DNA damage is a key factor affecting gametogenesis and embryo development. The integrity and stability of DNA are fundamental to a woman\'s successful conception, embryonic development, pregnancy and the production of healthy offspring. Aging, reactive oxygen species, radiation therapy, and chemotherapy often induce oocyte DNA damage, diminished ovarian reserve, and infertility in women. With the increase of infertility population, there is an increasing need to study the relationship between infertility related diseases and DNA damage and repair. Researchers have tried various methods to reduce DNA damage in oocytes and enhance their DNA repair capabilities in an attempt to protect oocytes. In this review, we summarize recent advances in the DNA damage response mechanisms in infertility diseases such as PCOS, endometriosis, diminished ovarian reserve and hydrosalpinx, which has important implications for fertility preservation.

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting approximately 5 to 18% of women of reproductive age and 3 to 11% of teenagers. The diagnostic criteria used in adult patients are not suitable for the diagnosis of adolescent patients, because some of the features may be physiological for puberty, so research is still ongoing to improve the criteria for diagnosing PCOS in teenagers. Polycystic ovary syndrome is associated with hormonal and metabolic changes and may predispose to the occurrence of many other diseases, such as obesity, metabolic syndrome, hypertension, type 2 diabetes and non-alcoholic fatty liver disease (NAFLD). Due to the high prevalence of PCOS and the various health problems it brings, it is necessary to select adolescent girls from the risk group, make an efficient diagnosis, start appropriate treatment, and lead the patient through a lifestyle change as soon as possible. Researchers\' attention is increasingly focused on patients presenting with PCOS already in their teenage years. In our work, we want to look at the latest reports regarding the prevalence, pathophysiology and diagnosis of PCOS in adolescent girls.

BACKGROUND: Polycystic ovary syndrome (PCOS) is the most prevalent female endocrinopathy. Although increased cardiovascular risk factors are well established for the syndrome, PCOS remains overlooked within the realm of cardiology. We conducted a systematic review and meta-analysis on the risk of clinical cardiovascular disease (CVD) events in women with PCOS to inform the 2023 International Evidence-Based PCOS Guideline.
RESULTS: A systematic review and meta-analysis was conducted comparing the risk of clinical CVD events in women with and without PCOS. Medline (Ovid), PsycInfo (Ovid), EMBASE, All EBM (Ovid), and CINAHL were searched from January 1, 2017, until March 1, 2023, to update the 2018 PCOS Guideline. Pooled odds ratios (ORs), incidence rate ratios (IRRs), and hazard ratios (HRs) were calculated. Twenty studies involving 1.06 million women (369 317 with PCOS and 692 963 without PCOS) were included. PCOS was associated with higher risk of composite CVD (OR, 1.68 [95% CI, 1.26-2.23]; I2 = 71.0%), composite ischemic heart disease (OR, 1.48 [95% CI, 1.07-2.05]; I2 = 81.0%), myocardial infarction (OR, 2.50 [95% CI, 1.43-4.38]; I2 = 83.3%), and stroke (OR, 1.71 [95% CI, 1.20-2.44]; I2 = 81.4%). The relationship with cardiovascular mortality was less clear (OR, 1.19 [95% CI, 0.53-2.69]; I2 = 0%). Meta-analyses of IRRs support these findings. Results from pooled HRs were limited by the small number of studies and significant heterogeneity.
CONCLUSIONS: This review provides evidence and highlights the importance of recognizing PCOS as a significant risk factor for CVD morbidity. The 2023 International Evidence-Based PCOS Guideline now recommends awareness of increased CVD risk and comprehensive risk assessment in PCOS to help mitigate the burden of CVD in this common and high-risk condition.

Extracellular vesicles (EVs), particles enriched in bioactive molecules like proteins, nucleic acids, and lipids, are crucial mediators of intercellular communication and play key roles in various physiological and pathological processes. EVs have been shown to be involved in ovarian follicular function and to be altered in two prevalent gynecological disorders; polycystic ovarian syndrome (PCOS) and endometriosis.Ovarian follicles are complex microenvironments where folliculogenesis takes place with well-orchestrated interactions between granulosa cells, oocytes, and their surrounding stromal cells. Recent research unveiled the presence of EVs, including exosomes and microvesicles, in the follicular fluid (FFEVs), which constitutes part of the developing oocyte\'s microenvironment. In the context of PCOS, a multifaceted endocrine, reproductive, and metabolic disorder, studies have explored the dysregulation of these FFEVs and their cargo. Nine PCOS studies were included in this review and two miRNAs were commonly reported in two different studies, miR-379 and miR-200, both known to play a role in female reproduction. Studies have also demonstrated the potential use of EVs as diagnostic tools and treatment options.Endometriosis, another prevalent gynecological disorder characterized by ectopic growth of endometrial-like tissue, has also been linked to aberrant EV signaling. EVs in the peritoneal fluid of women with endometriosis carry molecules that modulate the immune response and promote the establishment and maintenance of endometriosis lesions. EVs derived from endometriosis lesions, serum and peritoneal fluid obtained from patients with endometriosis showed no commonly reported biomolecules between the eleven reviewed studies. Importantly, circulating EVs have been shown to be potential biomarkers, also reflecting the severity of the pathology.Understanding the interplay of EVs within human ovarian follicles may provide valuable insights into the pathophysiology of both PCOS and endometriosis. Targeting EV-mediated communication may open avenues for novel diagnostic and therapeutic approaches for these common gynecological disorders. More research is essential to unravel the mechanisms underlying EV involvement in folliculogenesis and its dysregulation in PCOS and endometriosis, ultimately leading to more effective and personalized interventions.

Access to clean and safe water sadly remains an issue in the 21st century. Water reservoirs, whether groundwater or surface water, are routinely contaminated by various harmful Emerging Contaminants (ECs). One of most prevalent pollutants among these pollutants is Bisphenol A, which is classified as an Endocrine Disrupting Compound (EDC). This substance adversely interferes with the endocrine system, primarily by mimicking estrogen, and has been considered a potential contributor to Polycystic Ovary Syndrome (PCOS) with 82.70% of 1,391 women studied showing a positive correlation between BPA exposure and PCOS. PCOS is currently the most prevalent endocrine disorder affecting women of reproductive age; however, its pathogenesis remains unclear, complicating diagnosis and subsequently patient care. In this review, these topics are thoroughly examined, with particular emphasis on biochar, a new promising method for large-scale water purification. Biochar, derived from various organic waste materials, has emerged as a cost-effective substance with remarkable adsorption properties achieving up to 88% efficiency over four cycles of reuse, similar to that of activated carbon. This review interrogates the suitability of biochar for counteracting the issue of EDC pollutants.

UNASSIGNED: Polycystic ovary syndrome (PCOS) is an endocrine gynaecological disorder that affects many women of childbearing age.
UNASSIGNED: To evaluate the efficacy and safety of glucose-like peptide-1 receptor agonists for obese women with PCOS.
UNASSIGNED: We searched the PubMed, Embase, WOS, and Cochrane Libarary databases up to June 2023. Studies were eligible if they were randomised controlled trials (RCTs) comparing GLP-1RAs against any other treatments for patients with PCOS.
UNASSIGNED: Overall, a total of 8 RCTs were included in this review, 7 of the RCTs compared GLP-1RAs with metformin, and 1 RCT compared GLP-1Ras with dapagliflozin. Compared with control group, GLP-1RAs were more effective at improving insulin sensitivity, reducing BMI, and resulting in a smaller waist circumference.
UNASSIGNED: GLP-1RAs may be a good option for obese women with PCOS, especially those with insulin resistance. However, high-quality studies are also needed in the future to assess the efficacy of GLP-1RAs in women with PCOS.

Female fertility depends on the ovarian reserve of follicles, which is determined at birth. Primordial follicle development and oocyte maturation are regulated by multiple factors and pathways and classified into gonadotropin-independent and gonadotropin-dependent phases, according to the response to gonadotropins. Folliculogenesis has always been considered to be gonadotropin-dependent only from the antral stage, but evidence from the literature highlights the role of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) during early folliculogenesis with a potential role in the progression of the pool of primordial follicles. Hormonal and molecular pathway alterations during the very earliest stages of folliculogenesis may be the root cause of anovulation in polycystic ovary syndrome (PCOS) and in PCOS-like phenotypes related to antiepileptic treatment. Excessive induction of primordial follicle activation can also lead to premature ovarian insufficiency (POI), a condition characterized by menopause in women before 40 years of age. Future treatments aiming to suppress initial recruitment or prevent the growth of resting follicles could help in prolonging female fertility, especially in women with PCOS or POI. This review will briefly introduce the impact of gonadotropins on early folliculogenesis. We will discuss the influence of LH on ovarian reserve and its potential role in PCOS and POI infertility.

BACKGROUND: This study aims to analyze the efficacy of metformin on carotid intima media thickness (CIMT) and flow-mediated dilation (FMD) for patients with polycystic ovary syndrome (PCOS).
METHODS: A literature search of PubMed, Embase, and the Cochrane Library from inception to December 2023 was conducted. Then, after studies selection and data extraction, the mean difference (MD) with a 95% confidence interval (CI) was used to evaluate metformin efficacy in CIMT and FMD for PCOS patients. Heterogeneity was investigated through subgroup and sensitivity analysis. The protocol of our study has been registered in PROSPERO (CRD42024497239).
RESULTS: A total of 12 studies with 248 patients were included. CIMT was lower in the endpoint group (after metformin) compared with the baseline group (before metformin) (MD = -0.11, 95% CI = -0.21 to -0.01, p = 0.04). FMD was higher in the endpoint group compared with the baseline group (MD = 3.25, 95% CI = 1.85 to 4.66, p < 0.01). No statistically significant difference was observed in nitroglycerin-mediated dilation (NMD) between the two groups (MD = 0.65, p = 0.51). Subgroup analysis showed that a relatively lower MD of CIMT in PCOS patients from Europe in the endpoint group compared with the baseline group (MD = -0.09, 95% CI = -0.14 to -0.04, p < 0.001). However, the MD in CIMT was not significantly different between the endpoint group and baseline group in PCOS patients from Asia (p = 0.270).
CONCLUSIONS: Metformin may have a beneficial effect on CIMT and FMD, but not on NMD, suggesting that metformin may help reduce cardiovascular events in PCOS patients. Notably, the clinical efficacy of metformin can be influenced by regional differences and study types.

BACKGROUND: Polycystic Ovary Syndrome (PCOS) is a hormonal disorder in women associated with increased cardiovascular risk. Cinnamon, a Chinese herbal medicine, is known for its anti-inflammatory and insulin-sensitizing properties, making it a potential therapeutic agent for PCOS-related cardiovascular complications. This systematic review and meta-analysis aimed to assess the impact of cinnamon supplementation on cardiovascular risk markers in women diagnosed with PCOS.
METHODS: Twelve randomized controlled trials (RCTs) were included in the analysis. The primary outcomes assessed were body weight, insulin resistance measured by Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), and fasting blood sugar (FBS).
RESULTS: The meta-analysis revealed a statistically significant effect of cinnamon on reducing weight. Under the random-effects model, the pooled weighted mean difference (WMD) was -0.47 kg (95 % CI: -0.80 to -0.15, p < 0.001; I2 = 0.0 %). There was also a beneficial impact on insulin resistance, with reduced HOMA-IR scores following cinnamon supplementation (SMD=0.5015, 95 % CI: 0.2496 to 0.7533, p < 0.0001). Additionally, there was a significant improvement in FBS levels (pooled WMD: -7.72 mg/dL, 95 % CI: -12.33 to -3.12, p < 0.001; I2 = 91.3 %). The meta-analysis indicated a tendency towards reduced total cholesterol (WMD: -11.12 mg/dL, 95 % CI: -19.06 to -3.18, p = 0.01; I2 = 0.0 %) and LDL levels (WMD: -11.11 mg/dL, 95 % CI: -18.22 to -4.00, p < 0.01; I2 = 0.0 %) following cinnamon intervention. Substantial heterogeneity was observed among the studies, indicating the need for further research with larger sample sizes and standardized methodologies.
CONCLUSIONS: Cinnamon supplementation demonstrates promising effects on body weight, blood sugar, total cholesterol, LDL, and insulin resistance in women with PCOS, indicating its potential in mitigating cardiovascular risk factors associated with this condition.

OBJECTIVE: Polycystic ovary syndrome (PCOS) is a prevalent and complex endocrine disorder that affects women of reproductive age. It has significant implications for female endocrine function, reproductive health, and metabolic disturbances, including insulin resistance, impaired glucose tolerance, and dyslipidemia. Studies have shown that decreased heart rate variability (HRV), a marker of autonomic dysfunction, is associated with adverse cardiovascular events. Recent research has focused on investigating autonomic function in PCOS, and some studies have suggested altered autonomic drive in these patients. The aim of this systematic review and meta-analysis was to evaluate cardiac autonomic function by analyzing HRV in women with PCOS.
METHODS: This systematic review was prepared using PRISMA reporting guidelines. The databases searched were PubMed, Scopus, Web of Science, and Cochrane. Risk of Bias was assessed using ROBINS-I for non-RCTs. The GRADE approach was employed to evaluate the level of certainty in the evidence for each outcome. In order to identify the underlying cause of high heterogeneity, a subgroup analysis was conducted. Sensitivity analysis was checked. A random effect model was used and calculated a pooled standardized mean difference (SMD) with a 95% confidence interval (CI).
RESULTS: Seventeen articles were included in the final analysis, varied in quality, ranging from a \"low\" to a \"high risk of bias\". Combined analyses indicated a notable decrease in HRV among individuals with PCOS compared to the control group. Significant changes were observed in SDNN (SMD: -0.763, 95%CI [-1.289 to -0.237], p=0.004), PNN50 (SMD: -1.245, 95%CI [-2.07, -0.419], p=0.003), LF/HF ratio (SMD: 0.670, 95%CI [0.248, 1.091], p=0.002), HFnu (SMD: -0.873, 95%CI [-1.257, -0.489], p=0.000), LFnu (SMD: 0.840, 95%CI [0.428, 1.251], p=0.000) and TP (SMD: -1.997, 95%CI [-3.306, -0.687], p=0.003). The heterogeneity was partially explained by types of study design. Subgroup analysis revealed significant alterations of HRV in normal-weighted and overweight PCOS cases. Conversely, no significant changes in HRV were observed in obese PCOS cases.
CONCLUSIONS: The findings of this meta-analysis provide evidence suggesting diminished HRV in individuals with PCOS compared to non-PCOS control group.