Talk:Infertility in polycystic ovary syndrome: Difference between revisions

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Forked from PCOS

I forked this article from Polycystic ovary syndrome in order to avail for a specific sectioning into impact, diagnosis and management, as well as separate forking from Infertility. Mikael Häggström (talk) 08:32, 23 January 2011 (UTC)[reply]

Older study not in line with newer

I removed the following study from the article, because the newer study did not find a significant beneficial effect of metformin, and ESHRE/ASRM-sponsored Consensus workshop do not recommend metformin for ovulation stimulation: The most drastic increase in ovulation rate occurs with a combination of diet modification, weight loss, and treatment with metformin and clomiphene citrate.^[1] It is currently unknown if diet change and weight loss alone have an effect on live birth rates comparable to those reported with clomiphene and metformin

^ Andy C, Flake D, French L (2005). "Clinical inquiries. Do insulin-sensitizing drugs increase ovulation rates for women with PCOS?". J Fam Pract. 54 (2): 156, 159–60. PMID 15689292.{{cite journal}}: CS1 maint: multiple names: authors list (link)

Also, the following bulk of text seems to repeat what is already previously stated, so I removed it as well: The RCOG (The Royal College of Obstetricians and Gynaecologists) has recently published an opinion paper on "Metformin therapy for the management of women with polycystic ovary syndrome". The paper concluded that while initial studies appeared to be promising, more recent large randomised controlled trials have not observed beneficial effects of metformin either as first-line therapy or combined with clomifene citrate for the treatment of the anovulatory woman with PCOS. Most work has been undertaken in the management of anovulatory infertility and there are no good data from randomised controlled trials on the use of metformin in the management of other manifestations of PCOS. It is clear that the first aim for women with PCOS who are overweight is to make lifestyle changes with a combination of diet and exercise in order to lose weight and improve ovarian function. The European Society for Human Reproduction and Embryology and American Society for Reproductive Medicine consensus on infertility treatment for PCOS concluded that there is no clear role for insulin sensitising and insulin lowering drugs in the management of PCOS, and should be restricted to those patients with glucose intolerance or type 2 diabetes rather than those with just insulin resistance. Therefore, on current evidence metformin is not a first line treatment of choice in the management of PCOS(RCOG December 2008)[1]
Mikael Häggström (talk) 08:29, 23 January 2011 (UTC)[reply]

Is this about PCOS?

By the abstract from the recently added study PMID 17978119, I'm not sure it is specifically about PCOS. Does anyone want to check if it does? Mikael Häggström (talk) 06:55, 15 July 2011 (UTC)[reply]

Apparently it does not, so another reliable medical source needs to be found before reinserting such a claim. Mikael Häggström (talk) 10:33, 21 September 2011 (UTC)[reply]

Role of Anti-Mullerian-Hormone in menstrual cycle arrest/induction

Anyone ever heard of AMH being responsible for bad, non-existing menstrual cycles in PCOS-women?

http://www.ncbi.nlm.nih.gov/pubmed/25935176 http://www.ncbi.nlm.nih.gov/pubmed/23346251 http://www.ncbi.nlm.nih.gov/pubmed/24569407 http://www.hormones.gr/721/article/the-clinical-significance-of-anti-m252llerian-hormone%E2%80%A6.html

It is most likely THE cause of infertility in PCOS women, because AMH is elevated 3 times there. After 4 menstrual cycles, either pushed by down-regulation or alternating use of hormonal contraceptives one month and no contraceptives the next menstrual cycle, fertility should be restored completely due to a new cohort of follicles now being recruited that did not suffer from too much insulin in the first place. This works only of course if metformin or glitazone is used in a sufficient dosage in the first place.

[1] Andy C, Flake D, French L (2005). "Clinical inquiries. Do insulin-sensitizing drugs increase ovulation rates for women with PCOS?". J Fam Pract. 54 (2): 156, 159–60. PMID 15689292.{{cite journal}}: CS1 maint: multiple names: authors list (link)

[1]