Ovulation rate in adolescents with type 1 diabetes mellitus

Codner, Ethel; Eyzaguirre, Francisca; Íñiguez, Germán; López, Patricia; Pérez-Bravo, Francisco; Torrealba, I; Cassorla, Fernando

doi:10.1016/j.fertnstert.2010.10.041

Cited by 37 publications

(27 citation statements)

References 26 publications

(39 reference statements)

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“…This rate was similar to that observed in a recent paper published by our group analyzing non-hyperandrogenic girls with T1D during a 6-month period, which had 0.8 ovulations every 100 days in girls with HbA 1c ≥7.5% [31]. …”

Section: Discussionsupporting

confidence: 90%

Metformin for the Treatment of Hyperandrogenism in Adolescents with Type 1 Diabetes Mellitus

et al. 2013

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Background: A high prevalence of hyperandrogenism has been reported in women with type 1 diabetes (T1D). Metformin has been used as a therapeutic agent in patients with polycystic ovarian syndrome and in T1D patients without hyperandrogenism. This study sought to determine the effect of metformin on hyperandrogenism and ovarian function in adolescents with T1D. Methods: We recruited 24 girls with T1D. The participants had hyperandrogenism and displayed suboptimal metabolic control. The patients were enrolled in a randomized, double-blind, placebo-controlled trial. One group received metformin (850 mg bid) and the other group received a placebo. Treatment was administered for 9 months. Ovulation, steroids and gonadotropin levels were evaluated. Results: Metformin treatment was associated with decreases in testosterone, free androgen index, androstenedione, 17-OH progesterone and estradiol levels. The girls who were treated with placebo showed stable steroid, gonadotropin and sex hormone-binding globulin levels during the analysis. No differences were observed in the Ferriman-Gallwey scores, ovulation rates, HbA_1c levels or daily insulin doses of the girls treated with metformin compared with the placebo group. Conclusion: Treating hyperandrogenic T1D adolescents with metformin significantly decreased the serum androgens compared to the placebo, but metformin therapy did not significantly affect clinical parameters, such as hirsutism, ovulation and metabolic control.

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Section: Discussionsupporting

confidence: 90%

Metformin for the Treatment of Hyperandrogenism in Adolescents with Type 1 Diabetes Mellitus

et al. 2013

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“…The hypogonadotropic hypogonadism seen in amenorrheic diabetic females has been shown to be similar to that linked to other metabolic stress forms, including strenuous exercise and anorexia nervosa (35). However, other reports have shown that diabetic patients with secondary amenorrhea due to hypogonadotropic hypogonadism failed to recover following theimprovement in metabolic control (36), implying that a certain group of diabetic patients is prone to hypogonadism (34).The hypothalamic origin of the decreased levels of gonadotropin in amenorrheic and diabetic patients has been explained (25,26). Abnormalities of gonadotropin-releasing hormone (GnRH) pulse generator are hypothesized on LH pulses studies, indicating the secretory activity of the GnRH neurons (37).…”

Section: Pituitary-hypothalamic Functionmentioning

confidence: 98%

“…Metabolic control was found to have a slight effect on the rate of ovulation. An increased rate of ovulation every 100 days and a higher percentage of ovulatory cycles were reported in diabetic girls to optimal metabolic control that diabetic girls with insufficient control (25). Even though these data are suggestive of preserved ovulation, most studies have reported fewer pregnancies and live births in women with diabetes mellitus type 1 (47).…”

Section: Ovarian Functionmentioning

confidence: 99%

“…The current body of literature shows that conditions of negative energy balance and metabolic stress, such as diabetes mellitus type 1 in primates and rodents (20,22) acute inflammation in rats, and chronic dietary restriction can affect fertility (23,24). These conditions cause hypogonadism by suppressing the expression of the hypothalamic KiSS/ kisspeptin, implying that Kiss1 neurons are sensitive to alterations in metabolic status (25,26).…”

Section: Metabolic Disorder and Women's Fertilitymentioning

confidence: 99%

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Metabolic Syndrome and Infertility in Women

Awlaqi¹,

Alkhayat²,

Hammadeh³

2016

IJWHR

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“…The mean duration of the cycles decreased to 32.6 ± 5.1 and 32.2 ± 4.7 in the third and fourth years after menarche, with an ovulatory rate of 37% and 45%, respectively. This ovulatory rate was documented by a salivary progesterone > 0.06 ng/mL, obtained on days 13, 18, 23, and 28 of each menstrual cycle (12). Thus, the measurement of serum progesterone on day 20-24 of the cycle to diagnose ovulation may be misleading.…”

Section: Ovulatory or Menstrual Dysfunctionmentioning

confidence: 99%

A rational approach to the diagnosis of polycystic ovarian syndrome during adolescence

Merino

Codner

Cassorla

2011

Arq Bras Endocrinol Metab

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SUMMARYPolycystic ovarian syndrome (PCOS) is a lifelong disorder characterized by hyperandrogenism and ovulatory dysfunction, with a wide spectrum of clinical symptoms and signs. Three different sets of diagnostic criteria have been established in order to define this disease in adult women, but there is controversy regarding the use of these criteria in adolescence. During puberty, the adult criteria for ovulatory dysfunction does not seem applicable, because an irregular menstrual pattern and a decreased ovulatory rate is a physiologic event during this period of life. Also, a higher prevalence of polycystic ovarian morphology (PCOM) may be observed during this period, so PCOM is not a useful criterion to define PCOS in young women. These findings suggest that a key factor to diagnose to PCOS during adolescence is hyperandrogenism. In addition, since PCOM is not clearly associated with hyperandrogenism during this period of life, the term "polycystic ovarian syndrome" during adolescence creates confusion and may be misleading. Arq Bras Endocrinol Metab. 2011;55(8):590-8 Keywords Hyperandrogenism; hirsutism; polycystic ovarian syndrome; adolescence; diagnosis; puberty; polycystic ovarian morphology; menstrual irregularities; anti-Müllerian hormone SUMáRio A síndrome dos ovários policísticos (SOP) é uma desordem que afeta pacientes por toda a vida e é caracterizada por hiperandrogenismo e disfunção ovariana, com um amplo leque de sintomas e sinais clínicos. Três diferentes conjuntos de critérios diagnósticos foram estabelecidos para definir essa doença em mulheres adultas, mas existem controvérsias relacionadas ao uso desses critérios na adolescência. Durante a puberdade, o critério de disfunção ovariana usado em adultos não parece aplicável, porque um padrão menstrual irregular e uma menor taxa de ovulação são eventos fisiológicos nesse período da vida. Além disso, uma maior prevalência de morfologia ovariana policística (MOP) pode ser observada nesse período, de forma que a MOP não é um critério útil para se definir a SOP em mulheres jovens. Esses achados sugerem que o hiperandrogenismo é um fator-chave para o diagnóstico da SOP na adolescência. Além disso, como a MOP não está claramente associada com o hiperandrogenismo durante esse período da vida, o termo "síndrome dos ovários policísticos" durante a adolescência cria confusão e pode ser errôneo. Arq Bras Endocrinol Metab. 2011;55(8):590-8 Descritores

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Ovulation rate in adolescents with type 1 diabetes mellitus

Cited by 37 publications

References 26 publications

Metformin for the Treatment of Hyperandrogenism in Adolescents with Type 1 Diabetes Mellitus

Metformin for the Treatment of Hyperandrogenism in Adolescents with Type 1 Diabetes Mellitus

Metabolic Syndrome and Infertility in Women

A rational approach to the diagnosis of polycystic ovarian syndrome during adolescence

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