The regulation of the follicular synchronization and sensitivity of rats with PCOS by AMH during prolonged pituitary downregulation

Huang, Jiliang; Ding, Yang; Li, Zhiling

doi:10.1016/j.gene.2019.144106

Cited by 11 publications

(11 citation statements)

References 44 publications

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“…In this case, androgens cannot convert to estrogens and resulted in the elevation of androgen and consequently fall in estrogen levels (29). Besides, the increased level of testosterone in plasma, that resulted in prolonged diestrus phase and it was followed by an increase in body weight of PCOS group rats (30,31). Administration of long-term herbal extracts with phytoestrogens compounds can reduce plasma testosterone levels by the negative feedback effect on LH hormone (32).…”

Section: Resultsmentioning

confidence: 99%

Therapeutic efficacy of Trifolium pratense L. on letrozole induced polycystic ovary syndrome in rats

et al. 2020

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Polycystic ovary syndrome (PCOS) is considered as one of the leading endocrine disorders during reproductive age in women. This study designed to determine the therapeutic effects of red clover (Trifolium pratense) on letrozole-induced PCOS in vivo. Forty female Sprague–Dawley rats were equally divided into five groups. Control group with a regular sexual cycle received normal saline (letrozole vehicle). Letrozole (1 mg/kg) was used to induce the PCOS to the rats in the treatment groups. After induction of PCOS, four treatment groups received the normal saline, or clomiphene citrate (1 mg/kg), or red clover extracts (500 or 750 mg/kg) for 30-days. After treatment, ovary and uterus were removed, weighed, and the ovaries were subjected to histopathological studies. Serum testosterone and estradiol levels, antioxidant activities, and lipid profiles were evaluated. Red clover extracts and clomiphene citrate decreased testosterone levels and showed a significant increase in estradiol levels in comparison to PCOS induced group (p<0.05). Red clover administration restored the GSH, SOD and CAT levels (p<0.05) and decreased the NO and MDA levels (p<0.05). Treatments caused no significant change in levels of TG, TC, and FBG factors when compared to PCOS induced group (P>0.05). However, red clover (750 mg/kg) significantly increased HDL and decreased LDL levels when compared to PCOS induced group (P<0.05). Treatment with red clover reduced ovarian weight, volumes of ovarian, medulla, cortex and number of cysts and increased number of oocytes compared to PCOS group. Both red clover and clomiphene citrate could treat the letrozole induced PCOS in rats; however, red clover indicated antioxidant activities more than clomiphene citrate. Red clover may be used for discovering anti-PCOS drugs with lower side effects.

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Section: Resultsmentioning

confidence: 99%

Therapeutic efficacy of Trifolium pratense L. on letrozole induced polycystic ovary syndrome in rats

et al. 2020

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“…In the ovary, AMH is produced by the granulosa cells of early developing follicles and seems to be able to inhibit the initiation of primordial and FSH-induced follicle growth. Wang B et al speculated that in addition to the are up effect of GnRH-a, GnRH-a could reduce the AMH expression in small antral folliclea which increase the responsiveness to FSH and promote growth, however, the effect on larger follicles is not obvious (27,32). Mei's research provided the new evidence that GnRHa and GnRH-ant showed different effect on ovarian reserve and suggest that this discrepancy might be caused by different regulation on intraovairan autocrine/paracrine factors AMH and SCF through GnRHR-I system (33).…”

Section: Resultsmentioning

confidence: 99%

Cumulative live birth rates between GnRH-agonist long and GnRH-antagonist protocol in one ART cycle when all embryos transferred: Real-Word Data of 18853 women from China

Yang

Zhang

Ding

et al. 2021

Preprint

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Background: A consensus has been reached on the preferred primary outcome of all infertility treatment trials, which is the cumulative live birth rate (CLBR). Some recent randomized controlled trials (RCTs) and retrospective studies have compared the effectiveness of GnRH-antagonist and GnRH-agonist protocols but showed inconsistent results. Studies commonly used conservative estimates and optimal estimates to described the CLBR of one incomplete ART cycle and there are not many previous studies with data of the complete cycle to compare CLBRs in GnRH-antagonist versus GnRH-agonist protocols.Methods: A total of 18853 patients have completed their first IVF cycle including fresh and subsequent frozen-thawed cycles during 2016-2019, 16827 patients were treated with GnRH-a long and 2026 patients with GnRH-ant protocol. Multivariable logistic analysis was used to evaluate the difference of GnRH-a and GnRH-ant protocol in relation to CLBR.Results: Before PSM, significant differences were observed in baseline characteristics and the CLBR was 50.91% in the GnRH-a and 33.42% in the GnRH-ant (OR: 2.07; 95%CI: 1.88-2.28; P<0.001). Stratified analysis showed the CLBR of GnRH-ant was lower than GnRH-a in suboptimal responders(46.89% vs 27.42%, OR=2.34, 95%CI=1.99-2.74; P<0.001) and no differences of CLBR were observed in other patients between protocols. After adjusting for potential confounders, multivariable logistic analysis found the CLBR of GnRH-ant group was lower than that of GnRH-a group (OR=2.11, 95%CI:1.69-2.63,P<0.001). After PSM to balence the baseline between groups, the CLBR of GnRH-a group was higher than that of GnRH-ant group in suboptimal responders((38.61% vs 28.22%, OR=1.60, 95%CI= 1.28-1.99; P<0.001) and the normal fertilization rate and number of available embryo in GnRH-a were higher than these of GnRH-ant groups in suboptimal responders (77.39% vs 75.22%; 2.86±1.26 vs 2.61±1.22; P<0.05). No significant difference was observed in other patients between different protocols.Conclusions: It is crucial to optimize the utilization of protocols in different ovarian response patients and reconsider the field of application of GnRH-ant protocols in China.

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“…A 5-10% loss in BW over a period of six months, regardless of body mass index (BMI), may be associated with improvements in central obesity, hyperandrogenism, and ovulation rate [18,19]. For women who desire to become pregnant, clomiphene citrate (CC) has been long considered as the front-line treatment based on its high cost-effectiveness [2,[19][20][21][22][23][24], although recommendations from the international evidence-based guideline for the assessment and management of PCOS favored that letrozole should be considered first line pharmacological treatment for ovulation induction in women with PCOS with anovulatory infertility and no other infertility factors to improve ovulation, pregnancy and liver birth rates [10]. CC is a competitive inhibitor of estrogen that binds to estrogen receptors (ERs), resulting in an increase of the hypothalamic gonadotropin-releasing hormone (GnRH) pulse frequency and circulating concentrations of follicle-stimulating hormone (FSH) and luteinizing hormone (LH).…”

Section: Introductionmentioning

confidence: 99%

“…Most importantly, the cost of CC is very low. CC treatment also has fewer side effects and a lower chance of multiple pregnancies (2-13%) compared to other medical treatments, such as using GnRH agonists or antagonists, aromatase inhibitors (AIs), and gonadotropin stimulation treatments [2,[19][20][21][22][23][24]. The initial dose of CC is 50 mg per day.…”

Section: Introductionmentioning

confidence: 99%

“…Directly using another agent alone in place of CC in the management of POCS women is also widely used. These agents include metformin [18,19,25,[30][31][32][33][34][35][36][37]40]; rosiglitazone or rosiglitazone alone [21,33,40]; and AIs, such as letrozole [21,23,42] and gonadotropins [20,[22][23][24][26][27][28][29][30][31][32][33][34][35][36][37]. A Cochrane Database Systematic Review in 2017 suggested the potential benefits of a combination of metformin and CC in clinical pregnancy and ovulation among PCOS women with infertility compared to the use of CC alone [40].…”

Section: Introductionmentioning

confidence: 99%

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Molecular Mechanisms of Laparoscopic Ovarian Drilling and Its Therapeutic Effects in Polycystic Ovary Syndrome

Seow¹,

Chang

Chen

et al. 2020

IJMS

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Polycystic ovary syndrome (PCOS) is a common endocrinopathy, characterized by chronic anovulation, hyperandrogenism, and multiple small subcapsular cystic follicles in the ovary during ultrasonography, and affects 5–10% of women of reproductive age. PCOS is frequently associated with insulin resistance (IR) accompanied by compensatory hyperinsulinemia and, therefore, presents an increased risk of type 2 diabetes mellitus (DM). The pathophysiology of PCOS is unclear, and many hypotheses have been proposed. Among these hypotheses, IR and hyperandrogenism may be the two key factors. The first line of treatment in PCOS includes lifestyle changes and body weight reduction. Achieving a 5–15% body weight reduction may improve IR and PCOS-associated hormonal abnormalities. For women who desire pregnancy, clomiphene citrate (CC) is the front-line treatment for ovulation induction. Twenty five percent of women may fail to ovulate spontaneously after three cycles of CC treatment, which is called CC-resistant PCOS. For CC-resistant PCOS women, there are many strategies to improve ovulation rate, including medical treatment and surgical approaches. Among the various surgical approaches, one particular surgical method, called laparoscopic ovarian drilling (LOD), has been proposed as an alternative treatment. LOD results in an overall spontaneous ovulation rate of 30–90% and final pregnancy rates of 13–88%. These benefits are more significant for women with CC-resistant PCOS. Although the intra- and post-operative complications and sequelae are always important, we believe that a better understanding of the pathophysiological changes and/or molecular mechanisms after LOD may provide a rationale for this procedure. LOD, mediated mainly by thermal effects, produces a series of morphological and biochemical changes. These changes include the formation of artificial holes in the very thick cortical wall, loosening of the dense and hard cortical wall, destruction of ovarian follicles with a subsequently decreased amount of theca and/or granulosa cells, destruction of ovarian stromal tissue with the subsequent development of transient but purulent and acute inflammatory reactions to initiate the immune response, and the continuing leakage or drainage of “toxic” follicular fluid in these immature and growth-ceased pre-antral follicles. All these factors contribute to decreasing local and systemic androgen levels, the following apoptosis process with these pre-antral follicles to atresia; the re-starting of normal follicular recruitment, development, and maturation, and finally, the normalization of the “hypothalamus–pituitary–ovary” axis and subsequent spontaneous ovulation. The detailed local and systematic changes in PCOS women after LOD are comprehensively reviewed in the current article.

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The regulation of the follicular synchronization and sensitivity of rats with PCOS by AMH during prolonged pituitary downregulation

Cited by 11 publications

References 44 publications

Therapeutic efficacy of Trifolium pratense L. on letrozole induced polycystic ovary syndrome in rats

Therapeutic efficacy of Trifolium pratense L. on letrozole induced polycystic ovary syndrome in rats

Cumulative live birth rates between GnRH-agonist long and GnRH-antagonist protocol in one ART cycle when all embryos transferred: Real-Word Data of 18853 women from China

Molecular Mechanisms of Laparoscopic Ovarian Drilling and Its Therapeutic Effects in Polycystic Ovary Syndrome

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