTROL STUDY

2019 ◽  
pp. 248-251
Author(s):  
BRINDHA G ◽  
MADHANSHANKAR SR
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Polycystic Ovarian Syndrome ◽  
Reproductive Age ◽  
Age Group ◽  
Lifestyle Modifications ◽  
Food Pattern ◽  
South Indian ◽  
And Control ◽  
Ovarian Syndrome

Objective: Polycystic ovarian syndrome (PCOS) is the most prevalent endocrine disorder, affecting up to 6.8% of women at their prime reproductive age. The aim of the study is to prove the interrelationship between food patterns, age, and anthropometric measurements in relation with body mass index (BMI) among PCOS women and control participants. Methods: The study was performed among 80 PCOS women and control participants according to the Rotterdam criteria. The data were collected through questionnaire which included age, socioeconomic data, anthropometric details, and food pattern, and the values were analyzed using Minitab 17 by Box plot method for graphical representation. The comparative analysis between age group and BMI was done by ANOVA. Results: The results showed that there was significant relationship between inappropriate food pattern and PCOS women showing higher frequency of ±8.30 among age group (19-24 years) with an average BMI of 31.6 kg/m2. The unhealthy diet along with BMI was correlated with the visual examination of presence of hirsutism. From the ANOVA analysis, it was significantly proved with probability (p=0.002); there was stronger association between lifestyle modifications and PCOS. This is the first association study to correlate between dietary habitat and age group with BMI among South Indian in Coimbatore district. Conclusion: From the results obtained, it is necessary to create awareness for women and girls about the ill effects of lifestyle modifications, unhealthy food pattern, and lack of physical activity which lead hormonal and metabolic changes.

scholarly journals Psychological complications of polycystic ovarian syndrome and women’s health

2019 ◽  
Vol 8 (1) ◽  
pp. 159
Author(s):  
Umber Fatima ◽  
Mubashra Naz ◽  
Humaira Zafar ◽  
Anees Fatima ◽  
Attiya Yasmeen
Keyword(s):  
Polycystic Ovarian Syndrome ◽  
Depression Scale ◽  
Reproductive Age ◽  
Anxiety And Depression ◽  
P Value ◽  
Comprehensive Treatment ◽  
Chi Square ◽  
Related Quality ◽  
Chi Square Test ◽  
Ovarian Syndrome

Background: Polycystic Ovarian Syndrome (PCOS) affects approximately 5-10% females of reproductive age worldwide. Recent research shows that this syndrome is associated with psychological upset and devastating effects on women′s mental health and wellbeing.  Lack of clinicians′ awareness of adverse psychological effects is a major concern in developing countries to provide standard care and to improve overall health outcomes.Purpose of study was to determine the frequency of anxiety and depression among women with PCOS in order to promote awareness among clinicians about psychological complications of disease.Methods: Present study was conducted in the department of Obstetrics and Gynaecology/ University Medical and Dental College, from October 2018 to March 2019. Sixty patients with diagnosis of PCOD and sixty participants without this disease were included in the study. Participants having other endocrine or metabolic disorders were excluded from study. Hospital anxiety and depression scale was used to detect anxiety and depression among both groups. SPSS version 16 was used for data analysis. Chi- square test was applied to compare prevalence of anxiety and depression in both groups, p-value ˂0.05 was taken as statistically significant.Results: Women having PCOD exhibited statistically significant prevalence of anxiety (78.3% vs 35%) and depression (60% vs 30%) with p value of 0.0001 and 0.001 respectively.Conclusions: It is highly recommended that initial evaluation of these patients should include assessment of psychological domain of disease to provide more comprehensive treatment to improve overall health related quality of life.

Uterine Function: From Normal to Polycystic Ovarian Syndrome Alterations

2018 ◽  
Vol 25 (15) ◽  
pp. 1792-1804 ◽  
Author(s):  
Silvana R. Ferreira ◽  
Alicia B. Motta
Keyword(s):  
Endometrial Cancer ◽  
Adhesion Molecules ◽  
Polycystic Ovarian Syndrome ◽  
Cellular Proliferation ◽  
Steroid Receptors ◽  
Reproductive Age ◽  
Present Review ◽  
Implantation Failure ◽  
Uterine Function ◽  
Ovarian Syndrome

Background: The endometrium is one of the most important female reproductive organs. Polycystic ovarian syndrome (PCOS) is a reproductive and endocrine pathology that affect women of reproductive age. PCOS negatively affects the endometrium, leading to implantation failure and proliferative aberrations. Methods: We conducted a search at the http://www.ncbi.nlm.nhi.gov/pubmed/electronic database using the following key words: endometrial steroid receptors, endometrium, uterine function, endometrium and PCOS, implantation window, implantation and PCOS, implantation markers, inflammation, oxidative stress. We selected the articles based on their titles and abstracts, then we analyzed the full text and classified the articles depending on the information provided according to the sections of the present review. Results: The endocrine and metabolic abnormalities displayed in women with PCOS promote complex effects on the endometrium, leading to a low rate of implantation and even infertility. Women with PCOS show alterations in the Hypothalamic-Pituitary- Ovarian axis, which results in constant circulating levels of estrogen, similar to those at the early follicular phase, and a deficiency in the withdrawal of estrogen and progesterone. Besides this deficiency in the withdrawal of estrogen and progesterone, the insulin/ glucose pathway, adhesion molecules, cytokines and the inflammatory cascade, together with the establishment of a pro-oxidative status, lead to an imbalance in the uterine function, which in turn leads to implantation failure or even endometrial cancer. Conclusion: Women with PCOS display a dysregulation of the Hypothalamic-Pituitary- Ovarian axis, which alters the steroid pathway. In addition, the deficiency in the withdrawal of estrogen and progesterone in the endometrium results in abnormal endometrial cellular proliferation. The imbalance in adipose tissue observed in PCOS patients reinforces the increase in circulating hormones. The present review describes the role of hormones, metabolites, cytokines, adhesion molecules and the insulin/glucose pathway related to the uterine endometrium in women with PCOS and their role in implantation failure and development of endometrial cancer.

scholarly journals To Study the Effect on Fertility Outcome by Gonadotropins vs Laparoscopic Ovarian Drilling in Clomiphene-resistant Cases of Polycystic Ovarian Syndrome

2017 ◽  
Vol 9 (4) ◽  
pp. 336-340 ◽  
Author(s):  
Richa Singh ◽  
Meenal Jain ◽  
Poonam Yadav ◽  
Sarvesh Awasthi ◽  
Pallavi Raj
Keyword(s):  
Statistical Analysis ◽  
Ovulation Induction ◽  
Polycystic Ovarian Syndrome ◽  
Polycystic Ovary ◽  
Clomiphene Citrate ◽  
Reproductive Age ◽  
Multiple Pregnancies ◽  
Laparoscopic Ovarian Drilling ◽  
Ovarian Drilling ◽  
Ovarian Syndrome

ABSTRACT Introduction The polycystic ovary syndrome (PCOS) is the most common condition associated with chronic anovulation affecting 4 to 6% of reproductive age women. Aim To compare the effectiveness of laparoscopic ovarian drilling (LOD) for ovulation induction with gonadotropins in clomiphene-resistant PCOS in terms of ovulation, pregnancy, live birth, abortion, multiple pregnancies, and complication like ovarian hyperstimulation syndrome (OHSS). Setting and design A prospective hospital-based randomized trial. Materials and methods It was a prospective study, which was carried out from January 2012 to May 2015. Totally, 89 women were evaluated in the study, out of which 44 women were in gonadotropin group and 45 were in LOD group. Statistical analysis Standard statistical analysis was done and significance of difference in results was tested by chi-square test. Results Ovulation rate in gonadotropin group was 75.0% at 6 months, whereas in LOD group, it was 20% at 3 months and was increased up to 66.66% after addition of clomiphene citrate and gonadotropin. The primary outcome in terms of pregnancy in gonadotropin group was 45.45% after 6 cycles and in LOD group was 11.11% after 3 cycles and 40.00% after 6 cycles with supplementation of clomiphene citrate and gonadotropin. Conclusion The ongoing pregnancy rate from ovulation induction with LOD alone was significantly less but if supplemented by clomiphene citrate and gonadotropin, it seems equivalent to ovulation induction with gonadotropin, but the former procedure carries a lower risk of multiple pregnancies. How to cite this article Yadav P, Singh S, Singh R, Jain M, Awasthi S, Raj P. To Study the Effect on Fertility Outcome by Gonadotropins vs Laparoscopic Ovarian Drilling in Clomiphene-resistant Cases of Polycystic Ovarian Syndrome. J South Asian Feder Obst Gynae 2017;9(4):336-340.

scholarly journals An Ayurvedic Approach in Management of Poly Cystic Ovarian Syndrome

2020 ◽  
Vol 11 (4) ◽  
pp. 644-649
Author(s):  
Saroj Kumari ◽  
Sarvesh Kumar Singh ◽  
Kshipra Rajoria ◽  
Avadhesh Kumar
Keyword(s):  
Polycystic Ovarian Syndrome ◽  
Dietary Habits ◽  
Reproductive Age ◽  
Herbal Drugs ◽  
Polycystic Ovaries ◽  
Female Population ◽  
Hormonal Imbalance ◽  
Hormonal Dysfunction ◽  
Cardinal Feature ◽  
Ovarian Syndrome

Polycystic ovarian syndrome (PCOS) is a probably fastest growing endocrinological disorder in females of reproductive age. In PCOS, follicular growth is influenced by hormonal imbalance during the ovarian cycle, leads to affected follicles remain in the ovary. The prevalence of PCOS is estimated 6-10% globally and 3.7% - 22.5% in Indian female population, which is relatively high. It is characterised by hyperandrogenism, anovulation and polycystic ovaries which clinically manifests in the terms of amenorrhea or oligomenorrhea, hirsutism, acne, infertility etc. In present scenario, incidence of this disease increasing exponentially due to sedentary lifestyle and faulty dietary habits. This particular disease is not described word to word in Ayurveda. Associated features of PCOS are closely resembling with Bandhya Yonivyapada, Artavavahasrotasa-Vidhha Lakshana, Nastartava and Ksheenaartava described by Acharya Sushruta and Pushpghani Jatharini and Vikuta Jatharini mentioned by Acharya Kashyap. Maximum congruence of PCOS can be established with Bandhya Yonivyapada. The purpose of this study is to understand Nastartava which is the cardinal feature of Bandhya. Word Artava has been used exclusively in Samhita in context of menstrual blood, ovum and ovarian hormones. Therefore Amenorrhea, anovulation, hormonal dysfunction is considered exposed manifestations of Nastartava. Possible line of treatment is stipulated with Nidanaparivarjan, herbal drugs and Panchakarma procedures. Keywords- Ayurveda, Artava, Nastartava, PCOS, Herbal drugs, Panchakarma

scholarly journals Phenotypic Variation of Insulin Resistance among Polycystic Ovarian Syndrome Patients in Semiurban North Indian Population

2021 ◽  
Author(s):  
Chaitali Maitra ◽  
Ramesh Chandra Gupta ◽  
Rishika Raj
Keyword(s):  
Insulin Resistance ◽  
Regression Analysis ◽  
Polycystic Ovarian Syndrome ◽  
Specific Treatment ◽  
Reproductive Age ◽  
Model Assessment ◽  
Cross Sectional ◽  
Significant Difference ◽  
Ovarian Syndrome ◽  
Rotterdam Criteria

Introduction: Polycystic Ovarian Syndrome (PCOS) is a common endocrine disorder in the women of reproductive age. Studies show that there is an intensive relationship between insulin and gonadal function. As per Rotterdam Criteria, there are four major phenotypes of PCOS with different presentation. Early detection of Insulin Resistance (IR) and consequential prevention of Metabolic Syndrome (MS) associated with PCOS may lead to better prospect for the disease. Aim: To find the pattern of IR in all the phenotypes of PCOS in relation to Waist Hip Ratio (WHR), Body Mass Index (BMI) and Testosterone and thereby, providing data for designing phenotype specific treatment of the disease. Materials and Methods: In this cross-sectional observational study, fasting insulin and fasting glucose were analysed to calculate Homeostasis Model Assessment (HOMA-IR) and Testosterone for total 144 female subjects of reproductive age group (18-40 years). Subjects were classified in to four groups as per Rotterdam Criteria. Complete PCOS (PCO-COM), PCO with Oligo/Anovulation (PCO-O), Anovulation with Hyperandrogenism (O-HA), and PCO with Hyperandrogenism (PCO-HA). Regression analysis was done to find the relation among the study variables. Analysis of Variance (ANOVA) was used to analyse the significant variance among the groups. Results: IR was found to be maximum among O-HA phenotype (2.4±0.37) and lowest among PCO-HA phenotypes (1.3±0.22). Regression analysis shows that there exist significant associations between IR and BMI (t=4.96, p=0.001) as well as between IR and WHR (t=2.97, p=0.003). No independent association between testosterone and IR was observed. Conclusion: Significant difference of IR, WHR, and BMI was observed among the four phenotypes of PCOS. Due to increased IR, O-HA and PCO-COM phenotypes are more predisposed to Cardiometabolic consequences of PCOS.

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