Assessment of risk factors and prediction of premature ovarian failure

The problem of premature ovarian failure (POF) is currently in the spotlight of obstetricians and gynecologists worldwide. Early diagnosis of this pathology is necessary to prevent the development of serious pathological conditions. The systematization of modern ideas about laboratory and instrumental methods for POF diagnosing, assessing diagnostic value of parameters such as follicle stimulating hormone, anti-Mullerian hormone as well as the count of antral ovarian follicles, intraovarian blood flow and ovarian volume using ultrasound techniques, which can then be used as prognostic criteria for POF comprise a very important modality. Based on the findings obtained, early detection may lead to proposing new prognostic strategies.

Effect of Wenshentiaojing Decoction on Hormone Level and Follicular Number in Patients with Menstrual Disorder of Polycystic Ovary Syndrome

Objective. To explore the curative effect of Wenshentiaojing Decoction on the treatment of menstrual disorder caused by PCOS. Methods. Patients with menstrual disorders caused by PCOS admitted to our department from January 2020 to January 2021 were selected as the research objects and were divided into a control group and observation group according to the random number table method. The control group was treated with Western medicine, and the observation group was treated with Wenshentiaojing Decoction on the basis of Western medicine. The clinical efficacy of the two groups was compared. Before and after treatment, sex hormones (LH, FSH, LH/FSH, and testosterone (T)), ovarian volume, endometrial thickness, cervical mucus score, follicular number, menstrual conditions (menstrual duration, menstrual cycle, and menstrual volume), and other indicators in both groups were recorded. Results. After treatment, the total effective rate of the observation group (91.1% (41/45)) was higher than that of the control group (77.8% (35/45)), and the difference was statistically significant ( P < 0.05 ). After treatment, the LH, LH/FSH, and T levels in the observation group were lower than those in the control group, while the FSH level was higher than that in the control group ( P < 0.05 ). After treatment, the ovarian volume, endometrial thickness, cervical mucus score, and follicle number in the observation group were higher than those in the control group ( P < 0.05 ). After treatment, the menstrual duration and menstrual volume in the observation group were longer than those in the conventional group, and the menstrual cycle was shorter than that in the conventional group ( P < 0.05 ). Conclusion. For patients with menstrual disorders caused by PCOS, the treatment effect of Wenshentiaojing Decoction assisted with Western medicine is better, which can effectively improve the level of sex hormones, cervical mucus, and menstrual conditions, increase the ovarian volume, endometrial thickness, and follicle number, and improve the treatment effect, with fewer adverse reactions, which is worthy of further promotion and application.

Positive effect of combined exercise on adipokines levels and pubertal signs in overweight and obese girls with central precocious puberty

Background The prevalence of precocious puberty is increasing. Obesity has been demonstrated to be associated with changes in the adipokine profile and incidence of early puberty in girls. This study assessed the pubertal signs, the levels of adiponectin, resistin, and tumor necrosis factor-alpha (TNF-α) after 12 weeks of combined exercise and 4 weeks of detraining in overweight and obese girls with precocious puberty. Methods Thirty overweight and obese girls (aged 7–9) with precocious puberty, who had received Triptorelin, were randomly divided into two groups (15 exercise and 15 control). Initially, serum levels of adiponectin, resistin, TNF-α, luteinising hormone (LH), and follicle-stimulating hormone (FSH) and the signs of puberty progression (bone age, uterine length, and ovarian volume) were measured. The exercise group performed 60 min of combined (aerobic and resistance) exercise three times/week for 12 weeks. The control group did not receive any exercise. 48 h after the last training session and after 4 weeks of detraining, all research variables were measured (also in the control group). The statistical method used for data analysis was repeated measures ANOVA. Results In the exercise group, adiponectin significantly increased and resistin significantly decreased after 12 weeks. After 4 weeks of detraining, adiponectin significantly decreased, but resistin significantly increased. TNF-α levels did not change significantly during the study. There was no significant difference in all of the factors in the control group. Throughout the 16-week study period, the rate of puberty and LH significantly decreased in both exercise and control groups, but FSH, LH/FSH and ovarian volume significantly decreased in the exercise group alone (P<0.05). Conclusions Combined exercise increased adiponectin and decreased resistin and the rate of puberty. However, after 4 weeks of detraining, these effects diminished but did not disappear. Trial registration IRCT, IRCT56471. Registered 25 may 2021 - Retrospectively registered, https://fa.irct.ir/user/profile

NORMOTENSIVE RATS WITH PCOS EXHIBIT THE HYPERTENSIVE PATTERN: FOCUS ON OXIDATIVE STRESS

Numerous evidence implies complex interrelations between polycystic ovary syndrome (PCOS) and hypertension (HT) in reproductive-age women. We aimed to investigate the potential strain differences in ovarian morphology, hemodynamic and biochemical characteristics in an androgen-induced PCOS rat model. A total of 3 weeks old 24 rats (12 Wistar Kyoto - WK and 12 Spontaneously Hypertensive Rats – SHR) were divided into four groups: WK, WK PCOS, SHR, and SHR PCOS. PCOS was induced by daily subcutaneous injections of testosterone-enanthate (1 mg/100 g body weight (BW)) administered for 5 weeks. PCOS induction led to estrus cyclicity cessation, cystic ovarian appearance, and sex hormones disturbances in both strains. The morphometric parameters in ovaries were altered in a manner of PCOS-related changes in both strains (higher number in preantral, atretic and cystic follicles). Ultrasonographycally, a significant decrease in ovarian volume (OV) was registered in PCOS groups, but also in SHR compared to WK rats. All blood pressure parameters were higher in SHR compared to WK. PCOS modeling increased systolic, mean arterial and pulse pressure in WK strain, while in SHR, only mean arterial and pulse pressure were higher. Alterations in oxidative stress parameters could provide a molecular basis for PCOS-related changes: in PCOS groups, TBARS and O2- were higher in both strains, while SOD and GSH were significantly lowered.

STUDY OF UTTARBASTI IN PCOS (POLY CYSTIC OVARY SYNDROME) WITH SPECIAL REFERENCE TO ŚATĀVHĀDI TAIL.

PCOS means polycystic ovarian Syndrome PCOS affects 5% to 10% of women of reproductive age In Ayurvedic classics, cārya Kāśyapa mentioned PCOS in terms of 'Pupaghni Revatī. He narrated that woman who observes her fruitless menstruation in appropriate time, has corpulent and hairy cheeks, she is also (seized with) called as Pupaghni Revatī. The present clinical trial by trans cervical route by Śatāvhādi Tail based on the classical reference in Ashtang Samgraha The ingredients of Śatāvhādi Tail are viz, śatāvhā, Saŗśapa, Ajavāyan, Śigru,Hingu, Kustha, Mandanaphala, processed in Mustard oil. It has been given by Uttarbasti module. All the ingredients are mainly Katu Ras Usna Virya and Usna Tikshna Guna. The 30 married female recruited this clinical trial who received Śatāvhādi Tail 5-7 ml trancervical route at Bharati Vidyapeeth(D.U) College of Ayurved and Hospital, Katraj Dhanakawadi , Pune 43.The results assessed in terms of USG (Ovarian volume and no of follicles), LH:FSH Ratio and S.Testesterone and subjective parameter Sthula Lomash Ganda (Corupurulent hair on cheek) and Arthavkshaya. It showed effect on hormonal level {LH, FSH} but slight effect on serum

Clinical Observation on the Improvement of Serum Sex Hormone and Ovarian Function in Premature Ovarian Failure Patients with Deficiency-Cold Syndrome by Combining Wenjing Decoction with Tiaobu Chongren Acupuncture and Moxibustion

Objective. To explore the effect of Wenjing Decoction and Tiaobu Chongren acupuncture and moxibustion therapy on serum sex hormones and ovarian function recovery in premature ovarian failure (POF) patients with deficiency-cold syndrome. Methods. From February 2018 to October 2019, 119 POI patients with deficiency-cold syndrome who met the selection criteria were randomly divided into the control group (n = 59) and the observation group (n = 60). The control group was treated with hormone replacement therapy, and the observation group was treated with Wenjing Decoction and Tiaobu Chongren acupuncture and moxibustion therapy on the basis of the control group. Both groups were treated continuously for 3 months. After treatment, the clinical efficacy of the two groups was compared, the Chinese medicine syndrome score, serum estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), anti-mullerian hormone (AMH) and bilateral antral follicle count (AFC), mean ovarian volume, and endometrial thickness of the two groups before and after treatment were compared. Result. The effective rate of the observation group (93.10%) was higher than that of the control group (77.59%) ( P < 0.05 ). After treatment, the index scores of traditional Chinese medicine syndromes in two groups were lower than before ( P < 0.05 ), and the observation group was lower than the control group ( P < 0.05 ). The serum E2 and AMH levels in the two groups increased, while FSH and LH levels decreased compared with before treatment, and the observation group improved significantly compared with the control group ( P < 0.05 ). The bilateral AFC, mean ovarian volume, and endometrial thickness of the two groups increased compared with before treatment, and the observation group was higher than the control group ( P < 0.05 ). Conclusion. On the basis of hormone replacement therapy, the combination of Wenjing Decoction and Tiaobu Chongren acupuncture and moxibustion therapy is effective in treating POF patients with deficiency-cold syndrome, which can effectively regulate their serum sex hormone levels and promote the recovery of ovarian function.

Effect of resveratrol administration on ovarian morphology, determined by transvaginal ultrasound for the women with PCOS

Background: Intake of resveratrol has been associated with improved ovarian morphology under in vitro and in the animal models; however, this finding has not been confirmed in trials. The aim of our study was, therefore, to use a placebo-controlled approach with the detailed assessment of the ovarian morphology by applying transvaginal ultrasound to examine the effectiveness of this therapeutic approach in this group of women. Methods: Forty-one women with polycystic ovary syndrome (PCOS) were randomly assigned (1:1) to 3 months of daily 1000 mg resveratrol or placebo. Random assignment was done by blocked randomisation. Our primary endpoints were the change in the ovarian volume, stromal area and antral follicle count per ovary (FNPO) from the baseline to 3 months. Secondary endpoints were improvement in the distribution of follicles and ovarian echogenicity. Differences between the resveratrol and control groups were evaluated by Chi-square, fisher’s exact test and repeated-measures of ANOVA. Results: The mean age of all participants was 28.61 ± 4.99 years, with the mean BMI of 28.26 ± 5.62 kg/m2. Resveratrol therapy, as compared with placebo, was associated with a significantly higher rate of improvement in the ovarian morphology (p= 0.02). Women who received resveratrol had a more dominant follicle than those getting placebo, with a significant reduction in the ovarian volume (p<0.05). However, the number of FNPO, stromal area, ovarian echogenicity and distribution of follicles were not significantly altered (P>0.05). Conclusions: Treatment with resveratrol significantly reduced the ovarian volume and PCOM, thus suggesting a disease-modifying effect in PCOS. Trial registration: IRCT, IRCT2017061917139N2. Registered 7 July 2017, http://irct.ir/trial/15836.

Deep Learning-Based Ultrasound Imaging Diagnosis for Gonadotropin-Releasing Hormone Agonists Treatment of Central Precocious Puberty

To explore the adoption of ultrasound imaging diagnosis based on deep learning of convolutional neural networks (CNNs) in the treatment of central precocious puberty (CPP) by gonadotropin-releasing hormone agonists (GnRHa), ultrasound imaging based on CNN was utilized to treat CPP. The bone age, uterine and ovarian volume, and breast development of incomplete precocious puberty (IPP) group and CPP group were observed and recorded. The peak values of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) were measured. The uterine and ovarian volume before and after GnRHa treatment of CPP were compared. The results showed that the bone age (9.03 ± 1.07), uterine volume (2.37 ± 1.52), ovarian volume (2.36 ± 0.82 mL), and breast development of the CPP group were considerably higher in contrast to the IPP group and control group ( P < 0.05 ). The LH peak (11.97 ± 5.63) and FSH peak (12.89 ± 3.15) of the CPP group were substantially higher relative to the IPP group ( P < 0.05 ). The uterine volume (1.06 ± 0.42) and ovarian volume (1.12 ± 0.49) after treatment were inferior to those before treatment ( P < 0.05 ). In short, ultrasound images based on deep learning could diagnose precocious puberty, which could also provide a certain basis for GnRHa treatment of CPP, as well as an important basis for clinical diagnosis and treatment of precocious puberty.