Infertility caused by PCOS—health-related quality of life among Austrian and Moslem immigrant women in Austria

BACKGROUND: The polycystic ovarian syndrome (PCOS) is the most common endocrine disorder affecting female fertility. In this study, we examined the symptomatology of PCOS and the health-related quality of life among infertility patients suffering from PCOS with different socio-cultural and ethnic background. METHODS: Symptomatology of PCOS, body composition characteristics as well as socio-economic factors were examined in 49 PCOS infertility patients of the University Clinic for Gynecology and Obstetrics, in Vienna, who originated from two socio-cultural subgroups, Austrian women and Moslem immigrant women. Additionally, the Cronins healthrelated quality of life questionnaire of women with PCOS was used in order to examine the impact of PCOS symptoms on the individual quality of life of the affected women. RESULTS: In terms of the appearance of the symptoms, the typical heterogeneity of PCOS could be found in both subgroups with no differences. However, differences in the health-related quality of life were impressive. Health-related quality of life of women from an Islamic background was affected to a greater degree than that of Austrian women, although no differences in symptomatology were found. This was true of all five domains investigated (infertility, overweight, hirsutism, menstrual irregularities and emotional problems). First of all, infertility was a dramatic problem for immigrant women. Islamic women had very high reproductive pressure. The Moslem immigrant PCOS women suffer more from infertility than do Austrian women. CONCLUSIONS: Health professionals should be sensitive to the ethnicity, religious and cultural background of their patients to provide the best possible medical support

Pregnancy outcome in women with polycystic ovary syndrome comparing the effects of laparoscopic ovarian drilling and clomiphene citrate stimulation in women pre-treated with metformin: a retrospective study

<p>Abstract</p> <p>Background</p> <p>Ovarian stimulation in women with polycystic ovary syndrome (PCOS) increases the risk for perinatal complications. Ovulation induction by laparoscopic ovarian drilling (LOD) might improve the overall pregnancy outcomes. The aim of our study was to assess the adverse events or effects on pregnancy of LOD and clomiphene citrate (CC) stimulation in patients who received metformin.</p> <p>Methods</p> <p>Setting: Academic research institution. We retrospectively analyzed the courses of 40 spontaneous pregnancies after LOD for CC-resistance, 40 pregnancies after CC stimulation, and 40 pregnancies after metformin treatment alone. Patients in the LOD and the CC groups had been pre-treated with Metformin. Primary outcome parameters were: the rate of multiple pregnancies; the rate of early pregnancy losses/miscarriages; the development of gestational diabetes, pregnancy-induced hypertension, and preeclampsia/HELLP-syndrome; premature delivery; and birth weight.</p> <p>Results</p> <p>The rate of twin pregnancies did not differ between the CC group (12.5%), the LOD group (7.5%), and the metformin only group (2.5%, p = 0.239). Seventeen women suffered an early miscarriage. There were no differences with regard to the rates of gestational diabetes, pregnancy-induced hypertension, preeclampsia, and preterm delivery. By analyzing all pregnancy complications together, the overall pregnancy complication rate was highest in the CC group (70.0%, 28/40), followed by the LOD group (45.0%, 18/40), and the metformin only group (47.5%, 19/40; p = 0.047).</p> <p>Conclusions</p> <p>CC, but not LOD, increases the complication rate in pregnant patients who received metformin.</p

Sensitivity analysis excluding 10 controls with systemic contraceptive agents during the study period.

<p>Sensitivity analysis excluding 10 controls with systemic contraceptive agents during the study period.</p

Basic characteristics of the study sample.

<p>Basic characteristics of the study sample.</p

To Assess the Association between Glucose Metabolism and Ectopic Lipid Content in Different Clinical Classifications of PCOS - Fig 3

<p>Bee swarm plot of ectopic lipids in different subgroups: controls (CONT), females with PCOS classified by NIH 1999 criteria (PCOS-NIH) as well as females with PCOS additionally classified by the Rotterdam 2003 criteria (PCOS-ROT): A: Hepatocellular lipids (HCL), B: intramyocellular lipids (IMCL) in soleus muscle, C: intramyocellular lipids (IMCL) in tibialis muscle. Lines indicate first, second (median) and third quartiles.</p

Spaghetti plots of plasma glucose, insulin and C-Peptide dynamics during a 2h-oral glucose tolerance test (OGTT) in control subjects, patients with PCOS classified by NIH 1999 criteria (PCOS-NIH) as well as patients with PCOS additionally classified by the Rotterdam 2003 criteria (PCOS-ROT).

<p>Spaghetti plots of plasma glucose, insulin and C-Peptide dynamics during a 2h-oral glucose tolerance test (OGTT) in control subjects, patients with PCOS classified by NIH 1999 criteria (PCOS-NIH) as well as patients with PCOS additionally classified by the Rotterdam 2003 criteria (PCOS-ROT).</p

Summary of missing OGTT data in PCOS and controls.

<p>Summary of missing OGTT data in PCOS and controls.</p

Correlation map representing the amount of association of clinical and metabolic parameters with hepatic (HCL) and intramyocellular (IMCL) lipid content of females with PCOS.

<p>The magnitude of correlation is indicated by the shape of the ellipses (circle represents no correlation) and color (dark color represents higher correlation; positive = blue, negative = red).</p