Biography:

Debasis Bagchi, PhD, MACN, CNS, MAIChE, is the Chief Scientific Officer at Cepham Research Center, Piscataway, NJ; a Professor in the Department of Pharmacological and Pharmaceutical Sciences at the University of Houston College of Pharmacy, Houston, TX, and, an Adjunct Faculty in Texas Southern University, Houston, TX. He served as the Senior Vice President of R&D of InterHealth Nutraceuticals Inc, CA, from 1998 till Feb 2011, and then as Director of Innovation and Clinical Affairs, of Iovate Health Sciences, Oakville, ON, till June 2013. He is the Past Chairman of International Society of Nutraceuticals and Functional Foods (ISNFF), Past President of American College of Nutrition, Clearwater, FL, and Past Chair of the Nutraceuticals and Functional Foods Division of Institute of Food Technologists (IFT), Chicago, IL. He is serving as a Distinguished Advisor on the Japanese Institute for Health Food Standards (JIHFS). Dr. Bagchi is a Member of the Study Section and Peer Review Committee of NIH, Bethesda, MD. Dr. Bagchi has 315 papers in peer reviewed journals, 27 books and 18 patents. Dr. Bagchi is also a Member of the Society of Toxicology, Member of the New York Academy of Sciences and Fellow of the Nutrition Research

Abstract:

Polycystic ovary syndrome (PCOS) is the most prevalent hormonal disorder among women of reproductive age causing irregular menstrual cycles, excessive body or facial hair, miscarriage and infertility. Infertility is one of most common PCOS symptoms. Because the symptoms of PCOS are seemingly unrelated to one another, the condition is often overlooked and undiagnosed. We conducted an open label, one-arm, non-randomized, post-marketing surveillance study in 50 premenopausal women (18-45 years, BMI<42) diagnosed with PCOS using a novel fenugreek seed extract (Furocyst, 2 capsules of 500 mg each/day) over a period of 90 consecutive days to determine its efficacy on the reduction of ovarian volume and the number of ovarian cysts. Ethical committee approval was obtained for this study. Furocyst caused significant reduction in ovary volume. Approximately 46% of study population showed reduction in cyst size, while 36% of subjects showed complete dissolution of cyst. It is important to mention that 71% of subjects reported regular menstrual cycle on completion of the treatment and 12% of subjects got pregnant. Overall, 94% of patients were benefitted from this study. Significant increases in luteinizing hormone (LH) and follicular stimulating hormone (FSH) levels were observed compared to the baseline values. Extensive blood chemistry, hematological and biochemical assays demonstrated the broad spectrum safety. Furocyst caused significant decrease in both ovarian volume and the number of ovarian cysts. In summary, Furocyst was safe and efficacious in ameliorating PCOS

Biography:

Dr. Ninive Sanchez is an Assistant Professor of Social Work at the University of Missouri-Columbia, College of Human Environmental Sciences.  Dr. Sanchez earned her PhD in Social Work and Psychology from the University of Michigan.  Her research interests are in the areas of health disparities, sociodeterminants of health, and chronic disease among low socioeconomic status and racial/ethnic minority groups

Abstract:

According to the 2012 National Institutes of Health Evidence-based Methodology Workshop on Polycystic Ovary Syndrome, there is a need to improve public awareness of polycystic ovary syndrome (PCOS).  In the United States, people increasingly look to the Internet to find out what medical condition they or someone else might have.  Women’s digital magazines are a type of “edutainment” that publish health content in addition to beauty, fashion, and entertainment content.  These media have the potential to expose primarily women readers to information on PCOS.  This presentation will present content on PCOS-related hirsutism published in women’s digital magazines such as Cosmopolitan en Español, O, The Oprah Magazine, Prevention, Women’s Health, Health, and Redbook.  This includes descriptions of hirsutism, information on PCOS symptoms and consequences (e.g., infertility), and advice to consult health care providers.  Examples of how women’s magazines appeal to readers’ concerns with hair growth and then provide readers with hair removal strategies and product advertisements to achieve smooth faces and bodies will also be presented.  The limited content on racial/ethnic differences in hirsutism and information on campaigns to raise awareness of PCOS and support women with PCOS will be noted.  Implications of the potential effects that content in women’s digital magazines can have on readers’ perceptions of PCOS-related hirsutism and the effect that women’s hair removal techniques can have on health care providers’ assessment of hirsutism will be discussed.

Biography:

Currently, Dr. Donaldson is the Director of the Clinical Processing Specimen Laboratory and the Director of the CLIA Laboratory in the Institute for Personalized Medicine at Penn State University where he is an assistant professor of biochemistry and molecular biology at the Penn State College of Medicine, and Milton S. Hershey Medical Center. Dr. Donaldson is also the founder and CEO of Prescient Medicine, where his work includes predictive disease modeling, preconditional drug response determination, and system failure point analysis and avoidance. He got his MD from Temple University School of Medicine and his MSCE from the University of Pennsylvania.

Abstract:

Polycystic ovary syndrome (PCOS) affects 5-7% of reproductive-age women. PCOS is characterized by increased androgen levels, anovulation, insulin insensitivity and infertility. Despite the high prevalence, there is no single specific test to definitively diagnose PCOS, representing an unmet diagnostic need. Previous studies  have identified DENND1A, a clathrin-binding protein that sits in coated pits at the crossroads of receptor/ligand interactions with downstream intracellular signaling pathways, as a strong PCOS candidate gene. We have shown that the truncated isoform of DENND1A (DENN1A.V2) is increased in ovarian theca cells isolated from PCOS women.  Forced overexpression of DENND1A.V2 in theca cells from normal cycling women resulted in a PCOS phenotype of increased androgen biosynthesis. We previously described the development and performance characteristics of a urine assay for the detection of DENN1A.V2 in exosomes and total RNA isolated from the blood and urine utilizing standard real-time quantitative PCR.  We are in the process of developing and automating high-throughput urine RNA isolation coupled inline with a semi-quantitative allele specific microarray based analytic. This assay will allow for rapid reproducible diagnosis of PCOS leading to precision therapeutics.

Biography:

The search for an effective treatment protocol for patients with PCOS provides us with the opportunity to integrate Eastern and Western medicine. Western medicine offers us diagnostic tools and technologies, allowing us to see the structures of the body from the organ systems all the way down to cells and molecules. TCM is based on a holistic view of healthcare, which takes into account a person’s mind, emotions, habits and diet, all of which affect the energetic function of the body. Acupuncture modality focuses on the improvement of this function by improving the flow of Qi, blood and fluid, while herbal formulae and nutrition help to strengthen the structure. PCOS has been recognized and treated by TCM for thousands of years. It falls under the Zheng Jia category of disorder, which pertains to “masses created by stagnation of fluid, blood, and/or Qi.” Depending on the individual’s constitution and her environment, she may present with different symptoms. For example, one patient may have blood stagnation, manifesting as endometriosis, while another may have fluid stagnation, manifesting as cysts. Hormone therapies might provide a temporary boost, but they do not correct the problem at its source. TCM treatment is infinitely flexible: the meridian points and herbs chosen will vary day to day, based on changes in the menstrual cycle, life events, and physical environment. The goal is not only to manage symptoms, but to also correct the imbalances on a deeper level, and to prevent the problem from returning in the future

Abstract:

At the heart of Dr. Cai’s practices are her holistic approach to healing and her belief in the collaborative relationship of patient and doctor. From 1986 to 1997, Dr Cai practiced and taught at Chengdu University's TCM Hospital, a major teaching hospital in China that specializes in integrating Eastern and Western medicine. Dr. Cai first worked there as a gynecologist and then as a senior and chief physician overseeing new residents. In 1997, Dr. Cai moved to Santa Monica, CA, where she opened her own acupuncture clinic in 2007. In her more than 25 years of practice as a doctor of TCM, Dr. Cai has published numerous papers, and her research with a former colleague in China is still relied on as a remedy for treating uterine fibroid tumors.

Biography:

Felix Day is a career development fellow in the Growth and Development programme at the Medical Research Council Epidemiology Unit, University of Cambridge, UK, where he also did his PhD. Before moving to Cambridge, he studied at the University of Oxford, UK, and the London School of Hygiene and Tropical Medicine, UK. His research interests include the links between reproductive phenotypes and disease, particularly metabolic disorders. This research includes using methods in both genetics and epidemiology to understand causality in these conditions.

Abstract:

Polycystic ovary syndrome (PCOS) is the most common reproductive disorder in women, yet there is little consensus regarding its aetiology. Here we perform a genome-wide association study of PCOS in up to 5,184 self-reported cases of White European ancestry and 82,759 controls, with follow-up in a further ~2,000 clinically validated cases and ~100,000 controls. We identify six signals for PCOS at genome-wide statistical significance (P<5 × 10−8), in/near genes ERBB4/HER4, YAP1, THADA, FSHB, RAD50 and KRR1. Variants in/near three of the four epidermal growth factor receptor genes (ERBB2/HER2, ERBB3/HER3 and ERBB4/HER4) are associated with PCOS at or near genome-wide significance. Mendelian randomization analyses indicate causal roles in PCOS aetiology for higher BMI (P=2.5 × 10−9), higher insulin resistance (P=6 × 10−4) and lower serum sex hormone binding globulin concentrations (P=5 × 10−4). Furthermore, genetic susceptibility to later menopause is associated with higher PCOS risk (P=1.6 × 10−8) and PCOS-susceptibility alleles are associated with higher serum anti-Müllerian hormone concentrations in girls (P=8.9 × 10−5). This large-scale study implicates an aetiological role of the epidermal growth factor receptors, infers causal mechanisms relevant to clinical management and prevention, and suggests balancing selection mechanisms involved in PCOS risk.

Biography:

The polycystic ovary syndrome (PCOS) accounts for approximately 80% of women with anovulatory infertility. Various factors influence ovarian function and fertility is adversely affected by an individual being overweight, the degree of hyperandrogenism and having elevated serum concentrations of LH. Interestingly, a Finnish study showed that whilst women with PCOS may take longer to conceive but their lifetime fertility is not impaired and they may display sustained fertility with advancing age as compared with infertile eumenorrheic women. For those who do present with anovulatory infertility, the principles of therapy are first to optimize health before commencing treatment and then induce regular unifollicular ovulation, whilst minimizing the risks of OHSS and multiple pregnancy. Weight loss, in those who are overweight, should improve the endocrine profile, the likelihood of ovulation and a healthy pregnancy and the response to ovulation induction therapy. Anovulation associated with PCOS has long been known to be amenable to surgical treatment, and a long-term cohort study has shown persistence of ovulation and normalisation of serum androgens and SHBG up to 20 years after laparoscopic ovarian electrocautery in over 60% of subjects, particularly if they have a normal BMI

There is interesting new data on improved efficacy using aromatase inhibitors compared with CC. In vitro fertilization (IVF) may be required for women with anovulatory PCOS who do not conceive with ovulation induction or if there are other fertility factors such as tubal damage or male factors.

The effect of basal serum LH and LH/FSH ratio on outcomes of in vitro fertilization-embryo transfer in patients with polycystic ovarian syndrome will be discussed.

Abstract:

Mr Faraj is a consultant obstetrician and gynaecologist and has been in the speciality for the last 20 years. Mr Faraj is the lead of infertility Unit in Rotherham/South Yorkshire and had a wide experience in the management of infertile couples. He has a special interest in recurrent miscarriage, gynaecology scanning, endometriosis and Polycystic Ovary Syndrome. He was the medical director of the first IVF unit in Muscat and had the first IVF baby in the Sultanate of Oman.  Mr Faraj is also Senior Clinical Lecturer (Honorary) – University of Sheffield

Biography:

Johannes Ott has completed his PhD at the age of 30 years from postdoctoral studies at the Medical University of Vienna. He is a member of the Clinical Division of Gynecologic Endocrinology and Reproductive Medicine of the Medical University of Vienna. He serves as the “secretary” of the Austrian Society for Sterility, Fertility and Endocrinology. He has published more than 40 articles as first or senior author in reputed journals

Abstract:

Only about 70-80% of Clomifen-resistant women with polycystic ovary syndrome (PCOS) respond to laparoscopic ovarian drilling (LOD). Intraoperative hormone kinetics have been implemented in other surgical fiels including thyroid and parathyroid surgery. In a prospective study, we included 21 anovulatory women with clomiphene-citrate-resistant PCOS who underwent LOD and tested intra- and postoperative androstenedione levels as well as whether an intraoperative androstenedione change was predictive for spontaneous ovulation. Spontaneous ovulation, as the major outcome parameter, occurred in 15 women (71.4%) within three months after the operation. There was an intraoperative androstenedione decrease (median 3.5, IQR 2.2-4.8 vs. median 2.6, IQR 1.4-2.6 ng/ml, p=0.002). In multivariate analysis, only higher preoperative androstenedione (odds ratio, OR 6.53) and luteinizing hormone levels (OR 7.31), as well as secondary infertility (OR 5.40), were associated with higher rates of postoperative spontaneous ovulation (p<0.001). Thus, androstendione declined significantly during LOD. However, intraoperative kinetics were not useful for the prediction of spontaneous ovulation after LOD. In addition to these new results an overview on the literature about predictive factors for fertility outcome after LOD will be given in the presentation.

Biography:

Dr. Qin has completed his M.D. and PhD. from West China Medical Science College of Sichuan University. And he has finished his postdoctoral studies from Reproductive Medical Centre, Groningen University, Netherlands.  He has been worked for the most famous Reproductive Medical Centre for IVF-ET in West Area of China for 16 years. He is identified as Youth Member of Reproductive Medical, Gynecologic Endocrinology and Gynecologic Oncology in China. He awarded some important Scientific Fundus of China. He has published more than 15 papers in reputed journals and has been serving as a reviewer of some of them

Abstract:

Objective:  Immune  dysregulation  may  play  an  important  role  in  the  pathogenesis  of  polycystic  ovary syndrome  (PCOS).  The  purpose  of  this  study  was  to  investigate  the  Th1  and  Th2-related  cytokine  profile in  local  ovary  of  women  with  PCOS.

Study  Design:  The  T  lymphocytes  of  follicular  fluid  (FF)  were  obtained  at  the  time  of  oocyte  retrieval before  in-vitro  fertilization  (IVF)  in  woman  with  or  without  PCOS.  After  culturing  with  PMA,  Ionomycin and  Golgi  stop  agent,  cells  were  detected  for  the  intracellular  cytokine production  by  flow  cytometry.  The profile  of  Th1  (IFN-g,  IL-2)  and  Th2  (IL-4,  IL-10)  cytokines  of  CD3⁺CD4⁺ T  lymphocyte  subsets  were analyzed  through  invert  gating.  These cytokines  in  FF  were  also  evaluated  by  ELISA.

Results:  Flow  cytometry  analysis  showed  that  the  production  of  Th1  (IFN-g,  IL-2)  cytokines  in  FF lymphocytes  in  PCOS  patients  were  significantly  higher  than  those  in  controls;  ELISA  result  also demonstrated  that  the  concentration  of  Th1  cytokines  (IFN-γ,  IL-2)  in  FF  in  PCOS  patients  is  significantly increased  compared  with  those  in  controls.

Conclusion:  It  is  concluded  that  the  immune  dominance  of  Th1  may  be  the  immunological  feature  of  the ovary  in  PCOS  patients.  It  might  participate  in  the  immune  pathogenesis  in  the  ovary  of  PCOS  patients. These  results  suggest  that  chronic  inflammation  maybe  one  of  the  underlying  mechanism  for  the pathogenesis  of  PCOS

Biography:

Xu Wenming has completed his PhD (Physiology) in 2008 from The Chinese University of Hong Kong, Hong Kong and he got postdoctoral training from Columbia University School of Medicine. He is the principle investigator of Joint Lab for Reproductive Medicine, Sichuan University-The Chinese University of Hong Kong, in West China Second University Hospital. He has published more than thirty papers in reputed journals such as PNAS, Journal of Cell Science, Fertility&Sterility,et,al. and has been granted several awards such as First award of International Symposium on Frontiers in Life Sciences 2008. His major interests are epigenetic regulations of reproduction and reproductive diseases

Abstract:

miRNAs are important regulators of glucose metabolism and oxidative stress, which play key roles in the pathogenesis of PCOS. The objective was to study the expression of miRNA biogenesis related genes, including Dicer1, Ago2 and miR-15b and miR-503 in adipose of PCOS and normal controls, and further investigate the relationship of dysregulation of miRNA level with key parameters related to insulin resistance and oxidative stress in tissue level. PCOS patients and normal controls submitted to laparoscopic surgery were included, and adipose tissue and serum samples were collected. Our result shows that significantly reduced expression of Dicer1 were detected in adipose of PCOS patients. Correlation analysis indicated that miR-15b expression is positively correlated with Glut4 expression, while negatively correlatived with T-SOD. Our study also shows that follicular fluid contains microvesicle, which express Dicer proteins and could mediate the effects on phenotype of cumulus cells in ovary. Our result shows that dysregulation of miRNA biogenesis is related to the adipose insulin resistance and oxidative stress, and miR-15/16 famlily members, such as miR-15b is critical important for the insulin resistance and oxidative stress through targeting Glut4 pathway, thus represent a promising target of PCOS diagnosis and therapy.  

Biography:

Xiaomiao Zhao, MD.,Ph.D., an associate professor and associate chief physician of reproductive endocrine and advisor of Ph.D candidate, the vice president of Youth Committee of the Chinese OB/GT Committee of International Health Care Exchange and Promotive society. She has completed her M.D. at the age of 24 years and Ph.D at 30 years from Sun Yat-Sen University in Guangzhou, China and postdoctoral studies from Cedars-sinai medical center, University of California in Los Angeles, USA. She has published more than 45 papers, among which, over 19 papers in reputed English journals (e.g. Fertility and Sterility, Clinical Endocrinology, International of Caner, and International Journal of Cardiology, etc.) and serving as reviewer of International Journal of Cancer, JCEM and endocrinology. She takes charge of11 research grants of China.

Abstract:

This study is to investigate the distribution and progression of terminal hair growth in pregnant women and determine whether a simplified scoring system for assessing hirsutism was possible. We recruited 115 pregnant women (discovery cohort) from before pregnancy to 24^th gestation weeks and 1159 PCOS women (validation cohort) in out-patient department in an academic hospital and collected their clinical data including the assessment of facial and body terminal hair growth by modified Ferriman and Gallwey score system (mFG score) and the measurement of total testosterone (TT) level by liquid chromatographic tandem mass spectrometry (LC-MS/MS), through a prospective follow-up observational study. It showed that the TT level and mFG score increased as pregnancy progressing. Both the prospective study and receiver operating characteristics curve (ROC) indicated that the most contributive areas to hirsutism (defined as an mFG score ³ 5) with new terminal hair growth were upper lip, lower back, lower abdomen and thigh. From which, a simplified mFG scoring system (sFG) was developed and a cut-off value of ³3 was determined as ‘hirsutism’. The pregnant ‘hirsute’ women could be distinguished from ‘non-hirsute’ with an accuracy of 95.2%, sensitivity of 96.8% and specificity of 94.3% for detecting hirsutism. This was further validated in PCOS population with a sensitivity, specificity and PPV of 97.6%, 96.4% and 96.4%, respectively. This study suggests that upper lip, lower back, lower abdomen and thigh may be an effective simplified combination of the mFG system for the evaluation of excess hair growth in Chinese women.