Middle
East
Fertility
Society
Journal,
Vol.
12,
No.
3,
2007,
pp.
218-218
BOOK
REVIEW - Polycystic
ovary syndrome.
Mohamed
Aboulghar,
M.D.
Professor
in
Obstetrics
and
Gynecology,
Faculty
of
Medicine,
Cairo
University
Code
Number:
mf07042
Polycystic
ovary syndrome. Edited by Gautam N Allahbadia and Rina Agrawal. Anshan Ltd. Kent, UK. 2007.
This is a comprehensive book which covers all topics
related to polycystic ovarian syndrome. There is an introduction including the
history and the origin of polycystic ovarian syndrome, giving a coverage of
history and the early days of diagnosis. They include definitions of the
polycystic ovary syndrome.
The authors describe the Rotterdam ESHRE-ASRM
international consensus in 2003 which specifies that the presence of two of the
following criteria indicates the presence of polycystic ovarian disease. These
include oligomenorrhea and anovulation, clinical or biochemical evidence of
hyperandrogenism and polycystic ovaries on ultrasound examination.
The authors stressed that fact that there is a wide
discrepancy in the prevalence of polycystic ovarian disease in different parts
of the world. Different diagnostic criteria and several associated metabolic
syndromes are described. The importance of diagnosing polycystic ovarian
disease and the ultrasonographic appearance of polycystic ovarian disease are
all well described.
There is a chapter on genetic basis of polycystic
ovarian disease and the familial association of the disease. Another chapter
for the pathophysiology and consequence of PCO.
There is a stress on impaired glucose metabolism and
insulin resistance associated with the syndrome and its relation to diabetes,
obesity and hyperandrogenemia, dyslipidemia and the risk of cardiovascular
disease.
A large part of the book is devoted to infertility,
the pathogenesis of infertility and early pregnancy loss associated with
polycystic ovarian disease. One chapter is devoted for the treatment of
polycystic ovarian disease in adolescence before marriage and before
infertility becomes a problem. The authors stressed the importance of weight
loss for the obese and of treatment by antiandrogens. However, the use of
insulin sensitizers in adolescents with PCO is still debatable.
The book discussed induction of ovulation by
clomiphene citrate and gonadotrophins and stress on the value of chronic low
dose step-up protocol. The authors also discussed the value of metformin in
treatment and discussed all the studies which suggested that it is useful alone
or in combination with clomiphene citrate for ovulation induction. However, it
seems that this book was published before the publication of two major
randomized studies which showed that metformin does not improve pregnancy rate
in the treatment of polycystic ovarian disease.
The role of aromatase inhibitors in ovulation
induction was discussed and compared with the value of tamoxifen and clomiphene
citrate.
The strategies of prevention of ovarian
hyperstimulation syndrome in patients with polycystic ovarian disease, which
are known to be vulnerable to this complication, are well illustrated.
Oocyte quality in patients with polycystic ovary is
also discussed.
There is a chapter devoted to surgical treatment of
polycystic ovarian disease and the pros and cons of ovarian drilling.
Reproductive outcome following ovarian drilling was discussed. Pregnancy in
patients with polycystic ovarian disease was also discussed.
Copyright © Middle
East
Fertility
Society