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Endometrial Thickness as a Predictor of Endometrial Hyperplasia in Infertile Patients with Polycystic Ovary Syndrome

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Open Journal of Obstetrics and Gynecology 2018年第2期8卷 92-104页

作者： moamar al-jefout Aiman al-Qtaitat Dhamia al-Rahal Nedal al-Nawaiseh Futoon Rawashdeh Department of Obstetrics and Gynecology Faculty of Medicine Mutah University Mutah Jordan Department of Obstetrics and Gynecology College of Medicine & Health Sciences United Arab Emirates University Al Ain United Arab Emirates Department of Anatomy and Histology Faculty of Medicine Mutah University Mutah Jordan Department of Public Health Faculty of Medicine Mutah University Mutah Jordan

Background: Women with polycystic ovary syndrome (PCOS) are at higher risk of developing endometrial hyperplasia (EH). This study determined the prevalence of EH among women with infertility due to PCOS and assessed the predictive value of endometrial thickness (ET) measurement by trans-vaginal scan (TVS). Study Type & Population: This was a prospective study on infertile women with and without PCOS in which clinical data, hormonal profile, ET and endometrial biopsy (EB) for histopathological examination were collected. Methods: Thirty-seven women with PCOS and 23 women without PCOS presenting with infertility and/or abnormal uterine bleeding underwent TVS, hysteroscopy, laparoscopy and EB. Results: The overall prevalence of EH was 23.3 % while in PCOS group: 18.3 %. The mean ET (14.8 mm) was significantly higher in patients with EH (t = -2.74, P value = 0.009). The lower value of ET among women with EH was 10 mm. A cut-off point of 9.5 mm was set. An ET of >9.5 mm had 92.9% sensitivity and 51.85% specificity for the presence of EH. Women with ET ≥ 9.5 mm were 1.28 times more at risk of EH than women with ET 9.5 mm. Women with oligomenorrhea and irregular cycles were 5.5 and 13.7 times more at risk of EH compared to those with regular cycles, respectively. ET was positively correlated with insulin resistance (r = 0.439, P = 0.007). Conclusion: ET ≥ 9.5 mm predicts EH in infertile women with PCOS, with a high degree of sensitivity and a moderate degree of specificity. In PCOS patients with oligomenorrhea or irregular cycles, the risk of EH is higher than women with regular cycles.

关键词： Polycystic Ovary Syndrome Endometrial Hyperplasia Endometrial Thickness Oligomenorrhea Trans-Vaginal Scan Infertility

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The Effect of Balanced Hypocaloric Diet on the Anthropometric and Basic Metabolic Indicators in Infertile Women with Gluteofemoral Obesity

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Open Journal of Obstetrics and Gynecology 2019年第10期9卷 1325-1335页

作者： Natalia V. Artymuk Natalia A. Sukhova Olga A. Tachkova moamar al-jefout GA Ushakova Department of Obstetrics and Gynecology Kemerovo State Medical University Kemerovo Russia Hospital Therapy and Clinical Pharmacology Department Kemerovo State Medical University Kemerovo Russia The Department of Obstetrics & Gynecology College of Medicine and Health Sciences (CM & HS) United Arab Emirates University Al-Ain UAE The Department of Obstetrics & Gynecology Tawam Hospital Al-Ain UAE The Department of Obstetrics & Gynecology Faculty of Medicine Mutah University Karak Jordan The Department of Obstetrics and Gynecology Sechenov First Moscow State Medical University (Sechenov University) Moscow Russia.

Purpose: To evaluate the effect of balanced hypocaloric diet therapy on the anthropometric and basic metabolic indicators in obese women with infertility. Methods: The follow up interventional clinical study included 23 infertile women in reproductive age with grade I gluteofemoral obesity. all patients have prescribed a balanced hypocaloric diet (1200 kcal/day), underwent exercise and behavioral therapy. Before and after 12-month treatment, an anthropometric study was conducted, determining the level of metabolic and hormonal indicators. Results: The total final number of study participants was 20 patients. A decrease in body weight was achieved in 87% of patients from 4 to 24 kg, on the average, by 10.58 ± 5.70 kg, there was also a decrease in BMI from 32.53 ± 1.40 to 28.55 ± 2.50 kg/m2 (p 0.001). The decrease in body weight was accompanied by a statistically significant decrease in leptin levels (p 0.001), E1 (p = 0.049), E2 (p = 0.032), fasting glucose (p 0.001), HOMA-IR (p = 0.002), cholesterol (p al cycles were resumed in all women (p = 0.007) and pregnancy occurred within a year in 1 patient. Conclusion: The implementation of a hypocaloric diet for 12 months in infertile women with first-degree obesity helps to normalize metabolic and hormonal indicators, reduces body weight and restores ovulatory menstrual cycle in all patients.

关键词： Obesity Reproductive Age Infertility Diet Therapy Anovulation

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