Uterine Function: From Normal to Polycystic Ovarian Syndrome Alterations

2018 ◽  
Vol 25 (15) ◽  
pp. 1792-1804 ◽  
Author(s):  
Silvana R. Ferreira ◽  
Alicia B. Motta
Keyword(s):  
Endometrial Cancer ◽  
Adhesion Molecules ◽  
Polycystic Ovarian Syndrome ◽  
Cellular Proliferation ◽  
Steroid Receptors ◽  
Reproductive Age ◽  
Present Review ◽  
Implantation Failure ◽  
Uterine Function ◽  
Ovarian Syndrome

Background: The endometrium is one of the most important female reproductive organs. Polycystic ovarian syndrome (PCOS) is a reproductive and endocrine pathology that affect women of reproductive age. PCOS negatively affects the endometrium, leading to implantation failure and proliferative aberrations. Methods: We conducted a search at the http://www.ncbi.nlm.nhi.gov/pubmed/electronic database using the following key words: endometrial steroid receptors, endometrium, uterine function, endometrium and PCOS, implantation window, implantation and PCOS, implantation markers, inflammation, oxidative stress. We selected the articles based on their titles and abstracts, then we analyzed the full text and classified the articles depending on the information provided according to the sections of the present review. Results: The endocrine and metabolic abnormalities displayed in women with PCOS promote complex effects on the endometrium, leading to a low rate of implantation and even infertility. Women with PCOS show alterations in the Hypothalamic-Pituitary- Ovarian axis, which results in constant circulating levels of estrogen, similar to those at the early follicular phase, and a deficiency in the withdrawal of estrogen and progesterone. Besides this deficiency in the withdrawal of estrogen and progesterone, the insulin/ glucose pathway, adhesion molecules, cytokines and the inflammatory cascade, together with the establishment of a pro-oxidative status, lead to an imbalance in the uterine function, which in turn leads to implantation failure or even endometrial cancer. Conclusion: Women with PCOS display a dysregulation of the Hypothalamic-Pituitary- Ovarian axis, which alters the steroid pathway. In addition, the deficiency in the withdrawal of estrogen and progesterone in the endometrium results in abnormal endometrial cellular proliferation. The imbalance in adipose tissue observed in PCOS patients reinforces the increase in circulating hormones. The present review describes the role of hormones, metabolites, cytokines, adhesion molecules and the insulin/glucose pathway related to the uterine endometrium in women with PCOS and their role in implantation failure and development of endometrial cancer.

scholarly journals To Study the Effect on Fertility Outcome by Gonadotropins vs Laparoscopic Ovarian Drilling in Clomiphene-resistant Cases of Polycystic Ovarian Syndrome

2017 ◽  
Vol 9 (4) ◽  
pp. 336-340 ◽  
Author(s):  
Richa Singh ◽  
Meenal Jain ◽  
Poonam Yadav ◽  
Sarvesh Awasthi ◽  
Pallavi Raj
Keyword(s):  
Statistical Analysis ◽  
Ovulation Induction ◽  
Polycystic Ovarian Syndrome ◽  
Polycystic Ovary ◽  
Clomiphene Citrate ◽  
Reproductive Age ◽  
Multiple Pregnancies ◽  
Laparoscopic Ovarian Drilling ◽  
Ovarian Drilling ◽  
Ovarian Syndrome

ABSTRACT Introduction The polycystic ovary syndrome (PCOS) is the most common condition associated with chronic anovulation affecting 4 to 6% of reproductive age women. Aim To compare the effectiveness of laparoscopic ovarian drilling (LOD) for ovulation induction with gonadotropins in clomiphene-resistant PCOS in terms of ovulation, pregnancy, live birth, abortion, multiple pregnancies, and complication like ovarian hyperstimulation syndrome (OHSS). Setting and design A prospective hospital-based randomized trial. Materials and methods It was a prospective study, which was carried out from January 2012 to May 2015. Totally, 89 women were evaluated in the study, out of which 44 women were in gonadotropin group and 45 were in LOD group. Statistical analysis Standard statistical analysis was done and significance of difference in results was tested by chi-square test. Results Ovulation rate in gonadotropin group was 75.0% at 6 months, whereas in LOD group, it was 20% at 3 months and was increased up to 66.66% after addition of clomiphene citrate and gonadotropin. The primary outcome in terms of pregnancy in gonadotropin group was 45.45% after 6 cycles and in LOD group was 11.11% after 3 cycles and 40.00% after 6 cycles with supplementation of clomiphene citrate and gonadotropin. Conclusion The ongoing pregnancy rate from ovulation induction with LOD alone was significantly less but if supplemented by clomiphene citrate and gonadotropin, it seems equivalent to ovulation induction with gonadotropin, but the former procedure carries a lower risk of multiple pregnancies. How to cite this article Yadav P, Singh S, Singh R, Jain M, Awasthi S, Raj P. To Study the Effect on Fertility Outcome by Gonadotropins vs Laparoscopic Ovarian Drilling in Clomiphene-resistant Cases of Polycystic Ovarian Syndrome. J South Asian Feder Obst Gynae 2017;9(4):336-340.

scholarly journals An Ayurvedic Approach in Management of Poly Cystic Ovarian Syndrome

2020 ◽  
Vol 11 (4) ◽  
pp. 644-649
Author(s):  
Saroj Kumari ◽  
Sarvesh Kumar Singh ◽  
Kshipra Rajoria ◽  
Avadhesh Kumar
Keyword(s):  
Polycystic Ovarian Syndrome ◽  
Dietary Habits ◽  
Reproductive Age ◽  
Herbal Drugs ◽  
Polycystic Ovaries ◽  
Female Population ◽  
Hormonal Imbalance ◽  
Hormonal Dysfunction ◽  
Cardinal Feature ◽  
Ovarian Syndrome

Polycystic ovarian syndrome (PCOS) is a probably fastest growing endocrinological disorder in females of reproductive age. In PCOS, follicular growth is influenced by hormonal imbalance during the ovarian cycle, leads to affected follicles remain in the ovary. The prevalence of PCOS is estimated 6-10% globally and 3.7% - 22.5% in Indian female population, which is relatively high. It is characterised by hyperandrogenism, anovulation and polycystic ovaries which clinically manifests in the terms of amenorrhea or oligomenorrhea, hirsutism, acne, infertility etc. In present scenario, incidence of this disease increasing exponentially due to sedentary lifestyle and faulty dietary habits. This particular disease is not described word to word in Ayurveda. Associated features of PCOS are closely resembling with Bandhya Yonivyapada, Artavavahasrotasa-Vidhha Lakshana, Nastartava and Ksheenaartava described by Acharya Sushruta and Pushpghani Jatharini and Vikuta Jatharini mentioned by Acharya Kashyap. Maximum congruence of PCOS can be established with Bandhya Yonivyapada. The purpose of this study is to understand Nastartava which is the cardinal feature of Bandhya. Word Artava has been used exclusively in Samhita in context of menstrual blood, ovum and ovarian hormones. Therefore Amenorrhea, anovulation, hormonal dysfunction is considered exposed manifestations of Nastartava. Possible line of treatment is stipulated with Nidanaparivarjan, herbal drugs and Panchakarma procedures. Keywords- Ayurveda, Artava, Nastartava, PCOS, Herbal drugs, Panchakarma

scholarly journals Phenotypic Variation of Insulin Resistance among Polycystic Ovarian Syndrome Patients in Semiurban North Indian Population

2021 ◽  
Author(s):  
Chaitali Maitra ◽  
Ramesh Chandra Gupta ◽  
Rishika Raj
Keyword(s):  
Insulin Resistance ◽  
Regression Analysis ◽  
Polycystic Ovarian Syndrome ◽  
Specific Treatment ◽  
Reproductive Age ◽  
Model Assessment ◽  
Cross Sectional ◽  
Significant Difference ◽  
Ovarian Syndrome ◽  
Rotterdam Criteria

Introduction: Polycystic Ovarian Syndrome (PCOS) is a common endocrine disorder in the women of reproductive age. Studies show that there is an intensive relationship between insulin and gonadal function. As per Rotterdam Criteria, there are four major phenotypes of PCOS with different presentation. Early detection of Insulin Resistance (IR) and consequential prevention of Metabolic Syndrome (MS) associated with PCOS may lead to better prospect for the disease. Aim: To find the pattern of IR in all the phenotypes of PCOS in relation to Waist Hip Ratio (WHR), Body Mass Index (BMI) and Testosterone and thereby, providing data for designing phenotype specific treatment of the disease. Materials and Methods: In this cross-sectional observational study, fasting insulin and fasting glucose were analysed to calculate Homeostasis Model Assessment (HOMA-IR) and Testosterone for total 144 female subjects of reproductive age group (18-40 years). Subjects were classified in to four groups as per Rotterdam Criteria. Complete PCOS (PCO-COM), PCO with Oligo/Anovulation (PCO-O), Anovulation with Hyperandrogenism (O-HA), and PCO with Hyperandrogenism (PCO-HA). Regression analysis was done to find the relation among the study variables. Analysis of Variance (ANOVA) was used to analyse the significant variance among the groups. Results: IR was found to be maximum among O-HA phenotype (2.4±0.37) and lowest among PCO-HA phenotypes (1.3±0.22). Regression analysis shows that there exist significant associations between IR and BMI (t=4.96, p=0.001) as well as between IR and WHR (t=2.97, p=0.003). No independent association between testosterone and IR was observed. Conclusion: Significant difference of IR, WHR, and BMI was observed among the four phenotypes of PCOS. Due to increased IR, O-HA and PCO-COM phenotypes are more predisposed to Cardiometabolic consequences of PCOS.

scholarly journals Pregnancy Complications in Women with PCOS

2019 ◽  
Vol 3 (5) ◽  
Keyword(s):  
Pregnancy Loss ◽  
Polycystic Ovarian Syndrome ◽  
First Trimester ◽  
Reproductive Age ◽  
Multiple Pregnancies ◽  
Proper Understanding ◽  
Life Styles ◽  
Reproductive Age Women ◽  
Increased Risk ◽  
Ovarian Syndrome

The Polycystic ovarian syndrome affects 6-15 % of reproductive age women worldwide. And recently the changing life styles and rising obesity worldwide have contributed to a rise in the incidence of PCOS. Though there are many issues with PCOS post conception. PCOS women are at increased risk of early pregnancy loss which is approx. three fold as compared to the women without PCOS. After successfully crossing the first trimester, they are at risk of developing pre- eclampsia, GDM, preterm birth and birth of small for gestational age infant. Also higher incidence of multiple pregnancies is there and the risks associated with them. All these leading to higher rate of c -section delivery. So, proper understanding of these risks, informing and counseling the patients regarding them facilitate closer maternal and fetal surveillance and help improving the outcome of pregnancy.

scholarly journals Short Review on Polycystic Ovarian Syndrome

2017 ◽  
Vol 19 (1) ◽  
pp. 49-53
Author(s):  
Rabia Farooq
Keyword(s):  
Polycystic Ovarian Syndrome ◽  
Endocrine System ◽  
Short Review ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
The World ◽  
Long Time ◽  
System Disorder ◽  
Ovarian Syndrome

Polycystic ovarian syndrome (PCOS) is a metabolic disease and a common endocrine system disorder among women of reproductive age. Infrequent or prolonged menstrual periods, excess hair growth, acne, and obesity can occur in women with PCOS. Early diagnosis and treatment along with weight loss may reduce the risk of long-term complications. Now a days PCOS is also the cause of infertility. India is PCOS capital of the world. PCOS management is necessary to reduce its long time complications.J MEDICINE Jan 2018; 19 (1) : 49-53

scholarly journals Study of cutaneous manifestations of polycystic ovarian syndrome

2020 ◽  
Vol 9 (4) ◽  
pp. 1627
Author(s):  
Sukhleen Kaur ◽  
Sunil K. Gupta ◽  
Sunil K. Juneja ◽  
Sukhjot Kaur ◽  
Monika Rani
Keyword(s):  
Insulin Resistance ◽  
Acanthosis Nigricans ◽  
Polycystic Ovarian Syndrome ◽  
Free Testosterone ◽  
Reproductive Age ◽  
Common Finding ◽  
Serum Prolactin ◽  
Endocrine Disorders ◽  
Cutaneous Manifestations ◽  
Ovarian Syndrome

Background: Polycystic ovarian syndrome (PCOS) is one of the most frequently encountered endocrine disorders that occurs in as many as 4 to 10% of women of reproductive age group. It presents with a series of skin changes including acne, hirsutism, seborrhea, androgenetic alopecia (AGA) and acanthosis nigricans. Aim of the study was to determine the prevalence and frequency of different cutaneous manifestations in PCOS patients and to correlate them with the degree of hormonal abnormalities.Methods: A total 100 patients with features of PCOS who presented to department of dermatology, gynecology (January 2018-December 2019) with cutaneous manifestations were recorded and diagnosis of PCOS was made using Rotterdam’s criteria. Pregnant women and diagnosed cases of any other endocrine disorder were excluded. Hirsutism was assessed using Ferriman-Gallwey score and AGA according to Ludwig’s classification. Serum hormonal profile including FSH, LH, prolactin, testosterone (free), DHEAS, TSH, FBS, fasting insulin were done. Insulin resistance was determined by calculating HOMA-IR score.Results: Among cutaneous manifestations of PCOS, hirsutism (85%) was the most common finding followed by acne (73%), seborrhea (50%), AGA (36%), acanthosis nigricans (29%) and acrochordons (9%). The most common hormonal abnormality was insulin resistance in 53% patients, followed by raised free testosterone in 19% and serum prolactin in 18% patients. A statistically significant association was present between AGA and insulin resistance, hirsutism and raised prolactin levels, seborrhea and raised body mass index (p < 0.05).Conclusions: Dermatological manifestations of PCOS play a significant role in making the diagnosis and constitute a substantial portion of the symptoms experienced by women with this syndrome.

scholarly journals Effect of progressive resisted exercises and aerobic exercises in the management of polycystic ovarian syndrome among young women- A pilot randomized controlled trial

Biomedicine ◽  
2020 ◽  
Vol 39 (4) ◽  
pp. 608-612
Author(s):  
Veena Kirthika S. ◽  
Jibi Paul ◽  
Senthil Selvam P. ◽  
Sathya Priya V.
Keyword(s):  
Polycystic Ovarian Syndrome ◽  
Exercise Intervention ◽  
Controlled Trial ◽  
Free Testosterone ◽  
Reproductive Age ◽  
Group A ◽  
Young Subjects ◽  
Group B ◽  
Ovarian Syndrome ◽  
Hormonal Levels

Introduction and Aim: Polycystic ovarian syndrome (PCOS) is a heterogenous, multisystem endocrinopathy in women of reproductive age also called as Stein Leventhal syndrome. PCOS is a common female endocrine disorder with prevalence ranging from 2.2% to 26%. Prevalence of PCOS in Indian adolescents is 9.13%. This draws attention to the issue of early diagnosis in adolescent girls. The aim of this study was to determine the effect of progressive resisted exercises (PRE) and aerobic exercises in the management of subjects with PCOS. Materials and Methods: This was an experimental comparative pre and post-test type study. The subjects in the age group of 18-25 years with the diagnosis of PCOS were selected based on Rotterdam criteria and with the BMI ranging between 25-29. Twenty four subjects were recruited and were randomly divided into two groups. group A was treated with PRE +aerobic exercises + diet and group B with aerobic exercises + diet. The duration of the study was 24 weeks and the outcome measures used were BMI, PCOSQ and hormonal levels (SHBG, Free testosterone, HOMA IR, Hs CRP) Results: The result of the study showed that group A treated with PRE + aerobic exercises + diet had significant improvement in BMI at P?0.05 and PCOSQ and specific hormonal levels at P?0.001 when compared to group B. Conclusion: A 24 weeks exercise intervention with a combined PRE +aerobic exercises +diet was superior to aerobic exercises +diet among young subjects with PCOS. Keywords: BMI; quality of life; PRE; PCOSQ; Hormones.

scholarly journals The effect of progressive muscle relaxation on depression in polycystic ovarian syndrome

2018 ◽  
Vol 7 (8) ◽  
pp. 3029
Author(s):  
Jyoti Parle ◽  
Aishwarya D. Savant
Keyword(s):  
Polycystic Ovarian Syndrome ◽  
Polycystic Ovary ◽  
Muscle Relaxation ◽  
Progressive Muscle Relaxation ◽  
Reproductive Age ◽  
Ovary Syndrome ◽  
Exclusion Criteria ◽  
Before And After ◽  
Muscle Groups ◽  
Ovarian Syndrome

Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among women of reproductive age. Authors explored the effects of progressive muscle relaxation (PMR) on depression in females with polycystic ovarian syndrome (PCOS).Methods: In a 4-week study duration in which the intervention was for three times a week, 30 females which were selected according to the inclusion and exclusion criteria received a PMR protocol in which subjects were taught to contract and relax 16 muscle groups. The Becks Depression Inventory (BDI) was taken before and after the intervention as a depression analysis tool.Results: After 4 weeks of intervention, the patients showed significant improvement in depression (P < 0.05).Conclusions: In conclusion, this study suggests that PMR practice is effective in improving depression, in patients with PCOS.

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