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Bian, Xiaohua, Yifan Cao, Ximin Zhi, and Ni Ma. "Genome-Wide Identification and Analysis of the Plant Cysteine Oxidase (PCO) Gene Family in Brassica napus and Its Role in Abiotic Stress Response." International Journal of Molecular Sciences 24, no. 14 (July 8, 2023): 11242. http://dx.doi.org/10.3390/ijms241411242.
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Plant Cysteine Oxidase (PCO) is a plant O2-sensing enzyme catalyzing the oxidation of cysteine to Cys-sulfinic acid at the N-termini of target proteins. To better understand the Brassica napus PCO gene family, PCO genes in B. napus and related species were analyzed. In this study, 20, 7 and 8 PCO genes were identified in Brassica napus, Brassica rapa and Brassica oleracea, respectively. According to phylogenetic analysis, the PCOs were divided into five groups: PCO1, PCO2, PCO3, PCO4 and PCO5. Gene organization and motif distribution analysis suggested that the PCO gene family was relatively conserved during evolution. According to the public expression data, PCO genes were expressed in different tissues at different developmental stages. Moreover, qRT-PCR data showed that most of the Bna/Bra/BoPCO5 members were expressed in leaves, roots, flowers and siliques, suggesting an important role in both vegetative and reproductive development. Expression of BnaPCO was induced by various abiotic stress, especially waterlogging stress, which was consistent with the result of cis-element analysis. In this study, the PCO gene family of Brassicaceae was analyzed for the first time, which contributes to a comprehensive understanding of the origin and evolution of PCO genes in Brassicaceae and the function of BnaPCO in abiotic stress responses.
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White, Mark D., Laura Dalle Carbonare, Mikel Lavilla Puerta, Sergio Iacopino, Martin Edwards, Kate Dunne, Elisabete Pires, et al. "Structures of Arabidopsis thaliana oxygen-sensing plant cysteine oxidases 4 and 5 enable targeted manipulation of their activity." Proceedings of the National Academy of Sciences 117, no. 37 (August 31, 2020): 23140–47. http://dx.doi.org/10.1073/pnas.2000206117.
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In higher plants, molecular responses to exogenous hypoxia are driven by group VII ethylene response factors (ERF-VIIs). These transcriptional regulators accumulate in the nucleus under hypoxia to activate anaerobic genes but are destabilized in normoxic conditions through the action of oxygen-sensing plant cysteine oxidases (PCOs). The PCOs catalyze the reaction of oxygen with the conserved N-terminal cysteine of ERF-VIIs to form cysteine sulfinic acid, triggering degradation via the Cys/Arg branch of the N-degron pathway. The PCOs are therefore a vital component of the plant oxygen signaling system, connecting environmental stimulus with cellular and physiological response. Rational manipulation of PCO activity could regulate ERF-VII levels and improve flood tolerance, but requires detailed structural information. We report crystal structures of the constitutively expressed PCO4 and PCO5 from Arabidopsis thaliana to 1.24 and 1.91 Å resolution, respectively. The structures reveal that the PCOs comprise a cupin-like scaffold, which supports a central metal cofactor coordinated by three histidines. While this overall structure is consistent with other thiol dioxygenases, closer inspection of the active site indicates that other catalytic features are not conserved, suggesting that the PCOs may use divergent mechanisms to oxidize their substrates. Conservative substitution of two active site residues had dramatic effects on PCO4 function both in vitro and in vivo, through yeast and plant complementation assays. Collectively, our data identify key structural elements that are required for PCO activity and provide a platform for engineering crops with improved hypoxia tolerance.
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Bell, Robin J., Rakibul M. Islam, Marina A. Skiba, Dilinie Herbert, Alejandra Martinez Garcia, and Susan R. Davis. "Substituting serum anti-Müllerian hormone for polycystic ovary morphology increases the number of women diagnosed with polycystic ovary syndrome: a community-based cross-sectional study." Human Reproduction 37, no. 1 (November 6, 2021): 109–18. http://dx.doi.org/10.1093/humrep/deab232.
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Abstract STUDY QUESTION Can serum anti-Müllerian hormone (AMH) replace polycystic ovary morphology (PCOM) determined by ultrasound as a diagnostic component of polycystic ovary syndrome (PCOS)? SUMMARY ANSWER Despite good correlations between serum AMH and PCOM, the use of a high serum AMH as a proxy for PCOM resulted in the reclassification of PCOS in 5% of study participants, with the main effect being more women identified, although some women previously classified as having PCOS were no longer classified as such. WHAT IS KNOWN ALREADY AMH has been proposed as an alternative to PCOM as a diagnostic component of PCOS. Previous studies are limited by poorly defining PCOS, use of infertile women as comparators, measurement of hormones by immunoassay that lack precision in the female range, low-resolution ovarian ultrasound and inconsistent handling and storage of serum samples. STUDY DESIGN, SIZE, DURATION This is an Australian cross-sectional study of 163 non-healthcare-seeking women. PARTICIPANTS/MATERIALS, SETTING, METHODS Serum AMH was measured by both the Ansh picoAMH assay and the Beckman Coulter Access 2 (BA2) assay, in parallel with androgens measured by liquid chromatography–tandem mass spectrometry, in blood samples of women, not pregnant, breast feeding or using systemic steroids, who also underwent high-resolution ovarian ultrasound. PCOS was determined by the Rotterdam criteria with PCOM defined by the Androgen Excess-PCOS Taskforce recommendation of ≥25 follicles in at least one ovary. Cut-off serum concentrations that best identified women as having PCOM were identified by receiver operator characteristic (ROC) curves. MAIN RESULTS AND THE ROLE OF CHANCE A total of 163 women, mean (SD) age 32.5 (5.5) years, who provided a blood sample and had both ovaries visualized on ultrasound were included in the analysis. Women with isolated PCOM had higher median (range) Ansh AMH and BA2 AMH concentrations than those with no PCOS characteristics [56.9 pmol/l (34.6, 104.2) versus 18.7 (3.2, 50.9), P = 0.002 and 38.5 pmol/l (22.2, 100.2) versus 16.7 (3.5, 38.9), P = 0.002, respectively]. An AMH ≥ 44.0 pmol/l, suggested by the ROC curve, identified 80.6% of women with PCOM, falsely identified 15.2% of women without PCOM as having PCOS and had a positive predictive value of 55.6%. The negative predictive value was 94.9%. An AMH BA2 assay cut-off of ≥33.2 pmol/l provided a sensitivity of 80.6%, a specificity of 79.5% and a positive predictive value for PCOM of 48.1%. The negative predictive value was 94.6% for PCOM. When serum AMH was used in the place of PCOM as a diagnostic criterion for PCOS, the Ansh assay resulted in an additional seven women classified as having PCOS and no longer classified one woman as having PCOS. For the BA2 assay, eight additional and two fewer women were classified as having PCOS. Overall, both assays resulted in six more women being classified as having PCOS. LIMITATIONS, REASONS FOR CAUTION Women with functional hypogonadotrophic hypogonadism were not excluded and may have been misclassified as having an oligo-amenorrhoea-PCOM phenotype. As study participants were predominantly Caucasian/White, our findings cannot be generalized to women of other ethnicities. WIDER IMPLICATIONS OF THE FINDINGS Although serum AMH reflects the number of developing ovarian follicles, the absolute values vary between assays and specific reference ranges for individual assays are required. Irrespective of the assay used, replacing PCOM with serum AMH to diagnose PCOS in a community-based sample altered the number of women classified as having or not having PCOS. Consequently, although overall the risk of women being identified as having PCOS would be increased, some women would no longer be classified as having this condition. STUDY FUNDING/COMPETING INTEREST(S) The study was supported by the Norman Beischer Research Foundation and the Grollo-Ruzzene Foundation. S.R.D. is an NHMRC Senior Principal Research Fellow (Grant No. 1135843). S.R.D. reports unrelated support that includes grants from the NHMRC Australia, personal fees for educational activities from Besins Healthcare, Abbott Chile, BioFemme and Pfizer Australia, personal Advisory Board/consultancy fees from Theramex, Abbott Laboratories, Astellas, Mayne Pharmaceuticals, Roche Diagnostics, Lawley Pharmaceuticals and Que Oncology and has received institutional grant funding from Que Oncology and Ovoca research. The other authors declare no conflicts of interest. TRIAL REGISTRATION NUMBER N/A.
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Lazareva, Lyudmila, and Larisa Suturina. "Polycystic Ovarian Morphology: Diagnostic Criteria and Prevalence." International Journal of Biomedicine 12, no. 1 (March 10, 2022): 100–103. http://dx.doi.org/10.21103/article12(1)_ra6.
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The purpose of this brief review was to systematize the current information on the diagnosis, prevalence, and ethnic aspects of polycystic ovarian morphology (PCOM). The information search was conducted using Internet resources (Medline, Pubmed, Cochrane Library, and Google Scholar) and literature sources for the period from January 1999 to August 2021. The review includes only full-text articles. Based on the analysis of the literature, we demonstrated that the diagnostic value of PCOM has changed since the moment of the first description of polycystic ovarian syndrome (PCOS). Currently, ovarian size, ovarian volume and antral follicle count are key criteria for most PCOS phenotypes and complications. The diagnostic value of PCOM depends on age and racial characteristics, which requires large-scale epidemiological studies to determine PCOM characteristics in different populations. Standardizing PCOM diagnostic criteria is the key to PCOS effective diagnosis and, consequently, to preventing complications and comorbidities associated with PCOS.
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Brennan, Edwina, Thomas Keith Cunningham, Thozhukat Sathyapalan, and Stephen Lawrence Atkin. "The Association of the Polychlorinated Biphenyl Class of Endocrine Disruptors With Polycystic Ovary Syndrome and Thyroid Dysfunction." Journal of the Endocrine Society 5, Supplement_1 (May 1, 2021): A492. http://dx.doi.org/10.1210/jendso/bvab048.1006.
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Abstract Introduction:. Polychlorinated biphenyls (PCBs) are a class of endocrine disruptors with a long half-life in the body that are associated with irregular menses, growth and development delay, increased cancer risk, thyroid disorders and an increased risk of diabetes. Higher levels of PCBs have been related to polycystic ovary syndrome (PCOS). PCB toxicity depends on their structure, with coplanar PCBs being most toxic (akin to dioxins); therefore, PCB subtypes were determined to see if they differed in women with PCOS compared to normal controls. Methods:. PCB levels were compared in Caucasian women with (n=29) and without (n=30) PCOS and related to metabolic features. PCBs were fractionated then analysed by high-resolution gas chromatography-unit resolution mass spectrometry. Results:. The control and PCOS groups were age and BMI matched (p=ns); insulin resistance was not different (HOMA 1.7±1.0 v 2±1.6, p=ns) but free androgen index was increased in PCOS (p<0.004). PCB-118, 138, 153 and 180 were found in all subjects, whilst fewer subjects showed PCB-28(15/59), PCB-52(4/59) or PCB-101(26/59). There was no difference for PCB-188,138,153 and 180 between controls and PCOS, but all correlated with increasing age (p<0.01) and decreasing estimated glomerular filtration rate (p<0.05); no correlations with BMI, HOMA, testosterone, TSH or T3 were found; however, PCB-118 (the only coplanar PCB detected) associated with an increased T4/T3 ratio (p<0.01). Conclusion. Despite PCBs being banned over a decade ago, PCBs were detected, but did not differ between age and BMI matched women with and without PCOS. Thyroid dysfunction may be only associated with toxic coplanar PCBs, such as PCB-118 that was associated with a higher T4/T3 ratio.
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Ahmed, Batarfi, Bajouh, and Bakhashab. "Serum Anti-Müllerian Hormone in the Diagnosis of Polycystic Ovary Syndrome in Association with Clinical Symptoms." Diagnostics 9, no. 4 (October 1, 2019): 136. http://dx.doi.org/10.3390/diagnostics9040136.
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Polycystic ovary syndrome (PCOS) is one of the most prevalent endocrine diseases affecting women of reproductive age. The pathogeny of PCOS is still not completely understood, but one contributing factor that has been proposed is anti-Müllerian hormone (AMH). There is currently no clear correlation between levels of AMH and incidence of PCOS in Saudi Arabian patients. The goal of this study was to determine the threshold of AMH and correlate it with PCOS clinical features to facilitate a proper diagnosis for PCOS. In this case-control study, we recruited 79 PCOS women and 69 normal ovulatory women; PCOS patients were diagnosed according to the Rotterdam criterion. On days 2–4 of the menstrual cycle, transvaginal/abdominal ultrasound was performed and serum levels of AMH, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) were measured for all participants. The receiver operating characteristic curve (ROC) was used to determine the AMH diagnostic cut-off at 3.19 ng/mL, with 72% sensitivity and 70% specificity; AMH > 3.19 ng/mL was significantly correlated with PCOS. High AMH levels were correlated with age at menarche, polycystic ovarian morphology (PCOM), and oligo/amenorrhea. Serum AMH is a promising diagnostic marker of ovarian dysfunction in PCOS patients especially in cases in which the evaluation of PCOM was complicated.
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Murphy, M. K., J. E. Hall, J. M. Adams, H. Lee, and C. K. Welt. "Polycystic Ovarian Morphology in Normal Women Does Not Predict the Development of Polycystic Ovary Syndrome." Journal of Clinical Endocrinology & Metabolism 91, no. 10 (October 1, 2006): 3878–84. http://dx.doi.org/10.1210/jc.2006-1085.
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Abstract Context: Polycystic ovarian morphology (PCOM) is present in 25% of normal women in the absence of polycystic ovary syndrome (PCOS); however, the natural history of PCOM is unknown. Objective: We hypothesized that the presence of PCOM predisposes the development of PCOS. Design: The study was a longitudinal follow-up study over 8.2 ± 5.2 yr (mean ± sd; range 1.7–17.5 yr). Setting: The study took place in an outpatient setting. Subjects: Women who took part in a previous study as a normal control and had an ultrasound examination (n = 40) participated. Intervention: Subjects underwent an interval menstrual history, physical exam, blood sampling, and repeat ultrasound in the follicular phase. Main Outcome Measure: Development of PCOS was diagnosed by irregular menses and hyperandrogenism, in the absence of other disorders. Changes in ovarian morphology over time were evaluated. Results: At the baseline visit, 23 women (57.5%) had PCOM and 17 (42.5%) had normal ovarian morphology. One subject with PCOM developed irregular menses and presumptive PCOS. Eleven subjects with PCOM no longer met the criteria for PCOM at follow-up. There was no factor that predicted the change to normal ovarian morphology at the follow-up visit. Conclusions: These data suggest that PCOM in women with regular ovulatory cycles does not commonly predispose the development of PCOS. Although it is unusual to develop PCOM if the ovaries are normal on first assessment, ovaries in women with PCOM no longer meet the criteria for PCOM in approximately half of cases over time.
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Alamoudi, Abrar, Irfan Ullah Khan, Nida Aslam, Nourah Alqahtani, Hind S. Alsaif, Omran Al Dandan, Mohammed Al Gadeeb, and Ridha Al Bahrani. "A Deep Learning Fusion Approach to Diagnosis the Polycystic Ovary Syndrome (PCOS)." Applied Computational Intelligence and Soft Computing 2023 (February 14, 2023): 1–15. http://dx.doi.org/10.1155/2023/9686697.
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One of the leading causes of female infertility is PCOS, which is a hormonal disorder affecting women of childbearing age. The common symptoms of PCOS include increased acne, irregular period, increase in body hair, and overweight. Early diagnosis of PCOS is essential to manage the symptoms and reduce the associated health risks. Nonetheless, the diagnosis is based on Rotterdam criteria, including a high level of androgen hormones, ovulation failure, and polycystic ovaries on the ultrasound image (PCOM). At present, doctors and radiologists manually perform PCOM detection using ovary ultrasound by counting the number of follicles and determining their volume in the ovaries, which is one of the challenging PCOS diagnostic criteria. Moreover, such physicians require more tests and checks for biochemical/clinical signs in addition to the patient’s symptoms in order to decide the PCOS diagnosis. Furthermore, clinicians do not utilize a single diagnostic test or specific method to examine patients. This paper introduces the data set that includes the ultrasound image of the ovary with clinical data related to the patient that has been classified as PCOS and non-PCOS. Next, we proposed a deep learning model that can diagnose the PCOM based on the ultrasound image, which achieved 84.81% accuracy using the Inception model. Then, we proposed a fusion model that includes the ultrasound image with clinical data to diagnose the patient if they have PCOS or not. The best model that has been developed achieved 82.46% accuracy by extracting the image features using MobileNet architecture and combine with clinical features.
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RIEPSAMEN, Angelique H., Mark W. DONOGHOE, Inthrani R. INDRAN, Shelly LIEN, Leah HECHTMAN, David M. ROBERTSON, Robert B. GILCHRIST, Eu-Leong YONG, and William L. LEDGER. "Serum GDF9 and BMP15 as Markers of Ovarian Function in Healthy Women and Women with Polycystic Ovary Syndrome." Fertility & Reproduction 04, no. 03n04 (September 2022): 141. http://dx.doi.org/10.1142/s266131822274053x.
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Background: The oocyte-secreted factors growth differentiation factor-9 (GDF9) and bone morphogenetic protein-15 (BMP15) are key regulators of female fertility and are predominantly expressed by oocytes. Recently, methods to quantitate these proteins in serum have demonstrated diagnostic potential. It is unknown if concentrations reflect ovarian and endocrine function, particularly in women with polycystic ovary syndrome (PCOS), where GDF9/BMP15 function is suggested to be aberrant. Aim: To determine if serum GDF9/BMP15 are associated with ovarian and endocrine parameters, and the ovarian pathologies, PCOM and PCOS. Method: Women aged 21-45 years (n=381) were from a cross-sectional study at the National University Hospital, Singapore, including healthy volunteers and referrals from gynecological clinics. Transvaginal ultrasound scans, blood tests and questionnaire were performed. Serum GDF9 and BMP15 were assessed relative to ovarian (cycle regularity, ovarian volume, AFC, AMH) and androgenic (testosterone, DHT, androstenedione, DHEAS, SHBG, mFG score) characteristics. PCOM and PCOS were determined using the Rotterdam criteria. Statistical analyses used parametric survival models and Kendall’s tau correlation appropriate for data containing values below the limit of detection. Results: Serum GDF9 and BMP15 were detectable in 40% and 41% of women, respectively. Serum GDF9 positively correlated with ovarian volume (p=0.02), AFC (p=0.004), and weakly with AMH (p=0.05). Furthermore, irregular menstrual cycles were associated with high GDF9 (p=0.005), and similar, although non-significant associations were seen for BMP15. When stratified into PCOS (n=130), PCOM (n=59), and control (n=192), GDF9 and BMP15 concentrations were not significantly different, and were not associated with the majority of androgenic features of PCOS. However, the relationship between GDF9 and AFC was significantly different between PCOM, PCOS and control women (p=0.02). Conclusion: These results suggest that serum GDF9 and BMP15 reflect ovarian characteristics but not androgenic characteristics of PCOS, and that the relationships between GDF9 and AFC may be aberrant in women with PCOM/PCOS.
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Balogun, Mobolanle, Olayinka Coker, Titilola Samuel, Patrick Sluss, Christiana Udenze, Ricardo Azziz, Christian Chigozie Makwe, Joseph Ayo Olamijulo, and Ayesha Akinkugbe. "PMON245 Clinical Phenotypes of Polycystic Ovary Syndrome (PCOS) in Nigerian Women: Preliminary Results of the Nigeria PCOS Epidemiology & Phenotype (Nigeria-Pep) Study." Journal of the Endocrine Society 6, Supplement_1 (November 1, 2022): A696. http://dx.doi.org/10.1210/jendso/bvac150.1436.
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Abstract Background Although the phenotype of polycystic ovary syndrome (PCOS) is heterogeneous, there is paucity of data on the prevalence and phenotype of PCOS in sub-Saharan Africa. Methods We studied 75 consecutive consenting women, aged 18-45 years, who presented with features suggestive of PCOS. A standardized proforma was used to obtain relevant information. Anthropometric measurements were determined, and terminal hair growth was assessed using the modified Ferriman-Gallwey (mF-G) method. All subjects underwent an oral glucose tolerance test (OGTT) and pelvic ultrasonography on day 2-7 of the menstrual cycle. An mF-G score of ≥ 6 was regarded as evidence of clinical hyperandrogenism (HA). Menstrual dysfunction (MD) was defined as menstrual cycle lengths >35 or <25 days. Polycystic Ovarian Morphology (PCOM) was defined as an antral follicle count (AFC) of ≥12 2-9 mm follicles and/or an ovarian volume ≥10 cm3, in at least one ovary. Results The mean (SD) age of the study population was 28.6 (5.8) years, and the mean (SD) body mass index (BMI) was 26.3 (5.6) kg/m2. Three (4.0%) participants were underweighted, 27 (36.0%) had normal BMI, 30 (40%) were overweight, and 15 (20.0%) were obese. The mean (SD) systolic and diastolic blood pressures were 107.4 (12.6) mmHg and 72.6 (8.2) mmHg, respectively. OGTT results indicated that the mean (SD) fasting blood glucose was 86.6 (10.6) mg/dl and the mean (SD) 2-hr. postprandial glucose was 109.8 (22.2) mg/dl. Two women had impaired glucose tolerance and one had type 2 diabetes mellitus. Of the 75 subjects recruited, 26 (34.7%) had HA, 54 (72.0%) had MD, and 63 (84.0%) had PCOM. Of all subjects, 20 (26.7%) had HA+MD+PCOM, consistent with PCOS Phenotype A; one (1.3%) had HA+MD only, consistent with Phenotype B; four (5.3%) had HA+PCOM only, consistent with Phenotype C; and 28 (37.3%) had MD+PCOM only, consistent with Phenotype D. In 22 (29.4%) no evidence of PCOS was found. Overall, our results indicate that of subjects evaluated clinically, 53 (70.6%) had PCOS. Conclusions Our preliminary results indicate that in a referral (clinical) population in Lagos, Nigeria, using only the clinical presentation without circulating androgen measures, PCOS was detected in two-thirds, with Phenotype D (aka, 'non-hyperandrogenic PCOS’) being the most common presentation (53%), followed by Phenotype A (aka 'classic or full PCOS’) observed in 38% of all women with PCOS seen. However, as 72% of all subjects had MD and 63% had PCOM, many more of these women could have been diagnosed with PCOS if the presence of hyperandrogenemia could have been demonstrated. Overall, these observations suggest that accurate measurement of circulating androgen, lacking in many parts of Sub-Sahara Africa, may be critical to accurately detecting PCOS in that region. Studies are ongoing. Presentation: Monday, June 13, 2022 12:30 p.m. - 2:30 p.m.
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Wongwananuruk, Thanyarat, Panicha Chantrapanichkul, Vichuta Unalome, Suchada Indhavivadhana, Manee Rattanachaiyanont, Kitirat Techatraisak, Surasak Angsuwathana, and Kittayaporn Silprasit. "Polycystic ovarian morphology in Thai women of reproductive age with polycystic ovary syndrome." Asian Biomedicine 14, no. 6 (December 1, 2020): 271–77. http://dx.doi.org/10.1515/abm-2020-0036.
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Abstract Background Advancements in ultrasound technology have facilitated identifying polycystic ovarian morphology (PCOM) in women with and without polycystic ovary syndrome (PCOS), but it still has limitations due to follicle counting methods and variation of phenotypes according to ethnicity. Ethnicity-specific ovarian morphology may help to establish ethnicity-specific follicle count cut points for defining PCOM in women with PCOS. Objectives To investigate the prevalence and factors associated with PCOM in Thai women of a reproductive age with PCOS. Methods This prospective cross-sectional study was conducted in our gynecology department at a tertiary teaching hospital from February 2016 to May 2017. We included women with PCOS, who were measured for weight, height, waist circumference, and blood pressure. Blood samples were taken to measure fasting blood glucose, lipid profile, testosterone level, and 2 h post-load 75 g oral glucose tolerance test (OGTT). Transvaginal or transrectal sonography was performed to evaluate their ovaries. Results All 143 patient participants we included had oligomenorrhea, 77.6% of them had acne, and 64.3% hirsutism. Their average total testosterone level was 0.47 ± 0.10 ng/mL. The prevalence of PCOM was 55.2%. The proportions of PCOM diagnosed by ovarian follicle and ovarian volume criteria were 36.4% and 42.0%, respectively. There were 20.0 ± 9.5 follicles per ovary, 8.3 ± 3.1 follicles per cross section, and the mean ovarian volume was 7.9 ± 3.0 mL. Conclusion The overall prevalence of PCOM in Thai women of reproductive age with PCOS was 55.2%. Our univariate analysis found no factors significantly associated with PCOM.
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Skiba, Marina A., Robin J. Bell, Dilinie Herbert, Alejandra Martinez Garcia, Rakibul M. Islam, and Susan R. Davis. "Use of community-based reference ranges to estimate the prevalence of polycystic ovary syndrome by the recognised diagnostic criteria, a cross-sectional study." Human Reproduction 36, no. 6 (April 8, 2021): 1611–20. http://dx.doi.org/10.1093/humrep/deab069.
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Abstract STUDY QUESTION Does the application of reference ranges for sex steroids and the modified Ferriman-Gallwey (mFG) scale established in the community from which the study sample was drawn, combined with the most conservative polycystic ovary morphology (PCOM) criteria to the recognised diagnostic criteria for polycystic ovary syndrome (PCOS) improve the certainty of diagnosis of PCOS in non-healthcare-seeking women? SUMMARY ANSWER Despite application of the stringent definitions of the elements used to diagnose PCOS in a non-healthcare seeking community-based sample, the risk of diagnostic uncertainty remains. WHAT IS KNOWN ALREADY There is heterogeneity in prevalence estimates for PCOS due, in part, to lack of standardisation of the elements comprising the recognised National Institutes of Health (NIH), Rotterdam and Androgen Excess Society (AE-PCOS) diagnostic criteria. The AE-PCOS Society proposed refinements to the definitions of biochemical androgen excess and PCOM that can now be incorporated into these sets of diagnostic criteria to estimate PCOS prevalence. STUDY DESIGN, SIZE, DURATION An Australian cross-sectional study of 168 non-healthcare-seeking women. PARTICIPANTS/MATERIALS, SETTING, METHODS The 168 included women were aged 18–39 years, euthyroid and normoprolactinemic, not recently pregnant, breast feeding or using systemic hormones. Each provided menstrual history and assessment of the mFG, had measurement of sex steroids by liquid chromatography, tandem mass spectrometry, and a pelvic ultrasound. The presence of PCOS was determined using modified (m) NIH, Rotterdam, and AE-PCOS criteria according to AE-PCOS Society recommendations. MAIN RESULTS AND THE ROLE OF CHANCE Overall, 10.1% of the included participants met the mNIH PCOS criteria, which requires the presence of menstrual dysfunction, while 18.5% met the mRotterdam and 17.5% the AE-PCOS criteria, with the latter requiring hyperandrogenism. Eight of the 27 participants with menstrual dysfunction, 10 of 31 women with PCOM, and 39 of 68 women with hyperandrogenism had no other feature of PCOS. Of the 19 participants with hyperandrogenaemia, 10 met the mNIH criteria (52.5%) and 14 met both the mRotterdam and AE-PCOS criteria (78.9%). Women who had the combination of hyperandrogenism and PCOM explained the greatest discrepancy between the mNIH and the other criteria. LIMITATIONS, REASONS FOR CAUTION Clinical androgenisation relied on participant self-assessment, which has been shown to be valid when compared with clinician assessment. The sample size was a function of both the strict inclusion criteria and the requirements of non-healthcare-seeking women having a blood draw and pelvic ultrasound which may have introduced a selection bias. WIDER IMPLICATIONS OF THE FINDINGS Despite applying stringent cut-offs for serum androgens, the mFG scale and the ovarian follicle count, these criteria remain arbitrary. Accordingly, healthy women may be captured by these criteria, and misidentified as having PCOS, while women with the condition may be missed. Consequently, PCOS remains a diagnosis to be made with care. STUDY FUNDING/COMPETING INTEREST(S) The study was supported by the Grollo-Ruzzene Foundation. Dr S.R.D. is an NHMRC Senior Principal Research Fellow (Grant no. 1135843). S.R.D. has been paid for developing and delivering educational presentations for Besins Healthcare, BioFemme and Pfizer Australia, has been on Advisory Boards for Theramex, Abbott Laboratories, Mayne Pharmaceuticals and Roche and a consultant to Lawley Pharmaceuticals and Que Oncology and has received has received institutional grant funding for Que Oncology research; there are no other relationships or activities that could appear to have influenced the submitted work. TRIAL REGISTRATION NUMBER N/A
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Gu, Heng, Longyu Li, Bingyi Zhou, Mingzhen Li, Wenyao Zhong, Xiangcai Wei, and Xingmin Zhong. "Single nucleotide polymorphisms in binding site of miRNA-135a and targeted gene IRS2 are correlated with multiple clinical features of PCOS: A study in Chinese women." Technology and Health Care 30 (March 2, 2022): 71–80. http://dx.doi.org/10.3233/thc-228007.
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BACKGROUND: The etiology of polycystic ovary syndrome (PCOS) remains unclear with highly heterogeneous clinical manifestations, recently growing evidence revealing genetic variants play a crucial part in its pathogenesis. OBJECTIVE: This study aimed to examine the correlation between SNPs in miRNA-135a’s binding site of targeted gene IRS2 and clinical manifestations of PCOS in Chinese females. METHOD: A total of 126 Chinese women with PCOS and 109 healthy women were enrolled, divided into 4 groups based on different clinical features of hyperandrogenemia (HA), insulin resistance (IR), polycystic ovary morphology (PCOM) and obesity. We analyzed 2 single nucleotide polymorphisms (SNPs) of the IRS2 gene (rs2289046 and rs1865434) and clinical features’ laboratory measurements such as sex hormone, fasting plasma glucose (FPG), fasting plasma insulin (FINS). RESULTS: Located in miRNA-135a binding site of IRS2 gene, the rs2289046’s triple genotypes distribution showed a significant difference between PCOS/control group and PCOM/non-PCOM group (P< 0.05) while the rs1865434’s triple genotype distribution showed a significant difference between obesity/non-obesity group (P< 0.05). CONCLUSION: The results revealed the two SNPs as rs2289046 and rs1865434 in the IRS-2 binding region of miRNA-135a have correlations with the clinical features of PCOS in Chinese population.
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Pea, Jeffrey, Jahnay Bryan, Alexis L. Oldfield, Faith E. Carter, Lynn M. Johnson, and Marla E. Lujan. "LBMON234 Ultrasonographic Criteria In The Diagnosis Of Polycystic Ovary Syndrome: A Systematic Review And Meta Analysis." Journal of the Endocrine Society 6, Supplement_1 (November 1, 2022): A649. http://dx.doi.org/10.1210/jendso/bvac150.1342.
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Abstract Ultrasonographic evaluation of polycystic ovarian morphology (PCOM) is part of the diagnostic evaluation of polycystic ovarian syndrome (PCOS). The relevance of PCOM as a diagnostic criterion for PCOS was reaffirmed in the most recent International Evidence-Based Guideline for the Assessment and Management of PCOS. However, there remains a lack of clarity regarding the best practices and specific ultrasonographic markers to define PCOM. We synthesized evidence on diagnostic test accuracy of ovarian ultrasound features to comprehensively determine the most suitable markers to diagnose PCOS. The primary outcome was diagnostic accuracy measures (e. g., thresholds, sensitivity, specificity) for PCOS using the following ovarian markers: follicle number per ovary (FNPO) or per single cross-section (FNPS), ovarian volume (OV), and stromal features. Databases of PubMed, Web of Science, Scopus, CINAHL, and CENTRAL were searched until 7 November 2021 to identify studies that compared ultrasound markers between women with PCOS to those without PCOS. Risk of bias and applicability assessment for diagnostic test accuracy studies were determined using the QUADAS-2 and QUADAS-C tool for a single index test or between multiple index tests, respectively. From a total of 1869 records initially identified, 22 studies were included and 18 (N=6,337; [n=2991 PCOS; n= 3346 Control]) were pooled for meta-analysis. FNPO was the most accurate diagnostic marker (sensitivity: 84%, CI: 81% to 87%; specificity: 91%, CI: 87% to 94%). OV and FNPS had similar but inferior pooled sensitivity (OV: 81%, CI: 75% to 86%; FNPS: 81%, CI: 70% to 89%) and specificity (OV: 79%, CI: 73% to 84%; FNPS: 83%, CI: 75% to 88%) compared to FNPO. Majority of studies had high risk of bias for patient selection and index test methodology across all markers. Subgroup analysis indicated that stratification based on age, body mass index (BMI), and previously proposed thresholds did not account for the heterogeneity in diagnostic accuracy observed across studies. For FNPO, studies that used a transducer frequency <8MHz or the Rotterdam criteria had improved positive likelihood ratio (+LR) and sensitivity, respectively. European studies had improved diagnostic accuracy (specificity, diagnostic odds ratio, +LR) compared to North American studies for FNPO, potentially due to BMI differences between PCOS populations (North America: 30.29 ± 0.61kg/m2, Europe: 27.62 ± 0.73kg/m2). Our findings support the use of FNPO as the gold standard in the ultrasonographic diagnosis of PCOS, with OV and FNPS as robust alternatives if total antral follicle counts cannot be obtained. These findings also identify avenues for future research to refine the ultrasonographic definition of PCOM for timely diagnosis of PCOS and investigations into phenotypic variations in pathogenesis and response to treatment in this condition (PROSPERO ID: CRD42021259118). Presentation: Monday, June 13, 2022 12:30 p.m. - 2:30 p.m.
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Gupta, Neha, Uma Pandey, Shivi Jain, and Surya Kumar Singh. "Role of anti mullerian hormone (AMH) in diagnosis of polycystic ovarian syndrome (PCOS) in Indian women." Indian Journal of Obstetrics and Gynecology Research 10, no. 3 (August 15, 2023): 294–98. http://dx.doi.org/10.18231/j.ijogr.2023.060.
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: Transvaginal ultrasound is an important part of the Rotterdam criteria, which are commonly used to diagnose polycystic ovary syndrome (PCOS). Specifically, the presence of polycystic ovarian morphology (PCOM) is a key factor in the criteria. Another useful indicator of PCOM is the Anti-Mullerian hormone (AMH) level.The objective is to evaluate the diagnostic accuracy of serum Anti-Mullerian hormone (AMH) in identifying polycystic ovary syndrome (PCOS) and determine whether it can be used as a substitute for polycystic ovarian morphology (PCOM) in the Rotterdam criteria. Additionally, we aim to investigate the relationship between AMH levels and hyperandrogenism in PCOS patients.A study was out in SSH BHU various parameters will be used in diagnosis. Serum AMH Radiology: By Transvaginal Sonography single observer obtained dimensions for ovarian volume and the maximum number of follicles in one section. AMH levels will be estimated using commercially available Gen-II ELISA assay. Biochemical evaluation will be done in the Department of Bio-Chemistry IMS BHU. The Anti-Mullerian hormone (AMH) serum levels will be measured using a commercially available ultra-sensitive Gen-II enzyme-linked immunosorbent assay (ELISA) kit from Beckman Coulter, CA. The ELISA has a lower limit of detectability (LoD) of 0.08 ng/ml, a lower limit of quantification (LoQ) of 0.17 mg/ml, and an intra-assay coefficient of variation of 5.8%. The unit of measurement is ng/mL (1ng/mL=7.14 pmol/L). The study showed that Anti-Mullerian hormone (AMH) levels were markedly higher in individuals with polycystic ovary syndrome (PCOS) than in controls. While AMH alone was not a reliable diagnostic marker for PCOS, the findings suggested that incorporating AMH levels as an additional factor in the existing Rotterdam criteria could improve the accuracy of PCOS diagnosis. Therefore, AMH levels have the potential as a useful adjunct marker for the diagnosis of PCOS.
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Singh, Shakun, Arshiya Firdaus, Rachna Choudhary, and Vandana Dhama. "Role of anti-mullerian hormone as a diagnostic tool for polycystic ovary syndrome." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 9, no. 9 (August 27, 2020): 3730. http://dx.doi.org/10.18203/2320-1770.ijrcog20203847.
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Background: PCOS has been recognized as the most frequent endocrinopathy among reproductive aged women. This study has been done to determine whether the measurement of serum AMH can be used to diagnose PCOS and as a tool to predict the prognosis of PCOS.Methods: This was a prospective case control study on a woman attending gynae OPD of LLRM Medical College, Meerut, from May 2018 to June 2019. Study comprised of 50 women diagnosed with PCOS using Rotterdam criteria and 50 controls. Clinical data were collected including history, oligomenorrhea, hirsutism, examination included BMI, FG score and blood investigations including serum FSH, LH, TSH, prolactin, estradiol and serum AMH level. USG was done for all women.Results: Both PCOS cases and controls were matched for age and BMI. Mean level of AMH in PCOS cases and controls was 7.1096 and 2.423 respectively, AMH was two to three times higher in women with PCOS than controls which was statistically significant (p<0.05). Most frequent phenotype of PCOS in this study was phenotype A (48%). Highest mean level of AMH was also found in phenotype A (OA+HA+PCOM), thus reflecting the severity of PCOS. Maximum diagnostic potential for PCOS was at cut off 4.22 ng/ml with sensitivity of 92.5% and specificity of 100%.Conclusions: AMH level can be used as diagnostic and prognostic modalities in PCOS. AMH value rises when hyperandrogenism is present therefore serum AMH levels also reflect the phenotype of PCOS and severity of PCOS.
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Hoyos, Luis R., Jenny A. Visser, Anke McLuskey, Gregorio D. Chazenbalk, Tristan R. Grogan, and Daniel A. Dumesic. "Loss of anti-Müllerian hormone (AMH) immunoactivity due to a homozygous AMH gene variant rs10417628 in a woman with classical polycystic ovary syndrome (PCOS)." Human Reproduction 35, no. 10 (September 11, 2020): 2294–302. http://dx.doi.org/10.1093/humrep/deaa199.
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ABSTRACT Anti-Müllerian hormone (AMH) is produced by granulosa cells of pre-antral and small antral ovarian follicles. In polycystic ovary syndrome (PCOS), higher levels of serum AMH are usually encountered due to the ample presence of small antral follicles and a high AMH production per follicular unit which have led to the proposal of AMH as a serum diagnostic marker for PCOS or as a surrogate for polycystic ovarian morphology (PCOM). However, heterozygous coding mutations of the AMH gene with decreased in vitro bioactivity have been described in some women with PCOS. Such mutation carriers have a trend toward reduced serum AMH levels compared to noncarriers, although both types of women with PCOS have similar circulating gonadotropin and testosterone (T) levels. This report describes a normal-weight woman with PCOS by NIH criteria with severely reduced AMH levels (index woman with PCOS). Our objective was to examine the molecular basis for her reduced serum AMH levels and to compare her endocrine characteristics to similar-weight women with PCOS and detectable AMH levels. Twenty normoandrogenic ovulatory (control) and 13 age- and BMI-matched women with PCOS (19–35 years; 19–25 kg/m2) underwent transvaginal sonography and serum hormone measures including gonadotropins, sex hormone-binding globulin, total and free T, androstenedione, dehydroepiandrosterone sulfate, estrone, estradiol and AMH. The latter was measured by ELISA (Pico-AMH: Ansh Labs, Webster, TX, USA). Women with PCOS and detectable AMH had higher serum AMH (10.82 (6.74–13.40) ng/ml, median (interquartile range)), total and free T (total T: 55.5 (49.5–62.5) ng/dl; free T: 5.65 (4.75–6.6) pg/ml) levels and greater total antral follicle count (AFC) (46 (39–59) follicles) than controls (AMH: 4.03 (2.47–6.11) ng/ml; total T: 30 (24.5–34.5) ng/dl; free T: 2.2 (1.8–2.45) pg/ml; AFC 16 (14.5–21.5) follicles, P < 0.05, all values), along with a trend toward LH hypersecretion (P = 0.06). The index woman with PCOS had severely reduced serum AMH levels (∼0.1 ng/ml), although she also had a typical NIH-defined PCOS phenotype resembling that of the other women with PCOS and elevated AMH levels. All women with PCOS, including the index woman with PCOS, exhibited LH hypersecretion, hyperandrogenism, reduced serum estrogen/androgen ratios and PCOM. A homozygous Ala515Val variant (rs10417628) in the mature region of AMH was identified in the index woman with PCOS. Recombinant hAMH-515Val displayed normal processing and bioactivity, yet had severely reduced immunoactivity when measured by the commercial pico-AMH ELISA assay by Ansh Labs. In conclusion, homozygous AMH variant rs10417628 may severely impair serum AMH immunoactivity without affecting its bioactivity or PCOS phenotypic expression. Variants in AMH can interfere with serum AMH immunoactivity without affecting the phenotype in PCOS. This observation can be accompanied by discordance between AMH immunoactivity and bioactivity.
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Rostami Dovom, Marzieh, Maryam Rahmati, Saber Amanollahi Soudmand, Pardis Ziaeefar, Fereidoun Azizi, and Fahimeh Ramezani Tehrani. "The Hidden Link between Polycystic Ovary Syndrome and Kidney Stones: Finding from the Tehran Lipid and Glucose Study (TLGS)." Diagnostics 13, no. 17 (August 30, 2023): 2814. http://dx.doi.org/10.3390/diagnostics13172814.
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Background: We aimed to investigate the association between kidney stones and polycystic ovarian syndrome (PCOS). Materials and methods: In a cross-sectional study, data from the Tehran Lipid and Glucose Study (TLGS) were used to investigate the risk of kidney stones in women with Polycystic Ovary Syndrome (PCOS). Four distinct phenotypes of PCOS, as defined by the Rotterdam criteria, were examined in a sample of 520 women and compared to a control group of 1638 eumenorrheic non-hirsute healthy women. Univariate and multivariable logistic regression models were employed for analysis. The four PCOS phenotypes were classified as follows: Phenotype A, characterized by the presence of all three PCOS features (anovulation (OA), hyperandrogenism (HA), and polycystic ovarian morphology on ultrasound (PCOM)); Phenotype B, characterized by the presence of anovulation and hyperandrogenism; Phenotype C, characterized by the presence of hyperandrogenism and polycystic ovarian morphology on ultrasound; and Phenotype D, characterized by the presence of anovulation and polycystic ovarian morphology on ultrasound. Results: The prevalence of a history of kidney stones was found to be significantly higher in women with Polycystic Ovary Syndrome (PCOS) compared to healthy controls (12.5% vs. 7.7%, p = 0.001). This increased prevalence was observed across all PCOS phenotypes (p < 0.001). After adjusting for potential risk factors, including age, family history of kidney stones, waist-to-height ratio, total cholesterol, and low-density lipoprotein, the odds ratio for kidney stones in women with PCOS was found to be 1.59 [95% CI: 1.12–2.25, p = 0.01], indicating a 59% increase in risk compared to healthy women. Women with PCOS Phenotype A [OR: 1.97, 95% CI: 1.09–3.55, p = 0.02] and Phenotype D [OR: 3.03, 95% CI: 1.24–7.41, p = 0.01] were found to be at a higher risk for kidney stones. Conclusion: Women with Polycystic Ovary Syndrome (PCOS), particularly those exhibiting menstrual irregularities and polycystic ovarian morphology on ultrasound (PCOM), have been found to be two to three times more likely to develop kidney stones. This increased prevalence should be taken into consideration when providing preventive care and counseling to these individuals.
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Tarapure, Shruti R., Tushar Anil Annadate, and Hinaben Harshadkumar Shah. "MANAGEMENT OF GRANTHIBHUTA AARTAVA DUSHTI W.S.R. TO PCOD- A CASE REPORT." October - November 2020 p5, no. 01 (November 25, 2020): 2625–31. http://dx.doi.org/10.46607/iamj13p5012020.
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Poly Cystic Ovarian Disease is a heterogeneous multisystem endocrinopathy in women of reproductive age with the ovarian expression of various metabolic disturbances and clinical features like hyperandrogenism, chronic anovulation, and obesity, resulting from insulin resistance and the compensatory hyperinsulinemia. Poly Cystic Ovarian Disease is a condition where cysts on the ovaries are present that prevent the ovaries from performing normally. On the basis of ultrasound evaluation there will be presence of peripherally tiny follicles. Clinically the PCOS can be understood based on assessment for Granthibhuta Aartava Dushti. (PCOS) can be correlated with Aartava Kshaya, Arajaska Yonivyapad, Lohitakshaya Yonivyapad, Shushka Yonivyapad and Shandhi Yonivyapad. PCOD affects 5-6 % women in childbearing age and is increasing due to change in lifestyle and stress. It is also becoming the common problem in adolescents. So, the man-agement of PCOD is very helpful when it is done by the way which doesn’t affect other hormonal levels and without any further complications. In Ayurveda there are some medications and treatment protocols which are very helpful to manage the PCOS in such a way that doesn’t affect the health of woman. Also, Ayurvedic management of PCOS gives relief in other features of disease like Obesity. So, here attempt has been made for the management of Granthibhuta Aartava Dushti w.s.r. to PCOD.
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Zhao, Yang, Yinlong Zhao, Chunpeng Wang, Zhenzhen Liang, and Xin Liu. "DIAGNOSTIC VALUE OF ANTI-MÜLLERIAN HORMONE AS A BIOMARKER FOR POLYCYSTIC OVARY SYNDROME: A META-ANALYSIS UPDATE." Endocrine Practice 25, no. 10 (October 2019): 1056–66. http://dx.doi.org/10.4158/ep-2019-0098.
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Objective: A previous meta-analysis carried out on the predictive ability of anti-Müllerian hormone (AMH) for polycystic ovary syndrome (PCOS) showed that independent AMH may be a useful initial diagnostic test for PCOS. The aims of this study were to update the meta-analysis and to evaluate the diagnostic efficacy of AMH when it replaces polycystic ovary morphology (PCOM) in the Rotterdam criteria. Methods: Two independent reviewers searched PubMed, Cochrane Library, and the Web of Science databases systematically to identify relevant articles by using the key words “anti-Müllerian hormone” and “polycystic ovary syndrome.” The deadline for manuscript inclusion was July 31, 2018. A random effects model was used and subgroup analysis and meta regression were performed to identify possible sources of heterogeneity. The methodologic quality of each study was assessed by QUADAS-2 and funnel plot asymmetry test. Results: According to the inclusion criteria, 29 studies were included in this meta-analysis. The pooled sensitivity, specificity, and diagnostic odds ratio (DOR) for AMH alone detecting PCOS were 0.76 (95% confidence interval [CI] 0.71 to 0.81), 0.86 (95% CI 0.82 to 0.90) and 20 (95% CI 12 to 33), respectively. When AMH replaces polycystic ovary morphology (PCOM) for the diagnosis of PCOS, the pooled sensitivity, specificity, and DOR rose to 0.93 (95% CI 0.89 to 0.96), 0.99 (95% CI 0.95 to 1.00), and 1,634 (95% CI 217 to 12,324), respectively. The area under the summary receiver-operating characteristic curve for AMH alone and for AMH replacing PCOM detecting PCOS were 0.88 (95% CI 0.85 to 0.91) and 0.97 (95% CI 0.95 to 0.98), respectively, which was found to be significantly different ( Z = 4.89, P<.01). Conclusion: When AMH replaces PCOM in the Rotterdam criteria, the diagnostic efficacy for polycystic ovary syndrome is better. Abbreviations: AMH = anti-Müllerian hormone; AUC = area under the summary receiver operating characteristic curve; BMI = body mass index; CI = confidence interval; DOR = diagnostic odds ratio; HA = hyperandrogenism; IBC = Immunotech-Beckman Coulter; NLR = negative likelihood ratio; OA = oligo-anovulation; PCOM = polycystic ovary morphology; PCOS = polycystic ovary syndrome; PLR = positive likelihood ratio; QUADAS = the Quality Assessment of Diagnostic Accuracy Studies; SENS = sensitivity; SPEC = specificity
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Merino, Paulina M., Ethel Codner, and Fernando Cassorla. "A rational approach to the diagnosis of polycystic ovarian syndrome during adolescence." Arquivos Brasileiros de Endocrinologia & Metabologia 55, no. 8 (November 2011): 590–98. http://dx.doi.org/10.1590/s0004-27302011000800013.
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Polycystic ovarian syndrome (PCOS) is a lifelong disorder characterized by hyperandrogenism and ovulatory dysfunction, with a wide spectrum of clinical symptoms and signs. Three different sets of diagnostic criteria have been established in order to define this disease in adult women, but there is controversy regarding the use of these criteria in adolescence. During puberty, the adult criteria for ovulatory dysfunction does not seem applicable, because an irregular menstrual pattern and a decreased ovulatory rate is a physiologic event during this period of life. Also, a higher prevalence of polycystic ovarian morphology (PCOM) may be observed during this period, so PCOM is not a useful criterion to define PCOS in young women. These findings suggest that a key factor to diagnose to PCOS during adolescence is hyperandrogenism. In addition, since PCOM is not clearly associated with hyperandrogenism during this period of life, the term "polycystic ovarian syndrome" during adolescence creates confusion and may be misleading.
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Rudnicka, Ewa, Michał Kunicki, Anna Calik-Ksepka, Katarzyna Suchta, Anna Duszewska, Katarzyna Smolarczyk, and Roman Smolarczyk. "Anti-Müllerian Hormone in Pathogenesis, Diagnostic and Treatment of PCOS." International Journal of Molecular Sciences 22, no. 22 (November 19, 2021): 12507. http://dx.doi.org/10.3390/ijms222212507.
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Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among reproductive-aged women. It is characterized by chronic anovulation, hyperandrogenism, and the presence of polycystic ovary in ultrasound examination. PCOS is specified by an increased number of follicles at all growing stages, mainly seen in the preantral and small antral follicles and an increased serum level of Anti-Müllerian Hormone (AMH). Because of the strong correlation between circulating AMH levels and antral follicle count on ultrasound, Anti-Müllerian Hormone has been proposed as an alternative marker of ovulatory dysfunction in PCOS. However, the results from the current literature are not homogeneous, and the specific threshold of AMH in PCOS and PCOM is, therefore, very challenging. This review aims to update the current knowledge about AMH, the pathophysiology of AMH in the pathogenesis of PCOS, and the role of Anti-Müllerian Hormone in the treatment of this syndrome.
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Wojciechowska, Anna, Adam Osowski, Marcin Jóźwik, Ryszard Górecki, Andrzej Rynkiewicz, and Joanna Wojtkiewicz. "Inositols’ Importance in the Improvement of the Endocrine–Metabolic Profile in PCOS." International Journal of Molecular Sciences 20, no. 22 (November 18, 2019): 5787. http://dx.doi.org/10.3390/ijms20225787.
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Polycystic ovary syndrome (PCOS) is one of the most common causes of infertility and metabolic problems among women of reproductive age. The mechanism of PCOS is associated with concurrent alterations at the hormonal level. The diagnosis assumes the occurrence of three interrelated symptoms of varying severity, namely ovulation disorders, androgen excess, or polycystic ovarian morphology (PCOM), which all require a proper therapeutic approach. The main symptom seems to be an increased androgen concentration, which in turn may contribute to different metabolic disorders. A number of papers have demonstrated the significant role of inositol therapy in PCOS. However, there is a lack of detailed discussion about the importance of myo-inositol (MI) and d-chiro-inositol (DCI) in reference to particular symptoms. Thus, the aim of this review is to present the effectiveness of MI and DCI treatment for PCOS symptoms. Moreover, the review is focused on analyzing the use of inositols, taking into account their physiological properties, together with the mechanism of individual PCOS symptom formation.
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Banaszewska, Beata, Martyna Siakowska, Izabela Chudzicka-Strugala, R. Jeffrey Chang, Leszek Pawelczyk, Barbara Zwozdziak, Robert Spaczynski, and Antoni J. Duleba. "Elevation of markers of endotoxemia in women with polycystic ovary syndrome." Human Reproduction 35, no. 10 (September 1, 2020): 2303–11. http://dx.doi.org/10.1093/humrep/deaa194.
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Abstract STUDY QUESTION Is polycystic ovary syndrome (PCOS) associated with an elevation of markers of endotoxemia? SUMMARY ANSWER In women with PCOS serum levels of lipopolysaccharides (LPS), the LPS to high-density lipoprotein (HDL) ratio and LPS-binding protein (LBP) are significantly greater than those of normal control subjects. WHAT IS KNOWN ALREADY Mononuclear cells from women with PCOS respond excessively to LPS by releasing pro-inflammatory cytokines. In rat ovarian theca-interstitial cell cultures LPS stimulates androgen production. STUDY DESIGN, SIZE, DURATION Cross-sectional study comparing markers of endotoxemia in women with PCOS (n = 62), healthy ovulatory women with polycystic ovary morphology (PCOM, n = 39) and a control group of healthy ovulatory women without PCOM [normal (NL), n = 43]. PARTICIPANTS/MATERIALS, SETTING, METHODS LPS was measured using a chromogenic assay. LBP was measured by ELISA. Total cholesterol and lipids were measured using a homogeneous enzyme colorimetric method. Androgens, gonadotrophins, prolactin, insulin, high-sensitivity C-reactive protein (hs-CRP) and sex hormone-binding globulin were determined by electrochemiluminescence assays. Glucose was measured using an enzymatic reference method with hexokinase. MAIN RESULTS AND THE ROLE OF CHANCE Women with PCOS, when compared with NL subjects, had a significantly higher mean LPS (P = 0.045), LPS/HDL ratio (P = 0.007) and LBP (P = 0.01). Women with PCOM had intermediate levels of markers of endotoxemia. Comparison among all groups revealed that markers of endotoxemia correlated positively with testosterone level, ovarian volume, number of antral follicles and hirsutism score, but negatively with the number of spontaneous menses per year. In multiple regression analysis, all measures of endotoxemia correlated independently and positively with hs-CRP and with ovarian volume. LIMITATIONS, REASONS FOR CAUTION This cross-sectional study reveals that markers of endotoxemia are associated with several clinical features observed in women with PCOS. However, responsible mechanisms and causation remain unknown. Steroid quantification was carried out by electrochemiluminescence assays and not by the current gold standard: liquid chromatography-mass spectrometry. Hence, the relationship of endotoxemia with features of PCOS and the extent to which endotoxemia contributes to reproductive and metabolic dysfunction warrants further investigation. WIDER IMPLICATIONS OF THE FINDINGS This study reveals the novel observation that markers of endotoxemia are elevated in young and otherwise healthy women with PCOS without significant metabolic dysfunction. Moreover, the association of clinical and endocrine markers of PCOS with those of endotoxemia may represent a pathophysiologic link to reproductive dysfunction as well as metabolic and long-term cardiovascular risks associated with this disorder. STUDY FUNDING/COMPETING INTEREST(S) Intramural funding from Poznan University of Medical Sciences. The authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER N/A
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M, Sharath Kumar. "A Case Study- Dashamoola Niruha Basti and Shamana Chikitsa in PCOS w.s.r Arthava Kshaya." International Research Journal of Ayurveda & Yoga 05, no. 02 (2022): 49–52. http://dx.doi.org/10.47223/irjay.2022.5207.
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PCOD is one of the conditions affecting this unique capacity of woman. The disorder is probably the most common hormonal abnormality in women of reproductive age and certainly a leading cause of infertility. PCOS (polycystic ovarian syndrome) is a complex disorder comprising of anovulation, hyperandrogenism and polycystic ovaries. In Ayurveda all gynecological disorders are explained under Yonivyapad. Based on the principles of yonivyapad, PCOS can be diagnosed and treated as well. Her reports showed PCOS, right tubal block and Anovulatory cycles. She was treated with different Ayurveda treatment modalities Niruha basti (oil and decoction enema) and internal medicines like Abhraloha Aarogyavardhini and Dashamoolarishta.
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Krishnan, Abhaya, Sridhar Muthusami, Loganayaki Periyasamy, Jone A. Stanley, Vasudevan Gopalakrishnan, and Ilangovan Ramachandran. "Effect of DHT-Induced Hyperandrogenism on the Pro-Inflammatory Cytokines in a Rat Model of Polycystic Ovary Morphology." Medicina 56, no. 3 (February 27, 2020): 100. http://dx.doi.org/10.3390/medicina56030100.
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Background and Objectives: Polycystic ovary syndrome (PCOS) is one of the most prevalent disorders among women of reproductive age. It is considered as a pro-inflammatory state with chronic low-grade inflammation, one of the key factors contributing to the pathogenesis of this disorder. Polycystic ovary is a well-established criterion for PCOS. The present investigation aimed at finding the role of hyperandrogenism, the most important feature of PCOS, in the development of this inflammatory state. To address this problem, we adopted a model system that developed polycystic ovary morphology (PCOM), which could be most effectively used in order to study the role of non-aromatizable androgen in inflammation in PCOS. Materials and Methods: Six rats were used to induce PCOM in 21-days-old female Wistar albino rats by using a pre-determined release of dihydrotestosterone (DHT), a potent non-aromatizable androgen, achieved by implanting a DHT osmotic pump, which is designed to release a daily dose of 83 μg. Results: After 90 days, the rats displayed irregular estrous cycles and multiple ovarian cysts similar to human PCOS. Elevated serum inflammatory markers such as tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β), and the presence of a necrotic lesion in the liver, osteoclast in the femur, multinucleated giant cells and lymphocytes in the ovary based on histopathological observation of DHT-treated rats clearly indicated the onset of inflammation in the hyperandrogenic state. Our results show no significant alterations in serum hormones such as luteinizing hormone (LH), follicle stimulating hormone (FSH), insulin, and cortisol between control and hyperandrogenised rats. DHT was significantly elevated as compared to control. mRNA studies showed an increased expression level of TNF-α and IL-1β, further, the mRNA expression of urocortin 1 (Ucn-1) was stupendously elevated in the liver of hyperandrogenised rats. Conclusions: Thus, results from this study provide: (1) a good PCOM model system in order to study the inflammatory changes in PCOS aspects, (2) alteration of inflammatory markers in PCOM rats that could be either due to its direct effect or by the regulation of various inflammatory genes and markers in the liver of hyperandrogenic state suggesting the regulatory role of DHT, and (3) alteration in stress-related protein in the liver of PCOM rats.
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Tariq, Ayesha, Muhammad Azeem Mir, Saba Babar, and Rahat Akhtar. "PCOS;." Professional Medical Journal 25, no. 04 (April 8, 2018): 568–72. http://dx.doi.org/10.29309/tpmj/18.4295.
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Tariq, Ayesha, Muhammad Azeem Mir, Saba Babar, and Rahat Akhtar. "PCOS." Professional Medical Journal 25, no. 04 (April 10, 2018): 568–72. http://dx.doi.org/10.29309/tpmj/2018.25.04.348.
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Objectives: The objective is to compare the efficacy of Pioglitazone andMetformin for ovulation in patients of polycystic ovarian syndrome. Study Design: Randomizedcontrol trial. Setting: Department of Obstetrics and Gynecology, Nishtar Hospital Multan. Period:January 2017 to June 2017. Methodology: Total number of 66 patients was recruited for thisstudy. These patients were admitted through or outpatient department. Group A and Group B,33 patients each. In Group-A patients received metformin while in Group B pioglitazone wasadministered. Sample size was calculated using the reference study by Chaudhry I et al (9)using sample size calculator for two proportions (power of study 80% and confidence interval95% where prevalence (P1) was 52.17% and (P2) 75%). In group-A patients, Metformin withdose of 1500 mg per day in three divided doses were given for 6 months. In group B patients,Pioglitazone 15mg was administered for 6 months. At the end of 6 months, all the patients wereevaluated for efficacy. Results: Total no. of 66 patients was included. The mean age and BMIof the patients was 29.35±4.01 years and 29.74±2.75 kg/m2 respectively. The age distributionnoted as 66.7% (n=44) patients between 18-30 years and 33.3% (n=22) between 31-37 years.BMI distribution observed as 45.5% (n=30) patients between 24-29 kg/m2 and 54.5% (n=36)patients between 30-34 kg/m2. These 100% (n=66) patients were divided into 2 groups equally,33 in each, i.e. group A and group B. The mean age and BMI of the patients of group Awas 29.42±4.32 years and 29.87±2.58 kg/m2 respectively, while the mean age and BMI ofthe patients of group B was 29.27±3.75 years and 29.60±2.94 kg/m2 respectively. Ovulationwas noted as 42.4% (n=14) and 45.5% (=15) for groups A and B respectively. No associationwas found between efficacy and ovulation (p=0.849). Efficacy was notes as 69.7% (n=23) and72.7% (n=24) for group A and group B respectively. No difference was found between efficacyand groups i.e. between pioglitazone and metformin for ovulation in patients of polycystic ovarysyndrome (p=0.786). Similarly, no association was found between efficacy with age (p=0.442)and BMI (p=0.728), after applying the chi-square. Conclusion: This study concludes thatPioglitazone is as much effective as metformin for ovulation induction in women with PCOS.
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Chen, Kelly. "PCOS." Women's Reproductive Health 6, no. 2 (April 3, 2019): 141. http://dx.doi.org/10.1080/23293691.2019.1601907.
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Weiss, J. M., A. K. Schr�der, O. Ortmann, and K. Diedrich. "PCOS." Gyn�kologische Endokrinologie 1, no. 2 (February 1, 2003): 56–60. http://dx.doi.org/10.1007/s10304-003-0023-8.
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Rao, Bhagya Venkanna. "PCOD and PCOS: Are they same or Different???" Indian Journal of Pharmacy Practice 15, no. 4 (October 9, 2022): 256–57. http://dx.doi.org/10.5530/ijopp.15.4.46.
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Mohite, Swati S., and Sonali Sanjay Chaudhari. "COMPARATIVE STUDY OF PATHOGENESIS OF PCOS AND ITS CORRELATION CITED IN VARIOUS AYURVEDIC AND MODERN RESEARCH PAPERS PUB-LISHED." December 2020 8, no. 12 (December 18, 2020): 5333–38. http://dx.doi.org/10.46607/iamj2108122020.
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PCOS is the most common endocrine condition in reproductive-aged women. The word “Syndrome” is used to describe PCOD because, it is a complex manifestation involving many factors and organs. It is characterized by reproductive, endocrine, metabolic and physiological features. The presence of polycystic ovaries is an important diagnostic criterion for PCOS. This syndrome can also be associated with metabolic issues including obesity, insulin resistance, hyperinsulinemia. Recently, there has been an increase in inter-est in the field of PCOS research. It is categorized as a chronic disease with treatments that only address symptoms, the condition is terrifying to most because of its painful and uncomfortable side effects, ad-verse impact on fertility, and high risk of complications. PCOS in Ayurveda is correlated with Ar-tavakshaya. It needs early diagnosis and long-term management for avoiding long term complications. This article aims to provide a balanced review of the latest advances and current limitations in our knowledge about PCOS while also providing a few clear and simple principles, based on current evidence-based clini-cal guidelines, for the proper study of pathogenesis of PCOS, also by looking at the findings of modern medicine we are correlate here the exhibiting features of the disease with the dominate Dosha responsible for the disorder.
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Mohsen, Ahmed M., Rawaa S. A. AL-Azawi, Hawraa H. Naji, Hamzah H. Kzar, and Moaed E. Al-Gazally. "Investigation of the Omentin-1 V109D gene polymorphism as a risk factor for the incidence of Polycystic Ovary Syndrome." Bionatura 7, no. 3 (September 15, 2022): 1–4. http://dx.doi.org/10.21931/rb/2022.07.03.51.
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This study was conducted to assess the omentin-1 (OME-1) V109D gene SNP in women with PCOS and healthy control and to investigate the possible relationship between this adipokine and metabolic profile. This study includes 50 women in the range of age (19-43 Y) who have been diagnosed with PCOC as a patient group and 40 healthy women in age (17-45 Y) as a control group. Five ml of peripheral blood were drawn from both groups to perform the biochemical and genetic study. Metabolic profiles were assessed by spectrophotometric methods, and PCR-RFLP investigated V109D of OME-1 SNP. The results suggest a statistical decrease in FBG, BMI, TG, TC, and LDL(p-value<0.05) in the control group compared to the PCOS group and a statistical increase in HDL levels in control compared to the PCOS group. Genotyping analysis shows statistically significant differences between DD and VV genotypes in PCOS and control groups (OR=4.66 (CI 95%,1.6-8.3), (OR=2.4 (CI95%,0.7-6.9) respectively. These results suggest statistically significant differences in three genotypes (DD, DV, and VV) of the PCOS group depending on age and BMI (p-value <0.05). DD and VV genotypes of OME-1 V109D SNP have more risk factors for PCOS incidence and changes in metabolic profile in Iraqi women. Keywords: Polycystic ovary syndrome, Omentin-1, risk factor, polymorphism genetic
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Saini, Rishi R. S., Smirti Gupta, Mamta Tyagi, Sachin Agrawal, and Bharat K. Gupta. "Clinical, hormonal and ovarian morphological correlation in women with polycystic ovary syndrome." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 11, no. 4 (March 25, 2022): 1102. http://dx.doi.org/10.18203/2320-1770.ijrcog20220735.
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Background: Aim of the study was to study the correlation between clinical, ultrasonographical and hormonal features in women diagnosed as polycystic ovary syndrome (PCOS) and association with vitamin D levels.Methods: This prospective study was conducted among women attending gynecological outpatient department (OPD) of Subharti Medical College, Meerut over a period of two years among 100 patients with clinical diagnosis of PCOS/PCOD according to Rotterdam criteria (2013) were included in this study. All biochemical investigations to be carried out for levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), vitamin D levels, lipid profile to understand the endocrinal and metabolic derangements if any in the patient. Ultrasound pelvis for ovarian study was conducted to know the ovarian morphology, no of follicles if any and their size, which were helpful in the diagnosis of PCOS.Results: Nulliparity and multiparity was reported among 32% and 68% of the subjects respectively. Most common complaint was hirsuitism (43%). According to ultrasonography (USG), PCOS was found to be positive and negative among 87% and 13% of the subjects respectively. Most of the subjects had vitamin D level of 20-50 while <20 vitamin D level was found among 27% of the subjects. Vitamin D deficiency was found to be more in subjects having morphological presence of PCOS as compared to subjects with morphological absence of PCOS with statistically significant difference.Conclusions: On correlating ultrasonological findings with clinic hormonal changes in PCOS women we found that hirsuitism and vitamin d deficiency was significantly more common in women with sonological findings suggestive of PCOS.
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Sharma, Dr Renu, Dr Shikha Maheshwari, and Mr Umesh Kumar Pareek. "A Correlation Study between Polycystic Ovarian Syndrome (PCOD) and Its Related Endocrinal Hormones in Udaipur, Rajasthan, India." Scholars Journal of Applied Medical Sciences 9, no. 7 (July 9, 2021): 1147–51. http://dx.doi.org/10.36347/sjams.2021.v09i07.004.
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Background: Polycystic ovary syndrome (PCOS) is a complex endocrine disorder affecting 5–10 % of women of reproductive age. It generally manifests with oligo/anovulatory cycles, hirsutism and polycystic ovaries, together with a considerable prevalence of insulin resistance. Objectives: The objective of the study is to establish correlation among testosterone, insulin, FSH, LH and lipid profile among the women with polycystic ovary syndrome (PCOS), in order to evaluate their diagnostic and prognostic significance. Methodology: This study includes total 300 female participants of age Group between 18-40 year of age. They were divided in to two groups. Group 1(n=150) includes women having PCOD and Group 2(n=150) is control Group. Fasting Blood samples were obtained from all participants to measure Blood sugar, Lipid Profile insulin, HOMA-IR, Testosteron, FSH, LH and Prolactine. Result: The Mean level of S.Testosteron, S.FSH, S.LH, S.Prolactine and HOMA-IR Fasting Blood sugar, S.cholesterol, S, and Triglyceride S.Insulin is found to be Lower Control Group as compared to PCOD group and difference among them found to be statically significant. Conclusion: From our study I would like to conclude that a PCOS, as a syndrome, has got multiple components including reproductive, metabolic and hormonal, with long-term health concerns that cross the life span. Moreover, PCOS patients have a higher risk of metabolic and cardiovascular diseases and their related morbidity, if compared to the general population.
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Subashree, Ilangovan, Umakant Ramchandra Valvekar, and Geetha Prasad. "Study of serum calcium and vitamin D levels with hormonal profile along with biochemical profile in women with polycystic ovary syndrome." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 6, no. 9 (August 28, 2017): 4075. http://dx.doi.org/10.18203/2320-1770.ijrcog20174065.
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Background: The polycystic ovary syndrome (PCOS) is one of the commonest human endocrinopathies and is increasingly recognized as a variant of the metabolic syndrome in women with the characteristic features of insulin resistance, central obesity, impaired glucose metabolism, dyslipidemia, and hypertension.Methods: This study is mainly focused on study of parameters like gonadotropin hormonal profile, serum vitamin D and calcium levels in polycystic ovary disease (PCOD). The study comprised 45 clinically proven polycystic ovary disease patients in the age range of 19-34 years. The biochemical estimations carried out in the study were – Fasting Blood sugar, LH, FSH, prolactin, 25- OH vitamin D and calcium along with anthropometric data. The values obtained were compared with age matched equal number of healthy control female subjects from the same population.Results: The serum concentration of calcium and vitamin D levels are decreased significantly (P <0.001) when compared to controls. Insulin resistance is predominantly seen in PCOS subjects. The study outlines the importance of insulin resistance, dyslipidemia, decreased serum calcium and vitamin D levels in PCOS subjects may be a cause for the progression of polycystic ovary syndrome.Conclusions: In the present study vitamin D deficiency is highly prevalent in PCOS women from this area compared to control women. We also relations of vitamin D status with insulin sensitivity, HDL-C, and C-reactive protein in PCOS patients, which support the increasing evidence that vitamin D deficiency is associated with multiple metabolic risk factors in PCOS women. A high prevalence of vitamin D deficiency and low calcium levels were observed in PCOS women from our population when compared to controls. Insulin resistance was predominantly seen in PCOS subjects when compared with controls, indicating the association of vitamin D levels with insulin resistance.
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Kazemi, Maryam, Kathleen M. Hoeger, Steven D. Spandorfer, and Marla E. Lujan. "Ethnic Disparities in Cardio-Metabolic and Reproductive Profiles in Women With Polycystic Ovary Syndrome per the New International Guideline: A United-States Based Multi-Center Study." Journal of the Endocrine Society 5, Supplement_1 (May 1, 2021): A739—A740. http://dx.doi.org/10.1210/jendso/bvab048.1504.
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Abstract The magnitude and direction to which cardio-metabolic and reproductive aberrations may disproportionately impact diverse populations of women with PCOS are relevant yet unclear. The uncertainty stems, in part, from heterogeneity in PCOS diagnostic criteria used and technical challenges in the reliable assessment of this clinical population. We evaluated whether cardio-metabolic (abdominal adiposity, hypertension, impaired glucoregulatory status) and reproductive (hyperandrogenism, polycystic ovarian morphology [PCOM], menstrual irregularity) outcomes were different in PCOS (n = 120, 18-36 yrs.) across 4 groups: (1) Non-Hispanic White (n = 76); (2) Non-Hispanic Black (n = 14); (3) Non-Hispanic Asian (n = 15); and, (4) Hispanic White (n = 15). Women were prospectively recruited across 3 academic medical centers in New York State and were matched for age and body mass index. PCOS was defined by the Rotterdam criteria using the recommended thresholds of the 2018 International Evidence-based Guideline for the Assessment and Management of PCOS. Concerning abdominal adiposity, the Asian group (mean ± standard deviation; 0.78 ± 0.06) had a lower waist to hip ratio (WHR) compared to the White group (0.85 ± 0.09; P = 0.01). Also, the Asian group had a higher sex hormone binding globulin (SHBG, 65.9 ± 23.4 nmol/L) compared to all other groups (White [40.5 ± 22.3]; Black [43.8 ± 21.9]; Hispanic [36.8 ± 18.8] nmol/L; All: P < 0.04). In contrast, the White group were most hyperandrogenic, evidenced by their higher modified Ferriman-Gallwey (mFG) scores (10 ± 4) compared to other groups (Black [4 ± 0]; Asian [2 ± 0]; Hispanic [4 ± 1]; All: P ≤ 0.001). Consistently, the White group (1.0 ± 0.5 ng/dL) exhibited increased free testosterone (FT) compared to other groups (Black [0.5 ± 0]; Asian [0.4 ± 0]; Hispanic [0.6 ± 0.1] ng/dL; All: P ≤ 0.001), unlike total testosterone (P = 0.12). Regarding PCOM, the White group exhibited higher follicle numbers per ovary (FNPO 2-9 mm, 48 ± 22) compared to other groups (Black [30 ± 16]; Asian [26 ± 5]; Hispanic [22 ± 17]; All: P ≤ 0.05). Unlike Black (12.4 ± 1.3 mm; P = 0.05) and Hispanic (13.5 ± 1.1 mm; P = 0.89) groups, the White group (13.9 ± 2.1 mm) also exhibited larger ovarian volume (OV) compared to Asian group (12.4 ± 1.5 mm; P = 0.03). Women had comparable blood pressure (systolic, diastolic), fasting glucose, homeostatic model assessment of insulin resistance, or intermenstrual interval length (All: P ≥ 0.09). Overall, Asian women in the US likely exhibit the mildest PCOS metabolic (decreased WHR, increased SHBG) phenotype, whereas White women show the most severe reproductive (increased mFG, FT, FNPO, OV) phenotype. If confirmed by larger studies, our observations warrant additional population-specific diagnostic considerations to prevent and manage PCOS cardio-metabolic (e.g., metabolic syndrome risk) and reproductive (e.g., hirsutism, PCOM) complications across ethnicities.
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Meczekalski, Blazej, Olga Niwczyk, Anna Kostrzak, Marzena Maciejewska-Jeske, Gregory Bala, and Anna Szeliga. "PCOS in Adolescents—Ongoing Riddles in Diagnosis and Treatment." Journal of Clinical Medicine 12, no. 3 (February 3, 2023): 1221. http://dx.doi.org/10.3390/jcm12031221.
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Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women of reproductive age. A diagnosis of PCOS is established when a patient exhibits two of three Rotterdam criteria: oligoovulation or anovulation, excess androgen activity, and polycystic ovarian morphology. The pathogenesis of PCOS, as it affects adolescents, is often discussed in terms of a “two-hit” theory. This refers to a stepwise process in which the first “hit” is an inborn congenitally programmed predisposition, while the second “hit” arises from a provocative factor such as insulin resistance. The dynamic physiological and anatomical changes which occur in puberty make for a challenging diagnosis in this group of patients. It is important to be mindful of the physiological particularities in adolescence which often mimic the symptoms of PCOS. In their first-year post-menarche, approximately 75% of menstruating adolescents report their cycle to last between 21–45 days. Recent studies have shown that regular menstrual cyclicity is only achieved within 2–3 years post-menarche. Anovulation, as a crucial diagnostic element for PCOS, features in about half of early-post-menarchal adolescents. Hirsutism and acne are the most common clinical manifestations of hyperandrogenism, and mild features are developed by most adolescents as a result of elevated androgen levels. Distinguishing between a pathological sign and normal features of maturation is often difficult. A polycystic ovarian morphology (PCOM) through ultrasound has been found in up to 40%, 35%, and 33.3% of patients when assessed at 2, 3, and 4 years, respectively, after menarche. PCOM in adolescence is not associated with future abnormalities in ovulatory rate or menstrual cycle duration. For this reason, international guidelines recommend against the use of pelvic ultrasound until 8 years post-menarche. The primary aim of management is focused mainly on improving hormonal and metabolic status, the prevention of future comorbid complications, and generally improving the overall quality of life in young women with PCOS. Considerable controversy surrounds the choice of optimal pharmacological treatment to address PCOS in adolescents. Reliable studies, which include this sub-section of the population, are very limited. There is a lack of robust and reliable trials in the literature addressing the use of combined oral contraceptives. Further work needs to be undertaken in order to provide safe and effective care to the adolescent population in this regard.
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Tripathi, Pooja Pandey. "Effect of Wolly Workout in PCOS and PCOD Patients as Part of Management." SSR Institute of International Journal of Life Sciences 9, no. 4 (July 2023): 3281–89. http://dx.doi.org/10.21276/ssr-iijls.2023.9.4.7.
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Haidrani, Layla. "Verity PCOS." Nursing Standard 30, no. 7 (October 14, 2015): 28. http://dx.doi.org/10.7748/ns.30.7.28.s30.
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Witchel, Selma Feldman, Helena J. Teede, and Alexia S. Peña. "Curtailing PCOS." Pediatric Research 87, no. 2 (October 18, 2019): 353–61. http://dx.doi.org/10.1038/s41390-019-0615-1.
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Newland, Andrea. "PCOS management." Nurse Practitioner 44, no. 7 (July 2019): 1–2. http://dx.doi.org/10.1097/01.npr.0000565124.92469.d2.
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Pfieffer, Mary Lauren. "PCOS management." Nurse Practitioner 44, no. 7 (July 2019): 2. http://dx.doi.org/10.1097/01.npr.0000565128.30588.96.
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Cooney, L. G., I. Lee, M. A. Clapp, S. Bjorkman, M. Goldsammler, M. Sammel, B. Fisher, and A. Dokras. "PCOS IVF." Fertility and Sterility 110, no. 4 (September 2018): e115-e116. http://dx.doi.org/10.1016/j.fertnstert.2018.07.348.
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Modarres, Maryam, Kunal Rathod, Prashant Purohit, Vicky Minns, Bassam Nusair, Kuga Vigneswaran, Phoebe Howells, Mike Savvas, and Haitham Hamoda. "A review of 300 consecutive cases of Polycystic ovarian syndrome: clinical presentation and management." MOJ Women's Health 9, no. 3 (2020): 92–96. http://dx.doi.org/10.15406/mojwh.2020.09.00277.
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Background: Polycystic ovary syndrome (PCOS) is a common heterogeneous endocrine disorder. The prevalence of PCOS varies depending on which criteria are used to make the diagnosis, but can be as high as 15%–20%. Aim and objectives: To review the demographic details, presenting symptoms, biochemical features and management in women with PCOS and differentiate patients who have polycystic ovarian morphology (PCOM) and have hypothalamic amenorrhoea. Method: Retrospective observational study of 300 consecutive new cases with suspected PCOS were referred to the reproductive endocrinology clinic in a tertiary referral hospital (Kings college hospital, London) from 2008-2015. Electronic medical records were reviewed and Microsoft Excel software was used for data collection and analysis. Inclusion and exclusion criteria’s: All patients with suspected PCOS fulfilling Rotterdam criteria were included in the study. Phenotypically similar androgen excess disorders like congenital adrenal hyperplasia (CAH), androgen secreting-tumor and Cushing’s syndrome were excluded. Results: The mean (+/-SD) age was 30 (+/-6.7) years [range 14-49]. A total of 213 (71%) had oligomenorrhoea, 61 (20.3%) had amenorrhoea, while 26 (8.6%) had regular cycles. 135 (45%) presented with subfertility, while 93 (31%) had hirsutism. Mean (+/-SD) FSH and LH were 5.5 IU/L (+/-2.8) and 17.8 IU/L (+/-7.9), respectively, while mean (+/-SD) estradiol level was 253.4 pmol/L (+/-267.1). 27/61 (44.2%) women with amenorrhoea, had low estradiol [mean (+/-SD) <176 pmol/l (123.8+/-30.8 )]. Mean (+/-SD) anti-Mullerian hormone (AMH) was 44.6 pmol/L (+/-33.1). 39/45 (87%) had elevated AMH while 6/45 (13%) had normal AMH levels. Mean (+/-SD) testosterone level was 2.0nmol/L (+/-1.5) and 36 (16%) patients had elevated total testosterone levels. Mean (+/-SD) Sex Hormone Binding Globulin (SHBG) and Free Androgen Index (FAI) were 45.9 (+/- 29.4) and 5.8 (+/- 6.6). 20/43 (47% of women assessed) had elevated androstenedione levels with a Mean (+/-SD) of 13.06 (+/- 7.5). Elevated triglycerides and/or total cholesterol was noted in 13/44 (29.5% of women assessed). 13/28 (46.4% of women assessed) had raised HbA1C. In a total of six (2%) patients, the ovaries did not appear polycystic. Conclusion: A significant proportion of women with hypothalamic amenorrhea with PCOM were classed as PCOS.
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Nikbakht, Roshan, Mahvash Zargar, Farideh Moramezi, Mahnaz Ziafat, Hamed Tabesh, Ali Reza Sattari, and Shahab Aldin Sattari. "Insulin Resistance and Free Androgen as Predictors for Ovarian Hyperstimulation Syndrome in Non-PCOS Women." Hormone and Metabolic Research 52, no. 02 (January 23, 2020): 104–8. http://dx.doi.org/10.1055/a-1079-5342.
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AbstractWe evaluated the effect of insulin resistance and free androgen index (FAI) in non-PCOS (polycystic ovary syndrome) infertile women following controlled ovarian hyperstimulation. A prospective study was done on 144 infertile non-PCOS women with regular menstrual cycle. At first, insulin resistance (IR), free androgen index (FAI), PCOM (polycystic ovary morphology), AFC (antral follicle count), and AMH (anti-Müllerian hormone) were assessed. The patients underwent assisted reproductive technology (ART), and then preovulatory follicles and oocytes retrieved were recorded. The variables of the study were compared between two groups of patients with ovarian hyperstimulation syndrome (OHSS) (n=66) and non-OHSS patients (n=78). Of the 9 variables: BMI, HOMA-IR, FAI, AFC, AMH, PCOM, and preovulatory follicles were risk factors, while the age and retrieved oocytes were not. The 7 variables that showed significance in the univariate analyses were determined as independent variables included in the multivariable logistic regression analysis, as a result, a total of 5 risk factors, BMI, HOMA-IR, FAI, PCOM, and preovulatory follicles entered the equation. The maximum contribution was HOMA-IR followed by PCOM, FAI, preovulatory follicles and BMI. Patients with OHSS had higher chance to have ovaries with polycystic morphology (74%), about three times more than patients who did not develop OHSS (29%) (p<0.001). The best cut-points for IR, FAI, AFC, AMH, and preovulatry follicles were 2.36, 3.9, 8, 3.3 ng/ml, and 10, respectively. Patients with a higher value of BMI, FAI, HOMA-IR, and preovulatory follicles and the presence of PCOM are more likely to develop OHSS, which are not confined to PCOS patients.
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Grzywna, Natalia, Sylwia Zdun, Klaudia Walczak, Patrycja Walczak, Sylwia Nemeczek, Konrad Merkisz, Jakub Grzybowski, Agnieszka Marciniak, Karolina Jaskuła, and Władysław Orłowski. "Vitamin D supplementation in Polycystic ovary syndrome." Journal of Education, Health and Sport 13, no. 2 (December 29, 2022): 190–95. http://dx.doi.org/10.12775/jehs.2023.13.02.027.
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Introduction and Purpose. Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women of reproductive age worldwide. Patients may present with a wide range of symptoms. According to the most commonly used Rotterdam criteria, the presence of 2 out of 3 criteria is required for diagnosis: clinical and/or biochemical markers of hyperandrogenism (HA); ovulation disorders (oligo- or anovulation); polycystic ovaries on ultrasound (PCOM); and exclusion of disorders mimicking the clinical features of PCOS. The basis of treatment are birth control pills, metformin and antiandrogens. The pathogenesis of the syndrome is not fully understood. The aim of the study is to summarize the potential health benefits of vitamin D supplementation for women with PCOS based on publications from the last 10 years available on Pubmed. State of knowledge. Vitamin D receptors have been identified not only in calcium-regulating tissues, but also in many reproductive organs, such as the ovary (especially granulosa cells), uterus, placenta, testes, as well as hypothalamus and pituitary gland. In recent years, there have been studies analyzing the effect of vitamin D supplementation on the hormonal balance, metabolism and clinical symptoms in women with PCOS. Summary. The results of studies on vitamin D supplementation in women with PCOS are mixed. Some of them are promising and confirm a beneficial effect on glucose metabolism and insulin resistance, lipid metabolism, hormonal balance, alleviation of HA-related symptoms, improvement of menstrual frequency; while the results of other studies do not show significant improvement and do not confirm these effects. Therefore, there is a need for further research on the relationship between the pathogenesis of PCOS and vitamin D and the impact of its supplementation.
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Merino, Paulina M., Claudio Villarroel, Cristián Jesam, Patricia López, and Ethel Codner. "New Diagnostic Criteria of Polycystic Ovarian Morphology for Adolescents: Impact on Prevalence and Hormonal Profile." Hormone Research in Paediatrics 88, no. 6 (2017): 401–7. http://dx.doi.org/10.1159/000481532.
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Background: The ultrasonographic criteria used to identify polycystic ovarian morphology (PCOM) during adolescence have changed over time. Recently, a Worldwide Pediatric Consensus (PedC) defined PCOM using stricter criteria than the previous recommendations of the Rotterdam Consensus (RC) and Androgen Excess-Polycystic Ovarian Syndrome Society (AES/PCOS) criteria. The aim of this study was to determine the prevalence of PCOM in healthy adolescents according to the 3 reported diagnostic criteria and compare the hormonal profile in females with and without PCOM based on the PedC criteria. Methods: Nonobese adolescents (n = 102) with regular menstrual cycles were studied. Transabdominal ultrasound and hormonal profiles were assessed during the follicular phase. PCOM was defined on the basis of the 3 published criteria. Results: On the basis of the PedC, RC, and AES/PCOS criteria, PCOM was diagnosed in 13, 34, and 24% of adolescents, respectively. Adolescents with and without PCOM according to the PedC criteria had similar androgen levels. Serum anti-Müllerian hormone (AMH) levels were elevated in adolescents with PCOM, irrespective of the criteria used. Conclusions: Use of the new PedC diagnostic criteria for PCOM results in a lower prevalence of this ultrasonographic pattern in adolescents, but this condition is not associated with hyperandrogenism. Elevated AMH is associated with PCOM in adolescents regardless of the criteria used to determine the ultrasonographic pattern.
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Wasata, Ruhun. "Exploratory Study of knowledge and experience of Polycystic Ovary Syndrome (PCOS) among PCOS-diagnosed Bangladeshi women." Women Health Care and Issues 3, no. 1 (February 5, 2020): 01–09. http://dx.doi.org/10.31579/2642-9756/021.
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Objective: To explore the perceived experience of polycystic ovary syndrome (PCOS) among PCOS-diagnosed Bangladeshi women with examination of the influence of culture. Methods: This qualitative study included 25 Bangladeshi women who had been diagnosed with PCOS. The qualitative interviews were completed via Skype and/or phone between December 2017 to March 2018. Transcriptions of recorded, de-identified responses were analyzed using qualitative manual coding and thematic analysis. Results and discussion: Three overarching themes were identified from the narratives: PCOS diagnosis experience, PCOS knowledge, and role of religion and culture in relation to PCOS. The women expressed an unsatisfactory experience with their PCOS diagnosis including having to change healthcare professionals, inadequate access to resources, and concerns related to infertility and pregnancy complications. Lack of available evidence-based information was associated with limited knowledge of PCOS among the PCOS-diagnosed Bangladeshi women and their families. The respondents perceived that culture influenced refraining from sharing of information about PCOS thereby limiting knowledge, muting women’s health experience, and contributing to a negative perception on PCOS and related conditions. Participants felt that cultural expectations and emphasis on childbearing placed constant pressure on women and stigmatized PCOS. Conclusions: Bangladeshi women with PCOS perceive various challenges and limited access to information and resources. To minimize some of the challenges associated with PCOS, public health efforts should focus on increasing awareness, education, and resources for women and their families.
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Ryu, Youngjae, Sung Woo Kim, Yoon Young Kim, and Seung-Yup Ku. "Animal Models for Human Polycystic Ovary Syndrome (PCOS) Focused on the Use of Indirect Hormonal Perturbations: A Review of the Literature." International Journal of Molecular Sciences 20, no. 11 (June 3, 2019): 2720. http://dx.doi.org/10.3390/ijms20112720.
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Hormonal disturbances, such as hyperandrogenism, are considered important for developing polycystic ovary syndrome (PCOS) in humans. Accordingly, directly hormone-regulated animal models are widely used for studying PCOS, as they replicate several key PCOS features. However, the pathogenesis and treatment of PCOS are still unclear. In this review, we aimed to investigate animal PCOS models and PCOS-like phenotypes in animal experiments without direct hormonal interventions and determine the underlying mechanisms for a better understanding of PCOS. We summarized animal PCOS models that used indirect hormonal interventions and suggested or discussed pathogenesis of PCOS-like features in animals and PCOS-like phenotypes generated in other animals. We presented integrated physiological insights and shared cellular pathways underlying the pathogenesis of PCOS in reviewed animal models. Our review indicates that the hormonal and metabolic changes could be due to molecular dysregulations, such as upregulated PI3K-Akt and extracellular signal-regulated kinase (ERK) signalling, that potentially cause PCOS-like phenotypes in the animal models. This review will be helpful for considering alternative animal PCOS models to determine the cellular/molecular mechanisms underlying PCOS symptoms. The efforts to determine the specific cellular mechanisms of PCOS will contribute to novel treatments and control methods for this complex syndrome.