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T Bergh

Publications and source records attributed to T Bergh.

At least 19 recordsLinked to original sources
PubMed2006

Construction of an evidence-based integrated morphology cleavage embryo score for implantation potential of embryos scored and transferred on day 2 after oocyte retrieval.

BACKGROUND: Evidence-based morphological embryo scoring models for ranking of implantation potential are still scarce, and the need for a precise model increases when aiming for singleton pregnancies. METHODS: Prospectively, 2266 IVF/ICSI double-embryo, day 2 transfers were studied. The five variables scored in 3- to 5-step scales for the embryos transferred are blastomere number (BL), fragmentation, blastomere size variation ('equality', EQ), symmetry of the cleavage and mononuclearity in the blastomeres (NU). The scoring results of embryos with an individual traceability from scoring to implantation, i.e. treatments resulting in either no implantation (n=1385) or twin implantation (n=228), were studied for prognostic potential. RESULTS: Although all five variables correlated highly with implantation potential, only BL, NU and EQ remained independently significant after regression analysis. The equation thus derived formed the basis for a 10-point integrated morphology cleavage (IMC) embryo score. A table with the scoring point for each possible combination of the embryo variables is presented. The scoring model was statistically validated on the singleton pregnancy group (n=653). CONCLUSIONS: We suggest that this IMC embryo scoring, incorporating cleavage stage and information on the variation in blastomere size and the number of mononucleated blastomeres, may optimize embryo ranking and selection for day 2 transfers.

Adult↗
PubMed2003

Public opinion regarding oocyte donation in Sweden.

BACKGROUND: Oocyte donation has been permitted by Swedish legislation since January 2003. According to the law, offspring have the right to receive identifying information about the donor when they reach a mature age. The aim of the present study was to investigate public opinion regarding different aspects of oocyte donation. METHODS: A study-specific questionnaire regarding attitudes towards aspects of oocyte donation was sent to a randomized sample of 1000 women (73% response) and 1000 men (56% response). RESULTS: A majority of respondents supported treatment with oocyte donation. Seventeen per cent of the women considered donating in the future, whereas 56% of the men would support their partner. While nearly half of the respondents considered that offspring should receive identifying information of the donor, one-third were opposed to this. Overall, women were more positive towards disclosure to the offspring than were men (P < 0.001). CONCLUSIONS: The present results indicate strong support for the use of oocyte donation among a subset of the Swedish population. There was considerable interest among women in donating oocytes anonymously. While a majority advocated openness regarding the donation between parents and child, there was less support for the offspring to have a legal right to receive identifying information about their donor.

Adult↗
PubMed2003

Characterization of potential oocyte donors in Sweden.

BACKGROUND: Oocyte donation has been permitted by Swedish legislation since January 2003. While donors are anonymous to the receiving couple, offspring have the legal right to receive identifying information about the donor when they reach adult age. Our aim was to investigate factors of potential importance for women's willingness to donate oocytes. METHOD: A questionnaire regarding attitudes towards oocyte donation was sent to a randomized sample of 1000 women aged 25-35 years (73% response). RESULTS: Seventeen percent would consider donating oocytes, whereas 39% opposed this, and 44% were doubtful. Potential donors were less likely to have children of their own and thought the genetic link was of less importance. Potential donors would feel happy about helping a childless couple, and 38% would be glad to be contacted by the offspring. Factors that would increase women's willingness to donate were being able to talk to experienced donors, proximity to the clinic and availability of counselling. CONCLUSION: The results indicate considerable interest in donating oocytes among a subset of women in Sweden. Potential donors associated donation with altruistic motives. The issue of offspring's right to know about their origin appears to be complicated. This suggests that information about the consequences of donation is of great importance.

Adult↗
PubMed2001

Factors influencing the decision to use or discard cryopreserved embryos.

BACKGROUND: Couples' reasons for discarding supernumerary fertilized cryopreserved embryos and gender differences in attitudes toward the frozen embryos were investigated among Swedish couples undergoing in vitro fertilization (IVF) at a private clinic. At the time of the study Swedish law stipulated that couples could keep their frozen embryos for a maximum of one year, with the possibility of an extension based on individual requests. METHODS: A questionnaire with structured and unstructured questions was sent to 124 women and 124 men who had entered the IVF treatment and obtained supernumerary embryos from 1 January 1994 to 1 March 1995. Eighty-two women and 74 men completed the questionnaire. RESULTS: After a mean storage time of 25.3 (+/-11.0) months 22 (26.8%) of the responding couples had their embryos discarded. The reasons were mainly practical, such as a positive outcome of IVF and a legally too short storage time. Comparisons between women and men showed that fewer women (13;17.6%) than men (20;27%) had been uncertain during the IVF treatment about using the frozen embryos at a later date and that men more often than women expressed anxieties about possible effects of the freezing procedure on the potential child (p=0.009). CONCLUSION: A positive outcome of the original IVF treatment and a short maximum legal time of cryopreservation were the most common reasons why couples discarded their embryos. The men more often than women expressed anxieties about possible effects on a potential child. The results emphasize the need for giving detailed information to the couples about cryopreserved embryos and children born by this method.

Adult↗
PubMed2001

The impact of frozen embryos on emotional reactions during in vitro fertilization.

BACKGROUND: Emotional reactions of couples were investigated during in vitro fertilization (IVF) at a private clinic in Sweden. The purpose was to compare such reactions between couples who obtained supernumerary embryos that could be cryopreserved and couples without such embryos. METHODS: Forty women and men undergoing IVF treatment monitored individually their emotional reactions daily for one complete treatment cycle from the first day of down-regulation until the outcome of treatment was known. Ratings were extracted and analyzed from two separate days; the very first day of treatment and the day of embryo transfer. RESULTS: The group of women (n=16; 40%) with supernumerary embryos suitable for cryopreservation reported a greater increase in optimism than the group (n=24; 60%) without such embryos (p=0.024). Correspondingly, women with supernumerary embryos reported less pessimism than women without such embryos (p=0.014). Among men there was no difference in optimism or pessimism between the groups. The women and men with supernumerary embryos did not differ in distress reactions compared to those women and men without such embryos. There was no correlation between optimism and distress on the day of embryo transfer in women; r=-0.167 and men; r=-0.135 respectively. CONCLUSION: The presence of frozen embryos increased optimistic and reduced pessimistic feelings about pregnancy among women undergoing IVF treatment. However, the couples' increased optimism on the day of embryo transfer did not seem to reduce their experience of distress.

Adult↗
PubMed2000

Addition of gonadotrophin-releasing hormone agonist and/or two inseminations with husband's sperm do not improve the pregnancy rate in superovulated cycles.

BACKGROUND: A prospective randomized study was performed to evaluate the addition of a gonadotropin releasing hormone agonist (GnRH-a) during treatment with human menopausal gonadotropins (hMG) in cycles with artificial inseminations with husband's washed sperm (AIH). We also compared the pregnancy rate per cycle after one versus two AIHs. METHODS: We designed a 22 factorial trial. A total of 172 couples with unexplained infertility (n=88), endometriosis (n=39), or cervical (n=24) or male (n=21) factors were included, of whom 161 fulfilled the inclusion criteria and treatment. Eighty-one women were treated with GnRH-a/hMG and another 80 with hMG only, respectively. RESULTS: The pregnancy rates did not differ between the two stimulation protocols (12% for GnRH-a/hMG and 9% for hMG). With GnRH-a/hMG more follicles >15 mm (3.4 and 2.4, respectively; p<0.01) and a higher multiple pregnancy rate after 20 weeks of gestation were observed (55% vs. 0%; p<0.05). Eighty-seven women were treated with one AIH, whereas 65 women received two AIHs on two consecutive days. The pregnancy rates were similar in these two groups (11% and 9% respectively; n.s.) CONCLUSION: It is concluded that neither addition of GnRH-a before and during controlled ovarian hyperstimulation nor two AIHs compared with one single AIH per cycle has a beneficial effect on the pregnancy rate. However, GnRH-a increases the risk for multiple pregnancies.

Adult↗
PubMed1999

Deliveries and children born after in-vitro fertilisation in Sweden 1982-95: a retrospective cohort study.

BACKGROUND: In-vitro fertilisation is an effective treatment for infertility, but there is concern about the health of children. We investigated, in a retrospective registry study, malformations, cancers, and deaths in the complete Swedish in-vitro-fertilisation birth cohort compared with the general population. METHODS: We collected data from all in-vitro-fertilisation clinics in Sweden and compared the obstetric outcomes of babies (n=5856) born between 1982 and 1995 with all babies born in the general population (n=1,505,724) during the same period, according to data from the Swedish Medical Birth Registry and the Registry of Congenital Malformations. We investigated the incidence of childhood cancer through the Swedish Cancer Registry. Data were stratified for maternal age, parity, previous subfertility, year of birth, and multiple of pregnancies. FINDINGS: Multiple births occurred in 27% of pregnancies compared with 1% in the control group. In the in-vitro-fertilisation group, more babies were born preterm (<37 weeks) than controls (30.3 vs 6.3%) and more had low birthweights (<2500 g, 27.4 vs 4.6%). The perinatal mortality was 1.9% in the in-vitro fertilisation group and 1.1% in the controls. For in-vitro-fertilisation singletons, the risk ratios, adjusted for year of birth, for very preterm birth (<32 weeks) and very low birthweight (<1500 g) were 3.54 (95% CI 2.90-4.32) and 4.39 (3.62-5.32), respectively. Malformations occurred in 5.4% of all babies in the in-vitro-fertilisation group (1.39 [1.25-1.54]), and the rates of neural-tube defects and oesophageal atresia were higher than those in the controls. There was no increase in childhood cancer in the in-vitro-fertilisation group. INTERPRETATION: A high frequency of multiple births and maternal characteristics were the main factors that led to adverse outcomes, and not the in-vitro-fertilisation technique itself. The clinical practice of in-vitro-fertilisation needs to be changed to lower the rate of multiple pregnancy.

Cohort Studies↗
PubMed1999

Gender differences in psychological reactions to infertility among couples seeking IVF- and ICSI-treatment.

BACKGROUND: Gender differences and similarities in psychological reactions related to infertility, perception of social support, the effect of infertility on the marital relationship and coping-style were investigated among Swedish couples seeking in vitro fertilization -- or intracytoplasmic sperm injection - treatment. METHODS: Ninety-one couples entering treatment completed the Infertility Reaction Scale, a self-report questionnaire with structured and open-ended questions and the Miller Behavioral Style Scale. RESULTS: The women reacted more strongly to their infertility than the men as measured by the Infertility Reaction Scale (p<0.05). Factor analysis of the Infertility Reaction Scale produced three factors for men and women respectively. The first factor that emerged for the men was 'The male role and social pressure' and the second factor was 'The major focus of life'. For the women the two first factors were reversed compared to those of the men. The third factor 'Effect on sexual life' was similar for men and women. Significantly more men than women had not confided in anyone about their infertility problem (p<0.001). The information-seeking coping style was significantly correlated with infertility distress only among men (p<O.05). CONCLUSION: The women reacted more strongly to their infertility than the men and they felt an intense desire to have a child. They received more social support than their partners, who experienced the fulfillment of the male role as well as the social role to become a parent as the most central aspects of infertility. The information-seeking coping style was significantly correlated with infertility distress only among men.

Adult↗
PubMed1998

Effects of triptorelin versus placebo on the symptoms of endometriosis.

OBJECTIVE: To compare the effect of a GnRH-agonist, triptorelin, versus placebo on the symptoms of endometriosis. DESIGN: A prospective, randomized, double-blind study of 6 months of treatment followed by 12 months of follow-up. SETTING: Departments of Obstetrics and Gynecology at two universities and one general hospital. PATIENT(S): Forty-nine women with symptoms of laparoscopically verified endometriosis. INTERVENTION(S): Triptorelin depot or placebo was given every 4 weeks. Clinical evaluation, including the Duration Intensity Behavior Scale and Visual Analogue Scale for pain, was performed before the injections and up to 12 months after treatment. A control laparoscopy was performed 4-6 weeks after the last injection. MAIN OUTCOME MEASURE(S): Quantitation of pain. RESULT(S): Twenty-four patients had active treatment and 25 received placebo. Pain symptoms according to both scales were significantly more reduced after 2 months of triptorelin treatment compared to placebo. The extent of endometriotic lesions was reduced 50% during triptorelin treatment and increased 17% during placebo. The average area of endometriotic lesions was reduced 45% during triptorelin treatment but was unchanged during placebo. Side effects, mainly hot flushes, were experienced by 80% of the actively treated group but also by 33% of patients in the placebo group. Because of recurrent symptoms, only five patients could be observed for 12 months after completion of treatment. CONCLUSION(S): Triptorelin reduces endometriotic lesions and pain to a significantly higher degree than placebo.

Adult↗
PubMed1998

Psychological reactions during in-vitro fertilization: similar response pattern in husbands and wives.

The purpose of this study was to examine differences in daily emotional, physical and social reactions among husbands and wives during in-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). Forty couples about to undergo ICSI or IVF at a private infertility clinic monitored their emotional, physical and social reactions daily for one complete treatment cycle from the first day of stimulation until the outcome of treatment was known (approximately 35 days). The results showed that men and women had a similar response pattern to oocyte retrieval, fertilization, embryo transfer and the pregnancy test. These stages were associated with the most significant changes in reactions for both spouses. The pattern of results suggested that the most important psychological determinant of reactions during IVF was the uncertainty of treatment procedures. Spouses appeared to be equally sensitive to this uncertainty and both appeared to respond to it with ambivalent feelings involving emotional distress and positive feelings of hope and intimacy.

Adult↗
PubMed1998

Distress level in men undergoing intracytoplasmic sperm injection versus in-vitro fertilization.

The purpose of this study was to compare the psychological reactions of men undergoing intracytoplasmic sperm injection (ICSI) (n=18) or in-vitro fertilization (IVF) (n=22). Men monitored their psychological reactions daily for one complete treatment cycle from the first day of down-regulation until the outcome of treatment was known (approximately 52 days). The results showed that ICSI patients reported marginally more distress on the days prior to retrieval than the IVF patients. Other than this difference the pattern of results indicated that the psychological reactions of men undergoing ICSI or IVF were similar and that there was no need to manage these patients differently during treatment. However, ICSI patients may benefit from some reassuring comments on the days prior to retrieval when they showed more anticipatory anxiety.

Adult↗
PubMed1997

Prognostic factors for the success rate of embryo freezing.

To find some prognostic factors for the outcome of frozen-thawed cycles, we have retrospectively analysed all frozen pre-embryos that were thawed during 1993 and 1994 at two in-vitro fertilization (IVF) units in Sweden. Supernumerary pre-embryos were frozen from 551 oocyte retrievals and these resulted in 660 frozen-thawed cycles which lead to 623 thawed embryo transfers. The outcome of these transfers was 137 clinical pregnancies with a pregnancy rate of 22% per frozen-thawed embryo transfers. Women <40 years of age had a higher birth rate than those > or =40 years, 19 and 5% respectively (P < 0.01). Transfers with two and three pre-embryos resulted in pregnancy rates of 23 and 27%, respectively, compared with 14% for transfer of one embryo. A pregnancy resulting from the initial embryo transfers had a predictive value for results of the subsequent frozen-thawed cycle. Embryo grade and cleavage stage at the time of freezing was important for the survival of the frozen-thawed pre-embryos. The pregnancy rate was not influenced by the cleavage stage, but a tendency toward a lower pregnancy rate was seen for the embryos with lower grading. To conclude, cryopreservation seems to be beneficial in women <40 years of age, who have supernumerary pre-embryos of good quality for freezing and of which at least two can be transferred.

Adult↗
PubMed1996

Elevated ambulatory day-time blood pressure in women with polycystic ovary syndrome: a sign of a pre-hypertensive state?

The aim of this study was to evaluate office and 24 h blood pressures in women with polycystic ovary syndrome (PCOS) and normal controls in relation to insulin sensitivity. Office blood pressure, insulin sensitivity (euglycaemic hyperinsulinaemic clamp) and body fat distribution (skin-folds, waits:hip ratio) were investigated in 36 women with PCOS and 55 controls [body mass index (BMI) for PCOS patients, mean (confidence interval) 26.3 (24.6-28.2); controls, 25.1 (24.0-26.9)], and ambulatory 24 h blood pressure was recorded in representative subgroups of 17 and 16 women respectively. Compared with the controls, the women with PCOS had higher day-time systolic (mean +/- SD, 126 +/- 11 versus 119 +/- 12 mm Hg, P < 0.05) and mean arterial blood pressures (92 +/- 7 versus 86 +/- 7 mm Hg, P < 0.05) in ambulatory recordings, and greater increases in pulse rate (70%; P < 0.05) from night to day-time recordings, whereas the groups did not differ significantly in day-time diastolic blood pressure (74 +/- 6 versus 70 +/- 6 mm Hg, P = 0.05) or in night-time recordings. The women with PCOS had a more pronounced truncal-abdominal fat distribution (P < 0.05) and a lower insulin-mediated glucose disposal (P < 0.01) during the clamp. The increased day-time blood pressures in women with PCOS persisted after adjusting for BMI, body fat distribution and insulin resistance. It is concluded that women with PCOS have an increased prevalence of labile blood pressure, which may indicate a pre-hypertensive state, adding a further risk factor for cardiovascular disease in these women.

Androgens↗
PubMed1995

Restored insulin sensitivity but persistently increased early insulin secretion after weight loss in obese women with polycystic ovary syndrome.

The impact of weight reduction on metabolic, endocrine, and anthropometric variables was studied in 13 obese, insulin-resistant women with the polycystic ovary syndrome (PCOS). Insulin sensitivity (euglycemic insulin clamp), insulin secretion and glucose tolerance (iv glucose tolerance test), basal sex steroid hormones, gonadotropins and free fatty acids (FFA), skin folds and waist hip ratio (WHR) were evaluated before (PCO-BD) and after (PCO-AD) diet-induced weight reduction to a weight stable level [mean (SD) diet duration 14.9 (6.2) months]. Mean weight loss was 12.4 kg (4.7; P < 0.0001), equalling a reduction from a body mass index (BMI) of 32.2 (3.7) kg/m2 to 27.6 (3.7; P < 0.0001) kg/m2. The results were compared with those of two groups of weight stable (no diet) women, 21 with PCOS (PCO-ND) and 23 normal control subjects (C), who were matched to the BMI the diet group reached after weight loss. Insulin sensitivity index (M/I) improved on average 132% (P < 0.001) and plasma FFA by 32% (P < 0.01), serum sex hormone binding globulin levels increased by 35% (P < 0.01), and the sum of truncal-abdominal skin-folds (subscapular, umbilical, and suprailiacal) were reduced by 28% (P < 0.0001), whereas the early insulin response to iv glucose, the levels of gonadotropins and androstenedione, and the femoral sc fat did not change significantly with weight loss. M/I, levels of SHBG and FFA and truncal-abdominal fat reached levels similar to the controls, whereas PCO-ND had lower M/I (P < 0.01) and SHBG levels (P < 0.0001), greater concentrations of FFA (P < 0.01) and truncal-abdominal fat (P < 0.05) than C. Among women with normal glucose tolerance, the insulin increment was higher in both PCO-AD (P < 0.05) and PCO-ND (P < 0.01) than in C. There was a strong correlation between M/I and sum of truncal-abdominal skinfolds in all groups (PCO-BD: r = 0.82; P < 0.001, PCO-AD: r = 0.68; P < 0.05, PCO-ND: r = 0.81; P < 0.0001, C: r = 0.44; P < 0.05). The variation in M/I in PCO-AD and PCO-ND (pooled) was best explained by FFA and truncal-adbominal fat (model R2 = 0.67). In conclusion, insulin resistance in obese women with PCOS was reduced by weight loss to similar levels as BMI-matched control subjects, suggesting that insulin resistance in PCOS is not a feature of PCOS per se.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1994

Serum lipoprotein lipid profile in women with the polycystic ovary syndrome: relation to anthropometric, endocrine and metabolic variables.

OBJECTIVE: Although often associated with insulin resistance and glucose intolerance, various lipoprotein abnormalities have been found in polycystic ovary syndrome (PCOS) but not invariably so when the degree of obesity is taken into account. We have therefore investigated the serum lipid profile in a group of women with polycystic ovary syndrome with and without obesity. DESIGN: Cross-sectional study of serum lipoprotein lipids and plasma free fatty acids in relation to anthropometric, metabolic and hormonal variables in women with PCOS and weight-matched controls. PATIENTS: Twenty-four obese (Pob, mean BMI +/- SD 30.6 +/- 3.3 kg/m2) and 25 non-obese (Pnob, 22.2 +/- 2.3 kg/m2) women with PCOS. Twenty obese (Cob, 30.2 +/- 3.5 kg/m2) and 20 non-obese (Cnob, 21.4 +/- 1.5 kg/m2) controls. MEASUREMENTS: Fasting concentrations of plasma free fatty acids, serum cholesterol and triglycerides in high density lipoproteins (HDL), low density lipoproteins (LDL) and very low density lipoproteins (VLDL) in relation to insulin sensitivity index (M/I; assessed with the euglycaemic insulin clamp), glucose tolerance (k-value; intravenous glucose tolerance test), basal serum hormone concentrations, and body fat distribution (skinfolds and waist hip ratio). RESULTS: Plasma concentrations of free fatty acids were markedly higher in Pob than in the other groups (all P < 0.001). The lipoprotein lipids did not differ between Pob and Cob, or between the non-obese groups, whereas both obese groups had higher serum concentrations of triglycerides, totally and in VLDL, and lower HDL-cholesterol than their non-obese counterparts. Pob also had higher serum levels of total and LDL-cholesterol than Pnob. Pob had a more pronounced subcutaneous truncal-abdominal adiposity, higher fasting insulin levels and lower M/I than the other groups, and a lower k-value than Cob. Cob had higher levels of fasting insulin than Cnob. Free fatty acid levels correlated with the k-value (inversely) in both women with PCOS and controls, and with M/I (inversely), age and testosterone levels in PCOS. Stepwise regression analysis for the total population, comparing endocrine, anthropometric and metabolic explanatory variables, showed that the serum levels of HDL-cholesterol and triglycerides were mainly correlated with body fat distribution (both) and fasting insulin levels (triglycerides), and levels of total and LDL-cholesterol with BMI and age. CONCLUSIONS: Plasma free fatty acid correlations were markedly increased in obese women with PCOS, closely associated with the lower insulin sensitivity and lower glucose tolerance in these women. In spite of these profound metabolic aberrations, the lipoprotein lipid profile was not significantly more abnormal in obese women with PCOS than in their weight-matched controls.

Adult↗
PubMed1994

The independent effects of polycystic ovary syndrome and obesity on serum concentrations of gonadotrophins and sex steroids in premenopausal women.

OBJECTIVE: To investigate the basal levels of gonadotrophins and sex steroids, with special reference to the effects of obesity and body fat distribution, in premenopausal women, both those with polycystic ovary syndrome (PCOS) and those with normal ovaries and regular menstrual cycles. DESIGN: Cross-sectional study. The separate effects of obesity (and body fat distribution and fasting insulin levels) and PCOS on endocrine variables were evaluated by means of analysis of covariance. PATIENTS: Sixty-seven women with anovulatory menstrual cycles and polycystic ovaries according to ultrasonography and 59 women with normal ovaries and regular cycles, both groups covering a wide range of body mass index (BMI, PCOS, 17.6-37.4, mean 25.7 kg/m2; controls, 18.8-40.9, mean 25.1 kg/m2). MEASUREMENTS: Serum levels of gonadotrophins, sex steroid hormones, prolactin and GH obtained in the early follicular phase in the controls, fasting insulin levels, anthropometric measures (BMI, skinfolds, waist hip ratio). RESULTS: Mean serum concentrations of LH, androstenedione, testosterone, the free androgen index (FAI; all P < 0.0001) and DHEAS (P < 0.01) were higher, and serum FSH (P < 0.01) and serum SHBG levels lower (P < 0.0001), in the PCOS group than in the controls. Women with PCOS had a more pronounced upper body fat distribution and higher fasting insulin levels than the controls. Independent of PCOS, BMI was positively associated with serum levels of FSH (P < 0.001) and negatively with levels of LH (P < 0.05), LH/FSH ratio (P < 0.0001), SHBG (P < 0.0001) and androstenedione (P < 0.01), whereas for levels of testosterone, FAI and DHEAS the impact of obesity differed significantly between the groups. Thus, in the PCOS group, testosterone levels (P < 0.05) and the FAI (P < 0.001) were positively associated with BMI, whereas they were constant throughout the entire range of BMI in the controls. DHEAS levels were positively associated with BMI in the PCOS group (P < 0.05) and negatively in the controls (P < 0.01). Measures of upper body fat were related to testosterone and FAI levels, independent of BMI. CONCLUSIONS: Lower FSH levels were found in women with PCOS than during the early follicular phase of normally ovulating women, suggesting a role in anovulation in PCOS. Obesity itself exerted effects on endocrine variables, with the net result of a reduced LH/FSH ratio and lower serum levels of androstenedione and SHBG in both groups; obesity was associated with increased levels of DHEAS, testosterone and FAI exclusively in the women with PCOS. The results underline the endocrine impact of obesity and body fat distribution and the necessity of applying reference values of BMI matched subjects when establishing the endocrine profile of women with PCOS.

Adult↗
PubMed1994

Enhanced early insulin response to glucose in relation to insulin resistance in women with polycystic ovary syndrome and normal glucose tolerance.

Insulin secretion in response to iv glucose and insulin sensitivity (euglycemic hyperinsulinemic clamp) were evaluated in 49 women with polycystic ovary syndrome (PCOS) [body mass index (BMI), 17.6-37.2 kg/m2] and 42 control subjects (BMI, 18.8-38.1 kg/m2). Seven women with PCOS exhibited glucose intolerance with subnormal insulin secretion. Compared with control subjects, women with PCOS and normal glucose tolerance had an increased (36-56%) insulin increment, not explained by insulin resistance, and over the whole range of BMI. In contrast, insulin sensitivity was similar in women with PCOS and control subjects at BMI 21 kg/m2, but showed a more pronounced decline with increasing BMI in women with PCOS, who had 35% and 70% lower insulin sensitivities at BMI 28 and 35 kg/m2, respectively. After adjusting for truncal-abdominal sc fat distribution, which was more pronounced in the women with PCOS, the two groups had similar insulin sensitivity over the entire range of BMI (P = 0.9), whereas the difference in insulin increment was insignificant after adjusting for the free androgen index (testosterone x 100/sex hormone binding globulin; P = 0.16). Hemoglobin A1C levels were lower in women with PCOS than in the control subjects. It is concluded that the early insulin response to glucose was increased in women with PCOS, not accounted for by insulin resistance, closely associated to the increased androgenicity, and present also at low-normal BMI. In contrast, insulin resistance was seen only at higher BMI levels and was largely determined by the increased truncal-abdominal fat mass in PCOS.

Adult↗