Endometrial progesterone resistance and PCOS

Li, Xin; Feng, Yi; Lin, Jingfeng; Billig, Håkan; Shao, Ruijin

doi:10.1186/1423-0127-21-2

Cited by 123 publications

(99 citation statements)

References 55 publications

(103 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The fact that some outcomes were worsened in hyperandrogenic PCOS phenotypes may relate to the reciprocal relationship between HA and IR (either intrinsic or extrinsic related to obesity) 4,107 in PCOS. This likely aggravates sex hormone imbalances that contribute to adverse pregnancy and birth outcomes through endometrial abnormalities like thickening the endometrium, 108 dysregulating angiogenesis, 92 and inducing a state of inflammation in endometrium 94,[109][110][111] and consequently impacting on implantation and placentation. 25,92,108 The prevalence of outcomes did not significantly change on exclusion of studies using metformin during pregnancy, which is consistent with prior literature on miscarriage, 112 GDM, 113 and PE.…”

Section: Discussionmentioning

confidence: 99%

“…This likely aggravates sex hormone imbalances that contribute to adverse pregnancy and birth outcomes through endometrial abnormalities like thickening the endometrium, 108 dysregulating angiogenesis, 92 and inducing a state of inflammation in endometrium 94,[109][110][111] and consequently impacting on implantation and placentation. 25,92,108 The prevalence of outcomes did not significantly change on exclusion of studies using metformin during pregnancy, which is consistent with prior literature on miscarriage, 112 GDM, 113 and PE. 114 With regard to study quality, higher miscarriage, GDM, GHTN, PE, and CS were confirmed on good quality studies with the lowest risk of bias, validating the observed results on these outcomes.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Increased maternal pregnancy complications in polycystic ovary syndrome appear to be independent of obesity—A systematic review, meta‐analysis, and meta‐regression

et al. 2019

View full text Add to dashboard Cite

Summary Polycystic ovary syndrome (PCOS) is associated with an increased risk of maternal pregnancy and delivery complications. However, the impact of clinical features of PCOS and other potential risk factors in PCOS is still unknown. We aimed to investigate the association of PCOS with maternal pregnancy and delivery complications with consideration of risk factors and potential confounders. The meta‐analysis included 63 studies. PCOS was associated with higher miscarriage, gestational diabetes mellitus, gestational hypertension, pre‐eclampsia, induction of labour, and caesarean section. The association of PCOS with these outcomes varied by geographic continent, PCOS phenotypes, and study quality. Pre‐eclampsia and induction of labour were not associated with PCOS on body mass index‐matched studies. No outcome was associated with PCOS on assisted pregnancies. Age was significantly associated with higher miscarriage on meta‐regression. There were no studies assessing perinatal depression. We confirm that PCOS is associated with an increased risk of maternal pregnancy and delivery complications. The association of PCOS with the outcomes is worsened in hyperandrogenic PCOS phenotypes, in specific geographic continents, and in the highest quality studies but disappears in assisted pregnancies. Future studies in PCOS are warranted to investigate proper timing for screening and prevention of maternal pregnancy and delivery complications with consideration of clinical features of PCOS.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Increased maternal pregnancy complications in polycystic ovary syndrome appear to be independent of obesity—A systematic review, meta‐analysis, and meta‐regression

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Even though progesterone-based oral contraceptive therapy is often eicacious [19], approximately 30% of women with PCOS fail to respond to such treatment [20] and progress to the development of atypical hyperplasia and further transformation to endometrial cancer [21].…”

Section: Prevention Of Endometrial Hyperplasiamentioning

confidence: 99%

“…Patients with PCOS have a modiied ratio of PRA to PRB receptors present on stromal and epithelial cells of endometrium [21].…”

Section: Prevention Of Endometrial Hyperplasiamentioning

confidence: 99%

Lifestyle Changes and Weight Loss: Effects in PCOS

Ionescu¹,

Popescu²,

Banacu³

et al. 2018

Debatable Topics in PCOS Patients

View full text Add to dashboard Cite

Even though controversies surrounding the polycystic ovary syndrome are not yet close to be solved, its clinical manifestations are well known-insulin resistance and obesity, hirsutism, irregular and anovulatory menstrual cycles. The treatment of polycystic ovarian syndrome (PCOS) is mainly symptomatic as its etiology is not yet clear. Lifestyle changes are the primary therapy in overweight and obese women with PCOS. According to majority of the studies, lifestyle changes are the most efective form of treatment not only for weight loss but also for the improvement of insulin sensitivity, decreasing incidence of metabolic syndrome and type 2 diabetes. Studies also show that weight loss has fertility beneits by restoring ovulatory cycles. Although initial studies researching pharmacologic treatment were showing excellent results concerning the weight loss, maintenance of weight loss and reduction of cardiovascular risks, some of these drugs were in the end, has proven to actually increase the risk for cardiovascular events and were removed from the market. Bariatric surgery has been demonstrated to improve or even cure type 2 diabetes, hypertension, hyperlipidemia, and obstructive sleep apnea. More so, there are studies that reported complete resolution of all features of PCOS, even hirsutism, hyperandrogenism, anovulation, and menstrual irregularity.

show abstract

“…They suggested that the decrease in cell apoptosis during the implantation window in PCOS patients may be one of the causes of reduced endometrial receptivity. Finally, a recent review of endometrial progesterone resistance in women with PCOS concluded that progesterone-mediated signaling pathways of expression, regulation and signaling in the nucleus are involved [23].…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Menstrual preconditioning for the prevention of major obstetrical syndromes in polycystic ovary syndrome

Brosens

Benagiano

2015

American Journal of Obstetrics and Gynecology

View full text Add to dashboard Cite

The presence of multiple ovarian cysts, anovulation, and endometrial progesterone resistance in the neonate seems remarkably similar to ovarian and endometrial features of the polycystic ovary syndrome (PCOS) of adolescent and adult women. In fact, in the absence of cyclic menstruations after menarche, the neonatal progesterone resistance is likely to persist and adversely affect young women with PCOS at the time of pregnancy after induction of ovulation, because any persisting defect in progesterone response can interfere with the process of decidualization and trophoblast invasion. The primigravid woman with PCOS therefore is likely to be at risk of defective deep placentation as manifested by the increased risk of major obstetric syndromes. A recent, large epidemiologic study has demonstrated that the risk of preeclampsia and preterm delivery is elevated in the 13- to 15-year old group, although it does not persist in the 16- to 17-year old group. It is proposed therefore that induction of ovulation in the infertile nulligravid woman with PCOS should be preceded by a period of progesterone withdrawal bleedings to achieve full endometrial progesterone response by the time of pregnancy. The cyclic administration of clomiphene citrate for a period to be determined by vascular response may be an appropriate tool to reduce the risk of major obstetric syndromes by menstrual preconditioning.

show abstract

Endometrial progesterone resistance and PCOS

Cited by 123 publications

References 55 publications

Increased maternal pregnancy complications in polycystic ovary syndrome appear to be independent of obesity—A systematic review, meta‐analysis, and meta‐regression

Increased maternal pregnancy complications in polycystic ovary syndrome appear to be independent of obesity—A systematic review, meta‐analysis, and meta‐regression

Lifestyle Changes and Weight Loss: Effects in PCOS

Menstrual preconditioning for the prevention of major obstetrical syndromes in polycystic ovary syndrome

Contact Info

Product

Resources

About