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Do women with polycystic ovary syndrome have an increased risk of cardiovascular disease? Review of the evidence.

Polycystic ovary syndrome (PCOS) is a reproductive endocrine disorder found in ~5% of the general population and is characterized by chronic anovulation, hyperandrogenism, and insulin resistance. Women with PCOS are at increased risk for the development of Type II diabetes and may represent a unique group of women at high risk for the development of coronary heart disease (CHD). More adverse CHD risk profiles of women with PCOS have been demonstrated in several studies, yet actual health outcome studies have been inconclusive as to whether this translates into increased rates of cardiovascular disease in PCOS cases when compared to controls. This review focuses on the controversy surrounding the potential relationship between cardiovascular disease outcomes and polycystic ovary syndrome.

Adult↗

Post-cesarean section puerperal morbidity. The incidence and risk factors at Srinagarind Hospital.

We found that the incidence of post-cesarean puerperal morbidity at Srinagarind Hospital, Khon Kaen University was 5.5 per cent, which is very low compared to other reports. Statistically significant risk factors for post-cesarean puerperal morbidity included having less than 4 antenatal care visits, duration of labour longer than 12 hours and absence of prophylactic antibiotics.

Adolescent↗

Effect of the fungal toxin (zearalenone) on the reproductive system and fertility of male and female rats.

The fertility-inhibiting effects of long-term (8 weeks) consumption of maize infected with a fungus producing F2 toxin (zearalenone) was studied in adult male and female albino rats. The fertility rate was further decreased by 25-30% if the animals were kept on contaminated diet up to 14 weeks. The gonadal weight was decreased, follicular maturation and spermatogenesis were disturbed. The toxic diet consumed by mothers during pregnancy and lactation induced permanent changes in reproductive organs, disorders in vaginal cyclicity and disturbed fertility in the offspring. Neonatal administration of purified F2 toxin provoked similar changes. It is suggested that this fungal toxin may cause sterility syndrome in the offspring, similar to that produced by androgen or estrogen administration.

Animals↗

[Psychogenic sterility].

A question underlies this statement: is one justified in offering medically-assisted methods of procreation to couples with low fertility attributable to no identifiable cause? This question is based on the clinical experience of a psychoanalyst who has been working in the medical field of sterility for the past 15 years. Furthermore, this statement invites physicians to reflect on the possibilities open to them to take a request for a child in a way other than its face value. What then is one to make of the symptom of infertility with no cause as a response of the body to a problem which is not consciously identified by the subject affected.

Clinical Protocols↗

Unexplained infertility.

Unexplained infertility is a multifactorial disorder of reproduction. This review examines the potential contribution of decreased uterine perfusion, obscure luteal phase defect, intrinsic endometrial factor ovum captor inhibitor, microscopic endometriosis, and psychologic factors for the cause of unexplained infertility. Although specific therapy for unexplained infertility does not exist and treatment-independent pregnancy frequently occurs in this group of patients, many couples pursue treatment. In vitro fertilization, gamete intrafallopian transfer, zygote intrafallopian transfer, superovulation with intrauterine insemination, and direct intraperitoneal inseminations are several treatment options reported to be successful. However, a randomized prospective study using a uniform diagnostic assessment, strict entry criteria, identical ovulation-induction schemes, and semen-processing protocols is lacking to determine which patients will be most appropriately treated with each procedure and which is more effective. Unexplained infertility is not and should not be considered a permanent state. These couples should be considered to be subfertile rather than infertile.

Female↗

[Spontaneous abortions in women with androgyny].

Examinations of 1967 patients with various androgyny forms and their children have revealed the predominating role of environmental factors in the origin of reproductive function disorders in uncommon forms of androgyny. Employment of present-day informative methods of investigation, development of diagnostic criteria for the detection of various androgyny forms in patients liable to spontaneous abortions, and optimation of the therapeutic measures during pregnancy and without it help reduce the incidence of secondary sterility by four times and that of spontaneous abortions by 11 times; such measures promote prolongation of pregnancy to full-term and delivery of viable babies in 92% of the patients. Timely diagnosis and adequate pathogenetic therapy of androgyny in the mother is one of effective methods for the prevention of obstetric and gynecologic abnormalities in the offspring when adult.

Abortion, Spontaneous↗

[Pregnancy and labor after spontaneous and induced abortion].

The course of pregnancy, delivery and puerperium has been analysed in 91 women after spontaneous abortion in the past, 170 women after artificial abortion and in 91 women during the first pregnancy. The women after abortion were characterized by the advanced age the more frequent hemorrhage during the pregnancy, the renal failures, the preterm deliveries and the gestoses. After the artificial abortions the deliveries were longer and the blood loss greater. If compare women with the first pregnancy the women after abortion were characterized by more frequent complications during the puerperium. The clinical state of neonates from the group compared showed no significant differences.

Abortion, Induced↗