Síndrome de ovario poliquístico, endometrio y riesgo de aborto
DOI:
https://doi.org/10.18597/rcog.519Palabras clave:
síndrome de ovario poliquístico, aborto, endometrio, insulinaResumen
El síndrome de ovario poliquístico (SOP) es la endocrinopatía más frecuente en mujeres en edad reproductiva, se observa en el 5-7% de ellas. El diagnóstico se hace ante la presencia de por lo menos dos componentes de la triada: oligoovulación, hiperandrogenismo y ovarios poliquísticos. Estas mujeres tienen niveles elevados de lutropina (LH), hiperinsulinemia e hiperandrogenismo y se ha reportado un aumento en la incidencia de aborto en este grupo de pacientes. Este hecho podría estar relacionado con los cambios endometriales observados en estas mujeres y que se asocian a niveles elevados de andrógenos e insulina, provocando así, inadecuada implantación y probablemente mayor pérdida del embarazo en el primer trimestre. Medidas terapéuticas, como el uso de sensibilizantes a la acción de la insulina, que contribuyen a disminuir los niveles de insulina y por lo tanto de andrógenos, podrían tener un efecto favorable al disminuir la incidencia de aborto en pacientes con SOP.Biografía del autor/a
Carlos Arturo Vivas
Referencias bibliográficas
Barbieri RL. Metformin for the treatment of polycystic ovary syndrome. Obstet Gynecol 2003;101:785-93.
Lathi RB, Swierz L, Basina M, Giudice LC. The endometrium in polycystic ovary syndrome. Curr Opin Endocrinol Diabetes 2002;9:480-5.
Genazzani A, Battaglia C, Malavasi B, Strucchi C, Tortolani F, Gamba O. Metformin administration modulates and restores luteinizing hormone spontaneous episodic secretion and ovarian function in nonobese patients with polycystic ovary syndrome. Fertil Steril 2004:81:114-9.
Glueck CJ, Phillips H, Cameron D, Sieve-Smith L, Wang P. Continuing metformin throughout pregnancy in women with polycystic ovary syndrome appears to safely reduce first-trimester spontaneous abortion: a pilot study. Fertil Steril 2001:75:46-52.
The Rotterdam ESHRE–ASRM-sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod 2004;19:41-7.
Ehrman DA. Polycystic ovary syndrome. N Engl J Med 2005;352:1223-36.
Rebar R, Judd HL, Yen SS, Rakoff J, Vandenberg G, Naftolin F. Characterization of the inappropriate gonadotropin secretion in polycystic ovary syndrome. J Clin Invest 1976;57:1320-9.
DeUgarte CM, Bartolucci AA, Azziz R. Prevalence of insulin resistance in the polycystic ovary syndrome using the homeostasis model assessment. Fertil Steril 2005;83:1454-60.
Goodarzi MO, Korenman SG. The importance of insulin resistance in polycystic ovary syndrome. Fertil Steril 2003;80:255-8.
Cheviakoff S, Carmona S, Lahsen R. Estudios de variables clínicas y metabólicas en mujeres con hiperandrogenismo. Rev Chil Obstet Ginecol 2004;69:39-43.
Giudice LC. Potential biochemical markers of uterine receptivity. Hum Reprod 1999;14 Suppl 2:3-16.
Daftar y GS, Taylor HS. Molecular markers of implantation: clinical implications. Curr Opin Obstet Gynecol 2001;13:269-74.
Coetzee EJ, Jackson WP. Pregnancy in established non-insulin-dependent diabetics. A five-and-a-half year study at Groote Schuur Hospital. S Afr Med J 1980;58:795-802.
Clifford K, Rai R, Watson H, Franks S, Regan L. Does suppressing luteinising hormone secretion reduce the miscarriage rate? Results of a randomised controlled trial. BMJ 1996;312:1508-11.
Regan L, Owen EJ, Jacobs HS. Hypersecretion of luteinising hormone, infertility, and miscarriage. Lancet 1990;336:1141-4..
Homburg R, Armar NA, Eshel A, Adams J, Jacobs HS. Influence of serum luteinising hormone concentrations on ovulation, conception, and early pregnancy loss in polycystic ovary syndrome. BMJ 1988;297:1024–6.
Fedorcsak P, Storeng R, Dale PO, Tanbo T, Abyholm T. Obesity is a risk factor for early pregnancy loss after IVF or ICSI. Acta Obstet Gynecol Scand 2000;79:43-8.
Glueck CJ, Wang P, Fontaine RN, Sieve-Smith L, Tracy T, Moore SK. Plasminogen activator inhibitor activity: an independent risk factor for the high miscarriage rate during pregnancy in women with polycystic ovary syndrome. Metabolism 1999;48:1589-95.
Gris JC, Ripart-Neveu S, Maugard C, Tailland ML, Brun S, Courtieu C, et al. Retrospective evaluation of the prevalence of haemostasis abnormalities in unexplained primary early recurrent miscarriages. The Nimes Obstetricians and Haematologists(NOHA) study. Thromb Haemost 1997;77:1096-103.
Checa MA, Requena A, Salvador C, Tur R, Espinos JJ, et al. Reproductive Endocrinology Interest Group of the Spanish Society of Fertility. Insulin-sensitizing agents: use in pregnancy and as therapy in polycystic ovary syndrome. Hum Reprod Update 2005:11:375-90.
Lord J, Wilkin T. Metformin in polycystic ovary syndrome. Curr Opin Obstet Gynecol 2004;16:481-6.
Vanky E, Salvesen KA, Heimstad R, Fougner KJ, Romundstad P, Carlsen SM. Metformin reduces pregnancy complications without affecting androgen levels in pregnant polycystic ovary syndrome women: results of a randomized study. Hum Reprod 2004;19:1734-40.
Reis RM, Angelo A, Romao G, Santana L, Moura M, Ferriani RA. Can polycystic ovary syndrome interfere with the outcome of in vitro fertilization? Rev Bras Ginecol Obstet 2004;26:727-33.
Glueck CJ, Wang P, Goldenberg N, Sieve-Smith L. Pregnancy outcomes among women with polycystic ovary syndrome treated with metformin. Hum Reprod 2002;17:2858-64.
Glueck CJ, Goldenberg N, Pranikoff J, Loftspring M, Sieve L, Wang P. Height, weight, and motor-social development during the first 18 months of life in 126 infants born to 109 mothers with polycystic ovary syndrome who conceived on and continued metformin t hrough pregnancy. Hum Reprod 2004;19:1323-30.
Norman RJ, Wang JX, Hague W. Should we continue or stop insulin sensitizing drugs during pregnancy? Curr Opin Obstet Gynecol 2004;16: 245-50.
Lord JM, Flight IHK, Norman RJ. Insulin-sensitising drugs (metformin, troglitazone, rosiglitazone, pioglitazone, D-chiro-inositol) for polycystic ovary syndrome (Cochrane Review). In: The Cochrane Library, Issue 3, 2003. Oxford: Update Software.
Irwin JC, Suen LF, Martina NA, Mark SP, Giudice LC. Rol of the IGF system in trophoblast invasion and pre-eclampsia. Hum Reprod 1999;14 Suppl 2:90-6.
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