Incidence, Awareness and Association of Lifestyle Modification with Symptoms of Polycystic Ovaries (PCOs)

Objective: To determine incidence, awareness and association of Lifestyle modalities with symptoms of Polycystic Ovaries (PCOS) among females of two institutes Study design and setting: It was a Pilot study based survey at University of Karachi and Bahria University, Pakistan. Methodology: Following ethical approval, structured questionnaire was designed, validated and distributed as per convenient sampling. Results: SPSS analysis for 196 responses revealed that 4.6% were PCOS afflicted while 26% of non-PCOS were vulnerable cases on account of suffering any two of the three criterion symptoms of PCOS namely: menstrual irregularities, hirsutism and acne. Chi-square based cross tabulations revealed that PCOS females were predominantly between 21-25 years and were lean singles who exhibited a tendency to exercise, consumed poultry, slept late at night and used plastics by large in daily routine. Females susceptible to PCOS significantly exhibited the criterion symptoms when associated to consumption of poultry chicken, passive smoking and plastic usage on regular basis. Significantly larger proportion (70%) of non-PCOS females were aware about this disease but symptomatic, diagnostic and treatment based knowledge was significantly less prevalent. A significant percentage of females (61.5%) associated PCOS to the occurrence of infertility. Conclusion: Thus, concluding that imparting awareness about etiological factors, symptomatology and lifestyle triggers can enable females to ensure self-check and curb the chances of being prone to PCOS by avoiding plastics and smoking environment and incorporating weight management in their lifestyle

DHEA and polycystic ovarian syndrome: Meta-analysis of case-control studies

Background Polycystic ovarian syndrome is a heterogenous endocrine disorder characterized by irregular menstrual cycles, hirsuitism and polycystic ovaries. It is further complicated by metabolic syndrome, infertility and psychological stress. Although the etiopathogenesis is unclear, many studies have pointed out the role of stress in this syndrome. DHEA, being a stress marker is being used by scientists to compare the stress levels between polycystic ovarian cases and healthy controls. However, the results obtained from previous studies are equivocal. Objective To perform meta-analysis and find the association between stress and the syndrome. Data sources Relevant data till January 2021 were retrieved from PubMed, Scopus, Embase and Web of Science using MeSH terms. Study selection Case-control studies having PCOS subjects as cases and healthy women as controls were selected provided; their basal DHEA levels were mentioned in the published articles. Data extraction Two authors independently extracted the articles and qualified the final studies. Data synthesi Pooled meta-analysis was done using random effect model and showed level of DHEA statistically significant in PCOS compared to healthy controls (SMD = 1.15, 95% CI = 0.59–1.71).Heterogeneity was statistically significant as well (I2 = 95%). Conclusion Thismeta-analysis on DHEA and PCOS has helped in generating evidence regarding the involvement of stress in the pathogenesis of PCOS.

In-Silico Screening of Prime PCOS Biomarkers for the Identification of a Potential Model Organism

Polycystic ovarian syndrome (PCOS) is a multigenic endocrine disorder observed in women of reproductive age. Although the condition is characterized by the presence of polycystic ovaries and excess production of androgens, the exact aetiology has not been well deciphered due to the unavailability of a suitable model organism. Defects in the two prime biomarkers namely CYP11A and CYP19A1, have been found to play a role in disease progression. The objective of this study was to carry out an in-silico assessment of these two genes to identify a potential model organism for the efficacious study of PCOS. Bioinformatics tools such as BLAST and EMBOSS were used for local and global alignment respectively, to find sequence homology and thereby, establish a model organism. Sequence comparison was followed by phylogenetic analysis and secondary structure prediction of the enzymes encoded by the respective genes. Our in-silico study revealed Gorilla gorilla to be an ideal candidate for the study of PCOS owing to its high sequence and structural similarities with the human gene counterparts. Future prospects of the research include in-vitro analysis of the biomarkers on Gorilla gorilla ovarian theca cell line to pave the way for therapy.

Anti – Androgenic Activity of Caesalpinia bonducella in Androgen-induced Polycystic Ovarian Syndrome Rats

Aim: Our goal was to use the androgen and anabolic steroid (AAS) Testosterone Propionate (TP) to create a novel animal model to study polycystic ovaries. Materials and Methods: Thirty albino female Wistar rats weighing 200 – 250 g were split into five groups with six rats in each group. Group I was treated as standard control, Group II was treated as the PCOS induced group, Group III was treated as a standard group, Clomiphene citrate (20 mg per kg body weight), intraperitoneally (I.P) along with a 4 mg TP injection intramuscularly (I.M) in an oily solution, Group IV was treatment control group treated with a hydro-alcoholic extract of Caesalpinia bonducella (CBHAE) at a dose of 200 mg per kg body weight. Group V was given CBHAE at 400 mg per kg of body weight. Blood collected from animals examined for hormonal parameters and ovaries is subjected to histopathological studies. Results: There was a fall in testosterone volume and an increase in the efflux of female hormone constituents, which improved the ovarian development and helped to regulate menses. Conclusion: Significantly lower levels of Testosterone were produced as a result of the extract, which also showed superior anti-androgenic properties. However, additional intervention is recommended in order to investigate the therapeutic effect of Caesalpinia bonducella seed in further detail.

Sonographic Association of Polycystic Ovaries with Ovarian Arterial Pulsatility and Resistive Index

Aim: To evaluate the sonographic association of polycystic ovaries with ovarian arterial pulsatility and resistive index. Methodology: In Al Mustafa Trust Medical Centre Lahore, a comparative analytic study was conducted. 140 patients of age group 17 to 50 were included in this study with convenient sampling technique. All patients were females and 70 were with the history of PCOs and normal. Gray scale Ultrasound and Doppler was used to diagnose the PI and RI in normal and subject. Duration of study: 02- Aug-2021 to 14- Dec-2021 Results: 70 PCOs patients have hyperechoic ovarian stroma and other 70 shows normal echogenicity. In this study different age groups were selected with minimum age was 17 years and maximum age was 50 years. In PCO females the mean RI was 0.7333 and PI was 1.6303 and in normal females the mean RI was 0.8889 and PI was 2.7251. Out of 140 patients the mean volume of right ovary is 9.6557 cm3 and of left ovary is 9.7943 cm3. Our Study was significant at point 0.0001. Conclusion: It is concluded that ovarian Doppler ultrasound is a basic tool in the diagnosis of the PCOS and provide an insight into the pathophysiological state and degree of progression in the affected ovary. Keywords: Polycystic ovary syndrome, Doppler ultrasound

Pathophysiologic Mechanisms of Insulin Secretion and Signaling-Related Genes in Etiology of Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) is a common endocrinopathy in women. PCOS is characterized by anovulation, hyperandrogenism, polycystic ovaries, insulin resistance, and obesity. Despite the finding that the genetic origin of PCOS is well demonstrated in previous twin and familial clustering studies, genes and factors that can exactly explain the PCOS pathophysiology are not known. Objective(s). In this review, we attempted to identify genes related to secretion and signaling of insulin aspects of PCOS and their physiological functions in order to explain the pathways that are regulated by these genes which can be a prominent function in PCOS predisposition. Materials and Methods. For this purpose, published articles and reviews dealing with genetic evaluation of PCOS in women from peer-reviewed journals in PubMed and Google Scholar databases were included in this review. Results. The genomic investigations in women of different populations identified many candidate genes and loci that are associated with PCOS. The most important of them are INSR, IRS1-2, MTNR1A, MTNR1B, THADA, PPAR-γ2, ADIPOQ, and CAPN10. These are mainly associated with metabolic aspects of PCOS. Conclusions. In this review, we proposed that each of these genes may interrupt specific physiological pathways by affecting them and contribute to PCOS initiation. It is clear that the role of genes involved in insulin secretion and signaling is more critical than other pathways.

Polycystic ovary rat model exposure to 150 kHz intermediate frequency: hypothalamic-pituitary-ovarian axis at the receptor, cellular, tissue, and hormone levels

Introduction The hypothalamic-pituitary-ovarian (HPO) axis is the principal regulator of the reproductive system. The neurons in the arcuate nucleus of the hypothalamus signal the basophilic cells of the anterior pituitary to release luteinizing hormone (LH) and follicle stimulating hormone (FSH), which bind to the granulosa and theca cells of a follicle in the ovary to promote healthy follicular development. Disruption of this process at any time can lead to polycystic ovaries and, if left untreated, can lead to Polycystic Ovarian Syndrome (PCOS), one of the leading causes of infertility. A novel treatment option using 150 kHz Intermediate Frequency (IF) Electromagnetic Radiation (EMR) has been proposed to monitor the effect of this frequency during cystic development. Methods To prove this, an experiment was conducted to study the effect of whole-body exposure to 150 kHz EMR for 8 weeks at receptor, cellular, tissue and hormonal levels on the HPO axis of 25 young cyclic female rats. Results The results showed that 150 kHz EMR did not affect the histoarchitecture of neurons of arcuate nucleus of the hypothalamus of PCO-induced rats. It was also found that the number of basophilic cells of the pituitary gland was increased and the immunoreactivity of LH and FSH secretion increased. This EMR field also decreased the development of follicular cysts in the ovary and possibly increased the immunoreactivity of the LH and FSH receptors as well on the theca and granulosa cells of follicles in the ovary. Conclusion There are still many limitations to this study. If properly evaluated, the results of this experiment could help develop a new non-invasive treatment option for women with PCOS in the near future.

Reproductive Endocrinologic Pattern in Infertile Black Women with Polycystic Ovarian Syndrome

Background: Polycystic ovarian syndrome (PCOS) is a very common endocrine cause of infertility affecting about 10% of women of reproductive age. We evaluated the pattern of reproductive hormones in infertile Nigerian women with PCOS. Methods: This was a prospective cross-sectional study at the Lagos State University Teaching Hospital over a 6-month period in which One hundred and fifty infertile women, with diagnosis of PCOS using the Rotterdam’s criteria, had quantitative assessment of their reproductive hormones like Luteinizing Hormone (LH), Follicle Stimulating Hormone (FSH), Progesterone, Testosterone, Prolactin and Thyroid Stimulating Hormone (TSH), with relevant socio-demographic and clinical data noted in the study proforma. Z test, chi-square and correlation tests were used as appropriate to analyse the data with p<0.05 significance level. Results: The mean age of infertile women with PCOS was 26.50±4.4years; all the women had either oligomenorrhea (62%) or secondary amenorrhea (38%), 56.5% were obese and 33.3% had hirsutism. While 37.7% of the women had abnormally elevated serum LH, 16.4% had high serum FSH, 39% had LH:FSH ratio> 2.5, 96% had low serum progesterone, 29% had high serum prolactin, 17.4% had high serum TSH values and 92% had features of polycystic ovaries on trans-vaginal ultrasound. Correlation of age and BMI with serum FSH, LH and prolactin values were weak and insignificant. Conclusion: PCOS is common among young Nigerian women presenting for infertility treatment; with dominant features of oligomenorrhea and polycystic ovaries. Hormonal abnormalities are common, varied and not associated with other clinical characteristics.

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

Polycystic 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.

A Short-Term Altrenogest Treatment Post-weaning Followed by Superovulation Reduces Pregnancy Rates and Embryo Production Efficiency in Multiparous Sows

Although embryo transfer (ET) is a biotechnology ready for the swine industry, there are factors to be solved, the availability of embryo donors as one. Multiparous sows as donors ought to be considered since weaning is a natural and efficient method for estrus synchronization. In addition, superovulation treatments at weaning are effective in increasing the efficiency of donor embryo production. However, ET programs typically require more donors than those available from a single weaning, imposing grouping several weanings to establish a batch for ET. Since short-term administration of Altrenogest is effective in delaying estrus after weaning without effects on ovulation and embryo development, we investigated how Altrenogest combined with superovulation would affect reproductive parameters and embryo quality and quantity of weaned multiparous donor sows. The sows were administered Altrenogest from the day of weaning for 14 (SS-14 group; N = 26), 7 (SS-7 group; N = 31) and 4 (SS-4 group; N = 32) days. The sows were superovulated with eCG 24 h after the last administration of Altrenogest and with hCG at the onset of estrus. Sows not treated with Altrenogest that were superovulated with eCG 24 h post-weaning and hCG at the onset of estrus (SC group; N = 37) and sows with natural estrus after weaning (C group; N = 34) were used as control groups. The percentage of sows showing estrus within 10 days was not affected by the treatment, but the interval from Altrenogest withdrawal to estrus was longer (P &lt; 0.05) in the SS groups than the interval from weaning to estrus in the controls. SS treatments increased (P &lt; 0.05) the percentage of sows with ovarian cysts and the development of polycystic ovaries. The pregnancy and the fertilization rates, and the overall embryo production efficiency were also negatively affected by the SS treatments (P &lt; 0.05). Interestingly, almost 70% of the structures classified as unfertilized oocytes or degenerated embryos in sows from the SS groups were immature oocytes. In conclusion, although superovulation of weaned sows was highly efficient, short-term administration of Altrenogest in combination with superovulation had negative effects on most of the reproductive parameters assessed, particularly affecting the overall efficiency of pregnancy and embryo production.