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A 28-year-old woman presented the clinic with below mentioned history
Lab Parameters (Pre-treatment):
Lab Parameters (Post- treatment):
Hence, there was marked improvement observed in the patient after three months of treatment with M-Torr 800 and Egrich along with lifestyle modification and was able to conceive during ovulation induction at fourth month.
Feedback message from the physician:
Polycystic ovary syndrome (PCOS) is most common endocrine disorder affecting a woman in her reproductive age. It is characterized by hyperandrogenism, oligo- or anovulation and infertility. However, thepathophysiology of PCOS still remains unknown.
The mammalian target of rapamycin, mTOR, is a serine-threonine protein kinase downstream of the phosphatidylinositol 3-kinase (PI3K)-AKT axis. The pathway can regulate cell growth, proliferation, and survival by activating ribosomal kinases.
Recent studies have implicated the mTOR signalling pathway in ovarian neoplasms, polycystic ovary syndrome (PCOS) and premature ovarian failure (POF). 1 The mammalian target of rapamycin (mTOR) is a centralcomponent that regulates various processes including cell growth, proliferation, metabolism, and angiogenesis. mTOR signalling cascade has recently been examined in ovarian follicles where it regulates granulosa cellproliferation and differentiation. mTOR functions as two complexes, mTOR complex 1 and 2.
One study provided evidence that mTORC1and mTORC2 may have responsibility in increased ovarian follicular cell proliferation and growth in PCOS.2
DHEA supplementation has been used to enhance ovarian reserve.DHEA play significantly vital role as intermediates in androgen and estrogen formation. DHEA also have probable ‘oocyte factor’ and behave as endogenous agonists triggering calcium oscillations for oocyte activation. DHEA have been reported to regulate calcium channels for the passage of Ca2+ through the oocyte cytoplasm and for maintaining required threshold of Ca2+ oscillations. This role of DHEA assumes critical significance in assisted reproductive technology and in-vitro fertilization treatment cycles to enhance fertilization rates.3
Physical exercise is definitely a part of the lifestyle changes. It has been shown that regular, aerobic exercise of moderate intensity does not only contribute to weight loss and improved insulin resistance, but also improves reproductive outcomes, including ovulation and regulation of menstrual cycles. The recommendation for patients with PCOS in view of the improve reproductive and cardio metabolic outcomes is – aerobic physical activity of moderate intensity for 90 minutes per week. The adoption of a healthy lifestyle, composed of a hypocaloric diet and physical exercise that will generate weight loss. Hence, by adopting a healthy lifestyle and weight loss, it would improve the metabolic profile, reduce the risk of diabetes mellitus, cardiovascular disease or endometrial hyperplasia as well as the complete or at least partial disappearance of the symptoms and PCOS phenotype after weight loss.4
Available from: https://www.intechopen.com/chapters/58827
|Dr. Mohammed Shama Sultana
MBBS, DGO, FMAS, DRM (Germany), Obstetrician and Gynaecologist, Infertility Consultant.
Chairman and Consultant of HOPE WIN Hospitals, Guntur.