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bariatric surgery and pcos

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https://www.readbyqxmd.com/read/28378209/bariatric-surgery-reduces-serum-anti-mullerian-hormone-levels-in-obese-women-with-and-without-polycystic-ovarian-syndrome
#1
Francesco Chiofalo, Cristina Ciuoli, Caterina Formichi, Federico Selmi, Raffaella Forleo, Ornella Neri, Giuseppe Vuolo, Patrizia Paffetti, Furio Pacini
PURPOSE: Obesity in fertile women has negative effect on fertility. Anti-mullerian hormone (AMH) represents a good index of fertility, and it is considered a marker of ovarian reserve and of polycystic ovarian syndrome (PCOS) gravity. Previous studies evaluated the relationship between obesity and AMH with contradictory results. The aim of the study was to investigate the relationship between obesity and AMH and the changes of AMH in obese women in reproductive age submitted to bariatric surgery...
April 5, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28292619/obesity-and-female-infertility-potential-mediators-of-obesity-s-impact
#2
REVIEW
Darcy E Broughton, Kelle H Moley
The worldwide upward trend in obesity has been dramatic, now affecting more than 20% of American women of reproductive age. Obesity is associated with many adverse maternal and fetal effects prenatally, but it also exerts a negative influence on female fertility. Obese women are more likely to have ovulatory dysfunction due to dysregulation of the hypothalamic-pituitary-ovarian axis. Women with polycystic ovarian syndrome who are also obese demonstrate a more severe metabolic and reproductive phenotype. Obese women have reduced fecundity even when eumenorrheic and demonstrate poorer outcomes with the use of in vitro fertilization...
April 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/27965894/bariatric-surgery-polycystic-ovary-syndrome-and-infertility
#3
REVIEW
James Butterworth, Jean Deguara, Cynthia-Michelle Borg
Background. Polycystic ovary syndrome (PCOS) is the commonest cause of female infertility. Visceral obesity and insulin resistance are key pathophysiological mechanisms behind PCOS. Women suffering from this syndrome and infertility often seek bariatric surgery hoping that they would be able to conceive postoperatively. Objective. At present, there is no consensus on the role of bariatric surgery in the management of PCOS-associated infertility within the medical community, making it difficult to give specific advice to these women, so a review of the literature was necessary...
2016: Journal of Obesity
https://www.readbyqxmd.com/read/27866938/ovulation-induction-in-polycystic-ovary-syndrome-current-options
#4
REVIEW
Richard S Legro
There are a variety of effective treatment options to induce ovulation in women with polycystic ovary syndrome (PCOS). The most effective treatments are primarily reproductive and target the hypothalamic-pituitary-ovarian (HPO) axis. Letrozole, an aromatase inhibitor, is headed toward replacing clomiphene, a selective estrogen receptor modulator, as the first-choice option. Metabolic treatments likely work indirectly through the HPO axis. Many metabolic treatments have shown initial promise and later failed (troglitozone or d-chiro-inositol) or disappointed (metformin); further studies are needed of newer agents to treat type 2 diabetes...
November 2016: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/27773356/polycystic-ovary-syndrome-and-endometrial-hyperplasia-an-overview-of-the-role-of-bariatric-surgery-in-female-fertility
#5
REVIEW
Vasileios Charalampakis, Abd A Tahrani, Ahmed Helmy, Janesh K Gupta, Rishi Singhal
One of the most effective methods to tackle obesity and its related comorbidities is bariatric surgery. Polycystic ovary syndrome (PCOS) and endometrial hyperplasia (EH), which are associated with increased risk of endometrial carcinoma, have been identified as potentially new indications for bariatric surgery. PCOS is the most common endocrine disorder in women in the reproductive age and is associated with several components of the metabolic syndrome such as obesity, insulin resistance and hypertension. EH is a pre-cancerous condition which arises in the presence of chronic exposure to estrogen unopposed by progesterone such as both in PCOS and obesity...
December 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27548360/ten-challenges-in-contraception
#6
Audrey Binette, Kerry Howatt, Ashley Waddington, Robert L Reid
Despite the introduction of promising products into the contraceptive market, the rate of unintended pregnancies remains high. Women with underlying medical conditions should have access to safe and effective contraceptive methods for various reasons, including the potential deleterious effect of the disease on the pregnancy or the effect of the pregnancy on the disease process. Healthcare providers are often confronted with cases in which contraception counseling is problematic due to controversial evidence and persistent myths...
January 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/27511809/the-management-of-anovulatory-infertility-in-women-with-polycystic-ovary-syndrome-an-analysis-of-the-evidence-to-support-the-development-of-global-who-guidance
#7
REVIEW
Adam H Balen, Lara C Morley, Marie Misso, Stephen Franks, Richard S Legro, Chandrika N Wijeyaratne, Elisabet Stener-Victorin, Bart C J M Fauser, Robert J Norman, Helena Teede
BACKGROUND: Here we describe the consensus guideline methodology, summarise the evidence-based recommendations we provided to the World Health Organisation (WHO) for their consideration in the development of global guidance and present a narrative review on the management of anovulatory infertility in women with polycystic ovary syndrome (PCOS). OBJECTIVE AND RATIONALE: The aim of this paper was to present an evidence base for the management of anovulatory PCOS...
November 2016: Human Reproduction Update
https://www.readbyqxmd.com/read/27426125/gut-brain-axis-and-metabolism-in-polycystic-ovary-syndrome
#8
Basak Ozgen Saydam, Bulent O Yildiz
Polycystic ovary syndrome (PCOS) is a common and complex endocrine disorder, often accompanied and complicated by insulin resistance, glucose intolerance and obesity. Gut, brain and metabolism are highly related with each other in obesity and diabetes as well as in PCOS. Central nervous system regulates food intake through complex interactions of homeostatic and hedonic systems while gastrointestinal system contributes to food intake and metabolism via orexigenic and anorexigenic gastrointestinal hormones. Ghrelin is the only circulating orexigenic hormone whereas anorexigenic peptides include glucagon like peptide-1 (GLP-1), gastric inhibitory peptide (GIP), peptide YY (PYY) and cholecystokinin (CCK)...
2016: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/27317009/bariatric-surgery-in-obese-women-of-reproductive-age-improves-conditions-that-underlie-fertility-and-pregnancy-outcomes-retrospective-cohort-study-of-uk-national-bariatric-surgery-registry-nbsr
#9
Eric Edison, Martin Whyte, Jeremy van Vlymen, Simon Jones, Piers Gatenby, Simon de Lusignan, Jill Shawe
BACKGROUND: The aims of this study are the following: to describe the female population of reproductive age having bariatric surgery in the UK, to assess the age and ethnicity of women accessing surgery, and to assess the effect of bariatric surgery on factors that underlie fertility and pregnancy outcomes. METHODS: Demographic details, comorbidities, and operative type of women aged 18-45 years were extracted from the National Bariatric Surgery Registry (NBSR)...
December 2016: Obesity Surgery
https://www.readbyqxmd.com/read/27087540/effect-of-sleeve-gastrectomy-bariatric-surgery-induced-weight-loss-on-serum-amh-levels-in-reproductive-aged-women
#10
Shilpa Bhandari, Ishita Ganguly, Mohit Bhandari, Pallavi Agarwal, Aparna Singh, Nitika Gupta, Arun Mishra
OBJECTIVE: This study aims to evaluate the change in serum anti-Mullerian hormone (AMH) levels in patients with morbid obesity undergoing bariatric surgery for weight loss. MATERIAL AND METHODS: In this prospective observational study, 75 patients of reproductive age (20-35 years) undergoing bariatric surgery for morbid obesity were followed up after six months to determine the changes in weight, Body Mass Index (BMI), menstrual pattern and serum AMH. The results were further studied on basis of pre operative classification of patients in polycystic ovary syndrome (PCOS) and non-PCOS group...
October 2016: Gynecological Endocrinology
https://www.readbyqxmd.com/read/26972165/metabolic-syndrome-diet-and-exercise
#11
REVIEW
Sunita M C De Sousa, Robert J Norman
Polycystic ovary syndrome (PCOS) is associated with a range of metabolic complications including insulin resistance (IR), obesity, dyslipidaemia, hypertension, obstructive sleep apnoea (OSA) and non-alcoholic fatty liver disease. These compound risks result in a high prevalence of metabolic syndrome and possibly increased cardiovascular (CV) disease. As the cardiometabolic risk of PCOS is shared amongst the different diagnostic systems, all women with PCOS should undergo metabolic surveillance though the precise approach differs between guidelines...
November 2016: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/26520034/sleeve-gastrectomy-to-treat-concomitant-polycystyc-ovary-syndrome-insulin-and-leptin-resistance-in-a-27-years-morbidly-obese-woman-unresponsive-to-insulin-sensitizing-drugs-a-3-year-follow-up
#12
Luigi Schiavo, Giuseppe Scalera, Alfonso Barbarisi
INTRODUCTION: Insulin resistance (IR), leptin resistance (LR), and polycystic ovary syndrome (PCOS) commonly coexists with obesity. IR and PCOS are often successfully treated with the use of insulin-sensitizing drugs (ISDs). However, some women are poorly responsive or intolerant to them. If we additionally consider that currently no medical treatment for LR exists, it is crucial for the physician to find different therapeutic ways to treat patients with such multifactorial endocrinopathy...
2015: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/26431698/the-impact-of-bariatric-surgery-on-polycystic-ovary-syndrome-a-systematic-review-and-meta-analysis
#13
REVIEW
Daniel Skubleny, Noah J Switzer, Richdeep S Gill, Mark Dykstra, Xinzhe Shi, Margaret A Sagle, Christopher de Gara, Daniel W Birch, Shahzeer Karmali
Bariatric surgery has been proven to be a successful management strategy for morbid obesity, but limited studies exist on its effect on polycystic ovary syndrome (PCOS). A comprehensive search of electronic databases was completed. Meta-analysis was performed on PCOS, hirsutism, and menstrual irregularity outcomes following bariatric surgery. Thirteen primary studies involving a total of 2130 female patients were identified. The incidence of PCOS preoperatively was 45.6 %, which significantly decreased to 6...
January 2016: Obesity Surgery
https://www.readbyqxmd.com/read/25781065/novel-strategies-in-the-management-of-polycystic-ovary-syndrome
#14
REVIEW
P M Spritzer, A B Motta, T Sir-Petermann, E Diamanti-Kandarakis
Polycystic ovary syndrome (PCOS) is a common endocrinopathy affecting reproductive-aged women. PCOS has been recognized as a syndrome combining reproductive and metabolic abnormalities with lifelong health implications. Cardiometabolic alterations require regular screening and effective and targeted lifestyle advice to lose weight as well as to prevent weight gain. Pharmacological therapy includes insulin-sensitizer drugs and agents that act directly on metabolic comorbidities, such as statins and antiobesity drugs...
September 2015: Minerva Endocrinologica
https://www.readbyqxmd.com/read/25537661/effects-of-roux-en-y-gastric-bypass-surgery-on-eating-behaviour-and-allopregnanolone-levels-in-obese-women-with-polycystic-ovary-syndrome
#15
Sahruh Turkmen, Lotta Andreen, Yucel Cengiz
Polycystic ovary syndrome (PCOS) is associated with abnormal eating habits. We examined whether surgical treatment affected allopregnanolone levels and eating behaviour in nine women with PCOS who qualified for Rou-en-Y gastric bypass surgery. Blood samples were obtained to measure sex-hormone-binding globulin, total testosterone, progesterone, and allopregnanolone, and eating behaviour was evaluated using the Three-Factor Eating Questionnaire before surgery and at 6 and 12 months after surgery. Body mass index and total testosterone levels decreased, and progesterone and sex-hormone-binding globulin levels increased after bariatric surgery compared with pre-surgical values...
April 2015: Gynecological Endocrinology
https://www.readbyqxmd.com/read/25487256/polycystic-ovaries-and-obesity
#16
Ioannis E Messinis, Christina I Messini, George Anifandis, Konstantinos Dafopoulos
Almost 50% of the women with polycystic ovary syndrome (PCOS) are obese. Obesity in PCOS affects reproduction via various mechanisms. Hyperandrogenism, increased luteinizing hormone (LH) and insulin resistance play a pivotal role. Several substances produced by the adipose tissue including leptin, adiponectin, resistin and visfatin may play a role in the pathophysiology of PCOS. Infertility in PCOS is related to anovulation. For induction of ovulation, clomiphene citrate and human gonadotrophins are first- and second-line treatments, respectively...
May 2015: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/25436729/adipose-tissue-inflammation-and-metabolic-dysfunction-a-clinical-perspective
#17
REVIEW
Charmaine S Tam, Leanne M Redman
Obesity is characterized by a state of chronic low-grade inflammation due to increased immune cells, specifically infiltrated macrophages into adipose tissue, which in turn secrete a range of proinflammatory mediators. This nonselective low-grade inflammation of adipose tissue is systemic in nature and can impair insulin signaling pathways, thus, increasing the risk of developing insulin resistance and type 2 diabetes. The aim of this review is to provide an update on clinical studies examining the role of adipose tissue in the development of obesity-associated complications in humans...
September 2013: Hormone Molecular Biology and Clinical Investigation
https://www.readbyqxmd.com/read/25411807/obesity-and-polycystic-ovary-syndrome
#18
REVIEW
N Naderpoor, S Shorakae, A Joham, J Boyle, B De Courten, H J Teede
Obesity is now a major international health concern. It is increasingly common in young women with reproductive, metabolic and psychological health impacts. Reproductive health impacts are often poorly appreciated and include polycystic ovary syndrome (PCOS), infertility and pregnancy complications. PCOS is the most common endocrine condition in women and is underpinned by hormonal disturbances including insulin resistance and hyperandrogenism. Obesity exacerbates hormonal and clinical features of PCOS and women with PCOS appear at higher risk of obesity, with multiple underlying mechanisms linking the conditions...
March 2015: Minerva Endocrinologica
https://www.readbyqxmd.com/read/25092494/bariatric-surgery-for-severely-obese-adolescents
#19
REVIEW
Dominic A Fitzgerald, Louise Baur
Severe obesity is increasing in adolescents and is associated with cardiovascular disease, type 2 diabetes mellitus, obstructive sleep apnoea, polycystic ovarian syndrome and a range of musculoskeletal problems. Premature death is the inevitable outcome of persistent severe obesity in adolescents. In adults with severe obesity, medical and lifestyle interventions have been shown to be expensive and less effective in terms of weight loss than has bariatric surgery. The single completed randomised controlled trial in adolescents shows the same outcome...
September 2014: Paediatric Respiratory Reviews
https://www.readbyqxmd.com/read/24849517/the-polycystic-ovary-syndrome-a-position-statement-from-the-european-society-of-endocrinology
#20
REVIEW
Gerard Conway, Didier Dewailly, Evanthia Diamanti-Kandarakis, Héctor F Escobar-Morreale, Stephen Franks, Alessandra Gambineri, Fahrettin Kelestimur, Djuro Macut, Dragan Micic, Renato Pasquali, Marija Pfeifer, Duarte Pignatelli, Michel Pugeat, Bulent O Yildiz
Polycystic ovary syndrome (PCOS) is the most common ovarian disorder associated with androgen excess in women, which justifies the growing interest of endocrinologists. Great efforts have been made in the last 2 decades to define the syndrome. The presence of three different definitions for the diagnosis of PCOS reflects the phenotypic heterogeneity of the syndrome. Major criteria are required for the diagnosis, which in turn identifies different phenotypes according to the combination of different criteria...
October 2014: European Journal of Endocrinology
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