New aspects in diagnosis and pathophysiology of polycystic ovarian syndrome
Authors:
MUDr. Petr Krajkovič; Doc. MUDr. Stanislav Tomáš, Ph.D.; MUDr. Pavol Žúbor, Ph.D.
Authors‘ workplace:
Gynekologicko-pôrodnícka klinika Jesseniovej LF UK, Martin
Published in:
Prakt Gyn 2006; 10(5): 194-198
Publikováno v Praktickej gynekológii 2005; 12(1): 5–9.
Overview
The aim of the article is to summarise current views on diagnostic criteria for polycystic ovarian syndrome (PCOS) and to elaborate on some of the new findings in the disease pathophysiology. PCOS affects a heterogeneous group of women displaying variable clinical pictures and changes in endocrine and metabolic pathways. As a result, it is difficult to determine which diagnostic criteria shall prevail in determining the diagnosis. Based on the guidelines recommended by the Rotterdam consensus conference (2003 Rotterdam ESHRE/ASRM-sponsored PCOS consensus workshop group), female patients meeting internationally defined criteria can be diagnosed for PCOS. This is the basic prerequisite for large randomised multicentric studies to be conducted in further study of the disease [2].
Key words:
PCO syndrome – diagnostics – pathophysiology – insulin resistance – LH
Sources
1. Barbieri RL. Metformin for the treatment of polycystic ovary syndrome. Am J Obstetr Gyn 2003; 101: 785-793.
2. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 2004; 81: 19-25.
3. Bucket WM. Ovarian stromal echogenicity in women with normal and polycystic ovaries. Hum Reprod 2003; 18: 598-603.
4. Carmina E, Longo A, Lobo RA. Does ovarian blood flow distinguish between ovulatory and anovulatory patients with polycystic ovary syndrome? Am J Obst Gyn 2003; 189: 1283-1286.
5. Balen AH, Laven JS, Tan SL, Dewailly D. Ultrasound assessment of the polycystic ovary: international consensus definitions. Hum Reprod Update 2003; 9: 505-514.
6. Bucket WM, Bouzayen R, Watkin KL et al. Ovarian stromal echogenicity in women with normal and polycystic ovaries. Hum Reprod 2003; 18: 598–603.
7. Cibula D, Hill M, Starka L. The best correlation of the new index of hyperandrogenism with the grade of increased hair. Eur J Endocrinol 2000; 143: 405-408.
8. Slayden SM, Moran C, Sams WM Jr et al. Hyperandrogenemia in patients presenting with acne. Fertil Steril 2001; 75: 889–892.
9. Ferannini E, Natali A. Insulin resistance and hypersecretion in obesity. J Clin Invest 1997; 30: 1166-1173.
10. Barbieri RL. Induction of ovulation in infertile women with hyperandrogenism and insulin resistance. Am J Obstet Gynecol 2000; 183: 1412-1418.
11. Mather KJ, Hunt AE, Steinber HO et al. Repeatability characteristics of simple indices of insulin resistance: Implications for research applications. J Clin Endocrinol Metab 2001; 86: 5457-5464.
12. Dorn Ch, Mouillet JF. Insulin enhances the transcription of luteinizing hormone- gene, Am J Obst Gynecol 2004; 191: 132-137.
13. Cibula D, Stárka L, Vrbíková J et al. Syndrom polycystických ovarií. Maxdorf: Praha 2004: 126.
14. Dunaif A. Insulin resistance and polycystic ovary syndrome: Mechanism and implication for pathogenesis. Endocr Rev 1997; 6: 774-800.
15. Stumvoll M, Nurjhan N, Perriello G. Metabolic effects of metformin in non-insulin-dependent diabetes mellitus. N Engl J Med 1995; 333: 550-554.
16. Fauser BC, Pache TD, Lamberts SW et al. Serum bioactive and immunoreactive LH and FSH levels in women with cycle abnormalities, with or without PCOD. J Clin Endocrinol Metab 1991; 73: 811-817.
17. Laven JS, Imani B, Eijkemans MJ, Fauser BC. New approaches to PCOS and other forms of anovulation. Obstet Gynecol Surv 2002; 57: 755–767.
18. Balen AH, Tan SL, McDougall J, Jacobs HS. Misscariage rates following IVF are increased in women with PCO and reduced pituitary desensitization with buserelin. Hum Reprod 1993; 8: 959-964.
19. Gordon UD, Harisson RF, Hennelly B. A randomised prospective assessor-blind evaluation of LH dosage and IVF. Fertil Steril 2001; 75: 324-331.
20. Hardiman P, Pillay OS, Atiorno W. Polycystic ovary syndrome and endometrial carcinoma. Lancet 2003; 361: 1810-1812.
21. Wild RA. Long-term health consequences of PCOS. Hum Reprod Update 2002; 8: 231-241.
22. Legro RS. Polycystic ovary syndrome and cardiovascular disease: a premature association? Endocrine Rev 2003; 24: 302-312.
Labels
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicineArticle was published in
Practical Gynecology
2006 Issue 5
Most read in this issue
- New options for treatment of disturbances of balance of vaginal environment
- Extrauterine pregnancy after IVF/TESE: casuistic
- New aspects in diagnosis and pathophysiology of polycystic ovarian syndrome
- The family Anamnesis as the Risk Factor of the Breast Cancer