Obesity is a common disorder with a negative impact on IVF treatment outcome. It is not clear whether morbidly obese women (BMI >= 35 kg/m2) respond to treatment differently as compared to obese women (BMI = 30–34.9 kg/m2) in IVF. Our aim was to compare the outcome of IVF or ICSI treatments in obese patients to that in morbidly obese patients.

Ovarian hyperstimulation syndrome (OHSS) is often a complication of polycystic ovarian syndrome (PCOS), the most frequent disorder of the endocrine system, which affects women in their reproductive years. The etiology of OHSS is multifactorial, though the factors involved are not apparent. In an attempt to unveil the molecular basis of OHSS, we conducted transcriptome analysis of total RNA extracted from granulosa cells from PCOS patients with a history of OHSS (n = 6) and compared them to those with no history of OHSS (n = 18). We identified 59 significantly dysregulated genes (48 down-regulated, 11 up-regulated) in the PCOS with OHSS group compared to the PCOS without OHSS group (p-value < 0.01, fold change >1.5). Functional, pathway and network analyses revealed genes involved in cellular development, inflammatory and immune response, cellular growth and proliferation (including DCN, VIM, LIFR, GRN, IL33, INSR, KLF2, FOXO1, VEGF, RDX, PLCL1, PAPPA, and ZFP36), and significant alterations in the PPAR, IL6, IL10, JAK/STAT and NF-κB signaling pathways. Array findings were validated using quantitative RT-PCR. To the best of our knowledge, this is the largest cohort of Saudi PCOS cases (with or without OHSS) to date that was analyzed using a transcriptomic approach. Our data demonstrate alterations in various gene networks and pathways that may be involved in the pathophysiology of OHSS. Further studies are warranted to confirm the findings.

Background: Primary ovarian insufficiency (POI) is a condition causing hypergonadotropic hypogonadism before age 40, leading to menstrual irregularities, infertility, and estrogen deficiency. This study aimed to describe the clinical, endocrine, and reproductive characteristics of patients diagnosed with primary ovarian insufficiency (POI). and describe the distribution of these clinical and biochemical characteristics. Methods: This hospital-based retrospective study was conducted at King Faisal Specialized Hospital and Research Center (KFSHRC) in Riyadh, Saudi Arabia. Medical records of patients diagnosed with POI between 2008 and 2018 were reviewed and analyzed. Results: The onset of POI occurred before 20 years of age in 64.1% of patients. The most common presenting symptoms included infertility (50%), menstrual disturbances (42.2%), delayed puberty (25%), and estrogen deficiency (25%). More than half of the patients were overweight or obese (29.7% each). A family history of POI was reported in 12.5% of cases. Autoimmune diseases were present in 60.9% of patients, while dyslipidemia (25%), and psychiatric disorders (14.1%) were also common. A history of abdominal/pelvic surgery (25%), chemotherapy (28.1%), and radiotherapy (7.8%) was noted. Pelvic ultrasonography revealed that 18.5% of patients had normal findings, while 23/54 (42.6%) had gonadal dysgenesis/agenesis, and 16/54 (29.6%) had uterine abnormalities. Vitamin D deficiency was present in 25/35 (71.4%) of patients, while 3/35 (17.1%) had vitamin D insufficiency, and 3/35 (8.6%) had hypervitaminosis D. Diabetes mellitus was observed in 6/60 (10%) of patients. Autoimmune markers were positive in a subset of patients: anti-thyroid peroxidase antibodies (15/64, 23.4%), anti-thyroglobulin antibodies (12/64, 18.8%), rheumatoid factor (6/64, 9.4%), and other autoimmune markers 3/64 (4.7%). Bone mineral density was low in 23/44 (52.3%) of patients, and 2/44 (4.5%) had delayed bone age. Karyotype analysis identified Turner syndrome in 6/44 (13.6%) of patients, while 38/44 (86.4%) had a normal 46 XX karyotype. Molecular genetic testing for Fragile X syndrome identified one patient with a single gene mutation (1.6%) and one premutation carrier (1.6%). Conclusions: In this cohort, POI was commonly diagnosed before age 20 and was associated with delayed puberty, estrogen deficiency, infertility, and menstrual disturbances. Autoimmune diseases, vitamin D deficiency, and low bone mineral density were also frequently observed. The available data do not support identifying a predominant underlying etiology.