• The Journal of Korean Obstetrics and Gynecology
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• v.30 no.4
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• pp.59-76
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• 2017

Objectives: The purpose of this study is to investigate the effect on both herbal medicine periodic therapy and western medicine for polycystic ovary syndrome subfertility. Methods: We searched 8 electronic databases and search keywords were 'PCOS' and 'periodic therapy' or 'cyclic treatment'. We included randomized controlled clinical trials (RCTs) using the periodic therapy combined western medicine for PCOS patients. Results: We selected 8 studies. In studies, there were three studies in which the menstrual cycle was divided into 2 periods, one study divided into 3 periods, and four study divided into 4 periods. The meta-analysis of the 7 trials indicated that pregnancy rates integrated clomiphene and periodic therapy were higher than clomiphene alone. Conclusions: The periodic therapy combined western medicine for PCOS subfertility patients seems to improve pregnancy rates from this research. However, this result should be taken cautiously by unclear risk of bias. It would be necessary to fulfill further clinical study with herbal medicine periodic therapy on PCOS in Korean medicine to establish standard evidence of them.

• Clinical and Experimental Reproductive Medicine
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• v.38 no.2
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• pp.98-102
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• 2011

Objective: To investigate the effects of pioglitazone on controlled ovarian stimulation (COS), IVF outcomes, and follicular fluid (FF) cytokine concentrations in patients with polycystic ovary syndrome (PCOS). Methods: Eighty-six infertile patients with PCOS resistant to clomiphene citrate were randomized to receive pioglitazone (30 mg/day) or placebo on the starting day of oral contraceptive (OC) pretreatment, followed by an IVF protocol using a GnRH antagonist. Pioglitazone or placebo was administered once daily from the starting day of OC to the day of hCG injection. Results: Total dose and days of recombinant follicle-stimulating hormone administered, and the numbers of retrieved and mature oocytes, were significantly lower in the pioglitazone group than in the control group. FF tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) and interleukin-6 (IL-6) concentrations at oocyte retrieval were also significantly lower in the pioglitazone group. The clinical pregnancy rate was higher and the incidence of severe ovarian hyperstimulation syndrome was lower in the pioglitazone group, but the differences were not statistically significant. Conclusion: Pioglitazone reduces FF TNF-${\alpha}$ and IL-6 levels, and may improve ovarian response to COS in patients with PCOS.

• Clinical and Experimental Reproductive Medicine
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• v.48 no.4
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• pp.368-373
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• 2021

Objective: In this study we aimed to assess anorexigenic peptide levels in patients with or without polycystic ovary syndrome (PCOS) and their effects on assisted reproductive treatment (ART) outcomes. Methods: A prospective case-control study was conducted in a tertiary care university-based ART clinic. Eighty-three patients were included in the study. The PCOS group included 41 patients, and the non-PCOS group included 42 controls. The 2003 Rotterdam criteria were used for PCOS patient selection. The ART indications in the non-PCOS group were tubal factor or unexplained infertility. Venous blood samples were taken on the third day of the menstrual cycle to determine the serum anorexigenic peptide levels. The enzyme-linked immunosorbent assay method was used for laboratory analyses. Results: In the PCOS group, serum obestatin levels were significantly lower than in the control group, but serum anorexigenic peptide levels were similar in PCOS patients with or without clinical pregnancy. Ovarian hyperstimulation syndrome (OHSS) was diagnosed only in PCOS patients, and the obestatin levels of OHSS patients were significantly lower than those of other PCOS patients. Conclusion: Baseline anorexigenic peptide levels did not affect the clinical pregnancy rate in ART cycles. Obestatin may play a role in the pathophysiology of OHSS. This possibility should be confirmed in further research.

• Endocrinology and Metabolism
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• v.33 no.4
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• pp.447-458
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• 2018

Background: Polycystic ovarian syndrome (PCOS) is one of the most common endocrinopathies among reproductive-age women. Its metabolic features often overlap with those associated with metabolic syndrome (MS) and insulin resistance syndrome (IRS). The objective of this study was to determine the prevalence and predictors of MS and IRS in infertile Vietnamese women with PCOS. Methods: A cross-sectional study was conducted at a tertiary fertility centre at Hue University Hospital from June 2016 to November 2017. A total of 441 infertile women diagnosed with PCOS based on the revised 2003 Rotterdam consensus criteria were enrolled. MS and IRS were defined based on the National Heart, Lung, and Blood Institute/American Heart Association Adult Treatment Panel III 2005 and American College of Endocrinology IRS 2003 criteria, respectively. Complete clinical and biochemical measurements of 318 women were available for analysis. Independent predictors of MS and IRS were identified using multivariate logistic regression. Results: The overall prevalence of MS and IRS in women with PCOS was 10.4% and 27.0%, respectively. We identified older age (>30 years) and obesity as independent predictors of MS and IRS. Elevated anti-$M{\ddot{u}}llerian$ hormone levels increased the risk of IRS, but not that of MS. Conclusion: MS and IRS are prevalent disorders among infertile Vietnamese women with PCOS. PCOS is not solely a reproductive problem. Screening and early intervention for MS and/or IRS based on anthropometric, metabolic, and reproductive hormone risk factors should be an integral part of fertility care.

• 대한생식의학회:학술대회논문집
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• 2006.06a
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• pp.156.1-156.1
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• 2006

• Journal of Genetic Medicine
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• v.17 no.1
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• pp.1-10
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• 2020

Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in women, which is characterized by the oligo/anovulation, hyperandrogenism (HA) and polycystic ovarian morphology which are diagnostic criteria. PCOS has diverse clinical aspects in addition to those diagnostic criteria including increased risk for cardiovascular diseases, metabolic syndrome, dyslipidemia, type 2 diabetes and impaired fertility. Because of the heterogeneity of the disease, the pathogenesis of the disease has not been elucidated yet. Therefore, there is no cure for the endocrinopathy. HA and insulin resistance (IR) has been considered two major pillars of the pathogenesis of PCOS. Recent advances in animal studies revealed the critical role of neuroendocrine abnormalities in developing PCOS. Several pathways related to neuroendocrine origin have been investigated such as hypothalamus pituitary ovarian axis, hypothalamus pituitary adrenal axis and hypothalamus pituitary adipose axis. This review summarizes the current knowledge about the role of HA and IR in developing PCOS. In addition, we review the results of recent genome wide association studies for PCOS. This new perspective improves our understanding of the role of neuroendocrine origins in PCOS and suggest a novel potential therapeutic target for the treatment of PCOS.

• Clinical and Experimental Reproductive Medicine
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• v.36 no.1
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• pp.9-22
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• 2009

• The Journal of Korean Obstetrics and Gynecology
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• v.23 no.4
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• pp.155-163
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• 2010

Purpose: The aim of the study was to compare the characteristics of the autonomic innervation of the heart in polycystic ovary syndrome(PCOS) patients with regulary cycling controls. Methods: We studied 21 patients visiting $\bigcirc\bigcirc$hospital from 25th June 2009 to 25th June 2010. The subjects were categorized in two groups, 11 PCOS patients and 10 healthy regularly cycling controls. We studied the difference of Heart rate variability (HRV) between two groups by Independent samples T-test using SPSS for windows(version 17.0). Results: The Standard deviation of all normal R-R intervals (SDNN), The spuare root of the sum of the spuare of difference between adjacent normal R-R intervals (RMS-SD) of PCOS group was non-significantly lower than non-PCOS group. High frequency power (HF) and Normalized high frequency power (HF norm) of PCOS group was significantly higher than non-PCOS group. Normalized low frequency power (LF norm) of PCOS was signficantly lower than non-PCOS group. The results means increased sympathetic and decreased vagal modulation. Total power (TP), Very low frequency power (VLF) of PCOS group was non-significantly lower than non-PCOS group. Low frequency power (LF), LF/HF ratio of PCOS group was non-significantly higher than non-PCOS group. Conclusion: The results suggest that PCOS can be related to decreased activity of parasympathetic nervous system.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.8
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• pp.3747-3751
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• 2016

Background: Polycystic ovary syndrome (PCOS) is a combination of chronic anovulation, obesity, and hyperandrogenism and can affect sexual function in women of reproductive age. It is also associated with endometrial cancer. Our aim was to evaluate the frequency and predisposing factors of sexual dysfunction in PCOS patients. Materials and Methods: In this cross-sectional study, 16 married women with a definite diagnosis of PCOS were recruited. Sexual function was assessed in the domains of desire, arousal, lubrication, orgasm, satisfaction and pain using the female sexual function index (FSFI) questionnaire. Patients were also assessed for mental health using the depression, anxiety and stress (DASS-21) questionnaire. Presence of hirsutism was assessed using the Ferriman-Gallwey (FG) scoring system. Demographic data were obtained from patients during in-person interview. Results: Sexual dysfunction was present in 62.5% of patients with the domains of arousal and lubrication particularly affected (93.8% and 87.5%, respectively). Patients with symptoms of depression and anxiety were significantly more likely to suffer sexual dysfunction than those without these symptoms (p=0.04 and p=0.03 respectively). Patients with stress symptoms reported higher orgasm dysfunction than those without (p=0.02). No significant difference in any of the FSFI score domains was observed between patients with and without hirsutism. Conclusions: PCOS patients markedly suffer from sexual dysfunction and therefore it seems appropriate to be screened for intervention. Poor mental health conditions that may be the result of infertility or other complications of PCOS should also be considered as curable causes of sexual dysfunction in these patients.

• Clinical and Experimental Reproductive Medicine
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• v.41 no.2
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• pp.86-91
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• 2014

Objective: The aim of the present study was to investigate the relationship between ovarian follicle count and volume on ultrasonography and serum hormone levels including the levels of the anti-$M\ddot{u}llerian$ hormone (AMH) and gonadotropin in women with the polycystic ovary syndrome (PCOS). Methods: A total of 118 Korean women aged 18-35 years who were newly diagnosed with PCOS at a university hospital were included in this study. Serum LH, FSH, and AMH levels were measured in the early follicular phase, and the total antral follicle count (TFC) and the total ovarian volume (TOV) were assessed by ultrasonography. The correlations between serum hormonal parameters and ultrasonography characteristics in women with PCOS were evaluated using Pearson's correlation coefficients and a linear regression analysis. Results: Serum AMH levels were significantly correlated with serum LH levels and LH/FSH ratios, and TFC and TOV were significantly correlated with each other on ultrasonography. Serum AMH and LH levels and the LH/FSH ratio were significantly correlated with TFC. Statistically significant correlations between TOV and the LH level (r=0.208, p=0.024) and the LH/FSH ratio (r=0.237, p=0.010) were observed. However, the serum AMH level was not significantly correlated with the ovarian volume, and this result did not change after adjusting for age and body mass index. Conclusion: Serum AMH is not related to the ovarian volume in women with PCOS. My results suggest that serum LH level and the LH/FSH ratio may be more useful than the serum AMH level for representing the status of the ovarian volume in women with PCOS.