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Polycystic ovary syndrome （PCOS） is a reproductive endocrine disorder characterized by coexisting reproductive dysfunction and glucolipid metabolic disturbance， affecting 8%-13% of women of reproductive age and 3%-11% of adolescent females. Due to the highly heterogeneous clinical features， symptom-oriented individualized strategies are commonly adopted for the treatment of PCOS. Chronic low-grade inflammation is one of the core mechanisms for the occurrence of PCOS. Macrophages， as foundational cells of innate immunity， play an indispensable role in modulating systemic inflammatory responses. The imbalance of macrophage M1/M2 polarization is involved in chronic low-grade inflammation in PCOS via pathways such as activating pro-inflammatory responses， disrupting ovarian tissue repair， stimulating excessive synthesis of androgens， and promoting the occurrence of insulin resistance. Reshaping the phenotype of macrophages might serve as a potential therapeutic strategy for PCOS. Traditional Chinese medicine （TCM） holds that spleen deficiency and phlegm dampness is a crucial pathogenesis of PCOS. The spleen， being in charge of defensive function， plays a key role in ensuring normal physiological functions such as transportation and defense against external pathogen during the occurrence and development of PCOS. The imbalance of macrophage polarization resembles the transition from spleen being in charge of defensive function to spleen losing its defensive role in TCM. Therefore， this paper， for the first time， explores the deep connection between macrophage polarization and the pathogenesis of chronic low-grade inflammation in PCOS from the TCM theory of spleen being in charge of defensive function， providing theoretical support and new research directions for the treatment and drug research of PCOS.
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@#Objective To evaluate the effect of follicular fluid(FF)exosomal miRNAs on follicular dysplasia in patients with polycystic ovary syndrome(PCOS)mediated by glycolysis pathway of granulosa cells(GCs),and to explore the mechanism. Methods Three PCOS infertile patients and three non-PCOS infertile patients were recruited. The baseline hormone levels of the two groups were measured before ovulation induction. The bilateral FF was obtained by puncture after short-acting and long-term ovulation induction,and the exosomes were collected by ultracentrifugation and identified by transmission electron microscopy. The total exosomal RNA was extracted by Trizol method to construct the library,which was compared to the reference genome GRCh38 for statistical analysis after miRNA sequencing and quality control processing. Clustering Profiler R package was used to implement GO annotation analysis and KEGG pathway analysis of the differentially expressed genes(DEGs),and Omnipath software for miRNAs interaction analysis. A total of 16 miRNA were randomly selected and detected by qPCR to verify the accuracy of the miRNA sequencing results. Results Compared with the non-PCOS group,luteinizing hormone(LH),anti-Muerian hormone(AMH),testosterone and antral follicle counts in PCOS group increased significantly(t = 2. 479 ～ 9. 163,each P < 0. 05). The exosomes of FF in both groups showed the cup-shaped vesicles with clear edge and light staining in the center,with the diameters of 100 — 150 nm and intact structure,and the concentration was about 8 × 1010particles/mL. A total of 928 miRNAs were detected by miRNA sequencing. Compared with the non-PCOS group,59 differentially expressed miRNA(DEmiRNA)were screened out in exosomes of POCS group,of which 31 were up-regulated and 28 were down-regulated. The differential trend of gene expression detected by qPCR was highly similar to that of miRNA sequencing. In FF exosomes of PCOS patients,the glycolysis efficiency and apoptosis of GCs were significantly changed by miRNA regulating mRNA. PKM,PFKL and HK2 were the key target genes for miRNA to regulate GCs glycolysis,and SLC2A1 was the key target gene for miRNA to regulate GCs apoptosis. Conclusion The miRNAs in FF exosomes of PCOS patients can weaken the glycolysis of GCs while accelerate the apoptosis,thus reducing the production of ATP and lactic acid,resulting in follicular dysplasia.
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Poly cystic ovarian syndrome is a condition characterised by a wide range of signs and symptoms including menstrual irregularities, obesity, acne, hirsutism and is causing adverse effects on metabolic and endocrinal system. Exact etiology and pathophysiology is still unclear but it’s having a strong familial predisposition. This is a case report on an anovulatory infertility caused by PCOS. A 27-year-old female patient presented to the Streeroga OPD at ITRA On December 29, 2020, complaining of infertility, irregular and delayed menstruation, and weight gain over the past three years. She has been taking allopathic medicine for the same for the last two years. During her initial opd visit, she received a thorough medical history as well as all relevant clinical, physical, and laboratory tests. Bulky ovaries with polycystic morphology were discovered on sonography. Anovulatory factor infertility owing to PCOS was determined based on clinical symptoms and sonography. Pathadi choorna and Arogyavardhini rasa were chosen as medications and Samana oushadha was chosen as the line of management. The patient was counselled on lifestyle changes, the need of exercise, and correction of food habits. Patient was under medication for a period of 5 months. Patient got conceived after that and on 8th February 2022 she gave birth to a healthy male baby per vaginally with a baby weight of 3.2 kg.
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Secondary Infertility is defined as the inability to conceive following at least one prior conception. Ovulatory dysfunction contributes 30-40% of infertility. Polycystic ovarian syndrome is a common endocrinopathy typified by oligo/anovulation, signs of androgen excess, and multiple ovarian cysts. In Ayurveda, Vandhyatha (infertility) is considered as a complication of Yoni vyapath and is also considered as Artavavaha srotodushti lakshana. This is a case report of 30 years old lady complaining of inability to conceive a second child, heavy menstrual bleeding and curdy white discharge per vagina associated with itching. On USG, she was diagnosed with Polycystic Ovarian Syndrome. She also had severe allergic complaints and skin rashes. In this case treatment was given primarily to correct the Rakta dushti which was causing Artava dushti in the form of excessive bleeding. For that, initially in the bleeding phase, medicines for Rakta sthambana were given and after the stoppage of bleeding, medicines were given for correction of Rakta dushti. After achieving the menstrual regulation, the patient was given medicines for Vata kapha dushti for treating her Upaplutha condition. For the management of Yoni roga, she was given Sthanika karmas (local treatment) Yoni dhawana and Yoni pichu. Also local application of Nalpamaradi keram was done to reduce her vulval itching. The outcome of the treatment resulted in conception and delivered a full term female baby. So the present case signifies the effect of Ayurvedic management in the field of infertility.
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Polycystic Ovarian Syndrome (PCOS) is one of the most common endocrine disorders that affectingwomen in reproductive age. Incidence rate isabout5% to 10% in this age group. Nursesare in a position to improve attitude of individualsaffected with the syndrome, soenhancing the attitudeof nursing students regarding PCOS will help to modify attitude ofgeneral population. Aim of the study was to improve the attitudeof B.Sc. Nursing students regarding PCOS.Quasi experimental research approach,non-randomized control group pre-test-post–test design was used.80 B.Sc. Nursing students were selected by using purposivesampling technique.Likert scalewas used to collect the data from the samples.Result of the study revealed that in experimental group, mean pre-test attitude score was 54.70,more than half 75%of the nursing studentshad unfavorable attitude, 25%had moderately favorable attitudeand none of them had favorable attitude, Mean post-test attitudescore of B.Sc. Nursing students was 93.72, none of the nursing studenthad unfavorable attitude, 15% had moderately favorable attitudeand 85% had favorable attitude. In comparison group, Mean pre-test attitudescore of B.Sc. Nursing students was 55.22, more than half of the nursing students 87.5% had unfavorable attitude, 12.5%had moderately favorable attitudeand none of the nursing studenthad favorable attitude, Mean post-test attitudescore of B.Sc. Nursing students was 55.20, more than half of the nursing students 87.5% had unfavorable attitude, 12.5%had moderately favorable attitudeand none of the nursing student had favorable attitude.
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Growing evidence suggests that polycystic ovarian syndrome (PCOS) and Bronchial asthma coexist thanks to their common pathogenicity route. Both PCOS and Bronchial asthma has been associated with chronic low grade inflammation which results in hormonal disparity. One such case of a young woman with a medical history of Bronchial asthma presented with complaints of irregular menstrual cycle with amenorrhea and episodes of asthmatic attack once a month. The laboratory investigations including both blood and sonographic studies revealed the elevated absolute eosinophilic count, serum IgE and bilateral polycystic ovarian cyst. The Patient has been treated with internal medications and was advised to continue the physical activity such as walk for once a day and Pranayama (breathing exercise) as an adjunct to the treatment. After the treatment period of about 10 months, the outcome was assessed by both clinical prognosis as well as with USG report. The case study is about managing PCOS as well as bronchial asthma by Siddha therapeutic intervention and efficacy of the chosen drugs towards the ailments has also been explained with the help of preclinical studies conducted on the individual herbs of the formulation included in the study. This study could help to explore the therapeutic potential of Siddha medicine towards alleviating the low grade inflammation and hormonal imbalances associated with both Bronchial asthma as well as PCOS.
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BACKGROUND: The main features of polycystic ovary syndrome (PCOS) are abnormal follicular development and ovulatory dysfunction, which are caused by excessive apoptosis of ovarian granulosa cells. Acupuncture has been shown to improve follicular development abnormalities in patients with PCOS, but its mechanism is unknown. This study hypothesized that the mechanism of acupuncture on follicular development abnormalities in PCOS patients is the inhibition of granulosa cell apoptosis through LncMEG3-mediated regulation of miR-21-3p. METHODS: A PCOS-like rat model was established using subcutaneous injection of dehydroepiandrosterone (DHEA). Acupuncture was performed on rats for 15 d (CV-4, RN-3, CV-6, SP-6 and EX-CA 1). Ovarian morphology was observed by HE staining, and sex hormone and AMH levels were detected by ELISA. Primary granulosa cells were isolated from each group of rats to assess the association of acupuncture treatment, LncMEG3, miR-21-3p, and granulosa cell apoptosis in rats with PCOS. RESULTS: LncMEG3 and miR-21-3p were highly expressed in the ovarian granulosa cells of rats with PCOS, and LncMEG3-mediated regulation of miR-21-3p was involved in the development of PCOS in rats. Silencing of MEG3 attenuated sex hormone dysregulation and ovarian histopathological changes in PCOS rats and promoted follicle cell development and maturation. In addition, silencing MEG3 increased the viability and number of granulosa cells. In addition, silencing MEG3 further inhibited early and late apoptosis of ovarian granulosa cells in PCOS rats. Acupuncture improved polycystic ovarian morphology and sex hormone levels in PCOS rats. Acupuncture intervention increased the viability and number of granulosa cells. Acupuncture intervention inhibited early and late apoptosis of ovarian granulosa cells in PCOS rats by targeting miR-21-3p via LncMEG3. CONCLUSION: These results suggest that acupuncture can downregulate LncMEG3, thereby targeting and regulating miR-21-3p to suppress early and late granulosa cell apoptosis and normalize their proliferation. These factors ultimately compensate for abnormal follicular development. These findings shed light on the clinical potential of acupuncture as a safe treatment for follicular developmental abnormalities in PCOS. Highlights LncMEG3-mediated inhibition of miR-21-3p regulates ovarian granulosa cell apoptosis. LncMEG3 and miR-21-3p are involved in the occurrence and development of PCOS-related abnormal follicular development. CuONPs induce co-occurrence of autophagy activation and autophagic flux blockade. Acupuncture can improve the sex hormone levels and follicular development in the context of PCOS. The underlying mechanism of acupuncture in the treatment of PCOS abnormal follicular development was revealed.
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Humans , Animals , Female , Rats , Polycystic Ovary Syndrome/therapy , Acupuncture Therapy , MicroRNAs , RNA, Long Noncoding , Apoptosis , Granulosa CellsABSTRACT
Abstract Objectives The authors determined the level of Expression of Leptin (LEP) in Polycystic Ovary Syndrome (PCOS) patients with or without obesity and in GCs treated with insulin. Methods LEP expression was first assessed in ovary cortex specimens collected from women with PCOS with or without obesity as well as from healthy controls. Ovarian Granulosa Cells (OGCs) induced by insulin extracted from a mouse model were used in further functional research. Results Real-time PCR and western blotting indicated that LEP expression was upregulated in GCs induced by insulin, in comparison with that in GCs not induced by insulin. Furthermore, the knockdown of LEP resulted in a reduction in growth and multiplication and an increase in apoptosis and inflammation in GCs induced by insulin. Next, the authors evaluated the effect of LEP on three key pathways of inflammation (MAPK, NF-kB, and JAK1/STAT3); results showed that the JAK1/STAT3 pathway was induced by LEP knockdown, as evidenced by the upregulation of phosphor-JAK1, phosphor-STAT3, and nuclear STAT3 expression. Administration of curcumin, a specific inhibitor of STAT3, counteracted the effect of LEP knockdown on cell inflammation and apoptosis. Conclusion The present data suggest that upregulation of LEP expression in the PCOS granulosa cell model is essential for reducing apoptosis and inflammation by modulating the JAK1/STAT3 pathway axis.
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ObjectiveTo explore the effects and mechanisms of Kaiyu Zhongyutang on insulin resistance， glucose and lipid metabolism， psychological state， and embryo outcome in the infertile patients with polycystic ovary syndrome （PCOS） due to liver depression and kidney deficiency. MethodThe 126 infertile patients with PCOS due to liver depression and kidney deficiency who underwent in vitro fertilization-embryo transfer （IVF-ET） in the Department of Reproduction of the affiliated hospital of Nanjing university of Chinese medicine were randomly assigned into the observation （Kaiyu Zhongyutang + metformin） and control （metformin） groups. The two groups were compared in terms of traditional Chinese medicine （TCM） syndrome scores， body mass index （BMI）， glucose and lipid metabolism， homeostasis model assessment-insulin resistance （HOMA-IR）， interleukin （IL）-6， IL-8， C-reactive protein （CRP）， self-rating depression scale （SDS） score， self-rating anxiety scale （SAS） score， and clinical and laboratory scores of IVF after treatment. Result① After treatment， the observation group showed decreased scores of primary and secondary TCM syndromes and total TCM syndrome score （P < 0.05）， and the control group presented decreased scores of irritability and depression and total TCM syndrome score （P<0.05）. Compared with the control group， the observation group demonstrated reduced primary and secondary syndrome scores and total score after treatment （P<0.05）. ② After treatment， both groups showed decreased BMI， lowered levels of fasting insulin （FINS）， fasting plasma glucose （FPG）， cholesterol （TC）， triglyceride （TG）， low-density lipoprotein （LDL）， and HOMA-IR （P<0.05）， and elevated high-density lipoprotein （HDL） level （P<0.05）. Moreover， the observation group had lower BMI， FINS， FPG， TC， TG， LDL， and HOMA-IR and higher HDL than the control group （P<0.05）. ③ The treatment in both groups lowered the levels of IL-6， IL-8， and CRP and decreased SDS and SAS scores （P<0.05）. Moreover， the declines in the observation group were more obvious than those in the control group （P<0.05）. ④ Correlation analysis before treatment， IL-6， IL-8， and CRP had positive correlations with BMI， HOMA-IR， TC， TG， LDL， SDS， and SAS （P<0.05） and a negative correlation with HDL （P<0.05）. ⑤ The observation group showed reduced gonadotropin （Gn） using days and total Gn dose and higher two-pronuclear （2PN） fertilized oocytes， 2PN cleavage rate， normal fertilization rate， D3 transferable embryo number， D3 high-quality embryo number， high-quality embryo rate， and blastocyst formation rate than the control group （P<0.05）. ConclusionKaiyu Zhongyutang can treat PCOS patients by improving the emotional and reproductive functions and alleviating insulin resistance and glucose and lipid metabolism disorders. Moreover， it can reduce the Gn dose and Gn using days in the IVF process， improve the quality and maturity of eggs， increase the egg fertilization rate， enhance the potential of embryo development， and increase the rate of blastocyst formation by inhibiting inflammation.
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Aim To explore the regulatory effect of Cangfudaotan Decoction on the ovarian Toll receptor 4 (TLR4)/nuclear transcription factor kBp65 (NF-κB p65) signaling pathway in obese PCOS-IR rats. Methods Forty-eight female rats were randomly divided into normal group (n = 8) and model group (n = 40). The obese PCOS-IR rats were established by letrozole (1 mg · kg
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ObjectiveTo investigate the mechanism of Xiaonang Tiaojing decoction（XNTJD）in improving polycystic ovary syndrome with insulin resistance（PCOS-IR）model rats based on anti-Müllerian hormone（AMH）/AMH type Ⅱ receptor（AMHRⅡ）signaling pathway. MethodForty-eight adult female SD rats were randomly divided into the blank group， model group， XNTJD group（11.4 g·kg-1·d-1） and Diane-35 group（0.21 g·kg-1·d-1）， PCOS-IR model was established by high-fat and high-sugar diet combined with letrozole in rats of all groups except the blank group， rats in the administration groups were given the corresponding dose of drugs by gavage for 15 days with an interval of 1 d every 4 d， normal saline of the same volume was given to the blank group and the model group. Estrous cycle was recorded daily during treatment. At the end of treatment， body weight and Lee's index were recorded， AMH， luteinizing hormone（LH）， LH/follicle stimulating hormone（FSH）， testosterone（T）and estradiol（E2）levels were measured by enzyme-linked immunosorbent assay（ELISA）， fasting plasma glucose（FPG）was measured by glucometer， fasting insulin（FINS） level was measured by radioimmunoassay（RIA）， and the insulin resistance index（HOMA-IR） and insulin sensitivity index（QUICKI）were calculated， triglyceride（TG）and total cholesterol（TC）levels were measured by automatic biochemical analyzer， hematoxylin-eosin（HE）staining was used to observe the morphological changes of the ovary， the levels of AMHRⅡ， bone morphogenetic protein-15（BMP-15）and Smad5 in ovarian tissues were detected by immunohistochemistry（IHC），Western blot was used to analyze the protein expression levels of AMHRⅡ， BMP-15 and Smad5. ResultCompared with the blank group， a large number of leukocytes were observed in the vaginal exfoliated cells of rats in the model group， mainly in diestrus， the levels of body weight， Lee's index， glucose-lipid metabolism indexes（FPG， FINS， HOMA-IR， TG， TC）， AMH and sex hormones（LH， LH/FSH， T）were significantly increased（P<0.01）， and QUICKI and E2 levels were significantly decreased（P<0.01）， there were more cystic bulges on the ovarian surface， more wet weight， more atretic and cystic dilated follicles in the ovarian tissues， and the thickness of granulosa cell layer was reduced without oocytes， the expression level of AMHRⅡ protein in ovarian tissues was significantly increased（P<0.01）， and the expression levels of BMP-15 and Smad5 proteins were significantly decreased（P<0.01）. Compared with the model group， the exfoliated cells in the vagina of rats treated with XNTJD group showed keratinocytes from the 5th to 6th day of treatment， and a stable estrous cycle gradually appeared， body weight， Lee's index， glucose-lipid metabolism indexes（FPG， FINS， HOMA-IR， TG， TC）， AMH and sex hormones（LH， LH/FSH， T）levels were significantly decreased（P<0.05， P<0.01）， QUICKI and E2 levels were significantly increased（P<0.01）， ovarian surface was smoother and lighter in wet weight， oocytes and mature follicles were observed in ovarian tissues， the thickness of granulosa cell layer increased and the morphology was intact， the expression levels of BMP-15 and Smad5 proteins were significantly increased（P<0.01）and the expression level of AMHRⅡ protein was significantly decreased（P<0.01）in ovarian tissues. ConclusionXNTJD may mediate the up-regulation of BMP-15 and Smad5 in ovarian tissues of PCOS-IR rats by down-regulating AMH/AMHRⅡ， thereby improving ovarian function， sex hormones and glucose-lipid metabolism levels in PCOS-IR rats.
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【Objective】 To investigate the role of LIF/LIFR/STAT3 pathway in endometrial receptivity in rats with polycystic ovary syndrome (PCOS). 【Methods】 Forty 21-day-old SD female rats were divided into normal (control) group, model group, sham-operation group, and LIF group with 10 rats in each. The rat model of PCOS was constructed by subcutaneous injection of prasterone sodium sulfate at the back of the neck. The serum levels of testosterone (T), glucose and insulin in each group were detected. The morphological changes of the uterus in each group were observed by HE staining, and the morphological changes of endometrium were measured. Immunohistochemistry, Western blotting, and Real-time fluorescence quantitative PCR(qRT-PCR) were used to determine the protein expression and mRNA expression of LIF and STAT3 in rat endometrium. 【Results】 Compared with control group, the levels of integrin avb3, serum T, insulin and glucose in PCOS rats were significantly increased (P=0.000, P=0.000, P=0.001). Supplementation of exogenous LIF could significantly reduce the levels of integrin avb3, serum T, glucose and insulin in PCOS rats (P=0.000, P=0.002, P=0.003, P=0.007). HE results showed that exogenous LIF could reduce uterine cavity and glandular morphology in PCOS rats and increase the equivalent diameter (P=0.000, P=0.000) and area (P=0.000, P=0.000) of uterine glands and glandular cavity, the ratio of glandular interstitial area (P=0.000), and the average endometrial thickness (P=0.006), with statistically significant differences. Immunohistochemistry, Western blotting, and qRT-PCR results showed that the expression levels of LIF and p-STAT3 protein and mRNA in model group were significantly decreased compared with control group. Compared with model group, the protein and mRNA expressions of LIF and p-STAT3 in LIF group were significantly increased (P<0.05). 【Conclusion】 Exogenous LIF supplementation can improve endometrial receptivity in PCOS rats, and its mechanism is related to the LIF/LIFR/STAT3 pathway.
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Polycystic Ovarian Syndrome (PCOS) is one of the most common metabolic and reproductive disorders among women of reproductive age. It is characterized clinically as a combination of ovulatory dysfunction, hyper androgenic state and abnormal ovarian morphology. Women with PCOS are at increased risk of presenting with menstrual irregularities, hirsutism, obesity, insulin resistance, impaired glucose tolerance, Type 2 Diabetes mellitus, dyslipidemia and cardiovascular problems. PCOS being a syndrome cannot be correlated with any particular disease in Ayurveda. Hence for the better comprehension of this disease in terms with Ayurveda, the diseases mentioned in Ayurveda classics manifesting with signs and symptoms of PCOS have been studied in detail in relation with Nidana, Dosha, Srotas involved and their management. Diseases like Vandhya, Arajaska, Nashtarthava, Arthavakshaya and Pushpagni jathaharini shows resemblance in signs and symptoms and to some extend these can be related with PCOS
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Background: Polycystic ovarian syndrome (PCOS) is the most common and distressing disorder of reproductive age group female which include symptoms like amenorrhea, hirsutism, obesity, acne, infertility etc. Because of these distressing symptoms PCOS has been associated with significant psychiatric morbidity. Aims & objectives: 1.To study the sociodemographic characterstics of females with PCOS. 2.To find out the frequency of different symptoms in females suffering from PCOS. 3.To study the prevalence of anxiety and depression among females suffering from PCOS. Materials & methods: 30 consecutive female patients attending gynae OPD from 1/3/2022 to 1/4/2022 suffering from PCOS as per Rotterdam criteria diagnosed by a consulatant gynaecologist were taken for the study. They were thoroughly evaluated on a specially designed semistructred proforma,GHQ-12,Hamilton anxiety rating scale, Beck's depression inventory and PCOS questionnaire. Results were analysed using suitable statistics. Result and conclusion: Majority (60%) of the patients were from the age group 25-30 years. Most common symptom of PCOS in the patient was menstrual irregularity(90%) followed by obesity(80%), hirsutism(50%), acne(40%), alopecia(20%) and acanthosis nigricans(10%), 33%of the patients showed clinically significant anxiety symptoms, 10% shown clinically significant depression and 10% showed mixed anxiety depression disorders.
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Background- Polycystic ovary syndrome (PCOS) is major endocrine and metabolic disease in reproductive women. As per latest procedures, letrozole should be taken as the first-line pharmacological treatment for infertile women with PCOS. This study was planned to study the role of clinical profile in ovulation induction after letrozole therapy among infertile women with polycystic ovarian syndrome. This was a prospective analytical observational st Methods- udy carried out at the IVF centre, SMS Medical College, Jaipur. The present study enrolled 100 patients attending the IVF centre for fertility treatment who were diagnosed with PCOS as per Rotterdam criteria. Anthropometric measurements like Body mass index (BMI calculated as weight in kilograms divided by square of height in meters) and waist circumference (the smallest circumference at the level of umbilicus) was taken. A comprehensive physical examination of all patients was done to note signs of clinical hyperandrogenism like acne, alopecia, and hirsutism. Treatment response was defined as ovulation in response to letrozole in doses from 2.5 mg to 7.5 mg. In this study, women from 20 to 25 years of age w Results- ith shorter duration of infertility, lower BMI, lower waist circumference, absence of hirsutism, or mild hirsutism on clinical examination showed better response to Letrozole. ConclusionLetrozole can be considered a suitable ovulation induction agent in infertile PCOS patients with lower BMI, lower waist circumference, and absence of hirsutism. A predictive ovulation score can be developed from basic clinical parameters. Identification of various factors affecting response to letrozole may help the clinician to individualize ovulation induction protocols in PCOS women.
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ABSTRACT Objective: Despite the treatment of anovulation, infertility is still one of the main complications in PCOS women during reproductive age, which appears to be mainly due to impaired uterine receptivity. This study investigated the transcriptome profiles of endometrium in PCOS patients and healthy fertile individuals as the control group. Material and methods: Total mRNA was extracted from endometrial tissues of PCOS patients (n = 12) and healthy fertile individuals (n = 10) during the luteal phase. After cDNA synthesis, PCR array was performed using Human Female Infertility RT² Profiler PCR Array kit (Qiagen, Cat. No: PAHS-164Z) for evaluating expression of 84 genes contributing to the female infertility. Results: PCR Array data analysis identified significantly greater expression of CSF, IL11, IL15, IL1r1, IL1b, TNF, LIF, TNFRSF10B, TGFβ, C3, ITGA4 (Cd49d), SPP1, and Calca in PCOS women than in controls (P < 0.05). However, the expression of LIFR, C2, CD55, CFD, CALCA, LAM1, LAMC2, MMP2, MMP7, MMP9, ESR, SELL, ITGB3, and VCAM1 was significantly lower in PCOS group than in controls (P < 0.05). The results revealed dysregulation of immune-inflammatory molecules, complement activation and downregulation of IGF-I as well as adhesion molecules in PCOS group. Conclusion: The findings of this study indicated some potential causes of reduced receptivity of endometrium thus compromising the fertility in PCOS patients.
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Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among women of reproductive age. A convergent association between polycystic ovary syndrome (PCOS) and periodontal disease, in particular chronic periodontitis (CP), has recently been proposed. The underlying molecular mechanisms of this association are not fully understood, though it is thought that chronic inflammation is responsible. Aim: To assess the awareness of periodontal health status and systemic inflammation of women receiving medical treatment for PCOS and women newly diagnosed with PCOS. Materials and methods: A total of 500 PCOS diagnosed women were recruited based on convenience sampling and completed a survey containing questions related to demography, lifestyle preferences, PCOS awareness and periodontal awareness. Results: Lack of awareness of oral hygiene and its importance on overall treatment of PCOS was observed. Conclusion: There is a dire need of generating oral hygiene awareness via health centres, internet, media etc. and providing full information about the association of PCOS with Oral hygiene, so that many symptoms of PCOS can be overcome after strictly following oral hygiene measures.
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This narrative review has brought forward the recent important findings of polycystic ovary syndrome (PCOS) which is regarded as a prevalent endocrinological and metabolic disorder with several clinical features. Treatment for PCOS differs according to the presenting problems, underlying cause, age and requirements of the individuals. The review has discussed the status of PCOS in India separately, its etiologies, diagnosis and updated points of management. The phenomena of Insulin Resistance and its management have been discussed by reviewing various published works and the pathophysiologic relationship between PCOS and infertility has been discussed in detail. The role of hyperinsulinemia and Insulin Sensitivity in PCOS is discussed in detail with the relevant pathophysiological mechanism. Overall, this review is clinically significant and has discussed the essential points of a multisystem disorder (PCOS).
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Objective:To determine the frequency of dyslipidemia in patients of PCOS in BVH Bahawalpur.Material and methods:This cross sectional study was conducted at Department of Pathology, Quaid-e-Azam Medical College, Bahawalpur. Total 286 patients with PCOS having age 18-35 years were selected for this study. Total 3 ml fasting blood sample was taken from every patient for total cholesterol, LDL, HDL & Triglycerides. Results:Mean age of the patients was 24.40 ± 5.367 and mean BMI was 21.01 ± 1.912. Out of 286 patients of polycystic ovarian syndrome (PCOS) dyslipidemia was found in 69 (24.13%) patients. Statistically significant association between dyslipidemia and age of the patients was noted with p value 0.000. Significant association between BMI and dyslipidemia was noted with p value 0.000.Conclusion:Findings of this study showed higherpercentage of dyslipidemia in cases of PCOS. Age of the patients and BMI was significantly associated with dyslipidemia.
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Background:Polycystic ovary disease (PCOD) isacommon endocrine disorder, whichis mainlycharacterized by infertility,anovulation, hyperinsulinemia, dyslipidaemia, biochemical imbalance. In our present study we have evaluated the effect of NAC in womensuffering from PCOD in terms oftheir clinical, metabolic and hormonal parameters. Material And Methods:We conducted this prospective study for a period of 5 months on 60 women who are affected with PCOD (diagnosed by Rotterdam criteria) of age group 18–30 year, visiting OPD of obstetrics and gynaecology department of Acharya Vinobha Bhave Rural Hospital (AVBRH) Jawaharlal Nehru Medical College (J.N.M.C) located in Sawangi (Meghe), Wardha. Patients who had oligo/amenorrhoea, hirsutism (hyperandrogenism) and ultrasound finding (Polycystic ovaries) were included in this study. Clinical, metabolicparameter and hormonal profile were measured pre and post treatment with NAC. Result:Fifty-six patients who received tab N acetylcysteine 600 mg three times a day, shown improvement in BMI, waist circumference, WHR, fasting glucose, fasting insulin and total testosterone level after a period of 3 months but no significant reduction in weight. Conclusion:It has been concluded that longer treatment with N-acetyl cysteine may result in more desirable outcomes and more effective control of clinical symptoms of PCOS, hyperandrogenism, and carbohydrate parameters. So, NAC can be used as a insulin sensitizer drug for PCOS women.