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Anovulatory infertility is a major problem associated with polycystic ovary syndrome; however, several treatment options are now available to induce ovulation in affected individuals. The pros and cons of these medications, which include clomifene citrate, follicle-stimulating hormone, insulin-sensitizing agents, and aromatase inhibitors, are discussed in this Viewpoint.
The insulin-sensitizing agent metformin has been heralded as a novel therapy for women with polycystic ovary syndrome-associated anovulatory infertility. The author of this Viewpoint reviews the evidence from clinical trials and asks whether metformin will become the first-line therapy for ovulation induction in polycystic ovary syndrome.
This Review details the epidemiological, mechanistic, clinical, biological and pathological features of nonalcoholic fatty liver disease—the liver manifestation of the metabolic syndrome that can progress to end-stage liver disease, and the commonest liver disease in Western countries. The article also describes the treatment options, which include dietary modification and exercise.
This Review details the complex problems that Graves′ disease can cause for both mother and fetus. The authors describe physiological aspects of maternal thyroid function and the effects on fetal thyroid development. They then discuss the diagnostic testing and therapy of Graves′ disease, and review the ramifications of treatment for the fetus.
This Review describes effects of maternal factors such as diet and glucocorticoid levels on disease development later in the child's life. In particular, the barrier function of placental 11β-hydroxysteroid dehydrogenase type 2 in controlling fetal glucocorticoid exposure, and mechanisms that affect glucocorticoid receptor promoter usage and gene methylation are discussed.
Postoperative diabetes insipidus usually occurs transiently, owing to temporary compromise of arginine vasopressin secretion. Sometimes, however, a triphasic pattern occurs: initial diabetes insipidus is followed by a period of inappropriate antidiuresis that finally culminates in chronic diabetes insipidus. The authors discuss the pathophysiology of this process and the importance of adjusting treatment according to the pattern of the disease.
