Search

Polycystic ovary syndrome (PCOS) is characterized by the association of androgen excess with chronic oligoovulation and/or polycystic ovarian morphology, yet metabolic disorders and classic and nonclassic cardiovascular risk factors cluster in these women from very early in life. This chapter focuses on the mechanisms underlying the association of PCOS with metabolic dysfunction, focusing on the role of androgen excess on the development of visceral adiposity and adipose tissue dysfunction.

Context: Polycystic ovary syndrome (PCOS) is defined most commonly according to the proceedings of an expert conference sponsored by the National Institutes of Health (NIH) in April 1990, which noted the disorder as having 1) hyperandrogenism and/or hyperandrogenemia, 2) oligoovulation, and 3) exclusion of known disorders. Alternatively, another expert conference held in Rotterdam in May 2003 defined PCOS, after the exclusion of related disorders, by two of the following three features: 1) oligo- or anovulation, 2) clinical and/or biochemical signs of hyperandrogenism, or 3) polycystic ovaries. In essence, the Rotterdam 2003 expanded the NIH 1990 definition creating two new phenotypes: 1) ovulatory women with polycystic ovaries and hyperandrogenism, and 2) oligoanovulatory women with polycystic ovaries, but without hyperandrogenism. Objective: The objective of this study was to ascertain the validity of using the Rotterdam 2003 criteria rather than the NIH 1991 criteria for the diagnosis of PCOS. Interven...

Background. The relationship between tubal cornual polyps and endometriosis and ovulatory disorders in infertile women is unclear. Our objective was to determine such an association from our database and review the literature.Methods. Twenty-two infertile women with tubal cornual polyps were assessed for coexistence of oligoovulation/anovulation and endometriosis with stratification for polyp diameter (large: ≥5 mm diameter, small Result(s). Oligoovulation/anovulation was more prevalent in women with large versus small tubal cornual polyps (P=0.0048). Endometriosis was associated with both large and small polyps.Conclusion(s). This case series confirms the association of tubal cornual polyps with oligoovulation/anovulation and endometriosis in infertile women. This case series is limited by a lack of controls.

El síndrome de ovario poliquístico (SOP) es la endocrinopatía más frecuente en mujeres en edad reproductiva, se observa en el 5-7% de ellas. El diagnóstico se hace ante la presencia de por lo menos dos componentes de la triada: oligoovulación, hiperandrogenismo y ovarios poliquísticos. Estas mujeres tienen niveles elevados de lutropina (LH), hiperinsulinemia e hiperandrogenismo y se ha reportado un aumento en la incidencia de aborto en este grupo de pacientes. Este hecho podría estar relacionado con los cambios endometriales observados en estas mujeres y que se asocian a niveles elevados de andrógenos e insulina, provocando así, inadecuada implantación y probablemente mayor pérdida del embarazo en el primer trimestre. Medidas terapéuticas, como el uso de sensibilizantes a la acción de la insulina, que contribuyen a disminuir los niveles de insulina y por lo tanto de andrógenos, podrían tener un efecto favorable al disminuir la incidencia de aborto en pacientes con SOP.

The records of 159 women who underwent 561 cycles of donor insemination (AID) in the UCD artificial insemination program were analyzed in a study of the relationship of the numbers of motile sperm seen in the cervical mucus 48 hours after AID with subsequent ferblity. The numbers of motile sperm were expressed on an integral rank scaie (0 to 8). A relationship between the results and subsequent fertility was demonstrated. The distribution of the data on sperm numbers for fertile and infertile cycles were qualitatively and quantitatively different. The latter were consistently skewed toward low values, while the former were not. Overall, mean values were higher for conception cycles. Selective grouping of women to eliminate factors that could potentially have an adverse influence on fertility, such as pelvic abnormality, oligoovulation,or prior pelvic operation, increased the overall conception rate. However, they did not influence the relationship between low and high motile sperm numbers and subsequent conception.

SUMMARY Polycystic ovary syndrome (PCOS) is a heterogeneous endocrine disorder with variable prevalence, affecting about one in every 15 women worldwide. The diagnosis of polycystic ovary syndrome requires at least two of the following criteria: oligoovulation and/or anovulation, clinical and/or biochemical evidence of hyperandrogenism and morphology of polycystic ovaries. Women with PCOS appear to have a higher risk of developing metabolic disorders, hypertension and cardiovascular disorders. The aim of this article was to present a review of the literature by searching the databases Pubmed and Scielo, focusing on publications related to polycystic ovaries, including its pathogenesis, clinical manifestations, diagnosis and therapeutic aspects, as well as its association with cardiovascular and arterial hypertensive disorders. RESUMO A síndrome dos ovários policísticos (SOP) é uma desordem endócrina heterogênea com prevalência variável, que afeta cerca de uma em cada 15 mulheres no mundo. O diagnóstico da SOP requer, pelo menos, dois dos seguintes critérios: oligo-ovulação e/ou anovulação, evidência clínica e/ou bioquímica de hiperandrogenemia e morfologia dos ovários policísticos. As mulheres com SOP parecem ter um risco mais elevado de desenvolver distúrbios metabólicos, hipertensão e doenças cardiovasculares. O objetivo deste artigo foi apresentar uma revisão da literatura por meio de pesquisa nas bases de dados PubMed e Scielo, focada em publicações relacionadas com ovários policísticos, incluindo patogênese, manifestações clínicas, diagnóstico e aspectos terapêuticos, bem como associação com doenças cardiovasculares e hipertensão arterial.