Cardiometabolic health among gastric bypass surgery patients with polycystic ovarian syndrome

AIM:To examine the effect of gastric bypass surgery on cardiometabolic health among women with polycystic ovarian syndrome(PCOS).METHODS:Retrospective medical chart review identified women(n = 389) with PCOS who underwent Roux-en-Y gastric bypass surgery from 2001-2009 in one surgical practice.Separate repeated measures linear mixed models were fit using the MIXED procedureto assess mean change in cardiometabolic disease risk factors from before to 1-year after surgery and were evaluated by ethnicity [Hispanic,non-Hispanic black(NHB) and white(NHW)].RESULTS:The majority of the sample was Hispanic(66%,25% NHB,9% NHW).Mean body mass index significantly improved 1 year post-surgery for all ethnic groups(45.5 to 35.5 kg/m2 for Hispanics,46.8 to 37.7 kg/m2 for NHB and 45.7 to 36.7 kg/m2 for NHW,P < 0.001).Among Hispanic women mean total cholesterol(198.1 to 160.2 mg/dL),low-density lipoproteins(LDL) cholesterol(120.9 to 91.0 mg/dL),triglycerides(148.6 to 104.8 mg/dL),hemoglobin A1c(6.2% to 5.6%),alanine aminotransferase(28.1 to 23.0 U/L) and aspartate aminotransferase(23.5 to 21.6 U/L) decreased significantly(P < 0.001).Among NHB,mean total cholesterol(184.5 to 154.7 mg/dL),LDL cholesterol(111.7 to 88.9 mg/dL) and triglycerides(99.7 to 70.0 mg/dL) decreased significantly(P < 0.05).Among NHW,mean total cholesterol(200.9 to 172.8 mg/dL) and LDL cholesterol(124.2 to 96.6 mg/dL),decreased significantly(P < 0.05).Pairwise ethnic group comparisons of all cardiometabolic outcomes adjusted for age and type of surgery before and 1 year after surgery showed no statistical difference between the three groups for any outcome.CONCLUSION:Cardiometabolic disease risk improvements vary by ethnicity and obesity may impact glucose tolerance and liver function changes more in Hispanic women with PCOS vs non-Hispanic women.

Clinical Value of Serum Anti-Mullerian Hormone and Inhibin B in Prediction of Ovarian Response in Patients with Polycystic Ovary Syndrome

The present study aimed to investigate the clinical value of serum anti-mullerian hormone（AMH） and inhibin B（INHB） in predicting the ovarian response of patients with polycystic ovary syndrome（PCOS）. A total of 120 PCOS patients were enrolled and divided into three groups in terms of the ovarian response： a low-response group（n=36）, a normal-response group（n=44）, and a high-response group（n=40）. The serum AMH and INHB levels were measured by enzyme-linked immunosorbent assay（ELISA）. The follicle stimulating hormone（FSH）, luteinizing hormone（LH）, and estradiol（E2） levels were determined by chemiluminescence microparticle immunoassay. The correlation of the serum AMH and INHB levels with other indicators was analyzed. A receiver operating characteristic（ROC） curve was established to analyze the prediction of ovarian response by AMH and INHB. The results showed that there were significant differences in age, body mass index（BMI）, FSH, total gonadotropin-releasing hormone（Gn RH）, LH, E2, and antral follicle counts（AFCs） between the groups（P〈0.05）. The serum AMH and INHB levels were increased significantly with the ovarian response of PCOS patients increasing（P〈0.05）. The serum AMH and INHB levels were negatively correlated with the age, BMI, FSH level, Gn, and E2 levels（P〈0.05）. They were positively correlated with the LH levels and AFCs（P〈0.05）. ROC curve analysis of serum AMH and INHB in prediction of a low ovarian response showed that the area under the ROC curve（AUC） value of the serum AMH level was 0.817, with a cut-off value of 1.29 ng/m L. The sensitivity and specificity were 71.2% and 79.6%, respectively. The AUC value of serum INHB was 0.674, with a cut-off value of 38.65 ng/m L, and the sensitivity and specificity were 50.7% and 74.5%, respectively. ROC curve analysis showed when the serum AMH and INHB levels were used to predict a high ovarian response, the AUC value of the serum AMH level was 0.742, with a cut-off value of 2.84 ng/m L, and the sensitivity and specificity were 72.7% and 65.9%, respectively; the AUC value of the serum INHB level was 0.551 with a cut-off of 45.76 ng/m L, and the sensitivity and specificity were 76.3% and 40.2%, respectively. It was suggested the serum AMH and INHB levels have high clinical value in predicting the ovarian response of PCOS patients.

Flexible GnRH Antagonist Protocol versus Progestin-primed Ovarian Stimulation (PPOS) Protocol in Patients with Polycystic Ovary Syndrome: Comparison of Clinical Outcomes and Ovarian Response

Polycystic ovary syndrome (PCOS) is one of the most common causes of infertility in women. Progestin-primed ovarian stimulation (PPOS) protocol, which used oral progestin to prevent premature luteinizing hormone (LH) surges in ovarian stimulation, has been proved to be effective and safe in patients with PCOS. The aim of the present study was to compare the efficacy of PPOS protocol with that of the traditional gonadotropin-releasing hormone (GnRH) antagonist protocol in patients with PCOS. A total of 157 patients undergoing in-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) were recruited into this study. The patients were divided into two groups by the stimulation protocols: the GnRH antagonist protocol group and the PPOS protocol group. There was no significant difference in the clinical characteristics between the two groups. Dose and duration of gonadotropin were higher in the PPOS protocol group. Estradiol levels on the day of human chorionic gonadotropin (hCG) administration were significantly lower in the PPOS protocol group. Fertilization rates and the number of good quality embryos were similar between the two groups. Remarkably, we found 6 patients with moderate ovarian hyperstimulation syndrome (OHSS) in the GnRH antagonist protocol group but 0 in the PPOS protocol group. A total of 127 women completed their frozen embryo transfer (FET) cycles. There were no significant differences between the two groups in terms of clinical pregnancy rate per transfer, implantation rate, first-trimester miscarriage rate and on-going pregnancy rate per transfer. To conclude, PPOS protocol decreased the incidence of OHSS without adversely affecting clinical outcomes in patients with PCOS.

Influence of Thioctic Acid on the Hyperinsulinemia and Ovarian Volume in Female Patients with Polycystic Ovary Syndrome

45 female patients with polycystic ovary syndrome took thioctic acid (Thioctacid-HR), 600 mg (n = 25) or high protein diet (n = 20). Fast insulin and glucose stimulus insulin were investigated before and after 3 months taken treatment. The use of thioctic acid, 600 mg is a new effective pathogenetics therapy of polycystic ovary syndrome on influence of hyperinsulinemia, HOMA-IR index and ovary volume in female patients with polycystic ovary syndrome.

Synchrony between Ovarian Function &Sleep in Polycystic Ovary Syndrome Patients

Polycystic ovary syndrome (PCOS) is a complex, multifaceted, heterogeneous disorder, affecting 4% to 18% of reproductive-aged women and is associated with reproductive, metabolic and psychological dysfunction. In this study we determined the relationship between the time to sleep and serum levels of neurohormones in polycystic ovary syndrome (PCOS). Totally 77 PCO patients(case group) and 97 non-PCOS infertile women (control subjects) participated in this study between February 2012 and February 2013. A PSQI sleep questionnaire was completed by each patient in both groups. PSQI sleep questionnaire score and serum concentration of adrenaline, noradrenaline, melatonin, β-endorphin, cortisol and progesterone were compared in two groups. The results of the study indicate that serum levels of melatonin and β-endorphin were lower in women with PCOS. Serum level of stress hormones, adrenaline and noradrenaline were significantly correlated with patients’ sleep time in study group. Serum level of adrenaline in control group was significantly lower in women who wake up earlier in the morning. All hormones except for cortisol had no significant correlation with PSQI global score in both groups and also the people who sleep less than 8 hours had lower cortisol level. These data showed that changes in cortisol in PCO women were due to damage of disturbed sleep at night. Our preliminary work provided this study with new insight into the interactions between sleep-wake cycles in PCO women with specific sleep patterns.

Structures of ovary and ovarian follicle in flathead lobster,Thenus orientalis (Lund, 1793) (Crustacea: Decapoda: Scyllarida)

The ovary contains four morphological components: (1) the ovarian wall, (2) the reproductive epithelium, (3) the cellular layer containing oocytes, oogonia (especially for early-developing ovary) and follicle cells, and (4) the extensions of the ovarian wall. The ovarian wall and its extensions consist of blood vessels, sinuses, muscle cells and others. The extensions of the ovarian wall project into among the follicles and insert on the thick basal membrane of each follicle. From inside to outside, the follicles are composed of four parts: (1) the oocyte, (2) the perivitelline space, (3) the follicle cells, and (4) the basal membrane. The surface of the oocyte during vitellogenesis is folded into numerous long microvilli that project into the perivitelline space between the oocyte surface and the bace of the follicle cell layer. In addition, the plasma membrane of the vitellogenic oocyte contains many pinocytotic pits. The perivitelline space is engorged with with more electron- denser material as the development of the follicle. The inclusion of perivitelline space in the mature follicle is named specially as the chorine. The chorion is composed of two region, a thinner exochorion and a thicker endochorion containing electron-dense granular material. The follicle cell layer is composed of a single layer of polygonal follicle cells which exhibit higher synthetic activity. The synthetic product of the follicle cell layer is one scarce for the inclusion of the perivitelline space. The structures of the ovary and ovarian follicle in T. orientalis show that the exogenously biosyn- thetic yolk plays important roles in the vitellogenesis.

Effect of Rosiglitazone on Endocrine, Metabolism and Ovulatory Performance in Patients with Polycystic Ovary Syndrome and Insulin Resistance

The effect of rosiglitazone on endocrine, metabolism and ovulatory performance in the paitents with polycystic ovary syndrome(PCOS) and insulin resistance was investigated. Twenty-five patients diagnosed as having polycystic ovary syndrome (PCOS) combined with insulin resistance were treated with rosiglitazone for 12 weeks. Before and after treatment, serum luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol (E2), testosterone (T), androstenedione (A), sex hormone binding globulin (SHBG), insulin and glucose concentration, total cholesterol, triglycerides (TG), high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholestero (LDL-C), apolipoprotein A, apolipoprotein B levels and ovulatory performance were determined. The results showed that after treatment serum insulin levels was decreased significantly (P<0.01). The HDL-C was increased while LDL-C decreased significantly (P<0.05, P<0.01). The serum LH, T, A concentrations and the ratio of LH/FSH were decreased, while SHBG levels increased significantly (P<0.01). The ovulation rate during clomiphene citrate therapy was 72 %, significantly higher than that before treatment. It is likely that reduction of hyperinsulinemia that is produce by rosiglitazone may effectively improve the endocrine, metabolism and ovulatory performance in the patients with PCOS and insulin resistance.

Observation on human ovarian theca cell and granulosa cell interaction in polycystic ovary syndrome

Objective: To investigate the role of human theca cell(TC) and granulo sa cell(GC) interaction and insulin(INS) in steroidogenesis in normal ovarian cy cle and in patients with PCOS. Methods: Ovarian theca and granulosa cells from eleven normal wo men and eight PCOS patients were co-cultured on opposite side of collagen with or without INS. The concentrations of estradiol(E2), progesterone(P) and andro stenedione (A) in the culture medium were examined by ELISA method.Results: When co-cultured with GC, TC in PCOS group produced mo re A and less P than those of normal group. When co-cultured with theca cells, granulosa cells in PCOS group produced more E2 than those of normal group. Add ition of INS increased the difference significantly.Conclusions: The GC and TC interaction from the normal and PCOS ovaries is different. There is a high A and high E2 intraovary loop of PC OS leading to premature arrest of follicle growth and anovulation. Insulin may p lay an important regulatory role.

Endocrine and metabolic effects of metformin in combination with compound cyproterone acetate in women with polycystic ovarian syndrome

Objective:To study the endocrinologic and metabolic effects of metformin in combi-nation with compound cyproterone acetate (CPA) on patients with polycystic ovariansyndrome (PCOS).Methods: A prospective study involved total 65 patients, 45 PCOS patients as group Aand 20 non-PCOS infertility patients as control (group B). Complete baseline work-up inclu-ding body mass index (BMI), waist/hip ratio(WHR), Ferriman-Gallwey score(FGS), gona-dotrophin, testosterone(T), sex hormone-binding globulin (SHBG), dehydroepiandrosteronesulfate (DHEAS), and fasting lipid, glucose (FG) , insulin (FI) and oral glucose tolerancetest (OGTT), were performed in all patients. Patients in group A were treated with CPA a-lone (group A1), metformin alone (group A2) or combination of CPA with metformin (groupA3) , respectively by randomizatior. At the end of the 12-week therapy, subjects were re-evaluated and above parameters were measured.Results: Women in group A had significant increases in BMI, WHR, FGS, LH, T,FI, insulin resistance (IR), triglycerides(TG), and significant decrease in HDL-C com-paring with the control group (P＜0.01). No significant difference among A1, A2 andA3 were found at baseline. LH, T, FT (free testosterone) were significant decreasedfrom (13.9±5.9)IU/L, (2. 1±0. 8)nmol/L and (2.8±2.3)nmol/L respectively to(5.8±2.2)IU/L, (1.2±0. 4)nmol/L and (0. 8±0.5)nmol/L respectively and SHBGwas significant increased from (99 ± 42) nmol/L to (187±64)nmol/L in group A3,when compared with LH,T and FT from (13.8±7.6)IU/L, (2.2±1.1) nmol/L and(2. 5±1.9) nmol/L respectively to (11.8±6.5)IU/L, (1.8±0.8) nmol/L and (1.7±1.0) nmol/L respectively and SHBG from (99±40) nmol/L to (120±51) nmol/L ingroup A2 (P＜0.05,P＜0. 001). HDL-C was significant increased from (1.5±0.3)mmol/L to (1.8±0.3) mmol/L in group A3 comparing with HDL-C from (1.5±0.4)mmol/L to (1.6±0.4) mmol/L in groupA1(P＜0.001).Conclusions: The PCOS patients treated with metformin in combination with compoundcyproterone acetate may be more effective in inhibiting hyperandrogen and hypersecretion ofLH than metfrornin alone and more obvious in improving lipid profiles than CPA alone.

Effect of Acupuncture and Jianpi Bushen Decoction on Ovarian Function and Metabolic Disorders in Patients with PCOS

Objective:To study the effects of acupuncture combined with Jianpi Bushen Decoction on ovarian function and metabolic disorders in patients with polycystic ovary syndrome(PCOS).Methods:A total of 100 PCOS patients admitted in our hospital from October 2018-January 2020 were selected,and the patients were divided into the Jianpi Bushen Decoction group and the combined group with 50 patients each according to a completely random method.The patients in the Jianpi Bushen Decoction group were given Jianpi Bushen Decoction;the combined group was given acupuncture on the basis of the Jianpi Bushen Decoction group.Detection of follicle stimulating hormone(FSH),testosterone(T),pituitary prolactin(PRL),estradiol(E2),fasting insulin(FIN),fasting blood glucose(FBG),insulin resistance index(HOMA-IR),triglyceride Ester(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),endometrial thickness,ovarian volume,number of ovarian sinus follicles,C-reactive protein(CRP),procalcitonin(PCT).Statistical treatment is effective.Results:After treatment,FSH,T,PRL,FIN,FBG,HOMA-IR,TG,TC and LDL-C were lower in Jianpi Bushen Decoction group,and E2 and HDL-C levels were higher than Jianpi Bushen Decoction group(P<0.05).The endometrial thickness of the combined group was higher than that of Jianpi Bushen Decoction group,and the ovarian volume and the number of ovarian sinus follicles were lower than that of Jianpi Bushen Decoction group(P<0.05).The levels of CRP and PCT in the combination group were lower than those in the Jianpi Bushen Decoction group(P<0.05).The total effective rate of patients in combination group was higher than that in Jianpi Bushen Decoction group(P<0.05).Conclusion:Acupuncture combined with Jianpi Bushen Decoction has significant therapeutic effects on patients with PCOS,effectively improves patients'ovarian function,improves endocrine and metabolic disorders,and reduces inflammatory reactions,which deserves clinical promotion.

Effect of Astragalus-hawthorn on ovarian reproductive function and inflammatory mechanism of action in rats with polycystic ovary syndrome

Objective:To investigate the effects of prophylactic administration of Astragalus-Hawthorn on ovarian reproductive function and inflammatory mechanism in rats with polycystic ovary syndrome(PCOS).Methods:Fifty 21-day-old female rats were randomly divided into five groups of 10 rats each:Normal group,Model group,Astragalus group,Hawthorn group and Astragalus-Hawthorn group.All groups,except the normal group,were fed a high-fat model diet.Each treatment group received astragalus,hawthorn and an astragalus-hawthorn solution orally during the molding period for an intervention period of 15 weeks.The estrous cycle of the rats in each group was observed under the microscope from week 8,the interference rate was calculated,changes in ovarian tissues were observed by HE staining and the levels of sex hormones,proinflammatory and anti-inflammatory factors in the serum of the rats were measured by ELISA.Results:Rate of estrous cycle disorders were more frequent in the model group than in the normal group.(P<0.01);ovarian tissue was polycystic,with few corpora lutea and sinusoids and numerous follicular ovarian cysts;Luteinising hormone/follicle-stimulating hormone(LH/FSH),testosterone(T),interleukin 6(IL-6),interleukin 17A(IL-17A)and tumour necrosis factor(TNF-α)levels were significantly higher in the model group than in the normal group;interleukin 10(IL-10)was significantly lower than in the normal group(P<0.05).Compared to the model group,rats in the Astragalus and hawthorn groups had a lower rate of estrous cycle disorders(P<0.01);the number of cystic follicles in the ovarian tissue decreased;the number of mature follicles and corpus luteum increased;LH/FSH,T,IL-6 and IL-17A levels were significantly lower in the Astragalus group,hawthorn group and the Astragalus and hawthorn groups;TNF-αlevels were significantly lower in the astragalus and hawthorn groups;IL-10 levels were significantly higher in the hawthorn and astragalus hawthorn groups(P<0.05).IL-10 levels were significantly higher in the astragalus and hawthorn groups(P<0.05).Compared to the astragalus group,T levels were significantly lower in the astragalus and hawthorn groups and IL-10 levels were significantly higher in the astragalus and hawthorn groups(P<0.05).Compared to the hawthorn group,levels of T and IL-17A were significantly lower in the astragalus-hawthorn group(P<0.05).Conclusion:Astragalus-Hawthorn prophylactic administration can improve ovarian reproductive function in rats with PCOS,and the mechanism of action may be related to reducing the levels of pro-inflammatory factors IL-6,IL-17A and TNF-α,increasing the levels of anti-inflammatory factor IL-10,and reducing the inflammatory state.

The relationship of serum Myostatin content with lipid metabolism, insulin resistance and inflammatory response in patients with polycystic ovary syndrome

Objective:Objective:To investigate the relationship of serum Myostatin content with lipid metabolism,insulin resistance and inflammatory response in patients with polycystic ovary syndrome(PCOS).Methods:118 PCOS patients were taken as the PCOS group,and 100 healthy women of child-bearing age who underwent physical examination in our hospital during the same period were taken as the normal control group.The differences in serum Myostatin content,lipid metabolism index levels,insulin resistance index levels and inflammatory mediator contents were compared between the two groups,and the internal relationship between serum Myostatin content and the above disease-related index levels in PCOS patients was further analyzed.Results:Serum Myostatin content of PCOS group was higher than that of normal control group.Peripheral blood lipid metabolism indexes TC,LDL-C and ApoB levels of PCOS group were higher than those of normal control group whereas HDL-C and ApoA-Ⅰlevels were lower than those of normal control group;insulin resistance indexes FINS and HOMA-IR levels were higher than those of normal control group;inflammatory mediators IL-18,MCP-1 and CRP contents were higher than those of normal control group.Pearson test showed that serum Myostatin content in PCOS patients was directly correlated with the levels of the above disease-related indexes.Conclusion:Serum Myostatin content is abnormally high in PCOS patients,and the specific content is positively correlated with the disease severity.

Effect of Bailing capsule combined with ethinylestradiol and cyproterone acetate and metformin on lipid metabolism and insulin resistance in patients with polycystic ovary syndrome

Objective:To investigate the effect of Bailing capsule combined with ethinylestradiol and cyproterone acetate and metformin on lipid metabolism and insulin resistance in patients with polycystic ovary syndrome (PCOS).Methods: A total of 108 patients with PCOS who were treated in our hospital between November 2014 and April 2017 were reviewed and divided into routine group (n=67) who received routine therapy and Bailing capsule group (n=41) who received Bailing capsule combined with routine therapy. Routine group received ethinylestradiol and cyproterone acetate and metformin therapy, and Bailing capsule group were treated with Bailing capsule combined with ethinylestradiol and cyproterone acetate and metformin therapy. The differences in the levels of lipid metabolism, insulin resistance indexes as well as inflammatory factors were compared between the two groups before and after treatment.Results: There was no statistically significant difference in serum levels of lipid metabolism, insulin resistance-related indexes and inflammatory factors between the two groups before treatment. After treatment, serum HDL-C content of Bailing capsule group was higher than that of routine group whereas LDL-C and TC contents were lower than those of routine group;serum insulin resistance-related indexes FINS and HOMA-IR levels were lower than those of routine group;serum inflammatory cytokines IL-6, TNF-α, APN and LEP contents were lower than those of routine group.Conclusion: Bailing capsule combined with ethinylestradiol and cyproterone acetate and metformin therapy can effectively improve the lipid metabolism level and inhibit the insulin resistance in patients with PCOS.

Endometrial Cancer Research Based on Gut Microbiomics and Metabolomics:An Analysis of Correlation and Differences

Endometrial cancer(EC)is a malignant tumour that occurs in the epithelial cells of the endometrium and represents one of the most common malignancies involving the female reproductive system,with endometrioid adenocarcinoma as the most common type.In recent years,with an increasingly aging society and the growing number of obese people,the incidence of EC is constantly rising,posing a serious threat to women’s health.Some studies have reported that the interruption of digestion and absorption caused by imbalance in intestinal microbiota may lead to conditions such as obesity,hypertension,diabetes,and hormone imbalance,which are all risk factors for EC.Meanwhile,intestinal bacteria produce a series of metabolites during colonization and reproduction,which can rapidly respond to changes in the microenvironment of the body.Changes in their types and quantities can serve as sensitive indicators of physiological and pathological changes in the body.Patients with EC often suffer from metabolic diseases,which can lead to metabolic disorders involving carbohydrates,fats,and amino acid in their bodies.

Comparative transcriptomic analysis of ovary and testis reveals sex-related genes in roughskin sculpin Trachidermus fasciatus

The mechanisms underlying sex determination and differentiation have long intrigued researchers in the fields of development and evolutionary biology.The roughskin sculpin(Trachidermus fasciatus Heckel),displaying sexual dimorphism,provides an ideal model for studying the mechanisms.However,both genetic and genomic information concerning sex determination and differentiation,such as gonadal transcriptome data in roughskin sculpin,are lacking.Here,we present the first gonadal transcriptomes of roughskin sculpin and identify sex-related genes.We identified 8531 differentially expressed genes(DEGs),among them 4065 were upregulated in the ovary and 4466 upregulated in the testis.Several sex-related gene ontology(GO)terms were enriched in ovary-biased genes,including“binding of sperm to zona pellucida”,“egg coat formation”,“positive regulation of acrosome reaction”,“cell division”,and“cell cycle”,while the GO terms such as“spermatogenesis”,“sperm axoneme assembly”,“cilium assembly”,“cilium movement”,and“cilium movement involved in cell motility”were enriched in testis-biased genes.Moreover,six KEGG pathways were significantly enriched in the ovary,whereas only one was enriched in the testis.Of these DEGs,40 sex-related genes were identified,which including 26 testis-biased genes(such as Dmrtb 1,Gsdf,Sox 9 b,Wnt 4 b,Tcp 11 l 2,and Efhb),and 14 ovary-biased genes(such as Cyp 19 a 1 a,Foxh 1,Foxr 1,Gdf 3,Hsd 17 b 12,and Igf 2 bp 3).This gonadal transcript dataset would broaden our understanding of sex determination and differentiation mechanisms in roughskin sculpin,expand the genomic database,support future studies on sex-related gene functions,and facilitate molecular biology research into roughskin sculpin.

Clinical analysis of 12 cases of ovarian neuroendocrine carcinoma

BACKGROUND Neuroendocrine neoplasms of the female genital tract are rare.AIM To enhance our clinical understanding of neuroendocrine carcinoma(NEC)of the ovary.METHODS A retrospective review was conducted on 12 patients diagnosed with NEC of the ovary,analyzing clinicopathological characteristics,treatment modalities,and survival status.RESULTS The median age at diagnosis was 34.5 years(range:20 to 62 years).Among the 12 cases,9 were small cell carcinoma of the ovary and 3 were large cell NEC.Five cases were stage I tumors,one case was stage IV,and six cases were stage III.Eleven patients underwent surgery as part of their treatment.All patients received adjuvant chemotherapy.Among the 12 patients,one patient received radiotherapy,and one patient with a BRCA2 mutation was administered PARP inhibitor maintenance after chemotherapy.The median progression-free survival was 13 months,and the median overall survival was 19.5 months.Four cases remained disease-free,while eight cases experienced tumor recurrence,including three cases that resulted in death due to disease recurrence.CONCLUSION NEC of the ovary is a rare condition that is more common in women of childbearing age and is associated with aggressive behavior and poor clinical outcomes.Surgical resection remains the mainstay of treatment,with some patients benefiting from adjuvant chemoradiation therapy.

Impact of alcoholic extract from sea cucumber(Holothuria parva)on letrozole-induced polycystic ovary syndrome in adult female rats

Objective:To explore the potential therapeutic impact of an alcoholic extract derived from the sea cucumber(Holothuria parva)on letrozole-induced polycystic ovary syndrome(PCOS)in adult female Sprague-Dawley rats.Methods:Sixteen female rats,aged 8 to 10 weeks,with a mean weight of(200±20)g,were randomly assigned to four groups:the control,PCOS,and two treatment groups receiving sea cucumber extract and metformin,respectively.PCOS was induced by administering letrozole at a dose of 1 mg/kg to initiate the treatment period at 60 days of age.The study spanned four weeks,during which ovarian and uterine tissues were collected for histological examination,and blood samples were collected for hormonal levels.Results:Significant decreases in luteinizing hormone/follicle stimulating hormone(LH/FSH)and testosterone and increases progesterone levels among groups treated with sea cucumber extract were observed.While no significant differences were observed in follicle-stimulating hormone(FSH)and testosterone levels,the distinctive variations in key hormones suggested a potential role for sea cucumber alcoholic extract in ameliorating PCOS symptoms.Conclusions:This research highlights the moderate efficacy of sea cucumber extract as a therapeutic intervention for PCOS,providing a novel perspective in the search for effective remedies.The observed hormonal alterations,particularly in LH,estradiol,and progesterone,underscore the need for further exploration into the underlying mechanisms and for optimizing the application of sea cucumber extract in PCOS management.

Association between Metal(loid)Exposure and Risk of Polycystic Ovary Syndrome Mediated by Anti-Müllerian Hormone among Women Undergoing In Vitro Fertilization and Embryo Transfer

Objective To investigate the relationship and potential pathways between metal(loid)exposure and the risk of polycystic ovary syndrome(PCOS)in women of childbearing age.Methods This case-control study included 200 patients with PCOS(cases)and 896 non-PCOS controls with the age of 25-37 years.The concentrations of 29 metal(loid)s in the follicular fluid(FF)and clinical indicators in the serum were measured in all participants.Logistic regression analysis and mediation analysis were conducted to evaluate the associations between metal(loid)exposure and PCOS risk and investigate the possible roles of clinical indicators,respectively.Results Logistic regression analysis revealed an association between high copper levels in FF and increased PCOS risk(highest vs.lowest quartile:adjusted odds ratio=2.94,95%confidence interval:1.83-4.72).A high luteinizing hormone/follicle-stimulating hormone ratio and elevated levels of testosterone and anti-Müllerian hormone(AMH)were strongly associated with increased PCOS risk induced by high copper exposure.The mediation analysis indicated a mediating effect of AMH in the association between copper exposure and PCOS risk.Conclusion Copper may affect PCOS risk through the hypothalamic-pituitary-ovarian axis,mediated by AMH.Copper exposure and internal AMH levels are important indicators for early warning of PCOS development.

Adult-Type Granulosa Cell Tumor with Similar Clinical Findings Seen during Ovarian Cystectomy Performed at the Same Time as Laparoscopic Ovarian Drilling for Polycystic Ovarian Syndrome: An Extremely Rare Case

Polycystic ovary syndrome (PCOS) is a major cause of anovulatory infertility. Laparoscopic ovarian drilling (LOD) is a treatment for PCOS that allows the laparoscopic identification of other intra-abdominal lesions and the provision of diagnostic treatment. This study reports a case of PCOS with an ovarian mass in which LOD was aggressively used and a granulosa cell tumor (GCT) was found. A 34-year-old woman with secondary amenorrhea and irregular menstrual cycles presented to the emergency department with abdominal pain of unknown etiology. Imaging studies revealed a 6-cm left ovarian mass with an internal appearance suggestive of a hemorrhage. The patient’s secondary amenorrhea was subsequently diagnosed as PCOS, and LOD was performed to preserve her fertility. Simultaneously, a cystectomy was performed to evaluate the tumor in the left ovary;the diagnosis was adult-type GCT. Although concomitant GCT and PCOS are extremely rare, the two conditions have similar clinical manifestations. In women of reproductive age, the impact of surgery on future fertility should be considered, and the initial surgical technique should be chosen carefully.

Effect of Mitochondrial Function of Ovarian Granulosa Cells on In Vitro Fertilization and Embryo Transfer Outcomes in Obese Polycystic Ovary Syndrome Patients

Objective:To investigate the effect of abnormal ovarian granulosa cell metabolism on in vitro fertilization and embryo transfer(IVF-ET)outcomes in obese polycystic ovary syndrome(PCOS)patients.Methods:Patients with PCOS who met the study criteria were screened according to the inclusion criteria.A total of 32 patients with obese PCOS were recruited into the study group,and 39 patients with non-obese PCOS were recruited into the control group.The general data(age,body mass index,and years of infertility),insulin resistance index(HOMA-IR),follicle-stimulating hormone(FSH),luteinizing hormone(LH),granulosa cell mitochondrial function,and IVF-ET outcome of patients in the study group and control group were retrospectively analyzed.Results:The differences in age and years of infertility between the study group and the control group were insignificant(P>0.05),and the body mass index(BMI)of the study group and control group was 30.5±1.24 kg/m2 and 22.3±1.12 kg/m2,respectively,in which the difference was statistically significant(P<0.05);the HOMA-IR of the study group was significantly higher than that of the control group(P<0.05);the reactive oxygen species(ROS)in the study group was significantly higher than that in the control group(P<0.05),and the ATP content in the study group was significantly lower than that in the control group(P<0.05);comparing the FSH and LH levels between the two groups,the difference was not statistically significant(P>0.05);the rate of IVF-ET failure was significantly higher in the study group than in the control group.Conclusion:PCOS is a complex endocrine disorder,and obesity is one of the independent risk factors for the development of PCOS.