ABSTRACT
There is substantial heterogeneity of symptoms and signs among women with polycystic
ovary syndrome (PCOS). In addition to different diagnostic criteria used, the ethnic
background of women with PCOS may affect the clinical, hormonal, and metabolic characteristics
of this condition. We present here studies related to the clinical, hormonal, and
metabolic characteristics and response to the treatment of PCOS in Asia, which may
be different from those in Western countries. It is important to take into consideration
the ethnic background of patients in future studies related to PCOS.
KEYWORDS
Asian women - ethnic origin - polycystic ovary syndrome
REFERENCES
- 1
Azziz R, Woods K S, Reyna R, Key T J, Knochenhauer E S, Yildiz B O.
The prevalence and features of the polycystic ovary syndrome in an unselected population.
J Clin Endocrinol Metab.
2004;
89
2745-2749
- 2
Franks S.
Polycystic ovary syndrome.
N Engl J Med.
1995;
333
853-861
- 3
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.
Hum Reprod.
2004;
19
41-47
- 4
Adams J, Polson D W, Franks S.
Prevalence of polycystic ovaries in women with anovulation and idiopathic hirsutism.
BMJ.
1986;
293
355-359
- 5
Balen A H, Laven J SE, Tan S L, Dewailly D.
Ultrasound assessment of the polycystic ovary: international consensus definitions.
Hum Reprod Update.
2003;
9
505-514
- 6
Taponen S, Ahonkallio S, Martikainen H et al..
Prevalence of polycystic ovaries in women with self-reported symptoms of oligomenorrhea
and/or hirsutism: Northern Finland Birth Cohort 1966 study.
Hum Reprod.
2004;
19
1083-1088
- 7
Rodin D A, Bano G, Bland J M, Taylor K, Nussey S S.
Polycystic ovaries and associated metabolic abnormalities in Indian subcontinent Asian
women.
Clin Endocrinol (Oxf).
1998;
49
91-99
- 8
Ng E HY, Fong D YT, Yeung W SB, Ho P C.
Effects of age on hormonal and ultrasound markers of ovarian reserve in Chinese women
with proven fertility.
Hum Reprod.
2003;
18
2169-2174
- 9
Ng E HY, Chan C CW, Yeung W SB, Ho P C.
Effect of age on ovarian stromal flow measured by three-dimensional ultrasound with
power Doppler in Chinese women with proven fertility.
Hum Reprod.
2004;
19
2132-2137
- 10
Ng E HY, Chan C CW, Yeung W SB, Ho P C.
Antral follicle count and follicle stimulating hormone concentration after clomiphene
citrate challenge test in the prediction of ovarian response during in vitro fertilization
treatment.
Hum Reprod.
2005;
20
1647-1654
- 11
Chan C CW, Ng E HY, Tang O S, Lee C P, Ho P C.
The prevalence of polycystic ovary in Chinese women with a history of gestational
diabetes.
Gynecol Endocrinol.
2006;
22
516-520
- 12
Yao L Q, Kuang J Q, Feng Y J, Yang D Z, Li L, Xu C J.
Characterization of unilateral polycystic ovary compared with polycystic ovary syndrome.
Fertil Steril.
2006;
85
805-808
- 13
Zaidi J, Campbell S, Pittrof R et al..
Ovarian stromal blood flow in women with polycystic ovaries-a possible new marker
for diagnosis?.
Hum Reprod.
1995;
10
1992-1996
- 14
Agrawal R, Sladkevicius P, Engmann L et al..
Serum vascular endothelial growth factor concentrations and ovarian stromal blood
flow are increased in women with polycystic ovaries.
Hum Reprod.
1998;
13
651-655
- 15
Pairleitner H, Steiner H, Hasenoehrl G, Staudach A.
Three-dimensional power Doppler sonography: imaging and quantifying blood flow and
vascularization.
Ultrasound Obstet Gynecol.
1999;
14
139-143
- 16
Pan H A, Wu M H, Cheng Y C, Li C H, Chang F M.
Quantification of Doppler signal in polycystic ovary syndrome using three-dimensional
power Doppler ultrasonography: a possible new marker for diagnosis.
Hum Reprod.
2002;
17
201-206
- 17
Järvelä I Y, Mason H D, Sladkevicius P et al..
Characterization of normal and polycystic ovaries using three-dimensional power Doppler
ultrasonography.
J Assist Reprod Genet.
2002;
19
582-590
- 18
Ng E HY, Chan C CW, Yeung W SB, Ho P C.
Comparison of ovarian stromal flow measured by three-dimensional power Doppler ultrasound
between fertile women with normal ovaries and infertile women with polycystic ovary
syndrome.
Hum Reprod.
2005;
20
1881-1886
- 19
Carmina E, Koyama T, Chang L, Stanczyk F Z, Lobo R A.
Does ethnicity influence the prevalence of adrenal hyperandrogenism and insulin resistance
in polycystic ovary syndrome?.
Am J Obstet Gynecol.
1992;
167
1807-1812
- 20
Norman R J, Mahabeer S, Masters S.
Ethnic differences in insulin and glucose response to glucose between white and Indian
women with polycystic ovary syndrome.
Fertil Steril.
1995;
63
58-62
- 21
Wijeyaratne C N, Balen A H, Barth J H, Belchetz P E.
Clinical manifestations and insulin resistance (IR) in polycystic ovary syndrome PCOS)
among South Asians and Caucasians: is there a difference?.
Clin Endocrinol (Oxf).
2002;
57
343-350
- 22
Chen X, Yang D, Li L, Feng S, Wang L.
Abnormal glucose tolerance in Chinese women with polycystic ovary syndrome.
Hum Reprod.
2006;
21
2027-2032
- 23
Li L, Yang D, Chen X, Chen Y, Feng S, Wang L.
Clinical and metabolic features of polycystic ovary syndrome.
Int J Gynaecol Obstet.
2007;
97
129-134
- 24
Ng E HY, Chan C CW, Ho P C.
Are there differences in ultrasound parameters between women with polycystic ovaries
only and with polycystic ovary syndrome?.
Eur J Obstet Gynecol Reprod Biol.
2006;
125
92-98
- 25
The ESHRE Capri Workshop .
Female infertility: treatment options for complicated cases.
Hum Reprod.
1997;
12
1191-1196
- 26
Takahashi K, Uchida A, Yamasaki H, Ozaki T, Kitao M.
Transvaginal ultrasonic assessment of the response to clomiphene citrate in polycystic
ovarian syndrome.
Fertil Steril.
1994;
62
48-53
- 27
Kondoh Y, Uemura T, Ishikawa M, Yokoi N, Hirahara F.
Classification of polycystic ovary syndrome into three types according to response
to human corticotropin-releasing hormone.
Fertil Steril.
1999;
72
15-20
- 28
Andoh K, Mizunuma H, Liu X, Kamijo T, Yamada K, Ibuki Y.
A comparative study of fixed-dose, step-down, and low-dose step-up regimens of human
menopausal gonadotropin for patients with polycystic ovary syndrome.
Fertil Steril.
1998;
70
840-846
- 29
Dunaif A.
Insulin resistance and the polycystic ovary syndrome: mechanisms and implication for
pathogenesis.
Endocr Rev.
1997;
18
774-800
- 30
Lord J M, Flight I HK, Norman R J.
Metformin in polycystic ovary syndrome: systematic review and meta-analysis.
BMJ.
2003;
327
951-953
- 31
Ng E HY, Wat W MS, Ho P C.
Effects of metformin on ovulation rate, hormonal and metabolic profiles in women with
clomiphene resistant polycystic ovaries: a randomized, double-blinded placebo-controlled
trial.
Hum Reprod.
2001;
16
1625-1631
- 32
Moll E, Bossuyt P M, Korevaar J C, Lambalk C B, van der Veen F.
Effect of clomifene citrate plus metformin and clomifene citrate plus placebo on induction
of ovulation in women with newly diagnosed polycystic ovary syndrome: randomised double
blind clinical trial.
BMJ.
2006;
332
1485-1489
- 33
Legro R S, Barnhart H X, Schlaff W D et al..
Clomiphene, metformin, or both for infertility in the polycystic ovary syndrome.
N Engl J Med.
2007;
356
551-566
- 34
Kiddy D S, Hamilton-Fairley D, Bush A et al..
Improvement in endocrine and ovarian function during dietary treatment of obese women
with polycystic ovary syndrome.
Clin Endocrinol (Oxf).
1992;
36
105-111
- 35
Han L K, Takaku T, Li J, Kimura Y, Okuda H.
Anti-obesity action of oolong tea.
Int J Obes Relat Metab Disord.
1999;
23
98-105
- 36
Kao Y H, Hiipakka R A, Liao S.
Modulation of endocrine systems and food intake by green tea epigallocatechin gallate.
Endocrinology.
2000;
141
980-987
- 37
Chantre P, Lairon D.
Recent findings of green tea extract AR25 (Exolise) and its activity for the treatment
of obesity.
Phytomedicine.
2002;
9
3-8
- 38
Dulloo A G, Duret C, Rohrer D et al..
Efficacy of a green tea extract rich in catechin polyphenols and caffeine in increasing
24-h energy expenditure and fat oxidation in humans.
Am J Clin Nutr.
1999;
70
1040-1045
- 39
Yang T TC, Koo M WL.
Hypocholesterolemic effects of Chinese tea.
Pharmacol Res.
1997;
35
505-512
- 40
Chan C CW, Koo M WL, Ng E HY, Tang O S, Yeung W SB, Ho P C.
Effects of Chinese green tea on weight, hormonal and biochemical profiles in obese
patients with polycystic ovary syndrome - a randomized placebo controlled trial.
J Soc Gynecol Investig.
2006;
13
63-68
- 41
Imai K, Suga K, Nakachi K.
Cancer-preventive effects of drinking green tea among a Japanese population.
Prev Med.
1997;
26
769-775
- 42
Wang D Z, Wang Z Q, Shi L Y.
Treatment of polycystic ovary syndrome with Chinese drug longdan xiegan tang.
J Tradit Chin Med.
1988;
8
117-119
- 43
Takahashi K, Kitao M.
Effect of TJ-68 (shakuyaku-kanzo-to) on polycystic ovarian disease.
Int J Fertil Menopausal Stud.
1994;
39
69-76
- 44
Sakai A, Kondo Z, Kamei K, Izumi S, Sumi K.
Induction of ovulation by Sairei-to for polycystic ovary syndrome patients.
Endocr J.
1999;
46
217-220
- 45
Ushiroyama T, Ikeda A, Sakai M et al..
Effects of unkei-to, an herbal medicine, on endocrine function and ovulation in women
with high basal levels of luteinizing hormone secretion.
J Reprod Med.
2001;
6
451-456
- 46
Xiao B.
Chinese traditional medicine for induction of ovulation.
J Reprod Med.
2003;
12(Suppl 1)
1-8
- 47
Farquhar C, Lilford R J, Marjoribanks J, Vandekerckhove P.
Laparoscopic “drilling” by diathermy or laser for ovulation induction in anovulatory
polycystic ovary syndrome.
Cochrane Database Syst Rev.
2005;
3
CD001122
- 48
Wu X K, Su Y H, Zhang Z X.
Wedge resection to improve insulin resistance in polycystic ovary syndrome: a study
among Chinese women.
Br J Obstet Gynaecol.
1996;
103
822-825
- 49
Zhu W, Li X, Chen X, Lin Z, Zhang L.
Ovarian interstitial YAG-laser: an effective new method to manage anovulation in women
with polycystic ovary syndrome.
Am J Obstet Gynecol.
2006;
195
458-463
Ernest Hung Yu NgM.D.
Department of Obstetrics and Gynaecology, The University of Hong Kong
6/F, Professorial Block, Queen Mary Hospital, Pokfulam Road, Hong Kong
eMail: nghye@hkucc.hku.hk