1.Current view of pathologenesis of polycystic ovarian syndrome.
Journal of Korean Society of Endocrinology 1993;8(4):371-378
No abstract available.
Polycystic Ovary Syndrome*
2.Some ideas about the etiology and prophylaxy of the polycystic ovary syndrome
Journal of Medical Research 2000;11(1):61-67
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
3.Role of insulin sensitizing agents in the management of PCOS
Philippine Journal of Reproductive Endocrinology and Infertility 2005;2(2):83-
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
4.Association of metabolic syndrome with different phenotypes of polycystic ovarian syndrome among Filipino women in a tertiary hospital: A retrospective cohort study
Maria Anjelette Patricia F. Belen ; Susana S. Lao
Philippine Journal of Obstetrics and Gynecology 2022;46(6):242-248
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
5.A case of Stein-Leventhal syndrome with severe obesity.
Kyeong Sang KIM ; In Hee JUNG ; Hong Jin LEE ; Won Il PARK ; Kyung Ja LEE
Journal of the Korean Pediatric Society 1992;35(8):1164-1168
No abstract available.
Obesity, Morbid*
;
Polycystic Ovary Syndrome*
6.Molecular Variants of the LHbeta-subunit in Patients with Polycystic Ovary Syndrome (PCOS) in Korean Women.
Eu Gene LEE ; Tae Jong SOHN ; Nam Keun KIM ; Sook Hwan LEE ; Jung Jae KO ; Kwang Yul CHA ; Hyung Min CHUNG
Korean Journal of Fertility and Sterility 2000;27(2):173-178
No abstract available.
Female
;
Humans
;
Polycystic Ovary Syndrome*
7.Polycystic ovarian syndrome- metabolic aspects
Journal of Medical Research 2005;37(4):77-80
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
8.Polycystic ovary syndrome and its association with immune reproductive disorders: A reproductive study.
Amor S. REYES ; Marian C. DICHOSO
Philippine Journal of Reproductive Endocrinology and Infertility 2019;16(1):8-14
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.
Human ; Female ; Polycystic Ovary Syndrome
9.Infertilty and pregnancy complications in PCOS
Philippine Journal of Reproductive Endocrinology and Infertility 2017;14(2):64-67
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
10.Prevalence of the different phenotypes of polycystic ovarian syndrome in adolescents and its association to metabolic and cardiovascular risk
Lianne M. Mendoza ; Lylah D. Reyes
Philippine Journal of Obstetrics and Gynecology 2022;46(5):202-209
Background:
Polycystic ovarian syndrome (PCOS) is a prevalent heterogeneous disorder in females. Timely diagnosis and management are important, especially in adolescents; despite this, there is a paucity of data focusing on this group
Objective:
The aim of this study was to determine the prevalence of the different phenotypes of PCOS in adolescents and identify their association with metabolic and cardiovascular risk
Methodology:
All medical records of patients seen at the OPD of a tertiary institution from January 2015 to December 2019 that had a diagnosis of PCOS were reviewed. The data that were extracted included the patient’s age, blood pressure at the time of consult, weight, height, signs and symptoms (anovulation and hirsutism), and laboratory results (transvaginal ultrasound, 75 g oral glucose tolerance test [OGTT], and lipid profile). Purposive sampling was done for this study
Results:
The prevalence of phenotypes A is 31.9%, B at 31.9%, C around 5.8%, and D at 49.6%, respectively. Those Phenotype D adolescents had significantly higher body mass index (BMI) (P = 0.021), while those having phenotype B had significantly higher total cholesterol levels (P = 0.038). No significant differences were noted in the blood pressure, 75 g OGTT, low‑density lipoprotein (LDL), very LDL, high‑density lipoprotein, and triglycerides among the different PCOS phenotypes
Conclusion
Adolescents with PCOS have an increased risk for metabolic and cardiovascular outcomes; however, there is no significant difference when compared across all phenotypes. It was among those having phenotype D that were found to have a BMI classified as overweight, and phenotype B have elevated total cholesterol levels
Adolescent
;
Phenotype
;
Polycystic Ovary Syndrome