الفهرس 
The Polycystic ovary syndromeOnly 14 pages are availabe for public view
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Abstract
Polycystic ovary syndrome (PCOS) is a heterogenous disorder which has eluded definitive description because of varied combination of clinical, biochemical and ultrasonographic feature which may occur. The commonest association is of hyperandrogenism and chronic anovulation; recognition of characteristic ovarian ultrasound feature together with clinical symptoms of oligomenorrhoea. Hyperandrogenism, infertility or obesity is presently the preferred approach to diagnosis (Trivax and Azziz, 2007). Irregular menstrual cycles, reduced spontaneous and assisted fertility and an increased risk of miscarriage are risks associated with obesity that are often overlooked (Grodstein et al., 1994; Barbieri, 2001). Excessive weight and central distribution of body fat are both related to an increased risk of normogonadotrophic anovulation (zadstra et al., 1991). The mechanism through which weight impairs fertility is largely unknown, but thesepatient have a lower concentration of sex hormone-binding globulin (SHBG) (Kiddy et al., 1990) and increased androgens, insulin secretion and insulin resistance (Barbieri et al., 1988). Weight Lossinobese PCOS patients reduce circulating androgens and raises SHBG (Kiddy et al., 1990; Hollmannet al,. 1996), Enhances insulin sensitivity (Guzick et al., 1994; Andersen et al,. 1995; HOlte et al 1995; Huber-Bachholz et al., 1999) and regularly improve menstrual cyclicity and fertility rate (Bates and whiteworth, 1982; Franks et al,. 1991; Pasquali et al., 1997). On clinical grounds, weight losscan re-establish ovulation in obese anovulatory patients or improve their response to ovulation induction (Clark et al., 1995,1998; Grosignani et al,. 1999, 2002).Doppler ultrasound Transvaginalcolour and pulsed Doppler ultrasound in combination with B-mode imaging is used as a non-invasive method to assess blood flow in both obstetrics and gynaecology. Color or power Doppler allows detection of the uterine and ovarian vessels as well as the network within the ovarian stroma; power Doppler is more sensitive to slow flow and allows the detection of blood flow within the ovarian strobna(Battagliac, 1995). However, power Doppler does not as yet allow quantative measurement of blood flow. The spectral Doppler assessment of vascular changes in the ovarian and uterine arteries in women with PCO has improved our understanding of the pathogenesis of this common condition and provides an additional variable to traditional endocrinological and more recent ultrasound features for its diagnosis. In our study fifty women presented to the gynecological outpatient clinic at Banha university hospital, were recruited. All had no history of any medical disorders and there was no recent history of any drug intake. Based on clinical menstrual history, physical examination, biochemical data and ultrasound findings, all women diagnosed as polycystic ovarian syncrome by having the following criteria, aprevious history of anovulatory cycles and/or oligomenorrhea, clinical or biochemical evident of hyperandrogenism and finally the presence of polycystic ovaries by 2-D transvaginal ultrasound (The Rotter derm ESHRE/ASRM, 2004). Serum LH and FSH concentration were determined of day 2-4 of the cycle and BMI was calculated for all patients before and after 3 month of reduction of weight, and thenpulsed wave Doppler was done on the stromal. vessels to measure resistance index and pulsatile index before and after reduction of weight. The comparison between Doppler result before and after reduction of weight show no statistical difference.