Bassim Alsadi

By Bassim Alsadi

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women of reproductive age. The clinical picture characterized by both endocrine disorders (hyperandrogenism, menstrual cycle disorders, obesity) and metabolic alteration with implications for women’s health and reproductive and metabolic consequences. Leventhal described for the first time a syndrome characterized by polycystic ovaries associated with menstrual cycle disorders, hirsutism, and obesity. The pathophysiology and other metabolic disorders that make the PCOS more complex than originally described are the most common cause of infertility linked to chronic anovulation. In fact, this is a multifactorial disorder that involves the hypothalamus, pituitary, ovary, adrenal, and peripheral adipose tissues, which are simultaneously involved in the pathogenesis of the syndrome.

Part of the book: Pathophysiology

By Bassim Alsadi

Polycystic ovary syndrome (PCOS) is a widespread pathology that affects multiple aspects of the general health of women, with long-term effects that go well beyond the reproductive age. The considerable variability of the clinical presentation, together with the lack of universally accepted diagnostic criteria, has so far contributed to making it difficult to identify a clear etiology of the disease. The exact etiology of PCOS is still not perfectly clear to date. It is therefore a multifactorial etiology, sharing of genetic and environmental factors. The contribution of genetics to the pathogenesis of PCOS is not due to a single gene but inheritance of gene clusters. The term “polycystic ovary syndrome” does not completely reflect the complexity of this syndrome which manifests a wide spectrum of clinical manifestations and comorbidity and important metabolic implications. PCOS patients showed an increase risk of developing type 2 diabetes mellitus, dyslipidaemia, endometrial cancer and cardiovascular diseases. The clinical aspects of PCOS are hyperandrogenism, oligomenorrhoea and ultrasound morphology of the ovary. The identification of the different manifestations of PCOS in the various phases of life, can, of course, help to organize individual therapeutic strategies and likely to prevent long-term metabolic consequences. The therapeutic choices will be based on the type and extent of the disorders and if there is a desire for pregnancy.

Part of the book: Polycystic Ovarian Syndrome

By Bassim Alsadi

Polycystic ovary syndrome (PCOS) is a common female endocrine and reproductive system disorder which is found in 6–10% of the female population. PCOS is considered a multifactorial metabolic disease characterized by several clinical manifestations, such as hyperandrogenism, polycystic ovaries and ovulatory dysfunctions. PCOS patients have an increase in the oxidative stress with generation of excessive amounts of reactive oxygen species (ROS) and reduction of antioxidant capacity. Oxidative stress is defined as the imbalance between the production of free radicals and the ability of the organism to defend itself from their harmful effects damaging the plasma membrane, DNA and other cell organelles, inducing apoptosis. Oxidative stress markers are circulating significantly higher in PCOS patients than in healthy women, so these can be considered as potential inducers of the PCOS pathology. Therefore, the central role of the oxidative stress may be involved in the pathophysiology of various clinical disorders including the PCOS. This chapter reviewed the role of oxidative stress and carnitine in PCOS patients, indicating the beneficial action of the carnitine pool, and L-carnitine contributes to restore the energy balance to the oocyte during folliculogenesis and maturation, which represent an important strategy to improve the intraovarian environment and increase the probability of pregnancy.

Part of the book: Polycystic Ovary Syndrome

By Bassim Alsadi

The basic concept of in vitro maturation (IVM) of oocytes in practice clinic consists of the collection of immature oocytes from small antral follicles before spontaneous ovulation and then left to mature in vitro. IVM is based on the observations of Pincus and Enzmann in 1935 and Edwards in 1965, which highlighted the spontaneous nuclear maturation of the follicles when they were removed from their ovarian context and matured in vitro, and these first discoveries of in vitro folliculogenesis laid the foundations for the present research on the technique of in vitro maturation. In vitro folliculogenesis represents not only the possibility of extending the availability of female gametes in terms of the number of fertilizable oocytes but also a model within which to understand the complex mechanisms that regulate the synergistic development between the follicle and the female gamete. Deeper understanding of the complex orchestration of maturation, nuclear and cytoplasmic, of the oocyte based on research of bases on animal oocytes allowed the clinical application of the IVM technique to begin in reproductive medicine.

Part of the book: IVF Technologies and Infertility