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ESHRE/ ASRM PCOS

ч (2 3):

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); (

).

ESHRE/ASRM-Sponsored 3rd PCOS

Consensus Workshop Group

Bart C. J. M. Fauser, M.D.,a Basil C. Tarlatzis, M.D.,b Robert

W.Rebar, M.D.,c Richard S. Legro, M.D.,d

Adam H. Balen, M.D.,e Roger Lobo, M.D.,f Enrico Carmina,

M.D.,g Jeffrey Chang, M.D.,h Bulent O. Yildiz, M.D.,i

Joop S. E. Laven, M.D.,j Jacky Boivin, M.D.,k Felice Petraglia,

M.D.,l C. N. Wijeyeratne, M.D.,m

Robert J. Norman, M.D.,n Andrea Dunaif, M.D.,o Stephen Franks,

M.D.,p Robert A. Wild, M.D.,q Daniel Dumesic, M.D.,r

and Kurt Barnhart, M.D.s

A University Medical Center, Utrecht, the Netherlands; b

Medical School of Thessaloniki, Thessaloniki, Greece; c

University of Alabama,Birmingham, Alabama; d Penn State

College of Medicine, Hershey, Pennsylvania; e Leeds

Teaching Hospitals, Leeds, United Kingdom;f Columbia

University, New York, New York; g University of Palermo,

Palermo, Italy; h University of California, San Diego,

California;i Hacettepe University School of Medicine, Ankara,

Turkey; j Erasmus University Medical Center, Rotterdam, the

Netherlands; k Cardiff University, Cardiff, United Kingdom; l

University of Siena, Siena, Italy; m University of Colombo,

Colombo, Sri Lanka; n Robinson Institute, University of

Adelaide, Adelaide, South Australia, Australia; o

Northwestern University, Chicago, Illinois; p Imperial College,

London,United Kingdom; q Oklahoma University, Oklahoma

City, Oklahoma; r University of California, Los Angeles,

California; and s University of Pennsylvania, Philadelphia,

Pennsylvania

Polycystic ovary syndrome (PCOS) is the most

common endocrine disorder in females, with a

high prevalence. The etiology of this

heterogeneous condition remains obscure, and

its phenotype expression varies. Two widely

cited previous ESHRE/ASRMsponsored PCOS

consensus workshops focused on diagnosis

(published in 2004) and infertility management

(published in 2008), respectively. The present

third PCOS consensus report summarizes

current knowledge and identifies knowledge

РКps rОРКrНТЧР vКrТous аoЦОЧ’s СОКХtС КspОМts of PCOS.

Relevant topics addressed—all dealt with in a systematic fashion—include adolescence, hirsutism and acne, contraception, menstrual cycle abnormalities, quality of life, ethnicity, pregnancy complications, long-term metabolic and cardiovascular health, and finally cancer risk. Additional, comprehensive background information is provided separately in an extended online publication.

(Fertil Steril 2012;97:28–38. 2012 by American Society

for Reproductive Medicine.)

Schematic representation of the change in emphasis from early age

reproductive disorders to long-term metabolic and cardiovascular

health.

Fauser. ESHRE/ASRM PCOS Consensus. Fertil Steril 2012

Х я ъ з й я sex hormone-

binding globulin (SHBGдй я яз ъ з

я й

Insulin resistance

H'/perinsulmemia1

Decreased SHBG production by the liver

Increased ovarian production of androgen

Disordered release of LH/FSH"

Hyperandrogemsm Oligo-anovulation3

PCOS

И я

я . я

ч

я К

2. Pinar H. Kodaman et al. Statins: Do they have potential in the

treatment of polycystic ovary syndrome? Semin Reprod Med. 2008

Oxidative stress Insulin Resistance Systemic inflammation Hyperinsulinemia

Endothelial Dysfunction

Thecal Hyperplasia

Glucose intolerance Hypertension Dyslipidemia

T Insulin

Cardiovascular Disorders 1 2

Androgens

Hyperandrogenism i Anovulation i

Oxidative stress and its implications in

female infertility - a clinician's perspective.

Aqarwal A. Gupta S. Sharma R.

Author information

• 'CОЧtrО Пor AНvКЧМОН RОsОКrМС ТЧ HuЦКЧ Reproduction, Infertility, and Sexual Function,

Department of Obstetrics-Gynecology and

Glickman Urological Institute, The Cleveland

Clinic Foundation, OH 44195, USA

agarwaa@ccf.org

Abstract

Reactive oxygen species (ROS) have a role in the modulation of gamete quality and gamete interaction. Generation of ROS is inherent in spermatozoa and contaminating leukocytes. ROS influence spermatozoa, oocytes, embryos and their environment. Oxidative stress (OS) mediates peroxidative damage to the sperm membrane and induces nuclear DNA damage ROS can modulate the fertilizing capabilities of the spermatozoa. There is extensive literature on OS and its role in male infertility and sperm DNA damage and its effects on assisted reproductive techniques. Evidence is accumulating on the role of ROS in female reproduction. Many animal and human studies have elucidated a role for ROS in oocyte development, maturation, follicular atresia, corpus luteum function and luteolysis. OS-mediated precipitation of pathologies in the female reproductive tract is similar to those involved in male infertility. OS influences the oocyte and embryo quality and thus the fertilization rates. ROS appears to play a significant role in the modulation of gamete interaction and also for successful fertilization to take place.

ROS in culture media may impact postfertilization development, i.e. cleavage rate, blastocyst yield and quality (indicators of assisted reproduction outcomes). OS is reported to affect both natural and assisted fertility. Antioxidant strategies should be able to intercept both extracellular and intracellular ROS. This review discusses the sources of ROS in media used in IVF-embryo transfer and strategies to overcome OS in oocyte in-vitro maturation, in-vitro culture and sperm preparation techniques.

REPROD BIOMED ONLINE, 2005, NOV

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