Objective To evaluate the effectiveness of GnRH antagonist in vitro fertilization-embryo transfer (IVF-ET) in polycystic ovary syndrome (PCOS) patients.Methods Such databases as PubMed (1997 to 2010), PML (1997 to 2010), FMJS (2000 to 2010), CBMdisc (1979 to 2010), CNKI (1994 to 2010), VIP (1989 to 2010), WanFang (1994 to 2010), and duxiu scholar searcher (www.duxiu.com), and nine relevant Chinese journals were searched for retrieving the randomized controlled trails (RCTs) on the effectiveness of GnRH antagonist versus GnRH agonist for IVF-ET in PCOS Patients. The studies were screened according to the inclusive and exclusive criteria by two reviewers independently, the data was abstracted and the quality was evaluated. The RevMan 4.2.7 software was used for Meta-analyses. Results Six grade-B studies involving 699 participants were included. The results of Meta-analyses showed that, compared with the GnRH agonist, there was no significant difference in the GnRH antagonist group about the stimulation duration (WMD= –1.23, 95%CI –2.76 to –0.31), dose of gonadotrophins (Gns) (WMD= –4.87, 95%CI –14.20 to 4.46), serum E2 value on the day of HCG administration (WMD= 31.37, 95%CI –263.40 to 326), number of oocytes retrieved (WMD= 1.34, 95%CI –1.02 to 4.70), clinical pregnancy rate (OR= 1.27, 95%CI 0.77 to2.10), and miscarraige rate (Peto OR= 0.67, 95%CI 0.38 to1.18). But the OHSS rate in the GnRH antagonist group was lower with a significant difference (Peto OR= 0.35, 95%CI 0.24 to 0.50). Conclusions Compared with the GnRH agonist protocol, the GnRH antagonist protocol can obviously reduce the incidence of OHSS, but has the same effect in Gn dose, retrieving oocytes and clinical pregnancy rate. Because the GnRH antagonist can decrease the treatment duration and cost, and has better safety, so it may be an ideal choice for PCOS patients to have IVF-ET therapy. For the quality and quantity limitation, and the methodology difference of the included studies, it is suggested that the conclusion from this study should be only served as a reference of clinical analyses, and should be revaluated and updated unceasingly.
ObjectiveTo systematically review the efficacy of vitamin D supplementation on patients with polycystic ovary syndrome (PCOS).MethodsPubMed, EMbase, The Cochrane Library, Web of Science, EBSCO, CBM, WanFang Data, CNKI and VIP databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy of vitamin D supplementation for PCOS from inception to July 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 11 RCTs involving 692 patients were included. The results of meta-analysis showed that compared with placebo, vitamin D could reduce the level of hypersensitive C-reactive protein (hs-CRP) (MD=−0.54, 95%CI −1.00 to −0.08, P=0.02) and total testosterone (MD=−0.17, 95%CI −0.29 to −0.05, P=0.004), and increase endometrial thickness (MD=1.78, 95%CI 0.49 to 3.06, P=0.007). However, there were no significant differences between two groups in the incidence of sex hormone binding globulin (SHBG) level and hypertrichosis’s score (mF-G) (P>0.05).ConclusionsCurrent evidence indicates that vitamin D supplementation can significantly reduce the level of total testosterone and hs-CRP, and increase endometrial thickness of PCOS. Due to the limited quality and quantity of the included studies, more high quality studies are required to verify the above conclusions.
Objective To evaluate the efficacy and safety of rosiglitazone versus metformin in treating polycystic ovary syndrome (PCOS). Methods Randomized controlled trials (RCTs) about rosiglitazone versus metformin in treating PCOS were retrieved on computer in MEDLINE, The Cochrane Library, EMbase, EBSCO, CBM, CNKI, Chinese Medical Association Journal Database and VIP from the date of their establishment to December 2010. The trials were screened according to the inclusion and exclusion criteria by two reviewers independently, the data were extracted, the methodological quality was assessed, and finally meta-analysis was conducted with Stata 11.0 software. Results A total of six RCTs involving 286 PCOS patients were included. The results of meta-analyses showed that there was no significant difference between rosiglitazone and metformin in improving PCOS patients’ insulin sensitivity (SMD= –0.14, 95%CI –0.46 to 0.19, P=0.412) and lowering androgen levels (SMD=0.05, 95%CI –0.26 to 0.36, P=0.747). However, the effect of rosiglitazone was inferior to metformin in lowing patients’ weight with a significant difference (SMD=0.34, 95%CI 0.11 to 0.58, P=0.004). The rosiglitazone showed a lower incidence rate of adverse reaction compared with metformin. Conclusion Compared with metformin, the rosiglitazone is eqully effective in improving PCOS patients’ insulin sensitivity and lowering androgen levels, and has a lower incidence rate of adverse reaction although it is inferior to metformin in lowing patients’ weight. So rosiglitazone is more applicable for the patients who are of underweight or cannot tolerate the gastrointestinal side effects induced by metformin. There is no enough evidence for this conclusion due to the small sample size and limited number of RCTs. More high-quality, large-sample and multicentered RCTs are required to guide clinical treatment and benefit patients.
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age, which may result in infertility. Because of the complicated etiology and high morbidity, it has attracted wild attention of researchers around the world. The large quantity of blood specimens that have been obtained from multicenter clinical trials (PCOSAct) are precious resources for clinical research. It could not only contain clinical data of the related diseases but also provide vital guidance for the diagnosis and treatment of the disease. This paper discusses the collection, processing, storage, and testing of blood specimens as well as the potential problems, and emphasizes the importance of specimen quality for high quality clinical research. The purpose of this paper is to provide experience and reference for the standardized construction of biobank in future and improve the management of blood specimen in clinical trials.
Polycystic ovary syndrome (PCOS) is a complex and heterogeneous common endocrine disease, and periodontitis is a chronic infectious immune inflammatory disease caused by dental plaque. In recent years, a large number of studies have shown that PCOS and periodontitis may be related, but the pathological mechanism is still unclear. Therefore, this article reviews the correlation between PCOS and periodontitis and the possible biological mechanisms of their mutual influence, in order to provide a theoretical basis for the prevention and treatment of periodontal disease in patients with PCOS.
Objectives To evaluate the methodological bias and the reliability of the conclusions of systematic reviews on acupuncture for polycystic ovary syndrome. Methods We comprehensively searched PubMed, EMbase, The Cochrane Library, CBM, CNKI and WanFang Data to collect systematic reviews on acupuncture for polycystic ovary syndrome from the establishment time of databases to January 5th, 2018. The AMSTAR tool was applied for methodological quality assessment of included studies and the GRADE system was applied for evidence quality assessment of included outcomes of systematic reviews. Results A total of 11 systematic reviews were included. The results of assessment using AMSTAR showed that, among the 11 items, most problems occurred in Item 5 " Were there any lists of research articles included and excluded”, followed by Item 1" Was an‘a prior’design provided?”and Item 11" Were potential conflict of interest included?”. GRADE grading results showed that quality of evidence for the outcome measure were" low”or" very low”. Conclusions Current acupuncture treatment of polycystic ovary syndrome has a certain effect, however, the quality of evidence is low. Thus, physicians should apply the evidence to make decision on acupuncture for polycystic ovary syndrome with caution in clinical practice and consider the actual situation, combined with the patient’s value preferences and economic factors.
ObjectivesTo evaluate and compare the clinical impact of different methods of trigger in polycystic ovary syndrome (PCOS) with high ovarian response undergoing in vitro fertilization-embryo transfer (IVF-ET) cycles.MethodsA total of 323 PCOS patients with high ovarian response in an gonadotrophin-releasing hormone antagonist protocol in our reproductive medical center from January 1st, 2017 to December 31st, 2017 were included. Then they were divided into two groups based on the different trigger modes: Group A: gonadotrophin-releasing hormone agonist (GnRH-a) with low dose human chorionic gonadotrophin (HCG); Group B: HCG as trigger. Analysis and comparison of the general data of the two groups of patients, ovulation induction cycle treatment, embryo laboratory indicators and resuscitation cycle treatment outcome were performed retrospectively.ResultsThere were no significant differences in baseline such as ages, BMI, startup dose of Gn, the total dosage of drugs, promote ovulation days and so on (P>0.05). The serum E2 level on trigger day in group A was significantly higher than those in group B (7 256.94±2 031.92 vs. 6 200.26±1 001.44, P<0.05). There were no significant differences in the retrieved oocytes (23.90±7.99 vs. 23.81±7.15), binuclear fertilization rate (58.19% vs. 56.30%), and the number of frozen embryos (12.81±5.45 vs. 11.07±5.36) between two groups (P>0.05). There were also no significant differences between two groups in the incidence of moderate to severe OHSS (5.98% vs. 7.87%), clinical pregnancy rate (59.28% vs. 57.53%), implantation rate (41.05% vs. 38.24%), miscarriage rate (9.28% vs. 8.22%) and live birth rate (47.42% vs. 41.10%) during the frozen-thawed cycles (P>0.05).ConclusionsFor high responders of PCOS patients with GnRH antagonist protocol, using GnRH-a with low dose HCG as trigger maybe could decrease the incidence of moderate to severe OHSS. Embryo resuscitation and transfer cycle can also obtain ideal outcome.
目的:探讨二甲双胍合并克罗米芬在治疗多囊卵巢综合征中的作用,为多囊卵巢综合征的治疗提供合理依据。方法:80例患者给予二甲双胍合并克罗米芬治疗,比较治疗前后临床症状、内分泌和生化指标的变化情况,与单一给予克罗米芬促排卵治疗比较排卵、妊娠情况。结果:用药后体重指数(BMI)、腰臀比(WHR)、空腹胰岛素(FINS)、睾酮(T)促黄体生成素(LH)、LH/FSH明显下降,Plt;0.05;雌二醇(E2)、促卵泡生成素(FSH)改变不明显,联合用药后排卵、妊娠率明显高于单一克罗米芬治疗,Plt;0.05。结论:二甲双胍合并克罗米芬可改善临床症状,提高排卵、妊娠率,降低LH/FSH比值、LH、T水平,提高胰岛素的敏感性。
ObjectiveTo systematically review the association of micronucleus and polycystic ovary syndrome (PCOS).MethodsPubMed, OVID, Elsevier, CNKI, WanFang Data and CBM databases were electronically searched to collect case-control studies on the association of micronucleus and PCOS. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 5 case-control studies were included, in which 170 patients were in the case group and 148 in the control group. The results of meta-analysis showed: there were significant differences between the two groups for micronucleus frequency (MD=2.02%, 95%CI 1.63% to 2.41%, P<0.000 01) in peripheral blood lymphocytes and micro nucleated cells frequency (MD=2.43%, 95%CI 0.10% to 4.76%, P=0.04) in oral epithelial cells.ConclusionThe current evidence shows that micronucleus is associated with PCOS. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify above conclusion.