CLINICAL AND ANAMNESTETIC FEATURES OF PATIENTS WITH ENDOCRINE INFERTILITY FACTOR IN COMBINATION OF POLYCYSTIC OVARY SYNDROME AND METABOLIC SYNDROME
DOI:
https://doi.org/10.11603/24116-4944.2024.1.14751Keywords:
infertility, polycystic ovarian syndrome, metabolic syndrome, insulin resistance, anovulation, menstrual dysfunction, assisted reproductive technologies, miscarriagesAbstract
The aim of the study - to establish the characteristic clinical and anamnestic features of patients with polycystic ovary syndrome and metabolic syndrome, which may affect the results of infertility treatment using assisted reproductive technologies.
Materials and Methods. A retrospective analysis of 120 outpatient medical records of infertile patients treated at the Medical Center “The Clinic of Professor Stefan Khmil” from 2013 to 2023 was conducted. The main study group consisted of 46 infertile women with PCOS and metabolic syndrome. The comparison group consisted of 44 patients with infertility and PCOS. 30 patients with tubal factor infertility made up the control group.
Results and Discussion. The main complaint of the women in the study and control groups was failure to get pregnant for 1 year or more with regular open sexual intercourse. One-third of women (34.16 %) visited a reproductive specialist immediately after 1 year of independent attempts. The remaining women have a history of 2 to 9 years of infertility. Analysis of the parameters of menstrual function of women in the main and comparison groups revealed patterns characteristic of PCOS. Oligomenorrhea (less than 8 cycles per year) was more typical for the PCOS group, while in the PCOS and metabolic syndrome groups, cases of secondary amenorrhea (menstrual delay of more than 6 months) were not uncommon. Among the previously used treatment methods, it is worth noting ovulation induction with clomiphene citrate/letrozole (30.43 % of patients in the main group and 27.27 % in the comparison group), intrauterine insemination in induced cycles (10.87 % and 9.09 %, respectively), and even IVF cycles followed by embryo transfer (in 15.22 % and 11.36 % of patients, respectively).
Conclusions. The analysis of menstrual and reproductive function revealed the dominance of fertility and ovulation disorders, which caused infertility. Preliminary unsuccessful results of the use of ART techniques in the treatment of infertility in this cohort of women require special attention and optimization of the diagnostic and treatment algorithm.
References
Cox, C. M., Thoma, M. E., Tchangalova, N., Mburu, G., Bornstein, M. J., Johnson, C. L., & Kiarie, J. (2022). Infertility prevalence and the methods of estimation from 1990 to 2021: a systematic review and meta-analysis. Human reproduction open, 2022(4), hoac051. DOI: 10.1093/hropen/hoac051
World Health Organization. (2023). Infertility prevalence estimates: 1990–2021.
How common is male infertility, and what are its causes? (n.d.). NICHD. Retrieved from https://www.nichd.nih.gov/health/topics/menshealth/conditioninfo/infertility
Carson, S. A., & Kallen, A. N. (2021). Diagnosis and Management of Infertility: A Review. JAMA, 326(1), 65–76. DOI: 10.1001/jama.2021.4788
Walker, M. H., & Tobler, K. J. (2022). Female Infertility. In StatPearls. StatPearls Publishing.
Deswal, R., Narwal, V., Dang, A., & Pundir, C. S. (2020). The prevalence of polycystic ovary syndrome: a brief systematic review. Journal of human reproductive sciences, 13(4), 261–271. DOI: 10.4103/jhrs.JHRS_95_18
Rababa'h, A. M., Matani, B. R., & Yehya, A. (2022). An update of polycystic ovary syndrome: causes and therapeutics options. Heliyon, 8(10), e11010. DOI: 10.1016/j.heliyon.2022.e11010
Khmil, M., Khmil, S., & Marushchak, M. (2020). Hormone imbalance in women with infertility caused by polycystic ovary syndrome: is there a connection with body mass index?. Open Access Macedonian Journal of Medical Sciences, 8(B), 731-737.
Khmil Doswald, А.S., Khmil, M.S., & Khmil, S.V. (2021). Epidemiology of polycystic ovary syndrome, endometriosis and their comorbid course. Bulletin of Medical and Biological Research, 3(4), 135-145. DOI: 10.11603/bmbr.2706-6290.2021.4.12662
Khmil, M.S., Khmil Doswald, А.S., & Khmil, S.V. (2019). Polycystic ovary syndrome as a factor in endocrine infertility. Bulletin of Medical and Biological Research, (2), 77-83.
Khan, M. J., Ullah, A., & Basit, S. (2019). Genetic basis of Polycystic Ovary Syndrome (PCOS): current perspectives. The application of clinical genetics, 12, 249–260. DOI: 10.2147/TACG.S200341
Chandrasekaran, S., & Sagili, H. (2018) Metabolic syndrome in women with polycystic ovary syndrome. The Obstetrician & Gynaecologist (RCOG), 20 (4), 245-252 DOI: 10.1111/tog.12519
Leal, C. R. V., Zanolla, K., Spritzer, P. M., & Reis, F. M. (2024). Assisted Reproductive Technology in the Presence of Polycystic Ovary Syndrome: Current Evidence and Knowledge Gaps. Endocrine practice: official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 30(1), 64–69. DOI: 10.1016/j.eprac.2023.09.004
Sun, Y. F., Zhang, J., Xu, Y. M., Cao, Z. Y., Wang, Y. Z., Hao, G. M., & Gao, B. L. (2020). High BMI and insulin resistance are risk factors for spontaneous abortion in patients with polycystic ovary syndrome undergoing assisted reproductive treatment: a systematic review and meta-analysis. Frontiers in endocrinology, 11, 592495. DOI: 10.3389/fendo.2020.592495
Ding, H., Zhang, J., Zhang, F., Zhang, S., Chen, X., Liang, W., & Xie, Q. (2021). Resistance to the insulin and elevated level of androgen: a major cause of polycystic ovary syndrome. Frontiers in endocrinology, 12, 741764. DOI: 10.3389/fendo.2021.741764
Herman, R., Sikonja, J., Jensterle, M., Janez, A., & Dolzan, V. (2023). Insulin metabolism in polycystic ovary syndrome: secretion, signaling, and clearance. International journal of molecular sciences, 24(4), 3140. DOI: 10.3390/ijms24043140
Kim, C. H., & Lee, S. H. (2022). Effectiveness of lifestyle modification in polycystic ovary syndrome patients with obesity: a systematic review and meta-analysis. Life (Basel, Switzerland), 12(2), 308. DOI: 10.3390/life12020308
Shahid, R., Iahtisham-Ul-Haq, Mahnoor, Awan, K. A., Iqbal, M. J., Munir, H., & Saeed, I. (2022). Diet and lifestyle modifications for effective management of polycystic ovarian syndrome (PCOS). Journal of food biochemistry, 46(7), e14117. DOI: 10.1111/jfbc.14117
Khmil, M. S., Khmil-Dosvald, A. S., Khmil, S. V., & Pidhaina, I. Ya. (2018) The prospects of inozitol using in women with polycystic ovary syndrome (literature review). Bulletin of social hygiene and health protection organization of Ukraine, (4), 82-89.
Kotlyar, A. M., & Seifer, D. B. (2023). Women with PCOS who undergo IVF: a comprehensive review of therapeutic strategies for successful outcomes. Reproductive biology and endocrinology : RB&E, 21(1), 70. DOI: 10.1186/s12958-023-01120-7
Cakiroglu, Y., Doger, E., Vural, F., Kopuk, S. Y., & Vural, B. (2017). Impact of insulin resistance and obesity on intracytoplasmic sperm injection outcomes in young women with polycystıc ovary syndrome. Northern clinics of Istanbul, 4(3), 218–224. DOI: 10.14744/nci.2017.79663
Nair, N., More, A., Bankar, N. J., Badge, A., Gajbe, U., & Singh, B. R. (2024). A comprehensive approach to polycystic ovarian syndrome: a case report of successful intracytoplasmic sperm injection treatment utilizing the short antagonist protocol and hatching. Cureus, 16(2), e54457. DOI: 10.7759/cureus.54457
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Actual Problems of Pediatrics, Obstetrics and Gynecology
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish in this journal agree to the following terms:
1. The authors reserve the right to authorship of the work and pass the journal right of first publication of this work is licensed under a Creative Commons Attribution License, which allows others to freely distribute the work published with reference to the authors of the original work and the first publication of this magazine.
2. Authors are entitled to enter into a separate agreement on additional non-exclusive distribution of work in the form in which it was published in the magazine (eg work place in the electronic repository institution or publish monographs in part), provided that the reference to the first publication of this magazine.
3. Policy magazine allows and encourages authors placement on the Internet (eg, in storage facilities or on personal websites) manuscript of how to submit the manuscript to the editor and during his editorial processing, since it contributes to productive scientific discussion and positive impact on the efficiency and dynamics of citing published work (see. The Effect of Open Access).
