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Polycystic Ovary Syndrome (PCOSS

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Polycystic Ovary Syndrome (PCOS), diabetes mellitus, hyperprolactinemia, luteal phase defects, as well as thyroid antibodies and disease are regularly encountered endocrine factors that establish a hormonal link between RPL and infertility. Although the exact pathophysiology underlying these disorders in relation to RPL and infertility is unclear, commonly accepted mechanisms of action have been suggested.
Diabetes mellitus
There are two types of diabetes mellitus: Type 1 diabetes (T1D) and Type 2 diabetes (T2D). T1D is characterized by the inability to produce adequate insulin. T2D, which is more prevalent, is characterized by insulin resistance primarily due to fatty diets and sedentary lifestyles72,73. Sufficient insulin production and/or supplementation is vital to maintaining a healthy female
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It affects 5-10% of women of reproductive age77,78The Rotterdam Criteria are most commonly used to diagnose PCOS. At least two of the following three criteria must be present before a diagnosis can be made: oligo/anovulation, hyperandrogenism, and the presence of polycystic ovaries.
Women with PCOS exhibit high LH levels and thereby have elevated production of androgens by theca cells. Hyperandrogenism can, in turn, suppress FSH production, leading to ovarian dysfunction, anovulation and infertility. The prevalence of PCOS in women with RPL runs as high as 56% 79,80,81. Obesity coupled with high LH levels can hinder ovarian folliculogenesis and increase the risk of miscarriage. Studies have also suggested an association among PCOS and hyperinsulinemia/insulin resistance, obesity, and hyperhomocysteinemia. Hyperinsulinemia and insulin resistance can negatively affect implantation by decreasing activity of cell adhesion proteins. Hyperhomocysteinemia can also result in miscarriage because of its pro-coagulative nature, similar to cases of thrombophilia
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