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.
Background: Leptin is an adipocyte —secreted protein that participates in the regulation of energy homeostasis. It prevents the body from storing fat, controls hunger and cravings, regulates food intake and energy expenditure, provides the body with an index of nutritional status and controls the whole body fat metabolism. Leptin is a product of ob gene created by adipocytes. It seems to signal metabolic information to the reproductive system. Objective: The aim of this study to evaluate the relationship between serum leptin and infertility in oligozoospermic men. Materials and Methods: Seventy men were investigated; fertile normozoospermic as a control (n=35) and infertile oligozoospermic (n=35). The patients underwent estimation of body weight (kg), height body mass index (BMI), semen analysis, serum FSH, LH, testosterone and leptin, lipid profile and serum malondialdehyde (MDA). The infertile group was given a treatment course of clomiphene citrate (50 mg) and vitamin E (400mg) and then all the previous parameters were reevaluated after 3 months. Results: Mean body weight was significantly higher in infertile oligozoospermia compared to controls. The height showed no significant difference between the groups. Hormonal profile revealed significant (P=0.0001) difference in FSH between control group and oligozoospermic group (7.04±4.20 versus 3.35±1.47 mIU/ml), but after treatment with clomiphene citrate and vitamin E there is a slight non-significant (P=0.231) decrease in the level of FSH in oligozoospermic group. The level of testosterone showed a statistically significant (P=0.0001) difference between fertile normozoospermic (5.52 ±1.29 ng/ml) and infertile oligozoospermic. This hormone showed a significant (P<0.0001) increase in its level after treatment with clomiphene citrate and vitamin E (3.48±1.56 ng/ml). Other hormone showed non significant difference between the two groups pre and post treatment. Lipid profile showed no significant difference between the two groups. There was no significant (P=0.477) difference in serum MDA between the control and the infertile groups (4.69±1.32 vs. 5.18±1.19 µmol/L) respectively, but after treatment the results showed a mild significant (P=0.026) decrease in comparison to the level in the control group and also a significant (P=0.0001) decrease in comparison to the level before treatment. Infertile oligozoospermic had significantly higher serum leptin level (8.03±1.22 ng/ml) than control (3.62 ± 1.00 ng/ml). Conclusion: Serum leptin demonstrated a significant positive correlation with age, body weight, BMI and a significant inverse correlation with serum testosterone. It had nonsignificant correlation with the height and sperm concentration. These results are suggestive of a link between the adipocyte derived hormone leptin and male reproduction.
Background: Polycystic ovary syndrome is the most common, yet complex, endocrine disorder with principal features of anovulation, amenorrhea, ovulation-related infertility, polycystic ovaries, and obesity. Number of metabolic aberrations is now well recognized as a growing public health problem in PCOS as glucose intolerance, hyperinsulinemia and dyslipidemia. Objective: To investigate and analyze the anthropometric, hormonal profile and metabolic abnormalities of obese and non-obese women with this disorder. Materials and Methods: Sixty-five healthy Iraqi women serves as the control group and eighty-four infertile women divided into two subgroups depending on the BMI (< and ≥30 kg/m2) were studied. BMI, waist to hip ratio and waist to thigh ratio were measured. Serum levels of luteinizing hormone, follicle stimulating hormone, estradiol, testosterone, fasting blood glucose, and oral glucose tolerance test, and total lipid profile were measured. Results: BMI, waist/hip, waist/thigh ratio were significantly higher in PCOS than control women. Lower FSH level, higher LH and E2 levels, LH/FSH ratio, and lower E2/testosterone ratio was found in obese and non-obese PCOS. Higher blood sugar level, high cholesterol, triglyceride, LDL, VLDL and lower HDL levels in PCOS compared to control women. Conclusion: Obesity is a common finding of women with PCOS, but it is not part of the diagnostic criteria. Women with PCOS usually have the so-called centralobesity (Visceral adiposity), and therefore tend to have an increased waist-hip ratio (WHR) and waist to thigh ratio, regardless of the weight factor (i.e., in obese and non-obese). PCOS patients exhibited abnormal hormonal status and biochemical indices also regardless of obesity.
Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. Polycystic ovary syndrome signs and symptoms often begin soon after menarche. In some cases, PCOS develops later during the reproductive years, for instance, in response to substantial weight gain. The PCOS produces symptoms in about 5-10% of women of reproductive age(12-45 years) and it is one of the leading causes of female subfertility.Women with PCOS suffer not only from subfertility, but also from a high rate of early pregnancy loss. About 30-50% of clinically confirmed early pregnancy loss are associated with PCOS.In addition to early pregnancy loss, women with PCOS have increased risk of recurrent miscarriage ,which defined as 3 or more consecutive pregnancy loss before 20 week. Metformin hydrochloride, an insulin sensitizing agent, has been shown to have encouraging effects on several aspect of PCOS like insulin sensitivity, plasma glucose concentration & lipid profile.It is found that using Metformin during pregnancy in women with PCOS may reduce the pregnancy loss and also reduce the risk of gestational diabetes,intrauterine growth retardation(IUGR) & preterm labor. Aim of study: To evaluate the role of Metformin in women with recurrent miscarriage & its effect on other pregnancy complications in women with PCOS. Patients, Materials & Methods: A prospective study done at gynecology outpatient clinic of AL-Batool Teaching Hospital in Baquba-Diyala -Iraq, from September 2012 to September 2016. A total of 100 cases were studied, all have aconfirmed diagnosis of PCOS depending on the following criteria:1)Oligo or amenorrhea (8 or fewer cycles per a year) , 2) signs of hyperandrogenism 3)ultrasound features of PCOS.All should have history of 3 or more recurrent first trimester miscarriage & they were invistigated for other causes of recurrent miscarriage. All cases were followed before getting pregnant and received Metformin for enhancing fertility & when they become pregnant, they were divided into two groups: the 1st group stopped using Metformin once they get pregnant while the 2nd group continued to use Metformin in a dose of 500-1000mg per day throughout pregnancy .Both groups are followed to determine pregnancy outcome. Results: Patients who continued to receive Metformin during pregnancy had better pregnancy outcome regarding early pregnancy loss and recurrent miscarriage, gestational diabetes development, IUGR & preterm labor. Conclusions: Metformin use during pregnancy improve pregnancy outcome in patients with polycystic ovary syndrome.