Clinical specialties
Andrew Schofield, Paul Schofield in The Complete SAQ Study Guide, 2019
Laura and Richard, both aged 30, come to see you, having spent a year trying to conceive, with no success. Neither partner has had children from previous relationships. Explain the difference between primary and secondary infertility. (1)Name three causes of female infertility. (3)What lifestyle changes could you suggest? (2)Name two blood tests to look at ovulatory function. (2)Name one test to assess tubal patency. (1)Laura’s blood tests reveal anovulation and raised testosterone.On USS, there are multiple follicular cysts arranged in a pearl necklace fashion on each ovary. Name two possible symptoms of polycystic ovary syndrome (PCOS). (2)Name two medical treatments to treat PCOS-associated infertility. (2)
Female reproductive system
Aida Lai in Essential Concepts in Anatomy and Pathology for Undergraduate Revision, 2018
Polycystic ovary syndrome Associated with hyperoestrogenism and amenorrhoeaClinical features: – excess androgen (causes acne and hirsutism)– loss of control of menstrual cycle (causes oligomenorrhoea and amenorrhoea)Causes infertilityManagement: – anti-androgen drugs (cyproterone acetate, spironolactone)
The Biochemistry of Infertility
A. S. Curry, J. V. Hewitt in Biochemistry of Women: Clinical Concepts, 1974
The object of therapy in the polycystic ovary syndrome is to suppress the abnormal steroid secretion of the ovarian tissue. A fall in the androgenic steroid levels results in a reduction of the effect of the hypothalamic centers, which allows a return toward normal in gonadotrophin secretion. Direct suppression of ovarian steroids is rarely successful, but suppressing the adrenal component of androgens is more readily achieved and results in improvement in most cases. Suppression with prednisone is successful at relatively low dosage, often as little as 5 or 10 mg daily, levels which are little more than twice the physiological daily production of cortisol. After therapy is commenced, measurements of 17-oxosteroid excretion show suppression when adequate doses are reached. In most patients a dose of 7.5 mg prednisone daily (usually given as 5 mg each morning and 2.5 mg each night) will produce a satisfactory reduction in oxosteroid output. It is necessary, in difficult cases, to monitor urinary excretion carefully to ensure adequate suppression, if necessary using higher doses of prednisone. It is interesting to note that in general there is no advantage to be gained in giving the suppressing dose at night, although this is almost essential in congenital adrenal hyperplasia. It is probable, therefore, that during treatment the suppressant effect on cortisol metabolism is kept to a minimum.
Antioxidant supplements relieve insulin resistance but do not improve lipid metabolism in women with polycystic ovary syndrome: a meta-analysis of randomized clinical trials
Published in Gynecological Endocrinology, 2022
Ruye Wang, Chenyun Miao, Yun Chen, Ying Zhao, Liuqing Yang, Wei Cheng, Qin Zhang
Hyperandrogenemia is one of the main manifestations of polycystic ovary syndrome. Clinically, total testosterone, free testosterone, and sex hormone binding globulin(SHBG) are often used in the assessment of biochemical androgen excess in women [44].SHBG is a glycoprotein produced by the liver involved in the transport of sex hormones in the blood and has an important role in regulating the circulating free levels of sex hormones [45], it can be used to determine the severity of hyperandrogenism and to assess the efficacy of treatment [46]. In addition, recent studies have concluded that low SHBG levels are strongly correlated with the degree of metabolic syndrome in PCOS patients and its considered to be a strong biomarker associated with the development of insulin resistance and NAFLD in PCOS patients [45,47].
Diagnostic value of anti-Müllerian hormone combined with androgen-levels in Chinese patients with polycystic ovary syndrome
Published in Gynecological Endocrinology, 2023
Lingling Jiang, Xiangyan Ruan, Yanqiu Li, Muqing Gu, Jiaojiao Cheng, Yuejiao Wang, Yu Yang, Che Xu, Zhikun Wang, Lili Liu, Alfred O. Mueck
Polycystic ovary syndrome is a highly heterogeneous disease often associated with obesity, hyperandrogenemia, insulin resistance and ovulatory dysfunction. The global prevalence of polycystic ovary syndrome is 5% to 20% [1]. The prevalence of abdominal obesity in polycystic ovary syndrome is as high as 38–88% [2,3]. Patients with polycystic ovary syndrome often have a combination of metabolic and endocrine disorders, and polycystic ovary syndrome increases the risk of cardiovascular disease, metabolic disease and reduces the overall quality of life of women [4–6]. Despite the fact that polycystic ovary syndrome is the most common endocrine disorder, it remains undiagnosed in up to 70% of women [7,8]. According to the Rotterdam criteria, polycystic ovarian syndrome is diagnosed by anovulation or amenorrhea, hyperandrogenemia (HA) and/or clinical features of its associated disorders (e.g. hirsutism, acne, and androgenetic alopecia) and polycystic ovarian morphology (PCOM; e.g. follicles 2–9 mm in diameter in one or both ovaries). The diagnosis of polycystic ovarian syndrome is confirmed by at least two of these three criteria [2].
Determination of Neurodegeneration in Polycystic Ovary Syndrome with Retinal Segmentation Analysis
Published in Current Eye Research, 2021
Ender Sirakaya, Hatice Aslan Sirakaya, Esra Vural, Zeynep Duru, Hüseyin Aksoy
Polycystic ovary syndrome, one of the most common disorders among women of reproductive age, is characterized by small, subcapsular cystic follicles observed during ovarian ultrasonography, as well as hyperandrogenism, ovulatory dysfunction, irregular menstrual cycles, and oligomenorrhea or amenorrhea1,2 Based on the criteria of the National Institutes of Health, the prevalence of polycystic ovary syndrome in the general population is approximately 6–10%.3 As an endocrinological disorder, polycystic ovary syndrome is often accompanied by insulin resistance, obesity, and various metabolic alterations,4 and more than 40% of patients with polycystic ovary syndrome experience type 2 diabetes mellitus or glucose intolerance during their lives.5,6
Related Knowledge Centers
- Acanthosis Nigricans
- Acne
- Cyst
- Hirsutism
- Hyperandrogenism
- Infertility
- Menstrual Cycle
- Ovary
- Endocrine System
- Heavy Menstrual Bleeding