Canagliflozin combined with metformin versus metformin monotherapy for endocrine and metabolic profiles in overweight and obese women with polycystic ovary syndrome: A single-center, open-labeled prospective randomized controlled trial

Frontiers in Endocrinology, Journal Year: 2022, Volume and Issue: 13

Published: Sept. 6, 2022

Canagliflozin (CANA), a kind of sodium-glucose cotransporter-2 (SGLT-2) inhibition, study in which the role CANA monotherapy polycystic ovary syndrome (PCOS) has been investigated, and it could become novel option PCOS treatment. Nevertheless, trials focused on SGLT-2 combination therapy's efficacy, safety patients are limited. This randomized controlled trial compared efficacy metformin (MET) therapy MET endocrine metabolic profiles overweight obese women with (PCOS).Fifty-one or non-diabetic between 18 40 years old were enrolled. Patients randomly allocated to receive either CANA/MET The group received 100 mg once daily plus 1000 twice daily, while for three months. Changes menstrual pattern, anthropometric parameters, gonadal glucose lipid homeostasis, adverse events (AEs) evaluated.Compared group, have significantly lower level total testosterone (TT), area under curve (AUCGlu), insulin (AUCIns) AUCGlu ratio group. There no significant differences frequency, body weight, mass index, follicle-stimulating hormone, luteinizing free androgen sex hormone-binding globulin, androstenedione, fasting blood glucose, insulin, AUCIns, homeostasis model assessment-insulin resistance (HOMA-IR), triglycerides, cholesterol, low-density lipoprotein apolipoprotein A1 (Apo A1), B B), APO B/A1 ratio. AEs seen 57.70% (15/26) 68.00% (17/25) groups, respectively.In PCOS, may be similar improving weight control, hyperandrogenemia, relieving resistance. more benefits reducing TT, AUCGlu, AUCIns/AUCGlu within months than monotherapy.ClinicalTrials.gov, NCT04973891.

Language: Английский

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Exploring the dominant features and data-driven detection of polycystic ovary syndrome through modified stacking ensemble machine learning technique

Heliyon, Journal Year: 2023, Volume and Issue: 9(3), P. e14518 - e14518

Published: March 1, 2023

Polycystic ovary syndrome (PCOS) is the most frequent endocrinological anomaly in reproductive women that causes persistent hormonal secretion disruption, leading to formation of numerous cysts within ovaries and serious health complications. But real-world clinical detection technique for PCOS very critical since accuracy interpretations being substantially dependent on physician's expertise. Thus, an artificially intelligent prediction model might be a feasible additional error prone time-consuming diagnostic technique. In this study, modified ensemble machine learning (ML) classification approach proposed utilizing state-of-the-art stacking identification with patients' symptom data; employing five traditional ML models as base learners then one bagging or boosting meta-learner stacked model. Furthermore, three distinct types feature selection strategies are applied pick different sets features varied numbers combinations attributes. To evaluate explore dominant necessary predicting PCOS, variety other ten classifiers trained, tested assessed sets. As outcomes, significantly enhances comparison existing based techniques case all varieties However, among various investigated categorize non-PCOS patients, 'Gradient Boosting' classifier meta learner outperforms others 95.7% while top 25 selected using Principal Component Analysis (PCA)

Language: Английский

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Women with PCOS who undergo IVF: a comprehensive review of therapeutic strategies for successful outcomes

Reproductive Biology and Endocrinology, Journal Year: 2023, Volume and Issue: 21(1)

Published: Aug. 1, 2023

Abstract Polycystic ovarian syndrome (PCOS) is a widespread that poses unique challenges and constraints to the field of assisted reproductive technology. This condition most common cause anovulation among infertile couples. Debate exists over best therapeutic course action when patients with PCOS proceed IVF. In this review, we evaluate best-performing safest methods IVF preparation, stimulation, trigger method for maturation stimulated egg growth, planning embryo transfer. Pre-IVF considerations include being aware individual AMH vitamin D levels as well BMI prior selecting an stimulation protocol. Numerous supplements such myo-inositol complement benefits lifestyle change may enhance performance including oocyte yield pregnancy rate. Concerning protocols, antagonist cycles judicious use GnRH agonist trigger, pre-treatment metformin repletion help mitigate accompanied risk hyperstimulation (OHSS). Following typically undergo programmed frozen transfer (FET) which are more conducive women irregular cycles, but likely carry higher hypertensive disorders pregnancy. However, newer FET protocols using Letrozole offer improved outcomes. Overall, require careful tailoring their cycle achieve optimal results.

Language: Английский

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The kisspeptin system in and beyond reproduction: exploring intricate pathways and potential links between endometriosis and polycystic ovary syndrome

Reviews in Endocrine and Metabolic Disorders, Journal Year: 2023, Volume and Issue: 25(2), P. 239 - 257

Published: July 28, 2023

Language: Английский

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Alternative treatment of polycystic ovary syndrome: pre-clinical and clinical basis for using plant-based drugs

Frontiers in Endocrinology, Journal Year: 2024, Volume and Issue: 14

Published: Jan. 11, 2024

The most common cause of infertility and metabolic problems among women reproductive age is polycystic ovary syndrome (PCOS), a multifaceted disorder. It an endocrine disorder that occurs in approximately one seven women. Among these PCOS patients, two thirds will not ovulate on regular basis seek treatment for ovulation induction. symptoms vary their severity, namely disorders, excessive androgen levels, or ovarian morphology. All require therapeutic approach. Many drugs are used to eradicate symptoms, like metformin, clomiphene citrate, spironolactone, pioglitazone. Long-term required achieve the desired outcome, which often accompanied by significant adverse reactions. Some herbs phytochemicals equally effective treating produce minimal side effects. Recently, herbal products gaining popularity due wide biological activities, safety, availability, efficacy. present review covers aetiology, current treatment, pathophysiology, detailed pre-clinical clinical studies plants proven be useful associated with PCOS.

Language: Английский

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Association between maternal polycystic ovarian syndrome undergoing assisted reproductive technology and pregnancy complications and neonatal outcomes: a systematic review and meta-analysis

Journal of Ovarian Research, Journal Year: 2024, Volume and Issue: 17(1)

Published: Jan. 6, 2024

Abstract Background Polycystic ovarian syndrome (PCOS) is recognized as the most prevalent endocrine disorder among women of reproductive age. While utilization assisted technology (ART) has resulted in favorable outcomes for infertility treatment PCOS patients, inherent pathophysiological features condition give rise to complications and consequences during pregnancy delivery both mother offspring. This study was assess correlation between maternal various neonatal undergone ART. Methods A systematic search conducted on PubMed, EmBase, Cochrane Library identify observational studies that investigated association risk outcomes, including gestational diabetes mellitus (GDM), hypertension (PIH), preeclampsia (PE), preterm birth, abortion, congenital malformations (CA), small age (SGA), large (LGA), low birth weight (LBW), macrosomia, intensive care unit (NICU) admission weight. Eligible were selected based predetermined inclusion exclusion criteria. The meta-analysis using Review Manager Stata software, with odds ratios (ORs) or mean difference (MD), confidence intervals (CIs), heterogeneity (I 2 ) being calculated. up March 2023. Results total 33 a combined sample size 92,810 participants identified. findings indicate significantly associated an increased GDM (OR 1.51, 95% CI:1.17–1.94), PIH 1.72, CI:1.25–2.39), PE 2.12, CI:1.49–3.02), 1.29, CI:1.21–1.39), LBW CI:1.14–1.47). In subgroup analyses, risks 1.80, CI:1.23–2.62) abortion 1.41, CI:1.08–1.84) elevated fresh embryo transferred (ET) subgroup, whereas 1.82, CI:1.17–2.83) 1.31, CI:1.21–1.42) identified frozen ET subgroup. Whatever without hyperandrogenism, patients had higher 1.69, CI: 1.31–2.18; OR 1.24, CI:1.02–1.50) 1.38, CI:1.12–1.71; 1.23, CI:1.06–1.43). Conclusion Our suggest individuals ART are at notably experiencing unfavorable outcomes. Nevertheless, establish definitive pregnancy-related it necessary conduct extensive prospective, blinded cohort effectively control confounding variables.

Language: Английский

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Increased Oxidative and Nitrative Stress and Decreased Sex Steroid Relaxation in a Vitamin D-Deficient Hyperandrogenic Rodent Model—And a Validation of the Polycystic Ovary Syndrome Model

Nutrients, Journal Year: 2025, Volume and Issue: 17(2), P. 201 - 201

Published: Jan. 7, 2025

Both hyperandrogenism (HA) and vitamin D deficiency (VDD) can separately lead to impaired vascular reactivity ovulatory dysfunction in fertile females. The aim was examine the early interactions of these states a rat model PCOS. Four-week-old adolescent female rats were divided into four groups: (VD)-supplemented (n = 12); VD-supplemented testosterone-treated VDD- 11) VDD-and-testosterone-treated 11). Animals underwent transdermal testosterone treatment for 8 weeks. Target VD levels achieved with oral supplementation VD-free diet. Estrous cycles followed by vaginal smear, quantitative histomorphometric measurements ovaries also taken. In 8th week, testosterone- estrogen-induced relaxation coronary arterioles examined pressure angiography. Estrogen receptor (ER) density oxidative nitrative stress parameters (Poly-(ADP-Ribose)-Polymerase 3-nitrotyrosine) vessel wall investigated immunohistochemistry. VDD caused estrous cycles, anovulatory (the stopped at diestrous phase). combined resulted reduced estrogen vasorelaxation, lower ER density, higher wall. PCOS may be associated increased oxidative-nitrative arterioles. This stress, potentially and/or deficiency, could impair arterioles, possibly decreasing NO bioavailability disrupting pathway.

Language: Английский

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Diagnosis and management of infertility in patients with polycystic ovary syndrome (PCOS): guidelines from the Italian Society of Human Reproduction (SIRU) and the Italian Centers for the Study and Conservation of Eggs and Sperm (CECOS Italy)

Reproductive Biology and Endocrinology, Journal Year: 2025, Volume and Issue: 23(1)

Published: March 8, 2025

The polycystic ovary syndrome (PCOS) is a multifaced disease of the reproductive age associated with several comorbidities including infertility. Very few documents regarding management infertility in women PCOS, guidelines, position papers and consensus conferences, are available literature. Italian Law indicates that health professionals must comply recommendations set out guidelines developed by public private bodies institutions, as well scientific societies technical-scientific associations professions, except for specific cases. Unfortunately, no guideline diagnosis PCOS currently Italy. In 2024, Society Human Reproduction (SIRU) Centers Study Conservation Eggs Sperm (CECOS Italy) pointed need to produce on this topic established working group develop those guidelines. chose adapt highest quality context rather than developing de novo document. International Evidence-Based Guideline Assessment Management were selected. All extracted, adapted improved incorporating new or practical comments suggestions where needed.

Language: Английский

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Suppression of uterine and placental ferroptosis by N-acetylcysteine in a rat model of polycystic ovary syndrome

Molecular Human Reproduction, Journal Year: 2021, Volume and Issue: 27(12)

Published: Nov. 17, 2021

Abstract The mechanisms that link hyperandrogenism and insulin (INS) resistance (HAIR) to the increased miscarriage rate in women with polycystic ovary syndrome (PCOS) remain elusive. Previous studies demonstrate uterine placental ferroptosis is associated oxidative stress-induced fetal loss a pre-clinical PCOS-like rat model. Here, we investigated efficacy molecular mechanism of action antioxidant N-acetylcysteine (NAC) reversing gravid pregnant rats exposed 5α-dihydrotestosterone (DHT) INS. Molecular histological analyses showed NAC attenuated DHT INS-induced ferroptosis, including dose-dependent increases anti-ferroptosis gene content. Changes other factors after treatment were also observed placenta INS, such as glutathione peroxidase 4 protein level. Furthermore, apoptosis-inducing factor mitochondria-associated 2 mRNA expression was seen but not uterus. Additionally, sufficient rescue + mitochondria-morphological abnormalities uterus, whereas same partially reversed placenta. Finally, demonstrated selectively normalized leukemia inhibitory factor, osteopontin/secreted phosphoprotein 1, progesterone receptor, homeobox A11 estrogen-related receptor beta trophoblast-specific alpha expression. Collectively, our data provide insight into how exerts beneficial effects on differentially attenuating model loss. These results indicate exogenous administration represents potential therapeutic strategy HAIR-induced dysfunction.

Language: Английский

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Systematic review update and meta-analysis of randomized and non-randomized controlled trials of ovarian stimulation versus artificial cycle for endometrial preparation prior to frozen embryo transfer in women with polycystic ovary syndrome

Reproductive Biology and Endocrinology, Journal Year: 2022, Volume and Issue: 20(1)

Published: April 2, 2022

This systematic review and meta-analysis aimed to compare the short-term reproductive long-term obstetric outcomes after endometrial preparations by ovarian stimulation protocols hormone replacement therapy (HRT) in women with polycystic ovary syndrome (PCOS) prior frozen embryo transfer (FET).PubMed, EMBASE, Web of Science Cochrane Library were searched identify relevant studies. Primary outcome was live birth rate, secondary included rates clinical pregnancy, miscarriage, implantation hCG-postive, cycle cancellation, ectopic preterm birth, preeclampsia, gestational hypertension, diabetes mellitus abnormal placentation.Nine studies, including 8327 patients PCOS, identified. Live rate significantly higher (RR = 1.11, 95% CI 1.03-1.19) miscarriage 0.60, 0.46-0.78) lower stimulated protocol compared HRT. While ongoing implantation, hCG-positive, cancellation pregnancy showed no significant difference between two protocols. Compared HRT different protocols, 1.54, 1.20-1.98) found letrozole group, but not other subgroups. For outcomes, preeclampsia group that 0.85, 0.74-0.98; RR 0.57, 0.40-0.82, respectively), while placentation difference.The present data suggest as an preparation regimen FET might be superior a risk preeclampsia. Our study is better than for PCOS. However, quality evidence low, more well-designed RCT studies are still needed confirm results before recommendation, particularly direct comparisons regimens.

Language: Английский

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