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Showing 53 results for Polycystic Ovary Syndrome

Robab Davar, Abbas Aflatoonian,
Volume 2, Issue 2 (7-2004)

Background: In patients with anovulatory infertility the first choice of treatment for ovulation induction is an antiestrogen, most commonly clomiphene citrate (CC). However, 20-25% of the women are resistant to CC and do not ovulate perhaps due to antiestrogenic mechanism of the CC action, which involves long-lasting estrogen receptor (ER) depletion. Objective: The objective of the study was to mimic the action of CC without depletion of ERs by the administration of an aromatase inhibitor letrozole in a selected group of Poly Cystic Ovary (PCO) patients who demonstrated failure to ovulate after treatment with CC. Materials and Methods: 20 patients with anovulation due to polycystic ovary syndrome (PCOS), who had previously inadequately responded to CC were selected for study. The aromatase inhibitor letrozole was administered orally in a dose of 2.5 mg on days 3-7 of the menstrual cycle. Then, occurrence of ovulation, endometrial thickness, and pregnancy rates were determined. Result(s): Only one patient had one dominant follicle (1.8 cm diameter) on day 14 of the cycle (estradiol = 200 pg/ml). IUI was done; however, no pregnancy took place. In the remaining cases, several sonographies were done between days 9 to 15 of the cycle; however, all cycles were cancelled due to absence of a dominant follicle (>1.4 cm). Conclusion(s): Our study did not confirm the favorable effect of letrozole for induction of ovulation in patients with clomiphene resistant PCO. Article
Hossein Hadinedoushan, Robert Normann,
Volume 3, Issue 2 (7-2005)

Background: Polycystic ovary syndrome (PCOS) is related to obesity and to major metabolic alterations including both insulin resistance and beta-cell dysfunction. Ghrelin was identified as the endogenous ligand for the growth hormone secretagogue (GHS) receptor. The actions of ghrelin are carried out through interaction with specific receptor, named GHS-R. Objective: In a case-control study, we compared the expression of ghrelin and GHS-Rs mRNA by Quantitative Real-time PCR method in studied groups in order to determine the role of ghrelin and GHS-Rs in pathogenesis of PCOS. Materials & Methods: Follicular fluid samples were obtained at oocyte collection from 22 patients undergoing IVF-ET as control and 11 patients were diagnosed as having PCOS. Total RNA was extracted from isolated follicular fluid cells and 2�g RNA was diluted and reverses transcribed using random primers and Superscript II. Specific primers for the ghrelin, GHS-R1a and GHS-R1b were designed. Samples were run in triplicate on an ABI Geneamp 5700 sequence detection system. They were subjected to 40 cycles of amplification under condition 92�C- 20s and 62�C-1min using 3�l diluted cDNA (1:7), 10�l 2X SYBR green, 3�l diluted cDNA. ?-actin mRNA was assayed and then normalized to total RNA measurements for each sample. Results: Age, weight and resulting pregnancies did not vary between PCOS and non-PCOS patients, whereas the BMI and serum testosterone level of PCOS were significantly higher than non-PCOS patients. Quantitative real-time RT-PCR showed that mRNA for ghrelin and GHS-R 1b were detectable in follicular fluid cells from all patients. We failed to find mRNA for GHS-R 1a in any of follicular fluid cells. There were no significant difference in ghrelin and GHS-R1b mRNA expression levels between PCOS and non-PCOS groups. Conclusion: Our findings indicate that ghrelin and ghrelin receptors may not be considered risk factors for pathogenesis of PCOS.
Mohammad Hasan Sheikhha, Seyed Mehdi Kalantar, Nasrin Ghasemi,
Volume 5, Issue 2 (7-2007)

Background: Inversion of the uterus is very uncommon. Patients may present with pelvic pain, vaginal discharge, or hemodynamic shock. Case: We report a case of 35 years old women (virgin) who was admitted with profuse vaginal bleeding and cramps of uterus. In the vaginal examination at litothomy position a mass of 58 cm in size was protruded from the vagina. At first myomectomy was performed and after that laparotomy with total abdominal hysterectomy was done. Conclusion: Early diagnosis, immediate treatment of shock, and replacement are essential in uterine inversion.
Javad Mohiti-Ardekani, Nasim Tarof, Abbas Aflatonian,
Volume 7, Issue 3 (7-2009)

Background: Leptin is an adipokine that circulates in a free form and bound to a soluble leptin receptor. Patients with polycystic ovary syndrome have increased insulin resistance and high incidence of obesity. Objective: This study was carried out to evaluate levels of leptin and free leptin in women with polycystic ovarian syndrome (PCOS) and note any relationships with insulin resistance and adiposity. Materials and Methods: We assessed the correlation of metabolic parameters with the levels of free leptin and it’s bound form in 27 PCOS women (aged 26±5.6 years) and 27 healthy women with normal menstrual cycle as controls (aged 25 ±4 years).Total leptin and insulin levels were measured using ELISA. Free leptin form was purified by Gel filtration chromatography and their collected fractions were measured by a sensitive ELISA-Kit. Insulin resistance was calculated by homeostasis model assessment (HOMA). Results: In PCOS patients and control group a correlation between leptin and body mass index (BMI) was found. A significant difference was found between leptin and free leptin levels in PCOS subjects and controls (p<0.05). Significant correlations were found between free and total leptin with insulin resistant in PCOS subjects (r=0.78 p=0.00, r=0.84 p=0.003) and control groups respectively (r=0.86 p=0.00, r=0.69 p=0.00). Conclusion: Total and free leptin forms are correlated significantly with BMI in patients with PCOS and in controls. Total and free leptin forms showed significant correlations with insulin resistance but no significant difference was seen in the two groups investigated.
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.
Marzieh Agha Hosseini, Ashraf Aleyasin, Atossa Mahdavi, Sara Mokhtar, Leila Safdarian, Parvin Fallahi,
Volume 8, Issue 5 (7-2010)

Background: Anti-mullerian hormone (AMH) levels may represent the ovarian follicular pool and could be a useful marker of ovarian reserve. The clinical application of AMH measurement has been proposed in the prediction of quantitative and qualitative aspects in assisted reproductive technologies. Objective: This study aimed to assess the relationship between the serum levels of AMH and results of assisted reproductive technique (ART) outcome in polycystic ovary syndrome (PCOS) patients versus control group. Materials and Methods: This cohort study was conducted on 61 (PCOS) patients and 28 patients without PCOS (controls) candidates for assisted reproductive technique. Serum levels of AMH were measured on the 3rd day of menstrual cycle and all the patients underwent controlled ovarian hyper stimulation and ART. The relationship between AMH serum level with retrieved oocytes, mature oocytes and pregnancy rate were assessed. Results: There was significant correlation between the AMH level with number of total retrieved oocytes and mature oocytes in patients with PCOS and controls (p=0.001). In PCOS and control groups AMH level in pregnant patients was higher, but it was not statistically significant (p=0.65, p=0.46, respectively). The major outcome of the study (pregnancy) did not differ significantly between two groups. Conclusion: This study revealed that AMH level was higher in pregnant patients undergoing ART; but AMH may not be an accurate predictor for pregnancy in PCOS patients.
Robab Davar, Mojgan Javedani, Mohammad Hossein Fallahzadeh,
Volume 9, Issue 1 (7-2011)

Background: Polycystic ovary syndrome (PCOS) is associated with approximately 75% of women who suffer from infertility due to anovulation. Additionally, around 20– 25% of anovulatory women with PCOS do not respond at all to clomiphene citrate and are considered to be “clomiphene– resistant”. Aromatase inhibitors have been suggested as an alternative treatment to clomiphene as the discrepancy between ovulation and pregnancy rates with clomiphene citrate has been attributed to its anti-estrogenic action and estrogen receptor depletion. Objective: The aim of this study is to compare results of Metformin-letrozole with Metformin-clomiphene citrate in clomiphene resistance PCOS patients undergoing IUI. Materials and Methods: In this single blind randomized trial, ovarian cycles were studied in 100 clomiphene- resistant patients with PCOS. The inclusion criteria were patients who received 150mg clomiphene citrate daily for 3 cycles and failed to become pregnant. The patients were matched for their age, body mass index (BMI), and infertility period. They were randomly allocated to a metformin-letrozole group (n=50) and a metformin-clomiphene citrate group (n=50). Chemical and clinical pregnancies were assessed after IUI. Abortion rates were determined in both groups. Results: Regarding pregnancy rate, there was no significant difference between the two groups. One miscarriage (2%) occurred in the metformin-clomiphene citrate group, whereas none was seen in the metformin-letrozole group. Conclusion: There is no significant difference in pregnancy rate between clomiphene citrate and letrozole groups although it has been 2% in the former and 5% in the latter. Article
Azam Azargoon, Jafar Alavy Toussy, Fakhry Fakhr Darbanan,
Volume 10, Issue 1 (7-2012)

Background: Clomiphen citrate (CC) is the first line therapy for women with infertility and poly cystic ovary syndrome( PCOS). However, 20-25% of women are resistant to CC and do not ovulate.
Objective: The objective of this study was to evaluate the efficacy of sequential treatment of metformin and incremental doses of letrozole in induction of ovulation in cases of CC-resistant PCOS patients.
Materials and Methods: In this prospective before-after study, we enrolled 106 anovulatory PCOS women who failed to ovulate with CC alone from Amir-Almomenin University Hospital in Semnan, Iran. After an initial 6-8 weeks of metformin treatment, they received 2.5 mg letrozole daily on days 3-7 after menes. If they did not ovulate with 2.5 mg letrozole, the doses were increased to 5 to 7.5 mg daily in subsequent cycles. The main outcomes were ovulatory rate, pregnancy rate and cumulative pregnancy rate.
Results: 13.33% of patients conceived with metformin alone. Ovulation occurred in 83 out of remaining 91 patients (91.2%). 78.02% of patients responded to lower doses of letrozole. Cumulative pregnancy rate was 60/ 105 (57.14%).
Conclusion: We suggest that treatment in CC-resistant PCOS patients should begin at first with lower doses of letrozole and could increase to the higher dose depending on the patient response before considering more aggressive therapeutic alternatives such as gonadotropins.
Farideh Zafari Zangeneh, Alireza Abdollahi, Fatemeh Aminee, Mohammad Mahdi Naghizadeh,
Volume 10, Issue 2 (7-2012)

Abstract Background: “Polycystic ovary syndrome (PCOS) is a complex endocrine and metabolic disorder associated with ovulatory dysfunction”. “Autonomic and central nervous systems play important roles in the regulation of ovarian physiology”. The noradrenergic nucleus locus coeruleus (LC) plays a central role in the regulation of the sympathetic nervous system and synaptically connected to the preganglionic cell bodies of the ovarian sympathetic pathway and its activation is essential to trigger spontaneous or induced LH surges. This study evaluates sympathetic outflow in central and peripheral pathways in PCO rats. Objective: Our objectives in this study were (1) to estimate LC activity in rats with estradiol valerate (EV)-induced PCO; (2) to antagonized alpha2a adrenoceptor in systemic conditions with yohimbine. Materials and Methods: Forty two rats were divided into two groups: 1) LC and yohimbine and 2) control. Every group subdivided in two groups: eighteen rats were treated with estradiol valerate for induction of follicular cysts and the remainders were sesame oil groups. Results: Estradiol concentration was significantly augmented by the LC lesion in PCO rats (p<0.001), while LC lesion could not alter serum concentrations of LH and FSH, like yohimbine. The morphological observations of ovaries of LC lesion rats showed follicles with hyperthecosis, but yohimbine reduced the number of cysts, increased corpus lutea and developed follicles. Conclusion: Rats with EV-induced PCO increased sympathetic activity. LC lesion and yohimbine decreased the number of cysts and yohimbine increased corpus lutea and developed follicles in PCO rats.
Farnaz Sohrabvand, Shahrzad Sheikhhassani, Maryam Bagheri, Fedyeh Haghollahi, Maryam Shabihkhani, Mamak Shariat, Manijeh Nasr Esfahani,
Volume 10, Issue 3 (7-2012)

  Background: Polycystic ovary syndrome (PCOS) is a common cause of ovulatory disorders and infertility with high LH to FSH ratio. In order to prevent further increase of LH and follicle atresia, different regimens for ovulation induction have been recommended using FSH alone.   Objective: This study was performed in PCOS patients to compare ART outcomes in cycles induced by FSH alone, using either recombinant or urinary products.   Materials and Methods: In a randomized trial, from 623 patients who underwent down regulation with GnRH analogue in a long protocol, 160 PCOS patients were randomly divided into two groups of 80. Group A received 150 IU/d recombinant FSH (Gonal-F) and group B 150 IU/d urinary FSH (Fostimon). Results: 33 cases (41.2%) in group A and 36 (45%) in group B achieved clinical pregnancy, which was not significantly different (p=0.67). Total number of oocytes retrieved (13.03±5.56 vs. 14.17±4.89, p=0.17), quality and number of embryos (7.42±3.35 vs. 7.63±3.28, p=0.68) and OHSS rate were similar in group A compared to group B. Endometrial thickness which was 9.66±1.67 mm in group A and 10.36±1.35 mm in group B, showed a significant difference (p=0.004). Conclusion: It seems that in PCOS patients, both pure FSH products used for controlled ovarian hyperstimulation have similar effects on ART outcome and can be used according to availability and patient acceptance without significant difference.
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.
Shokoufeh Bonakdaran, Zahra Mazloom Khorasani, Behrooz Davachi, Javad Mazloom Khorasani,
Volume 10, Issue 5 (10-2012)

Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in females of reproductive age. Insulin resistance is a frequent metabolic disturbance in PCOS. Vitamin D deficiency is a common problem. Accumulating evidence suggests that vitamin D has a role on insulin sensitivity so may contribute to reduction of hyperandrogenemia. Objective: The aim was to determine the effects of vitamin D treatment in metabolic components and ovulation evidence in PCOS. Materials and Methods: Fifty one untreated PCOS patients were randomly divided into three groups and treated with calcitriol, metformin, or placebo. Before and 3 months after treatment, ovulation evidence was assessed by ovarian trans abdominal sonography. Plasma fasting glucose, insulin, homeostasis model assessment insulin resistance (HOMA-IR), 25-hydroxyvitamin D, parathyroid hormone and androgen levels were measured before and after treatment. A 75gr glucose test was performed before and after treatment and two set of results was compared. Results: Three patients did not continue this study. Only 11 patient (22.9%) had sufficient vitamin D levels (>30 ng/ml). Metformin caused a significant decrease in weight (p=0.027), insulin level (p=0.043), and insulin resistance (p=0.048). Systolic blood pressure and PTH significantly improved after calcitriol (p=0.029, p=0.009 respectively). An improvement in ovulation was detected after calcitriol and seven patients, without evidence of ovulation before treatment, illustrated ovulation after 3 months. Difference with calcitriol in ovulation was significant versus other two methods (p=0.02). Conclusion: Calcitriol treatment in PCOS may be prior to metformin in ovulation induction.
Mohammad Hossein Gozashti, Ahmad Gholamhosseinian, Fatemeh Musavi, Mahdieh Mashrouteh,
Volume 11, Issue 1 (4-2013)

Background: Polycystic ovary syndrome (PCOS) causes an increased risk of metabolic cardiovascular syndrome. Also, cystatin C serum levels are associated with the risk of cardiovascular events in metabolic syndrome patients.
Objective: To investigate the relationship between cystatin C in PCOS patients.
Materials and Methods: 35 women with PCOS were compared to 35 women with healthy matched age and body mass index. They all underwent tests to determine plasma levels of C-reactive protein (CRP), cystatin C, lipid profile and apo-lipoprotein. Blood pressure and demographic variables of each subject were obtained.
Results: Systolic and diastolic blood pressure were higher in PCOS patients compared to control group. Triglyceride and low-density lipoprotein cholesterol levels were higher in PCOS; contrariwise, high-density lipoprotein was lower from that of healthy volunteers. Cystatin and CRP levels were significantly higher in patients with PCOS in comparison with healthy subjects (p<0.0001). Among measured determinants, only PCOS status was independently associated with cystatin C.
Conclusion: Cystatin C was positively correlated with PCOS status concentrations but not with systolic and diastolic blood pressure, or any of the lipid profile variables or demographic characteristics. Indeed, no correlation was found between cystatin C and CRP levels. Therefore, cystatin C might be related to PCOS beyond its use as a marker of the renal function.
Fahimeh Ramezani Tehrani, Maryam Daneshpour, Somayeh Hashemi, Maryam Zarkesh, Feridoun Azizi,
Volume 11, Issue 3 (5-2013)

Background: Polycystic ovary syndrome (PCOS) is a complex disease having both genetic and environmental components and candidate genes on obesity and insulin metabolism have been hypothesized to be involved in its etiology.
Objective: We examined the possible association of adiponectin and insulin receptor gene polymorphisms with PCOS.
Materials and Methods: A total of 186 women with PCOS using NIH criteria and 156 healthy women were recruited. Their samples were genotyped for the polymorphism in exon 17 and 8 of the insulin receptor gene or exon and intron 2 of the adiponectin gene.
Results: The distributions of genotypes and alleles of both polymorphisms were not different in women with PCOS and controls. There was no significant differences on the anthropometric and hormonal profiles of various adiponectin and insulin receptor genes polymorphisms among both groups.
Conclusion: Adiponectin and insulin receptor gene polymorphisms are not associated with PCOS in a sample of Iranian population.
Azadeh Nadjarzadeh, Razieh Dehghani Firouzabadi, Niloofar Vaziri, Hoorieh Daneshbodi, Mohammad Hassan Lotfi, Hassan Mozaffari-Khosravi,
Volume 11, Issue 8 (11-2013)

Background: There is some evidence regarding the effect of poly unsaturated fatty acid intake on androgen levels and gonadal function in polycystic ovary syndrome (PCOS).
Objective: This study was conducted to determine the effect of omega-3 supplementation on sex hormone-binding protein (SHBG), testosterone, free androgen index (FAI) and menstrual status in women with PCOS.
Materials and Methods: This double-blind randomized clinical trial was conducted on 78 overweight/obese women with PCOS. Participants were randomized to receive omega-3 (3gr/day) or placebo for 8 weeks. Data about weight, height and nutrient intake as well as blood samples were collected before and after intervention. Serum concentrations of testosterone (nmol/L) and SHBG (nmol/L) were measured. FAI was also calculated as the ratio of testosterone to SHBG.
Results: Seventy eight patients (age: 26.92±5.46 yrs, Body Mass Index: 31.69±4.84 Kg/m2) completed the study. There was no significant difference in mean age, weight, height, Body Mass Index and intake of energy, and macronutrients between 2 study groups before and after treatment. All the participants had irregular periods. After the trial the percentage of regular menstruation in the omega-3 group was more than the placebo group (47.2% vs. 22.9%, p=0.049). Furthermore, testosterone concentration was significantly lower in the omega-3 group compared with placebo, after supplementation (p=0.04). SHBG and FAI did not change in either group.
Conclusion: Omega-3 supplementation could reduce serum concentrations of testosterone and regulate menstrual cycle without significant effect on SHBG and FAI. Future studies with longer period of supplementation are warranted.
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.
Fatemeh Bazarganipour, Saeide Ziaei, Ali Montazeri, Fatemeh Foroozanfard, Soghrat Faghihzadeh,
Volume 11, Issue 9 (12-2013)

Background: A preliminary report indicated that the Iranian version of modified polycystic ovary syndrome health-related quality of life questionnaire (MPCOSQ) is a valid measure of health-related quality of life (HRQOL) in PCOS patients. Accordingly, the Iranian version of MPCOSQ was subjected to further psychometric analyses among a different sample of patients with PCOS.
Objective: To examine discriminant and convergent validity of the Iranian version of MPCOSQ.
Materials and Methods: This was a cross sectional study of 200 women with PCOS that was carried out in two private gynecology clinics in Kashan, Iran. Discriminant validity was assessed using the known groups comparison. Convergent validity was evaluated by assessing the correlation between similar content on the MPCOSQ and the SF-36.
Results: The mean scores for the MPCOSQ showed that women rated lowest on the infertility and menstrual subscales indicating worst health in these dimensions. The results from the SF-36 questionnaire indicated that emotional and vitality domains were the areas of poorest health. Known groups comparison showed that the MPCOSQ differentiated well between sub-groups of women who differed in PCOS specific symptoms, lending support to its discriminant validity. Convergent validity was assessed and as expected a good positive correlation was found between related subscales of the two instruments.
Conclusion: The MPCOSQ has now been extensively tested in Iran and can be considered for using as an outcome measure in future outcome studies in this population.
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.
Fatemeh Bazarganipour, Saeide Ziaei, Ali Montazeri, Fatemeh Foroozanfard, Anoshirvan Kazemnejad, Soghrat Faghihzadeh,
Volume 11, Issue 10 (12-2013)

Background: Most previous research has focused on polycystic ovary syndrome (PCOS) characteristics and their association with psychological disorders, such as anxiety and depression. Objective: In the present study, our aim was to study whether PCOS characteristics are associated with several aspects of psychological well-being namely self-esteem and body satisfaction. Materials and Methods: This was a cross-sectional study of 300 women with PCOS that was carried out in Kashan, Iran. Main outcome measures were the Body Image Concern Inventory (BICI) and the Rosenberg’s Self-Esteem Scale and clinical information of PCOS. Major clinical PCOS features including obesity (BMI), excessive body hair (hirsutism score), acne, menstrual cycle disturbances and infertility. Results: The findings of regression analysis indicated that infertile women had lower levels of self-esteem (=-0.11, p=0.049) and poorer body satisfaction (=0.121, p=0.036) compared with PCOS women without infertility. Furthermore, hirsute women experienced poorer self-esteem than women without hirsutism (=-0.124, p=0.032). Women with menstrual irregularities had higher body dissatisfaction (=0.159, p=0.005). Moreover, women with higher body mass index scores had poorer body satisfaction (=0.151, p=0.009) but were not associated with self-esteem. Conclusion: The emotional well-being of the patients presenting with the syndrome needs to be recognized more fully, particularly in relation to the low self-esteem, poor body image, and struggles with weight, menstrual irregularities, hirsutism and infertility. The results of this study raise implications for clinical practice and suggest that a multidisciplinary approach to the management of women with PCOS.

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