Infertility management. Advances in the management of polycystic ovarian disease.

Despite affecting ~11-13% of women globally, polycystic ovary syndrome (PCOS) is a substantially understudied condition. PCOS, possibly extending to men's health, imposes a considerable health and economic burden worldwide. Diagnosis in adults follows the International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome, requiring two out of three criteria - clinical or biochemical hyperandrogenism, ovulatory dysfunction, and/or specific ovarian morphological characteristics or elevated anti-Müllerian hormone...

INTRODUCTION: Infertility is defined as the inability to conceive after unprotected sexual intercourse for at least 12 consecutive months. Our objective is to present an updated narrative review on the endocrine causes of infertility in women. AREAS COVERED: A comprehensive review was conducted using Scielo, Scopus, and EMBASE databases, comprising 245 articles. The pathophysiology of infertility in women was described, including endocrinopathies such as hypothalamic amenorrhea, hyperprolactinemia, polycystic ovary syndrome, primary ovarian insufficiency, obesity, thyroid dysfunction, and adrenal disorders...

Non-alcoholic fatty liver disease (NAFLD) is a frequent occurrence in polycystic ovarian syndrome (PCOS). We studied the frequencies and characteristics of NAFLD in PCOS women. We compared various methods of detection of advanced fibrosis/cirrhosis. One hundred and forty women with PCOS and seventy controls, matched for age, were evaluated for the presence of NAFLD. Anthropometric variables, serum levels of aminotransferases, glucose, lipids and transient elastography were done. Thirty-six percent of the NAFLD patients had abnormal aminotransferases...

Polycystic ovary syndrome (PCOS) is a multifaceted condition characterized by chronic anovulation and excess ovarian activity, in contrast to other causes of anovulation that involve ovarian dormancy or primary insufficiency. Recent studies indicated that PCOS is associated with low-grade chronic inflammation and that women with PCOS are at increased risk of non-alcoholic fatty liver disease. The inflammatory and metabolic derangements associated with PCOS are explained in part by the coexistence of insulin resistance and obesity but are further fueled by the androgen excess...

OBJECTIVE: To review family physicians' role in investigation and management of infertile couples. QUALITY OF EVIDENCE: MEDLINE and PubMed were searched using the MeSH headings infertility, advanced maternal age, polycystic ovarian syndrome, clomiphene citrate, and insulin sensitizers. Bibliographies of review articles and textbooks were also searched. Review articles, randomized trials, observational studies, and case series are cited. MAIN MESSAGE: Approximately 8% of Canadian couples have difficulty conceiving...

PURPOSE: To discuss the diagnosis and management of polycystic ovary syndrome (PCOS) by the advanced practice nurse in primary care. DATA SOURCES: Selected research and clinical articles. CONCLUSIONS: The disorder is an endocrinopathy characterized by chronic anovulation, resulting in multiple ovarian cysts. Recent research suggests a genetic etiology and a close association with obesity. Patients often present with hyperandrogenism, irregular menses, and infertility...