PATHOGENETIC INTERSECTIONS OF POLYCYSTIC OVARY SYNDROME AND METABOLIC SYNDROME IN WOMEN WITH INFERTILITY

(LITERATURE REVIEW)

Authors

  • S. V. Khmil I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
  • Yu. B. Pravak I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine

DOI:

https://doi.org/10.11603/1681-2786.2024.1.14631

Keywords:

infertility, PCOS, metabolic syndrome, anovulation, insulin resistance, assisted reproductive technologies, in vitro fertilisation, steroid hormones, obesity, pregnancy

Abstract

Purpose: to determine the characteristics and potential obstetric consequences of the combined course of polycystic ovary syndrome and metabolic syndrome in infertility in young women with unrealized reproductive potential.

Materials and Methods. A systematic review and comparative analysis of 25 scientific publications and literature sources from the PubMed database over the past 5 years related to research in the field of reproductive medicine on the impact of polycystic ovary syndrome and metabolic syndrome on the development of infertility in women of reproductive age and on pregnancy.

Results. The literature review revealed a number of common links in the pathogenesis of PCOS and metabolic syndrome in women with infertility and other fertility disorders. Recent studies recommend classifying PCOS into two subtypes: reproductive and metabolic. Insulin resistance plays a key role in the development of PCOS. The pathological circle is also closed by hyperandrogenism and obesity. It is the defective steroidogenesis that provokes the development of various metabolic disorders, which are quite heterogeneous, and together, insulin resistance, visceral obesity, dyslipidemia, and hyperandrogenism present in PCOS can be classified as a metabolic syndrome. Some issues related to infertility management in PCOS and metabolic syndrome are highly debatable and controversial, as indicated by authors from around the world.

Conclusions. Polycystic ovary syndrome is a kind of platform for the development of many comorbid pathologies. The quality of life of such patients, their reproductive and somatic health, and the realization of reproductive plans directly depend on the management of all existing manifestations of the pathology. The approach to the diagnosis and treatment of women of reproductive age with fertility problems, infertility and miscarriage should be comprehensive.

Author Biographies

S. V. Khmil, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine

DM (Medicine), professor of the Department of Obstetrics and Gynecology No. 1, I. Horbachevsky Ternopil National Medical University

Yu. B. Pravak, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine

is a postgraduate student of the Department of Obstetrics and Gynecology No. 1, I. Horbachevsky Ternopil National Medical University

References

Grieger, J.A., Hutchesson, M.J., Cooray, S.D., Bahri Khomami, M., Zaman, S., Segan, L., … Moran, L.J. (2021). A review of maternal overweight and obesity and its impact on cardiometabolic outcomes during pregnancy and postpartum. Therapeutic advances in reproductive health, 15. DOI 10.1177/2633494120986544.

Li, Y., Jiang, Y., Zhang, S., Liu, H., & Zhang, C. (2023). Association of HOMA-IR with Ovarian Sensitivity Index in Women Undergoing IVF/ICSI: A Retrospective Cohort Study. Diabetes, metabolic syndrome and obesity: targets and therapy, 16, 309-320. DOI 10.2147/DMSO.S399105.

Aydogan Mathyk, B., & Quaas, A.M. (2021). Obesity and IVF: weighing in on the evidence. Journal of assisted reproduction and genetics, 38(2), 343-345. DOI 10.1007/s10815-021-02068-6.

Liimatta, J., Utriainen, P., Laitinen, T., Voutilainen, R., & Jääskeläinen, J. (2019). Cardiometabolic Risk Profile Among Young Adult Females With a History of Premature Adrenarche. Journal of the Endocrine Society, 3(10), 1771-1783. DOI 10.1210/js.2019-00193.

Chen, W., & Pang, Y. (2021). Metabolic Syndrome and PCOS: Pathogenesis and the Role of Metabolites. Metabolites, 11(12). DOI 10.3390/metabo11120869.

Christ, J.P., & Cedars, M.I. (2023). Current Guidelines for Diagnosing PCOS. Diagnostics (Basel, Switzerland), 13(6). DOI 10.3390/diagnostics13061113.

Sachdeva, G., Gainder, S., Suri, V., Sachdeva, N., & Chopra, S. (2019). Comparison of the Different PCOS Phenotypes Based on Clinical Metabolic, and Hormonal Profile, and their Response to Clomiphene. Indian journal of endocrinology and metabolism, 23(3), 326-331. DOI 10.4103/ijem.IJEM_30_19.

Pedro-Botet, J., Ascaso, J.F., Barrios, V., De la Sierra, A., Escalada, J., Millán, J., … Valdivielso, P. (2018). COSMIC project: consensus on the objectives of the metabolic syndrome in clinic. Diabetes, metabolic syndrome and obesity: targets and therapy, 11, 683-697. DOI 10.2147/DMSO.S165740.

Dapas, M., Lin, F.T.J., Nadkarni, G.N., Sisk, R., Legro, R.S., Urbanek, M., … Dunaif, A. (2020). Distinct subtypes of polycystic ovary syndrome with novel genetic associations: An unsupervised, phenotypic clustering analysis. PLoS medicine, 17(6). DOI 10.1371/journal.pmed.1003132.

Hussein, K., & Karami, M. (2023). Association between insulin resistance and abnormal menstrual cycle in Saudi females with polycystic ovary syndrome. Saudi pharmaceutical journal, 31(6), 1104-1108. DOI 10.1016/j.jsps.2023.03.021.

Luo, Z., Wang, L., Wang, Y., Fan, Y., Jiang, L., Xu, X., … Hao, G. (2023). Impact of Insulin Resistance on Ovarian Sensitivity and Pregnancy Outcomes in Patients with Polycystic Ovary Syndrome Undergoing IVF. Journal of clinical medicine, 12(3). DOI 10.3390/jcm12030818.

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, 21(1), 70. DOI 10.1186/s12958-023-01120-7.

Mann, A., Sagili, H., & Subbaiah, M. (2020). Pregnancy Outcome in Women with Polycystic Ovary Syndrome. Journal of obstetrics and gynaecology of India, 70(5), 360-365. DOI 10.1007/s13224-020-01356-y.

Giri, A., Joshi, A., Shrestha, S., & Chaudhary, A. (2022). Metabolic Syndrome among Patients with Polycystic Ovarian Syndrome Presenting to a Tertiary Care Hospital: A Descriptive Cross-Sectional Study. Journal of the Nepal Medical Association, 60(246), 137-141. DOI 10.31729/jnma.7221.

Mitkova Orbetzova, M. (2020). Clinical Impact of Insulin Resistance in Women with Polycystic Ovary Syndrome. Polycystic Ovarian Syndrome. DOI 10.5772/intechopen.90749.

García-Ferreyra, J., Carpio, J., Zambrano, M., Valdivieso-Mejía, P., & Valdivieso-Rivera, P. (2021). Overweight and obesity significantly reduce pregnancy, implantation, and live birth rates in women undergoing In Vitro Fertilization procedures. JBRA assisted reproduction, 25(3), 394-402. DOI 10.5935/1518-0557.20200105.

Kshetrimayum, C., Sharma, A., Mishra, V.V., & Kumar, S. (2019). Polycystic ovarian syndrome: Environmental/occupational, lifestyle factors; an overview. Journal of the Turkish German Gynecological Association, 20(4), 255-263. DOI 10.4274/jtgga.galenos.2019.2018.0142.

Rababaʼh, A. M., Matani, B.R., & Yehya, A. (2022). An update of polycystic ovary syndrome: causes and therapeutics options. Heliyon, 8(10). DOI 10.1016/j.heliyon.2022.e11010.

Ballesta-Castillejos, A., Gómez-Salgado, J., Rodríguez-Almagro, J., Ortiz-Esquinas, I., & Hernández-Martínez, A. (2020). Relationship between Maternal Body Mass Index and Obstetric and Perinatal Complications. Journal of clinical medicine, 9(3). DOI 10.3390/jcm9030707.

Kumar, R., Minerva, S., Shah, R., Bhat, A., Verma, S., Chander, G., … Ganie, M. A. (2022). Role of genetic, environmental, and hormonal factors in the progression of PCOS: A review. Journal of Reproductive Healthcare and Medicine, 3, 3. DOI 10.25259/jrhm_16_2021.

Sanchez-Garrido, M.A., & Tena-Sempere, M. (2020). Metabolic dysfunction in polycystic ovary syndrome: Pathogenic role of androgen excess and potential therapeutic strategies. Molecular metabolism, 35, 100937. DOI 10.1016/j.molmet.2020.01.001.

Shirazi, F.K.H., Khodamoradi, Z., & Jeddi, M. (2021). Insulin resistance and high molecular weight adiponectin in obese and non-obese patients with Polycystic Ovarian Syndrome (PCOS). BMC endocrine disorders, 21(1), 45. DOI 10.1186/s12902-021-00710-z.

Revelli, A., Gennarelli, G., Biasoni, V., Chiadò, A., Carosso, A., Evangelista, F., … Benedetto, C. (2020). The Ovarian Sensitivity Index (OSI) Significantly Correlates with Ovarian Reserve Biomarkers, Is More Predictive of Clinical Pregnancy than the Total Number of Oocytes, and Is Consistent in Consecutive IVF Cycles. Journal of clinical medicine, 9(6), 1914. DOI 10.3390/jcm9061914.

Wang, C., Wen, Y.X., & Mai, Q.Y. (2022). Impact of metabolic disorders on endometrial receptivity in patients with polycystic ovary syndrome. Experimental and therapeutic medicine, 23(3), 221. DOI 10.3892/etm.2022.11145.

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Published

2024-04-30

How to Cite

Khmil, S. V., & Pravak, Y. B. (2024). PATHOGENETIC INTERSECTIONS OF POLYCYSTIC OVARY SYNDROME AND METABOLIC SYNDROME IN WOMEN WITH INFERTILITY: (LITERATURE REVIEW). Bulletin of Social Hygiene and Health Protection Organization of Ukraine, (1), 95–100. https://doi.org/10.11603/1681-2786.2024.1.14631

Issue

No. 1 (2024)

Section

The review of the scientific literature

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