Study of the Therapeutic Effect of Some Hormonal Disorders Associated With Polycystic Ovary Syndrome in Iraqi Women
Abstract
Background: Polycystic ovary syndrome (PCOS) is a hormonal imbalance resulting from high levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) in females, leading to immaturity of eggs, ovarian cysts, irregular menstrual cycle, infertility, excessive facial hair growth, and acne. Materials and Methods: This study was conducted to follow up the therapeutic effect on some blood and hormonal variables of 35 patients with polycystic ovary syndrome (PCOS) from women suffering from infertility and infertility, and who visited Azadi Teaching Hospital and private laboratories in Kirkuk city, their ages ranged between (18 - 40 years). Sample collection and follow-up began by observing some clinical signs in addition to verifying the results of ultrasound examinations from early February 2023 to early November 2023. Each patient’s examinations were followed up before treatment and three months after taking the treatment. Result: The results we obtained after three months of treatment were compared with the results of the examinations of the patients in the pre-treatment stage and the control group. The treatment plan was based on modifying the patient's dietary lifestyle by following a healthy diet and giving treatment represented by oral contraceptives, fertility drugs and the use of sugar-lowering drugs such as Glucophage or Metformin, in addition to nutritional supplements such as antioxidants. Conclusion: The results showed a significant decrease in the level of hemoglobin before and after treatment compared to the control group. Other blood variables did not show any significant differences (0.05 < p). Pituitary hormones (LH, FSH) showed a significant decrease at a significant level (0.000 > p) respectively after three months of continuing to take the treatment. They also showed the therapeutic effect of improving the level of thyroid-stimulating hormone TSH and T3 changed numerically and not significantly after (3) months of taking the treatment compared to the pre-treatment stage and the control group. As for the T4 hormone, it did not show any significant differences during the treatment period. The therapeutic effect on the leptin hormone showed a significant decrease at a level (0.001 > p). ) After three months of taking the treatment compared to the pre-treatment stage and the control group.
References
Dubey, P., Reddy, S., Boyd, S., Bracamontes, C., Sanchez, S., Chattopadhyay, M., & Dwivedi, A. (2021). Effect of Nutritional Supplementation on Oxidative Stress and Hormonal and Lipid Profiles in PCOS-Affected.
Eiras MC, Pinheiro DP, Romcy KAM, Ferriani RA, Dos Reis RM, Furtado CLM.(2021). Polycystic Ovary Syndrome: the Epigenetics Behind the Disease. Reprod Sci: 1-15. Dunaif A. Polycystic ovary syndrome in 2011: Genes, aging and sleep apnea in polycystic ovary syndrome. Nature reviews Endocrinology. 8(2): 72.
Kathleen M Hoeger, Anuja Dokras, Terhi Piltonen.(2021) Update on PCOS: Consequences, Challenges, and Guiding Treatment, The Journal of Clinical Endocrinology & Metabolism, Volume 106, Issue 3, March 2021, Pages e1071-e1083
Azziz, R. (2016). Introduction: Determinants of polycystic ovary syndrome. Fertility and Sterility, 106(1), 4-5.
Kasililika, A. G., Odukogbe, A. T. A., Dairo, M. D., Balandya, B. S., & Bunuma, E. K. (2021). Lifestyle and oxidative stress status in infertile women in Dar es Salaam, Tanzania: comparative cross-sectional study. Middle East Fertility Society Journal, 26(1), 1-8.
Rooney, K. L., & Domar, A. D. (2022). The relationship between stress and infertility. Dialogues in clinical neuroscience. 143(2), 85-88
Yusuf,S.,Reddy,S., Ounpuu,S.Anand,S.Global burden of cardiovascular diseases : part I : general considerations ,the epidemiologic transition , risk factors ,and impact of urbanization. Circulation .2001 ;104(22):2746.
Alnajjar,M.K.,Abu-Naser ,S.S.Heart sounds analysis and classification for cardiovascular diseases diagnosis using deep learning ,Int.J.Aca.Eng.Res.2022;6(1):7-23.
Somigliana, E., Paffoni, A., Busnelli, A., Filippi, F., Pagliardini, L., Vigano, P., & Vercellini, P. (2016). Age-related infertility and unexplained infertility: an intricate clinical dilemma. Human Reproduction, 31(7), 1390-1396.
Practice Committee of the American Society for Reproductive Medicine. (2021). Fertility evaluation of infertile women: a committee opinion. Fertility and Sterility, 116(5), 1255-1265.
Altaee HA; Almadfa ZA; Alkhafaji ZH.(2013). Effect of obesity on ovarian reserve parameters in mid-reproductive agewomen, F1000Research 1:43
Chen, J., & Katznelson, L. (2022). The role of growth hormone for fertility in women with hypopituitarism. Growth Hormone & IGF Research ,pp: 63, 101458.
Carson, S. A., & Kallen, A. N. (2021). Diagnosis and management of infertility: a review. Jama, 326(1), 65-76.? ISO 690.
Shams Al-Din, Nouri Nouri Bashboush and Habib, Sanaa Obaidi. (2014). Study of reproductive hormonal changes in polycystic ovary syndrome in women affected by reproductive age in Najaf city, Journal of University of Kufa Life Sciences; 6 (3): 7-1.
Silva JF, Ocarino NM, Serakides R. (2018).Thyroid hormones and female reproduction. Biol Reprod Nov 1;99(5):907-921. doi :10.1093 /biolre/ioy115. PMID :29767691.
Childs,G.V.,Odle,A.K.,MacNicol,M.C.,& MacNicol ,A.M. (2021) .The importance of leptin to reproduction .Endocrinology ,162(2) ,bqaa204.
Youssef, Mai Nafeh and Ahmed, Munif Saab (2017) Study and follow-up of the therapeutic effect of some hormonal disorders associated with polycystic ovary syndrome in women in Tikrit city, Journal of the City of Science University College. 9.2. pp. 125-129.
Jadav, P. M. (2020). A study of Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH) in women of Polycystic Ovarian Disease (PCOD) at Tertiary Care Hospital of Gujarat, India. International Journal of Clinical Biochemistry and Research, 5(1), 112–115. https://doi.org/10.18231/2394-6377.2018.0022
Al-Mayahy, Laheeb Shaker Mahmoud (2021): Association of zinc alpha 2 glycoprotein and heat shock protein 70 with polycystic ovary syndrome in infertile Iraqi women. Master's thesis, College of Medicine, University of Karbala.
Zhang, Y.; Meng, F.; Sun, X.; Sun, X.; Hu, M.; Cui, P. and Wu, X.-K.(2019). Hyperandrogenism and insulin resistance contribute to hepatic steatosis and inflammation in female rat liver. Oncotarget , 9, 18180–18197.
Baldani, D. P.; Skrgatic, L.; Kasum, M.; Oguic S. K. and Herman M. (2019). Altered leptin, adiponectin, resistin and ghrelin secretion may represent an intrinsic polycystic ovary syndrome abnormality,Gynecological Endocrinology,35:5, 401-405.
Deswal, R.; Nanda, S. and Dang, A. S. (2019). Association of Luteinizing hormone and LH receptor gene polymorphism with susceptibility of Polycystic ovary syndrome. Systems biology in reproductive medicine, 65(5), 400-408.
Choi, J. and Smitz, J. (2014).Luteinizing hormone and human chorionic gonadotropin: distinguishing unique physiologic roles. Gynecol Endocrinol 30, 174–181.
Al-Jubouri, Liqa Hassoun Sakban (2014). Molecular and physiological study of polycystic ovary syndrome in women in Karbala Governorate - University of Karbala, College of Education for Pure Sciences - PhD thesis
Vale W, Wiater E, Gray P, Harrison C, Bilezikjian L, Choe S. (2004) Activins and inhibins and their signaling. Ann N Y Acad Sci. Dec ;1038:142-7.doi: 10.1196/annals.1315.023.PMID : 15838109.
Banaszewska B, Spaczyński RZ, Pelesz M, Pawelczyk L. (2003). Incidence of elevated LH/FSH ratio in polycystic ovary syndrome womenwith normo- and hyperinsulinemia. Annals Academiae. Medicae Bialostocensis. 48: 132-134.
Ran, Y.; Yi, Q. and Li, C. (2021). The Relationship of Anti-Mullerian Hormone in Polycystic Ovary Syndrome Patients with Different Subgroups. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 14, 1419.
Esmaeilinezhad, Z.; Babajafari, S.; Sohrabi, Z.; Eskandari, M. H.; Amooee, S. and Barati-Boldaji, R. (2019). Effect of synbiotic pomegranate juice on glycemic, sex hormone profile and anthropometric indices in PCOS: A randomized, triple blind, controlled trial. Nutrition, Metabolism and Cardiovascular Diseases, 29(2), 201-208.
AlFaisal, A. H. M. and Al-Deresawi, M. S. G. (2013). The correlation between thyroid hormones, reproductive hormones, body mass index (BMI) and hirsute in Iraqi women with polycystic ovary syndrome (PCOS). J of Univ. Anbar Pure Science, 7: 1-6.
Zwain, Z.M. and Aziz M. K. (2016). Polycystic ovarian syndrome and thyroid disorders. J. of Technical Research and Applications, 4(5):73-77.
Allahbadia,G.N .and Merchant, R.(2011). Polycystic ovary syndrome and impact on health. Middle East Fertity Society, 16:19–37.
Dittrich, R.; Kajaia, N.; Cupisti, S.; Hoffmann, I.; Beckmann, M. W. and Mueller, A. (2009). Association of thyroid-stimulating hormone with insulin resistance and androgen parameters in women with PCOS. Reproductive Biomedicine Online, 19(3): 319-325.
Kargasheh, F. B.; Ansaripour, S.; Borumandnia, N.; Moradi, N.; Zandieh, Z.;Maleki, M. and Vatannejad, A. (2021). Association of leptin G2548A and leptin receptor Q223R polymorphisms and their serum levels with infertility and recurrent pregnancy loss in Iranian women with PCOS. Plos one, 16(8), e0255920.
Salem A. M. (2021). Variation of Leptin During Menstrual Cycle and Its Relation to the Hypothalamic-Pituitary-Gonadal (HPG) Axis: A Systematic Review. International journal of women's health, 13, 445–458.
Yonis, R. A.; Fadhila S. Al-Doski.(2020). "Fluctuation of Serum Leptin Through Menstrual Cycle in Young Fertile Women in Mosul City". Annals of the College of Medicine, Mosul, 41, 2, 125-131.
Anwar, A. A.; Abdullah, N.; Padjalangi, A. N.; Hamid, F.; Mappeware, N. A. andLukas, E. (2021). Serum leptin concentration is correlated to insulin resistance in polycystic ovary syndrome (PCOS) patients. Molecular and Cellular Biomedical Sciences, 5(2), 93-7.
Namavar Jahromi, B.; Dabaghmanesh, M. H.; Parsanezhad, M. E. and Fatehpoor, F. (2017). Association of leptin and insulin resistance in PCOS: A case-controlled study. International journal of reproductive biomedicine, 15(7), 423–428.
Rashid, A.; Ganie, M. A.; Wani, I. A.; Bhat, G. A.; Shaheen, F.; Wani, I. A. and Shah, Z. A. (2020). Differential impact of insulin sensitizers vs. anti-androgen on serum leptin levels in Vitamin D replete PCOS women: a six month open labeled randomized study. Hormone and Metabolic Research, 52(02), 89-94.
