Login Register Cart 0
Generic placeholder image

Current Women`s Health Reviews

Editor-in-Chief

ISSN (Print): 1573-4048
ISSN (Online): 1875-6581

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Review Article

A Complex Condition; Polycystic Ovary Syndrome (PCOS): A Review of its Recent Advanced Treatment

Author(s): Pranay Wal, Bhagawati Saxena, Namra Aziz*, Chandana Pyne, Ankita Wal and Shruti Rathore

Volume 20, Issue 6, 2024

Published on: 10 November, 2023

Article ID: e101123223425 Pages: 18

DOI: 10.2174/0115734048259334231020120628

Price: $65

Abstract

Polycystic ovary syndrome (PCOS) is a common endocrine and metabolic disorder affecting women worldwide. It refers to a condition that often has ‘poly’ liquid containing sacks around ovaries. It affects reproductive-aged females, giving rise to menstrual and related reproductive issues. PCOS is marked by hormonal imbalance, often resulting in hyperandrogenism. Women with PCOS might experience abnormal insulin activity and complications such as acne, mood swings, hirsutism, obesity, and infertility. The disease is linked with severe clinical ailments such as type 2 diabetes (T2DM), cardiovascular diseases (CVDs), and cancer. A faulty lifestyle, neuroendocrine factors, genetic causes, and androgen exposures often cause PCOS. The approach of society towards physiological problems such as PCOS in women is that it must be under the veil that is the ultimate barrier to the early diagnosis of PCOS. Thus, this review summarizes the causes, symptoms, pathophysiology, diagnosis, and possible treatment (medical, herbal, and lifestyle improvement, acupuncture, and bariatric surgery) related to PCOS.

Keywords: Polycystic ovaries, obesity, hormonal imbalance, infertility, hirusitism, menstrual cycle.

Graphical Abstract

[1]
Witchel, S.F.; Teede, H.J.; Peña, A.S. Curtailing PCOS. Pediatr. Res., 2020, 87(2), 353-361.
[http://dx.doi.org/10.1038/s41390-019-0615-1] [PMID: 31627209]
[2]
Ajmal, N.; Khan, S.Z.; Shaikh, R. Polycystic ovary syndrome (PCOS) and genetic predisposition: A review article. Eur. J. Obstet. Gynecol. Reprod. Biol. X, 2019 Jul;3, 100060.
[http://dx.doi.org/10.1016/j.eurox.2019.100060] [PMID: 31403134]
[3]
Mason, H.; Colao, A.; Blume-Peytavi, U.; Rice, S.; Qureshi, A.; Pellatt, L.; Orio, F.; Atkin, S.L. Polycystic ovary syndrome (PCOS) trilogy: A translational and clinical review. Clin. Endocrinol., 2008, 69(6), 831-844.
[http://dx.doi.org/10.1111/j.1365-2265.2008.03329.x] [PMID: 18616705]
[4]
Tasali, E.; Van Cauter, E.; Ehrmann, D.A. Polycystic ovary syndrome and obstructive sleep apnea. Sleep Med. Clin., 2008, 3(1), 37-46.
[http://dx.doi.org/10.1016/j.jsmc.2007.11.001] [PMID: 19255602]
[5]
Deeks, A.A.; Gibson-Helm, M.E.; Teede, H.J. Anxiety and depression in polycystic ovary syndrome: A comprehensive investigation. Fertil. Steril., 2010, 93(7), 2421-2423.
[http://dx.doi.org/10.1016/j.fertnstert.2009.09.018] [PMID: 20117778]
[6]
Hughesdon, PE Morphology and morphogenesis of the Stein-Leventhal ovary and of so-called" hyperthecosis". Obstet Gynecol Surv., 1982 Feb 1;37(2), 59-77.
[http://dx.doi.org/10.1097/00006254-198202000-00001] [PMID: 7033852]
[7]
Giampaolino, P.; Foreste, V.; Di Filippo, C.; Gallo, A.; Mercorio, A.; Serafino, P.; Improda, F.P.; Verrazzo, P.; Zara, G.; Buonfantino, C.; Borgo, M.; Riemma, G.; Angelis, C.D.; Zizolfi, B.; Bifulco, G.; Della Corte, L. Microbiome and PCOS: State-of-art and future aspects. Int. J. Mol. Sci., 2021, 22(4), 2048.
[http://dx.doi.org/10.3390/ijms22042048] [PMID: 33669557]
[8]
Stener-Victorin, E.; Padmanabhan, V.; Walters, K.A.; Campbell, R.E.; Benrick, A.; Giacobini, P.; Dumesic, D.A.; Abbott, D.H. Animal models to understand the etiology and pathophysiology of polycystic ovary syndrome. Endocr. Rev., 2020, 41(4), bnaa010.
[http://dx.doi.org/10.1210/endrev/bnaa010] [PMID: 32310267]
[9]
Kosova, G.; Urbanek, M. Genetics of the polycystic ovary syndrome. Mol. Cell. Endocrinol., 2013, 373(1-2), 29-38.
[http://dx.doi.org/10.1016/j.mce.2012.10.009] [PMID: 23079471]
[10]
Anagnostis, P.; Tarlatzis, B.C.; Kauffman, R.P. Polycystic ovarian syndrome (PCOS): Long-term metabolic consequences. Metab., 2018, 86, 33-43.
[http://dx.doi.org/10.1016/j.metabol.2017.09.016] [PMID: 29024702]
[11]
Reddy, B.M.; Dasgupta, S. Present status of understanding on the genetic etiology of polycystic ovary syndrome. J. Postgrad. Med., 2008, 54(2), 115-125.
[http://dx.doi.org/10.4103/0022-3859.40778] [PMID: 18480528]
[12]
Govind, A.; Obhrai, M.S.; Clayton, R.N. Polycystic ovaries are inherited as an autosomal dominant trait: Analysis of 29 polycystic ovary syndrome and 10 control families. J. Clin. Endocrinol. Metab., 1999, 84(1), 38-43.
[http://dx.doi.org/10.1210/jcem.84.1.5382] [PMID: 9920059]
[13]
Witchel, S.F.; Oberfield, S.E.; Peña, A.S. Polycystic ovary syndrome: Pathophysiology, presentation, and treatment with emphasis on adolescent girls. J. Endocr. Soc., 2019, 3(8), 1545-1573.
[http://dx.doi.org/10.1210/js.2019-00078] [PMID: 31384717]
[14]
Atiomo, W.U.; Pearson, S.; Shaw, S.; Prentice, A.; Dubbins, P. Ultrasound criteria in the diagnosis of polycystic ovary syndrome (PCOS). Ultrasound Med. Biol., 2000, 26(6), 977-980.
[http://dx.doi.org/10.1016/S0301-5629(00)00219-2] [PMID: 10996697]
[15]
Wallace, A.M.; Sattar, N. The changing role of the clinical laboratory in the investigation of polycystic ovarian syndrome. Clin. Biochem. Rev., 2007, 28(3), 79-92.
[PMID: 17909612]
[16]
Azziz, R. Polycystic ovary syndrome. Obstet. Gynecol., 2018, 132(2), 321-336.
[http://dx.doi.org/10.1097/AOG.0000000000002698] [PMID: 29995717]
[17]
Abinaya, S.; Siva, D.; Sabitha, R.; Achiraman, S. An overview of hyperandrogenism in PCOS and the prospective underlying factors. Res. J. Life Sci. Bioinform. Pharm. Chem. Sci., 2019, 1(5), 179-186.
[http://dx.doi.org/10.26479/2019.0501.18]
[18]
Franks, S. Polycystic ovary syndrome: A changing perspective. Clin. Endocrinol., 1989, 31(1), 87-120.
[http://dx.doi.org/10.1111/j.1365-2265.1989.tb00457.x] [PMID: 2513151]
[19]
Hoeger, K.M.; Dokras, A.; Piltonen, T. Update on PCOS: Consequences, challenges, and guiding treatment. J. Clin. Endocrinol. Metab., 2021, 106(3), e1071-e1083.
[http://dx.doi.org/10.1210/clinem/dgaa839] [PMID: 33211867]
[20]
Marshall, J.C.; Eagleson, C.A. Neuroendocrine aspects of polycystic ovary syndrome. Endocrinol. Metab. Clin. North Am., 1999, 28(2), 295-324.
[http://dx.doi.org/10.1016/S0889-8529(05)70071-2] [PMID: 10352920]
[21]
Patel, S. Polycystic ovary syndrome (PCOS), an inflammatory, systemic, lifestyle endocrinopathy. J. Steroid Biochem. Mol. Biol., 2018, 182, 27-36.
[http://dx.doi.org/10.1016/j.jsbmb.2018.04.008] [PMID: 29678491]
[22]
Khan, M.J.; Ullah, A.; Basit, S. Genetic basis of polycystic ovary syndrome (PCOS): Current perspectives. Appl. Clin. Genet., 2019, 12, 249-260.
[http://dx.doi.org/10.2147/TACG.S200341] [PMID: 31920361]
[23]
Roldán, B.; San Millán, J.L.; Escobar-Morreale, H.F. Genetic basis of metabolic abnormalities in polycystic ovary syndrome: Implications for therapy. Am. J. Pharmacogenomics, 2004, 4(2), 93-107.
[http://dx.doi.org/10.2165/00129785-200404020-00004] [PMID: 15059032]
[24]
De Leo, V.; Musacchio, M.C.; Cappelli, V.; Massaro, M.G.; Morgante, G.; Petraglia, F. Genetic, hormonal and metabolic aspects of PCOS: An update. Reprod. Biol. Endocrinol., 2016, 14(1), 38.
[http://dx.doi.org/10.1186/s12958-016-0173-x] [PMID: 27423183] [PMCID: PMC4947298]
[25]
Azziz, R.; Carmina, E.; Dewailly, D.; Diamanti-Kandarakis, E.; Escobar-Morreale, H.F.; Futterweit, W.; Janssen, O.E.; Legro, R.S.; Norman, R.J.; Taylor, A.E.; Witchel, S.F. The Androgen excess and PCOS society criteria for the polycystic ovary syndrome: the complete task force report. Fertil. Steril., 2009, 91(2), 456-488.
[http://dx.doi.org/10.1016/j.fertnstert.2008.06.035] [PMID: 18950759]
[26]
Ye, W.; Xie, T.; Song, Y.; Zhou, L. The role of androgen and its related signals in PCOS. J. Cell. Mol. Med., 2021, 25(4), 1825-1837.
[http://dx.doi.org/10.1111/jcmm.16205] [PMID: 33369146]
[27]
Insulin Resistance in PCOS; Farid, N.R.; Diamanti-Kandarakis, E. Diagnosis and Management of Polycystic Ovary Syndrome: Boston, Springer, 2009, 16, pp. Jan 11;(1)MA.p.35-61.
[http://dx.doi.org/10.1186/s13048-022-01091-0] [PMID: 36631836] [PMCID: PMC9832677]
[28]
Nestler, J. Role of hyperinsulinemia in the pathogenesis of the polycystic ovary syndrome, and its clinical implications. Semin. Reprod. Med., 1997, 15(2), 111-122.
[http://dx.doi.org/10.1055/s-2007-1016294] [PMID: 9165656]
[29]
Ibáñez, L.; Oberfield, S.E.; Witchel, S.; Auchus, R.J.; Chang, R.J.; Codner, E.; Dabadghao, P.; Darendeliler, F.; Elbarbary, N.S.; Gambineri, A.; Garcia Rudaz, C.; Hoeger, K.M.; López-Bermejo, A.; Ong, K.; Peña, A.S.; Reinehr, T.; Santoro, N.; Tena-Sempere, M.; Tao, R.; Yildiz, B.O.; Alkhayyat, H.; Deeb, A.; Joel, D.; Horikawa, R.; de Zegher, F.; Lee, P.A. An international consortium update: pathophysiology, diagnosis, and treatment of polycystic ovarian syndrome in adolescence. Horm. Res. Paediatr., 2017, 88(6), 371-395.
[http://dx.doi.org/10.1159/000479371] [PMID: 29156452]
[30]
Rojas, J.; Chavez, M.; Olivar, L.; Rojas, M.; Morillo, J.; Mejías, J.; Calvo, M.; Bermudez, V. Polycystic ovary syndrome, insulin resistance, and obesity: Navigating the pathophysiologic labyrinth. Int. J. Reprod. Med., 2014 Oct;2014, 719050.
[http://dx.doi.org/10.1155/2014/719050] [PMID: 25763405] [PMCID: PMC4334071]
[31]
Barber, T.M.; McCarthy, M.I.; Wass, J.A.H.; Franks, S. Obesity and polycystic ovary syndrome. Clin. Endocrinol., 2006, 65(2), 137-145.
[http://dx.doi.org/10.1111/j.1365-2265.2006.02587.x] [PMID: 16886951]
[32]
Vrbikova, J.; Hainer, V. Obesity and polycystic ovary syndrome. Obes. Facts, 2009, 2(1), 26-35.
[http://dx.doi.org/10.1159/000194971] [PMID: 20054201]
[33]
Barber, T.M.; Hanson, P.; Weickert, M.O.; Franks, S. Obesity and polycystic ovary syndrome: Implications for pathogenesis and novel management strategies. Clin. Med. Insights Reprod. Health, 2019, 13
[http://dx.doi.org/10.1177/1179558119874042] [PMID: 31523137]
[34]
Zhang, B.; Zhou, W.; Shi, Y.; Zhang, J.; Cui, L.; Chen, Z.J. Lifestyle and environmental contributions to ovulatory dysfunction in women of polycystic ovary syndrome. BMC Endocr. Disord., 2020, 20(1), 19.
[http://dx.doi.org/10.1186/s12902-020-0497-6] [PMID: 32000752]
[35]
Rutkowska, A.; Rachoń, D.; Bisphenol, A. Bisphenol A (BPA) and its potential role in the pathogenesis of the polycystic ovary syndrome (PCOS). Gynecol. Endocrinol., 2014, 30(4), 260-265.
[http://dx.doi.org/10.3109/09513590.2013.871517] [PMID: 24397396]
[36]
Eisenberg, E.; Legro, R.S.; Diamond, M.P.; Huang, H.; O’Brien, L.M.; Smith, Y.R.; Coutifaris, C.; Hansen, K.R.; Santoro, N.; Zhang, H. Sleep habits of women with infertility. J. Clin. Endocrinol. Metab., 2021, 106(11), e4414-e4426.
[http://dx.doi.org/10.1210/clinem/dgab474] [PMID: 34180998]
[37]
Farshchi, H.; Rane, A.; Love, A.; Kennedy, R.L. Diet and nutrition in polycystic ovary syndrome (PCOS): Pointers for nutritional management. J. Obstet. Gynaecol., 2007, 27(8), 762-773.
[http://dx.doi.org/10.1080/01443610701667338] [PMID: 18097891]
[38]
Wal, A.; Wal, P.; Saraswat, N.; Wadhwa, S. A detailed review on herbal treatments for treatment of PCOS-polycystic ovary syndrome (PCOS). Curr. Nutraceuticals., 2021, 2(2174)
[http://dx.doi.org/10.22270/ajprd.v8i4.769]
[39]
Jeffrey Chang, R. A practical approach to the diagnosis of polycystic ovary syndrome. Am. J. Obstet. Gynecol., 2004, 191(3), 713-717.
[http://dx.doi.org/10.1016/j.ajog.2004.04.045] [PMID: 15467530]
[40]
Battaglia, C.; Mancini, F.; Persico, N.; Zaccaria, V.; Aloysio, D. Ultrasound evaluation of PCO, PCOS and OHSS. Reprod. Biomed. Online, 2004, 9(6), 614-619.
[http://dx.doi.org/10.1016/S1472-6483(10)61770-1] [PMID: 15670405]
[41]
McCartney, C.R.; Eagleson, C.A.; Marshall, J.C. Regulation of gonadotropin secretion: implications for polycystic ovary syndrome. Semin. Reprod. Med., 2002, 20(4), 317-326.
[http://dx.doi.org/10.1055/s-2002-36706] [PMID: 12536355]
[42]
McCartney, C.R.; Campbell, R.E.; Marshall, J.C.; Moenter, S.M. The role of gonadotropin-releasing hormone neurons in polycystic ovary syndrome. J. Neuroendocrinol., 2022, 34(5), e13093.
[http://dx.doi.org/10.1111/jne.13093] [PMID: 35083794]
[43]
Guzick, D.S. Polycystic ovary syndrome. Obstet. Gynecol., 2004, 103(1), 181-193.
[http://dx.doi.org/10.1097/01.AOG.0000104485.44999.C6] [PMID: 14704263]
[44]
Yildiz, B.O. Diagnosis of hyperandrogenism: Clinical criteria. Best Pract. Res. Clin. Endocrinol. Metab., 2006, 20(2), 167-176.
[http://dx.doi.org/10.1016/j.beem.2006.02.004] [PMID: 16772149]
[45]
Nisenblat, V.; Norman, R.J. Androgens and polycystic ovary syndrome. Curr. Opin. Endocrinol. Diabetes Obes., 2009, 16(3), 224-231.
[http://dx.doi.org/10.1097/MED.0b013e32832afd4d] [PMID: 19390322]
[46]
Zhu, J.; Chen, Z.; Feng, W.; Long, S.; Mo, Z.C. Sex hormone-binding globulin and polycystic ovary syndrome. Clin. Chim. Acta, 2019, 499, 142-148.
[http://dx.doi.org/10.1016/j.cca.2019.09.010] [PMID: 31525346]
[47]
Qu, X.; Donnelly, R. Sex hormone-binding globulin (SHBG) as an early biomarker and therapeutic target in polycystic ovary syndrome. Int. J. Mol. Sci., 2020, 21(21), 8191.
[http://dx.doi.org/10.3390/ijms21218191] [PMID: 33139661]
[48]
Xing, C.; Zhang, J.; Zhao, H.; He, B. Effect of sex hormone-binding globulin on polycystic ovary syndrome: Mechanisms, manifestations, genetics, and treatment. Int. J. Women's Health., 2022 Feb;2, 91-105.
[http://dx.doi.org/10.2147/IJWH.S344542] [PMID: 35140526] [PMCID: PMC8818772]
[49]
Eilertsen, T.B.; Vanky, E.; Carlsen, S.M. Anti-Mullerian hormone in the diagnosis of polycystic ovary syndrome: Can morphologic description be replaced? Hum. Reprod., 2012, 27(8), 2494-2502.
[http://dx.doi.org/10.1093/humrep/des213] [PMID: 22693172]
[50]
Dewailly, D.; Barbotin, A.L.; Dumont, A.; Catteau-Jonard, S.; Robin, G. Role of anti-Müllerian hormone in the pathogenesis of polycystic ovary syndrome. Front. Endocrinol., 2020 Sep 9;11, 641.
[http://dx.doi.org/10.3389/fendo.2020.00641] [PMID: 33013710] [PMCID: PMC7509053]
[51]
Dumont, A.; Robin, G.; Catteau-Jonard, S.; Dewailly, D. Role of anti-müllerian hormone in pathophysiology, diagnosis and treatment of polycystic ovary syndrome: A review. Reprod. Biol. Endocrinol., 2015, 13(1), 137.
[http://dx.doi.org/10.1186/s12958-015-0134-9] [PMID: 26691645]
[52]
Bannigida, D.M.; Nayak, B.S.; Vijayaraghavan, R. Insulin resistance and oxidative marker in women with PCOS. Arch. Physiol. Biochem., 2020, 126(2), 183-186.
[http://dx.doi.org/10.1080/13813455.2018.1499120] [PMID: 30450993]
[53]
Goodarzi, M.O.; Korenman, S.G. The importance of insulin resistance in polycystic ovary syndrome. Fertil. Steril., 2003, 80(2), 255-258.
[http://dx.doi.org/10.1016/S0015-0282(03)00734-9] [PMID: 12909480]
[54]
Della Corte, L.; Foreste, V.; Barra, F.; Gustavino, C.; Alessandri, F.; Centurioni, M.G.; Ferrero, S.; Bifulco, G.; Giampaolino, P. Current and experimental drug therapy for the treatment of polycystic ovarian syndrome. Expert Opin. Investig. Drugs, 2020, 29(8), 819-830.
[http://dx.doi.org/10.1080/13543784.2020.1781815] [PMID: 32543238]
[55]
Saha, L.; Kaur, S.; Saha, P.K. Pharmacotherapy of polycystic ovary syndrome - an update. Fundam. Clin. Pharmacol., 2012, 26(1), 54-62.
[http://dx.doi.org/10.1111/j.1472-8206.2010.00916.x] [PMID: 21210850]
[56]
Witchel, S.F.; Burghard, A.C.; Tao, R.H.; Oberfield, S.E. The diagnosis and treatment of PCOS in adolescents. Curr. Opin. Pediatr., 2019, 31(4), 562-569.
[http://dx.doi.org/10.1097/MOP.0000000000000778] [PMID: 31299022]
[57]
Harwood, K.; Vuguin, P.; DiMartino-Nardi, J. Current approaches to the diagnosis and treatment of polycystic ovarian syndrome in youth. Horm. Res., 2007, 68(5), 209-217.
[PMID: 17426408]
[58]
Kar, S. Clomiphene citrate or letrozole as first-line ovulation induction drug in infertile PCOS women: A prospective randomized trial. J. Hum. Reprod. Sci., 2012, 5(3), 262-265.
[http://dx.doi.org/10.4103/0974-1208.106338] [PMID: 23531705]
[59]
Panidis, D.; Tziomalos, K.; Papadakis, E.; Katsikis, I. Infertility treatment in polycystic ovary syndrome: Lifestyle interventions, medications and surgery. Front. Horm. Res., 2013, 40, 128-141.
[http://dx.doi.org/10.1159/000341824] [PMID: 24002410]
[60]
Morgante, G.; Massaro, M.G.; Di Sabatino, A.; Cappelli, V.; De Leo, V. Therapeutic approach for metabolic disorders and infertility in women with PCOS. Gynecol. Endocrinol., 2018, 34(1), 4-9.
[http://dx.doi.org/10.1080/09513590.2017.1370644] [PMID: 28850273]
[61]
Palomba, S.; Pasquali, R.; Orio, F., Jr; Nestler, J.E. Clomiphene citrate, metformin or both as first-step approach in treating anovulatory infertility in patients with polycystic ovary syndrome (PCOS): A systematic review of head-to-head randomized controlled studies and meta-analysis. Clin. Endocrinol., 2009, 70(2), 311-321.
[http://dx.doi.org/10.1111/j.1365-2265.2008.03369.x] [PMID: 18691273]
[62]
Lord, J.M.; Flight, I.H.; Norman, R.J. Metformin in polycystic ovary syndrome: systematic review and meta-analysis. BMJ, 2003, 327(7421), 951-953.
[http://dx.doi.org/10.1136/bmj.327.7421.951] [PMID: 14576245]
[63]
Nestler, J.E. Metformin for the treatment of the polycystic ovary syndrome. N. Engl. J. Med., 2008, 358(1), 47-54.
[http://dx.doi.org/10.1056/NEJMct0707092] [PMID: 18172174]
[64]
Stadtmauer, L.A.; Toma, S.K.; Riehl, R.M.; Talbert, L.M. Metformin treatment of patients with polycystic ovary syndrome undergoing in vitro fertilization improves outcomes and is associated with modulation of the insulin-like growth factors. Fertil. Steril., 2001, 75(3), 505-509.
[http://dx.doi.org/10.1016/S0015-0282(00)01766-0] [PMID: 11239532]
[65]
De Leo, V.; Musacchio, M.C.; Morgante, G.; Piomboni, P.; Petraglia, F. Metformin treatment is effective in obese teenage girls with PCOS. Hum. Reprod., 2006, 21(9), 2252-2256.
[http://dx.doi.org/10.1093/humrep/del185] [PMID: 16785260]
[66]
Costello, M.F.; Misso, M.L.; Wong, J.; Hart, R.; Rombauts, L.; Melder, A.; Norman, R.J.; Teede, H.J. The treatment of infertility in polycystic ovary syndrome: A brief update. Aust. N. Z. J. Obstet. Gynaecol., 2012, 52(4), 400-403.
[http://dx.doi.org/10.1111/j.1479-828X.2012.01448.x] [PMID: 22639834]
[67]
Bayar, Ü.; Basaran, M.; Kiran, S.; Coskun, A.; Gezer, S. Use of an aromatase inhibitor in patients with polycystic ovary syndrome: A prospective randomized trial. Fertil. Steril., 2006, 86(5), 1447-1451.
[http://dx.doi.org/10.1016/j.fertnstert.2006.04.026] [PMID: 17070196]
[68]
Casper, R.F. Aromatase inhibitors in ovarian stimulation. J. Steroid Biochem. Mol. Biol., 2007, 106(1-5), 71-75.
[http://dx.doi.org/10.1016/j.jsbmb.2007.05.025] [PMID: 17604615]
[69]
Misso, M.L.; Wong, J.L.A.; Teede, H.J.; Hart, R.; Rombauts, L.; Melder, A.M.; Norman, R.J.; Costello, M.F. Aromatase inhibitors for PCOS: A systematic review and meta-analysis. Hum. Reprod. Update, 2012, 18(3), 301-312.
[http://dx.doi.org/10.1093/humupd/dms003] [PMID: 22431566]
[70]
Badawy, A.; Elnashar, A. Treatment options for polycystic ovary syndrome. Int. J. Womens Health, 2011, 3, 25-35.
[http://dx.doi.org/10.2147/IJWH.S11304] [PMID: 21339935]
[71]
Doldi, N.; Persico, P.; Di Sebastiano, F.; Marsiglio, E.; Ferrari, A. Gonadotropin-releasing hormone antagonist and metformin for treatment of polycystic ovary syndrome patients undergoing in vitro fertilization–embryo transfer. Gynecol. Endocrinol., 2006, 22(5), 235-238.
[http://dx.doi.org/10.1080/14767050600761893] [PMID: 16785142]
[72]
Balen, A. Surgical treatment of polycystic ovary syndrome. Best Pract. Res. Clin. Endocrinol. Metab., 2006, 20(2), 271-280.
[http://dx.doi.org/10.1016/j.beem.2006.03.006] [PMID: 16772157]
[73]
Gomel, V.; Yarali, H. Surgical treatment of polycystic ovary syndrome associated with infertility. Reprod. Biomed. Online, 2004, 9(1), 35-42.
[http://dx.doi.org/10.1016/S1472-6483(10)62107-4] [PMID: 15257815]
[74]
Lebbi, I.; Ben Temime, R.; Fadhlaoui, A.; Feki, A. Ovarian drilling in PCOS: is it really useful? Front. Surg., 2015, 2, 30.
[http://dx.doi.org/10.3389/fsurg.2015.00030] [PMID: 26236709]
[75]
Li, Y.J.; Han, Y.; He, B. Effects of bariatric surgery on obese polycystic ovary syndrome: A systematic review and meta-analysis. Surg. Obes. Relat. Dis., 2019, 15(6), 942-950.
[http://dx.doi.org/10.1016/j.soard.2019.03.032] [PMID: 31113751]
[76]
Malik, S.M.; Traub, M.L. Defining the role of bariatric surgery in polycystic ovarian syndrome patients. World J. Diabetes, 2012, 3(4), 71-79.
[http://dx.doi.org/10.4239/wjd.v3.i4.71] [PMID: 22532886]
[77]
Tian, Z.; Zhang, Y.C.; Wang, Y.; Chang, X.H.; Zhu, H.L.; Zhao, Y. Effects of bariatric surgery on patients with obesity and polycystic ovary syndrome: A meta-analysis. Surg. Obes. Relat. Dis., 2021, 17(8), 1399-1408.
[http://dx.doi.org/10.1016/j.soard.2021.04.009] [PMID: 34006495]
[78]
Melo, A.S.; Ferriani, R.A.; Navarro, P.A. Treatment of infertility in women with polycystic ovary syndrome: Approach to clinical practice. Clinics, 2015, 70(11), 765-769.
[http://dx.doi.org/10.6061/clinics/2015(11)09] [PMID: 26602525]
[79]
Wang, J.; Wei, Y.; Diao, F.; Cui, Y.; Mao, Y.; Wang, W.; Liu, J. The association between polycystic ovary syndrome and ectopic pregnancy after in vitro fertilization and embryo transfer. Am. J. Obstet. Gynecol., 2013, 209(2), 139.e1-139.e9.
[http://dx.doi.org/10.1016/j.ajog.2013.05.007] [PMID: 23659986]
[80]
Dale, P.O.; Tanbo, T.; Ã…byholm, T. In vitro fertilization in infertile women with the polycystic ovarian syndrome. Hum. Reprod., 1991, 6(2), 238-241.
[http://dx.doi.org/10.1093/oxfordjournals.humrep.a137313] [PMID: 1905314]
[81]
Barnes, R.; Rosenfield, R.L. The polycystic ovary syndrome: pathogenesis and treatment. Ann. Intern. Med., 1989, 110(5), 386-399.
[http://dx.doi.org/10.7326/0003-4819-110-5-386] [PMID: 2492787]
[82]
Bajuk Studen, K.; Šebeštjen, M.; Pfeifer, M.; Preželj, J. Influence of spironolactone treatment on endothelial function in non-obese women with polycystic ovary syndrome. Eur. J. Endocrinol., 2011, 164(3), 389-395.
[http://dx.doi.org/10.1530/EJE-10-0709] [PMID: 21156647]
[83]
Marx, T.L.; Mehta, A.E. Polycystic ovary syndrome: pathogenesis and treatment over the short and long term. Cleve. Clin. J. Med., 2003, 70(1), 31-33, 36-41, 45.
[http://dx.doi.org/10.3949/ccjm.70.1.31] [PMID: 12549723]
[84]
Ajossa, S.; Guerriero, S.; Paoletti, A.M.; Orrù, M.; Melis, G.B. The antiandrogenic effect of flutamide improves uterine perfusion in women with polycystic ovary syndrome. Fertil. Steril., 2002, 77(6), 1136-1140.
[http://dx.doi.org/10.1016/S0015-0282(02)03101-1] [PMID: 12057718]
[85]
Paradisi, R.; Fabbri, R.; Battaglia, C.; Venturoli, S. Ovulatory effects of flutamide in the polycystic ovary syndrome. Gynecol. Endocrinol., 2013, 29(4), 391-395.
[http://dx.doi.org/10.3109/09513590.2012.754876] [PMID: 23327685]
[86]
Warren-Ulanch, J.; Arslanian, S. Treatment of PCOS in adolescence. Best Pract. Res. Clin. Endocrinol. Metab., 2006, 20(2), 311-330.
[http://dx.doi.org/10.1016/j.beem.2006.02.002] [PMID: 16772160]
[87]
Lakryc, E.M.; Motta, E.L.A.; Soares, J.M., Jr; Haidar, M.A.; Rodrigues de Lima, G.; Baracat, E.C. The benefits of finasteride for hirsute women with polycystic ovary syndrome or idiopathic hirsutism. Gynecol. Endocrinol., 2003, 17(1), 57-63.
[http://dx.doi.org/10.1080/gye.17.1.57.63] [PMID: 12724020]
[88]
Hu, A.C.; Chapman, L.W.; Mesinkovska, N.A. The efficacy and use of finasteride in women: A systematic review. Int. J. Dermatol., 2019, 58(7), 759-776.
[http://dx.doi.org/10.1111/ijd.14370] [PMID: 30604525]
[89]
Rittmaster, R.S. Antiandrogen treatment of polycystic ovary syndrome. Endocrinol. Metab. Clin. North Am., 1999, 28(2), 409-421.
[http://dx.doi.org/10.1016/S0889-8529(05)70077-3] [PMID: 10352926]
[90]
Ruan, X.; Kubba, A.; Aguilar, A.; Mueck, A.O. Use of cyproterone acetate/ethinylestradiol in polycystic ovary syndrome: rationale and practical aspects. Eur. J. Contracept. Reprod. Health Care, 2017, 22(3), 183-190.
[http://dx.doi.org/10.1080/13625187.2017.1317735] [PMID: 28463030]
[91]
Tan, W.C.; Yap, C.; Tan, A.S.A. Clinical management of PCOS. Acta Obstet. Gynecol. Scand., 2001, 80(8), 689-696.
[http://dx.doi.org/10.1034/j.1600-0412.2001.080008689.x] [PMID: 11531609]
[92]
Pugeat, M.; Ducluzeau, P.H. Insulin resistance, polycystic ovary syndrome and metformin. Drugs, 1999, 58(1 Suppl), 41-46.
[http://dx.doi.org/10.2165/00003495-199958001-00010] [PMID: 10576524]
[93]
Pauli, J.M.; Raja-Khan, N.; Wu, X.; Legro, R.S. Current perspectives of insulin resistance and polycystic ovary syndrome. Diabet. Med., 2011, 28(12), 1445-1454.
[http://dx.doi.org/10.1111/j.1464-5491.2011.03460.x] [PMID: 21950959]
[94]
Diamanti-Kandarakis, E.; Mara Spritzer, P.; Sir-Petermann, T.; Beatriz Motta, A. Insulin resistance and polycystic ovary syndrome through life. Curr. Pharm. Des., 2012, 18(34), 5569-5576.
[http://dx.doi.org/10.2174/138161212803307590] [PMID: 22834924]
[95]
Pasquali, R.; Gambineri, A. Targeting insulin sensitivity in the treatment of polycystic ovary syndrome. Expert Opin. Ther. Targets, 2009, 13(10), 1205-1226.
[http://dx.doi.org/10.1517/14728220903190699] [PMID: 19650762]
[96]
Hasegawa, I.; Murakawa, H.; Suzuki, M.; Yamamoto, Y.; Kurabayashi, T.; Tanaka, K. Effect of troglitazone on endocrine and ovulatory performance in women with insulin resistance–related polycystic ovary syndrome. Fertil. Steril., 1999, 71(2), 323-327.
[http://dx.doi.org/10.1016/S0015-0282(98)00454-3] [PMID: 9988406]
[97]
Azziz, R.; Ehrmann, D.; Legro, R.S.; Whitcomb, R.W.; Hanley, R.; Fereshetian, A.G.; O’Keefe, M.; Ghazzi, M.N. Troglitazone improves ovulation and hirsutism in the polycystic ovary syndrome: A multicenter, double blind, placebo-controlled trial. J. Clin. Endocrinol. Metab., 2001, 86(4), 1626-1632.
[http://dx.doi.org/10.1210/jc.86.4.1626] [PMID: 11297595]
[98]
Glintborg, D.; Andersen, M. Thiazolinedione treatment in PCOS – an update. Gynecol. Endocrinol., 2010, 26(11), 791-803.
[http://dx.doi.org/10.3109/09513590.2010.491572] [PMID: 20528570]
[99]
Elkind-Hirsch, K.E. Thiazolidinediones for the therapeutic management of polycystic ovary syndrome : impact on metabolic and reproductive abnormalities. Treat. Endocrinol., 2006, 5(3), 171-187.
[http://dx.doi.org/10.2165/00024677-200605030-00005] [PMID: 16677059]
[100]
Stout, D.L.; Fugate, S.E. Thiazolidinediones for treatment of polycystic ovary syndrome. Pharmacotherap: J HumPharmacol D Therap., 2005 Feb;25(2), 244-52.
[http://dx.doi.org/10.1592/phco.25.2.244.56943]
[101]
Romualdi, D.; Guido, M.; Ciampelli, M.; Giuliani, M.; Leoni, F.; Perri, C.; Lanzone, A. Selective effects of pioglitazone on insulin and androgen abnormalities in normo- and hyperinsulinaemic obese patients with polycystic ovary syndrome. Hum. Reprod., 2003, 18(6), 1210-1218.
[http://dx.doi.org/10.1093/humrep/deg264] [PMID: 12773448]
[102]
Aroda, V.R.; Ciaraldi, T.P.; Burke, P.; Mudaliar, S.; Clopton, P.; Phillips, S.; Chang, R.J.; Henry, R.R. Metabolic and hormonal changes induced by pioglitazone in polycystic ovary syndrome: A randomized, placebo-controlled clinical trial. J. Clin. Endocrinol. Metab., 2009, 94(2), 469-476.
[http://dx.doi.org/10.1210/jc.2008-1133] [PMID: 18984667]
[103]
Guido, M.; Romualdi, D.; Suriano, R.; Giuliani, M.; Costantini, B.; Apa, R.; Lanzone, A. Effect of pioglitazone treatment on the adrenal androgen response to corticotrophin in obese patients with polycystic ovary syndrome. Hum. Reprod., 2004, 19(3), 534-539.
[http://dx.doi.org/10.1093/humrep/deh145] [PMID: 14998947]
[104]
Brewer, C.J.; Balen, A.H. Focus on obesity. Reproduction, 2010, 140(3), 347-364.
[http://dx.doi.org/10.1530/REP-09-0568] [PMID: 20395425]
[105]
Messinis, I.E.; Messini, C.I.; Anifandis, G.; Dafopoulos, K. Polycystic ovaries and obesity. Best Pract. Res. Clin. Obstet. Gynaecol., 2015, 29(4), 479-488.
[http://dx.doi.org/10.1016/j.bpobgyn.2014.11.001] [PMID: 25487256]
[106]
Gambineri, A.; Pelusi, C.; Vicennati, V.; Pagotto, U.; Pasquali, R. Obesity and the polycystic ovary syndrome. Int. J. Obes., 2002, 26(7), 883-896.
[http://dx.doi.org/10.1038/sj.ijo.0801994] [PMID: 12080440]
[107]
Nieuwenhuis-Ruifrok, A.E.; Kuchenbecker, W.K.H.; Hoek, A.; Middleton, P.; Norman, R.J. Insulin sensitizing drugs for weight loss in women of reproductive age who are overweight or obese: systematic review and meta-analysis. Hum. Reprod. Update, 2008, 15(1), 57-68.
[http://dx.doi.org/10.1093/humupd/dmn043] [PMID: 18927072]
[108]
Legro, R. Obesity and PCOS: implications for diagnosis and treatment. Semin. Reprod. Med., 2012, 30(6), 496-506.
[http://dx.doi.org/10.1055/s-0032-1328878] [PMID: 23074008]
[109]
Panidis, D.; Tziomalos, K.; Papadakis, E.; Vosnakis, C.; Chatzis, P.; Katsikis, I. Lifestyle intervention and anti-obesity therapies in the polycystic ovary syndrome: impact on metabolism and fertility. Endocrine, 2013, 44(3), 583-590.
[http://dx.doi.org/10.1007/s12020-013-9971-5] [PMID: 23625194]
[110]
Chanoine, J.P.; Hampl, S.; Jensen, C.; Boldrin, M.; Hauptman, J. Effect of orlistat on weight and body composition in obese adolescents: A randomized controlled trial. JAMA, 2005, 293(23), 2873-2883.
[http://dx.doi.org/10.1001/jama.293.23.2873] [PMID: 15956632]
[111]
Shah, M.; Vella, A. Effects of GLP-1 on appetite and weight. Rev. Endocr. Metab. Disord., 2014, 15(3), 181-187.
[http://dx.doi.org/10.1007/s11154-014-9289-5] [PMID: 24811133]
[112]
Kelly, A.S.; Rudser, K.D.; Nathan, B.M.; Fox, C.K.; Metzig, A.M.; Coombes, B.J.; Fitch, A.K.; Bomberg, E.M.; Abuzzahab, M.J. The effect of glucagon-like peptide-1 receptor agonist therapy on body mass index in adolescents with severe obesity: A randomized, placebo-controlled, clinical trial. JAMA Pediatr., 2013, 167(4), 355-360.
[http://dx.doi.org/10.1001/jamapediatrics.2013.1045] [PMID: 23380890]
[113]
Akre, S.; Sharma, K.; Chakole, S.; Wanjari, M.B. Recent advances in the management of polycystic ovary syndrome: A review article. Cureus, 2022, 14(8), e27689.
[http://dx.doi.org/10.7759/cureus.27689] [PMID: 36072214]
[114]
Ozgen Saydam, B.; Yildiz, B.O. Weight management strategies for patients with PCOS: current perspectives. Expert Rev. Endocrinol. Metab., 2021, 16(2), 49-62.
[http://dx.doi.org/10.1080/17446651.2021.1896966] [PMID: 33719818]
[115]
Skubleny, D.; Switzer, N.J.; Gill, R.S.; Dykstra, M.; Shi, X.; Sagle, M.A.; de Gara, C.; Birch, D.W.; Karmali, S. The impact of bariatric surgery on polycystic ovary syndrome: A systematic review and meta-analysis. Obes. Surg., 2016, 26(1), 169-176.
[http://dx.doi.org/10.1007/s11695-015-1902-5] [PMID: 26431698]
[116]
Stefater, M.A.; Jenkins, T.; Inge, T.H. Bariatric surgery for adolescents. Pediatr. Diabetes, 2013, 14(1), 1-12.
[http://dx.doi.org/10.1111/j.1399-5448.2012.00899.x] [PMID: 22830534]
[117]
Charalampakis, V.; Tahrani, A.A.; Helmy, A.; Gupta, J.K.; Singhal, R. Polycystic ovary syndrome and endometrial hyperplasia: An overview of the role of bariatric surgery in female fertility. Eur. J. Obstet. Gynecol. Reprod. Biol., 2016, 207, 220-226.
[http://dx.doi.org/10.1016/j.ejogrb.2016.10.001] [PMID: 27773356]
[118]
Chopra, A.; Chao, E.; Etkin, Y.; Merklinger, L.; Lieb, J.; Delany, H. Laparoscopic sleeve gastrectomy for obesity: can it be considered a definitive procedure? Surg. Endosc., 2012, 26(3), 831-837.
[http://dx.doi.org/10.1007/s00464-011-1960-2] [PMID: 22179438]
[119]
Moy, J.; Pomp, A.; Dakin, G.; Parikh, M.; Gagner, M. Laparoscopic sleeve gastrectomy for morbid obesity. Am. J. Surg., 2008, 196(5), e56-e59.
[http://dx.doi.org/10.1016/j.amjsurg.2008.04.008] [PMID: 18954593]
[120]
O’Brien, P.E.; Dixon, J.B. Laparoscopic adjustable gastric banding in the treatment of morbid obesity. Arch. Surg., 2003, 138(4), 376-382.
[http://dx.doi.org/10.1001/archsurg.138.4.376] [PMID: 12686523]
[121]
Huber-Buchholz, M.M.; Carey, D.G.; Norman, R.J. Restoration of reproductive potential by lifestyle modification in obese polycystic ovary syndrome: Role of insulin sensitivity and luteinizing hormone. J. Clin. Endocrinol. Metab., 1999, 84(4), 1470-1474.
[http://dx.doi.org/10.1210/jc.84.4.1470] [PMID: 10199797]
[122]
Moran, L.J.; Brinkworth, G.; Noakes, M.; Norman, R.J. Effects of lifestyle modification in polycystic ovarian syndrome. Reprod. Biomed. Online, 2006, 12(5), 569-578.
[http://dx.doi.org/10.1016/S1472-6483(10)61182-0] [PMID: 16790100]
[123]
Norman, R.J.; Davies, M.J.; Lord, J.; Moran, L.J. The role of lifestyle modification in polycystic ovary syndrome. Trends Endocrinol. Metab., 2002, 13(6), 251-257.
[http://dx.doi.org/10.1016/S1043-2760(02)00612-4] [PMID: 12128286]
[124]
Marsh, K.; Brand-Miller, J. The optimal diet for women with polycystic ovary syndrome? Br. J. Nutr., 2005, 94(2), 154-165.
[http://dx.doi.org/10.1079/BJN20051475] [PMID: 16115348]
[125]
Jeanes, Y.M.; Barr, S.; Smith, K.; Hart, K.H. Dietary management of women with polycystic ovary syndrome in the united kingdom: The role of dietitians. J. Hum. Nutr. Diet., 2009, 22(6), 551-558.
[http://dx.doi.org/10.1111/j.1365-277X.2009.00988.x] [PMID: 19735349]
[126]
Hajivandi, L.; Noroozi, M.; Mostafavi, F.; Ekramzadeh, M. Food habits in overweight and obese adolescent girls with polycystic ovary syndrome (PCOS): A qualitative study in Iran. BMC Pediatr., 2020, 20(1), 277.
[http://dx.doi.org/10.1186/s12887-020-02173-y] [PMID: 32498675]
[127]
Nidhi, R.; Padmalatha, V.; Nagarathna, R.; Ram, A. Effect of a yoga program on glucose metabolism and blood lipid levels in adolescent girls with polycystic ovary syndrome. Int. J. Gynaecol. Obstet., 2012, 118(1), 37-41.
[http://dx.doi.org/10.1016/j.ijgo.2012.01.027] [PMID: 22507264]
[128]
Woodward, A.; Klonizakis, M.; Broom, D. Exercise and polycystic ovary syndrome. Adv. Exp. Med. Biol., 2020, 1228, 123-136.
[http://dx.doi.org/10.1007/978-981-15-1792-1_8] [PMID: 32342454]
[129]
Shele, G.; Genkil, J.; Speelman, D. A systematic review of the effects of exercise on hormones in women with polycystic ovary syndrome. J. Funct. Morphol. Kinesiol., 2020, 5(2), 35.
[http://dx.doi.org/10.3390/jfmk5020035] [PMID: 33467251]
[130]
Patel, V.; Menezes, H.; Menezes, C.; Bouwer, S.; Bostick-Smith, C.A.; Speelman, D.L. Regular mindful yoga practice as a method to improve androgen levels in women with polycystic ovary syndrome: A randomized, controlled trial. J. Am. Osteopath. Assoc., 2020, 120(5), 323-335.
[PMID: 32285088]
[131]
Nidhi, R.; Padmalatha, V.; Nagarathna, R.; Amritanshu, R. Effects of a holistic yoga program on endocrine parameters in adolescents with polycystic ovarian syndrome: A randomized controlled trial. J. Altern. Complement. Med., 2013, 19(2), 153-160.
[http://dx.doi.org/10.1089/acm.2011.0868] [PMID: 22808940]
[132]
Thakur, D.; Saurabh Singh, D.S.; Tripathi, D.M.; Lufang, D. Effect of yoga on polycystic ovarian syndrome: A systematic review. J. Bodyw. Mov. Ther., 2021, 27, 281-286.
[http://dx.doi.org/10.1016/j.jbmt.2021.02.018] [PMID: 34391246]
[133]
Mojaverrostami, S.; Asghari, N.; Khamisabadi, M.; Heidari Khoei, H. The role of melatonin in polycystic ovary syndrome: A review. Int. J. Reprod. Biomed., 2019, 17(12), 865-882.
[http://dx.doi.org/10.18502/ijrm.v17i12.5789] [PMID: 31970309]
[134]
Tagliaferri, V.; Romualdi, D.; Scarinci, E.; De Cicco, S.; Di Florio, C.; Immediata, V.; Tropea, A.; Santarsiero, C.M.; Lanzone, A.; Apa, R. Melatonin treatment may be able to restore menstrual cyclicity in women with PCOS: A pilot study. Reprod. Sci., 2018, 25(2), 269-275.
[http://dx.doi.org/10.1177/1933719117711262] [PMID: 28558523]
[135]
Jain, M.; Jain, P.; Haldar, C.; Singh, T.; Jain, S. Melatonin and its correlation with testosterone in polycystic ovarian syndrome. J. Hum. Reprod. Sci., 2013, 6(4), 253-258.
[http://dx.doi.org/10.4103/0974-1208.126295] [PMID: 24672165]
[136]
Kim, M.K.; Park, E.A.; Kim, H.J.; Choi, W.Y.; Cho, J.H.; Lee, W.S.; Cha, K.Y.; Kim, Y.S.; Lee, D.R.; Yoon, T.K. Does supplementation of in vitro culture medium with melatonin improve IVF outcome in PCOS? Reprod. Biomed. Online, 2013, 26(1), 22-29.
[http://dx.doi.org/10.1016/j.rbmo.2012.10.007] [PMID: 23177415]
[137]
Chakraborty, S.; Rajeswari, V.D. Therapeutic role of β-glucan on the association between polycystic ovarian disease and insulin resistance-a perspective review. Int. J. Pharm. Sci. Res., 2022, 14(4)
[138]
Weiss, J.M.; Tauchert, S.; Ludwig, A.K.; Diedrich, K. Treatment strategies in PCOS patients. Reprod. Biomed. Online, 2005, 10(3 Suppl.), 67-74.
[http://dx.doi.org/10.1016/S1472-6483(11)60393-3] [PMID: 23577418]
[139]
Duleba, A.J. Medical management of metabolic dysfunction in PCOS. Steroids, 2012, 77(4), 306-311.
[http://dx.doi.org/10.1016/j.steroids.2011.11.014] [PMID: 22182833]
[140]
Zhang, Y.Y.; Hou, L.Q.; Zhao, T.Y. Effects of acarbose on polycystic ovary syndrome: A meta-analysis. Exp. Clin. Endocrinol. Diabetes, 2014, 122(6), 373-378.
[http://dx.doi.org/10.1055/s-0034-1375676] [PMID: 24941435]
[141]
Penna, I.A.A.; Canella, P.R.B.; Reis, R.M.; Silva de Sá, M.F.; Ferriani, R.A. Acarbose in obese patients with polycystic ovarian syndrome: A double-blind, randomized, placebo-controlled study. Hum. Reprod., 2005, 20(9), 2396-2401.
[http://dx.doi.org/10.1093/humrep/dei104] [PMID: 16006454]
[142]
Rizk, A.Y.; Bedaiwy, M.A.; Al-Inany, H.G. N-acetyl-cysteine is a novel adjuvant to clomiphene citrate in clomiphene citrate–resistant patients with polycystic ovary syndrome. Fertil. Steril., 2005, 83(2), 367-370.
[http://dx.doi.org/10.1016/j.fertnstert.2004.07.960] [PMID: 15705376]
[143]
Fulghesu, A.M.; Ciampelli, M.; Muzj, G.; Belosi, C.; Selvaggi, L.; Ayala, G.F.; Lanzone, A. N-acetyl-cysteine treatment improves insulin sensitivity in women with polycystic ovary syndrome. Fertil. Steril., 2002, 77(6), 1128-1135.
[http://dx.doi.org/10.1016/S0015-0282(02)03133-3] [PMID: 12057717]
[144]
Badawy, A.; State, O.; Abdelgawad, S. N-Acetyl cysteine and clomiphene citrate for induction of ovulation in polycystic ovary syndrome: A cross-over trial. Acta Obstet. Gynecol. Scand., 2007, 86(2), 218-222.
[http://dx.doi.org/10.1080/00016340601090337] [PMID: 17364286]
[145]
Salehpour, S.; Tohidi, M.; Akhound, M.R.; Amirzargar, N. N Acetyl Cysteine, A novel Remedy for Poly Cystic Ovarian Syndrome. Int. J. Fertil. Steril., 2008, 3(2), 66-3.
[146]
Dinicola, S.; Chiu, T.T.Y.; Unfer, V.; Carlomagno, G.; Bizzarri, M. The rationale of the myo-inositol and D-chiro-inositol combined treatment for polycystic ovary syndrome. J. Clin. Pharmacol., 2014, 54(10), 1079-1092.
[http://dx.doi.org/10.1002/jcph.362] [PMID: 25042908]
[147]
Roseff, S.; Montenegro, M. Inositol treatment for PCOS should be science-based and not arbitrary. Int. J. Endocrinol., 2020, 2020, 1-8.
[http://dx.doi.org/10.1155/2020/6461254] [PMID: 32308679]
[148]
Bizzarri, M.; Carlomagno, G. Inositol: history of an effective therapy for Polycystic Ovary Syndrome. Eur. Rev. Med. Pharmacol. Sci., 2014, 18(13), 1896-1903.
[PMID: 25010620]
[149]
Genazzani, A.D. Inositol as putative integrative treatment for PCOS. Reprod. Biomed. Online, 2016, 33(6), 770-780.
[http://dx.doi.org/10.1016/j.rbmo.2016.08.024] [PMID: 27717596]
[150]
Garg, D.; Tal, R. Inositol treatment and ART outcomes in women with PCOS. Int. J. Endocrinol., 2016, 2016, 1-9.
[http://dx.doi.org/10.1155/2016/1979654] [PMID: 27795706]
[151]
Wojciechowska, A.; Osowski, A.; Jóźwik, M.; Górecki, R.; Rynkiewicz, A.; Wojtkiewicz, J. Inositols’ importance in the improvement of the endocrine–metabolic profile in PCOS. Int. J. Mol. Sci., 2019, 20(22), 5787.
[http://dx.doi.org/10.3390/ijms20225787] [PMID: 31752081]
[152]
Oner, G.; Muderris, I.I. Efficacy of omega-3 in the treatment of polycystic ovary syndrome. J. Obstet. Gynaecol., 2013, 33(3), 289-291.
[http://dx.doi.org/10.3109/01443615.2012.751365] [PMID: 23550861]
[153]
Yang, K.; Zeng, L.; Bao, T.; Ge, J. Effectiveness of Omega-3 fatty acid for polycystic ovary syndrome: A systematic review and meta-analysis. Reprod. Biol. Endocrinol., 2018, 16(1), 27.
[http://dx.doi.org/10.1186/s12958-018-0346-x] [PMID: 29580250]
[154]
Maarouf, T.; Mohamed, D.; Tantawy, A.; Eid, P. Effect of omega-3 fatty acids on hormonal profile and ovarian stromal blood flow in patients with polycystic ovary syndrome. evid. based women health j., 2019, 9(4), 542-548.
[155]
Cassidy-Vu, L.; Joe, E.; Kirk, J.K. Role of statin drugs for polycystic ovary syndrome. J. Family Reprod. Health, 2016, 10(4), 165-175.
[PMID: 28546815]
[156]
Kodaman, P.; Duleba, A. Statins in the treatment of polycystic ovary syndrome. Semin. Reprod. Med., 2008, 26(1), 127-138.
[http://dx.doi.org/10.1055/s-2007-992933] [PMID: 18181091]
[157]
Puurunen, J.; Piltonen, T.; Puukka, K.; Ruokonen, A.; Savolainen, M.J.; Bloigu, R.; Morin-Papunen, L.; Tapanainen, J.S. Statin therapy worsens insulin sensitivity in women with polycystic ovary syndrome (PCOS): A prospective, randomized, double-blind, placebo-controlled study. J. Clin. Endocrinol. Metab., 2013, 98(12), 4798-4807.
[http://dx.doi.org/10.1210/jc.2013-2674] [PMID: 24152688]
[158]
Morgante, G.; Darino, I.; Spanò, A.; Luisi, S.; Luddi, A.; Piomboni, P.; Governini, L.; De Leo, V. PCOS physiopathology and vitamin d deficiency: Biological insights and perspectives for treatment. J. Clin. Med., 2022, 11(15), 4509.
[http://dx.doi.org/10.3390/jcm11154509] [PMID: 35956124]
[159]
Firouzabadi, R.; Aflatoonian, A.; Modarresi, S.; Sekhavat, L.; MohammadTaheri, S. Therapeutic effects of calcium & vitamin D supplementation in women with PCOS. Complement. Ther. Clin. Pract., 2012, 18(2), 85-88.
[http://dx.doi.org/10.1016/j.ctcp.2012.01.005]
[160]
Kharb, S.; Gaur, S. Role of vitamin d in polycystic ovarian syndrome patients. Ann. Clin. Lab. Res., 2021, 9(5), 351-355.
[161]
Legro, R.S.; Arslanian, S.A.; Ehrmann, D.A.; Hoeger, K.M.; Murad, M.H.; Pasquali, R.; Welt, C.K. Diagnosis and treatment of polycystic ovary syndrome: An Endocrine Society clinical practice guideline. J. Clin. Endocrinol. Metab., 2013, 98(12), 4565-4592.
[http://dx.doi.org/10.1210/jc.2013-2350] [PMID: 24151290]
[162]
Teede, H.J.; Misso, M.L.; Costello, M.F.; Dokras, A.; Laven, J.; Moran, L.; Piltonen, T.; Norman, R.J.; Andersen, M.; Azziz, R.; Balen, A.; Baye, E.; Boyle, J.; Brennan, L.; Broekmans, F.; Dabadghao, P.; Devoto, L.; Dewailly, D.; Downes, L.; Fauser, B.; Franks, S.; Garad, R.M.; Gibson-Helm, M.; Harrison, C.; Hart, R.; Hawkes, R.; Hirschberg, A.; Hoeger, K.; Hohmann, F.; Hutchison, S.; Joham, A.; Johnson, L.; Jordan, C.; Kulkarni, J.; Legro, R.S.; Li, R.; Lujan, M.; Malhotra, J.; Mansfield, D.; Marsh, K.; McAllister, V.; Mocanu, E.; Mol, B.W.; Ng, E.; Oberfield, S.; Ottey, S.; Peña, A.; Qiao, J.; Redman, L.; Rodgers, R.; Rombauts, L.; Romualdi, D.; Shah, D.; Speight, J.; Spritzer, P.M.; Stener-Victorin, E.; Stepto, N.; Tapanainen, J.S.; Tassone, E.C.; Thangaratinam, S.; Thondan, M.; Tzeng, C-R.; van der Spuy, Z.; Vanky, E.; Vogiatzi, M.; Wan, A.; Wijeyaratne, C.; Witchel, S.; Woolcock, J.; Yildiz, B.O. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome†. Hum. Reprod., 2018, 33(9), 1602-1618.
[http://dx.doi.org/10.1093/humrep/dey256] [PMID: 30052961]
[163]
Moran, L.J.; Hutchison, S.K.; Norman, R.J. Telemessaging: A novel tool for the provision of individualized feedback and support in the management of polycystic ovary syndrome. Fertil. Steril., 2011, 95(1), 236-239.
[PMID: 21550045]
[164]
Dokras, A. Mood and anxiety disorders in women with PCOS. Steroids, 2008, 73(8), 754-757.
[PMID: 22178257]
[165]
Dokras, A.; Stener-Victorin, E. Advancing care for women with polycystic ovary syndrome: translating evidence into practice. J. Clin. Endocrinol. Metab., 2012, 97(11), 3760-3763.
[166]
Naderpoor, N.; Shorakae, S.; Joham, A.; Boyle, J.; De Courten, B.; Teede, H.J. Obesity and polycystic ovary syndrome. Minerva Endocrinol., 2015, 40(1), 37-51.
[PMID: 25411807]
[167]
Palomba, S.; de Wilde, M.A.; Falbo, A.; Koster, M.P.H.; La Sala, G.B.; Fauser, B.C.J.M. Pregnancy complications in women with polycystic ovary syndrome. Hum. Reprod. Update, 2015, 21(5), 575-592.
[http://dx.doi.org/10.1093/humupd/dmv029] [PMID: 26117684]
[168]
Haqq, L.; McFarlane, J.; Dieberg, G.; Smart, N. Effect of lifestyle intervention on the reproductive endocrine profile in women with polycystic ovarian syndrome: A systematic review and meta-analysis. Endo Con, 2017, 6(8), 647-658.

Rights & Permissions Print Cite
Article Metrics
13
2
Wayfinder Image
© 2024 Bentham Science Publishers | Privacy Policy