• Clinical and Experimental Reproductive Medicine
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• v.48 no.3
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• pp.194-197
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• 2021

Polycystic ovary syndrome (PCOS) is a common disorder in reproductive-age women. In 2018, an international evidence-based guideline announced recommendations spanning a wide range of issues on the assessment and management of PCOS. From the 166 recommendations, the present study reviews those that are of particular clinical relevance for daily practice and introduces other relevant studies that have been published since the global guideline. The 2018 guideline increased the antral follicle count cutoff for the diagnosis of PCOS from 12 to 20 when using a high-frequency probe. Hirsutism was defined as having a score of ≥4-6 based on a lower percentile of 85%-90% or cluster analysis, which was lower than the traditionally used 95th percentile-based cutoff. The diagnosis of PCOS in adolescents is challenging, and irregular menstruation was defined carefully according to years from menarche. The use of ultrasonography for the diagnosis of PCOS was restricted to those 8 years after menarche. As medication for non-fertility indications, combined oral contraceptives are the first-line drug. Metformin, in addition to lifestyle modifications, should be considered for adult patients with a body mass index ≥25 kg/m² for the management of weight and metabolic outcomes. An aromatase inhibitor is the recommended first-line medication for ovulation induction, a subsequent individual patient data meta-analysis also reported the same conclusion. Whether the new global guideline will be fully adopted by many specialists and change clinical practice is open to question. Further studies are needed to better understand and manage PCOS patients well.

• Clinical and Experimental Reproductive Medicine
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• v.48 no.2
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• pp.156-162
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• 2021

Objective: The aim of the present study was to evaluate the predictive capability of fasting-state measurements of glucose and insulin levels alone for abnormal glucose tolerance in women with polycystic ovary syndrome (PCOS). Methods: In total, 153 Korean women with PCOS were included in this study. The correlations between the 2-hour postload glucose (2-hr PG) level during the 75-g oral glucose tolerance test (OGTT) and other parameters were evaluated using Pearson correlation coefficients and linear regression analysis. The predictive accuracy of fasting glucose and insulin levels and other fasting-state indices for assessing insulin sensitivity derived from glucose and insulin levels for abnormal glucose tolerance was evaluated using receiver operating characteristic (ROC) curve analysis. Results: Significant correlations were observed between the 2-hr PG level and most fasting-state parameters in women with PCOS. However, the area under the ROC curve values for each fasting-state parameter for predicting abnormal glucose tolerance were all between 0.5 and 0.7 in the study participants, which falls into the "less accurate" category for prediction. Conclusion: Fasting-state measurements of glucose and insulin alone are not enough to predict abnormal glucose tolerance in women with PCOS. A standard OGTT is needed to screen for impaired glucose tolerance and type 2 diabetes mellitus in women with PCOS.

• Clinical and Experimental Reproductive Medicine
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• v.49 no.2
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• pp.127-134
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• 2022

Objective: This study aimed to investigate the impact of hyperandrogenism (HA) on the outcomes of ovulation induction (OI) using gonadotropin and intrauterine insemination (IUI) in patients with polycystic ovary syndrome (PCOS). Methods: This was a retrospective cohort study including 415 patients undergoing OI using gonadotropin and IUI treatment between January 2018 and December 2020 at a single infertility center. Baseline characteristics, clinical and laboratory parameters, and pregnancy outcomes were investigated. Results: Among the study population, there were 105 hyperandrogenic (25.3%) and 310 non-hyperandrogenic patients (74.7%). The live birth rate was lower in the HA group than in the non-HA group, but this difference did not reach statistical significance due to the limited sample size (14.3% vs. 21.0%, relative risk=0.68; 95% CI, 0.41-1.14, p=0.153). No predictive factors for live birth were identified through logistic regression analysis. Conclusion: HA did not negatively affect the outcomes of OI using gonadotropin and IUI cycles in Vietnamese women with PCOS. The result may not be applicable elsewhere due to the large variation in the characteristics of women with PCOS across races and populations.

• The Journal of Pediatrics of Korean Medicine
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• v.38 no.2
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• pp.53-67
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• 2024

Objective This study aimed to assess the trend of randomized clinical trials conducted in China involving oral herbal medicine for treating adolescent polycystic ovary syndrome (PCOS). Methods We used the China National Knowledge Infrastructure as our primary resource and conducted a search using keywords such as "PCOS", "多囊卵巢" and "多囊卵巢综合征". We identified and analyzed seven RCTs. Results 1. The group receiving herbal medicine treatment demonstrated significant improvements in total efficiency, sex hormone levels, and ultrasound-measurable values compared to the control group. 2. Epimedii Herba (淫羊藿), Alviae Miltiorrhizae Radix (丹參), and Angelicae Gigantis et Acutilobae Radix (當歸) were among the most used herbs in Traditional Chinese medicine decoctions for treating PCOS. Conclusions The findings suggest that oral herbal medicine is an effective treatment for patients with PCOS. This study provides a foundation for future research on the use of oral herbal medicine in PCOS treatment.

• Clinical and Experimental Reproductive Medicine
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• v.35 no.3
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• pp.223-229
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• 2008

Objective: This pilot study was performed to investigate the effect of metformin on insulin resistance, hormone levels, and lipid profiles in non-obese patients with polycystic ovary syndrome. Methods: This study included 16 non-obese patients with polycystic ovary syndrome diagnosed at our hospital from June 2006 to September 2007. Blood samples were collected before and 6 months after metformin treatment for analysis of fasting serum glucose levels, fasting serum insulin levels, a glycemic response to 75 g oral glucose tolerance test (OGTT), and hormonal blood profile including FSH, LH, estradiol, testosterone, free testosterone, serum lipid profiles. Insulin resistance was estimated by calculating fasting glucose/insulin ratio (FGIR), 2 hr glucose/insulin ratio after 75 g glucose load. And we investigated insulin resistance and pancreatic beta cell function by calculating HOMA beta cell function and HOMA IR. Results: After the treatment of metformin, there was significant increase in 2 hr glucose/insulin ratio after 75 g glucose load (p=0.04) and decrease in HOMA IR (p=0.000). But serum lipid profiles did not change significantly. Also the metformin treatment induced a significant reduction in serum free testosterone and LH levels, and LH/FSH ratio (p=0.001, p=0.000, p=0.034). Conclusion: This pilot study showed that metformin might be effective in improving insulin sensitivity, ameliorating hyperandrogenemia in non-obese patients with polycystic ovary syndrome. Further investigations with larger number of patients and long-term observations are necessary to determine the role of metformin.

• Clinical and Experimental Reproductive Medicine
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• v.49 no.4
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• pp.239-247
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• 2022

Objective: Asafoetida is a gum derived from Ferula assa-foetida, which is used in traditional Iranian medicine to treat some reproductive system disorders. The effects of asafoetida on ovarian tissue, expression of certain genes associated with polycystic ovary syndrome (PCOS), and levels of liver, kidney, and blood cell factors after treatment in a rat model were investigated. Methods: Thirty rats were divided into five groups: normal, polycystic, and treatment with three doses of asafoetida (12.5, 25, and 50 mg/kg for 3 weeks after PCOS induction). PCOS was induced by letrozole at a dose of 1 mg/kg administered orally for 3 weeks. Blood samples were taken, and the ovaries were removed and prepared for histomorphometric examination. Liver and kidney parameters were measured. The mRNA expression levels of luteinizing hormone receptor, CYP11A1, adenosine monophosphate-activated protein kinase, adiponectin, and adiponectin receptors 1 and 2 were also measured by real-time polymerase chain reaction. Results: The levels of liver, kidney, and blood parameters did not significantly differ between the treatment groups and the control group. At doses of 25 and 50 mg/kg, ovarian histopathology, especially the thicknesses of the theca and granulosa layers, was significantly improved relative to the PCOS group. The expression of target genes also improved in the 25 and 50 mg/kg treatment groups. Conclusion: Asafoetida can be used to treat PCOS as a complementary approach to conventional therapies. Asafoetida appears to act by regulating and activating metabolic and ovarian cycle enzymes.

• 대한생식의학회:학술대회논문집
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• 2002.11a
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• pp.31-45
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• 2002

• Clinical and Experimental Reproductive Medicine
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• v.41 no.1
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• pp.29-32
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• 2014

Objective: To investigate the causes of amenorrhea in Korean women. Methods: Medical records from 1,212 women with amenorrhea who visited the Department of Obstetrics and Gynecology, Asan Medical Center, between January 1989 and December 2011 were retrospectively reviewed. Amenorrhea was categorized as either primary or secondary. Results: Primary amenorrhea was identified in 132 of the patients (10.9%) and secondary amenorrhea in 1,080 (89.1%). The most frequent causes of primary amenorrhea were gonadal dysgenesis (28.0%, 37/132); Mayer-Rokitansky-K$\ddot{u}$ster-Hauser syndrome (20.0%, 27/132); and constitutional delay and androgen insensitivity syndrome (8.3%, 11/132; 8.3%, 11/132, respectively). Secondary amenorrhea was due to polycystic ovary syndrome (48.4%, 523/1,080); premature ovarian insufficiency (14.0%, 151/1,080); and nutrition-related hypogonadotropic hypogonadism (8.3%, 90/1,080). Conclusion: In this retrospective study, gonadal dysgenesis was the most common cause of primary amenorrhea and polycystic ovary syndrome was the most common cause of secondary amenorrhea in Korean women.

• The Journal of Korean Obstetrics and Gynecology
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• v.20 no.1
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• pp.84-98
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• 2007

Purpose : Polycystic ovarian syndrome(PCOS) is a endocrine disorder and still remains as one of the common causes of anovulation in women of reproductive age. There are some evidences that nerve growth factor(NGF) is involved in the pathogenesis of PCOS. In this research, the effects of ShingihwanhapChangbudodam- Tang(SCT) on the estradiol valerate(EV)-induced polycystic ovary(PCO) were investigated in rats. Methods : PCO was induced by single intramuscular injection with EV(4mg) in female rats. Rats in PCO control group(n = 8) were EV injected and orally administrated distilled water for sixty days. Rats in SCT-treated group(n = 8) were EV injected and orally administrated SCT for same duration. The weights of body, ovary and adrenal gland were measured. And also, ovarian histopathology and NGF immunohistochemistry were performed. Results : The weights of ovaries in SCT-treated group were significantly increased compared with control group. The numbers of secondly and mature follicles, and corpora lutea in SCT-treated group were significantly increased compared with control group. The numbers of atretic follicles were significantly decreased compared with control group. The expression of NGF positive reaction in the ovarian granulosa cells of SCT-treated group were lesser observed than control group. Conclusion : From the these results, we concluded that ShingihwanhapChangbudodam-Tang(SCT) has inhibitory effect on the development of EV-induced polycystic ovary. And it's effect may be related with decreased NGF activities in the ovary.

• The Journal of Korean Obstetrics and Gynecology
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• v.27 no.4
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• pp.25-42
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• 2014

Objectives: To observe the effects of Herb medication on Polycystic Ovary (PCO) in rats. Methods: Riss (Research Information Sharing Service) was searched for Oriental medicine about PCO on 2000~2014. So, Experimental studies using PCO model induced by Estradiol Valerate (EV) was selected to analyze how effects they were. Consequently, 10 studies published on 2000~2014 were selected to analyze about weight of model and both ovaries, the number aries, the number of follicle and corpus of follicle and corpus luteum, the level of serum Androstenedione (ADD) and total estrogen, the level of Nerve Growth Factor (NGF) and Corticotropin Releasing Factor (CRF), the crossover rate and the number of implantation. Results: Among them, there was significantly difference between treatment group and control group in weight of both ovaries, the number of follicle and corpora lutea, the crossover rate and the number of implantation. Conclusions: The effects of Herb medication was observed on making weight of ovaries with PCO to promote. The study about effect of Herb medication on NGF and CRF with PCOS had to be conducted. The further research have to focus on treatment of subfertility and infertility, that is field showing the advantage of Oriental medicine.