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Nizamani M, Zaheer Uddin M, Nagdev C, Ahmed N, Raza A. Comparative efficacy of metformin combined with cabergoline versus metformin alone in patients with PCOS and hyperprolactinemia: A systematic review and meta-analysis of randomized controlled trials. Eur J Obstet Gynecol Reprod Biol 2024; 299:289-295. [PMID: 38945085 DOI: 10.1016/j.ejogrb.2024.06.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Revised: 06/10/2024] [Accepted: 06/26/2024] [Indexed: 07/02/2024]
Abstract
Isntroduction. Polycystic ovary syndrome (PCOS) is a multifaceted endocrine-gynecological condition affecting a substantial number of women during their reproductive years. Metformin (MET) has been shown to improve ovarian function in PCOS-related conditions, while cabergoline is recognized for its powerful and sustained ability to reduce prolactin levels. This study investigates the potential impact of combining cabergoline with metformin while comparing it with metformin alone in the treatment of PCOS alongside hyperprolactinemia. METHOD To gather data, we searched PubMed, Google Scholar, ScienceDirect, and Cochrane Central. Eligible studies were randomized controlled trials involving patients with PCOS and hyperprolactinemia. Outcome measures included changes in the levels of prolactin, testosterone, DHEAS, BMI and menstrual irregularities. RevMan version 5.4 was used to analyze outcomes. RESULT This study incorporated three Randomized Controlled Trials (RCTs) involving 405 participants in total. Patients receiving a combination of metformin and cabergoline experienced significant reductions in prolactin and testosterone levels (p= <0.0001 and p=<0.0001, respectively). Conversely, alterations in DHEAS levels and BMI did not reach statistical significance (p = 0.19 and p = 0.71, respectively). Notably, women solely prescribed metformin exhibited significantly higher rates of menstrual irregularities compared to those receiving both metformin and cabergoline (p=<0.0001). CONCLUSION Our analysis underscores the synergistic effect achieved by pairing metformin and cabergoline in patients with PCOS and hyperprolactinemia. However, we encountered only a restricted number of studies meeting our criteria. It is imperative to consistently assess the combined effects of metformin and cabergoline to gain deeper insights into their effectiveness in addressing PCOS and hyperprolactinemia.
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Affiliation(s)
| | | | | | | | - Alisha Raza
- Multan Medical and Dental College, Multan, Pakistan
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Li F, Qi JJ, Li LX, Yan TF. Impact of insulin resistance on IVF/ICSI outcomes in women with polycystic ovary syndrome: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2024; 299:54-61. [PMID: 38838387 DOI: 10.1016/j.ejogrb.2024.05.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 05/22/2024] [Accepted: 05/31/2024] [Indexed: 06/07/2024]
Abstract
OBJECTIVE To evaluate the effect of insulin resistance (IR) on in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) outcomes in patients with polycystic ovary syndrome (PCOS). STUDY DESIGN PubMed, Google Scholar,Web of Science, Embase, Scopus and the Cochrane Library were searched to identify relevant studies. A total of 6,137 PCOS women undergoing IVF/ICSI with or without IR were included in the systematic review and meta-analysis. RESULTS The systematic review and meta-analysis included twelve observational studies that were free from inherent bias. When comparing PCOS women undergoing IVF/ICSI, the IR and non-IR groups did not show significant differences in oocytes retrieved (WMD = -0.63, 95 % CI: -2.37 to 1.12, P = 0. 483), fertilization rate (WMD = 1.01, 95 % CI: -0.66 to 2.67, P = 0.236; OR = 0.97, 95 % CI: 0.79 to 1.19, P = 0.783), and live birth rate (OR = 1.02, 95 % CI: 0.78 to 1.33, P = 0.892). However, the group with IR had a lower number of MII oocytes (WMD = -1.07, 95 % CI: -1.54 to -0.59, P < 0.001), total embryos (WMD = -1.37, 95 % CI: -1. 78 to -0.95, P < 0.001), and clinical pregnancy rate (OR = 0.77, 95 % CI: 0.59 to 0.99, P = 0.042), as well as a higher miscarriage rate (OR = 1.11, 95 % CI: 1.02 to 1.22, P = 0.017) compared to the non-IR group. CONCLUSION In women with PCOS, IR had a negative impact on IVF/ICSI outcomes. To obtain more favourable empirical support, larger studies are necessary.
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Affiliation(s)
- Feng Li
- Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou 570311 Hainan Province, China
| | - Ju-Ju Qi
- The First Hospital of Shijiazhuang, Shijiazhuang 050011, Heibei Province, China
| | - Li-Xin Li
- The First Hospital of Shijiazhuang, Shijiazhuang 050011, Heibei Province, China
| | - Teng-Fei Yan
- Baoding No.1 Central Hospital, Baoding 071000, Hebei Province, China.
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Akbari LN, Kheirollahi A, Vatannejad A, Hamidi H. Association of rs4588 polymorphism in vitamin D binding protein gene with polycystic ovarian syndrome in Iranian women: a case-control study. BMC Res Notes 2024; 17:207. [PMID: 39068475 PMCID: PMC11283716 DOI: 10.1186/s13104-024-06857-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 07/05/2024] [Indexed: 07/30/2024] Open
Abstract
OBJECTIVE Vitamin D deficiency and variations in the vitamin D binding protein (VDBP) gene may play a role in the development of Polycystic ovary syndrome (PCOS). This study aims to investigate the association of the rs4588 polymorphism with PCOS in Iranian women, as well as its association with infertility and recurrent pregnancy loss (RPL) in these patients. RESULTS The analysis revealed statistically significant differences in the distributions of genotypes and alleles of the rs4588 polymorphism among the three groups (p < 0.0001). The AC genotype and A allele showed an association with an elevated risk of PCOS and infertility. In this study, no association was found between genotypes and alleles of the rs4588 polymorphism and the risk of RPL in women with PCOS. Subjects with the AA or AC genotype exhibited significantly higher levels of LDL compared to those with the CC genotype.
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Affiliation(s)
- Leila Nazarpoor Akbari
- Department of Comparative Biosciences, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Asma Kheirollahi
- Department of Comparative Biosciences, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran.
| | - Akram Vatannejad
- Department of Comparative Biosciences, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Hediyeh Hamidi
- Department of Comparative Biosciences, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
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Busari KA, Tulay P. Polycystic ovary syndrome: emerging stem cell therapies. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2024; 70:e20231436. [PMID: 39045951 PMCID: PMC11288272 DOI: 10.1590/1806-9282.20231436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 03/05/2024] [Indexed: 07/25/2024]
Affiliation(s)
- Karimat Adeola Busari
- Near East University, Faculty of Medicine, Department of Medical Genetics – Nicosia, Cyprus
| | - Pinar Tulay
- Near East University, Faculty of Medicine, Department of Medical Genetics – Nicosia, Cyprus
- Near East University, DESAM Research Institute – Nicosia, Cyprus
- Near East University, Center of Excellence, Genetics and Cancer Diagnosis-Research Center – Nicosia, Cyprus
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Deng YP, Zhou YL, Wei TT, He GS, Zhu ZX, Zhang SN, Liu MJ, Xue JJ, Zhang WX, Yang XG. Combined traditional Chinese medicine therapy for the treatment of infertility with polycystic ovary syndrome: A network meta-analysis of randomized controlled trials. Medicine (Baltimore) 2024; 103:e38912. [PMID: 38996123 PMCID: PMC11245265 DOI: 10.1097/md.0000000000038912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 06/21/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) infertility has attracted great attention from researchers due to its high incidence. Numerous studies have shown that Chinese medicine is effective in treating this disease, but there is a wide variety of Chinese medicine therapies available, and there is a lack of comparative evaluation of the efficacy of various Chinese medicine combination therapies in the clinic, which requires further in-depth exploration. This study aims to evaluate the efficacy of a combined traditional Chinese medicine (TCM) therapy for the treatment of infertility with PCOS using network meta-analysis (NMA). METHODS In PubMed, web of Science, Cochrane Library, Embase, China Knowledge Network, Wanfang Data, VIP Database, China Biomedical Literature Database (SinoMed) databases, searchs were conducted for information about the randomized controlled trials (RCTs) of combined TCM therapy for the treatment of infertility with PCOS. Quality evaluation was performed using the Cochrane 5.3 risk of bias assessment tool, and NMA using Stata 16.0. RESULTS This study comprised 28 RCTs using 8 combined TCM therapies in total. The results of the NMA showed that moxibustion + herbal, fire acupuncture + herbal, acupuncture + herbal, electroacupuncture + herbal, and acupoint application + herbal improved the clinical pregnancy rate better than acupuncture, herbal, and western medicines monotherapy (P < .05). Additionally, ear point pressure + herbal enema + herbal, acupuncture and moxibustion + herbal, fire acupuncture + herbal, and acupuncture + herbal improved the ovulation rate better than acupuncture, herbal, and western medicines monotherapy (P < .05). Moxibustion + herbal, fire acupuncture + herbal, and acupuncture + herbal are the 3 most effective therapies for improving the clinical pregnancy rate. Fire acupuncture + herbal, acupuncture + herbal, and ear point pressure + herbal enema + herbal are the 3 most effective therapies for improving the ovulation rate. CONCLUSION The combined TCM therapy demonstrated better efficacy for the treatment of infertility with PCOS compared to acupuncture, herbal, and western medicines monotherapy. However, the optimal treatment therapy varied depending on the outcome indicators. Further large sample, high-quality, and standardized RCTs are needed to verify these findings.
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Affiliation(s)
- Yun-Peng Deng
- Henan University of Chinese Medicine, Zhengzhou, China
- Third Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Yan-Li Zhou
- Henan University of Chinese Medicine, Zhengzhou, China
- Third Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Teng-Teng Wei
- Henan University of Chinese Medicine, Zhengzhou, China
- Third Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Guang-Shuai He
- Henan University of Chinese Medicine, Zhengzhou, China
- Third Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Zhi-Xin Zhu
- Henan University of Chinese Medicine, Zhengzhou, China
- Third Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Shu-Ning Zhang
- Henan University of Chinese Medicine, Zhengzhou, China
- Third Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Mei-Jun Liu
- Henan University of Chinese Medicine, Zhengzhou, China
- Third Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Jing-Jing Xue
- Henan University of Chinese Medicine, Zhengzhou, China
- Third Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Wei-Xing Zhang
- Henan University of Chinese Medicine, Zhengzhou, China
- Third Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Xu-Guang Yang
- Henan University of Chinese Medicine, Zhengzhou, China
- Third Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
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Zhuang Y, Li L, Zhang Y, Liu X, Zeng B, Zhu B, Dai F. Association between Life's Essential 8 and Infertility as Well as the Mediating Effects of Oxidative Stress and Inflammatory Factors Among U.S. Women Aged 18-45 Years. Reprod Sci 2024:10.1007/s43032-024-01635-3. [PMID: 38977640 DOI: 10.1007/s43032-024-01635-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Accepted: 06/24/2024] [Indexed: 07/10/2024]
Abstract
Management of cardiovascular disease in pregnancy is important, yet the association between cardiovascular health and infertility is rarely reported. In this study, we aimed to explore the association between Life's Essential 8 (LE8), a novel cardiovascular health (CVH) measure, and infertility, and to investigate potential mediating mechanisms. This study investigated cross-sectional data from the 2013-2018 National Health and Nutrition Examination Survey. LE8 score (ranging from 0 to 100) was calculated as the unweighted average of eight CVH metrics. The association between LE8 and infertility was explored through weighted multiple logistic regression. Restricted cubic splines were used to explore nonlinear correlation. In addition, mediation analysis was conducted to investigate the role of oxidative stress and inflammatory markers systematically. After strict exclusion criteria, 1703 American women aged 18-45 years were included. After full adjustment, the LE8 score showed a negative correlation with infertility [per 1 SD increase, OR = 0.675, 95% CI: 0.553-0.824], with a linear dose-response relationship (non-linear P = 0.122). Similar linear negative correlations were found between health factor scores and infertility, with higher body mass index and glucose scores having a significantly lower risk of infertility. Stratified analyses showed a stronger inversed relationship between LE8 and infertility in younger populations. Moreover, mediation analysis revealed that uric acid concentration and lymphocyte count mediated the effect of LE8 on infertility (P < 0.05). LE8 and its subscale scores were linearly and negatively associated with infertility, which may be mediated in part through uric acid and lymphocyte count. Focusing on weight management and glycemic control can effectively reduce the risk of infertility.
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Affiliation(s)
- Yan Zhuang
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Laifu Li
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yanqi Zhang
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xuna Liu
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Beibei Zeng
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Boxu Zhu
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Fei Dai
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
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Zhang Q, Ke W, Ye J, Zhang P, Yang Q, Pan F, Wang K, Zha B. Is thyroid function associated with polycystic ovary syndrome? A bidirectional Mendelian randomization study. Endocrine 2024; 85:380-391. [PMID: 38472621 DOI: 10.1007/s12020-024-03756-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 02/18/2024] [Indexed: 03/14/2024]
Abstract
OBJECTIVE Some observational studies have suggested the association between thyroid function and polycystic ovary syndrome (PCOS). However, it remains to be determined whether these associations are causal or not. The aim of this study was to investigate the underlying causal association between different thyroid function status and PCOS. METHODS Bidirectional Mendelian randomization (MR) analysis was conducted to explore the impact of different thyroid function statuses on PCOS. The study included 10,074 individuals with PCOS and 103,164 controls for the primary analysis, with validation analysis repeated in the FinnGen R9 and EstBB PCOS cohorts. Female-specific thyroid function GWAS data were obtained from European population, including Hyperthyroidism (22,383 cases and 54,288 controls) and Hypothyroidism (27,383 cases and 54,288 controls) from the UK Biobank, and TSH (54,288 cases and 72,167 controls) and FT4 (49,269 cases and 72,167 controls) within the reference range from the ThyroidOmics Consortium. Inverse variance weighting (IVW) was chosen as the principal method, and sensitivity analysis was conducted to test for the presence of horizontal pleiotropy or heterogeneity. RESULTS The IVW analysis indicated nominal significance between normal TSH levels and PCOS after adjusted for age and BMI [OR (95% CI) = 0.78(0.62,0.97), P = 0.029], suggesting that maintaining normal TSH levels might act as a protective factor against the pathogenesis of PCOS. Besides, in order to increase the statistical power, we pooled PCOS GWAS above together by meta-analysis and found PCOS contributed to the occurrence of hyperthyroidism [OR(95%CI) = 1.37(0.73,2.57), P = 0.012]. However, no causal relationship was found after Bonferroni correction (P-value < 0.0031). CONCLUSION Although the MR analysis didn't indicate genetic causal association between thyroid function and PCOS after Bonferroni correction. Further efforts are needed to interpret the potential causal relationship between thyroid function and PCOS in different age and BMI subgroup.
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Affiliation(s)
- Qinnan Zhang
- Department of Endocrinology, Fifth People's Hospital of Shanghai Fudan University, Shanghai, China
| | - Wencai Ke
- Department of Clinical Laboratory Medicine, Fifth People's Hospital of Shanghai Fudan University, Shanghai, China
| | - Jun Ye
- Department of Obstetrics and Gynecology, Fifth People's Hospital of Shanghai Fudan University, Shanghai, China
| | - Panpan Zhang
- Department of Endocrinology, Fifth People's Hospital of Shanghai Fudan University, Shanghai, China
| | - Qian Yang
- Department of Endocrinology, Fifth People's Hospital of Shanghai Fudan University, Shanghai, China
| | - Fanfan Pan
- Department of Endocrinology, Fifth People's Hospital of Shanghai Fudan University, Shanghai, China
| | - Kai Wang
- Department of Endocrinology, Fifth People's Hospital of Shanghai Fudan University, Shanghai, China.
| | - Bingbing Zha
- Department of Endocrinology, Fifth People's Hospital of Shanghai Fudan University, Shanghai, China.
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Sha Y, Zhu J, Shen F. A meta-analysis of efficacy on dexamethasone and clomiphene in the treatment of polycystic ovary syndrome patients. BMC Womens Health 2024; 24:298. [PMID: 38769509 PMCID: PMC11103836 DOI: 10.1186/s12905-024-03141-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 05/10/2024] [Indexed: 05/22/2024] Open
Abstract
OBJECTIVE Polycystic ovary syndrome (PCOS) is an endocrine gynecological disease affecting many women of reproductive age. Clomiphene is the first-line treatment for PCOS patients, but most individuals may be resistant to it. This study aims to assess the efficacy of dexamethasone and clomiphene in the treatment of PCOS patients, and to provide a theoretical basis for clinicians to study and treat PCOS. METHODS Chinese and English databases including PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), WanFang Medical Network, and VIP Information Chinese Journal Service Platform (VIP) were searched from the inception to January 2023. Review Manager and Stata software were used for meta- analysis. The risk of bias of eligible studies were assessed using Cochrane's risk of bias tool. Publication bias was assessed by funnel plots, Begg's and Egger's tests. RESULTS A total of 12 literatures were finally included, with a total of 1270 PCOS patients. Compared with the control group, dexamethasone combined with clomiphene could significantly improve pregnancy (RR = 1.71, P < 0.00001), ovulation (RR = 1.30, P < 0.00001), luteinizing hormone level (SMD = -0.94, P < 0.00001), estradiol level (SMD = 0.99, P = 0.05), progesterone level (SMD = 5.08, P = 0.002) and testosterone level (SMD = -1.59, P < 0.00001). However, there were no significant effects on ovulation-stimulating hormone level (SMD = 0.15, P = 0.37), adverse reactions (RR = 1.30, P = 0.30), dizziness (RR = 1.50, P = 0.45), and vomiting (RR = 1.67, P = 0.48). CONCLUSION The treatment of dexamethasone combined with clomiphene is helpful to improve the ovulation and pregnancy rate in patients with PCOS, and improve the hormone levels of patients.
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Affiliation(s)
- Ying Sha
- Department of Obstetrics and Gynecology, Zhangjiagang Second People's Hospital, Zhangjiagang City, Jiangsu Province, China
| | - Jianfen Zhu
- Department of Obstetrics and Gynecology, Zhangjiagang Second People's Hospital, Zhangjiagang City, Jiangsu Province, China
| | - Fangrong Shen
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Suzhou University, Suzhou City, Jiangsu Province, China.
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Sekar S, Fernando S, Budithi S. Association between polycystic ovarian syndrome and incompetent uterine cervix: A systematic review and meta-analysis. J Gynecol Obstet Hum Reprod 2024; 53:102763. [PMID: 38432628 DOI: 10.1016/j.jogoh.2024.102763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 02/03/2024] [Accepted: 02/29/2024] [Indexed: 03/05/2024]
Abstract
OBJECTIVE We aimed to determine the association between polycystic ovarian syndrome (PCOS) and cervical incompetence (CI). We hypothesise that insulin resistance induces a glucose metabolism disorder that could potentially cause cervical incompetence, resulting in an adverse outcome. DESIGN We conducted a systematic review and meta-analysis of observational studies to summarise the evidence regarding the strength of the association of occurrence of CI in a PCOS pregnant woman compared to a non-PCOS pregnant woman. We defined PCOS as the presence of two of the three Rotterdam criteria, and a combination of clinical symptoms and ultrasound findings were used to diagnose CI. METHOD This review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) reporting standards and the PROSPERO registration. We systematically searched PubMed, Embase and Cochrane databases to identify observational studies up to December 2022. We included studies in English which compared the PCOS and non-PCOS pregnant women who were diagnosed using Rotterdam criteria and subsequently developed CI in the same pregnancy. We excluded the studies which did not report CI as an outcome. Two reviewers independently screened studies, extracted data, and assessed the risk of bias (JBI critical appraisal tools). In the meta-analysis, effect estimates were pooled using the random effects model, and heterogeneity was measured using I2 statistics. RESULTS We identified 23 articles, of which 19 were screened, and three studies were included in the meta-analysis. Three observational studies reported the data of 3845 pregnant women with PCOS and 9449 pregnant women without PCOS. One hundred and forty-one (3.7 %) pregnant women with PCOS developed CI compared to 58 (0.6 %) non-PCOS pregnant women [Risk ratio: 5.3; 95 % confidence interval: 1.9-14.6; I2: 89 %]. Of the three studies included, two had a low risk of bias, and one had a moderate risk of bias. CONCLUSION The findings of the review suggested higher risk of CI in a pregnant woman with PCOS compared to pregnant women without PCOS. These findings highlight the necessity of establishing guidelines for early identification of CI in PCOS pregnant mothers to prevent adverse maternal and neonatal outcomes following preterm labour.
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Affiliation(s)
- Sindhu Sekar
- Wrexham Maelor Hospital, Betsi Cadwaladr University Health Board, Wrexham LL13 7TD, United Kingdom.
| | - Sujeewa Fernando
- Wrexham Maelor Hospital, Betsi Cadwaladr University Health Board, Wrexham LL13 7TD, United Kingdom
| | - Srividhya Budithi
- Wrexham Maelor Hospital, Betsi Cadwaladr University Health Board, Wrexham LL13 7TD, United Kingdom
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10
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He Y, Wang X, Liu Q, Liu H, Yang S. Exploring the mechanism of clomiphene citrate to improve ovulation disorder in PCOS rats based on follicular fluid metabolomics. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2024; 397:2281-2296. [PMID: 37815607 DOI: 10.1007/s00210-023-02750-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 09/26/2023] [Indexed: 10/11/2023]
Abstract
To examine the effects of clomiphene citrate (CC) on follicular fluid metabolites and related metabolic pathways in rats with polycystic ovary syndrome (PCOS) using non-targeted metabolomics and determine how CC treats ovulation disorder in PCOS. The Sprague Dawley rats were randomly divided into control, model, and CC groups. A PCOS model was established with letrozole. Body weight, ovarian weight, estrus cycles, serum hormone levels, and ovary histopathology of the rats were collected for further evaluation. Moreover, through ultra-performance liquid chromatography-mass spectrometry, the study of follicular fluid metabolites revealed the mechanism of action of CC. CC reduced ovarian weight and regulated estrous cycles and serum hormone levels in PCOS rats but did not affect their body weight. Moreover, the metabolomic results showed that CC adjusted 153 metabolites, among which 16 cross metabolites like testosterone, androstenedione, 17α-hydroxyprogesterone, and cholic acid were considered as potential biomarkers for CC to improve ovulation disorders in PCOS rats. Kyoto Encyclopedia of Genes and Genomes pathway enrichment also showed that the CC group mainly engaged in tryptophan metabolism and steroid hormone biosynthesis. CC can improve ovulation disorders in rats, and its mechanism is related to the regulation of the secretion of serum hormone and follicular fluid metabolites and the amelioration of multi-metabolic pathways.
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Affiliation(s)
- Yiqing He
- College of Integrated Traditional Chinese and Western Medicine, Hunan University of Chinese Medicine, Changsha, 410208, Hunan, China
| | - Xi Wang
- College of Integrated Traditional Chinese and Western Medicine, Hunan University of Chinese Medicine, Changsha, 410208, Hunan, China
| | - Quan Liu
- College of Integrated Traditional Chinese and Western Medicine, Hunan University of Chinese Medicine, Changsha, 410208, Hunan, China
| | - Huiping Liu
- Hunan University of Chinese Medicine, Changsha, 410208, Hunan, China
| | - Shuo Yang
- Hunan University of Chinese Medicine, Changsha, 410208, Hunan, China.
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11
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Armijo-Sánchez A, Benítez Castillo N, García-Vidal E, Luna Chadid M, Salvador Ballada C, Valls Ricart G, Torres Pellens V. Treatment With a Patented 3.6:1 Myo-Inositol to D-chiro-Inositol Ratio, Antioxidants, Vitamins and Minerals Food Supplement in Women With a History of Assisted Reproductive Technique (ART) Failures: A Series of Case Reports. CLINICAL MEDICINE INSIGHTS-CASE REPORTS 2024; 17:11795476241242265. [PMID: 38559382 PMCID: PMC10981332 DOI: 10.1177/11795476241242265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 03/11/2024] [Indexed: 04/04/2024]
Abstract
Infertility affects 15% of couples in reproductive age worldwide. In women in particular, infertility can be caused by various abnormalities, with polycystic ovary syndrome (PCOS) being the most common. Currently, there are many assisted reproductive techniques (ART) available to combat the burden of infertility. However, positive results are not guaranteed. The administration of inositol has been shown to increase positive reproductive outcomes in women undergoing ART. Here we present a series of clinical cases in which women with a history of infertility and previously failed ART, supplemented with a specific 3.6:1 MYO:DCI ratio, antioxidants, vitamins, and minerals for a period of 1 to 3 months before undergoing in vitro fertilization (IVF). In this series of case reports, we provide preliminary evidence that supplementation with a specific 3.6:1 MYO to DCI ratio, as well as antioxidants, vitamins, and minerals may contribute positively to female fertility in women undergoing IVF, with a history of primary or secondary infertility and previously failed ART.
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Affiliation(s)
| | - N. Benítez Castillo
- Hospital Universitario Materno Infantil de Canarias, Las Palmas de Gran Canaria, Spain
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12
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Guan M, Li R, Shen Q, Wang GP, Li Z, Xiao M, Lei J. Women's experience of polycystic ovary syndrome management: A systematic review and meta-synthesis. Int J Gynaecol Obstet 2024; 164:857-868. [PMID: 37605982 DOI: 10.1002/ijgo.15031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 07/09/2023] [Accepted: 07/23/2023] [Indexed: 08/23/2023]
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is a common chronic condition in women of child-bearing age. There is currently no effective treatment, so early and long-term management is essential. However, there are many problems in the practice of disease management in women with PCOS that make it difficult to achieve good outcomes. OBJECTIVE To explore women's experience of PCOS management and identify the relevant facilitators and barriers to management. SEARCH STRATEGY A structured search was undertaken in five bibliographic databases (MEDLINE, Web of Science, CINAHL, Embase, PubMed, and Cochrane) from the date of establishment of the database up to December 2022. SELECTION CRITERIA All qualitative and mixed-methods studies available in English describing the experience of PCOS management from the patients' perspective were included. DATA COLLECTION AND ANALYSIS The Joanna Briggs Institute Qualitative Assessment and Review Instrument was used to appraise study quality. The evidence was synthesized using a pragmatic meta-aggregative approach guided by the capability, opportunity, and motivation model of behavior (COM-B). MAIN RESULTS A total of 13 studies were included with 85 equivocal findings and 12 credible findings. The findings were meta-aggregated into three themes: (1) capability of women with PCOS, including patients' attitudes toward disease and management, knowledge, and skills of the disease; (2) opportunities in PCOS management, including information about PCOS, diagnostic delay, disease characteristics, disease management plan, and logistical and environmental problems; and (3) motivation in PCOS management, including impact of symptoms, perceived needs, support and feedback, and unpleasant medical experience. CONCLUSIONS This study identifies facilitators and barriers to PCOS management from the patient perspective, which can guide the design and implementation of PCOS management programs for patients. This study also provides information for future research into how the COM-B theory can be incorporated into specific management plans to promote patient action.
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Affiliation(s)
- Minhui Guan
- Xiang Ya Nursing School of Central South University, Changsha, China
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Rong Li
- Xiang Ya Nursing School of Central South University, Changsha, China
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Quan Shen
- Xiang Ya Nursing School of Central South University, Changsha, China
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Guang Peng Wang
- Xiang Ya Nursing School of Central South University, Changsha, China
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Ziyan Li
- Xiang Ya Nursing School of Central South University, Changsha, China
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Meili Xiao
- Xiang Ya Nursing School of Central South University, Changsha, China
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Jun Lei
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, Changsha, China
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13
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Samarasinghe SNS, Woods C, Miras AD. Bariatric Surgery in Women with Polycystic Ovary Syndrome. Metabolism 2024; 151:155745. [PMID: 38036245 DOI: 10.1016/j.metabol.2023.155745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/13/2023] [Accepted: 11/21/2023] [Indexed: 12/02/2023]
Abstract
Polycystic ovary syndrome (PCOS) is the most common endocrine condition in premenopausal women and is a common cause of anovulatory subfertility. Although obesity does not form part of the diagnostic criteria, it affects a significant proportion of women with PCOS and is strongly implicated in the pathophysiology of the disease. Both PCOS and obesity are known to impact fertility in women; obesity also reduces the success of assisted reproductive technology (ART). With or without pharmacotherapy, lifestyle intervention remains the first-line treatment in women with PCOS and obesity. Bariatric surgery is still an experimental treatment in women with PCOS and subfertility. This review will present an overview of the pathophysiology of PCOS and obesity and the role of bariatric surgery. Although data are sparse regarding the impact of bariatric surgery on subfertility in women with PCOS and obesity, existing studies point to a beneficial role in treating metabolic and reproductive dysfunction.
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14
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Liu X, Zhang J, Wang S. Global, regional, and national burden of infertility attributable to PCOS, 1990-2019. Hum Reprod 2024; 39:108-118. [PMID: 38011904 DOI: 10.1093/humrep/dead241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 11/01/2023] [Indexed: 11/29/2023] Open
Abstract
STUDY QUESTION What is the current burden of infertility attributable to PCOS at global, regional, and national levels by age and socio-demographic index (SDI) across 21 regions and 204 countries and territories? SUMMARY ANSWER The burden of infertility attributable to PCOS increased from 6.00 million prevalent cases in 1990 to 12.13 million in 2019 globally and increased sharply in most regions and nations. WHAT IS KNOWN ALREADY PCOS is the most common cause of anovulatory infertility, affecting up to 80% of women with anovulation. No comprehensive and detailed epidemiological estimates of infertility attributable to PCOS in reproductive women aged 15-49 years by age and SDI, at the global, regional, and national level, have been reported. STUDY DESIGN, SIZE, DURATION An age- and SDI-stratified systematic analysis of the prevalence and years lived with disability (YLD) of infertility attributable to PCOS across 21 regions and 204 countries and territories from 1990 to 2019 has been performed. PARTICIPANTS/MATERIALS, SETTING, METHODS The prevalence and YLD of female infertility attributable to PCOS in reproductive women aged 15-49 years from 1990 to 2019 were retrieved directly from the Global Burden of Diseases 2019. The number, rates per 100 000 persons, and average annual percentage changes (AAPCs) of prevalence and YLD were estimated at the global, regional, and national levels. MAIN RESULTS AND THE ROLE OF CHANCE Globally, the prevalent cases of infertility attributable to PCOS among women of reproductive age (15-49 years) doubled from 1990 to 2019, with 6.00 million prevalent cases in 1900 and 12.13 million in 2019. The global age-standardized prevalence rates (ASPRs) of infertility attributable to PCOS were 223.50/100 000 persons in 1990 and 308.25/100 000 persons in 2019. At global level, the YLDs of infertility attributable to PCOS increased by 98.0% from 35.20 thousand in 1990 to 69.70 thousand in 2019. The burden of infertility attributable to PCOS in the high SDI region was significantly higher than that in the other four SDI regions. The greatest annual increases in rates of ASPR and age-standardized YLD rate were observed in the middle SDI region (AAPC 1.96 [95% CI 1.87-2.06], 1.94 [1.87-2.00], respectively) and the low-middle SDI region (AAPC 1.96 [1.90-2.03], 1.90 [1.85-1.94], respectively). The regional highest ASPR and the age-standardized YLD rate of infertility were observed in High-income Asia Pacific. The national highest ASPR and the age-standardized YLD rate of infertility were observed in Italy. Positive associations were observed between these burden estimates and the SDI level (all P < 0.001). LIMITATIONS, REASONS FOR CAUTION Although the Global Burden of Diseases 2019 has tried its best to collect all available data, some countries have limited data, which may result in an underestimation of the burden of infertility attributable to PCOS. The diagnostic criteria of PCOS are constantly changing, which may induce bias in infertility attributable to PCOS. No information on the PCOS phenotype is provided in the Global Burden of Diseases 2019, so we cannot estimate the infertility attributable to a specific PCOS phenotype. Detection bias would lead to a higher prevalence of PCOS and infertility attributable to PCOS in developed countries with well-established medical systems and greater willingness of the populace to seek medical attention. Thus, health resource allocation for infertility attributable to PCOS in low-prevalence areas should not be ignored. WIDER IMPLICATIONS OF THE FINDINGS The global burden of infertility attributable to PCOS increased sharply from 1990 to 2019. Effective health interventions and efficient preventative and managerial strategies should be established to reduce the burden of infertility attributable to PCOS. Weight control is suggested to reduce the burden of infertility attributable to PCOS, especially in the high SDI region. STUDY FUNDING/COMPETING INTEREST(S) This study was supported by the National Key Research and Development Program of China (grant number, 2022YFC2704100) and the National Natural Science Foundation of China (Nos 82001498 and 82371648). The authors declare no competing interests. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Xingyu Liu
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- National Clinical Research Center for Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Key Laboratory of Cancer Invasion and Metastasis, Ministry of Education, Huazhong University of Science and Technology, Wuhan, China
| | - Jinjin Zhang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- National Clinical Research Center for Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Key Laboratory of Cancer Invasion and Metastasis, Ministry of Education, Huazhong University of Science and Technology, Wuhan, China
| | - Shixuan Wang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- National Clinical Research Center for Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Key Laboratory of Cancer Invasion and Metastasis, Ministry of Education, Huazhong University of Science and Technology, Wuhan, China
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Khemani S, More A, Nair N, Choudhary N, Shrivastava J, Mamankar D. Comprehensive Management of Polycystic Ovarian Syndrome and Secondary Infertility: Optimizing Fertility Outcomes. Cureus 2024; 16:e52597. [PMID: 38374852 PMCID: PMC10875149 DOI: 10.7759/cureus.52597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 01/19/2024] [Indexed: 02/21/2024] Open
Abstract
A 33-year-old woman with secondary infertility and polycystic ovarian syndrome (PCOS) is profiled in this case report. In 2020, an in-vitro fertilization/intracytoplasmic sperm injection pregnancy resulted in a missed abortion, which is part of the patient's medical history. In order to enhance fertility outcomes, this case report seeks to give an overall perspective on the treatment and medical care strategy for people with PCOS and previous cases of infertility. One of the physical characteristics of PCOS, bilateral polycystic ovaries, was seen in the patient. Treatments included long-term gonadotropin-releasing hormone agonist treatment, medications, and optimizing endometrial preparation. The patient was regularly monitored with routine ultrasound evaluations, hormone profiling, and psychological support. For patients with PCOS and secondary infertility, the case report emphasizes the value of individualized treatment strategies, close monitoring, and supportive care to enhance pregnancy outcomes. Clinicians handling situations similar to this one will greatly benefit from the conclusions and treatment plans offered in this case study, which emphasizes the need for a multifaceted strategy to deal with the complexity of PCOS-related infertility.
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Affiliation(s)
- Shivani Khemani
- Clinical Embryology, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Akash More
- Clinical Embryology, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Nancy Nair
- Clinical Embryology, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Namrata Choudhary
- Clinical Embryology, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Jarul Shrivastava
- Clinical Embryology, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Deepali Mamankar
- Obstetrics and Gynecology, Amardeep Hospital and Test Tube Baby Centre, Akola, IND
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Yu F, Xue Y, Zhao Y, Zhang L, He X, Liu Z. Isorhamnetin inhibits inflammatory response to alleviate DHEA-induced polycystic ovary syndrome in rats. Gynecol Endocrinol 2023; 39:2183045. [PMID: 36842967 DOI: 10.1080/09513590.2023.2183045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/28/2023] Open
Abstract
OBJECTIVE To explore the role of isorhamnetin on polycystic ovary syndrome (PCOS) in rats. METHODS Sprague Dawley (SD) rats were subcutaneously injected with dehydroepiandrosteron (DHEA) to establish PCOS model. Hematoxylin and eosin (H&E) staining and TdT-mediated dUTP Nick-End Labeling (TUNEL) were used to measure histological changes and apoptosis of ovary tissues. The levels of serum hormones and inflammatory factors in ovary tissues were measured by enzyme-linked immuno sorbent assay (ELISA). RESULTS In DHEA-induced PCOS rats, the levels of serum glucose, insulin, testosterone and luteinizing hormone (LH) were enhanced, estradiol (E2), sex hormone-binding globulin (SHBG), follicle stimulating hormone (FSH) levels were decreased, inflammatory levels and apoptosis of ovary tissues were increased. Additionally, DHEA increased the body weight, ovary weight, and ovary volume, cystic follicles, and decreased corpus luteum. Moreover, the tumor necrosis factor (TNF) signaling pathway was activated in PCOS rats. The levels of TNF receptor superfamily member 1 A (TNFR1), TNF-α, and fas cell surface death feceptor (FAS) were enhanced in ovary tissues of DHEA induced PCOS rats. Isorhamnetin (ISO) treatment after DHEA modeling markedly reduced serum levels of glucose, insulin, testosterone and LH, increased E2, SHBG, FSH level, decreased inflammatory levels, and inhibited apoptosis and decreased body weight, ovary weight, and ovary volume. The levels of TNFR1, TNF-α, and FAS were markedly decreased after ISO treatment in PCOS rats. Additionally, ISO alone had no significant effect on rats. CONCLUSION Isorhamnetin inhibits inflammatory response to alleviate DHEA-induced PCOS in rats by inactivating the TNF signaling pathway.
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Affiliation(s)
- Fei Yu
- Department of Traditional Chinese Medicine, Cangzhou People's Hospital, Cangzhou, Hebei, P.R. China
| | - Yanfeng Xue
- Department of Traditional Chinese Medicine, Cangzhou People's Hospital, Cangzhou, Hebei, P.R. China
| | - Yunyan Zhao
- Department of Traditional Chinese Medicine, Cangzhou People's Hospital, Cangzhou, Hebei, P.R. China
| | - Long Zhang
- Department of Traditional Chinese Medicine, Cangzhou People's Hospital, Cangzhou, Hebei, P.R. China
| | - Xiao He
- Department of Traditional Chinese Medicine, Cangzhou People's Hospital, Cangzhou, Hebei, P.R. China
| | - Zheng Liu
- Department of Traditional Chinese Medicine, Cangzhou People's Hospital, Cangzhou, Hebei, P.R. China
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17
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Sun N, Chen Y, Lu L, Yan H, Zhou J, Li K, Zhang W, Yuan L, Heng BC, Zeng W, Shi Y, Tong G, Yin P. Peptidomic analysis of follicular fluid in patients with polycystic ovarian syndrome. Front Cell Dev Biol 2023; 11:1289063. [PMID: 38020909 PMCID: PMC10666747 DOI: 10.3389/fcell.2023.1289063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 10/10/2023] [Indexed: 12/01/2023] Open
Abstract
Objective: The aim of this study was to analyze and compare the differential expression of peptides within the follicular fluid of polycystic ovary syndrome (PCOS) patients versus normal women by using peptidomics techniques. The underlying mechanisms involved in PCOS pathogenesis will be explored, together with screening and identification of potential functional peptides via bioinformatics analysis. Materials and methods: A total of 12 patients who underwent in vitro fertilization and embryo transfer (IVF-ET) at the Reproductive Medicine Center of Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from 1 September 2022 to 1 November 2022 were included in this study. The follicular fluid of PCOS patients (n = 6) and normal women (n = 6) were collected. The presence and concentration differences of various peptides were detected by the LC-MS/MS method. GO and KEGG analysis were performed on the precursor proteins of the differentially-expressed peptides, and protein network interaction analysis was carried out to identify functionally-relevant peptides among the various peptides. Results: A variety of peptides within the follicular fluid of PCOS versus normal patients were detected by peptidomics techniques. Altogether, 843 upregulated peptides and 236 downregulated peptides were detected (absolute fold change ≥2 and p < 0.05). Of these, 718 (718 = 488 + 230) peptides were only detected in the PCOS group, while 205 (205 = 174 + 31) were only detected in the control group. Gene Ontology enrichment and pathway analysis were performed to characterize peptides through their precursor proteins. We identified 18 peptides from 7 precursor proteins associated with PCOS, and 4 peptide sequences were located in the functional domains of their corresponding precursor proteins. Conclusion: In this study, differences in the follicular development of PCOS versus normal patients were revealed from the polypeptidomics of follicular development, which thus provided new insights for future studies on the pathological mechanisms of PCOS development.
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Affiliation(s)
- Ningyu Sun
- Department of Reproductive Medicine, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yuanyuan Chen
- Department of Reproductive Medicine, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lu Lu
- Department of Reproductive Medicine, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Hua Yan
- Department of Reproductive Medicine, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jing Zhou
- Department of Gynecology of Traditional Chinese Medicine, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Kai Li
- Department of Reproductive Medicine, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wuwen Zhang
- Department of Reproductive Medicine, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lihua Yuan
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Boon Chin Heng
- School of Stomatology, Peking University, Beijing, China
| | - Weiwei Zeng
- Department of Gynecology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yin Shi
- Key Laboratory of Acupuncture and Immunological Effects, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Guoqing Tong
- Department of Reproductive Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Ping Yin
- Department of Reproductive Medicine, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Rizzuti A, Alvarenga C, Stocker G, Fraga L, Santos HO. Early Pharmacologic Approaches to Avert Anabolic Steroid-induced Male Infertility: A Narrative Review. Clin Ther 2023; 45:e234-e241. [PMID: 37806813 DOI: 10.1016/j.clinthera.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 08/23/2023] [Accepted: 09/03/2023] [Indexed: 10/10/2023]
Abstract
PURPOSE To review the impact of testosterone and other androgenic-anabolic steroids (AASs) on male fertility, exploring potential drugs that can be used to preserve or restore male fertility upon AAS use or prior contact. METHODS A review was performed to provide a unifying clinical link between drugs used to preserve or restore male fertility (ie, clomiphene citrate, human chorionic gonadotropin, selective estrogen receptor modulators, recombinant luteinizing and follicle-stimulating hormones, and human menopausal gonadotrophin) in the context of AAS-induced infertility and related aspects. FINDINGS Human chorionic gonadotropin (125-500 IU every other day), clomiphene citrate (12.5-50 mg/d), recombinant luteinizing hormone (125-500 IU every other day), recombinant follicle-stimulating hormone (75-150 IU 1-3×/wk), and human menopausal gonadotrophin (75-150 IU 1-3×/wk) are promising early pharmacologic approaches to avert AAS-induced male infertility. Additionally, a full partner assessment is crucial to the success of a couple planning to have children. The partner's age and gynecopathies must be considered. Egg or sperm cryopreservation can also be alternatives for future fertility. Reinforcing AAS cessation is imperative to achieving better success in misusers. IMPLICATIONS The exponential increase in AAS misuse raises concerns about the impact on male fertility. This review suggests that gonadotropin analogs and selective androgen receptor modulators (clomiphene citrate) are viable approaches to early preserve or restore fertility in men on AAS use or with previous contact. However, proper standardization of doses and combinations is required and hence physicians should also be aware of patients' and partners' fertility.
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Affiliation(s)
- André Rizzuti
- School of Medicine, Estácio de Sá University (UNESA), Rio de Janeiro, RJ, Brazil
| | - Conrado Alvarenga
- School of Medicine, Department of Urology, University of Sao Paulo (USP), Sao Paulo, Brazil
| | - Gustavo Stocker
- School of Medicine, University Center Assis Gurgacz Foundation (FAG), Cascavel, PR, Brazil
| | - Lucas Fraga
- School of medicine, Santa Casa da misericordia de Vitorica (EMESCAM), Vitória, ES, Brazil
| | - Heitor O Santos
- School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, MG, Brazil.
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Zheng X, Zhao D, Jin Y, Liu Y, Liu D. Role of the NLRP3 inflammasome in gynecological disease. Biomed Pharmacother 2023; 166:115393. [PMID: 37660654 DOI: 10.1016/j.biopha.2023.115393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 08/20/2023] [Accepted: 08/26/2023] [Indexed: 09/05/2023] Open
Abstract
The NLR family pyrin domain containing 3 (NLRP3) inflammasome is involved in the innate immune system and is a three-part macromolecular complex comprising the NLRP3 protein, apoptosis-associated speck-like protein containing a CARD (ASC) and the cysteine protease pro-caspase-1. When the NLRP3 inflammasome is activated, it can produce interleukin (IL)- 1β and IL-18 and eventually lead to inflammatory cell pyroptosis. Related studies have demonstrated that the NLRP3 inflammasome can induce an immune response and is related to the occurrence and development of gynecological diseases, such as endometriosis, polycystic ovary syndrome and breast cancer. NLRP3 inflammasome inhibitors are beneficial for maintaining cellular homeostasis and tissue health and have been found effective in targeting some gynecological diseases. However, excessive inhibitor concentrations have been found to cause adverse effects. Therefore, proper control of NLRP3 inflammasome activity is critical. This paper summarizes the structure and function of the NLRP3 inflammasome and highlights the therapeutic potential of targeting it in gynecological diseases, such as endometriosis, polycystic ovary syndrome and breast cancer The application of NLRP3 inflammasome inhibitors is also discussed.
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Affiliation(s)
- Xu Zheng
- College of Acupuncture and Massage, Changchun University of Chinese Medicine, Changchun 130117, Jilin, China
| | - Dan Zhao
- College of Acupuncture and Massage, Changchun University of Chinese Medicine, Changchun 130117, Jilin, China
| | - Ye Jin
- School of Pharmacy, Changchun University of Chinese Medicine, Changchun 130117, Jilin, China.
| | - Yang Liu
- Acupuncture department,Affiliated Hospital of Changchun University of Chinese Medicine, Changchun 130117, Jilin, China.
| | - Da Liu
- School of Pharmacy, Changchun University of Chinese Medicine, Changchun 130117, Jilin, China.
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20
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Kumari Y, Bai P, Waqar F, Asif AT, Irshad B, Raj S, Varagantiwar V, Kumar M, Neha F, Chand S, Kumar S, Varrassi G, Khatri M, Mohamad T. Advancements in the Management of Endocrine System Disorders and Arrhythmias: A Comprehensive Narrative Review. Cureus 2023; 15:e46484. [PMID: 37927670 PMCID: PMC10624418 DOI: 10.7759/cureus.46484] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 10/04/2023] [Indexed: 11/07/2023] Open
Abstract
In recent years, notable advancements have been made in managing endocrine system disorders and arrhythmias. These advancements have brought about significant changes in healthcare providers' approach towards these complex medical conditions. Endocrine system disorders encompass a diverse range of conditions, including but not limited to diabetes mellitus, thyroid dysfunction, and adrenal disorders. Significant advancements in comprehending the molecular underpinnings of these disorders have laid the foundation for implementing personalized medicine. Advancements in genomic profiling and biomarker identification have facilitated achieving more accurate diagnoses and developing customized treatment plans. Furthermore, the utilization of cutting-edge pharmaceuticals and advanced delivery systems presents a significant advancement in achieving enhanced glycemic control and minimizing adverse effects for individuals afflicted with endocrine disorders. Arrhythmias, characterized by irregular heart rhythms, present a substantial risk to cardiovascular well-being. Innovative strategies for managing arrhythmia encompass catheter-based ablation techniques, wearable cardiac monitoring devices, and predictive algorithms powered by artificial intelligence. These advancements facilitate the early detection, stratification of risks, and implementation of targeted interventions, ultimately leading to improved patient outcomes. Incorporating technology and telemedicine has been instrumental in enhancing the accessibility and continuity of care for individuals diagnosed with endocrine disorders and arrhythmias. The utilization of remote patient monitoring and telehealth consultations enables prompt modifications to treatment regimens and alleviates the need for frequent visits to the clinic. This is particularly significant in light of the current global health crisis. This review highlights the interdisciplinary nature of managing endocrine disorders and arrhythmias, underscoring the significance of collaboration among endocrinologists, cardiologists, electrophysiologists, and other healthcare professionals. Multidisciplinary care teams have enhanced their capabilities to effectively address the intricate relationship between the endocrine and cardiovascular systems. In summary, endocrine system disorders and arrhythmias management have undergone significant advancements due to groundbreaking research, technological advancements, and collaborative healthcare approaches. This narrative review provides a comprehensive overview of the advancements, showcasing their potential to enhance patient care, improve quality of life, and decrease healthcare expenses. Healthcare providers must comprehend and integrate these advancements into their clinical practice to enhance outcomes for individuals with endocrine system disorders and arrhythmias.
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Affiliation(s)
- Yogita Kumari
- Medicine, Jinnah Postgraduate Medical Centre, Karachi, PAK
| | - Pooja Bai
- Internal Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, PAK
| | - Fahad Waqar
- Medicine, Allama Iqbal Medical College, Lahore, PAK
| | - Ahmad Talal Asif
- Medicine, King Edward Medical University (KEMU) Lahore, Lahore, PAK
| | - Beena Irshad
- Medicine, Sharif Medical and Dental College, Lahore, PAK
| | - Sahil Raj
- Internal Medicine, Jinnah Sindh Medical University, Karachi, PAK
| | | | - Mahendra Kumar
- Medicine, Sardar Patel Medical College Bikaner India, Bikaner, IND
| | - Fnu Neha
- Medicine, Peoples University of Medical & Health Science for Women, Nawabshah, PAK
| | - Surat Chand
- Medicine, Ghulam Mohammad Mahar Medical College, Sukkur, PAK
| | - Satesh Kumar
- Medicine and Surgery, Shaheed Mohtarma Benazir Bhutto Medical College, Karachi, PAK
| | | | - Mahima Khatri
- Medicine and Surgery, Dow University of Health Sciences, Karachi, Karachi, PAK
| | - Tamam Mohamad
- Cardiovascular Medicine, Wayne State University, Detroit, USA
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21
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Concepción-Zavaleta MJ, Coronado-Arroyo JC, Quiroz-Aldave JE, Durand-Vásquez MDC, Ildefonso-Najarro SP, Rafael-Robles LDP, Concepción-Urteaga LA, Gamarra-Osorio ER, Suárez-Rojas J, Paz-Ibarra J. Endocrine factors associated with infertility in women: an updated review. Expert Rev Endocrinol Metab 2023; 18:399-417. [PMID: 37702309 DOI: 10.1080/17446651.2023.2256405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 08/09/2023] [Accepted: 09/04/2023] [Indexed: 09/14/2023]
Abstract
INTRODUCTION Infertility is defined as the inability to conceive after unprotected sexual intercourse for at least 12 consecutive months. Our objective is to present an updated narrative review on the endocrine causes of infertility in women. AREAS COVERED A comprehensive review was conducted using Scielo, Scopus, and EMBASE databases, comprising 245 articles. The pathophysiology of infertility in women was described, including endocrinopathies such as hypothalamic amenorrhea, hyperprolactinemia, polycystic ovary syndrome, primary ovarian insufficiency, obesity, thyroid dysfunction, and adrenal disorders. The diagnostic approach was outlined, emphasizing the necessity of hormonal studies and ovarian response assessments. Additionally, the treatment plan was presented, commencing with non-pharmacological interventions, encompassing the adoption of a Mediterranean diet, vitamin supplementation, moderate exercise, and maintaining a healthy weight. Subsequently, pharmacological treatment was discussed, focusing on the management of associated endocrine disorders and ovulatory dysfunction. EXPERT OPINION This comprehensive review highlights the impact of endocrine disorders on fertility in women, providing diagnostic and therapeutic algorithms. Despite remaining knowledge gaps that hinder more effective treatments, ongoing research and advancements show promise for improved fertility success rates within the next five years. Enhanced comprehension of the pathophysiology behind endocrine causes and the progress in genetic research will facilitate the delivery of personalized treatments, thus enhancing fertility rates.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - José Paz-Ibarra
- Department of Medicine, School of Medicine, Universidad Nacional Mayor de San Marcos, Lima, Perú
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Dar MA, Maqbool M, Ara I. The PCOS puzzle: putting the pieces together for optimal care. Int J Adolesc Med Health 2023; 35:299-311. [PMID: 37596861 DOI: 10.1515/ijamh-2023-0102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 07/30/2023] [Indexed: 08/20/2023]
Abstract
Polycystic ovary syndrome (PCOS) is a multifaceted hormonal disorder that has significant ramifications for both women's reproductive and metabolic well-being. This analysis aims to offer a thorough comprehension of PCOS by investigating the various contributing factors that are crucial for its effective management. We delve into the topic of hormonal imbalances, such as elevated androgens and disrupted estrogen-progesterone dynamics, and their effects on reproductive and metabolic health. Furthermore, we explore the intricate connection between insulin resistance, hyperinsulinemia, and PCOS, highlighting their pivotal role in metabolic dysfunction. Additionally, we examine fertility challenges, irregular menstrual patterns, and metabolic complications while also reviewing current treatment methodologies. Moreover, we address the latest research concerning genetic, environmental, and epigenetic influences on PCOS. By piecing together these essential elements, healthcare professionals can attain a comprehensive understanding of PCOS and deliver optimal care for those affected by the condition.
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Affiliation(s)
- Mohd Altaf Dar
- Department of Pharmacology, CT Institute of Pharmaceutical Sciences, PTU, Jalandhar, Punjab, India
| | - Mudasir Maqbool
- Department of Pharmaceutical Sciences, University Of Kashmir, Srinagar, Jammu and Kashmir, India
| | - Irfat Ara
- Regional Research Institute of Unani Medicine, Srinagar, Jammu and Kashmir, India
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Ma N, Zhou J, Zhou Z, Wan B, Lu W. Effects of UBE3A on the insulin resistance in polycystic ovary syndrome through the ubiquitination of AMPK. BMC Endocr Disord 2023; 23:152. [PMID: 37461021 PMCID: PMC10351129 DOI: 10.1186/s12902-023-01400-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 07/03/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is a reproductive hormonal abnormality and a metabolic disorder, which is frequently associated with insulin resistance (IR). We aim to investigate the potential therapeutic effects of Ubiquitin-protein ligase E3A (UBE3A) on IR in the PCOS rats via Adenosine 5'-monophosphate (AMP)-activated protein kinase (AMPK) activation. METHODS The PCOS and IR rats model was established by dehydroepiandrosterone (DHEA) and high fat diet (HFD) treatment, and the fat rate, glucose tolerance and insulin tolerance were measured. The IR rats numbers were calculated. Besides, the mRNA levels of glucose transporter 4 (GLUT4) and UBE3A were detected by RT-qPCR. Furthermore, the relationship between was demonstrated by co-IP assay. The phosphorylation and ubiquitination of AMPK were analyzed by western blot. RESULTS UBE3A was up-regulated in the PCOS rats. UBE3A knockdown significantly decreased the fat rate, glucose tolerance and insulin tolerance in the PCOS and IR rats. Additionally, the GLUT4 levels were significantly increased in PCOS + IR rats. Besides, after UBE3A knockdown, the IR rats were decreased, the p-IRS1 and p-AKT levels were significantly up-regulated. Furthermore, UBE3A knockdown enhanced phosphorylation of AMPK through decreasing the ubiquitination of AMPK. AMPK knockdown reversed the role of UBE3A knockdown in the PCOS + IR rats. CONCLUSIONS UBE3A knockdown inhibited the IR in PCOS rats through targeting AMPK. Our study indicated that UBE3A might become a potential biological target for the clinical treatment of PCOS.
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Affiliation(s)
- Ning Ma
- Reproductive Medical Center, Hainan Women and Children's Medical Center, No.75 Longkun South Road, Haikou, Hainan, 570206, China
| | - Jing Zhou
- Reproductive Medical Center, Hainan Women and Children's Medical Center, No.75 Longkun South Road, Haikou, Hainan, 570206, China
| | - Zhi Zhou
- Reproductive Medical Center, Hainan Women and Children's Medical Center, No.75 Longkun South Road, Haikou, Hainan, 570206, China
| | - Bangbei Wan
- Reproductive Medical Center, Hainan Women and Children's Medical Center, No.75 Longkun South Road, Haikou, Hainan, 570206, China
| | - Weiying Lu
- Reproductive Medical Center, Hainan Women and Children's Medical Center, No.75 Longkun South Road, Haikou, Hainan, 570206, China.
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Fu X, Shi L, Liu P, Jiao Y, Guo S, Chen Q, Zheng Q, Chen X, Wang Y. Expression and Clinical Significance of HIF-1α in Follicular Fluid and Granulosa Cells in Infertile PCOS Patients. Reprod Sci 2023; 30:2263-2274. [PMID: 36690916 DOI: 10.1007/s43032-022-01135-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 11/17/2022] [Indexed: 01/25/2023]
Abstract
The present study aimed to determine the clinical predictive significance of HIF-1α in follicular development and assisted reproductive technology (ART). We collected follicular fluid (FF) and granulosa cells (GCs) from PCOS (polycystic ovary syndrome) patients (experimental group) and other patients who were infertile due to tubal factors or male factors (control group) with IVF/ICSI-ET. The localization and expression of HIF-1α in GCs were determined by immunofluorescence staining. HIF-1α protein and mRNA expression were detected by enzyme-linked immunosorbent assay and quantitative real-time PCR, respectively. To clarify the regulation of HIF-1α by TGF-β1, we added the HIF-1α-specific blocker YC-1 to GCs. The serum AMH, LH, LH/FSH, testosterone, BMI and the number of oocytes retrieved in the PCOS group were significantly higher, while the cleavage rate was significantly lower, than those in the control group. HIF-1α protein was expressed in the cytoplasm of GCs. The expression of HIF-1α protein in the FF of the PCOS group was significantly lower than that in the control group. However, the expression of HIF-1α protein in GCs between the two groups was not significantly different. HIF-1α protein was highly expressed in large FF (follicular diameter ≥ 14 mm). Compared with the control group, the expression of HIF-1α mRNA in GCs of the PCOS group was significantly lower. The results showed a significant positive correlation between HIF-1α and TGF-β1 expression. We found that both HIF-1α and TGF-β1 were involved in the development of PCOS follicular development. The mutual regulation of HIF-1α and TGF-β1 may be one of the important mechanisms of the occurrence and development of PCOS.
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Affiliation(s)
- Xiayan Fu
- Reproductive Medical Center, Department of Gynecology and Obstetrics, Tongji Hospital, Tongji University School of Medicine, Shanghai, 200065, China
| | - Lihong Shi
- Reproductive Medical Center, Department of Gynecology and Obstetrics, Tongji Hospital, Tongji University School of Medicine, Shanghai, 200065, China
| | - Ping Liu
- Reproductive Medical Center, Department of Gynecology and Obstetrics, Tongji Hospital, Tongji University School of Medicine, Shanghai, 200065, China
| | - Yufan Jiao
- Reproductive Medical Center, Department of Gynecology and Obstetrics, Tongji Hospital, Tongji University School of Medicine, Shanghai, 200065, China
| | - Shana Guo
- Reproductive Medical Center, Department of Gynecology and Obstetrics, Tongji Hospital, Tongji University School of Medicine, Shanghai, 200065, China
| | - Qizhen Chen
- Reproductive Medical Center, Department of Gynecology and Obstetrics, Tongji Hospital, Tongji University School of Medicine, Shanghai, 200065, China
| | - Qichang Zheng
- School of Chinese Medicine, Macau University of Science and Technology, Macau, China
| | - Xiangyun Chen
- Department of Gynecology and Obstetrics, Nanxiang Hospital, Shanghai, 201802, China
| | - Yanqiu Wang
- Reproductive Medical Center, Department of Gynecology and Obstetrics, Tongji Hospital, Tongji University School of Medicine, Shanghai, 200065, China.
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Liu Y, Guo Y, Ding R, Yan X, Tan H, Wang X, Wang Y, Wang L. Heterogeneity and associated factors of patients with polycystic ovary syndrome health behaviors: a latent class analysis. BMC Endocr Disord 2023; 23:135. [PMID: 37357262 DOI: 10.1186/s12902-023-01385-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 06/07/2023] [Indexed: 06/27/2023] Open
Abstract
OBJECTIVE Using latent class to analyze whether there are subtypes of health behaviors in patients with PCOS can be addressed using targeted interventions. METHODS October 2021 to June 2022, 471 PCOS patients were surveyed using the Health Promoting Lifestyle Profile Questionnaire. Latent class analysis (LCA) was used to identify subgroups of PCOS patients. Subsequent multinomial latent variable regressions identified factors that were associated with health behaviors. RESULTS A three-class subtypes was the optimum grouping classification: (1)High healthy behavior risk; (2)high healthy responsibility and physical activity risk; (3)low healthy behavior risk. The multinomial logistic regression analysis revealed that (1)Single (OR = 2.061,95% CI = 1.207-3.659), Education level is primary school or below (OR = 4.997,95%CI = 1.732-14.416), participants is student (OR = 0.362,95%=0.138-0.948), participants with pregnancy needs (OR = 1.869,95%=1.009-3.463) were significantly more likely to be in the high healthy behavior risk subtypes; (2)The older the age (OR = 0.953,95%=0.867-1.047) and the larger the WC (OR = 0.954,95%=0.916-0.993), participants is married (OR = 1.126,95%=0.725-1.961), participants is employed ( OR = 1.418,95%=0.667-3.012) were significantly more likely to be in the high health responsibility and physical activity risk subtypes. CONCLUSION Patients with PCOS are a heterogeneous population with potential subtypes that may be suitable for customized multi-level care and targeted interventions.
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Affiliation(s)
- Ying Liu
- Nursing Department, Affiliated Hospital of Zunyi Medical University, 563000, ZunYi, Guizhou, China
- Nursing College, ZunYi Medical University, 563000, ZunYi, Guizhou, China
| | - Yunmei Guo
- Nursing Department, Affiliated Hospital of Zunyi Medical University, 563000, ZunYi, Guizhou, China
- Nursing College, ZunYi Medical University, 563000, ZunYi, Guizhou, China
| | - Rui Ding
- Nursing Department, Affiliated Hospital of Zunyi Medical University, 563000, ZunYi, Guizhou, China
- Nursing College, ZunYi Medical University, 563000, ZunYi, Guizhou, China
| | - Xin Yan
- Nursing Department, Affiliated Hospital of Zunyi Medical University, 563000, ZunYi, Guizhou, China
- Nursing College, ZunYi Medical University, 563000, ZunYi, Guizhou, China
| | - Huiwen Tan
- Nursing Department, Affiliated Hospital of Zunyi Medical University, 563000, ZunYi, Guizhou, China
- Nursing College, ZunYi Medical University, 563000, ZunYi, Guizhou, China
| | - Xueting Wang
- Nursing Department, Affiliated Hospital of Zunyi Medical University, 563000, ZunYi, Guizhou, China
- Nursing College, ZunYi Medical University, 563000, ZunYi, Guizhou, China
| | - Yousha Wang
- Nursing Department, Affiliated Hospital of Zunyi Medical University, 563000, ZunYi, Guizhou, China
- Nursing College, ZunYi Medical University, 563000, ZunYi, Guizhou, China
| | - LianHong Wang
- Nursing Department, Affiliated Hospital of Zunyi Medical University, 563000, ZunYi, Guizhou, China.
- Nursing College, ZunYi Medical University, 563000, ZunYi, Guizhou, China.
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Della Corte L, Boccia D, Palumbo M, Mercorio A, Ronsini C, Bifulco G, Giampaolino P. Is There Still a Place for Surgery in Patients with PCOS? A Review. Life (Basel) 2023; 13:1270. [PMID: 37374053 DOI: 10.3390/life13061270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/14/2023] [Accepted: 05/26/2023] [Indexed: 06/29/2023] Open
Abstract
OBJECTIVE The surgical management of polycystic ovary syndrome (PCOS) represents an unclear option compared to medical therapy, and it is necessary to deepen the role of minimally invasive surgery, represented by laparoscopic ovarian drilling (LOD) and transvaginal hydrolaparoscopy (THL), for the treatment of PCOS in infertile women resistant to drug therapy and to establish its success in terms of ovulation and pregnancy rates. METHODS A search was performed in the main electronic databases (MEDLINE, EMBASE, Web of Science, PubMed, and the Cochrane Library) from 1994 to October 2022 in order to evaluate the role of surgery in patients with PCOS resistant to pharmacological treatment. Only original scientific articles in English were included. RESULTS Seventeen studies were analyzed in this review. In all analyzed studies, more than 50% of the population underwent spontaneous ovulation after surgical treatment without great differences between the two surgical techniques (LOD and THL). More than 40% of patients delivered, with a higher rate after LOD, although eight ectopic pregnancies and sixty-three miscarriages were reported. A lower risk of adhesion formation after THL has been reported. No clear data regarding the effect of surgery on the regularization of the menstrual cycle has been described. A reduction in LH and AMH serum levels as well as the LH/FSH ratio compared to preoperative levels for both surgical techniques has been described. CONCLUSIONS Despite the scarcity and heterogeneity of data, surgical therapy could be considered an effective and safe approach in the management of PCOS patients with resistance to pharmacological treatment who desire to become pregnant.
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Affiliation(s)
- Luigi Della Corte
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples "Federico II", 80131 Naples, Italy
| | - Dominga Boccia
- Department of Public Health, School of Medicine, University of Naples "Federico II", 80131 Naples, Italy
| | - Mario Palumbo
- Department of Public Health, School of Medicine, University of Naples "Federico II", 80131 Naples, Italy
| | - Antonio Mercorio
- Department of Public Health, School of Medicine, University of Naples "Federico II", 80131 Naples, Italy
| | - Carlo Ronsini
- Department of Woman, Child and General and Specialized Surgery, School of Medicine, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Giuseppe Bifulco
- Department of Public Health, School of Medicine, University of Naples "Federico II", 80131 Naples, Italy
| | - Pierluigi Giampaolino
- Department of Public Health, School of Medicine, University of Naples "Federico II", 80131 Naples, Italy
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Juber NF, Abdulle A, AlJunaibi A, AlNaeemi A, Ahmad A, Leinberger-Jabari A, Al Dhaheri AS, AlZaabi E, Mezhal F, Al-Maskari F, Alanouti F, Alsafar H, Alkaabi J, Wareth LA, Aljaber M, Kazim M, Weitzman M, Al-Houqani M, Hag-Ali M, Oumeziane N, El-Shahawy O, Sherman S, Shah SM, Loney T, Almahmeed W, Idaghdour Y, Ali R. Association between pediatric asthma and adult polycystic ovarian syndrome (PCOS): a cross-sectional analysis of the UAE healthy future Study (UAEHFS). Front Endocrinol (Lausanne) 2023; 14:1022272. [PMID: 37293507 PMCID: PMC10246854 DOI: 10.3389/fendo.2023.1022272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 05/10/2023] [Indexed: 06/10/2023] Open
Abstract
Introduction Asthma and polycystic ovarian syndrome (PCOS) are linked in several possible ways. To date, there has been no study evaluating whether pediatric asthma is an independent risk factor for adult PCOS. Our study aimed to examine the association between pediatric asthma (diagnosed at 0-19 years) and adult PCOS (diagnosed at ≥20 years). We further assessed whether the aforementioned association differed in two phenotypes of adult PCOS which were diagnosed at 20-25 years (young adult PCOS), and at >25 years (older adult PCOS). We also evaluated whether the age of asthma diagnosis (0-10 vs 11-19 years) modified the association between pediatric asthma and adult PCOS. Material and methods This is a retrospective cross-sectional analysis using the United Arab Emirates Healthy Future Study (UAEHFS) collected from February 2016 to April 2022 involving 1334 Emirati females aged 18-49 years. We fitted a Poisson regression model to estimate the risk ratio (RR) and its 95% confidence interval (95% CI) to assess the association between pediatric asthma and adult PCOS adjusting for age, urbanicity at birth, and parental smoking at birth. Results After adjusting for confounding factors and comparing to non-asthmatic counterparts, we found that females with pediatric asthma had a statistically significant association with adult PCOS diagnosed at ≥20 years (RR=1.56, 95% CI: 1.02-2.41), with a stronger magnitude of the association found in the older adult PCOS phenotype diagnosed at >25 years (RR=2.06, 95% CI: 1.16-3.65). Further, we also found females reported thinner childhood body size had a two-fold to three-fold increased risk of adult PCOS diagnosed at ≥20 years in main analysis and stratified analyses by age of asthma and PCOS diagnoses (RR=2.06, 95% CI: 1.08-3.93 in main analysis; RR=2.74, 95% CI: 1.22-6.15 among those diagnosed with PCOS > 25 years; and RR=3.50, 95% CI: 1.38-8.43 among those diagnosed with asthma at 11-19 years). Conclusions Pediatric asthma was found to be an independent risk factor for adult PCOS. More targeted surveillance for those at risk of adult PCOS among pediatric asthmatics may prevent or delay PCOS in this at-risk group. Future studies with robust longitudinal designs aimed to elucidate the exact mechanism between pediatric asthma and PCOS are warranted.
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Affiliation(s)
- Nirmin F. Juber
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Abdishakur Abdulle
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Abdulla AlJunaibi
- Department of Pediatrics, Zayed Military Hospital, Abu Dhabi, United Arab Emirates
| | - Abdulla AlNaeemi
- Department of Cardiology, Zayed Military Hospital, Abu Dhabi, United Arab Emirates
| | - Amar Ahmad
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | | | - Ayesha S. Al Dhaheri
- Department of Nutrition and Health, College of Medicine and Health Sciences; United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Eiman AlZaabi
- Department of Pathology, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | - Fatima Mezhal
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Fatma Al-Maskari
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
- Zayed Center for Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Fatme Alanouti
- College of Natural and Health Sciences, Zayed University, Abu Dhabi, United Arab Emirates
| | - Habiba Alsafar
- Center for Biotechnology, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
- Department of Genetics and Molecular Biology, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
- Department of Biomedical Engineering, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
| | - Juma Alkaabi
- Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Laila Abdel Wareth
- Department of Laboratory Medicine, National Reference Laboratory, Abu Dhabi, United Arab Emirates
| | - Mai Aljaber
- Healthpoint Hospital, Abu Dhabi, United Arab Emirates
| | - Marina Kazim
- Abu Dhabi Blood Bank Services, SEHA, Abu Dhabi & Al-Ain, United Arab Emirates
| | - Michael Weitzman
- Department of Environmental Medicine, New York University of Medicine, New York, United States
| | - Mohammed Al-Houqani
- Department of Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Mohammed Hag-Ali
- Faculty of Health Sciences, Higher Colleges of Technology, Abu Dhabi, United Arab Emirates
| | - Naima Oumeziane
- Abu Dhabi Blood Bank Services, SEHA, Abu Dhabi & Al-Ain, United Arab Emirates
| | - Omar El-Shahawy
- Department of Population Health, New York University School of Medicine, New York, United States
| | - Scott Sherman
- Department of Population Health, New York University School of Medicine, New York, United States
| | - Syed M. Shah
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Tom Loney
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Wael Almahmeed
- Heart and Vascular Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Youssef Idaghdour
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Raghib Ali
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
- Medical Research Council (MRC) Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
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Rodrigues P, Marques M, Manero JA, Marujo MD, Carvalho MJ, Plancha CE. In vitro maturation of oocytes as a laboratory approach to polycystic ovarian syndrome (PCOS): From oocyte to embryo. WIREs Mech Dis 2023; 15:e1600. [PMID: 36781832 DOI: 10.1002/wsbm.1600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 12/12/2022] [Accepted: 01/05/2023] [Indexed: 02/15/2023]
Abstract
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting women of reproductive age, which in some case leads to infertility. This disorder is characterized by hyperandrogenism, ovulatory dysfunction and polycystic ovarian morphology. Infertile PCOS women that need in vitro fertilization (IVF) have greater risk of ovarian hyperstimulation syndrome (OHSS) if conventional ovarian stimulation is used. In vitro oocyte maturation (IVM) is an alternative technique that prevents OHSS in infertile PCOS women. In the last decade, IVM protocols have improved, particularly with the development of biphasic IVM culture accounting for better pregnancy and live birth rates. This technique has been extended to other treatments like, fertility preservation, when patients have no time, or a contra-indication for ovarian stimulation, and poor responders. In this review, we will discuss IVM as a viable option for PCOS infertile patients. This article is categorized under: Reproductive System Diseases > Molecular and Cellular Physiology Reproductive System Diseases > Environmental Factors Reproductive System Diseases > Genetics/Genomics/Epigenetics.
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Affiliation(s)
- Patricia Rodrigues
- Centro Médico de Assistência à Reprodução - CEMEARE, Lisbon, Portugal
- Escola de Psicologia e Ciências da Vida, Universidade Lusófona de Humanidade e Tecnologia de Lisboa, Lisbon, Portugal
| | - Monica Marques
- Centro Médico de Assistência à Reprodução - CEMEARE, Lisbon, Portugal
| | - Juan Aibar Manero
- Centro Médico de Assistência à Reprodução - CEMEARE, Lisbon, Portugal
| | - Maria D Marujo
- Centro Médico de Assistência à Reprodução - CEMEARE, Lisbon, Portugal
| | | | - Carlos E Plancha
- Centro Médico de Assistência à Reprodução - CEMEARE, Lisbon, Portugal
- Inst. Histologia e Biol. Desenvolvimento, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
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Guarnieri G, Iervolino M, Cavallone S, Unfer V, Vianello A. The "Asthma-Polycystic Ovary Overlap Syndrome" and the Therapeutic Role of Myo-Inositol. Int J Mol Sci 2023; 24:ijms24086959. [PMID: 37108123 PMCID: PMC10138395 DOI: 10.3390/ijms24086959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/03/2023] [Accepted: 04/07/2023] [Indexed: 04/29/2023] Open
Abstract
Asthma is a heterogeneous inflammatory disease characterized by abnormalities in immune response. Due to the inherent complexity of the disease and the presence of comorbidities, asthma control is often difficult to obtain. In asthmatic patients, an increased prevalence of irregular menstrual cycles, infertility, obesity, and insulin resistance has been reported. Given that these conditions are also common in patients with polycystic ovary syndrome (PCOS), we propose the definition of "asthma-PCOS overlap syndrome" to indicate a medical condition which shares characteristics of both diseases. The aim of this review is to analyze the links between asthma and PCOS and evaluate the therapeutic role of myo-inositol, a natural compound currently utilized in patients with PCOS, in the management of asthma patients.
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Affiliation(s)
- Gabriella Guarnieri
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
| | | | | | - Vittorio Unfer
- Systems Biology Group Laboratory, 00163 Rome, Italy
- The Experts Group on Inositol in Basic and Clinical Research (EGOI), 00161 Rome, Italy
| | - Andrea Vianello
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
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Hassan A, Yates L, Hing AK, Hirz AE, Hardeman R. Dobbs and disability: Implications of abortion restrictions for people with chronic health conditions. Health Serv Res 2023; 58:197-201. [PMID: 36424122 PMCID: PMC9836943 DOI: 10.1111/1475-6773.14108] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Asha Hassan
- Center for Antiracism Research for Health EquityUniversity of Minnesota School of Public HealthMinneapolisMinnesotaUSA
| | - Lindsey Yates
- Center of Excellence, Department of Maternal and Child Health, Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Anna K. Hing
- Center for Antiracism Research for Health EquityUniversity of Minnesota School of Public HealthMinneapolisMinnesotaUSA
| | - Alanna E. Hirz
- Fielding School of Public HealthUniversity of CaliforniaLos AngelesCaliforniaUSA
| | - Rachel Hardeman
- Center for Antiracism Research for Health EquityUniversity of Minnesota School of Public HealthMinneapolisMinnesotaUSA
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31
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Aasif A, Alam R, Ahsan H, Khan MM, Khan A, Khan S. The role of kisspeptin in the pathogenesis of a polycystic ovary syndrome. Endocr Regul 2023; 57:292-303. [PMID: 38127687 DOI: 10.2478/enr-2023-0032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
Hypothalamic-pituitary gonadal (HPG) axis is responsible for the development and regulation of the female reproductive system. In polycystic ovary syndrome (PCOS), there is a disturbance in the HPG axis. Kisspeptin, a neuropeptide produced by the KISS1 gene, plays a vital role in the regulation of HPG axis by binding with its receptors KISS1R/GPR54, and stimulates gonadotropin secretion from the hypothalamus into pituitary to release luteinizing hormone (LH) and follicle stimulating hormone (FSH). Polymorphisms or mutations in the KISS1 gene can cause disturbance in the kisspeptin signaling pathway and is thought to disrupt HPG axis. Altered signaling of kisspeptin can cause abnormal secretion of GnRH pulse, which leads to increased LH/FSH ratio, thereby affecting androgen levels and ovulation. The increased levels of androgen worsen the symptoms of PCOS. In the present article, we review the molecular physiology and pathology of kisspeptin and how it is responsible for the development of PCOS. The goal of this review article is to provide an overview and metabolic profile of kisspeptin in PCOS patients and the expression of kisspeptin in PCOS animal models. In the present article, we also review the molecular physiology and pathology of kisspeptin and how it is responsible for the development of PCOS.
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Affiliation(s)
- Adiba Aasif
- 1Department of Biochemistry, Integral Institute of Medical Sciences and Research, Lucknow, India
| | - Roshan Alam
- 1Department of Biochemistry, Integral Institute of Medical Sciences and Research, Lucknow, India
| | - Haseeb Ahsan
- 2Department of Biochemistry, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | - Mohammad Mustufa Khan
- 3Department of Basic Medical Sciences, Integral Institute of Allied Health Sciences and Research, Integral University, Lucknow, India
| | - Arshiya Khan
- 4Department of Obstetrics and Gynecology, Integral Institute of Medical Sciences and Research, Lucknow, India
| | - Saba Khan
- 1Department of Biochemistry, Integral Institute of Medical Sciences and Research, Lucknow, India
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The Complex Roles of Adipokines in Polycystic Ovary Syndrome and Endometriosis. Biomedicines 2022; 10:biomedicines10102503. [PMID: 36289764 PMCID: PMC9598769 DOI: 10.3390/biomedicines10102503] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/26/2022] [Accepted: 09/27/2022] [Indexed: 11/30/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) and endometriosis are frequent diseases of the female reproductive tract causing high morbidity as they can significantly affect fertility and quality of life. Adipokines are pleiotropic signaling molecules secreted by white or brown adipose tissues with a central role in energy metabolism. More recently, their involvement in PCOS and endometriosis has been demonstrated. In this review article, we provide an update on the role of adipokines in both diseases and summarize previous findings. We also address the results of multi-omics approaches in adipokine research to examine the role of single nucleotide polymorphisms (SNPs) in genes coding for adipokines and their receptors, the secretome of adipocytes and to identify epigenetic alterations of adipokine genes that might be conferred from mother to child. Finally, we address novel data on the role of brown adipose tissue (BAT), which seems to have notable effects on PCOS. For this review, original research articles on adipokine actions in PCOS and endometriosis are considered, which are listed in the PubMed database.
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33
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Kim EJ, Nho JH. Lifestyle Interventions for Adults with Infertility. J Lifestyle Med 2022; 12:69-71. [PMID: 36157889 PMCID: PMC9490012 DOI: 10.15280/jlm.2022.12.2.69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 04/15/2022] [Indexed: 11/30/2022] Open
Abstract
With a significant increase in the age-standardized prevalence of infertile men and women, infertility has become a widespread global issue. Furthermore, infertility has led to increased stigma and disease burden. The causes of infertility include lifestyle factors such as obesity, an unbalanced diet, and physical activity. To increase the rate of successful pregnancy, infertile men and women must improve their health and fertility through lifestyle improvements.
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Affiliation(s)
- Eun Jin Kim
- College of Nursing, Jeonbuk National University, Jeonju, Korea
| | - Ju-Hee Nho
- College of Nursing, Jeonbuk National University, Jeonju, Korea
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Zhang JH, Zhan L, Zhao MY, Wang JJ, Xie FF, Xu ZY, Xu Q, Cao YX, Liu QW. Role of EGFR expressed on the granulosa cells in the pathogenesis of polycystic ovarian syndrome. Front Endocrinol (Lausanne) 2022; 13:971564. [PMID: 36440230 PMCID: PMC9691951 DOI: 10.3389/fendo.2022.971564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 10/31/2022] [Indexed: 11/13/2022] Open
Abstract
Polycystic ovarian syndrome (PCOS) is one of the most common endocrinological disorders affecting between 6 to 20% of reproductive aged women. However, the etiology of PCOS is still unclear. Epidermal growth factor receptor (EGFR) plays a critical role in the growth and development of ovarian follicles. In our previous study, we showed that the expression level of EGFR was significantly higher in the cumulus granulosa cells from women with PCOS than that of normal women, suggesting that EGFR may play a potential role in the pathogenesis of PCOS. The present study further evaluated the association between EGFR and PCOS through both in clinical observation and animal experiments. We firstly validated the differential expression of EGFR in cumulus granulosa cells between PCOS patients and normal subjects by qRT-PCR and immunofluorescence staining. Then we generated a mouse model (n=20) of PCOS by injecting dehydroepiandrosterone (DHEA). The PCOS mice were then injected with an E corpus GFR inhibitor (AG1478) (n=10), which significantly improved the sex hormone levels in the estrous cycle stage, and the serum levels of LH, FSH and testosterone were compared with the PCOS mice without EGFR inhibitor treatment (n=10). Decreasing the expression level of EGFR in the PCOS mice also improved the ovulatory function of their ovaries which was indicated by the multifarious follicle stage in these mice as compared with the PCOS mice without EGFR inhibitor treatment. Also, the number of corpopa lutea were higher in the control group and the EGFR inhibitor treated group than in the PCOS group. The sex hormone levels and reproductive function were not significantly different between the control mice and the PCOS mice treated with the EGFR inhibitor. Our results demonstrated that EGF/EGFR signaling affected the proliferation of cumulus granulosa cells, oocyte maturation and meiosis, and played a potential role in the pathogenesis of PCOS. Therefore, the selective inhibition of EGFR may serve as a novel strategy for the clinical management of PCOS.
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Affiliation(s)
- Jun-Hui Zhang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- National Health Commission (NHC) Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, Anhui, China
- Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Ministry of Education of the People’s Republic of China, Hefei, Anhui, China
| | - Lei Zhan
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- National Health Commission (NHC) Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, Anhui, China
- Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Ministry of Education of the People’s Republic of China, Hefei, Anhui, China
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Ming-Ye Zhao
- Interventional Operating Room, Weihai Central Hospital, Weihai, Shandong, China
| | - Jin-Juan Wang
- Department of Gynecological Minimal Invasive Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
- Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Fen-Fen Xie
- Department of Histology and Embryology, Anhui Medical University, Hefei, Anhui, China
| | - Zu-Ying Xu
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- National Health Commission (NHC) Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, Anhui, China
- Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Ministry of Education of the People’s Republic of China, Hefei, Anhui, China
| | - Qian Xu
- Department of Gynecological Minimal Invasive Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
- Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Yun-Xia Cao
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- National Health Commission (NHC) Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, Anhui, China
- Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Ministry of Education of the People’s Republic of China, Hefei, Anhui, China
- *Correspondence: Yun-Xia Cao, ; Qi-Wei Liu,
| | - Qi-Wei Liu
- Department of Gynecological Minimal Invasive Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
- Beijing Maternal and Child Health Care Hospital, Beijing, China
- *Correspondence: Yun-Xia Cao, ; Qi-Wei Liu,
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