Background: Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disorders among females in reproductive age. Women with PCOS have several cardiovascular disease risk factors. Hyperinsulinemia and insulin resistance (IR) which is a known key factor in the development of type 2 diabetes (T2DM) may associate PCOS. Homocysteine, a sulfur-containing amino acid, is toxic to vascular endothelium, leads to early atherosclerosis. PCOS said to be associated with high plasma homocysteine. Objective: To determine the correlation between insulin resistance and homocysteine in PCOS patients. Methods: Patients diagnosed as PCO according to Androgen Excess and PCOS Society/2009 criteria were grouped into two groups: those with BMI less than 30kg/m2 and those with BMI 30kg/m2 and more. Blood was drawn for biochemical and hormonal assay. Information tabulated, means and percentages used, and the results were analyzed. Results: Homocysteine levels were significantly higher (P value < 0.05) in PCOS group (12.28±1.89 µmol/l) as compared to control (9.51±1.92 µmol/l).HOMA-IR was significantly higher (P value < 0.05) in PCOS (4.15±2.54) as compared to control (1.69±0.54) .There was no correlation between IR and homocysteine within PCOS group. Conclusions: Polycystic ovarian patients have higher levels of homocysteine and IR compared to control but there is no correlation between IR and homocysteine within PCOS group.
Polycystic ovarian syndrome (PCOS) is a group of clinically distinct endocrine conditions. Insulin resistance-related proteins are involved in PCOS pathogenesis. Irisin is a new myokine that functions similarly to adipokines. Irisin has been linked to insulin resistance and metabolic syndrome. There have been conflicting findings regarding irisin levels and their connection to hormonal and metabolic alterations in PCOS .This study aimed to compare the levels of irisin in follicular fluid and serum between women with PCOS and healthy women and correlate them with oocyte and embryo quality in women undergoing the ICSI cycle .Ninety infertile Iraqi women were enrolled, 46 women with PCOS and 44 weight-matched non-PCOS controls, in whom ICSI was done for them and evaluated the level of follicular fluid, serum Irisin, and insulin level with measure of Homeostasis Model of Assessment-Insulin Resistance (HOMA-IR) and correlate them to with oocyte and embryo quality. HOMA-IR, FF, and serum irisin levels in PCOS considerably increased. (P ≤ 0.01). In addition, there was a significant negative correlation between Irisin levels in follicular fluid and serum with MII oocyte, oocyte maturity rate, and grade 1 embryo. The serum, follicular fluid Irisin, and HOMA-IR were significantly higher in PCOS than in control cases, which may cause a reduction in oocyte maturation, embryo quality, and pregnancy outcome.
Background : With the rapid evolution of assisted reproductive technologies, more and more studies are concerned about the possible influential factors on the success rates of these procedures, with the efforts are now mainly directed toward defining these factors in a trial to increase these rates. Of these factors, inflammation is considered among the most remarkable and is in the focus of the updated studies. However, most of these studies are evaluating the role of inflammation in patients with polycystic ovarian syndrome(PCOS) , while the impact of this inflammation in insulin resistant non PCOS patients is underesti mated and not well evaluated . Objectives: This study is a trial to elucidate the importance of one of the inflam matory mediators , Tumor Necrosis Factor-alpha (TNF – α) , in insulin resistant patients undergoing IVF ( ICSI ) cycles . Patients and Methods: A group of 27non-PCOS infertile patients were select ed for this clinical randomized prospective study from patients attending the high institute for infertility diagnosis and assisted reproductive technologies / Al-Nahrain University and subjected to intra-cytoplasmic sperm injection (ICSI) procedure. BMI was measured for all patients and they were classified according to WHO classification into 3 groups : Acceptable , overweight and obese . Fast ing plasma level of glucose and insulin was investigated and insulin resistance index (HOMA) was calculated. Serum TNF-α has been measured using ELISA and the relation with insulin resistance was investigated. Finally, the pregnancy rate, as a primary reproductive endpoint was compared according to TNF -a and insulin resistance levels between different study subjects. Results: Of the 27 infertile patients , 17(63 %) were non obese and 10 (37%) were obese , 15(55.5%) were having HOMA index < 1.6 and 12 (44.5 %) were having HOMA index ≥ 1.6 . BMI was found to be positively correlated with high er HOMA index ( P = 0.01 and R= 0.4 in spearman correlation). Investigating the relation between TNF-α with BMI revealed that TNF-α levels are increasing with the increment in BMI, However , the difference in the mean TNF-α between the three BMI groups failed to achieve statistical significance (P=0.1). In contrast to that, when stratifying for HOMA index , TNF-α was significantly correlated with it ( spearman correlation R= 0.4 , P=0.01 ) , and patients with HOMA index ≥1.6 were found to have higher levels of TNF-α ( P = 0.03) and to be more obese ( P=0.02 ) than those with HOMA index <1.6.
Background: Polycystic ovary syndrome (PCOS) is the most common and prevalent endocrinopathy in women, and the most common cause of anovulatory infertility. An altered lipid profile is common in polycystic ovary syndrome (PCOS) and is usually characterized by increased total cholesterol, triglycerides, low-density lipoproteins and very low density lipoprotein levels with low high-density lipoprotein. PCOS is associated with a higher frequency of cardiovascular disease because of dyslipidemia. Which are potent markers for cardiovascular risk factors. Metformin, is a widely used antihyperglycemic agent. It decreases insulin resistance and reduces hyperglycemia through a reduction of the hepatic glucose production. Objectives: Determine the beneficial effect of metformin in PCOS patients in reducing lipid profile and subsequently reduction in cardiovascular disease. Method: Measurements and analysis levels of total cholesterol, triglycerides, low-density lipoproteins, very low density lipoprotein and high-density lipoprotein were samples collected at the Institute of embryo research and infertility treatment, Al-Nahrain University. PCOS patients were recruited at the consultant clinic Patients: forty three women with PCOS were studied. Anthropometric data, lipid profile, were evaluated, before oral metformin (500mg/twice daily) treatment and after three months of use. Results: Patients with PCOS after oral metformin treatment, revealed a significant lowering serum concentrations of total cholesterol, triglyceride, low-density lipoproteins and very low density lipoprotein and elevated high-density lipoprotein compared to before treatment. Conclusions: dyslipidemia is common finding in PCOS women, in this study we found that the use of oral metformin tablets 500mg/twice daily for three months will correct lipid profile level (cholesterol, triglyceride, LDL, VLDL and HDL) which is considered as cardiovascular risk factors and this lead to reduce risk of cardiovascular diseases.
Glycotoxins termed as advanced glycation endproducts (AGEs) are made endogenously and exogenously. Maillard reaction is a chemical non-enzymatic process, between sugars and a free amino acid group of nucleic acids, proteins, and lipids which happens exogenously when handled with high temperature for a prolonged period and in a dry environment, resulting in glycotoxins (AGEs) formations. This reaction is responsible for the taste, color, and smell of food. Glycotoxins derived from food are absorbed in the intestine and store in cells and tissues. Also, glycotoxins are derived exogenously from smoking. While endogenous glycotoxins are generated by normal body physiology. Obesity and insulin resistance may induce glycotoxins (AGEs) accumulation. The objective of this study was to evaluate the relationship between glycotoxins (AGEs) and obesity. 66 infertile females who were undergoing intracytoplasmic sperm injection ICSI. These females were classified into three groups according to their body mass index. On the day of ova pick up the collect serum and follicular fluid for subsequent measurement of glycotoxins (AGEs) by ELISA kits. there was a significant difference in the concentration of glycotoxins in follicular fluid and serum between the three ICSI groups of patients. As well as there was a significant difference in the concentration of glycotoxins (AGEs) in follicular fluid and serum in the same ICSI groups of patients. there is a significant positive relation between glycotoxins (AGEs) and increase BMI.
Background: Metformin is anti-hyperglycemic effect due to decrease of hepatic glucose production. Another effect, leading decrease insulin resistance, regarded a safe drug, treatment of choice for overweight. Objective: To investigate the effects of 3 concentration of MF administered orally to male mice on sperm parameters as model for human being. Materials and Methods: In current study, 80 male mice were taken with age ranging between 1.5-2 month and weights ranging between 25-30 grams males classified into four groups of a control group (G1) and treated group (G2, G3 and G4) doses of MF were employed, 0.2, 0.4, 0.6 mg/mice daily to groups, given orally for 6 weeks and then the animals were scarified. Results Results have revealed a significant difference (P < 0.05) in sperm concentration for 3 groups compared to G1 group. Progressive motility (%) appeared with significant difference (P< 0.05) for G3 group as compared to other treated and G1 group. Furthermore, the result illustrated a significant decreased (P< 0.05) in the abnormal sperm morphology for G3 group compared with treated and control. However, sperm agglutination (%) confirmed that the G3 group exhibited highly statistical significant decrease (p≤0.001) compared to G1, G2 and G4. Conclusions From results of the present study, it was concluded that the administration of MF doses reduce sperm concentration .while, 0.4mg dose improve certain sperm parameters.