BMI: >31 = Obesity Lipid profile: Triglycerides: <200 mg/dl LDL <100 mg/dL HDL >45 mg/dL Cholesterol <200 mg/dL 2 hour fasting blood glucose: 140-200 mg/dL = impaired glucose tolerance Fasting insulin >15 uU/ml Main reason to diagnose insulin resistance is go further on to look for type 2 diabetes Blood pressure: Normal systolic <130 mm Hg Normal diastolic <85 mm Hg Medications: Birth control methods Insulin-sensitizing agents Weight control drugs Hypertensive drugs Fertility drugs
Gout (deposits of sodium urate crystals in small joints and surrounding tissues) due to increased uric acid levels (associated with obesity). Gallbladder disease due to ↓ HDL & ↑ triglycerides (associated with the five “F’s”—female, fat, forty, fair, fertile). Endometrial cancer caused by proliferation of uterine cells in response to increased levels of estrogen. If this proliferation is left unopposed by progesterone, periodic loss of endometrium at menstruation is prevented and a build-up of the endometrium occurs. Fat cells have the ability to convert precursor hormones in the blood to estrogens. Obesity due to increased lipogenesis (associated with high levels of insulin). NIDDM due to glucose intolerance and hyperinsulinemia. Hypertension and CVD due to ↑ triglycerides, ↑ LDL cholesterol, and ↓ HDL cholesterol. Infertility due to anovulation or other menstrual disturbances.
The pathogenesis of altered ovarian morphology in asymptomatic PCO should be evaluated by 3D and Doppler ultrasonic in those apparently normal women where up to 20% of fertile women have PCO on ultrasound
T elfax 0020502319922 & 0020502312299 Email. [email_address] www.ivfmifc.com Prof. DR. MOHAMMAD EMAM Thank you