Document Type : Research Paper

Authors

1 University of Baghdad- Institute Genetics Engineering and biotechnology for Postgraduate

2 Waset niversity – College Of Science

Abstract

This research was conducted to study the relationship between the polycystic ovarysyndrome (PCOS) and thyroid disorders. The study includes 50 infertile Iraqi women with polycystic ovary syndrome (PCOS) and 20 healthy women. Blood samples were collected from the Infertility Center of AL-Yarmok Teaching Hospital in Baghdad, during the period from November, 2010 to May, 2011. The age of infertile and fertile women was ranged from 16 to 45 years. Hormonal study of Estradiol (E2), Luteinizing hormone (LH), Follicle stimulating hormone (FSH), Testosterone (T),Thyroid stimulating hormone (TSH) , Triiodothyronine (T3) and Thyroxin(T4) was done for each patient. The results showed that there is a significant (P <0.05) decrease in E2 and FSH levels in PCOS women comparing with fertile women. Also a significant (P <0.05) increase in LHFSH was detected in PCOS women and fertile women and non-significant (P <0.05) differences in testosterone,TSH,T3 and T4 levels between infertile and fertile women.The hormonal profile according to Body mass index -BMI was showed to be significantly (P <0.05) decreased in testosterone in obese and overweight PCOS women, significant (P <0.05) decrease in FSH level in obese PCOS women and no significant differences in E2 and LH levels.According to the hirsute in PCOS women the hormonal profile showed a significant (P <0.05) decrease in E2 and FSH levels in hirsute PCOS women, no significant differences in LH levels and elevated in testosterone levels but without significance in hirsute PCOS

Keywords

Main Subjects

1. Marx. T. L. and Mehta. A.E.(2003). Polycystic ovary syndrome: pathogenesis and treatment over the short and long term. Cleve.Clin.j.Med.70(1):31-41
2. Guyton, A.C. and Hall, J.E. (2001). Female Physiology before pregnancy;and the female hormones. In: Medical Physiology. Guyton, A.C. and Hall, J.E. (eds.). W.B. Saunders Company. Philadelphia. Pp 929-943.
3. King. J. (2006) .Polycystic Ovary Syndrome. Journal of Midwifery & Women’s Health. 51(6):1-3.
4. Tsilchorozidou,T., Overton, C., and Conway, G.S.(2004). The pathophysiology of polycystic ovary syndrome. Clin. Endocrinol.60:1–17.
5. Ehrmann, D. A. (2005). Polycystic ovary syndrome. Nat. Engl. J .Med. 352:1223–1236
6. Guzick , D.S.( 2004). Polycystic ovary syndrome. Obstet. Gynecol. 103:181–193.
7.Hill ,K.M. (2003): The pathogenesis and treatment of PCOS. Nurse Pract. 28: 8-25.
8. Azziz, R., Ochoa, T.M., Bradley, E.L., Potter, H. D., Boots, L.R. (1995). Leuprolide and estrogen versus oral contraceptive pills for the treatment of hirsutism: a prospective randomized study. J. Clin. Endocrinol. Metab; 80:3406-3411.
9.Gilling-Smith, C., Willis, D.S., Beard, R.W., and Franks, S. (1994). Hypersecretion of and rostenedione by isolated thecal cells from polycystic ovaries. J. Clin .Endocrinol. Metab. 79:1158-1165.
10. Kiddy, D. S., Sharp, P.S., White, D.M., Scanlon, M.F., Mason, H.D., Bray, C.S., and Franks, S. (1990). Differences in clinical and endocrine features between obese and non-obese subjects with polycystic ovary syndrome: an analysis of 263 consecutive cases. Clin. Endocrinol.(Oxf) 32:213–220.
11. Macklon, N.S., and Fauser, B.C.(2000). Regulation of follicle development and novel approaches to ovarian stimulation for IVF. Hum. Reprod. Update 6(4):307-312.
12. Mulders ,A., Laven, J., Visser ,J.,Themmen, A., Jong, F., and Fauser, J.M. (2005). Anti-Mullerian hormone serum concentrations in normoovulatory and anovulatory women of reproductive age. J. Clin. Endo. Metab. 89(1):318-323.
13. Flegal, K. M., Graubard, B. I., Williamson, D. F., and Gail, M. H. (2005). Excess deaths associated with underweight, Overweight, and Obesity. J. American Med. Assoc. 293(15):1861-1867
14. Dewhurst, A.(1999). Textbook of Obstetrics and Gynaecology for Postgraduates. 7th edition. Page 52, chapter 6.
15. Bronstein , J., Tawdekar, S ., Liu, Y., Pawelczak, M., David, R ., and Shah ,B. (2011). Age of Onset of Polycystic Ovarian Syndrome in Girls May Be Earlier Than Previously Thought. J .Pediatr. Adolesc. Gynecol.24:15-20
16. Chang, R. J. and Katz, S.E.(1999). Diagnosis of polycystic ovary syndrome. Endocrinol. Metab. Clin. North Am.28(2):397–408.
17. Laven, J.S., Mulders, A.G., Visser, J.A., Themmen, A.P., De Jong, F.H. and Fauser, B.C.(2004): Anti-Mullerian hormone serum concentrations in normoovulatory and anovulatory women of reproductive age. J. Clin. Endocrinol. Metab. 89 :318–323.
18.Agarwal, S.K., Judd, H.L, and Magoffin, D.A. (1999). A mechanism for the suppression of estrogen production in polycystic ovary syndrome. J. Clin. Endocrinol. Metab, 81:3686–3691
19. Carmina, E., Rosato, F., Janni, A., Rizzo, M and Longo R.A. (2006). Extensive clinical experience: relative prevalence of different androgen excess disorders in 950 women referred because of clinical hyperandrogenism. J. Clin. Endocrinol. Metab.91:2–6.
20. Allahbadia, G.N .and Merchant, R.(2011). Polycystic ovary syndrome and impact on health. Mid. East Fert. Societ: 16:19–37.
21. Mc Cartney, C.R., Eagleson, C.A., and Marshall ,J. C.(2002). Regulation of gonadotropin secretion: implications for polycystic ovary syndrome. Semin. Reprod. Med. 20:317–336.
22. Taylor, A.E., McCourt, B., and Martin, K.A.(1997). Determinants of abnormal gonadotropin secretion in clinically defined women with polycystic ovary syndrome. J. Clin. Endocrinol. Metab. 82:2248–2256.
23. Begawy A.F., El-Mazny ,A .N., Abou-Salem ,N.A., and El-aweel.N.E. (2010) . Anti-Mu¨ llerian hormone in polycystic ovary syndrome and normo-ovulatory women: Correlation with clinical, hormonal and ultrasonographic parameters . Mid. East Fert. Soci. J. 15:253–258
24. Ehremaan, D.A. and Rosen field, R.L. (1992). Detection of functional ovarian hyperandrogenism in women with androgen excess .Nat. Engl. J. Med. 291:157-162.
25.Urbanek,M.,Lergo.R.S.,Driscoll.D.A.,Azziz.R., Ehrmann. D. A. ,Norman, et al. (1999).Thirty seven candidate genes for polycystic ovary syndrome: Strongest evidence for linkage is with follistatin. Proc. Natl. Acad.Sci.96 :8573-8578.
26. Arroyo, A., Laughlin, G.A, Morales, A.J and Yen, S.S. (1997). Inappropriate gonadotropin secretion in polycystic ovary syndrome: influence of adiposity. J .Clin. Endocrinol. Metab ;82:3728–3733.
27.Ganie,M.A., Laway, B.A., Wani, T.A., Zargar, M.A., Nisar, S . Ahamed ,F .and Khurana, M. L. (2011). Association of subclinical hypothyroidism and phenotype, insulin resistance, and lipid parameters in young women with polycystic ovary syndrome. Fertil. Steril. 95( 6):1-5
28. Dittrich, R., Kajaia , N ., Cupisti, S ., Hoffmann, I., Beckmann, M. and Mueller, A.(2009).Association of thyroid-stimulating hormone with insulin resistance and androgen parameters in women with PCOS. Repro. Bio .Med. 19(3):319-325.
29. Beydoun, H., Stadtmauer,L .,Russell, H., Zhaol, Y and Oehninger, S .(2009).Polycystic ovary syndrome, body mass index and outcomes of assisted reproductive technologies . Repro. Bio Med. Online. 18(6):856-863
30. Liou, T., Yang, J., Hsieh, C., Lee, C., Hsu,C., and Hsu, M. ( 2009 ). Clinical and biochemical presentations of polycystic ovary syndrome among obese and nonobese women . Fertil & Steril . 92(6), Pp1960-1965.
31. Benson, S. ,Janssen, O. E., Hahn, S., Tan, S., Dietz, T. and Man, K.(2008). Obisity, depression, and chronic low-grade inflammation in women with polycystic ovary syndrome. Brain, behave.& immune. 22:177-184.
32. Wang, J. X., Davies, M. J., and Norman, R. J.(2001). Polycystic ovarian syndrome and the risk of spontaneous abortion following assisted reproductive technology treatment. Hum. Reprod. 16:2606–2609.
33. Chang. R. J.(2004). A practical approach to the diagnosis of polycystic ovary syndrome. Amer .J. Obst. Gynecol. 191:713–717 .
34. Siegel, S., Futterweit, W. and Davies, T.F.( 2002). A C/T single nucleotide polymorphism at the tyrosine kinase domain of the insulin receptor gene is associated with polycystic ovary syndrome. Fertil. Steril. 78:1240-1243.
35. Freytag, U. (2003): Subcutaneous adipose tissue pattern in lean and obese women with PCOS. Diploma thesis-Francens-University Mader, S.S. (2004). Understanding Human Anatomy and Physiology. (5th .ed). M cCraw-Hill.Pp:1-443.
36. Deugarte, C.M., Woods, K.S., Bartolucci, A.A., and Azziz, R. (2006). Degree of facial and body terminal hair growth in unselected black and white women: toward a populational definition of hirsutism. J. Clin. Endocrinol. Metab. 91:1345–1350.
37. Azziz, R., Sanchez, L. A., Knochenhauer, E. S., Moran, C., Lazenby, J, and Stephens, K.C. (2004). Androgen excess in women: experience with over 1000 consecutive patients. J. Clin. Endocrinol. Metab.;89: 453–462.
38. Ovalle, F., and Azziz, R. (2002). Insulin resistance, polycystic ovary syndrome, and type 2 diabetes mellitus. Fert. Steril. 77(6): 1095-1105.
39.Ovalle .F., and Azziz. R. (2002). Insulin resistance, polycystic ovary syndrome and type 2 diabetes mellitus. Fert and Steril. 77(6): Pp1095-1105.