Acupuncture and physical exercise for affective symptoms and health-related quality of life in polycystic ovary syndrome: secondary analysis from a randomized controlled trial Global Improvement of Vascular Function and Redox State With Low-Dose Folic Acid: Implications for Folate Therapy in Patients With Coronary Artery Disease N-Acetylcysteine as an adjuvant to clomiphene citrate for successful induction of ovulation in infertile patients with polycystic ovary syndrome. Isoflavone phytoestrogens consumed in soy decrease F(2)-isoprostane concentrations and increase resistance of low-density lipoprotein to oxidation in humans. N‐Acetyl cysteine and clomiphene citrate for induction of ovulation in polycystic ovary syndrome: a cross‐over trial Effects of Metformin With or Without Supplementation With Folate on Homocysteine Levels and Vascular Endothelium of Women With Polycystic Ovary Syndrome Effect of folic acid on endothelial function following acute myocardial infarction. Benefits of omega-3 Fatty acids supplementation on serum paraoxonase 1 activity and lipids ratios in polycystic ovary syndrome. N-acetyl-cysteine treatment improves insulin sensitivity in women with polycystic ovary syndrome. The effects of calcium-vitamin D and metformin on polycystic ovary syndrome: a pilot study. Is there a role for soy isoflavones in the therapeutic approach to polycystic ovary syndrome? Results from a pilot study. Revisiting the ovarian volume as a diagnostic criterion for polycystic ovaries. Effect of folic acid in women with and without insulin resistance who have hyperhomocysteinemic polycystic ovary syndrome. Therapeutic implications of vitamin D and calcium in overweight women with polycystic ovary syndrome Therapeutic effects of calcium & vitamin D supplementation in women with PCOS.
Background Women with polycystic ovary syndrome ( PCOS ) have symptoms of depression and anxiety and impaired health related quality of life ( HRQoL ) . Here we test the post-hoc hypothesis that acupuncture and exercise improve depression and anxiety symptoms and HRQoL in PCOS women . Methods Seventy-two PCOS women were r and omly assigned to 16 weeks of 1 ) acupuncture ( n = 28 ) ; 2 ) exercise ( n = 29 ) ; or 3 ) no intervention ( control ) ( n = 15 ) . Outcome measures included : change in Montgomery Åsberg Depression Rating Scale ( MADRS-S ) , Brief Scale for Anxiety ( BSA-S ) , Swedish Short-Form 36 ( SF-36 ) , and PCOS Question naire ( PCOSQ ) scores from baseline to after 16-week intervention , and to 16-week post-intervention follow-up . Results A reduction in MADRS-S and BSA-S from baseline to 16-weeks post-intervention follow-up was observed for the acupuncture group . The SF-36 domains role physical , energy/vitality , general health perception and the mental component of summary scores improved in the acupuncture group after intervention and at follow-up . Within the exercise group the role physical decreased after treatment , while physical functioning and general health perception scores increased at follow-up . The emotion domain in the PCOSQ improved after 16-weeks of intervention within all three groups , and at follow-up in acupuncture and exercise groups . At follow-up , improvement in the infertility domain was observed within the exercise group . Conclusion There was a modest improvement in depression and anxiety scores  in women treated with  acupuncture  , and improved HRQoL scores were noted in both intervention groups . While not a primary focus of the trial , these data suggest continued investigation of mental health outcomes in women treated for PCOS.Trial registration number Clinical Trials.gov Identifier : Background — Although dietary folate fortification lowers plasma homocysteine and may reduce cardiovascular risk , high-dose folic acid therapy appears to not alter clinical outcome . Folic acid and its principal circulating metabolite , 5-methyltetrahydrofolate , improve vascular function , but mechanisms relating folate dose to vascular function remain unclear . We compared the effects of folic acid on human vessels using pharmacological high-dose versus low-dose treatment , equivalent to dietary folate fortification . Methods and Results — Fifty-six non – folate-fortified patients with coronary artery disease were r and omized to receive low-dose ( 400 & mgr;g/d ) or high-dose ( 5 mg/d ) folic acid or placebo for 7 weeks before coronary artery bypass grafting . Vascular function was quantified by magnetic resonance imaging before and after treatment . Vascular superoxide and nitric oxide bioavailability were determined in segments of saphenous vein and internal mammary artery . Low-dose folic acid increased nitric oxide – mediated endothelium-dependent vasomotor responses , reduced vascular superoxide production , and improved enzymatic coupling of endothelial nitric oxide synthase through availability of the cofactor tetrahydrobiopterin . No further improvement in these parameters occurred with high-dose compared with low-dose treatment . Whereas plasma 5-methyltetrahydrofolate increased proportionately with treatment dose of folic acid , vascular tissue 5-methyltetrahydrofolate showed no further increment with high-dose compared with low-dose folic acid . Conclusions — Low-dose folic acid treatment , comparable to daily intake and dietary fortification , improves vascular function through effects on endothelial nitric oxide synthase and vascular oxidative stress . High-dose folic acid treatment provides no additional benefit . These direct vascular effects are related to vascular tissue levels of 5-methyltetrahydrofolate rather than plasma levels . High-dose folic acid treatment likely confers no further benefit in subjects already receiving folate supplementation AIM The aim of this study was to evaluate the effect of oral N-acetylcysteine ( NAC ) administration as an adjuvant to clomiphene citrate ( CC ) on induction of ovulation outcomes in patients with polycystic ovary syndrome ( PCOS ) . MATERIAL AND METHODS In this placebo-controlled double-blind r and omized clinical trial , 180 PCOS infertile patients were r and omly divided into two groups for induction of ovulation . Patients in group 1 received CC 100 mg/d plus NAC 1.2 g/d and patients in group 2 received CC plus placebo for 5 days starting at day 3 of the cycle . On the 12th day of the menstrual cycle in the presence of at least one follicle with an 18 - 20-mm diameter in ultrasound evaluation , 10,000 U hCG was injected intramuscularly and timed intercourse was advised 36 h after hCG injection . Serum β-hCG level was measured on the 16th day after hCG injection . RESULTS The number of follicles > 18 mm and the mean endometrial thickness on the day of hCG administration were significantly higher among the CC+NAC group ( P-value = 0.001 ) . The ovulation and pregnancy rates were also significantly higher in the CC+NAC group ( P-value = 0.02 and 0.04 , respectively ) . No adverse side-effects and no cases of ovarian hyperstimulation syndrome were observed in the group receiving NAC . CONCLUSION NAC as a safe and well-tolerated adjuvant to CC for induction of ovulation can improve the ovulation and pregnancy rates in PCOS patients . It may also have some beneficial impacts on endometrial thickness BACKGROUND Oxidative damage to lipids may be involved in the etiology of atherosclerosis , cardiovascular disease in general , and cancer . The soy isoflavone phytoestrogens , genistein and daidzein , and equol ( a daidzein metabolite produced by intestinal microflora ) are antioxidants in vitro ; equol is a particularly good inhibitor of LDL oxidation and membrane lipid peroxidation . OBJECTIVE We sought to investigate the effects of a diet enriched with soy containing isoflavones on in vivo biomarkers of lipid peroxidation and resistance of LDL to oxidation , compared with a diet enriched with soy from which the isoflavones had been extracted . DESIGN : A r and omized , crossover design was used to compare diets enriched with soy that was low or high in isoflavones in 24 subjects .  Plasma concentrations of an F(2)-isoprostane , 8-epi-prostagl and in F(2)(alpha ) ( 8-epi-PGF(2)(alpha ) ) , a biomarker of in vivo lipid peroxidation , and resistance of LDL to copper-ion-induced oxidation were determined . RESULTS Plasma concentrations of 8-epi-PGF(2)(alpha ) were significantly lower after the high-isoflavone dietary treatment than after the low-isoflavone dietary treatment ( 326 + /- 32 and 405 + /- 50 ng/L , respectively ; P = 0.028 ) and the lag time for copper-ion-induced LDL oxidation was longer ( 48 + /- 2.4 and 44 + /- 1.9 min , respectively ; P = 0.017 ) . Lag time for oxidation of unfractionated plasma and plasma concentrations of malondialdehyde , LDL alpha-tocopherol , polyunsaturated fatty acids , and isoflavonoids did not differ significantly between dietary treatments . CONCLUSIONS Consumption of soy containing naturally occurring amounts of isoflavone phytoestrogens reduced lipid peroxidation in vivo and increased the resistance of LDL to oxidation . This antioxidant action may be significant with regard to risk of atherosclerosis , cardiovascular disease in general , and cancer Objective . To compare clomiphene citrate plus N‐acetyl cysteine versus clomiphene citrate for inducing ovulation in patients with polycystic ovary syndrome . Design . Prospect i ve cross‐over trial . Setting . University teaching hospital and a private practice setting . Patients . Five hundred and seventy‐three patients were treated with clomiphene citrate for one menstrual cycle among which 470 patients were treated with clomiphene citrate plus N‐acetyl cysteine for another cycle . All women suffered from polycystic ovary syndrome . Interventions . Patients had clomiphene citrate 50‐mg tablets twice daily alone or with N‐acetyl cysteine 1,200 mg/day orally for 5 days starting on day 3 of the menstrual cycle . Outcome measures . Primary outcomes were number of mature follicles , serum E2 , serum progesterone , and endometrial thickness . Secondary outcome was the occurrence of pregnancy . Results . Ovulation rate improved significantly after the addition of N‐acetyl cysteine ( 17.9 % versus 52.1 % ) . Although the number of mature follicles was more in the N‐acetyl cysteine group ( 2.1±0.88 versus 3.2±0.93 ) , the difference was not statistically significant . The mean E2 levels ( pg/ml ) at the time of human chorionic gonadotropine injection , serum progesterone levels ( ng/ml ) on days 21–23 of the cycle , and the endometrial thickness were significantly improved in the N‐acetyl cysteine group . The overall pregnancy rate was 11.5 % in the N‐acetyl cysteine group .  Insulin resistance occurred in 260 patients ( 55.4 % ) . There was no significant difference between the insulin resistance group ( n = 260 ) and non‐insulin resistance group ( n = 210 ) as regards ovulation rate , number of follicles , serum E2 ( pg/ml ) , serum progesterone ( ng/ml ) , endometrial thickness ( mm ) , or pregnancy rate . Conclusion . N‐Acetyl cysteine is proved effective in inducing or augmenting ovulation in polycystic ovary patients OBJECTIVE To evaluate whether the administration of metformin exerts any effects on serum homocysteine ( Hcy ) levels in patients with polycystic ovary syndrome ( PCOS ) and whether supplementation with folate enhances the positive effects of metformin on the structure and function of the vascular endothelium . RESEARCH DESIGN AND METHODS A total of 50 patients affected by PCOS , without additional metabolic or cardiovascular diseases , were enrolled in a prospect i ve nonr and omized placebo-controlled double-blind clinical study . They were grouped into two treatment arms that were matched for age and BMI . Patients were treated with a 6-month course of metformin ( 1,700 mg daily ) plus folic acid ( 400 μg daily ; experimental group , n = 25 ) or placebo ( control group , n = 25 ) . Complete hormonal and metabolic patterns , serum Hcy , folate , vitamin B12 , endothelin-1 levels , brachial artery diameter at the baseline ( BAD-B ) and after reactive hyperemia ( BAD-RH ) , flow-mediated dilation , and intima-media thickness in both common carotid arteries were evaluated . RESULTS After treatment , a significant increase in serum Hcy levels was observed in the control group compared with the baseline values and the experimental group . A beneficial effect was observed in the concentrations of BAD-B , BAD-RH , flow-mediated dilation , intima-media thickness , and serum endothelin-1 in both groups . However , the results were improved more significantly in the experimental group than in the control subjects . CONCLUSIONS Metformin exerts a slight but significant deleterious effect on serum Hcy levels in patients with PCOS , and supplementation with folate is useful to increase the beneficial effect of metformin on the vascular endothelium The aim of this study was to test the influence of high-dose folic acid ( 10 mg/d ) on endothelial function in patients referred for coronary intervention after an acute myocardial infa rct ion ( AMI ) and determine its relation to homocysteine levels . Flow-mediated dilation ( FMD ) of the brachial artery was performed in 40 patients after AMI ( 16 with normal homocysteine levels and 24 patients with elevated levels [ > 11 micromol/L ] ) . Subjects were r and omized to receive first folic acid ( 10 mg/day ; group A ) or placebo ( group B ) for 6 weeks in a double-blind crossover trial with a 2-week washout . Plasma folate , total homocysteine and its subtypes ( oxidized , reduced , and protein-bound ) , FMD , and nitroglycerin-mediated dilation were assessed at baseline and at 6 and 14 weeks . In group A , folic acid improved FMD from 3.98 + /- 0.35 % to 6.44 + /- 0.56 % ( p < 0.001 ) . This effect persisted after the crossover with placebo ( 5.42 + /- 0.59 , p = 0.13 ) . In group B , placebo did not increase FMD ( 4.01 + /- 0.34 % vs 4.46 + /- 0.38 , p = 0.38 ) ; however , a significant increase was observed in the second active treatment period ( 6.49 + /- 0.56 % , p = 0.005 ) . In both groups , improved FMD neither correlated with basal levels of homocysteine and its subtypes nor with changes induced during the folate treatment . Nitroglycerin-mediated dilation did not change significantly in either group . Folic acid increased FMD in both normo- and hyperhomocysteinanemic groups ( p = 0.006 and p < 0.001 ) . In conclusion , 6-week treatment with high-dose folic acid improves endothelial function in post-AMI patients , independent from homocysteine status . Folic acid can be recommended to improve postinfa rct ion endothelial dysfunction in patients with normo- and hyperhomocysteinemia BACKGROUND Polycystic ovary syndrome ( PCOS ) is a common endocrine disorder associated with increased risk of cardiovascular disease . The purpose of this study was to investigate the ef¬fects of omega-3 fatty acids on serum paraoxonase 1 activity and lipids ratios in polycystic ovary syndrome . METHODS This double-blind r and omized controlled clinical trial was conducted on 64 PCOS pa¬tients with 20 - 35 years old . Thirty two of the subjects had taken 4 g/day omega -3 fatty acids and 32 patients were given placebo for 8 weeks . Fasting blood sample s , anthropometric measure¬ments and dietary intakes were collected at the beginning and the end of the study . Serum total cholesterol , triglyceride , and HDL-C were measured using the enzymatic methods . LDL-C con¬centration was calculated by the Friedewald formula and arylesterase activity of serum PON1 was measured . Data were analyzed using SPSS software . RESULTS Omega-3 fatty acids significantly decreased TC/HDL-C and LDL-C/HDL-C ratios ( P = 0.009 for both ) and significantly increased serum PON1 activity ( P = 0.048 ) compared with placebo . Changes in TG/HDL-C ratio were not statistically significant in omega-3 fatty acids group at the end of the study in comparison to placebo group . Reduction in TC/HDL-C , LDL-C/HDL-C and TG/HDL-C ratios and increase in serum PON1 activity were also significant in omega-3 fatty acids group at the end of the study compared with baseline values ( P < 0.001 , P < 0.001 , P = 0.004 , and P = 0.001 , respectively ) . CONCLUSION Omega-3 fatty acids may decrease the risk for cardiovascular disease through the improvement in paraxonase-1 activity and reduction in some lipids ratio in PCOS women OBJECTIVE To evaluate the effect of N-acetyl-cysteine ( NAC ) on insulin secretion and peripheral insulin resistance in subjects with polycystic ovary syndrome ( PCOS ) . DESIGN Prospect i ve data analysis . SETTING Volunteer women in an academic research environment . PATIENT(S ) Six lean and 31 obese subjects , aged 19 - 33 years . INTERVENTION(S ) Patients were treated for 5 - 6 weeks with NAC at a dose of 1.8 g/day orally . A dose of 3 g/day was arbitrarily chosen for massively obese subjects . Six of 31 obese patients with PCOS were treated with placebo and served as controls . MAIN OUTCOME MEASURE(S ) Before and after the treatment period , the hormonal and lipid blood profile and insulin sensitivity , assessed by an hyperinsulinemic euglycemic clamp , were evaluated and an oral glucose tolerance test ( OGTT ) was performed . RESULT ( S ) Fasting glucose , fasting insulin , and glucose area under curve ( AUC ) were unchanged after treatment . Insulin AUC after OGTT was significantly reduced , and the peripheral insulin sensitivity increased after NAC administration , whereas the hepatic insulin extraction was unaffected . The NAC treatment induced a significant fall in T levels and in free and rogen index values ( P<.05 ) . In analyzing patients according to their insulinemic response to OGTT , normoinsulinemic subjects and placebo-treated patients did not show any modification of the above parameters , whereas a significant improvement was observed in hyperinsulinemic subjects . CONCLUSION ( S ) NAC may be a new treatment for the improvement of insulin circulating levels and insulin sensitivity in hyperinsulinemic patients with polycystic ovary syndrome OBJECTIVE The aim of this study was to evaluate the effects of calcium-vitamin D and metformin on the menstrual cycle and ovulation in patients with polycystic ovary syndrome ( PCOS ) . MATERIAL S AND METHODS In this pilot study , 60 infertile PCOS patients were enrolled in a r and omized clinical trial and divided into three equal groups . Group 1 received 1,000 mg of calcium and 400 IU of vitamin D per day , orally . Group 2 received the same as Group 1 , plus 1,500 mg/day of metformin . Group 3 received 1,500 mg/day of metformin . The patients were treated for 3 months and followed up for a further 3 months . Regularity of menses , number of large follicles ( > or = 14 mm ) and pregnancy rates were compared among the three groups . RESULTS Generalized estimating equation tests showed that the number of dominant follicles ( > or = 14 mm ) during the 2 - 3 months of follow-up was higher in the calcium-vitamin D plus metformin group than in either of the other two groups ( p = 0.03 ) . CONCLUSION The effects of metformin and calcium-vitamin D in regulating the menstrual cycle suggest that they could also be effective for the treatment of anovulation and oligomenorrhea , with possible consequences for pregnancy rates in PCOS patients OBJECTIVE To evaluate the effect of the soy isoflavone genistein on the metabolic and hormonal disturbances of polycystic ovary syndrome ( PCOS ) , we studied a group of obese , hyperinsulinemic , and dyslipidemic women presenting this syndrome during 6 months of phytoestrogen administration .  DESIGN Pilot prospect i ve study . SETTING Operative division of endocrinological gynecology in a university hospital . PATIENT(S ) Twelve Caucasian obese , hyperinsulinemic , and dyslipidemic women with PCOS . INTERVENTION(S ) Patients received 36 mg/d of genistein for 6 months . Ultrasonographic pelvic exams , hormonal and lipid features , oral glucose tolerance test , and euglycemic hyperinsulinemic clamp were performed at baseline and after 3 and 6 months of treatment . MAIN OUTCOME MEASURE(S ) Basal hormonal assays , lipid profile , and glycoinsulinemic assessment . RESULT ( S ) Phytoestrogens supplementation significantly improved total cholesterol levels , reducing low-density lipoprotein ( LDL ) cholesterol and result ing in a significant decrease in the LDL-high-density lipoprotein ratio ( LDL-HDL ) . Triglycerides showed a trend toward decrease , whereas no changes were detected in very low-density lipoprotein cholesterol plasma levels . Genistein treatment did not significantly affect anthropometric features , the hormonal milieu , and menstrual cyclicity . No significant changes occurred in glycoinsulinemic metabolism . CONCLUSION ( S ) The possible advantages derived from the therapeutic use of phytoestrogens in PCOS are limited to improvement of the lipidic assessment BACKGROUND This study revisited the ovarian volume ( OV ) as a diagnostic criterion for polycystic ovaries ( PCO ) . Indeed , a threshold of 10 cm(3 ) for the OV , chosen at the polycystic ovary syndrome ( PCOS ) international consensus held at Rotterdam in 2003 , was to date not based on appropriate studies such as receiver operator characteristic ( ROC ) curve analysis . METHODS This prospect i ve study included 154 women with PCOS , selected by using the former National Institutes of Health criteria , who were compared with 57 women with normal ovarian function .  Ultrasound examination was performed between cycle days 2 and 7 with a 7 MHz transvaginal transducer . RESULTS Mean OV , ovarian area ( OA ) and follicle number ( FN ) values were significantly higher in the PCOS group than in controls . The area under the ROC curve ( AUC ) was > 0.9 for all three criteria , indicating a satisfactory diagnostic potency for each . Concerning the OV , setting the threshold at 7 cm(3 ) offered the best compromise between specificity ( 91.2 % ) and sensitivity ( 67.5 % ) . In comparison , specificity and sensitivity were 98.2 and 45 % , respectively , with a threshold at 10 cm(3 ) . Nevertheless , the highest AUC was obtained for FN ( 0.956 ) and then for OA ( 0.941 ) . CONCLUSIONS OV is a good diagnostic criterion for PCO but , on the basis of the present data , we propose to lower its threshold to 7 cm(3 ) . The FN > 12 still appears as the best diagnostic criterion . The OA could be used as a surrogate for OV in difficult situations OBJECTIVE To study the effect of folic acid on homocysteine ( Hcy ) levels in women with insulin resistance and polycystic ovary syndrome ( PCOS ) in a prospect i ve clinical trial . METHOD Of 210 women with PCOS , 70 were hyperhomocysteinemic ; and of these , 32 were insulin resistant and 38 were not . The 70 women were treated with folic acid for 3 months .  Baseline and serum levels of Hcy and insulin were measured in both groups . RESULTS In both groups Hcy concentrations were significantly decreased following folic acid supplementation . The mean+/-SD levels before and after treatment were 14.03+/-1.5 micromol/L and 12.53+/-1.72 micromol/L in group 1 ( P<0.001 ) , and they were 12.07+/-0.87 micromol/L and 8.83+/-0.78 micromol/L in group 2 ( P<0.001 ) . CONCLUSION The Hcy levels of hyperhomocysteinemic women with PCOS were reduced after 3 months of folic acid supplementation , and the rate of reduction was higher among women without insulin resistance . No change was found in fasting insulin levels Objective : To assess effects of vitamin D and Calcium ( Ca ) on hormonal and metabolic milieu of polycystic ovary syndrome ( PCOS ) . Design : Single arm open label trial . Methods : Twelve overweight and vitamin D deficient women with PCOS underwent a 2 hour oral glucose tolerance testing at baseline and following 3-month supplementation with vitamin D ( daily dose of 3533 IU , increased to 8533 IU after the first five participants ) and 530 mg elemental Ca daily . Main outcome measures : Blood pressure ( BP ) , plasma glucose , insulin , total testosterone ( T ) and rostenedione ( A ) , sex hormone binding globulin , lifestyle parameters were assessed at baseline and following 3-month intervention . Insulin resistance ( IR ) and area under the curve for glucose and insulin were computed ; paired analyses were conducted . Results : Improved serum 25OHD ( p < 0.001 ) and reductions in total T ( p = 0.036 ) and A ( p = 0.090 ) levels were noted following 3-month supplementation , compared to baseline . Significant lowering in BP parameters was seen in participants with baseline BP ≥ 120/80 mmHg ( n = 8) and in those with baseline serum 25OHD ≤20 ng/ml ( n = 9 ) . Parameters of glucose homeostasis and IR remained unchanged ( p > 0.05 ) . Conclusions : And rogen and BP profiles improved followed three month intervention , suggesting therapeutic implication s of vitamin D and Ca in overweight and vitamin D deficient women with PCOS OBJECTIVE To evaluate the efficacy of calcium & vitamin D supplementation in infertile women suffering from polycystic ovary syndrome ( PCOS ) , and to assess levels of 25-hydroxy vitamin D in these patients . METHODS In a case control study , 100 infertile PCOS women based on a r and omly divided into two groups . Group I ( n = 50 ) were treated with metformin 1500 mg/day , and group II ( n = 50 ) treated with metformin 1500 mg/day plus Calcium 1000 mg/day and Vitamin D 100000 IU/month for 6 months . Patients were followed by transvaginal sonography at first , 3 and 6 months later for evaluating dominant follicle . BMI , menstrual regularity , follicle diameter , pregnancy , serum 25-OH-vitamin D level were matured and compared in two groups . RESULTS BMI decreased almost significantly ( 25.49 ± 1.88 vs 26.28 ± 2.15 , p : 0.054 ) in group II . A better improvement was gained in regulating menstrual abnormalities ( 70 % vs 58 % , p : 0.211 ) , follicle maturation ( 28 % vs 22 % , p : 0.698 ) , and infertility ( 18 % vs 12 % , p : 0.401 ) in group II compared with group I , but these results were not statistically significant . Eighty three percent of all the PCOS patients  showed vitamin D deficiency while 35 % were severely deficient . The serum 25-OH-vitamin D mean levels were 13.38 ± 6.48 ng/ml . Vitamin D deficiency was recompensed in 74 % of the PCOS patients who had taken calcium & vitamin D supplementation . There was no correlation between BMI and 25-OH-VD before and after the treatment ( p ≥ 0.01 ) . CONCLUSION This study showed the positive effects of calcium & vitamin D supplementation  on weight loss , follicle maturation , menstrual regularity , and improvement of hyper and rogenism , in infertile women with PCOS
BACKGROUND Recently there is a focus on the antioxidants as adjuvant treatment of polycystic ovary syndrome ( PCOS ) , the most endocrinopathy in reproductive age women .
OBJECTIVE The aim of this review is answer to the question whether antioxidants are effective for managing of hormonal and metabolic problems in women with PCOS based on first degree evidence s from Iran .