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Showing 13 results for Hyperandrogenism

Homayoun Naderian, Hossein Nikzad, Akbar Aliasgharzadeh, Mohammad Ali Atlasi,
Volume 7, Issue 2 (7-2009)

Background: Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disorders which cause anovulatory infertility and hyperandrogenism in young women. The common feature in PCOS women is increased ovarian androgen secretion which can effect on the prevalence of miscarriage rate.
Objective: The aim of this study was to investigate the effect of PCOS patient's serum on in vitro developmental stages of mouse embryo from two cells to hatching blastocyst.
Materials and Methods: After superovulating and fertilizing Balb/c mice, 219 two cells embryos were retrieved, 109 embryos were cultured in 10% PCOS patient's serum and 90% medium and 110 embryos were cultured in 10% normal serum and 90% medium to hatching blastocyst stage. The PCOS patient's serum which added to medium had higher hormonal concentrations than normal serum. The early developmental stages of embryos were studied in 2, 4, 8 cells, morula, early, late and hatching blastocyst stages.
Results: The statistical analysis confirmed the decreasing rate in the number of embryos in all developmental stages from 2 cells to hatching blastocyst in PCOS group in comparison with the normal group (p<0.05).
Conclusion: The PCOS patient's serum causes the decreasing rate of in vitro development of the early stage in mouse embryos.
Nasrin Ghasemi, Mohammad Reza Mortazavizadeh, Aboolfazl Khorasani Gerdekoohi,
Volume 8, Issue 3 (7-2010)

Background: Polycystic ovary syndrome (PCOS) is a heterogeneous complex genetic disorder characterized by hyperandrogenemia hyperinsulinemia insulin resistance and chronic anovulation. It is the most common endocrine disorder in women of reproductive age with an enigmatic pathophysiologic and molecular basis. Obesity hyperandrogenism and infertility occur frequently in PCOS which mostly have a genetic predisposition and are features known to be associated with the development of breast cancer risk.
Objective: In present study frequency of PCOS in patients with premenopausal breast cancer was compared with the frequency in women without breast cancer.
Materials and Methods: This is a case-control study which compared PCOS frequency in 166 patients with premenopausal breast cancer and 166 healthy controls with normal mammography in last 6 months.
Results: Eleven patients (6.62%) in case group and 16 patients (9.63%) in control group had polycystic ovary syndrome according to their questionnaire. The difference was not significant (p=0.645).
Conclusion: There was no relationship between frequency of polycystic ovary syndrome and breast cancer in this study. This might be due to the age of patients with breast cancer in this study which was mostly over 40. It could be significant if the patients were chosen in lower age for showing more effect of genetic than environment. The adjustment or matching of other risk factors could help to find the better results.
Ramaswamy Suganthi, Subbian Manonayaki, Jahangir Ali Fathima Benazir,
Volume 8, Issue 4 (7-2010)

Background: Polycystic ovary syndrome (PCOS) is a disorder in which there are numerous benign cysts that form on ovaries under a thick white covering that is one of the causes of infertility. Follistatin is a single chain glycosylated polypeptide that can bind to activin. When follistatin binds to activin it suppresses the role of activin to stimulate the secretion of Follicle Stimulating Hormone (FSH). FSH plays an important role in folliculogenesis and decrease in FSH level may arrest follicular development.
Objective: The aim is this study was to determine the circulating follistatin concentrations in PCOS patients compared to regularly menstruating women. Materials and Methods: The PCOS study group consisted of 88 oligo/amenorrheic women with PCOS. The control group consisted of 60 healthy women with regular menstrual cycles (26–30 days) and with no signs of hyperandrogenism. Body mass index (BMI Kg/m2) was calculated. Serum follistatin Serum Leutenizing hormone (LH) and FSH were determined. Student’s t-test and Pearson correlation coefficients were used carried out statistical analysis of the data.
Results: Serum follistatin levels were 0.11±0.04 and 0.31±0.08 ng/ml in control subjects and PCOS patients respectively (mean ± SD) and mean follistatin concentration in PCOS was high. The relationship between serum follistatin and FSH for control study was negatively correlated (r= -0.107 p=0.415) and was not significant whereas for PCOS patients the correlation was negative (r= -0.011 p=0.027) and however significant.
Conclusion: Follistatin concentrations were high in PCOS patients compared to control subjects in this study. The high concentration of follistatin in PCOS decreased the FSH level and thus follistatin and FSH levels were negatively correlated in this study.
Diana Chanukvadze, Jenara Kristesashvili, Nana Kvashilava,
Volume 10, Issue 4 (8-2012)

Background: Polycystic ovary syndrome (PCOS) is the most common cause of hyperandrogenism in women. Non-classic congenital adrenal hyperplasia (NCAH) is very close to PCOS. The diagnosis of hyperandrogenism is not based on the finding of decreased or increased levels of a single hormone. Objective: In our paper, we are going to test correlation between clinical signs and biochemical markers of hyperandrogenism.
Materials and Methods: In this prospective study, we calculated free testosterone (cFT), bioavailable testosterone (cBT), free androgen index (FAI), free estrogen index (FEI), total testosterone (TT), sex-hormone binding globulin (SHBG), estradiol (E2), dehydroepiandrosterone-sulfat (DHEA-S), 17α -hydroxyprogesterone (17α -OHP), prolactin (P), C-peptid and homeostasis model assessment for insulin resistance (Homa-IR) were measured in two groups of young untreated women with PCOS and NCAH.
Results: In our research, we did not find any significant differences between PCOS and NCAH groups by age, hormonal and calculated parameters of androgens. Waist to hip ratio (WHP) and body mass index (BMI) values were higher in the group of patients with PCOS than NCAH group. But in all patients we found positive correlation between hirsutism score and FAI, cFT, cBT, as well as we found negative correlation between hirsutism score and SHBG. We also tested hormonal and calculated parameters of androgens between PCOS patients by upper body and lower body obesity, but we did not find any significant differences. There was not any difference by the hirsutism score in these groups either.
Conclusion: In our research we found that the calculated values of cFT, cBT and FAI are helpful for determinate hirsutism score in all hirsute patients, despite of ovarian or adrenal hyperandrogenemia.
Sedigheh Amooee, Mohammad Ebrahim Parsanezhad, Maryam Ravanbod Shirazi, Saeed Alborzi, Alamtaj Samsami,
Volume 11, Issue 8 (11-2013)

Background: Chromium picolinate could be effective in clomiphen citrate resistant PCOS patients.
Objective: To compare the effects of chromium picolinate vs. metformin in clomiphen citrate resistant PCOS patients.
Materials and Methods: The present randomized clinical trial was performed on 92 women with clomiphen citrate-resistant PCOS at the clinics which were affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. The subjects were randomly assigned to two groups receiving either chromium picolinate (200μg daily) or metformin (1500mg daily) for 3 months. Anthropometric and hormonal profile were measured and compared both before and after the treatment. Ovulation and pregnancy rate was measured in the two study groups, as well.
Results: Chromium picolinate significantly decreased fasting blood sugar (FBS) after 3 months of treatment (p=0.042). In the same way, the serum levels of fasting insulin had significantly decreased leading to an increase in insulin sensitivity as measured by QUICKI index (p=0.014). In comparison to the patients who received chromium picolinate, those who received metformin had significantly lower levels of testosterone (p=0.001) and free testosterone (p=0.001) after 3 months of treatment. Nevertheless, no significant difference was found between the two study groups regarding ovulation (p=0.417) and pregnancy rates (p=0.500).
Conclusion: Chromium picolinate decreased FBS and insulin levels and, thus, increased insulin sensitivity in clomiphene citrate-resistance PCOS women. These effects were comparable with metformin; however, metformin treatment was associated with decreased hyperandrogenism. Overall, chromium picolinate was better tolerated compared to metformin; nonetheless, the two study groups were not significantly different regarding ovulation and pregnancy rates.
Zhongyu Qu, Yanhui Zhu, Jingjing Jiang, Yuhua Shi, Zijiang Chen,
Volume 11, Issue 9 (12-2013)

Background: Polycystic ovary syndrome (PCOS) is highly associated with non-alcoholic fatty liver disease (NAFLD). There are extensive ethnic differences in the clinical manifestations, pathological changes, and ovarian changes in women with PCOS.
Objective: To investigate the prevalence and clinical characteristics of NAFLD in Chinese women with PCOS.
Materials and Methods: Non-pregnant women with PCOS (N= 602) and matched controls without PCOS (N=588) were recruited. Basal endocrine, oral glucose tolerance test, insulin release level, lipid level, blood pressure, and body mass index (BMI) were measured. Liver biochemical and B-hepatitis and C-hepatitis indices were determined.
Results: NAFLD was significantly more prevalent in women with PCOS than controls (32.9% vs. 18.5%) and included 113 (57.1%) mild, 75 (37.8%) moderate and 10 (5.1%) severe cases. Luteinizing hormone was significantly lower in PCOS women with NAFLD than without NAFLD. In the PCOS group, NAFLD prevalence and severity increased with BMI. The liver index was significantly higher (p<0.001), and the quantitative insulin sensitivity check index and high density lipoprotein cholesterol were significantly lower (p<0.001) in the PCOS group than controls. Insulin resistance, abdominal obesity, diabetes mellitus, abnormal glucose tolerance, liver dysfunction, dyslipidemia, hypertension, and metabolic syndrome were significantly more prevalent in the NAFLD group than controls.
Conclusion: Chinese women with PCOS have a high prevalence of mostly mild and moderate NAFLD, not significantly associated with hyperandrogenism that increased significantly with BMI. Insulin resistance and metabolic abnormalities are important factors associated with NAFLD. Chinese women with BMI ≥24 kg/mP2P should be screened for NAFLD.
Tahereh Eftekhar, Farnaz Sohrabvand, Neda Zabandan, Mamak Shariat, Fedyeh Haghollahi, Akram Ghahghaei-Nezamabadi,
Volume 12, Issue 8 (8-2014)

Background: Polycystic Ovary Syndrome (PCOS) is presented with characteristic complications such as chronic an ovulation, obesity, and hyperandrogenism which can affect sexual function in women of reproductive age.
Objective: Herein we evaluated the frequency and predisposing factors of sexual dysfunction in infertile PCOS patients.
Materials and Methods: In this cross-sectional study, 130 married women with a definite diagnosis of PCOS who were referred due to infertility were recruited. They were evaluated concerning their sexual function in the domains of desire, arousal, lubrication, orgasm, satisfaction and pain with the female sexual function index (FSFI) questionnaire.
Results: The frequency of sexual dysfunction was verified 57.7% in PCOS patients with the domains of desire and arousal being commonly affected in 99.2% and 98.5%of cases respectively. BMI had a significant effect on sexual desire and arousal (p=0.02) while the effect of hirsutism was significant on all domains (p<0.001 for total FSFI score) except for dyspareunia.
Conclusion: PCOS patients markedly suffer from sexual dysfunction as comorbidity. It seems appropriate to screen all PCOS patients for sexual function with a simple short questionnaire such as FSFI. Targeted interventions could be considered to help improve their quality of life along with other treatments. 
Azadeh-Sadat Nazouri, Mona Khosravifar, Ali-Asghar Akhlaghi, Marzieh Shiva, Parvaneh Afsharian,
Volume 13, Issue 12 (1-2015)

Background: Polycystic ovary syndrome (PCOS) is one of the most common endocrine women’s disorders in reproductive age. Hyperandrogenism has a critical role in the etiology of PCOS and it can cause fault in Steroidogenesis process. During steroidogenesis, steroidogenic acute regulatory protein (StAR) seems to increase the delivery of cholesterol through mitochondrial membrane. Therefore, polymorphisms of StAR might effect on this protein and play a role in the etiology of PCOS. Objective: The aim of this study was to investigate the association between StAR SNPs with PCOS. Thus, seven polymorphisms in this gene: rs104894086, rs104894089, rs104894090, rs137852689, rs10489487, rs104894085 were detected. Materials and Methods: In this case control study, 45 PCOS women, 40 male factor/unexplained infertile women, and 40 fertile women as two control groups were participated from 2008-2012. Polymorphisms were detected using restriction fragment length polymorphism (PCR-RFLP) method. Results: Heterozygote genotyping for rs137852689 SNP (amino acid 218 C > T) was only seen in seven PCOS patients, one in normal ovulatory women, and five in male factor/unexplained infertile women (15.5%, 2.5%, 12.5%, respectively) (p= 0.12). While, it has shown no association between other SNPS with PCOs. Conclusion: The RFLP results for seven chosen SNPs, which located in exon 5 and 7 showed normal status in three groups, it means no heterozygous or homozygous forms of selected SNPs were observed. So, it seems evaluation of the active amino acid sites should be investigated and also the study population should be increased.
Anahita Mehdizadeh, Seyed Mehdi Kalantar, Mohammad Hassan Sheikhha, Bibi Shahnaz Aali, Azam Ghanei,
Volume 15, Issue 8 (9-2017)

Background: Genetic factors are believed to play an important role in the etiology of polycystic ovarian syndrome (PCOS) which is the most common endocrinological disorder of women in their reproductive age. Androgen metabolism is impaired in PCOS and, thus, CYP19 gene which is involved in this pathway can be a candidate gene. Previous studies have shown a relationship between single nucleotide polymorphism (SNP) of CYP19 in hyperandrogenism and PCOS in some racial groups.
Objective: This study was designed to elucidate the role of CYP19 gene in PCOS in Iran.
Materials and Methods: In this case-control study, 70 PCOS women and 70 non-PCOS women as normal control were selected. Following the informed consent, 5 ml blood was taken from individuals and subsequently, genomic DNA was extracted by salting out method. Furthermore, a set of polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) was carried out using specific primers for SNP rs.2414096 followed by enzyme digestion, with HSP92II.
Results: Genotype frequencies of SNP rs. 2414096 in PCOS women were as follows: AA (14.4%), AG (44.3%), and GG (41.4%) while in normal group, genotypes were 24.3%, 52.8%, and 22.9%, respectively. Allele frequencies in PCOS group were 49.3% for A and 50.7% for G, whereas normal group had a different percentage of A (36.4%) and G (63.6%). The calculations for both genotypic and allelic frequencies showed statistical significance difference.
Conclusion: Variants of SNP rs. 2414096 in CYP19 could play a role in the development of PCOS in Iranian women.
Marzieh Zohrabi, Elham Rahmani, Niloofar Motamed, Samad Akbarzadeh,
Volume 15, Issue 10 (12-2017)

Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disease and associated with insulin resistance. CXC Ligand 5 (CXCL5) is a new cytokine which is secreted from white adipose tissue during obesity and by blocking insulin signaling pathway inhibits the activity of insulin and promotes insulin resistance.
Objective: The aim of this study was to assess serum level of CXCL5 in PCOS women with normal body mass index.
Materials and Methods: In this case-control study, 30 PCOS women with normal body mass index as the case group and 30 non-PCOS women as the controls were enrolled. Serum levels of CXCL5, insulin and other hormones factors related with PCOS were measured by ELISA method, also the biochemical parameters were measured by autoanalyzer.
Results: Significant increases in serum insulin concentration, homeostasis model assessments of insulin resistance, luteinizing hormone, luteinizing hormone/follicle-stimulating hormone, fasting blood sugar, testosterone, and prolactin were observed in the case group compared to the controls. were in the serum level of CXCL5, cholesterol, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol,dehydroepiandrosterone-sulfate, creatinine, and homeostasis model assessment of beta cell function between these two groups.
Conclusion: In this study, no significant change was observed in serum concentrations of CXCL5 in PCOS women with normal BMI.
Zahra Kalhori, Malek Soleimani Mehranjani, Mehri Azadbakht, Mohammad Ali Shariaatzadeh,
Volume 16, Issue 4 (4-2018)

Background: Polycystic ovary syndrome (PCOS) is an endocrine disorder featured by insulin resistance and hyperandrogenism. Testosterone enanthate can induce PCOS in mice models.
Objective: We investigated the ovary stereological features along with the oxidative stress and inflammatory factors in mice following PCOS induction using testosterone enanthate.
Materials and Methods: Twelve female NMRI mice (3 wk old) were divided into 2 groups (n=6/each): Control and PCOS. PCOS was induced through daily injections of testosterone enanthate (1 mg/100g subcutaneous s.c for 5 wk). Finally, ovaries were studied stereologically. The serum levels of the follicle-stimulating hormone, luteinizing hormone, testosterone, interleukin-6, and tumor necrosis factor-α were measured using ELISA kit. Serum levels of Malondialdehyde and the antioxidant capacity were measured relatively using thiobarbituric acid and ferric reducing antioxidant power assay.
Results: The mean total volume of ovary and the mean volume of cortex (p<0.001), volume of oocyte in the preantral (p=0.011) and antral follicle (p=0.015), thickness of zona pellucida (p=0.016), the number of antral follicles (p=0.012), the serum levels of follicle-stimulating hormone (p<0.001) and the antioxidant capacity (p=0.020) reduced significantly in the PCOS group compared to the control. The number of primary (p=0.017) and preantral (p=0.006) follicles and the serum levels of testosterone (p<0.001), Luteinizing hormone (p=0.002), Malondialdehyde, Interleukin 6 and Tumor necrosis factor-α (p<0.001) showed a significant increase in the PCOS group compared to the control.
Conclusion: Testosterone enanthate induced PCOS causes stereological features in the ovary, increases the oxidative stress and inflammatory markers in mice.
Andon Hestiantoro, Rachmat Dediat Kapnosa Hasani, Amalia Shadrina, Herbert Situmorang, Nurul Ilma, Raden Muharam, Kanadi Sumapraja, Budi Wiweko,
Volume 16, Issue 10 (10-2018)

Background: Polycystic ovary syndrome (PCOS) is an endocrinopathic disorder most commonly experienced by women of reproductive age, and it is characterized by a low-grade chronic inflammatory condition. Excessive fat deposit has been long considered as an etiological factor in the pathogenesis of this inflammatory condition. Currently, body mass index (BMI) or percentage of body fat is used as a marker to assess the body fat composition of a person.
Objective: To determine whether BMI or body fat percentage (BFP) can be used as a better marker for measuring inflammation related to body fat accumulation in polycystic ovary syndrome patients.
Materials and Methods: This study took place at the Center for Reproductive Medicine, Yasmin Clinic, Cipto Mangunkusumo Hospital from January to December 2015. In this cross-sectional study, 32 reproductive age women with PCOS according to the Rotterdam criteria (2003) participated. Women with hyperandrogenism caused by non-classic congenital adrenal hyperplasia, pregnant and lactating women, etc., were excluded. Some variables such as BMI, clinical hyperandrogenism sign, BFP, and inflammatory markers were assessed and statistically analyzed.
Results: From a total of 32 subjects of the study, BFP had a significant positive correlation with procalcitonin levels (r=0.35; p=0.048), while BMI did not (r=0.27; p=0.131).
Conclusion: BFP can be used as a better marker for measuring inflammation related to body fat accumulation in PCOS subjects.
Jam Ashkezari, Nasim Namiranian, Somaye Gholami, Maryam Elahi, Masoud Rahmanian,
Volume 17, Issue 2 (2-2019)

Anti-Müllerian hormone (AMH) is made by the granulosa cells of preantral and small antral follicles which blocks the transition from the primordial to the primary follicular stage. Metformin may be associated with a decrease in AMH serum level and antral follicles in women who suffer from polycystic ovary syndrome (PCOs)
It was reported that metformin in women with polycystic ovary syndrome (PCOs) is associated with a decrease in both AMH serum level and antral follicles.
The objective of the current letter was the evaluation of the effects of metformin on hormonal profile of women with PCOs. In this prospective, randomized, doubleblind controlled clinical trial, 42 women (aged 17–45 yr) with PCOs who were randomly allocated to receive 500 mg Metformin orally three times a day or placebo for three months were included. Fasting plasma glucose, follicular stimulating hormone, luteinizing hormone (LH), prolactin (PRL), testosterone and AMH levels were measured at baseline and at the end of the period. In this study, independent and paired t-test were used for quantitative comparison and chi-square analysis for qualitative variables. Logistic regression analysis was done to identify independent risk factors, and Pvalue of lower than 0.05 were considered significant. All of the statistical analyses were done by SPSS software, version 20.0. We didn’t find any significant change after the study between treatment and control groups in hormonal profiles especially AMH. However, in subgroup analysis, we revealed that AMH and LH levels decreased significantly in normal weight patients (p= 0.024, 0.048, respectively) and prolactin levels in subgroup of overweight patients (p= 0.001). Moreover, patients in metformin group at the end of study had more regular menses, more weight loss, and lower hair loss (p= .001, 0.04, 0.014, respectively). Women with PCOs have elevated levels of LH that is secondary to increased sensitivity of pituitary to GnRH. Increased levels
of LH lead to hyperandrogenism. Metformin can improve this condition. In this study, we observed that LH was decreased significantly in the metformin group of PCOs patients (p= 0.05). It is in agreement with some of the previous studies, however, De Leo and et al. reported a non-significant decrease in LH levels after treatment with metformin (1). Pieces of evidence showed that AMH levels in PCOs patients are 2 to 3 times higher than age-matched normal women (2), and this condition is a marker for PCOs and can be a surrogate test of hyperandrogenism (3). Metformin in our study improved the irregularity in the menstrual cycle (p< 0.001), hair loss (p= 0.014), and prolactin secretion (p= 0.024), as well as LH secretion (p= 0.05); however, it didn’t show any significant decrease on AMH levels. Metformin can reduce ovarian volume in PCOs patients especially in hyperinsulinemic subgroups (4); however, we observed that in normal weight subgroup of patients, metformin decreased AMH significantly (p= 0.024), and in overweight or obese patients, prolactin decreased in response to metformin, significantly (p= 0.001). Moreover, metformin leads to improvement in follicular development with fewer percentage of preantral follicles and cysts and higher percentages of antral follicles (5). Considering these pieces of evidence, it seems that AMH after metformin treatment in PCOs patients was secret in comparable amounts of pretreatment; however, the source of secretion after starting metformin is different from pretreatment and switched from small follicles and cysts to more developed follicles and structures such as antral follicles and corpora lutea. Further investigations that can differentiate secreted AMH from a different source will shed more light on this field. The most important limitation of our study is the small sample size. GI side effects of metformin caused some patients in metformin group to refuse getting the treatment. Studies with more attendants can display the difference between different phenotypes of PCOs patients in response to metformin. In conclusion, this study showed that
metformin can cause favorable effects on the hormonal profile of PCOs patients, and although AMH levels were not decreased significantly, menstruation improved in the treated group.
The most important limitation of our study is the small sample size. GI side effects of metformin caused some patients in metformin group to refuse getting the treatment. Studies with more attendants can display the difference between different phenotypes of PCOs patients in response to metformin. In conclusion, this study showed that metformin can cause favorable effects on the hormonal profile of PCOs patients, and although AMH levels were not decreased significantly, menstruation improved in the treated group.

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