Female ; Humans ; Polycystic Ovary Syndrome ; drug therapy

Infertility due to polycystic ovarian syndrome (PCOS) is a worldwide problem that is increasing at alarming rates. Insulin resistance, the prime factor of PCOS, induces comorbid metabolic syndrome as well. Durian (Durio zibenthinus Linn), a fruit of Southeast Asia, is used as a natural supplement in healthy diets. This paper is a short literature review that examines the fruit's effects against various components of metabolic syndrome and its fertility-enhancing properties in PCOS. Various published literature was reviewed to learn of the anti-inflammatory, anti-oxidant, anti-obesity, anticholesterol, and antihypoglycaemic nature of the fruit. The literature search was done using PubMed, Google Scholar and library databases. The keywords used were polycystic ovarian syndrome, infertility, metabolic syndrome and Durian zibenthinus Linn. Reviewed studies showed that the fruit is effective against various components of metabolic syndrome, but the mechanisms of action against anovulation and menstrual disturbances in PCOS have yet to be studied. The traditional use of durian as a fertility-enhancing agent needs to be validated scientifically by isolating its various components and ascertaining its fertility enhancing properties.
Bombacaceae ; chemistry ; Female ; Fruit ; Humans ; Infertility, Female ; drug therapy ; etiology ; Phytotherapy ; Polycystic Ovary Syndrome ; drug therapy

BACKGROUND: Obesity and insulin resistance (IR) are common features of polycystic ovary syndrome (PCOS). Metformin (MET) increases insulin sensitivity, but it is associated with unsatisfactory weight loss. The glucagon-like peptide-1 receptor agonist exenatide has been shown to reduce weight and IR in patients with diabetes. This study aimed to explore the therapeutic effects of exenatide once-weekly (QW) combined with MET on body weight, as well as metabolic and endocrinological parameters in overweight/obese women with PCOS. METHODS: Fifty overweight/obese women with PCOS diagnosed via the Rotterdam criteria were randomized to one of two treatment groups: MET (500 mg three times a day [TID]) or combination treatment (COM) (MET 500 mg TID, exenatide 2 mg QW) for 12 weeks. The primary outcomes were anthropometric changes associated with obesity, and the secondary outcomes included changes in reproductive hormone levels, glucose and lipid metabolism, and C-reactive protein. RESULTS: Forty (80%) patients completed the study. COM therapy was superior to MET monotherapy in reducing weight (P = 0.045), body mass index (BMI) (P = 0.041), and waist circumference (P = 0.023). Patients in the COM group on an average lost 3.8 ± 2.4 kg compared with 2.1 ± 3.0 kg in the MET group. In the COM group, BMI and waist circumference decreased by 1.4 ± 0.87 kg/m2 and 4.63 ± 4.42 cm compared with 0.77 ± 1.17 kg/m2 and 1.72 ± 3.07 cm in the MET group, respectively. Moreover, levels of fasting glucose, oral glucose tolerance test (OGTT) 2-h glucose, and OGTT 2-h insulin were significantly lower with COM therapy than with MET (P < 0.050). Mild and moderate gastrointestinal reactions were the most common adverse events in both groups. CONCLUSIONS: COM therapy was more effective than MET alone in reducing body weight, BMI, and waist circumference, and improving insulin sensitivity in overweight/obese women with PCOS, with acceptable short-term side effects. TRIAL REGISTRATION ClinicalTrials.gov, NCT04029272. https://clinicaltrials.gov/ct2/show/NCT04029272.
Exenatide/therapeutic use* ; Female ; Humans ; Metformin/therapeutic use* ; Obesity/drug therapy* ; Overweight ; Polycystic Ovary Syndrome/drug therapy*

Polycystic ovarian syndrome (PCOS) is one of the most popular diseases that cause menstrual dysfunction and infertility in women. The present paper is a brief retrospection on the progress in treatment of PCOS caused infertility with integrative Chinese and Western medicine (ICWM). It can be seen from these materials that using traditional Chinese medicine (TCM) recipes formulated by Shen-replenishing herbs or acupuncture to reinforce Gan-Shen, regulate Chong-Ren Channels in treating PCOS, stable clinical efficacy could be obtained, with less adverse reaction, though the effect initiated somewhat late. Whereas, when Shen-replenishing recipe and acupuncture are combined with hormone or ovulation promoting drugs of Western medicine, the above-mentioned shortcomings would be overcome. So, this combined therapy is frequently used in clinical practice.
Acupuncture Therapy ; Combined Modality Therapy ; Female ; Humans ; Medicine, Chinese Traditional ; Ovulation ; drug effects ; Polycystic Ovary Syndrome ; therapy

Macroscopic and microscopic views on different types of polycystic ovary syndrome (PCOS) before and after treatment was comparatively discussed in this paper, which differentiated and explained the laboratory bases of clinical manifestation (TCM syndromes) for the first time, and its contents in details was supplemented well-foundedly upon the laboratory data. It was considered to be not only knowledgeable for study on PCOS, but may practically benefit the diagnosis and treatment of PCOS for gynecologists in TCM, integrative medicine, and especially helpful for the doctors working in grass-roots unit but lacking in laboratory assay.
Animals ; Diagnosis, Differential ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Medicine, Chinese Traditional ; Phytotherapy ; Polycystic Ovary Syndrome ; diagnosis ; drug therapy

OBJECTIVETo investigate the therapeutical effects of visfatin and metformin on insulin resistance and reproductive endocrine disorder in rats with polycystic ovary syndrome (PCOS).

METHODSForty female Wistar rats were divided into 4 equal groups, and in groups A, B and C, the rats were injected subcutaneously with dehydroepiandrosterone (DHEA) for PCOS modeling, with group D as the blank control injected with soybean oil. Vaginal smears and serological testing were taken to assess the modeling. After the modeling, the rats in group A received 10 µg reorganized visfatin injection and those in group B were treated with metformin (14 mg/100 g) on a daily basis for 15 days. Serum levels of T, LH, FSH, FINS and blood glucose levels during OGTT were measured before and after the treatments, and HOMA-IR and LH to FSH ratio were calculated. The ovaries were then dissected for pathological examination.

RESULTSIn groups A and B, FINS, FPG, T, HOMA-IR and blood glucose levels during OGTT were significantly decreased after the treatments (P<0.05), which resulted in recovery of regular menses in 8 (80%) rats in group A and 7 (77.8%) rats in group B with the development of normal follicles. Visfatin and metformin produced equivalent therapeutic effects in improving the insulin resistance and hyperandrogenism in PCOS rats.

CONCLUSIONVisfatin and metformin have equivalent therapeutic effects in improving insulin resistance and hyperandrogenism and in promoting the recovery of regular menses and development of normal follicles in PCOS rats.

Animals ; Female ; Humans ; Insulin Resistance ; Metformin ; pharmacology ; Nicotinamide Phosphoribosyltransferase ; pharmacology ; Polycystic Ovary Syndrome ; complications ; drug therapy ; Rats ; Rats, Wistar

Anti-Müllerian hormone (AMH), a peptide growth factor of the transforming growth factor-β family, is a reliable marker of ovarian reserve. Regarding assisted reproductive technology, AMH has been efficiently used as a marker to predict ovarian response to stimulation. The clinical use of AMH has recently been extended and emphasized. The uses of AMH as a predictive marker of menopause onset, diagnostic tool for polycystic ovary syndrome, and assessment of ovarian function before and after gynecologic surgeries or gonadotoxic agents such as chemotherapy have been investigated. Serum AMH levels can also be affected by environmental and genetic factors; thus, the effects of factors that may alter AMH test results should be considered. This review summarizes the findings of recent studies focusing on the clinical application of AMH and factors that influence the AMH level and opinions on the use of the AMH level to assess the probability of conception before reproductive life planning as a “fertility test.”
Drug Therapy ; Female ; Fertility ; Fertilization ; Gynecologic Surgical Procedures ; Humans ; Menopause ; Ovarian Reserve ; Polycystic Ovary Syndrome ; Reproductive Techniques, Assisted

OBJECTIVETo observe the clinical therapeutic effect of acupuncture combined with Chinese herbs on polycystic ovary syndrome of kidney deficiency and phlegm stasis type and probe into the mechanism.

METHODSSixty-three cases of polycystic ovary syndrome of kidney deficiency and phlegm stasis type were randomly divided in to a combined acupuncture and Chinese herb group (n=32) treated with acupuncture at Qihai (CV 6), Guanyuan (CV 4), et al. and oral administration of Chinese herbs, and a simple Chinese herb group (n=31) treated with oral administration of the same Chinese herbs as in the combined acupuncture and Chinese herb group. The therapeutic effects and changes of follicle stimulating hormone (FSH), luteotropic hormone (LH), testosterone (T) and LH/FSH were compared between the two groups.

RESULTSThe total effective rate was 93.8% in the combined acupuncture and Chinese herb group and 80.6% in the simple Chinese herb group, the former being significantly better than the latter (P < 0.05). The decrease of T in the combined acupuncture and Chinese herb group was significantly su perior to that in the simple Chinese herb group (P < 0.01).

CONCLUSIONAcupuncture combined with Chinese herb therapy is superior to the simple Chinese herb in the clinical therapeutic effect on polycystic ovary syndrome of kidney deficiency and phlegm stasis type and decrease of T level, indicating this method is a better one for polycystic ovary syndrome of kidney deficiency and phlegm stasis type.

Acupuncture Therapy ; Adolescent ; Adult ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Kidney ; drug effects ; physiopathology ; Phytotherapy ; Polycystic Ovary Syndrome ; drug therapy ; metabolism ; physiopathology ; therapy ; Sputum ; metabolism ; Young Adult

OBJECTIVETo observe the therapeutic effect of modified Longdan Xiegan Decoction (LXD) on hyperandrogenism in patients with polycystic ovary syndrome (POS) of stagnant fire in Gan channel type.

METHODSForty-eight patients were divided into two groups: the LXD group (25 cases) treated with LXI) for 3 months, and the Diane-35 group (23 cases) with Diane-35. Condition of menstruation, acne, hairiness were observed, basal body temperature (BBT) was measured, and the serum levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin (PRL), free testosterone (FT), and androstenedione (A) were detected before and after 3 months' treatment. Meanwhile, adverse reaction was observed.

RESULTSAfter treatment, the condition of menstrual disorder, acne and single-phase BBT were improved significantly, and serum levels of LH, LH/FSH, FT and A decreased in both groups (P < 0.05), showed insignificant difference between them (P > 0.05). The PRL level dropped in the LXD group (P < 0.05), which significantly lower than that in the Diane-35 group (P < 0.05). There were 3 cases with adverse reaction of irregular colporrhagia and 5 cases with nausea and vomiting in the Diane-35 group, while no adverse reaction in the LXD group occurred.

CONCLUSIONModified LXD could significantly improve the condition in hyperandrogenism patients with POS of stagnant fire in Gan channel type.

Adolescent ; Adult ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Hyperandrogenism ; drug therapy ; etiology ; Medicine, Chinese Traditional ; Phytotherapy ; Polycystic Ovary Syndrome ; complications ; drug therapy

To investigate the clinical effect of tonifying the kidney and promoting blood circulation to promote oocyte decoction in the treatment of anovulatory infertility caused by polycystic ovary syndrome. Sixty cases were selected from the out-patient department of Xiyuan hospital of China academy of Chinese medical sciences and the Chinese academy of traditional Chinese medicine, Chinese medicine out-patient department. Sixty patients with PCOS patients were randomly divided into the treatment group and the control group, with 30 cases and 30 cases respectively. The treatment group was given decoction of the reinforcing kidney, activating blood circulation and ovarian stimulation compound recipe. The control group was treated with clomiphene. Through the treatment of 1-2 courses, in the treatment group the pregnancy rate was 56.67%, the ovulation rate 61%; in control group of clomiphene citrate ovulation ratepregnancy rate was 30% , 72.84% of ovulation rate. The difference was significant between two groups (P < 0.05), the pregnancy rate in the treatment group was higher than the control group. The treatment group has regulatory effect on FSH, LH and their ratio, and increase E2 level, decrease T, PRL, INS and other hormone levels, contributing to the mature development of the follicles and endometrium growth, increase the ovulation rate and pregnancy rate. The control group on FSH, E2 increased, LH, T, PRL and INS showed no obvious effect.
Adult ; Drugs, Chinese Herbal ; pharmacology ; Female ; Fertility Agents, Female ; pharmacology ; Humans ; Infertility, Female ; drug therapy ; etiology ; Kidney ; drug effects ; Ovulation ; drug effects ; Ovulation Induction ; Polycystic Ovary Syndrome ; complications