Women with polycystic ovary syndrome are more prone to insomnia during motherhood
the verdict
INSUFFICIENT LEANING
refutedsupported
the weight of evidence
2 sources for · 0 against
While studies show that women with polycystic ovary syndrome have a generally elevated risk of sleep disturbances, the evidence base lacks data specifically addressing whether they are more prone to insomnia during motherhood.
Background Polycystic ovary syndrome (PCOS) is a common gynecologic disorder related to abnormal circadian rhythm. Therefore, we aimed to find whether the level of melatonin, a rhythm regulating hormone changed in the ovarian microenvironment in this disease. Methods The melatonin concentrations in follicular fluid (FF) were measured in 35 PCOS and 36 non-PCOS women undergoing in vitro fertilization (IVF) treatment. Results The FF melatonin concentration was significantly lower in PCOS women than non-PCOS women ( p = 0.045) and it was found positively correlated with serum basal FSH level (r = 0.308, p = 0.013). In IVF procedures, there was no significant difference in the fertilization rate of oocytes between the two groups, but the high-quality embryogenesis rate on the third day of the PCOS group was significantly lower than that of the control group ( p = 0.042), which showed a weak positive correlation with the FF melatonin concentration (r s = 0.240, p = 0.044). Furthermore, there was no significant difference in overall pregnancy outcome. The PSQI questionnaire showed that sleep disorders were more likely to exist in the PCOS group, though there was no significant difference. Conclusion The obtained results suggested PCOS women had lower melatonin concentrations in the ovarian microenvironment.
68 bmcwh BMC Women's Health BMC Womens Health BMC PMC8935689 8935689 8935689 35313872 10.1186/s12905-022-01661-w Women with polycystic ovary syndrome (PCOS) have reduced melatonin concentrations in their follicles and have mild sleep disturbances Li Hongwanyu 1 3 Liu Mei 4 Zhang Cong 1 2 3 ✉ 1 Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200135 China 2 Shandong Provincial Key Laboratory of Animal Resistance Biology, College of Life Sciences, Shandong Normal University, Jinan, Shandong China 3 Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China 4 Department of Obstetrics, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, No.
If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ . The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Abstract Background Polycystic ovary syndrome (PCOS) is a common gynecologic disorder related to abnormal circadian rhythm.
Conclusion The obtained results suggested PCOS women had lower melatonin concentrations in the ovarian microenvironment. Keywords: Melatonin, Polycystic ovarian syndrome, Follicular fluid, Circadian rhythm; Sleep quality status released display-pdf yes is-olf no is-manuscript no is-preprint no is-journal-matter no is-scanned no is-retracted no Received 2021 Jul 28; Accepted 2022 Mar 4; Collection date 2022. Introduction Circadian rhythm is an oscillation phenomenon with a cycle of about 24 h, also known as biological clock. This clock transforms the light–dark cycle of the environment to endogenous rhythmic signals in vivo and optimize the time sequence of life activities.
Polycystic ovary syndrome (PCOS) is considered to be one of the most common reproductive endocrine diseases, and about 10% of women suffer from the disease during childbearing age [ 12 ]. The most typical clinical manifestation of PCOS are ovulation dysfunction (oligomenorrhea or amenorrhea), hyperandrogenism, and polycystic ovarian morphology. Besides metabolic disorder like insulin resistance is also common problems in PCOS patients. It is worth noting that PCOS patients are more likely to suffer from sleep disorders such as drowsiness and obstructive sleep apnea [ 13 ].
It was also found that there was a weak positive correlation between the melatonin concentration and the ratio of high-quality embryos on D3 (rs = 0.240, p = 0.044). After selection on D3, there was no significant difference between the blastocyst formation rate of D5 or D6 and the percentage of high-quality blastocysts (Table 2 ). Table 2 IVF outcomes of the control and polycystic ovarian syndrome (PCOS) group Controls ( n = 36 ) PCOS ( n = 35 ) P value No.
Table 3 Transplantation and pregnancy outcomes of the control and polycystic ovarian syndrome (PCOS) group Control (n = 48) PCOS (n = 40) P value Rate of clinical pregnancy 62.5% (30/48) 77.5% (31/40) 0.129 Rate of implantation 59.3% (35/59) 66.7% (32/48) 0.435 Rate of early abortion 6.7% (2/28) 0.0% (0/31) 0.238 a Rate of live birth 58.3% (28/48) 77.5% (31/40) 0.057 a Fisher exact test is used Rate of clinical pregnancy was based on the number of cycles with ultrasound diagnosis of clinical pregnancy/ the number of transfer cycles Rate of implantation was based on the number of embryo sacs under ultrasound diagnosis /the number of embryo transferred (one or two embryos was transferred per cycle) Rate of early abortion was based on the number of cycles with abortion in 12 weeks/ the number of cycles with clinical pregnancy Rate of live birth was based on the number of cycles with live birth/ the number of transfer cycles Sleep quality analysis PCOS women tended to have a higher rate of sleep disorders as more of them had high PSQI scores, though not significant (Table 4 ).
Our results further prove the positive role of melatonin in the clinical treatment of infertility in PCOS women. On the one hand, melatonin tends to make it easier for PCOS women to become pregnant naturally. A previous clinical study found that oral melatonin can significantly reduce serum androgen levels and AMH, increase FSH and improve the menstrual cycle [ 42 ]. Moreover, melatonin may promote oocyte and embryo
Objective: A meta-analysis is used to explore the relationship between polycystic ovary syndrome (PCOS) and the risk of Sleep disturbances. Method: Cochrane Library, PubMed, Embase, and Web of Science databases are searched by computer from their establishment to 1 May 2022. Review Manager 5.4 software is used for the meta-analysis. Results: A total of nine articles are included, with 1,107 subjects. The results show that PCOS is positively associated with the risk of Sleep disturbances. Comparing with the “PCOS group” (experimental group) with the “NON-PCOS group” (control group), the incidence of Sleep disturbances is higher (OR = 11.24, 95% CI: 2.00–63.10, Z = 2.75, p = 0.006); the Pittsburgh Sleep Quality Index (PSQI) scores of the PCOS group is higher than that of the NON-PCOS group (MD = 0.78, 95% CI: 0.32–1.25, Z = 3.30, p = 0.001); the Epworth Sleepiness Scale (ESS) scores of the PCOS group is higher than that of the NON-PCOS group (MD = 2.49, 95% CI: 0.80–4.18, Z = 2.88, p = 0.004); Apnea hypopnea index (AHIs) in the PCOS group are higher than those in the NON-PCOS group (MD = 2.68, 95% CI: 1.07–4.28, Z = 3.27, p = 0.001); the sleep efficiency of the PCOS group is lower than that of the NON-PCOS group (MD = -5.16, 95% CI: 9.39–-0.93, Z = 2.39, p = 0.02); the sleep onset latency of the PCOS group is higher than that of the NON-PCOS group (MD = 2.45, 95% CI: 1.40–3.50, Z = 4.57, p < 0.001); and the Rapid Eyes Movement (REM) sleep in the PCOS group is higher than that in the NON-PCOS group (MD = 17.19, 95% CI: 11.62–55.76, Z = 6.05, p < 0.001). The studies included in each analysis have publication biases of different sizes. After subgroup analysis and sensitivity analysis, the heterogeneity of each study in the meta-analysis is reduced, the bias is reduced accordingly, and the stability of the results can be maintained. Conclusion: PCOS is positively associated with the risk of Sleep disturbances. In order to reduce such risk, attention should be paid to the
This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Abstract Objective: A meta-analysis is used to explore the relationship between polycystic ovary syndrome (PCOS) and the risk of Sleep disturbances.
Keywords: polycystic ovary syndrome (PCO), sleep disturbances, relationship, meta-analysis', risk status released display-pdf yes is-olf no is-manuscript no is-preprint no is-journal-matter no is-scanned no is-retracted no Received 2022 May 30; Accepted 2022 Sep 12; Collection date 2022. 1 Introduction Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age (4–12%) ( Azziz et al., 2004 ), while its prevalence depends on the choice of diagnostic criteria. A community-based prevalence study using the Rotterdam criteria found that approximately 18% of women had PCOS, 70% of whom had not been diagnosed previously ( Teede et al., 2010 ).
English search terms included “polycystic ovary syndrome”, “PCOS”, “Stein-leventhal Syndrome”, “Sclerocystic Ovarian Degeneration”, “Ovary Syndrome, Polycystic”, “Syndrome, Polycystic Ovary”, “Stein-Leventhal Syndrome”, “Stein Leventhal Syndrome”, “Syndrome, Stein-Leventhal”, “Ovarian Degeneration, Sclerocystic”, “Sclerocystic Ovary Syndrome”, “Polycystic Ovarian Syndrome”, “Sclerocystic Ovaries”, “Ovary, Sclerocystic","Sclerocystic Ovary”, Sleep Wake Disorders","Disorder, Sleep Wake”, “sleep disturbances”, “Disorder, Sleep Wake”, “Disorders, Sleep Wake”, “Sleep Wake Disorder”, “Wake Disorder, Sleep”, “Wake Disorders, Sleep Disorders”, “Disorder, Sleep”, “Disorders, Sleep”, “Sleep Disorder”, “Short Sleeper Syndrome”, “Short Sleeper Syndromes”, “Sleeper Syndrome, Short”, “Sleeper Syndromes, Short”, “Syndrome, Short Sleeper”, “Syndromes, Short Sleeper”, “Short Sleep Phenotype”, “Phenotype, Short Sleep”, “Phenotypes, Short Sleep”, “Short Sleep Phenotypes”, “Sleep Phenotypes, Short”, “Sleep”.
Study Country Ages (Years) Sample size n (T/C) Criteria for PCOS Criteria for SDB BMI (kg/m2) Research object characteristics Fogel, 2001 ( Fogel et al., 2001 ) United States T: 31.1 ± 1.3, C: 32.3 ± 1.3 36 (18/18) NIH Polysomnography/Sleep questionnaire T: 36.96 ± 1.3, C: 36.96 ± 1.4 no concomitant disease Tasali 2008 ( Tasali et al., 2008a ) United States 18–40 73 (52/21) NIH Polysomnography >25 kg/m2 no concomitant disease Yang 2009 ( Yang et al., 2009 ) Taiwan, China T: 29.1 ± 1.43 28 (18/10) Rotterdam Polysomnography/Sleep questionnaire T: 21.7 ± 0.57 non-obese C: 31.6 ± 3.87 C: 20.9 ± 0.58 no concomitant disease Sousa 2010 ( de Sousa et al., 2010 ) Germany T: 15.2 ± 1.3 33 (22/11) NIH Polysomnography T: 31.7 ± 6.2 no concomitant disease C: 15.0 ± 1.0 C: 34.8 ± 8.7 Sousa 2011 ( de Sousa et al., 2011 ) Germany T: 15.0 ± 1.0 50 (31/19) NIH Polysomnography T: 32.7 ± 6.2 no concomitant disease C: 15.2 ± 1.1 C: 32.4 ± 4.0 Shreeve 2013 ( Shreeve et al., 2013 ) Britain T: 29.8 ± 3.7 52 (26/26) Rotterdam actiwatch/Sleep questionnaire T: 29.3 ± 8.2 no concomitant disease C: 26.3 ± 5.6 C: 24.6 ± 3.3 Suri 2016 ( Suri et al., 2016 ) India T: 27.9 ± 6.44 150 (50/100) Rotterdam Polysomnography/Sleep questionnaire T: 28.0 ± 4.01 no concomitant disease C: 28.3 ± 6.05 C: 25.3 ± 2.93 Su 2017 ( Su et al., 2017 ) China T: 29.03 ± 3.26 285 (129/156) Rotterdam Sleep questionnaire Unlimited no concomitant disease C: 31.72 ± 3.86 Kutenaee 2019 ( Azizi et al., 2020 ) Iran T: 27.86 ± 5.84 400 (201/199) Rotterdam Sleep questionnaire T: 22.73 ± 9.62 no concomitant disease C: 28.06 ± 6.51 C: 23.95 ± 4.96 Abbreviations: PCOS, polycystic ovary syndrome; SDB, sleep-disordered breathing; BMI, body mass
Everything we examined (2)
This check searched the claim as stated. It did not run a separate search for evidence against it.