MODERN CONCEPTS OF POLYCYSTIC OVARY SYNDROME


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Abstract

The article presents new data on the etiology and pathogenesis of polycystic ovary syndrome (PCOS). Current approaches to diagnosis and treatment of this disease are discussed. Particular attention is paid to the treatment of infertility in women with PCOS. The main methods used to induce ovulation in this category of patients are discussed. The data of large population-based studies to assess the risk of venous thromboembolism with the use of various contraceptives are presented. Class of contraceptive of drugs with minimal, comparable to the general population risk of venous thromboembolism is discussed.

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About the authors

N. M Podzolkova

Department of Obstetrics and Gynecology SBEI FPE RMAPE of RMPH Moscow

Yu. A Koloda

Email: julkol@yandex.ru
Department of Obstetrics and Gynecology SBEI FPE RMAPE of RMPH Moscow

References

  1. Lebbi I., Temime B.R., Fadhlaoui A., Feki A. Ovarian drilling in PCOS: is it really useful? Front Surg. 2015;2:30.
  2. Erin K. Barthelmess and Rajesh K. Naz Polycystic ovary syndrome: current status and future perspective Front Biosci (Elite Ed). 2015;6:104-19.
  3. Azziz R., Woods K.S., Reyna R., Key T.J., Knochenhauer E.S., Yildiz B.O. The prevalence and features of the polycystic ovary syndrome in an unselected population. J. Clin. Endocrinol. Metab. 2004;89:2745-49.
  4. Diamanti-Kanarakis E., Kouli C.R., Bergiele A.T., Filandra F.A., Tsianateli T.C., Spina G.G., Zapanti E.D., Bartzis M.I. A survey of the polycystic ovary syndrome in the Greek island of Lesbos: hormonal and metabolic profile. J. Clin. Endocrinol. Metab. 1999;84:4006-11.
  5. Park Y.W., Zhu S., Palaniappan L., Heshka S., Carnethon M.R., Heymsfield S.B. The metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988-1994. Arch. Int. Med. 2003;163:427-36.
  6. Merkin S.S., Azziz R., Seeman T., Calderon-Margalit R., Daviglus M., Kiefe C., Matthews K., Sternfeld B., Siscovick D. Socioeconomic status and polycystic ovary syndrome. J. Womens Health. 2011;20:413-19.
  7. Mohamed-Hussein Z.A., Harun S. Construction of a polycystic ovarian syndrome (PCOS) pathway based on the interactions of PCOS-related proteins retrieved from bibliomic data. Theor. Biol. Med. Model. 2009;6:18.
  8. Уварова Е.В. Хащенко Е.П. Синдром поликистозных яичников с позиций современных данных патогенеза. Репродуктивное здоровье детей и подростков. 2013. 7 с.
  9. Duskova M., Cermakova I., Hill M., Vankova M., Samalakova P., Starka L. What may be the markers of the male equivalent of polycystic ovary syndrome? Physiol. Res. 2004;53:287-94.
  10. Gur E.B., Karadeniz M., Turan G.A. Fetal programming of polycystic ovary syndrome. World J. Diabetes. 2015;6(7):936-42.
  11. De Zegher F., Lopez-Bermejo A., Ibanez L. Adipose tissue expandability and the early origins of PCOS. Trends Endocrinol. Metab. 2009;20:418-23
  12. Ibanez L., de Zegher F., Potau N. Premature pubarche, ovarian hyperandrogenism, hyper-insulinism and the polycystic ovary syndrome: from a complex constellation to a simple sequence of prenatal onset. J. Endocrinol. Invest. 1998:21:558-66.
  13. Conway G.S., Dewailly D., Diamanti-Kandarakis E., Escobar Morreale H., Franks S., Gambineri A., Kelestimur F., Macut D., Micic D., Pasquali R., Pfeifer M., Pignatelli D., Pugeat M., Yildiz B. The Polycystic Ovary Syndrome: an Endocrinological Perspective from the European Society of Endocrinology. Eur. J. Endocrinol. 2014;pii: EJE-14-0253.
  14. Escobar-Morreale HF Iron metabolism and the polycystic ovary syndrome. Trends Endocrinol. Metab. 2012;23(10):509-1.
  15. Irani M., Merhi Z. Role of vitamin D in ovarian physiology and its implication in reproduction: a systematic review Fertil Steril. 2014;102(2):460-68.
  16. Joseph S., Barai R.S., Bhujbalrao R., Idicula-Thomas S. PCOSKB: A KnowledgeBase on genes, diseases, ontology terms and biochemical pathways associated with PolyCystic Ovary Syndrome. Nucleic Acids Res. 2016;44(D1).
  17. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum. Reprod. 2004;19:41-7.
  18. Iliodromiti S., Kelsey T.W., Anderson R.A., Nelson S.M. Can anti-Mullerian hormone predict the diagnosis of polycystic ovary syndrome? A systematic review and meta-analysis of extracted data. J. Clin. Endocrinol. Metab. 2013;98(8):3332-40.
  19. Legro R.S., Arslanian S.A., Ehrmann D.A., Hoeger K.M., Murad M.H., Pasquali R., Welt C.K. Endocrine Society. Diagnosis and treatment of polycystic ovary syndrome: an endocrine society clinical practice guideline. J. Clin. Endocrinol. Metab. 2013;98(12):4565-92.
  20. Consensus on women's health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Fertil Steril. 2012; 97(1):28-38.
  21. Caruso S., Cianci S., Malandrino C., Cicero C., Lo Presti L., Cianci Hyperandrogenic women treated with a continuous-regimen oral contraceptive. Eur. J. Obstet. Gynecol. Reprod. Biol. 2013;171(2):307-10.
  22. Zimmerman Y., Eijkemans M.J.C., Coelingh H.J., et al. The effect of combined oral contraception on testosterone levels in healthy women: a systematic review and meta-analysis. Hum.Reprod. Update. 2014;20(1):76-105.
  23. Guido M., Romualdi D., Campagna G., Ricciardi L., Bompiani A., Lanzone A. Ethinylestradiolchlormadinone acetate combination for the treatment of hirsutism and hormonal alterations of normal-weight women with polycystic ovary syndrome: evaluation of the metabolic impact. Reprod Sci. 2010;17(8):767-75.
  24. Uras R., Orru M., Pani F., Marotto M.F., Pilloni M., Guerriero S., Etzi R., Zedda P., Sorge R., Lello S., Melis G.B., Paoletti A.M. Endocrinological, metabolic and clinical features of treatment with oral contraceptive formulation containing ethinylestradiol plus chlormadinone acetate in non-obese women with polycystic ovary syndrome. Contraception. 2010;82(2):131-38.
  25. Angstwurm M.W., Gartner R., Ziegler-Heitbrock H.W. Cyclic plasma IL-6 levels during normal menstrual cycle. Cytokine. 1997;9:370-74.
  26. Petrikova J, Lazurova I, Yehuda S. Polycystic ovary syndrome and autoimmunity. Eur. J. Intern. Med. 2010;21:369-71.
  27. Butts C.L., Shukair S.A., Duncan K.M., Bowers E., Horn C., Belyavskaya E., Tonelli L., Sternberg E.M. Progesterone inhibits mature rat dendritic cells in a receptor-mediated fashion. Int. Immunol. 2007;19:287-96.
  28. Ilie I.R., Marian I., Mocan T., Ilie R., Mocan L., Duncea I., Pepene C.E. Ethinylestradiol30μg-drospirenone and metformin: could this combination improve endothelial dysfunction in polycystic ovary syndrome? BMC Endocr. Disord. 2012;12:9.
  29. Barry J.A., Azizia M.M., Hardiman P.J. Risk of endometrial, ovarian and breast cancer in women with polycystic ovary syndrome: a systematic review and meta-analysis. Hum. Reprod. Update. 2014;20(5):748-58.
  30. Schindler A.E. Non-contraceptive benefits of oral hormonal contraceptives Int. J. Endocrinol. Metab. 2013;11(1):41-7.
  31. Okoroh E.M., Hooper W.C., Atrash H.K., Yusuf H.R., Boulet S.L. Is polycystic ovary syndrome another risk factor for venous thromboembolism? United States, 2003-2008.
  32. Schramm G.A., Steffens D. A 12-month evaluation of the CMA-containing oral contraceptive Belara: efficacy, tolerability and anti-androgenic properties. Contraception. 2003; 67(4):305-12.
  33. Thessaloniki ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Consensus on infertility treatment related to polycystic ovary syndrome. Fertil Steril. 2008;89:505-22.
  34. Berger J.J., Bates G.W.Jr. Optimal management of subfertility in polycystic ovary syndrome. Int. J. Womens Health. 2014:6:613-21.
  35. Hurst B.S., Hickman J.M., Matthews M.L., Usadi R.S., Marshburn P.B. Novel Clomiphene"Stair-Step" Protocol Reduces Time to Ovulation in Women with Polycystic Ovarian Syndrome. AJOG. 2009;200(5):510.e1-510.e4.
  36. Diamond M.P., Kruger M., Santoro N., Zhang H., Casson P., Schlaff W., Coutifaris C., Brzyski R., Christman G., Carr B.R., McGovern P.G., Cataldo N.A., Steinkampf M.P., Gosman G.G., Nestler J.E., Carson S., Myers E.E., Eisenberg E., Legro R.S. Endometrial Shedding Effect on Conception and Live Birth in Women With Polycystic OvarySyndrom Obstet. Gynecol. 2012; 119(5):902-8.
  37. Paulina A., et al. The Pathophysiology of Miscarriage in Women with Polycystic Ovary Syndrome. Review and Proposed Hypothesis of Mechanisms Involved Hormones 2004; 3(4):221-27.
  38. Legro R.S., Dodson W.C., Kris-Etherton P.M., Kunselman A.R., Stetter C.M., Williams N.I., Gnatuk C.L., Estes S.J., Fleming J., Allison K.C., Sarwer D.B., Coutifaris C., Dokras A. Randomized Controlled Trial of Preconception Interventions in Infertile Women With Polycystic Ovary Syndrome. J. Clin. Endocrinol. Metab. 2015;100(11):4048-58.
  39. Palomba S., Falbo A., Orio F.Jr., Russo T., Tolino A., Zullo F. Pretreatment with oral contraceptives in infertile anovulatory patients with polycystic ovary syndrome who receive gonadotropins for controlled ovarian stimulation. Fertil Steril. 2008;89(6):1838-42.
  40. Weiss N.S., Nahuis M., Bayram N., Mol B.W., Van der Veen F., van Wely M. Gonadotrophins for ovulation induction in women with polycystic ovarian syndrome Cochrane Database Syst. Rev. 2015;9:CD010290.
  41. Григорян О. Р., Шереметьева Е. В., Андреева Е. Н. Место сенситайзера к инсулину (метформина гидрохлорид) в лечении синдрома хронической ановуляции у пациенток с избыточной массой тела и ожирением (обзор литературы) Проблемы репродукции. 2015;3:51.
  42. Farquhar C., Brown J., Marjoribanks J. Laparoscopic drilling by diathermy or laser for ovulation induction in anovulatory polycystic ovary syndrome. Cochrane Database Syst. Rev. 2012;6:CD001122.
  43. Радзинский В.Е., Духин А.О., Алеев И.А., Опарин И.С. перспективы репродуктивной хирургии. Проблемы репродукции 2011. Спецвып. 6 международный конгресс по репродуктивной медицине:270-71.
  44. Калугина А.С., Бобров К.Ю. Синдром поликистозных яичников: современные представления и роль в проблеме бесплодия (обзор литературы) Проблемы репродукции. 2015;2:31-5.
  45. Приказ Минздрава России от 30.08.2012 № 107н «О порядке использования вспомогательных репродуктивных технологий, противопоказаниях и ограничениях к их применению».
  46. ЭКО при гинекологических и эндокринных заболеваниях/ Под ред.Т.А. Назаренко. М., 2016. 176 с.
  47. Pan J.X., Liu Y., Ke Z.H., Zhou C.L., Meng Q., Ding G.L., Xu G.F., Sheng J.Z., Huang H.F. Successive and cyclic oral contraceptive pill pretreatment improves IVF/ICSI outcomes of PCOS patients and ameliorates hyperandrogenism and antral follicle excess. Gynecol. Endocrinol. 2015;31(4):332-36.
  48. Wu C.C., Lei P., Ruan Y.M., Lin X.M., Xiong Y.L., Yang G.Y. Effects of oral contraceptive pretreatment on controlled ovarian hyperstimulation and outcomes of IVF-ETZhonghua Nan Ke Xue. 2012;18(7):623-26.
  49. Griesinger G., Venetis C.A., Tarlatzis B., Kolibianakis E.M. To pill or not to pill in GnRH-antagonist cycles: the answer is in the data already! Reprod Biomed Online. 2015; 31(1):6-8.
  50. Bermejo A., Iglesias C., Ruiz-Alonso M., Blesa D., Simon C., Pellicer A., Garcia-Velasco J. The impact of using the combined oral contraceptive pill for cycle scheduling on gene expression related to endometrial receptivity Hum. Reprod. 2014;29(6):1271-78.
  51. Tso L.O., Costello M.F., Albuquerque L.E., et al. Metformin treatment before and during IVF or ICSI in women with polycystic ovary syndrome. Cochrane Database Syst. Rev. 20148;11:CD006105.
  52. Corbett S., Shmorgun D., Claman P., Healey S., Gysler M. The prevention of ovarian hyperstimulation syndrome. J Obstet Gynaecol Can. 2014;36(11):1024-36.
  53. Kostov I., Ingilizova G. In vitro maturation-a potential approach of infertility treatment of patients withPCOS. Akush Ginekol (Sofiia). 2013;52(4):25-8.
  54. Zhao J.Z., Lin J.J., Yang H. Y., Zhang W., Huang X.F., Huang Y.P. Effects of oral contraceptives and metformin on the outcome of in vitro maturation in infertile women with polycystic ovary syndrome. J Womens Health (Larchmt). 2010;19(2):261-65.

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