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Objective: To investigate the independent effects of irisin on insulin resistance (IR) in ovary of polycystic ovary syndrome (PCOS) and explore possible pathways. Methods: We established PCOS medel using Poretsky L's method, then PCOS rats were randomly divided into model group (M) and irisin group (I), and normal rats (N) were used as the control. Then rats in the group I were injected with recombinant irisin. Then the levels of circulating fasting blood glucose (FBG), fasting insulin (FINS), homeostasis model assessment of IR (HOMA‐IR) and PI3K/AKT and MAPK/ERK pathways in each group were observed, as well as the effects of irisin on the levels of circulating HOMA‐IR and PI3K/AKT and MAPK/ERK pathways in ovary of PCOS rats were evaluated. Results: Compared with normal group, levels of FBG, FINS, and HOMA‐IR of model group were significantly increased (p < 0.001, p < 0.001, and p < 0.001, respectively), levels of average optical density by IHC of p‐PI3K, PI3K, p‐AKT, and AKT (p = 0.015, p = 0.010, p = 0.005, and p = 0.009, respectively) and levels of mRNA concentration of PI3K and AKT (p = 0.001, and p = 0.005, respectively) were decreased, while the levels of average optical density of p‐ERK, ERK (p = 0.011, and p = 0.013, respectively) and level of mRNA concentration of ERK (p < 0.001) were increased in ovary. After irisin intervention, compared with model group, levels of FBG, FINS, and HOMA‐IR of rats in irisin group were significantly decreased (p = 0.001, p < 0.001, and p < 0.001, respectively), levels of average optical density by IHC of p‐PI3K, PI3K, p‐AKT, and AKT (p = 0.030, p = 0.024, p = 0.012, and p = 0.025, respectively) and levels of mRNA concentration of PI3K and AKT (p = 0.002, and p = 0.003, respectively) were significantly increased, while the levels of average optical density of p‐ERK, ERK (p = 0.004, and p = 0.026, respectively) and level of mRNA concentration of ERK (p = 0.001) were significantly decreased. Conclusion: Our study demonstrated that irisin could not only improve circulating insulin resistance, but may also improve ovarian IR through an increase in the activity of PI3K/AKT signaling and a decrease of MAPK/ERK signaling. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the relationship between AMH and ovarian response to controlled ovarian hyperstimulation in women with PCOM and PCOS. Methods: A retrospective study was conducted on 559 patients who underwent the IVF‐ET cycle between January 2018 and December 2022 at Gangnam Cha Hospital. Patients were divided into 3 groups matched for age and BMI: the PCOS group (n = 54), based on the new 2023 PCOS guideline; the PCOM group (n = 53); and the control group (n = 452) with normal ovaries. Serum AMH levels were converted to multiples of the median (MoM) for each corresponding age. The ovarian sensitivity index (OSI) was calculated as the number of retrieved oocytes divided by the total dose of recombinant FSH administered (per 1000 IU). Results: There were significant differences in AMH‐MoM value among women with PCOS [2.7 ± 1.3 (95% CI 2.3–3.0)], those with PCOM [2.0 ± 1.0 (95% CI 1.7–2.3)], and controls [0.8 ± 0.7 (95% CI 0.8–0.9)] (p < 0.001). The abortion rates in the normoovulatory, PCOM, and PCOS groups were 18.2%, 21.1%, and 25.0%, respectively. OSI and live birth rate were positively correlated with the AMH‐MoM value in normoovulatory women (r = 0.389, p < 0.05, r = 0.122, p < 0.05), while no such correlation was observed in women with PCOM and PCOS. Conclusions: Ovarian response and live birth rate are possibly correlated with the AMH‐MoM value in normoovulatory women, but not in women with PCOM and PCOS. [ABSTRACT FROM AUTHOR]

Introduction: Polycystic ovary syndrome (PCOS) is an endocrine and metabolic disturbance that affects many women worldwide and is characterized by chronic anovulation, hyperandrogenism, and ovarian dysfunction. Placenta-derived mesenchymal stem cells (PDMSCs) are derived from the placenta and have advantages over other sources of MSCs in terms of availability, safety, and immunomodulation. Materials and methods: In this experimental study, twenty female Wistar rats were assigned to four groups (n = 5) including control, sham, PCOS, and PCOS+PDMSCs groups. Then, PCOS was induced in the rats through administering letrozole for 21 days. PDMSCs (1 × 106 cells) were injected through the tail vein. Fourteen days after the cell infusion, evaluation was performed on the number of healthy follicles, corpus luteum, and cystic follicles as well as the levels of testosterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), fasting blood glucose, fasting insulin, and insulin resistance. Moreover, the serum levels of cholesterol, triglyceride (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL) were measured. Liver function was also determined by the evaluation of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels. Results: The number of corpus luteum and primordial, primary, secondary, and antral follicles was significantly elevated in the PCOS+PDMSCs group compared to the PCOS group. However, the number of cystic follicles significantly decreased in the PCOS+PDMSCs group. The LH and testosterone levels also decreased significantly, while FSH levels increased significantly in the PCOS+PDMSCs group. The levels of fasting blood glucose, fasting insulin, and insulin resistance notably decreased in the PCOS+PDMSCs group. Moreover, the lipid profile improved in the PCOS+PDMSCs group along with a significant decrease of cholesterol, LDL, and TG and an increase in HDL. The PCOS+PDMSCs group exhibited marked decreases in the AST and ALT levels as well. Conclusion: The results of this study suggest that PDMSCs are a potential treatment option for PCOS because they can effectively restore folliculogenesis and correct hormonal imbalances, lipid profiles and liver dysfunction in a rat model of PCOS. However, further research is needed to establish the safety and effectiveness of PDMSCs for treating PCOS. [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder impacting women's health and quality of life. This scoping review explores the use of the Internet of Things (IoT) in PCOS management. Results were grouped into six domains of the IoT: mobile apps, social media, wearables, machine learning, websites, and phone-based. A further domain was created to capture participants' perspectives on using the IoT in PCOS management. Mobile apps appear to be useful for menstrual cycle tracking, symptom recording, and education. Despite concerns regarding the quality and reliability of social media content, these platforms may play an important role in disseminating PCOS-related information. Wearables facilitate detailed symptom monitoring and improve communication with healthcare providers. Machine learning algorithms show promising results in PCOS diagnosis accuracy, risk prediction, and app development. Although abundant, PCOS-related content on websites may lack quality and cultural considerations. While patients express concerns about online misinformation, they consider online forums valuable for peer connection. Using text messages and phone calls to provide feedback and support to PCOS patients may help them improve lifestyle behaviors and self-management skills. Advancing evidence-based, culturally sensitive, and accessible IoT solutions can enhance their potential to transform PCOS care, address misinformation, and empower women to better manage their symptoms. [ABSTRACT FROM AUTHOR]

Gynaecological conditions (e.g., endometriosis, PCOS) result in bodily changes that negatively impact body image. Psychological interventions (e.g., CBT, psychoeducation) have shown promise in reviews with the general population for alleviating body image concerns. This systematic review and meta-analysis aims to provide asynthesis of the impact of psychological interventions for reducing body image concerns for individuals with gynaecological conditions. Electronic databases were searched for relevant psychological intervention studies with body image outcomes. Twenty-one eligible studies were included in the systematic review (ten were included in a random-effects meta-analysis). Studies included participants (N = 1483, M = 71.85, SD = 52.79) with a range of gynaecological conditions, ages (Mage = 35.08, SD = 12.17) and cultural backgrounds. Most included studies reported at least one positive effect with the meta-analysis indicating psychological interventions were moderately superior to control conditions for reducing body image concerns (SMD -.41, 95% CI [−0.20 −0.62]). However, there was a high risk of bias and moderate heterogeneity. Results suggest psychological interventions may hold promise for reducing body image concerns among individuals gynaecological conditions in the short term. Further, preliminary support was found for the use of theory-guided psychological interventions delivered in group settings in particular, with further research needed on optimal intervention length and particular psychotherapeutic approach. [ABSTRACT FROM AUTHOR]

Polycystic ovarian syndrome (PCOS) is a widely prevalent endocrine disorder. The multifaceted clinical presentation of PCOS requires a comprehensive approach, addressing not only the biological aspects but also holistic dimensions, encompassing psychological, emotional, social, and spiritual factors for optimal clinical outcomes. Current management primarily emphasizes the biological dimension, utilizing pharmaceutical interventions and some lifestyle modifications. Despite promising outcomes, the precise approach, rationale, and efficacy of naturopathy and yoga in PCOS management have not been thoroughly investigated. A comprehensive literature search was conducted using various databases to identify relevant studies. The evidence gathered was synthesized and organized around the following key themes: consultation, nutrition, fasting, herbs, elemental therapies, massage, yoga, acupuncture, and sustainable health principles. While this review provides insights that could enhance the understanding of the naturopathic approach in PCOS management, it emphasizes the need for future clinical trials and systematic reviews to validate these findings. [ABSTRACT FROM AUTHOR]

In the pathogenesis of polycystic ovary syndrome (PCOS), despite the importance of autophagy and transforming growth factor-β1 (TGF-β1), there is scarce information about their inter-relationship. Therefore, here we assessed the correlations between beclin-1, a cornerstone in autophagy, and TGF-β1 in a letrozole-induced PCOS rat model. Accordingly, a total of 45 female adult albino Wistar rats were randomly assigned into control, vehicle (carboxymethyl cellulose), and PCO groups. To establish the PCOS model, letrozole (1.0 mg/kg body wt., p.o.) was given once daily for three successive weeks. Circulating levels of luteinizing hormone, follicle-stimulating hormone, testosterone, estradiol, and progesterone were assayed along with ovarian total antioxidant capacity (TAC), protein carbonyl content (PCC), beclin-1 level, and TGF-β1 level. Ovarian morphology and ultrastructure were examined by hematoxylin and eosin staining and electron microscopy, respectively. Compared to control groups, hormonal levels and ovarian morphology in the letrozole-exposed animals indicated the successful construction of the PCOS model. Further, the PCO group exhibited an oxidative stress status reflected by a significant decrease in ovarian TAC and a significant elevation in the PCC. Moreover, ovarian beclin-1 and TGF-β1 levels were significantly increased with an enhancement of autophagy as revealed by electron microscopy. In multiple linear regression models, only TGF-β1 was observed in the final model where it explained the 62.3% variability of Beclin-1. In conclusion, the ovarian level of TGF-β1 might be a determinant factor of beclin-1 level in PCOS which may provide new insight into the pathophysiology and therapy of the disease. [ABSTRACT FROM AUTHOR]

Background: It is hypothesized that fenugreek seeds are a rich source of fiber with anti-diabetic effects, which can help to lower blood glucose in patients with polycystic ovary syndrome (PCOS). In this study, the clinical and metabolic effects of fenugreek were compared to those of metformin in women with PCOS aged 16-40 years. Methods: In a randomized, triple-blind, parallel clinical trial, the efficacy of fenugreek 333 mg (n=55) was compared with metformin 500 mg (n=55), both administered three times a day in women with PCOS of reproductive age. Changes in some clinical outcomes and metabolic laboratory profile outcomes were evaluated at baseline and two months after the study. Results: By the end of the intervention period, all investigated factors improved significantly in patients of both groups (p<0.05). Reduction in biometric indices (body mass index and waist–hip ratio), fasting blood sugar (FBS), and insulin resistance was significantly higher after metformin consumption (p<0.001). Metformin also significantly improved irregular menstruation (p=0.02). In contrast, fenugreek significantly improved patients' lipid profiles, including low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglyceride (TG) compared to metformin (p<0.001). Both interventions improved the patient's hair loss and hirsutism. Conclusion: Fenugreek cannot substitute metformin in PCOS treatment. However, regarding its lipid-lowering ability and low frequency of adverse effects, it can be used as an adjuvant treatment in PCOS, especially in PCOS patients with hyperlipidemia and severe hair loss. [ABSTRACT FROM AUTHOR]

Aim: To investigate the effects of short-term oral intake of spironolactone on parathyroid hormone (PTH) and calcium levels, as well as other biochemical and clinical parameters in normotensive female patients with polycystic ovary syndrome (PCOS). Method: 32 PCOS patients were studied at baseline and three months after regular intake of a daily dose of 50 mg or 100 mg spironolactone. PTH, calcium and other biochemical tests as well as clinical parameters were evaluated at baseline and after three months. Results: Body mass index and serum PTH levels decreased significantly after treatment (p: 0.021 andp: 0.043, respectively). Mean high-density lipoprotein was significantly decreased after treatment (p: 0.011). No significant change was observed in calcium, phosphorus, total cholesterol, triglycerides, and fasting blood glucose levels. Serum testosterone and dehydroepiandrosterone sulphate decreased significantly after 3 months of therapy (p: 0.000 andp: 0.006; respectively). Conclusions: In our study, taking spironolactone at a dose of 100 mg/day lowered PTH levels and had a positive effect on weight loss and insulin resistance. New studies are needed to investigate the effects of treatment with spironolactone on bone and metabolism. It is recommended to monitor dyslipidemia while taking the drug. [ABSTRACT FROM AUTHOR]

Introduction: Polycystic ovarian syndrome (PCOS) is prevalent among women, impacting health and quality of life. The present study aimed to investigate the effect of adding whole-body vibration (WBV) to the traditional treatment of PCOS. Material and methods: Forty-six women diagnosed with PCOS, aged 20 to 35 years, with BMI 25-29.9 kg/m², were randomly divided into two equal groups. The study group followed an iso-caloric, low-glycemic diet and performed aerobic exercises in addition to WBV, and the control group followed an iso-caloric, low-glycemic diet and performed aerobic exercise only (n = 23 each). Treatment lasted for eight weeks, three sessions per week. BMI, waist-hip ratio (WHR), and LH/FSH ratio were assessed pre- and post- treatment. Insulin resistance was assessed by HOMA-IR (Homeostatic Model Assessment for Insulin Resistance) pre- and post-treatment. Results: Significant decreases in weight, BMI, HOMA-IR, and LH/FSH ratio were noted between the two time points (before and after-treatment) in both groups (p < 0.05). However, WHR only showed a significant decrease in the study group (p < 0.05). Compared to the control group, the study group showed a significant reduction in weight (-8.08 kg vs. - 4.39 kg, p = 0.0009), BMI (-2.99 kg/m² vs. -1.6 kg/m², p = 0.004), WHR (-0.05 vs. -0.018, p = 0.009), HOMA-IR (-1.54 vs. - 0.77, p = 0.03), and LH/FSH ratio (-0.53 vs. -0.5, p = 0.02) after eight weeks of treatment. Conclusions: Adding WBV to aerobic exercise appears to have favourable outcomes for patients with PCOS. [ABSTRACT FROM AUTHOR]

Background: This study was designed to evaluate the effects of low-frequency electroacupuncture (EA) on glucose and lipid disturbances in a rat model of polycystic ovary syndrome (PCOS) characterized by insulin resistance (IR) and hepatic steatosis. Methods: The PCOS rat model was induced by continuous administration of letrozole (LET) combined with a high-fat diet (HFD). Female Sprague–Dawley rats were divided into the following four groups: control, control + EA, LET + HFD and LET + HFD + EA. EA was administered five or six times a week with a maximum of 20 treatment sessions. Body weight, estrous cyclicity, hormonal status, glucose and insulin tolerance, lipid profiles, liver inflammation factors, liver morphology and changes in the phosphatidylinositol 3-kinase (PI3-K)/Akt (protein kinase B) pathway were evaluated. Results: The rat model presented anovulatory cycles, increased body weight, elevated testosterone, abnormal glucose and lipid metabolism, IR, liver inflammation, hepatic steatosis and dysregulation of the insulin-mediated PI3-K/Akt signaling axis. EA reduced fasting blood glucose, fasting insulin, area under the curve for glucose, homeostasis model assessment of IR indices, triglycerides and free fatty acids, and alleviated hepatic steatosis. Furthermore, low-frequency EA downregulated mRNA expression of tumor necrosis factor (TNF)-α and interleukin (IL)-6, upregulated mRNA expression of peroxisome proliferator-activated receptor (PPAR)-α, increased protein expression of phosphorylated (p)-Akt (Ser473), p-glycogen synthase kinase (GSK) 3β (Ser9) and glucose transporter 4 (GLUT4), increased the ratio of p-GSK3β to GSK3β and downregulated protein expression of GSK3β. Conclusion: An obese PCOS rat model with IR and hepatic steatosis was successfully established by the combination of LET and HFD. EA improved dysfunctional glucose and lipid metabolism in this PCOS-IR rat model, and the molecular mechanism appeared to involve regulation of the expression of key molecules of the PI3-K/Akt insulin signaling pathway in the liver. [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome (PCOS) is a widely prevalent condition that affects approximately 5-10% of women of reproductive age. Although first described in the 18th century, a detailed account of the disease was not provided until Stein and Leventhal's 1935 report. Due to the varied symptomatology of PCOS, treatment must be tailored and often involves using multiple drugs for optimal pharmacotherapy. Berberine, an alkaloid with a longstanding history of use, has gained popularity as a potential treatment option for PCOS. Previous studies have demonstrated that berberine can improve hormonal imbalances by reducing testosterone and FAI, increasing SHBG, and mitigating the clinical symptoms of androgen excess, including hirsutism and acne. Moreover, berberine enhances the therapeutic effects of other drugs commonly used in PCOS, such as metformin and oral contraceptive pills. It is generally well-tolerated with a favourable safety profile. However, further research is warranted to establish conclusive evidence regarding berberine's mechanistic underpinnings, therapeutic potential, and long-term safety as a PCOS treatment modality. [ABSTRACT FROM AUTHOR]

Aim: To assess the reproductive outcome after ovarian drilling by laparoscopic technique, and also to analyze a number of penetrations per ovary to improve the ART outcome. Materials and methods: A retrospective study was performed at Sudha Hospital and Research Institute, Erode, Tamil Nadu over a period from January 2018 to December 2020. This study includes 254 infertile women with polycystic ovary syndrome (PCOS) and clomiphene–citrate resistance, who were subjected to ovarian drilling by laparoscopy using a drilling needle. Patients are divided into 2 groups, 1st group had less than 4 penetrations per ovary and 2nd group had above 4 penetrations per ovary. The results elicited from both the groups were compared. Results: The 2 groups did not show any significant difference about body mass index (BMI), insulin, and glucose levels before and after the procedure. The confirmed pregnancy was 79.2% in the group with 4 punctures and it was 74.6% in the group with more than 4 punctures. The miscarriage rate was 8.1% and 13.9% in the group with punctures less than 4 and more than 4 respectively. Significant improvement (p-value = 0.029) in live birth rate (70.3%) was observed in the group with less than 4 punctures. Conclusion: Ovarian drilling is a successful treatment in patients with clomiphene citrate-resistant PCOS. A remarkable improvement was observed in the confirmed pregnancy rate in patients who were subjected to ovarian drilling. It was observed that 4 penetrations per ovary were adequate to increase the outcome in comparison to more than 4 punctures per ovary. [ABSTRACT FROM AUTHOR]

Objective: The primary aim of this study was to investigate the effects of autologous intrauterine platelet-rich plasma (IU-PRP) infusion during ovulation induction with clomiphene citrate (CC) on endometrial thickness (EMT) and clinical pregnancy in patients with polycystic ovary syndrome (PCOS) and thin endometrium. The secondary outcome was to detect possible transformations in oligomenorrheic cycles after PRP. Methods: This study was conducted on 35 anovulatory PCOS patients aged between 22 and 29 years who applied for infertility treatment. The patients had a thin endometrium in their past history. EMT 7 mm was considered thin endometrium. The diagnosis of PCOS was made according to the revised Rotterdam criteria. A total of 35 patients were divided into two groups according to whether they received PRP or not. Twenty patients received CC plus PRP treatment, whereas 15 patients received CC treatment alone. Patients in both groups were administered CC at a dose of 100 mg/day for 5 days, starting from the 3rd day of progesterone-related withdrawal bleeding. Follicular development and EMT were recorded using transvaginal ultrasonography. In cases with EMT <7 mm, approximately 0.5-1 mL of autologous PRP was infused with the IUI catheter, four days after CC treatment, i.e., on the ninth day of the cycle. EMT was measured and recorded again 3 and 6 days after PRP. Timed intercourse was recommended for cases with a follicle with a mean diameter of at least 16-18 mm. The biochemical and clinical pregnancy rates of both groups were recorded. Results: Both groups were similar in terms of participant age and body mass index. All participants in the CC plus PRP group were successfully infused with autologous PRP on the ninth day of the cycle. The serum estradiol, testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and LH/FSH ratios of both groups were similar. Biochemical pregnancy and clinical pregnancy rates of the CC plus PRP group were significantly higher than those of the CC alone group (p<0.03 and p<0.02, respectively). Although clinical pregnancy was detected in 5 individuals in the PRP group (25%), clinical pregnancy was recorded in 2 individuals in the CC alone group (13.3%). There was no significant change in the oligo/anovulatory cycle patterns of patients with and without PRP. EMT values on the sixth (4.96±2.11 mm vs. 4.68±2.47 mm, p<0.37) and eighth days were similar between the two groups (5.11±3.10 mm vs. 5.29±3.01 mm, p<0.51). Compared with the CC alone group, the EMT values measured both at day 12 (6.34±1.09 mm vs. 5.47±3.90 mm, p<0.02) and at day 15 (7.44±2.60 mm vs. 6.23±2.70 mm, p<0.01) in the PRP group were found to be significantly higher. Conclusion: IU-PRP infusion in PCOS patients with thin endometrium who underwent ovulation stimulation with CC significantly increased both EMT and clinical pregnancy rates. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Women of reproductive age are frequently affected with Polycystic Ovarian Syndrome, an endocrine disorder that causes anovulation and infertility. There is a paucity in the evidence of comparing the effectiveness of the Swiss ball and resistance training among PCOS subjects. Purpose: To compare the effect of Swiss ball exercise and Resistance training in symptoms females with Polycystic Ovarian Syndrome. Materials and Method: A total of 30 subjects were selected from Private Institute. As outcome measures, the menstrual irregularity questionnaire (MIQ), BMI, and abdominal girth measurement were used. Subjects were divided randomly into resistance training group (n = 15) received exercises with dumbbells and Swiss ball training group (n = 15) received exercises with Swiss ball, in addition to aerobic exercise. Results: Females with PCOS symptoms in RTG experienced statistically significant improvement in BMI from 28.3 ± 3.3 to 25.3 ± 3.3, in Abdominal girth 93.6 ± 4.6 to 88.8 ± 4.6, in MIQ 18.3 ± 3.8 to 13.5 ± 3.3, with a p value of < 0.05 than in SBG which had BMI from 28.3 ± 3.7 to 27.9 ± 3.5, Abdominal girth 93.6 ± 5.3 to 92.6 ± 5.3, MIQ 18.1 ± 3.5 to 16.4 ± 3.8, with a p value < 0.05. Conclusion: In comparison to a Swiss ball exercise, resistance training programme combined with aerobic activity is more effective at helping women with PCOS symptoms. [ABSTRACT FROM AUTHOR]

Background: Ploy cystic ovary syndrome (PCOS) is a common gynecological disorder affecting between 4-20% of females worldwide. Curcumin, the active ingredient in turmeric (Curcuma longa Zingiberaceae) is a yellow polyphenol with a wide range of pharmacological activities such as antioxidant, anti-inflammatory, anti-tumor, neuroprotective and cardioprotective properties. Methods: Letrozole was used to induce PCOS in female Wistar rats. Curcumin, metformin, or a combination of both was given to assess their therapeutic effects. Body weight, estrogen, progesterone, testosterone, and glucose levels were measured after disease induction and at the conclusion of treatment. Additionally ovarian histomorphology was examined after sacrificing the animals and removal of the ovaries. Results and conclusion: Weight was significantly reduced in the curcumin, metformin and curcumin and metformin combination groups. Testosterone was decreased, progesterone was increased, and normal ovarian morphology was restored in the three groups. Conclusions: curcumin is therapeutically effective for PCOS and is comparable to metformin. [ABSTRACT FROM AUTHOR]

Purpose Polycystic ovary syndrome (PCOS) is a complex genetic trait and the most common endocrine disorder of women, clinically evident in 5% to 15% of reproductive-aged women globally, with associated cardiometabolic dysfunction. Adipose tissue (AT) dysfunction appears to play an important role in the pathophysiology of PCOS even in patients who do not have excess adiposity. Methods We undertook a systematic review concerning AT dysfunction in PCOS, and prioritized studies that assessed AT function directly. We also explored therapies that targeted AT dysfunction for the treatment of PCOS. Results Various mechanisms of AT dysfunction in PCOS were identified including dysregulation in storage capacity, hypoxia, and hyperplasia; impaired adipogenesis; impaired insulin signaling and glucose transport; dysregulated lipolysis and nonesterified free fatty acids (NEFAs) kinetics; adipokine and cytokine dysregulation and subacute inflammation; epigenetic dysregulation; and mitochondrial dysfunction and endoplasmic reticulum and oxidative stress. Decreased glucose transporter-4 expression and content in adipocytes, leading to decreased insulin-mediated glucose transport in AT, was a consistent abnormality despite no alterations in insulin binding or in IRS/PI3K/Akt signaling. Adiponectin secretion in response to cytokines/chemokines is affected in PCOS compared to controls. Interestingly, epigenetic modulation via DNA methylation and microRNA regulation appears to be important mechanisms underlying AT dysfunction in PCOS. Conclusion AT dysfunction, more than AT distribution and excess adiposity, contributes to the metabolic and inflammation abnormalities of PCOS. Nonetheless, many studies provided contradictory, unclear, or limited data, highlighting the urgent need for additional research in this important field. [ABSTRACT FROM AUTHOR]

With the emergence of the age of information, the data on reproductive medicine has improved immensely. Nonetheless, healthcare workers who wish to utilise the relevance and implied value of the various data available to aid clinical decision-making encounter the difficulty of statistically analysing such large data. The application of artificial intelligence becoming widespread in recent years has emerged as a turning point in this regard. Artificial neural networks (ANNs) exhibit beneficial characteristics of comprehensive analysis and autonomous learning, owing to which these are being applied to disease diagnosis, embryo quality assessment, and prediction of pregnancy outcomes. The present report aims to summarise the application of ANNs in the field of reproduction and analyse its further application potential. [ABSTRACT FROM AUTHOR]

Hyperandrogenemia and polycystic ovary syndrome are a result of the imbalance of androgen levels in females. Androgen receptor (Ar) mediates the effect of androgen, and this study examines how neuronal Ar in the central nervous system mediates metabolism under normal and increased androgen conditions in female mice. The neuron-specific ARKO mouse (SynARKO) was created from female (Ar fl/wt; synapsin promoter driven Cre) and male (Ar fl/y) mice. A glucose tolerance test revealed impaired glucose tolerance that was partially alleviated in the SynARKO-dihydrotestosterone (DHT) mice compared with Con-DHT mice after 4 months of DHT treatment. Heat production and food intake was higher in Con-DHT mice than in Con-veh mice; these effects were not altered between SynARKO-veh and SynARKO-DHT mice, indicating that excess androgens may partially alter calorie intake and energy expenditure in females via the neuronal Ar. The pAkt/Akt activity was higher in the hypothalamus in Con-DHT mice than in Con-veh mice, and this effect was attenuated in SynARKO-DHT mice. Western blot studies show that markers of inflammation and microglia activation, such as NF-kB p-65 and IBA1, increased in the hypothalamus of Con-DHT mice compared with Con-veh. These studies suggest that neuronal Ar mediates the metabolic impacts of androgen excess in females. [ABSTRACT FROM AUTHOR]

Introduction: Polycystic Ovary Syndrome (PCOS) is a complex disorder with diverse clinical presentations. Women with PCOS use traditional, complementary, and integrative medicines, including Ayurveda (traditional Indian medicine) to manage their symptoms. Therefore, it is important to understand the current evidence base and the potential areas that require further research. Objective: This novel study aimed at providing a description of the Ayurveda studies conducted on women with PCOS and identifying gaps for future research. Methods: This scoping review was undertaken using the Joanna Briggs Institute scoping review guidelines. Relevant electronic databases were searched for any peer-reviewed original research that examined the role of Ayurveda (interventions using single/compound formula of herbs or minerals or metals, Panchakarma procedures and other therapies, and Ayurveda-based diet and lifestyle) for managing symptoms of PCOS in women of reproductive age. Two reviewers independently screened the records, extracted the data on population, intervention, comparator, and outcome characteristics and descriptively summarized the data. Results: Of the 1820 records identified, 57 articles met the inclusion criteria; 32 case studies, 13 randomized controlled trials, 9 pre-post trials, 2 case series, and 1 non-randomized trial. Most studies were conducted in India and used either a compound formula or a complex intervention (e.g., panchakarma therapies and lifestyle modifications). The majority of the case studies/series used an Ayurvedic diagnostic approach that influenced the choice of Ayurveda intervention. Among the interventions, shatapushpa (dill seeds) and krishnatila (black sesame seeds) were the most used single herbs whereas kanchanara guggulu and rajapravartini vati were the most used compound formulas. Basti karma (therapeutic enema) was the most used complex intervention. Reproductive outcomes were the most studied; menstruation, PCOS-related infertility, and polycystic ovary morphology. Conclusions: There are a number of clinical studies on Ayurveda interventions for PCOS with a promising role in managing symptoms of PCOS. However, a few gaps were identified. Future research should aim at: (1) exploring a wider range of interventions, including Ayurvedic diet and lifestyle in different settings/locations; (2) exploring the effectiveness of Ayurveda treatments as an adjunct to biomedical treatments (3) a greater range of outcome measures such as obesity, type 2 diabetes, anxiety, depression, and quality of life needs to be further explored in women with PCOS; and (4) finally, safety and adverse event reporting needs to be undertaken rigorously and systematically. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Tepecik Education & Research Hospital / İzmir Tepecik Eğitim ve Araştırma Hastanesi Dergisi is the property of Logos Medical Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A relatively frequent endocrine-metabolic illness called polycystic ovarian syndrome (PCOS) is characterized by polycystic ovaries, persistent anovulation, and hyperandrogenism, which cause symptoms such as irregular menstruation, infertility, and hirsutism. PCOS is linked to obesity, insulin resistance, and increased amounts of androgens, or male hormones. The sedentary lifestyle, dietary fluctuations, inactivity, and stress are other contributing variables. According to estimates from India in 2021, around 22.5% of women, or one in five Indian women, suffer from PCOS. Evidence-based medical care for PCOS places a strong focus on a multidisciplinary approach, as standard pharmacological treatment frequently targets a single symptom, may be contraindicated, has adverse effects, and is ineffective in certain circumstances. However, long-term treatments have drawbacks and are likely to be ineffective, making complementary and alternative therapies a worthwhile choice. Yoga science is a thorough treatment plan for a healthy body and mind that may eradicate PCOS's primary causes, stress and obesity. Some common herbal remedies, including Foeniculum vulgare, Tinospora cordifolia, Asparagus racemosus, Ocimum tenuiflorum, Areca catechu, and Lepidium meyenii, have been highly regarded sources that have the benefits of lowering PCOS as well as having hypoglycemic and antiobesity effects. In light of existing literature, women with PCOS experienced symptomatic relief, improvement in hormonal balance, and the quality of life by utilizing yoga practices as well as herbal remedies. In conclusion, combining lifestyle modifications with herbal remedies can be used in the management of PCOS as a holistic approach. Therefore, this review opens a new window for researchers all across the world to validate such findings. [ABSTRACT FROM AUTHOR]

Background & Aims: Polycystic ovary syndrome is one of the common endocrine diseases that affects 5-10% of women of reproductive age. The purpose of this research was to explain the effect of Tabata training in water on TSP-1 and TIMP-3 and insulin resistance in obese women with polycystic ovary syndrome. Methods: To conduct this semi-experimental research, 30 women with a BMI greater than 29.9 in Isfahan city were selected and randomly divided into two experimental groups (metformin + Tabata exercise) (15 people) and control (metformin) (15 people). The Tabata training program consisted of 3 sessions per week for 40 minutes (10 minutes of warm-up, 20 minutes of exercise and 10 minutes of cooling down) consisting of 4-minute periods (20 seconds of activity and 10 seconds of rest) for 12 weeks. Subjects also took 500 mg metformin twice a day after breakfast and dinner. To measure the research variables, blood was taken after 12 to 14 hours of fasting and in two stages before and 48 hours after the last training session. To analyze the data, Shapiro-Wilk tests, one-way analysis of variance and Tukey's post hoc tests were used. People with endocrine diseases, untreated thyroid, Cushing's syndrome (a type of metabolic syndrome in which high levels of glucocorticoids lead to insulin resistance in muscle tissue, liver and fat tissue), congenital adrenal hyperplasia, suspected ovarian or adrenal tumor, heart patients, use of oral contraceptive pills, progestin and hormone induction (Inplanol), use of hormone therapy or herbal medicines during the last 2 months, use of acupuncture during the last 2 months, exercise during Last 2 months, pregnancy, history of abortion or childbirth in the last 6 weeks, history of breastfeeding in the last 4 months, having bariatric surgery in the last 12 months, unwillingness to fill out the consent form to enter the study, patients with or with a history of Cervical, endometrial, or breast cancer were excluded from the study. After selecting the sample, the subjects completed the personal information questionnaire and blood was drawn after 12 hours of overnight fasting to determine the level of insulin resistance factors, TSP-1 and TIMP-3. Then the experimental group did the training program including 12 weeks, 3 sessions per week and each session lasted 40 minutes and also used metformin. But the control group only took metformin. The exercise protocol consisted of 10 minutes of walking forwards, backwards, sideways, and jogging in the shallow part of the pool (where the water level is below the neck) and then doing stretching exercises. Then, Tabata training was performed with a special training song for 20 minutes and 10 minutes of stretching and cooling down. 48 hours after the last training session, blood was drawn again from all subjects. Also, in order to comply with ethical considerations at the end of the research, the treatment protocols in the form of manuals were provided to the control group so that they can use it if they wish. Similar to protocols on land, in water intensity interval training programs, participants complete "very hard" bouts with "easy" recovery periods, and due to the higher viscosity and density of water, large movements with increased speed will have greater resistance to water flow. He said that this leads to the creation of an ideal environment for increasing work efficiency and energy consumption. Also, metformin is a biguanide drug and is sensitive to insulin. This drug is able to limit the secretion of insulin and its increase. It also reduces the amount of androgen secretion that is secreted from the ovary and adrenal gland. Therefore, metformin seems to be an effective drug in patients with PCOS, especially in those who are resistant to clomiphene. Metformin improves the menstrual cycle in patients with the syndrome and causes an increase in the sensitivity of the response of drugs effective in stimulating ovulation, especially in women with PCOS resistant to clomiphene citrate, and leads to a decrease in obesity. Results: The results showed that exercise caused a significant decrease in insulin resistance and a significant increase in TSP-1 and TIMP-3 in the experimental group. The results showed that 12 weeks of Tabata training in water has a significant effect on insulin resistance in obese women with polycystic ovary syndrome (P=0.0001, f3.59=11.097). Also, the results of Tukey's post hoc test showed that there is a significant difference between the pre-test of the water training group and the control post-test group and the post-test of the water training group with test control group, but does not have there is a significant difference between the other groups. In this study, it was found that 12 weeks of Tabata training in water has a significant effect on TIMP-3 in obese women with polycystic ovary syndrome (P=0.0001, f3,59=20/270). Also, the results of Tukey's post hoc test showed that there is a significant difference between the pre-test of the water exercise group and the post-test of the water exercise group and between the post-test of the water exercise group and the control but pretest and the control post-test, There is no significant difference between the other groups. In the present study, it was found that 12 weeks of Tabata training in water has a significant effect on TSP-1 in obese women with polycystic ovary syndrome (P=0.0001, f3,59=111/20). Also, the results of Tukey's post hoc test showed that there is a significant difference between the pre-test of the water exercise group and the post-test of the water exercise group and between the post-test of the water exercise group and the control.but pre-test and the control post-test, There is no significant difference between the other groups. In the present study, it was found that 12 weeks of Tabata training in water has a significant effect on TIMP-3 in obese women with polycystic ovary syndrome. Also, the results of Tukey's post hoc test showed that there is a significant difference between the pre-test of the water exercise group and the post-test of the water exercise group and between the post-test of the water exercise group and the control pre-test and the control post-test, but between the other groups. There is no significant difference. Another finding showed that 12 weeks of Tabata training program in water and metformin intake led to a significant increase in TIMP-3 factor in obese women with polycystic ovary syndrome, so that there was a significant difference between the pre-test of the water training group and the post-test of the water training group. On the one hand, there is a significant difference between the post-test of water training, the control pre-test and the control post-test. According to our studies, the effect of sports activity on TIMP-3 changes has not been investigated yet. Conclusion: The results of the present study confirm the effect of Tabata exercise in water along with metformin on the factors involved in angiogenesis and insulin resistance in women with polycystic ovary syndrome. [ABSTRACT FROM AUTHOR]

Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder characterized by hyperandrogenism and follicular arrest. Electroacupuncture (EA) has been shown to be effective at improving hyperandrogenism and follicular arrest in PCOS; however, its mechanism of action remains to be deciphered. Objective: In this study, we investigated whether EA improved follicular development in an obese rat model of PCOS and regulated the expression of adiponectin, AMP-activated protein kinase (AMPK) and acetyl-CoA carboxylase (ACC). Methods: EA was administered at CV3, CV4 and ST40. Changes in body weight, paraovarian fat, estrus cycle, ovarian morphology, levels of related hormones, and glucose and lipid metabolism were evaluated. In addition, protein and mRNA expression of adiponectin, AMPK and ACC was measured. Results: The body weight and paraovarian fat of rats in the EA group were reduced, while estrus cyclicity and ovarian morphology improved. Levels of free fatty acids, triglycerides, total cholesterol and low-density lipoprotein cholesterol were significantly reduced in the EA group, as well as blood glucose levels. Furthermore, levels of testosterone and luteinizing hormone were reduced in the EA group, while estradiol levels were increased. Protein and mRNA expression of adiponectin, AMPKα1 and liver kinase B1 (LKB1) was found to be increased in the EA group, while protein and mRNA expression of ACC were significantly reduced. Conclusion: Our findings suggest that EA improved follicular development and metabolism and regulated expression levels of adiponectin, AMPKα1, LKB1 and ACC in our obese rat model of PCOS. [ABSTRACT FROM AUTHOR]

Context Numerous meta-analyses have been conducted on the effects of nutritional interventions on various health outcomes in women with polycystic ovary syndrome (PCOS). However, the strength of the evidence and its clinical significance are unclear. Objective This umbrella review aimed to summarize the effects of nutritional interventions on women with PCOS and assess the strength of the evidence. Data Sources PubMed, Scopus, and Web of Science were searched from inception until March 17, 2021. Data Extraction Meta-analyses of randomized clinical trials (RCTs) that examined the impact of dietary modifications or supplementations on women with PCOS were selected. Data extraction, quality assessments of the meta-analyses, and evaluation of the strength of the evidence were conducted independently by 2 investigators and confirmed by a third. Data Analysis Twenty-eight RCT meta-analyses were included, reporting 40 different outcomes. Lower carbohydrate, Dietary Approaches to Stop Hypertension, or lower glycemic index/load diets in women with PCOS significantly improved some anthropometric and metabolic characteristics (with very low to low certainty). Probiotics/synbiotics reduced fasting plasma glucose, fasting insulin (FI), and homeostasis model assessment–estimated insulin resistance (HOMA-IR) (with moderate to high certainty). Curcumin supplementation decreased fasting plasma glucose, FI, and HOMA-IR (with moderate certainty). Fish oil supplementation decreased FI and HOMA-IR, and omega-3 reduced triglycerides (with moderate certainty). There were also improvements in FI after taking vitamin D or inositol supplements (with moderate certainty). Supplementation with fish oil increased adiponectin (with high certainty), and probiotics/synbiotics reduced total testosterone (with moderate certainty). In subfertile women with PCOS, inositol increased the ovulation rates (with moderate certainty). Conclusion There was no high-certainty evidence that diets alone in women with PCOS improved health or reproductive outcomes. Supplementation with vitamin D, probiotics/synbiotics, omega-3, inositol, and curcumin showed favorable effects on some metabolic outcomes. Probiotics/synbiotics possibly reduces total testosterone, and inositol stimulates ovulation in women with PCOS. Registration PROSPERO registration no. CRD42021251496. [ABSTRACT FROM AUTHOR]

Background & Aims: Overweight and obesity are related to increased risk of coronary heart disease, stroke, high blood pressure, type 2 diabetes and some specific cancers. In recent years, inactivity, obesity and metabolic syndrome have been increasing in developing societies (2). Among various diseases, polycystic ovary syndrome is among the cases that are strongly related to obesity (3). Studies in recent decades have shown that PCO syndrome can be a pro-inflammatory stage, because among them cardiovascular diseases, diabetes 2, insulin resistance and metabolic syndrome are seen with a high incidence (4). In the meantime, investigating and identifying the inflammatory causes of this condition for the above reasons can help specialists in its treatment with the process of reducing its negative effects through aerobic exercise. In this regard, the above research investigated some inflammatory factors such as E-selectin and nuclear factor kappa B (NF-κB). To improve the physical condition of obese people, instead of medicine, sports activities, both anaerobic and aerobic, are used, and each of these activities affects the improvement of physical condition through different mechanisms (2). Researchers believe that regular and not heavy exercise is a healthy and natural method for patients with polycystic ovary syndrome apart from clinical treatments (18). Physical activity improves menstrual irregularity, ovulation, ovarian morphology and fertility by reducing abdominal fat, blood sugar, blood fat, reducing insulin resistance, affecting hormone secretion and reducing cardiovascular risk factors. Be (7). But the question is, what exercise? With what intensity? And for how long? Treatment with all kinds of drugs may cause male characteristics, and unfortunately, most of the side effects are irreversible, so non-drug treatment strategies are necessary and need to be examined and studied. On the other hand, by reviewing the research done inside and outside the country, no research has been done on the effect of Tabata exercise on the research variables and even aerobic exercise on the research variables in women with polycystic ovary syndrome, so the purpose of this research is to determine The effect of a session of Tabata exercise in water and metformin on E-selectin and NF-κB in obese women with PCOS. Methods: The current research was semi-experimental and applied with a pre-test-post-test research design. For this purpose, 30 women with a body mass index greater than 29.9 in Isfahan city, who were diagnosed with polycystic ovary syndrome by an endocrinologist or gynecologist and diagnostic tests and ultrasound, were considered as a statistical sample. They were selected and randomly divided into two experimental groups (metformin + exercise in water) and control. 24 Before starting the exercises, the subjects first completed the personal information questionnaire and blood was taken after 12 hours of overnight fasting to determine the level of the variables. Experimental group for 12 weeks, 3 sessions a week and each session 40 minutes of exercises in the water (including 10 minutes of walking forward, backward, sideways and soft running in the shallow part of the pool where the water level is below the neck and Then they performed stretching exercises. Then they performed Tabata exercise with a special exercise song played in the pool for 20 minutes, and then they did 10 minutes of stretching and cooling (22) and 500 mg metformin twice consumed during the day and after breakfast and dinner. 48 hours after the last training session, blood was taken again from all subjects. At the end, descriptive statistics (mean and standard deviation), Shapiro-Wilk test to check the normality of data distribution and covariance analysis to check research hypotheses using spss/21 software at a significance level of α≤0.05 were used. became. Results: The results showed that the E-selectin factor in obese women with PCOS at the end of the period in the group of Tabata exercise in water and metformin intake had a significant difference compared to the control group (P=0.001 and F=134.6). Tukey's post hoc test results It showed that there is a significant difference between the pre-test of the Tabata training group in water and the post-test of the Tabata training group in water on the one hand, and between the post-test of the Tabata training group in water and the pre-test and post-test of the control group on the other hand, but between the other groups. There is no significant difference. (Table 2). The results showed that Tabata exercise in water and metformin consumption have a significant effect on NF-Κb factor in obese women with PCOS (P=0.025 and F=354.3). The results of Tukey's post hoc test showed that there is a significant difference between the pretest of the Tabata group in water and the post-test of the Tabata group in water, but there is no significant difference between the other groups (Table 3). Conclusion: The results showed that the E-selectin factor was significantly higher in obese women with polycystic ovary syndrome at the end of the period in the aerobic exercise and metformin group than in the control group. The results of the follow-up test showed that there is a significant difference between the pre-test of the Tabata aerobic training group and the post-test of the Tabata aerobic training group on the one hand, and between the post-test of the Tabata aerobic training group and the pre-test and post-test of the control group on the other hand, but between the other There is no significant difference between the groups. Aerobic exercises decreased VCAM-1 and ICAM-1 adhesive molecules; While its effects on E-selectin and P-selectin have been inconsistent. Of course, it seems that the effect of aerobic exercise on these conditions depends on the type and duration of the exercise intervention and the disease conditions such as the presence of ischemia. As presented in this review, there is a high level of evidence that sports activity has a positive effect on key factors in the development of atherosclerosis. This can partly explain the scientifically proven anti-atherogenic effects of aerobic exercise and has significant clinical effects (23). The results showed that the NF-Κb factor in obese women with polycystic ovary syndrome was significantly lower in the aerobic exercise and metformin group at the end of the period than in the control group. The results of Tukey's post hoc test showed that there is a significant difference between the pre-test of the Tabata aerobic exercise group and the post-test of the Tabata aerobic exercise group, but there is no significant difference between the other groups. In the explanation above, it can be stated that NF-κb is stimulated and activated in response to cellular stimuli. So far, about 450 stimuli, including physical, chemical, physiological and oxidative stimuli, have been identified for NFκB. Also, mitogens, receptor ligands, bacteria, viruses, parasites, fungi and their products, pro-inflammatory cytokines and some pathological conditions are among the stimuli of this transcription factor (28). The transcription factor NFκB is responsible for supplying a large number of pro-inflammatory genes, including cytokines, chemokines, immune receptors, enzymes and other pro-inflammatory molecules (29). Inappropriate activity of NFκB is one of the mechanisms of some diseases, especially those associated with inflammation (30). [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. Characterised by insulin resistance and hyperinsulinaemia, it is associated with increased risk of cardiovascular and cerebrovascular events, type 2 diabetes and impaired glucose tolerance. It is further linked to pregnancy-related complications, including gestational diabetes and venous thromboembolism. The disease is distinguished by the presence and degree of three major features: irregular menstruation, hyperandrogenism, and polycystic ovarian morphology (including increased follicle numbers and enlarged ovaries). PCOS is a life-long problem. However, the symptoms can be successfully managed with proper medication and lifestyle interventions. [ABSTRACT FROM AUTHOR]

Background: Polycystic ovary syndrome (PCOS) presents clinical symptoms of menstrual abnormalities, excessive hair growth (hirsutism), scalp hair loss, acne and infertility. Metabolic abnormalities such as obesity, insulin resistance, glucose intolerance and cardiovascular problems constitute an essential part of PCOS, all of which can have significant long-term health consequences. Low-grade chronic inflammation demonstrated by persistent moderately elevated serum levels of inflammatory and coagulatory markers plays a critical role in the pathogenesis of PCOS. Oral contraceptive pills (OCPs) constitute the mainstay of pharmacologic therapy for women with PCOS to regularize cyclicity and ameliorate androgen excess. On the other hand, OCP use is associated with various venous thromboembolic and proinflammatory events in the general population. PCOS women always carriers the increased lifetime risk of these events. The studies on the effect of OCPs on inflammatory, coagulation and metabolic parameters in PCOS are less robust. Therefore in this study, we investigated and compared the messenger RNA (mRNA) expression profiles of genes implicated in inflammatory and coagulation pathways between drug-naive and OCP-treated PCOS women. The selected genes include intercellular adhesion molecule-1 (ICAM-1), tumor necrosis factor-α (TNF-α), monocyte chemoattractant protein-1 (MCP-1) and plasminogen activator inhibitor-1 (PAI-1). Furthermore, the correlation between the selected markers and various metabolic indices in the OCP group has also been explored. Method: The relative amounts of ICAM-1, TNF-α, MCP-1 and PAI-1 mRNA in peripheral blood mononuclear cells from 25 drug-naive PCOS subjects (controls) and 25 PCOS subjects who received OCPs containing 0.03 mg-ethinyl-estradiol and 0.15 mg-levonorgestrel for at least six months (cases) were estimated using real-time qPCR. The statistical interpretation was conducted using SPSS version 20.0 (SPSS, Inc, Chicago, IL), Epi Info version 2002 (Disease Control and Prevention Centres, Atlanta, GA) and GraphPad Prism 5 (GraphPad Software, La Jolla, CA) software. Result: Six months of OCP therapy enhanced the expression of inflammatory genes viz ICAM-1, TNF-α and MCP-1 mRNA in PCOS women by 2.54, 2.05 and 1.74 folds, respectively, in this study. However, PAI-1 mRNA in the OCP group showed no significant increase. Furthermore, in cases, ICAM-1 mRNA expression positively correlated with body mass index (BMI) (p = 0.01), fasting insulin (p = 0.01), insulin 2 h p = 0.02), glucose 2 h (p = 0.01) and triglycerides (p = 0.01). TNF-α mRNA expression positively correlated with fasting insulin (p = 0.0007). MCP-1 mRNA expression positively correlated with (BMI) (p = 0.002). Conclusion: OCPs helped reduce clinical hyperandrogenism and regularise menstrual cycles in women with PCOS. However, OCP use was associated with increased fold expression of inflammatory markers which positively correlated with metabolic abnormalities. [ABSTRACT FROM AUTHOR]

This cohort study investigated whether letrozole versus hormone replacement therapy (HRT) results in higher live birth rate among anovulatory and oligoovulatory women in frozen-thawed embryo transfer (FET) cycles. It was conducted from 1st February 2018 to 31st January 2019 and included 261 anovulatory and oligoovulatory women. Since letrozole has become an effective alternative to HRT cycles, 121 patients received letrozole in 121 cycles from 1st February 2018 to 31st January 2019 and were compared to 140 HRT FET cycles among 140 women from 1st February 2017 to 31st January 2018. The primary outcome was live birth rate. Secondary outcomes were clinical pregnancy, multiple pregnancy and miscarriage rates. Clinical pregnancy and live birth rates of transferred cleavage embryos were higher in the letrozole compared to the HRT group (36/65 (55.3%) vs. 20/110 (18.1%), p < 0.001) and (25/65 (38.4%) vs. 17/110 (15.4%), p < 0.001) respectively, whilst these rates were similar for transferred blastocyst embryos. Miscarriage and multiple pregnancy rates were similar between groups. The letrozole group was older than the HRT group (31.8 ± 5.1 vs. 29.9 ± 5.1 years, p = 0.002) and more smoked cigarettes (p = 0.035). Groups were similar regarding BMI, male versus non-male indication for fertility treatment, peak oestradiol levels, and numbers of oocytes retrieved, blastocysts, frozen and transferred embryos. Letrozole compared to HRT might improve live birth and clinical pregnancy rates among anovulatory and oligoovulatory women undergoing FET cycles. [ABSTRACT FROM AUTHOR]

Polycystic Ovary Syndrome (PCOS) is one of the most prevalent endocrine disorder in women of reproductive age characterized by hyperandrogenism (HA). Current treatment options for PCOS are either with adverse effects or ineffective. Saptasaram kashayam (SK), an ayurvedic formulation is often been a safe traditional alternative medicine to improve the PCOS symptoms as well as its pathological development. However, its principle phytoconstituents or underlying mechanisms have not been investigated. In order to achieve this, the current study systematically utilized computational tools, network pharmacology approaches and molecular docking studies. All identified phytoconstituents of SK were screened by QikProp ADME prediction and 47 were selected based on oral bioavailability and drug likeliness scores. Their 3D structures were submitted to three online target fishing webservers PharmMapper, ChemMapper and Swiss Target Prediction which produced 1084 biological targets for SK comprehensively. 350 known PCOS therapeutic targets were retreived as common targets from three different interrogative disease centric bioinformatic platforms DisGeNET, OMIM and GeneCards. Intersection of 1084 biological targets of SK and 350 PCOS therapeutic targets produced, 88 potential therapeutic targets of SK against PCOS. STRING PPI and Compound-Target-Pathway networks were constructed and analysed using Cytoscape software. GO & KEGG pathway enrichment analysis was performed using DAVID database. 15 PCOS therapeutic target proteins were short listed from network analysis report-PIK3CA, PDPK1, AKT1, PIK3R1, STAT3, MAPK1, MAPK3, EGFR, AR, ESR1, ESR2, SHGB, NOS3, F2 & CREBBP. Targets that were likely to be inhibited/modulated by SK for treatment of PCOS were docked against the screened phytoconstituents and their respective standard inhibitors using GLIDE-SP of Schrodinger suite, Maestro version-13.0. Results showed that Quercetin, Catechin, Boeravinone J, Genistein, Protocatechuic Acid, Gentisic Acid, Xanthoarnol, Luteolin, Boeravinone F, Tyrosine, Kaempferol, Dalbergioidin, etc exhibited good binding affinities when compared to standard drugs and might be responsible for synergistic/additive protective effect of SK against PCOS. Meanwhile PI3K-Akt signaling pathway, Prolactin signaling pathway, AGE-RAG diabetic complications, HIF-1 signaling pathway and Estrogen signaling pathway were found to be involving the hub genes of interest and in this way, they might be intervened during treatment of PCOS by SK. Present study succeeded in identifying the drug like principle phytoconstituents, probable PCOS therapeutic targets and the underlying molecular mechanism of SK apart from providing reliable evidence for therapeutic potential of SK against PCOS. However further validation by in vitro and in vivo investigations is necessary. [ABSTRACT FROM AUTHOR]

Zincum metallicum, a holistic homeopathic medicine, has a huge characteristic range of action in the treatment of diseases and the maintenance of health systems. It helps build the immune system. Oxidative stress is a known factor in chronic diseases. Zinc in the form of Zincum metallicum or any other form acts as an antioxidant by reducing oxidative stress and helping to treat many conditions. Some of this Zincum metallicum is potent in treating various diseases caused by oxidative stress or sedentary lifestyle. Zincum metallicum has been shown to treat polycystic ovarian syndrome (PCOS) by regulating insulin resistance and lipid levels in women with PCOS and improving ovarian function. It is also helpful for the reproductive organs as it improves sperm count in men and ovarian function in women. Zincum metallicum not only treats the disease, but also acts on other organs to improve the metabolic activity of the system. Since Zincum metallicum acts on the central nervous system, it helps in the treatment of various diseases related to the nervous system, such as Parkinson's disease. Zincum metallicum helps in the treatment of liver related diseases such as hepatitis, liver cirrhosis. Mild zinc deficiencies are likely to cause chronic metabolic disorders resulting in health complications. Zincum metallicum is great for treating metabolic disorders. [ABSTRACT FROM AUTHOR]

Background: Polycystic ovarian syndrome (PCOS) is the most common endocrine problem in females with an incidence of (6 -10%). The purpose of this study was to make a comparison between the effect of clomiphene citrate versus letrozole on the endometrial receptivity and perifollicular vascularity among infertile patients having PCOS. Methods: This randomized comparative clinical study was conducted at infertility clinic of laparoscopy cytogenic unit, Obstetrics and Gynecology Department, Zagazig University, Egypt from June 2019 to June 2020. It included a total of 54 infertile women diagnosed as having PCOS, 27 women received Clomiphene Citrate 100 mg and 27 patients received letrozole 5mg for ovulation induction. Thickness and pattern of the endometrium, uterine and spiral artery Doppler indices were calculated for 3 subsequent cycles on HCG injection day. Either clomiphene citrate or Letrozole was administrated by mouth for 5 days from day 3 of menstrual cycle. Results: As regards peri follicular vascularity, highly valuable difference was detected between two tested groups on HCG injection day in the 3 subsequent cycles. Ovulation rates were higher in the letrozole group than in the Clomiphene citrate group, however the discrepancy was not statistically valuable, in letrozole (70%, 74%, 81%) and in clomiphene citrate (63.0%, 67%, 77%) in 3 subsequent cycles. Conclusions: Both Clomiphene citrate and letrozole increase perifollicular blood flow with a significant difference in favor to letrozole, in letrozole group, the most of follicles were (grade3) and in Clomiphene citrate group (grade2). [ABSTRACT FROM AUTHOR]

Background: Polycystic ovarian syndrome (PCOS) is an endocrine disorder adversely affecting fertility and reproductive health with diverse clinical manifestations in women. Aim: The objectives of the present study are to determine and compare the prevalence of PCOS between rural and urban Assamese women in Guwahati, Assam. Methods: A total of 150 (75 rural; 75 urban) Assamese women aged 18-35 years have been collected at Pratiksha Hospital, Guwahati, Assam. The relevant data were collected through selfadministered pre-structured and interview methods. Results: Higher prevalence of PCOS was found in the urban areas living in nuclear families in comparison to rural areas. Recent weight gain and obesity with a higher prevalence of oligomenorrhea were found to be higher among the urban participants. An excess androgen activity evidenced by increased hirsutism was higher in the urban areas as compared to rural areas in association with increased levels of serum insulin. Conclusion: A long-term personalized management program is required for effectively treating individuals with PCOS which may help in regulating the symptoms and various other metabolic complications. [ABSTRACT FROM AUTHOR]

Purpose: Effect of multi-strain probiotic along with dietary and lifestyle modifications in the management of polycystic ovary syndrome (PCOS) has rarely been reported. We thus aimed to investigate the effect of multi-strain probiotic (Lactobacillus acidophilus UBLA-34, L. rhamnosus UBLR-58, L. reuteri UBLRu-87 (each of 2 billion colony forming units (CFU)); L. plantarum UBLP-40, L. casei UBLC-42, L. fermentum UBLF-31, Bifidobacterium bifidum UBBB-55 (each of 1 billion CFU) and fructo-oligosaccharides (100 mg)) and dietary and lifestyle modifications on restoration of menstrual regularity, weight reduction, metabolic and hormonal profile in women with PCOS. Methods: A 104 participants (age 18–40 years) were randomly allocated to receive probiotic or placebo capsules for 6 months. Baseline and end line assessment were performed for menstrual cycle regularity, ultrasonography scan for ovaries, total testosterone, dehydroepiandrosterone (DHEAS), insulin, luteinizing hormone/follicle stimulating hormone (LH/FSH) ratio, fasting blood sugar (FBS), homeostatic model assessment-insulin resistance (HOMA-IR), weight reduction, waist-/hip circumference (WC, HC), waist to hip ratio (WHR), and body mass index (BMI). Plasma lipopolysaccharide and effect of intervention on quality of life was investigated. Diet and exercise were controlled during the trial. Results: Probiotic supplement along with dietary and lifestyle modifications significantly regularised menstrual cycle (p 0.023), improved levels of total testosterone (p 0.043), WC (p 0.030), WHR (p 0.027) and menstrual domain of quality of life (p 0.034) as compared to placebo. No adverse events related to study were reported. Conclusion: Multi-strain probiotic along with dietary and lifestyle modifications were effective in the management of PCOS. Trial registration: CTRI: CTRI/2016/07/007086, dated 13 July 2016. [ABSTRACT FROM AUTHOR]

The main symptoms of polycystic ovary syndrome (PCOS) are hirsutism, menstrual irregularity, obesity, infertility, and so on. Respondents for the present study were interviewed at Sri Maharaja Gulab Singh (SMGS) Hospital in the Jammu district of the union territory of Jammu and Kashmir in India. In-depth interviews were conducted for 41 respondents suffering from PCOS. It was observed that women in this part of the country fail to understand this disease and expressed their dilemma related to it. Except for a few, majority of the respondents were not aware that the disease they were suffering from was PCOS. For unmarried women, this disease was either the onset of hirsutism or menstrual irregularity or acne whereas for married ones, it was usually the onset of infertility. Depending upon their social desire, they consulted doctor to get rid of that particular symptom only. By means of constructivist perspective, it was found that it is the social impact of PCOS which makes these women to consult a doctor. In India, role of women is usually determined by their social status, and this determines their health-seeking behaviour. Since married women with no children are looked down in the Indian society, these women seek treatment only for infertility. Similarly, unmarried women fail to understand physiological disturbances resulting in menstrual irregularity and they seek treatment for that. Others wanted treatment for acne and hirsutism. There was an absence of common discourse related to PCOS due to which different respondents had different expressions for the same disease. [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome characterized by irregular menstruation, high serum androgen levels and infertility in the reproductive period. New markers are being studied to facilitate diagnosis. Asprosin is a peptide that is synthesized during fasting and stimulates glucose production from the liver. High levels of asprosin have been found to be associated with obesity, insulin resistance and diabetes. The aim is to answer the question 'Can serum asprosin level be used as a marker in the initial diagnosis of PCOS in adolescents without any disease?'. A total of 65 people between the ages of 12-18 who applied to the Antalya Training and Research Hospital Gynecology and Obstetrics Polyclinic between June 2020 and January 2021 were included in the study. The group was divided into two as 38 patients newly diagnosed with PCOS and 27 healthy control groups without any pathology. When the asprosin level of the cases diagnosed with PCOS and the cases in the control group were compared, it was observed that the asprosin level of the cases with PCOS was significantly higher (p=0.004). This study was a study showing that serum asprosin level can be used in the diagnosis of PCOS. It should be supported by other studies. [ABSTRACT FROM AUTHOR]

Background. Acupuncture has been confirmed as a suitable therapy for treating polycystic ovary syndrome (PCOS). However, there is no bibliometric analysis of the global use of acupuncture for PCOS. Our study used CiteSpace (5.8.R3) to provide a profile of the current state and trends in this field. Methods. Articles regarding acupuncture therapy for treating PCOS were retrieved from the Web of Science Core Collection. CiteSpace was used to analyze the number of publications, countries, institutions, journals, authors, cited references, and keywords by using standard bibliometric indicators. Results. A total of 159 publications were considered for the final analysis. The number of publications has slowly increased with fluctuations between years, and the most active countries, institutions, journals, and authors concerning acupuncture therapy for PCOS were identified. Evidence-Based Complementary and Alternative Medicine was the most productive journal, and Fertil Steril was the most cited. China and Heilongjiang University of Chinese Medicine were considered the most prolific countries and institutions in this field, respectively. Elisabet Stener Victorin became the most influential author and most cited author. Jedel E. published the most cited article. "Polycystic ovary syndrome" was the most frequent keyword, and the top three frontiers mentioned were research method, intervention, and outcome. Conclusion. The current status and trends in clinical research of acupuncture therapy on PCOS patients are revealed according to the results of this bibliometric study, which may facilitate researchers to identify hot topics and new directions for future study in this field. [ABSTRACT FROM AUTHOR]

Ovulatory disorders are common causes of amenorrhea, abnormal uterine bleeding, and infertility, and are frequent manifestations of polycystic ovary syndrome (PCOS). There are many potential causes and contributors to ovulatory dysfunction that challenge clinicians, trainees, educators, and those who perform basic, translational, clinical, and epidemiological research. Similarly, therapeutic approaches to ovulatory dysfunction potentially involve a spectrum of lifestyle, psychological, medical, and procedural interventions. Collaborative research, effective education, and consistent clinical care remain challenged by the absence of a consensus comprehensive system for classification of these disorders. The existing and complex system, attributed to WHO, was developed more than three decades ago and did not consider more than 30 years of research into these disorders in addition to technical advances in imaging and endocrinology. This manuscript describes the development of a new classification of ovulatory disorders performed under the aegis of the International Federation of Gynecology and Obstetrics (FIGO) and conducted using a rigorously applied Delphi process. The stakeholder organizations and individuals who participated in this process comprised specialty journals, experts at large, national, specialty obstetrical and gynecological societies, and informed lay representatives. After two face-to-face meetings and five Delphi rounds, the result is a three-level multi-tiered system. The system is applied after a preliminary assessment identifies the presence of an ovulatory disorder. The primary level of the system is based on an anatomic model (Hypothalamus, Pituitary, Ovary) that is completed with a separate category for PCOS. This core component of the system is easily remembered using the acronym HyPO-P. Each anatomic category is stratified in the second layer of the system to provide granularity for investigators, clinicians, and trainees using the "GAIN-FIT-PIE" mnemonic (Genetic, Autoimmune, Iatrogenic, Neoplasm; Functional, Infectious and Inflammatory, Trauma and Vascular; Physiological, Idiopathic, Endocrine). The tertiary level allows for specific diagnostic entities. It is anticipated that, if widely adopted, this system will facilitate education, clinical care, and the design and interpretation of research in a fashion that better informs progress in this field. Integral to the deployment of this system is a periodic process of reevaluation and appropriate revision, reflecting an improved understanding of this collection of disorders. [ABSTRACT FROM AUTHOR]

NPs are in an ideal position to educate patients on the lifelong implications of polycystic ovary syndrome (PCOS). A timely diagnosis and comprehensive plan are needed to appropriately manage patients with PCOS. This article highlights diagnostic criteria, common comorbid conditions, psychological impacts of the clinical manifestations, management approaches, and implications for NPs. [ABSTRACT FROM AUTHOR]

(1) Background: Human polycystic ovary/ovarian syndrome (PCOS) is linked to endocrine, metabolic, and psychological complications. We propose a randomized controlled pilot study for an acupuncture protocol regarding the management of PCOS symptoms based on TCM diagnosis; (2) Methods: We will randomly allocate 120 women diagnosed with PCOS into two groups. The study group will be treated with acupuncture for points known to act upon the autonomous regulation of the hormonal, metabolic and emotional components. (3) Results and Conclusions: We expect to provide evidence of high methodological quality related to the effects and safety of an acupuncture protocol based on the perspective of a TCM diagnostic. [ABSTRACT FROM AUTHOR]

Background: Polycystic ovarian syndrome (PCOS) is a common disorder seen in women at their reproductive age with a prevalence rate of 4 to 12%. Diagnosis of hyperandrogenism or chronic anovulation without any adrenal or pituitary conditions can be called as PCOS. Swiss ball exercises are found to be a better alternative which is safe for the joints, and also demands moderate physical exertion without loading joints to stress. A combined aerobic and Swiss ball exercise protocols help in muscle strengthening, preventing loss of lean muscle mass, reducing obesity, and improves disease-related hyperandrogenism and insulin sensitivity in PCOS. Aim & objective of the study: To analyze and understand the effect of swiss ball exercises along with aerobic exercises among college girls with polycystic ovarian syndrome. Data Analysis and Results: This study results shows that there is statistically significant improvement in the variables of Menorrhea Impact Score (MIS) pre and post mean values of 4.99 and 0.99 in subjects with p<0.05. Thus null hypothesis has been rejected and alternate hypothesis has been accepted for this study. Conclusion: The study is concluded that there is statistically significant improvement in Menorrhea Impact Questionnaire score in college girls in and around Madurai with Poly Cystic Ovarian Syndrome after the intervention of Swiss Ball Exercises along with Aerobic Exercises Program for 6 weeks. [ABSTRACT FROM AUTHOR]

Polycystic ovarian syndrome (PCOS) is alarmingly rising and sustainable therapy/prevention is needed. Here, we evaluated the therapeutic effects of oregano or Origanum vulgare (O. vulgare) essence (OE) on the PCOS rat model system. Vaginal smears monitored the estrous cycle of 40 virgin adult rats, and they received 2 mg estradiol valerate (EV)/0.2 ml corn oil intramuscularly to induce PCOS. At 60 days post-EV injection, all rats were evaluated for follicular development/cysts. The EV-induced PCOS rats were orally administered 250 and 500 mg/kgBW/day of OE for 30 days. OE was also further assessed for its predominant components along with hormonal, histological, and inflammatory-related gene expressions in the ovaries. The main components of the OE were predominantly pulegone (36.3), L-menthone (31.3%), far less piperitone (7.8%), isopiperitone (6.4%), isomenthol (3.6%), humulene epoxide II (2.2%), α-pinene (1.7%), and thymol (1.5%). Hormonal, histological, and inflammatory-related gene expression results showed >4-fold and 1.5-fold increase in FSH and progesterone; ∼50%, 85%, 45%, 55%, and 30% decreased in LH, estradiol, estrogen, testosterone, and AMH; and dose-dependently decreased in mRNA expression of IL-6, IL-1α, NF-kB, TNF-α, and IL-1β by 25–65%, 55–75%, 15–40%, 30–55%, and 35–55%, respectively, and thus decreased the severity of PCOS, boosted endocrine balance, restored functional follicles and corpus luteum, and thus ovulation in PCOS rats. Overall, in the disrupted PCOS rats, OE oral treatment effectively relieved estradiol-induced PCOS rats via: (1) its endocrine balancing on GnRH, FSH, and LH and (2) its anti-inflammatory and antioxidant properties on ovary caused by OE's useful compounds like pulegone, thymol, and L-menthone. Though many aspects of the effects remain to be tested, such an underlying mechanistic reproductive regulatory effect observed in OE-administered rats further proves its sensible pharmaceutical applications in reproductive medicine and more specifically, PCOS. [ABSTRACT FROM AUTHOR]

Background. Acupuncture, a treatment derived from traditional Chinese medicine, can effectively relieve the symptoms and improve pregnancy outcome in patients with polycystic ovary syndrome (PCOS); however, its mechanism remains unclear. This study aimed at investigating whether acupuncture could improve endometrial angiogenesis and thus endometrial receptivity via activating PI3K/AKT pathway in PCOS rats. Methods. We established a rat model with PCOS, which was induced by DHEA. Acupuncture was performed every other day for 15 days, and the PI3K inhibitor (LY294002) was intraperitoneal injected 30 mins before acupuncture treatment. Females rats were mated with male SPF SD rats in a ratio of 2 : 1 after treatment and sacrificed on the 5th day when the vaginal plug was identified. The number of implantation sites was observed, followed by ovarian and endometrial morphology detected with hematoxylin-eosin staining and a scanning electron microscope, estrous cycle detected with vaginal smear analysis, and sex hormones and angiogenesis-related PI3K/AKT gene/protein expression detected with enzyme-linked immunosorbent assay, western blotting, immune histochemistry, and quantitative real-time PCR. Results. Acupuncture notably improved implantation sites' number, endometrial receptivity factors including endometrial morphology, pinopodes, HOX-10, and LIF protein expression, as well as angiogenesis and PI3K/AKT pathway factors such as VEGF, VEGFR2, Ang-1, PI3K, AKT, and P-AKT gene/protein expression and the level of eNOS and NO in the endometrium of rats with PCOS; PCOS-like symptoms were alleviated as well. The efficacy of acupuncture on a rat model with PCOS was counteracted by the combination with the PI3K inhibitor. Conclusion. Acupuncture improves endometrial angiogenesis by activating the PI3K/AKT pathway, thus promoting endometrial receptivity and the number of implantation sites in rats with PCOS. [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome is the most common endocrine disorder in women of reproductive age, which is still incurable. However, the symptoms can be successfully managed with proper medication and lifestyle interventions. Despite its prevalence, little is known about its etiology. In this review article, the up-to-date diagnostic features and parameters recommended on the grounds of evidence-based data and different guidelines are explored. The ambiguity and insufficiency of data when diagnosing adolescent women have been put under special focus. We look at some of the most recent research done to establish relationships between different gene polymorphisms with polycystic ovary syndrome in various populations along with the underestimated impact of environmental factors like endocrine-disrupting chemicals on the reproductive health of these women. Furthermore, the article concludes with existing treatments options and the scopes for advancement in the near future. Various therapies have been considered as potential treatment through multiple randomized controlled studies, and clinical trials conducted over the years are described in this article. Standard therapies ranging from metformin to newly found alternatives based on vitamin D and gut microbiota could shine some light and guidance toward a permanent cure for this female reproductive health issue in the future. [ABSTRACT FROM AUTHOR]