Ovulation induction techniques in women with polycystic ovary syndrome

Vyrides, Andreas A.; Mahdi, Essam El; Giannakou, Konstantinos

doi:10.3389/fmed.2022.982230

Cited by 9 publications

(3 citation statements)

References 111 publications

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“…Since the exact biochemical stage of the pregnancy is precisely determined during fertility treatment, this enables investigation of the effect of AIT/SCH in women with PCOS at the earliest gestational stages ( 164 ). Obese women with PCOS should first be counselled on lifestyle modifications, such as a hypocaloric diet and physical exercise, before starting pharmacological treatments ( 6 , 173 , 174 ). If these interventions fail, and in anovulatory non-obese patients with PCOS, oral ovulation induction with letrozole or clomiphene citrate (CC) may be considered as first-line treatment ( 6 ).…”

Section: Resultsmentioning

confidence: 99%

Polycystic ovary syndrome and thyroid disorder: a comprehensive narrative review of the literature

Palomba,

Colombo,

Busnelli

et al. 2023

Front. Endocrinol.

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BackgroundPublished data on the relationship between polycystic ovary syndrome (PCOS) and thyroid dysfunction are sparse and confusing.ObjectiveTo comprehensively review data available in the literature regarding the relationship between PCOS and the thyroid function, and its abnormalities.MethodsNine main areas of interest were identified and analyzed according to the available evidence: 1) Evaluation of thyroid function for PCOS diagnosis; 2) Epidemiology data on thyroid function/disorders in patients with PCOS, and vice versa; 3) Experimental data supporting the relationship between thyroid function/disorders and PCOS; 4) Effects of thyroid function/disorders on PCOS features, and vice versa; 5) Effect of thyroid alterations on the cardiometabolic risk in women with PCOS; 6) Effect of thyroid abnormalities on reproductive outcomes in women with PCOS; 7) Relationship between thyroid function/abnormalities in patients with PCOS who are undergoing fertility treatment; 8) Effect of treatments for thyroid diseases on PCOS; and 9) Effect of treatments for PCOS on thyroid function. An extensive literature search for specific keywords was performed for articles published from 1970 to March 2023 using PubMed and Web of Science. Data were reported in a narrative fashion.ResultsPCOS is a diagnosis of exclusion for which diagnosis is possible only after excluding disorders that mimic the PCOS phenotype, including thyroid dysfunctions. However, the tests and the cutoff values used for this are not specified. Many experimental and clinical data suggest a relationship between perturbations of the thyroid function and PCOS. Direct and unequivocal evidence on the effects of thyroid function/disorders on PCOS features are lacking. High thyroid-stimulating hormone levels and subclinical hypothyroidism may be associated with significant worsening of several intermediate endpoints of cardiometabolic risk in women with PCOS. Thyroid abnormalities may worsen reproductive outcomes, especially in patients undergoing fertility treatment. To date, there are no data demonstrating the efficacy of thyroid medications on fertility and cardiometabolic risk in women with PCOS. Lifestyle modification changes, metformin, and vitamin D seem to improve thyroid function in the general population.ConclusionPCOS and thyroid disorders are closely related, and their coexistence may identify patients with a higher reproductive and metabolic risk. Regular screening for thyroid function and thyroid-specific autoantibodies in women with PCOS, particularly before and during pregnancy, is highly recommended.

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Section: Resultsmentioning

confidence: 99%

Polycystic ovary syndrome and thyroid disorder: a comprehensive narrative review of the literature

Palomba,

Colombo,

Busnelli

et al. 2023

Front. Endocrinol.

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show abstract

“…Accumulating evidence suggests that the ovaries are not the primary abnormality in PCOS [225,230,231]. Women with PCOS often respond promptly to gonadotropin stimulation with clomiphene and gonadotropin-releasing hormone agonists or antiandrogenic compounds [232]. Furthermore, lifestyle interventions, such as weight loss and exercise, reduce IR and insulin levels, normalize gonadotropin secretion, and regulate menstrual cycles in women with PCOS [233].…”

Section: Insulin Resistance and Hyperandrogenismmentioning

confidence: 99%

Pathophysiological Effects of Contemporary Lifestyle on Evolutionary-Conserved Survival Mechanisms in Polycystic Ovary Syndrome

Parker

2023

Life

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Polycystic ovary syndrome (PCOS) is increasingly being characterized as an evolutionary mismatch disorder that presents with a complex mixture of metabolic and endocrine symptoms. The Evolutionary Model proposes that PCOS arises from a collection of inherited polymorphisms that have been consistently demonstrated in a variety of ethnic groups and races. In utero developmental programming of susceptible genomic variants are thought to predispose the offspring to develop PCOS. Postnatal exposure to lifestyle and environmental risk factors results in epigenetic activation of developmentally programmed genes and disturbance of the hallmarks of health. The resulting pathophysiological changes represent the consequences of poor-quality diet, sedentary behaviour, endocrine disrupting chemicals, stress, circadian disruption, and other lifestyle factors. Emerging evidence suggests that lifestyle-induced gastrointestinal dysbiosis plays a central role in the pathogenesis of PCOS. Lifestyle and environmental exposures initiate changes that result in disturbance of the gastrointestinal microbiome (dysbiosis), immune dysregulation (chronic inflammation), altered metabolism (insulin resistance), endocrine and reproductive imbalance (hyperandrogenism), and central nervous system dysfunction (neuroendocrine and autonomic nervous system). PCOS can be a progressive metabolic condition that leads to obesity, gestational diabetes, type two diabetes, metabolic-associated fatty liver disease, metabolic syndrome, cardiovascular disease, and cancer. This review explores the mechanisms that underpin the evolutionary mismatch between ancient survival pathways and contemporary lifestyle factors involved in the pathogenesis and pathophysiology of PCOS.

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“…Accumulating evidence suggests that the ovaries are not the primary abnormality in PCOS (242,247,248). Women with PCOS often respond promptly to gonadotropin stimulation with clomiphene and gonadotropin releasing hormone agonists, or antiandrogenic compounds (249). Furthermore, lifestyle interventions such as weight loss and exercise, reduce IR and insulin levels, normalize gonadotropin secretion, and regulate menstrual cycles in women with PCOS (250).…”

Section: Insulin Resistance and Hyperandrogenismmentioning

confidence: 99%

Pathophysiological Effects of Contemporary Lifestyle on Evolutionary-Conserved Survival Mechanisms that Disturb the Hallmarks of Health in Polycystic Ovary Syndrome

Parker¹

2023

Preprint

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Polycystic ovary syndrome (PCOS) is increasingly being characterized as an evolutionary mismatch disorder that presents with a complex mixture of metabolic and endocrine symptoms. The Evolutionary Model proposes that PCOS arises from a collection of inherited polymorphisms that have been consistently demonstrated in a variety of ethnic groups and races. In-utero developmental programming of susceptible genomic variants are thought to predispose the offspring to develop PCOS. Postnatal exposure to lifestyle and environmental risk factors results in epigenetic activation of developmentally programmed genes and disturbance of the hallmarks of health. The resulting pathophysiological changes represent the consequences of poor-quality diet, sedentary behaviour, endocrine disrupting chemicals, stress, circadian disruption, and other lifestyle factors. Emerging evidence suggests that lifestyle-induced gastrointestinal dysbiosis plays a central role in the pathogenesis of PCOS. Lifestyle and environmental exposures initiate changes that result in disturbance of the gastrointestinal microbiome (dysbiosis), immune dysregulation (chronic inflammation), altered metabolism (insulin resistance), endocrine and reproductive imbalance (hyperandrogenism), and central nervous system dysfunction (neuroendocrine, autonomic nervous system). PCOS can be a progressive metabolic condition that leads to obesity, gestational diabetes, type 2 diabetes, metabolic-associated fatty liver disease, metabolic syndrome, cardiovascular disease, and cancer. This review explores the mechanisms that underpin the evolutionary mismatch between ancient survival pathways and contemporary lifestyle factors involved in the pathogenesis and pathophysiology of PCOS.

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Ovulation induction techniques in women with polycystic ovary syndrome

Cited by 9 publications

References 111 publications

Polycystic ovary syndrome and thyroid disorder: a comprehensive narrative review of the literature

Polycystic ovary syndrome and thyroid disorder: a comprehensive narrative review of the literature

Pathophysiological Effects of Contemporary Lifestyle on Evolutionary-Conserved Survival Mechanisms in Polycystic Ovary Syndrome

Pathophysiological Effects of Contemporary Lifestyle on Evolutionary-Conserved Survival Mechanisms that Disturb the Hallmarks of Health in Polycystic Ovary Syndrome

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