• Clinical and Experimental Reproductive Medicine
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• 제39권1호
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• pp.22-27
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• 2012

Objective: To evaluate the effectiveness of GnRH antagonist multiple dose protocol applied during early and late follicular phase (MDP-EL) in comparison with standard GnRH agonist luteal long protocol (LP) in each non-obese and obese polycystic ovary syndrome (PCOS) women undergoing IVF. Methods: Two hundred eleven infertile women with PCOS were recruited and randomized to undergo either GnRH antagonist MDP-EL (antagonist group) or standard GnRH agonist luteal LP (agonist group). IVF cycle outcomes were compared between the two groups. Results: Total dose and days of recombinant human follicle stimulating hormone (rhFSH) administered were significantly fewer in the antagonist group than in the agonist group. Incidence of severe ovarian hyperstimulation syndrome was significantly lower in the antagonist group. However, IVF and pregnancy outcomes were similar in the two groups. When all subjects were divided into non-obese and obese subgroups, in non-obese PCOS subgroup, IVF and pregnancy outcomes were comparable in the antagonist and agonist groups but total dose and days of rhFSH were also significantly fewer in the antagonist group. Similar findings were also observed in obese PCOS subgroup. Conclusion: GnRH antagonist MDP-EL is at least as effective as GnRH agonist LP and may be a more patient-friendly alternative in controlled ovarian stimulation for PCOS patients undergoing IVF, independent of body mass index.

• 셀메드
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• 제14권2호
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• pp.5.1-5.4
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• 2024

PCOS is the most common endocrine pathology in females of reproductive worldwide. The prevalence ranges between 5% and 15% depending on the diagnostic criteria applied.Its etiology involves both genetic and environmental factors. Typically, women with PCOS show clinical and biochemical hyperandrogenism, oligoanovulation, and micropolycystic morphology of the ovaries. Unani formulation containing Nankhwah, Badiyan and Wajturki possessing the properties of Mudirr-i-Bawl-o- Hayd, mujaff -iBalgham, Munaffis-i- balgham, Muhallil, Muqawwi-i-Jigar were used in the form of Joshanda 6gm BD Starting from 5 days prior to expected period date to 5 days during menses for 3 cycles, which led to regain regularity of menses, correcting the amount of flow and reducing the ovarian volume on US. Thus unani medications have the potential to treat ths symtoms of PCOS and improve the quality of life of women.

• Clinical and Experimental Reproductive Medicine
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• 제29권4호
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• pp.251-258
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• 2002

Objective : The aim of this study was to evaluate the outcomes of the GnRH antagonist (Cetrotide) minimal stimulation protocol comparing with GnRH agonist combined long step down stimulation protocol in PCOS patients. Materials and Method: From Apr 2001 to May 2002, 22 patients (22 cycles) were performed in controlled ovarian hyperstimulation using by GnRH antagonist and GnRH agonist for PCOS patients. GnRH antagonist (Cetrotide) combined minimal stimulation protocol was administered in 10 patients (10 cycles, Study Group) and GnRH agonist long step down stimulation protocol was administered in 12 patients (12 cycles, Control Group). We compared the pregnancy rate/cycle, total FSH (A)/cycle, Retrieved oocyte/cycle, the incidence of ovarian hyperstimulation syndrome, multiple pregnancy rate between the two groups. Student-t test were used to determine statistical significance. Statistical significance was defined as p<0.05. Results: Group of GnRH antagonist (Cetrorelix) minimal stimulation protocol produced fewer oocytes (6.4 versus 16.3 oocytes/cycle) using a lower dose of FSH (22.2 versus 36.1 Ample/cycle) and none developed OHSS and multiple pregnancy. Although the trends were in favour of the GnRH antagonist (Cetrorelix) protocol, the differences did not reach statistical significance. This was probably due to small sample size. Conclusion: The use of GnRH antagonist reduce the risk of ovarian hyperstimulation and multiple pregnancy. We suggest that GnRH antagonist might be alternative controlled ovarian hyperstimulation method, especially in PCOS patients who will be ovarian high response.

• Asian Pacific Journal of Cancer Prevention
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• 제16권16호
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• pp.7129-7138
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• 2015

Background: The polycystic ovary syndrome (PCOS), characterized by hyperandrogenism and chronic anovulation, is a common endocrine disorder in women. PCOS, which is associated with polycystic ovaries, hirsutism, obesity and insulin resistance, is a leading cause of female infertility. In this condition there is an imbalance in female sex hormones. All the sequelae symptoms of PCOS gradually lead to cancer in the course of time. It is heterogeneous disorder of unknown etiology so it is essential to find the exact cause. Materials and Methods: In this study both invasive and non-invasive techniques were employed to establish the etiology. Diagnosis was based on Rotterdam criteria (hyperandrogenism, ovulatory dysfunction, PCOM) and multiparameters using buccal samples and dermatoglypic analysis and cytogenetic study for 10 cases and four age and sex matched controls. Results: In clinical analysis we have observed the mean value of total testosterone level was 23.6nmol/L, total hirsutism score was from 12-24, facial acne was found in in 70% patients with 7-12 subcapsular follicular cysts, each measuring 2-8 mm in diameter. In dermatoglypic analysis we observed increases in mean value ($45.9^{\circ}$) of ATD angle when compared with control group and also found increased frequency (38%) of Ulnar loops on both fingers (UU), (18%) whorls on the right finger and Ulnar loop on left finger (WU) and (16%) arches on right and left fingers (AA) were observed in PCOS patients when compared with control subjects. Features which could be applied as markers for PCOS patients are the presence of Ulnar loops in middle and little fingers of right and left hand. The buccal micronucleus cytome assay in exfoliated buccal cells, we found decrease in frequency of micronuclei and significant increases in frequency of karyolysed nuclei in polycystic ovarian syndrome patients. Chromosome aberration analysis revealed a significant increase in frequency of chromosome aberrations (CAs) in PCOS patients when compared with controls. Conclusions: From this present work it can be concluded that non-invasive technique like dermatoglypics analysis and buccal micronucleus cytome assays with exfoliated buccal cell can also be effective biomarkers for PCOS, along with increased CAs in lymphocytes as a sign of genetic instability. There is a hypothesis that micronuclei and chromosomal aberrations could have a predictive value for cancer. From this present work it can be concluded to some extent that non-invasive technique like dermatoglypics and buccal cell analysis can also be effective for diagnosis.

• Clinical and Experimental Reproductive Medicine
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• 제20권2호
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• pp.125-130
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• 1993

Polycystic ovarian syndrome (PCOS) patients have a characteristic of high leuteinizing hormone (LH) to follicle -stimulating hormone (FSH) ratio. Usually, human menopausal gonadotropin (hMG) is used to induce ovulation in clomiphene citrate-resistant PCOS patients. However, HMG contains two components, namely, LH and FSH, with 50%, respectively. Therefore, FSH is theoretically recommended to stimulate follicular maturation. From the pituitary, LH is secreted by pulsatile pattern. So, we have been using intermittent subcutaneous injection of pure FSH for ovulation induction in 10 PCOS patients from March, 1990 to August, 1992. We obtained good results by intermittent subcutaneous injection of pure FSH. Ovulation is 100% per patient, and 88.2% per cycle. Pregnancy rate is 80% per patient, and 23.5% per cycle. Ovarian hyperstimulation syndrome (OHSS) is 50% per patient, 41.2% per all cycles, and 46.7% per all ovulated cycles. In comparison with HMG, pregnancy rate per cycle is relatively low. But, ovulation rate and pregnacy rate per person is higher than HMG. Because of the strict check of ovaries by the vaginal ultrasonography, OHSS rate is relatively high.

• 대한한방부인과학회지
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• 제31권4호
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• pp.39-53
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• 2018

Objectives: The purpose of this review was to overview and evaluate the efficacy of electroacupunture for women with polycystic ovarian syndrome (PCOS) Methods: Relevant randomized controlled studies (RCTs) were identified by database searches in PubMED, EMBASE, OASIS, and Google scholar, up to May 2018. Data were extracted regarding hyperandrogenism, obesity and hyperinsulinemia indices. The risk of bias was assessed. Results: Five RCTs were included for analysis. In one RCT, electroacupuncture group had significantly lower free testosterone and testosterone, compared to no treatment group. However, The other RCTs showed no significant difference between two groups. For LH/FSH, Ferriman Gallway score, anti-mullerian hormone, body mass index, weight and waist, and insulin, electroacupuncture group showed no significant difference, compared to physical exercise, no treatment, and sham acupuncture group. Conclusions: Only a limited number of RCTs have been reported. At present, there is insufficient evidence to support the use of electroacupuncture for treatment of PCOS.

• Clinical and Experimental Reproductive Medicine
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• 제28권4호
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• pp.255-264
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• 2001

Objective : This study was performed to investigate the effect of metformin therapy on ovulation induction & pregnancy rate in clomiphene citrate-resistant PCOS women. Method: This study used a randomized, single-blinded, case-controlled methods. Total study group consisted of 21 women who showed clomiphene citrate-resistant parttern on previous ovulation induction cycles. Patients of metformin group received metformin 500 mg three times daily, for 7 weeks. Control group received none. Metformin group was consisted of 10 women and control group was consisted of 11 women. Then clomiphene was administrated at daily 50 mg for 5 days to both groups. Clomiphene dosage was increased to daily 150 mg until ovulation was occurred. Before and After metformin treatment, blood samples for measurement of insulin, glucose, steroids were obtained. Results: In the metformin and control groups, 6 of 10 women (60%) and 2 of 11 women (18%) ovulated. And 4 of 10 women (40%) and 0 of 11 women (0%) conceived. Comparisons between the groups were significant. Conclusion: In PCOS women who are resistant to CC, metformin use increased the ovulation rate and pregnancy rate from CC treatment, significantly.

• 대한한방부인과학회지
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• 제20권1호
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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.

• Clinical and Experimental Reproductive Medicine
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• 제18권2호
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• pp.215-222
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• 1991

Treatment with low-dose follicle-stimulating hormone and laparoscopic laser vaporization is associated with a high rate of ovulation in anovulatory women with polycystic ovarian syndrome (PCOS), but it is not clear which is better. We undertook a randomized controlled study to compare the effects of urinary FSH and hMG using a low dose regimen and laparoscopic laser vaporization of ovaries in sixty women with PCOS. Ovulation occured in 65% subjects and in 71.1% of cycles induced with FSH and in 70% of women and 76% of cycles of those treated with hMG and in 80% of women in laparoscopic laser vaporization of ovaries. A single dominant follicle developed in 62.2% (FSH) and 60% (hMG) of cycles, respectively. Eight singleton pregnancies occured in FSH, hMG group and 12 singleton pregnancies occured in laparoscopic laser vaporization. This study shows that selected patients with PCOS and by induced to ovulate and subsequently conceive by laparoscopically partially vaporizing their ovaries with laser energy.

• Clinical and Experimental Reproductive Medicine
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• 제43권4호
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• pp.207-214
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• 2016

Objective: This study aimed to determine the threshold of $anti-M{\ddot{u}}llerian$ hormone (AMH) as predictor of follicular growth failure in polycystic ovary syndrome (PCOS) patients treated with clomiphene citrate (CC). Methods: Fifty female subjects with PCOS were recruited and divided into two groups based on successful and unsuccessful follicular growth. Related variables such as age, infertility duration, cigarette smoking, use of Moslem hijab, sunlight exposure, fiber intake, body mass index, waist circumference, AMH level, 25-hydroxy vitamin D level, and growth of dominant follicles were obtained, assessed, and statistically analyzed. Results: The AMH levels of patients with successful follicular growth were significantly lower (p= 0.001) than those with unsuccessful follicular growth ($6.10{\pm}3.52$ vs. $10.43{\pm}4.78ng/mL$). A higher volume of fiber intake was also observed in the successful follicular growth group compared to unsuccessful follicular growth group (p= 0.001). Our study found the probability of successful follicle growth was a function of AMH level and the amount of fiber intake, expressed as Y =-2.35+($-0.312{\times}AMH\;level$)+($0.464{\times}fiber\;intake$) (area under the curve, 0.88; 95% confidence interval, 0.79-0.98; p< 0.001). Conclusion: The optimal threshold of AMH level in predicting the failure of follicle growth in patients with PCOS treated with CC was 8.58 ng/mL.