Female ; Humans ; Polycystic Ovary Syndrome/epidemiology* ; Risk Factors ; Singapore/epidemiology*

Polycystic ovary syndrome (PCOS) is a common endocrine disorder characterized by oligomenorrhea, hyperandrogenism and polycystic ovaries. The prevalence of PCOS varies between 6% and 10% depending on the diagnostic criteria and the ethnicity. Diagnosis of PCOS relies on a combination of clinical, biological and ultrasound criteria that are used worldwide in different variations. Few studies have extensively examined reproductive and metabolic characteristics and hyperandrogenism in Korean women. Despite the paucity of these studies, they are critical for ascertaining PCOS diagnostic criteria for this population. This review addresses the epidemiology and diagnostic criteria of PCOS specifically for Korean women.
Diagnosis ; Epidemiology* ; Female ; Humans ; Hyperandrogenism ; Oligomenorrhea ; Ovary ; Polycystic Ovary Syndrome* ; Prevalence ; Ultrasonography

Adult ; Female ; Humans ; Phenotype ; Polycystic Ovary Syndrome ; diagnosis ; epidemiology ; ethnology ; genetics

Fatty Liver ; complications ; epidemiology ; therapy ; Female ; Humans ; Insulin Resistance ; Non-alcoholic Fatty Liver Disease ; Polycystic Ovary Syndrome ; complications ; epidemiology ; therapy

OBJECTIVETo compare the clinical outcomes of fresh embryo transfer and cryopreserved-thawed embryo transfer in high-risk patients with ovarian hyperstimulation syndrome (OHSS).

METHODSWe retrospectively analyzed the clinical data of 1784 high-risk OHSS patients undergoing IVF-ET, who were divided into groups A (n=939) and B (n=845). The former received fresh embryo transfer and the latter cryopreserved-thawed embryo transfer. We compared gonadotropin (Gn) administration, body mass index (BMI), the prevalence of polycystic ovary syndrome (PCOS), the number of oocytes retrieved, and the rates of clinical pregnancy, embryo implantation and OHSS incidnece between the two groups.

RESULTSTotally, 657 (69.97%) and 586 (69.35%) pregnancies were achieved in groups A and B, respectively, with 33 cases of moderate OHSS (3.5%) in the former and 30 (3.6%) in the latter. The prevalence of PCOS, the E2 level at hCG trigger, the number of oocytes retrieved, the number of mature oocytes, and the number of quality embryos were significantly lower in group A than in B (P <0.01). No statistically significant differences were found between the two groups in age, infertility duration, BMI, Gn administration, embryo implantation rate, clinical pregnancy rate, abortion rate, and OHSS incidence (P >0.05).

CONCLUSIONIn IVF-ET cycles, cryopreserved-thawed embryo transfer does not influence the clinical outcome in high-risk OHSS patients and can avoid the incidence of severe OHSS.

Body Mass Index ; Cryopreservation ; Embryo Implantation ; Embryo Transfer ; Female ; Gonadotropins ; administration & dosage ; Humans ; Oocytes ; Ovarian Hyperstimulation Syndrome ; epidemiology ; Polycystic Ovary Syndrome ; Pregnancy ; Pregnancy Rate ; Prevalence ; Retrospective Studies ; Treatment Outcome

PURPOSE: To evaluate lipid profiles and liver enzymes as surrogate markers used for recognizing insulin resistance in Korean women with polycystic ovary syndrome (PCOS). MATERIALS AND METHODS: 458 women with PCOS were divided into two groups: non-obese with a body mass index (BMI)<25.0 kg/m2 and obese with a BMI> or =25.0 kg/m2. Anthropometric measures and blood sampling for hormone assay, liver enzymes, lipid profiles and 75 g oral glucose tolerance test were performed. Insulin resistance was defined as homeostasis model assessment of insulin resistance (HOMA-IR)> or =2.5. Areas under the receiver operating characteristic (ROC) curves were used to compare the power of serum markers. Multiple linear regression analysis was used to evaluate the contribution of each confounding factor for HOMA-IR. RESULTS: In non-obese and obese groups, the ROC curve analyses demonstrated that the best marker for insulin resistance was triglyceride (TG), with the areas under the ROC curve of 0.617 and 0.837, respectively. Low-density lipoprotein cholesterol (LDL-C) was the significant marker for insulin resistance with areas under the ROC curve of 0.698 in obese group, but not significant in non-obese group. TG and LDL-C were significantly associated with HOMA-IR in both non-obese and obese PCOS women by multiple linear regression analysis. The optimal cut-off points of TG> or =68.5 was a marker for predicting insulin resistance in non-obese PCOS patients and TG> or =100.5 in obese group. CONCLUSION: TG can be used as a useful marker for insulin resistance in Korean women with PCOS, especially for obese patients.
Adult ; Asian Continental Ancestry Group/ethnology ; Biological Markers/blood ; Body Mass Index ; Cholesterol, LDL/blood ; Female ; Glucose Tolerance Test ; Humans ; Insulin/blood ; Insulin Resistance/ethnology/*physiology ; Lipids/blood ; Obesity/*blood/ethnology ; Polycystic Ovary Syndrome/*blood/ethnology ; ROC Curve ; Regression Analysis ; Republic of Korea/epidemiology ; Triglycerides/*blood

The increased levels of intracellular reactive oxygen species (ROS) in granulosa cells (GCs) may affect the pregnancy results in women with polycystic ovary syndrome (PCOS). In this study, we compared the in vitro fertilization and embryo transfer (IVF-ET) results of 22 patients with PCOS and 25 patients with tubal factor infertility and detected the ROS levels in the GCs of these two groups. Results showed that the PCOS group had significantly larger follicles on the administration day for human chorionic gonadotropin than the tubal factor group (P < 0.05); however, the number of retrieved oocytes was not significantly different between the two groups (P > 0.05). PCOS group had slightly lower fertilization, cleavage, grade I/II embryo, clinical pregnancy, and implantation rates and higher miscarriage rate than the tubal factor group (P > 0.05). We further found a significantly higher ROS level of GCs in the PCOS group than in the tubal factor group (P < 0.05). The increased ROS levels in GCs caused GC apoptosis, whereas NADPH oxidase 2 (NOX2) specific inhibitors (diphenyleneiodonium and apocynin) significantly reduced the ROS production in the PCOS group. In conclusion, the increased ROS expression levels in PCOS GCs greatly induced cell apoptosis, which further affected the oocyte quality and reduced the positive IVF-ET pregnancy results of women with PCOS. NADPH oxidase pathway may be involved in the mechanism of ROS production in GCs of women with PCOS.
Abortion, Spontaneous ; epidemiology ; Acetophenones ; therapeutic use ; Adult ; Apoptosis ; drug effects ; Embryo Transfer ; Female ; Fertilization in Vitro ; Granulosa Cells ; metabolism ; Humans ; NADPH Oxidases ; antagonists & inhibitors ; Onium Compounds ; therapeutic use ; Oocyte Retrieval ; Oxidative Stress ; Polycystic Ovary Syndrome ; drug therapy ; Pregnancy ; Pregnancy Rate ; Reactive Oxygen Species ; metabolism