The polycystic ovary syndrome is very well known by its high frequency in women, which can get 16% of healthy women and 75% of anovulatory infertile patients. Nevertheless, its etiology and prophylaxy till now remains unclear in the literature. In this work the author discussed on these two problems. According to him the main cause of this pathological pattern would be the diminution of response of ovarian follicles to gonadotropins caused by the presence of androgens, so that no follicle can reach maturity and no ovulation can occur. On the other hand, any cause of diminution of ovarian vascularization such as pelvic inflammatory diseases, adhesion of the adnexa including the ovary may conduct to polycystic ovary. For the prophylaxy, the author suggested that any indication of use of androgenic drugs must be restricted, mostly for young girls and pregnant women to prevent the development of polycystic ovary. Adnexitis would be also treated as soon as possible
Polycystic Ovary Syndrome ; Etiology

No abstract available.
Polycystic Ovary Syndrome*

Polycystic ovary syndrome (PCOS) is characterized by oligo/anovulation, clinical or biochemical evidence of hyperandrogenism and polycystic ovaries, with exclusion of other related disorders. It affects 6 percent-10 percent of women of childbearing age and is the most common cause of anovulatory infertility. Insulin resistance and its compensatory hyperinsulinemia play a key pathogenic role in anovulation and infertility associated with PCOS. Evidence indicates that improving insulin resistance increases ovulation, the success of ovulation induction with clomiphene and pregnancy rates. Lifestyle modification, specifically a weight-reducing diet and exercise, is recommended as first-line therapy for all obese women with PCOS Clomiphene citrate is used as first-line therapy to induce ovulation in women with PCOS, followed by gonadotrophin administration for those who failed to respond to clomiphene. A novel therapeutic approach has emerged from the observation that most women with PCOS suffer from hyperinsulinemic insulin resistance and from evidence that strongly suggests that the elevated circulating insulin concentration impedes ovulation. Insulin sensitizing agents (ISA) used for ovulation induction in PCOS are metformin, rosiglitazone, pioglitazone, troglitazone and d-chiro inositol. The last two are not available. Use of rosiglitazone and pioglitazone (Category B drugs) for PCOS have been reported. Their primary mechanism of action is to enhance peripheral insulin sensitivity. Metformin (Category B drug) has been used in most studies on PCOS. Metformins primary mechanism of action is to reduce hepatic glucose production by improving hepatic insulin sensitivity. It is a safe, effective and rational treatment for the metabolic and endocrine abnormalities in PCOS. Kim, et al. recommended institution of ISA only after clomiphene failure induction. ISA are useful in the treatment of obese and non-obese women with PCOS. In a multinational, randomized, single-blind placebo controlled trial, metformin monotherapy yielded a higher rate of ovulation compared to placebo but a head-to-head trial of ISA vs. clomiphene for initial ovulation induction has not been reported. However, substantial evidence exists, including results from randomized clinical trials, that metformin enhances the likelihood of successful ovulation induction with clomiphene. A multicenter, randomized, double-blind, placebo-controlled trial showed a 75 percent ovulation rate with clomiphene-metformin vs. 27 percent in the clomiphene-placebo group. Fifty eight percent conceived in the clomiphene-metformin group vs. 13 percent in the clomiphene-placebo group Metformin treatment may allow a reduced rate of hyperstimulation with FSH therapy and may reduce the risk of multiple gestation. No randomized, double-blind, placebo-controlled trial of ISA as an adjuvant to gonadotrophin ovulation inductionhas been reported In an abstract at the 1999 meeting of the ASRM, it was reported that metformin increased the number of mature oocytes retrieved from women with PCOS undergoing gonadotrophin-stimulated IVF-ET and ICSI. Women with PCOS have a 30 percent-50 percent first trimester pregnancy loss and 36 percent-82 percent of women with recurrent pregnancy loss are reported to have PCOS. Hyperinsulinemia maybe the important factor in the pregnancy losses. A recent pilot study and a preliminary report both reported a 10 fold reduction in miscarriage in women with PCOS treated throughout pregnancy with metformin. No prospective controlled trials have addressed this issue. In PCOS, use of metformin is associated with a 10-fold reduction in gestational diabetes (31 percent to 3 percent). It also reduces insulin resistance and insulin secretion, thus decreasing the secretory demands imposed on pancreatic beta cells by insulin resistance and pregnancy. It is not teratogenic.
POLYCYSTIC OVARY SYNDROME

Introduction: Polycystic ovarian syndrome (PCOS) is a common endocrinopathy affecting women during reproductive age. Women affected by PCOS generally have a higher risk of developing Metabolic syndrome (MetS). MetS on each phenotype of PCOS reflects some phenotypes with worse metabolic profiles and a higher risk of developing long-term complications in women with PCOS. Objective: To determine the association of MetS with different phenotypes of PCOS among Filipino women in a tertiary hospital. Materials and Methods: This is a retrospective cohort study of 154 women in a tertiary hospital, both private and service divisions Results: A total of 154 patients with PCOS were analyzed in this study: 67 (43.51%) Phenotype A, 25 (16.23%) Phenotype B, 3 (1.95%) Phenotype C, and 59 (38.31%) phenotype D. The prevalence of MetS in PCOS was 69.48%, with no significant difference statistically between phenotypes. MetS was most prevalent in Phenotype A (74.63%) and least prevalent in phenotype D (62.71%). Among Filipino women with PCOS, Phenotype A had a 2.5 times increased risk of developing MetS compared to Phenotype D. Conclusion Phenotype A is the most common phenotype and has the highest prevalence in developing metabolic changes. Increasing body mass index and age played significant roles in elevating the risk of developing MetS. Early detection of MetS in all phenotypes of PCOS can aid in preventing the development of long-term complications such as cardiovascular disease and diabetes mellitus type II.
Metabolic Syndrome ; Polycystic Ovary Syndrome

No abstract available.
Obesity, Morbid* ; Polycystic Ovary Syndrome*

No abstract available.
Female ; Humans ; Polycystic Ovary Syndrome*

Polycystic ovarian syndrome (PCOS) was not considered as a simple disease at ovary but as a metabolic syndrome. The centre of this process is the disturbance of gonadotropin and metabolism of insulin/insulin-like growth factor 1 (IGF1). Some main symptoms: mentruation disorder, hyperandrogenaemia, obesity and hyperresistant to peripheral insulin with hyperinsulinaemia. For those patients have symptoms on skin, the local treatment is provided, other systemic treatments were used for those have metabolic diseases. Women with polycystic ovarian syndrome often are obesity. Metformin lose weight, regulate menstruation circle and increase significantly ovulation. Reducing androgen concentration can improve the symptom of acne and hypertrichosis. Infertile treatment, metformin can be effect in stimulating ovaries by clomiphen or FSH, increase the rate of having pregancy and reduce the rate of miscarriage in women with PCOS.
Polycystic Ovary Syndrome, Basal Metabolism

Polycystic Ovary Syndrome (PCOS), one of the most common endocrine disorders occurring during reproductive age, is characterized by ovulatory dysfunction, biochemical or clinical hyperandrogenism, and polycystic ovaries.1 Its prevalence ranges from 5% to 10% based on population studies, and largely depends on the diagnostic criteria used, and ethnicity of the population being investigated. PCOS is currently considered a syndrome with metabolic and reproductive consequences that could affect women's health during different stages of reproductive age. There is increasing body of evidence suggesting a negative effect of PCOS on fertility and pregnancy outcomes.
Pregnancy Complications ; Polycystic Ovary Syndrome

BACKGROUND

In-vitro maturation (IVM) is utilized to avoid ovarian hyperstimulation syndrome and decrease the cost of IVF. However, there are different opinions regarding its utility. We evaluated outcomes of rescue IVM in polycystic ovary syndrome, diminished and normal ovarian reserve.

This retrospective cohort involves 615 immature oocytes retrieved from 221 IVF cycles. Outcomes of in-vitro matured oocytes were compared to sibling in-vivo mature oocytes. Association between stimulation an study trigger protocol were analyzed.

Laboratory outcomes of Rescue-IVM (R-IVM) matured oocytes showed no statistically significant difference among groups. In-vivo mature oocytes showed a significantly higher fertilization rate and blastocyst rate (p < 0.0001) compared to in-vitro matured oocytes. Progestin primed protocol and combination/dual trigger had significantly higher maturation rates.

Immature oocytes undergoing R-IVM can potentially undergo maturation, fertilization and even developed to blastocyst stage. However, given the low efficiency of development to blastocyst stage, higher power studies are needed to evaluate its practical use.

BACKGOUND: Polycystic ovary syndrome (PCOS) is usually present with reproductive dysfunction. Ovarian function of women with polycystic ovary syndrome might be disturbed, with resultant abnormal folliculogenesis and steroidogenesis. Although it is difficult to define the exact pathogenesis of anovulation, multiple other possible abnormalities have been postulated as contributory factors in the reproductive failure.

OBJECTIVE: The study aimed to determine the association of polycystic ovary syndrome with immune reproductive disorder.

MATERIALS AND METHODS: The study was carried out in a private institution from October 2017 to November 2017. A total of 192 patients were included in the study with ages ranging from 19-40 years old. Review of clinical charts and laboratory results were the primary mode of data gathering. The primary outcome of the study was the presence of immune reproductive disorders among women with and without polycystic ovary syndrome. The Rotterdam criteria were used for the diagnosis of polycystic ovary syndrome and positive results of immunoassays for the five categories were used for the basis for diagnosis of the immune reproductive disorder.

RESULTS: A total of 102 patients were included in the first group and 90 were included in the second group. Out of 102 in Group A, 66 (64.71%) tested positive for immune reproductive disorder. On the other hand, out of 90 patients in Group B, 59 (65.56%) tested positive for immune reproductive disorder. The computed relative risk is almost 1, which means that there is no difference in the risk of having immune reproductive disorder for patients with or without polycystic ovary syndrome.

CONCLUSION: Current evidence does not support a central role of autoimmunity in the pathogenesis of PCOS.