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PRECONCEPTION PREPARATION FOR WOMEN WITH POLYCYSTIC OVARY
SYNDROME
Mohira Tursunova
Assistant of the Department of Obstetrics and Gynecology and Pediatric Gynecology
https://doi.org/10.5281/zenodo.12604561
Relevance.
Polycystic ovary syndrome (PCOS) is a common hormonal disorder that
occurs in women of reproductive age. PCOS usually begins in adolescence, but symptoms may
change over time.In recent decades, due to global urbanization and a decrease in physical
activity, there has been an active increase in the number of people with overweight and
obesity around the world, which makes this problem one of the most pressing for the medical
community. Weight gain is associated with many associated diseases, including metabolic and
cardiovascular disorders.
Keywords.
PCOS(Polycystic ovary syndrome), Obesity, reproductive disorders,
Hyperinsulinemia
Purpose.
PCOS can cause hormonal imbalances, irregular menstrual cycles, excessive
androgen levels, and the formation of cysts in the ovaries. An irregular menstrual cycle,
usually accompanied by a lack of ovulation, can make it difficult to get pregnant. PCOS is the
leading cause of infertility.
Materials and methods.
The mechanism of development of infertility in such patients
includes deregulation of the gonadotropic axis, changes in the follicular apparatus of the
ovaries with the formation of PCOS and impaired endometrial receptivity. These defects are
mediated by increased IR, subsequent compensatory hyperinsulinemia, decreased
adiponectin concentrations, increased androgen production, and increased levels of leptin,
interleukin (IL) 6, and tumor necrosis factor α (TNF-α). Due to significant clinical
heterogeneity, giving rise to a number of phenotypes with or without weight loss, the
difference and variability of clinical signs that change throughout life, as well as the systemic
effect on the div, infertility treatment in PCOS, despite active study in the last decade, seems
a pressing issue that deserves close attention. The complex pathophysiology and clinical
heterogeneity of PCOS do not facilitate a clear understanding of the interactions between
PCOS, excess div weight, and div fat distribution. Obesity with visceral distribution of
adipose tissue increases IR and compensatory hyperinsulinemia. Due to the interaction
between IR and the gonadotropic, luteinizing hormone-stimulating action of insulin, an
increase in the level of circulating androgens occurs. Hyperinsulinemia plays an important
role in the pathogenesis of PCOS, causing a decrease in serum sex steroid binding globulin,
which leads to an increase in free and metabolically active androgens in the serum, a decrease
in androgen clearance and aromatase activity, and increased steroidogenesis. This aggravates
the clinical manifestations of PCOS and accelerates its manifestation, so it is often difficult to
say what became the primary pathology: a disorder of fat metabolism or PCOS. Obesity affects
the phenotypic expression of PCOS, exacerbating metabolic, reproductive and psychological
disorders.
Results.
PCOS is a significant public health problem and one of the most common
hormonal disorders among women of reproductive age. The syndrome is estimated to occur
in 8–13% of women of reproductive age, with up to 70% of cases remaining undiagnosed. The
prevalence of PCOS is higher in some ethnic groups, whose representatives may be more
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likely to experience complications of the syndrome, in particular metabolic disorders. The
physical and psychological consequences of PCOS, especially those related to obesity, div
image and infertility, can lead to mental health problems and social stigma. The incidence of
overweight or obesity is higher in women with PCOS compared to the general population,
which may be due to a genetic predisposition to obesity in these patients. If the prevalence of
MS in the general population is 14–24%, then among patients with PCOS it reaches 43%. In
women with a BMI>25 kg/m2, the diagnosis of PCOS is 9% more common. Once diagnosed
with PCOS, the incidence of obesity increases in the future. Abdominal obesity increases over
time with a progressive increase in waist-to-hip ratio between 20–25 and 40–45 years of age.
Conclusion.
WHO is working with Member States to address PCOS as part of its efforts
to improve the health and reproductive well-being of women worldwide. In collaboration
with government and non-government partners, the Organization raises awareness of PCOS
and provides health care providers with guidance on how to identify and treat the syndrome.
In addition, WHO promotes research to develop the most effective methods for preventing,
diagnosing and treating infertility caused by PCOS, and identifies the most pressing
unresolved issues in this area.
References:
1.
Akopyan A.S., Kharchenko V.I., Mishiev V.G. Health status and mortality of children and
adults of reproductive age in modern Russia (monograph). M., 1999. -
2.
Blumenthal P., McIntosh N. A quick guide to reproductive health and contraception.
1996-1998.
3.
Hormonal contraception. Edited by Ronald L.Kleitman. MFPS., 1990.
4.
Zhuravlev Yu.V., Dorodeiko V.G., Suprun L.Ya. Intrauterine contraception. Vitebsk. -1997.
5.
Manuilova I.A. Modern contraceptives.- M.
