Effect of Ramadan Fasting on Ovulation and Insuline Resistance in Patients With PCOS

Study Overview
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Brief Summary
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Polycystic ovary syndrome (PCOS) has a heterogeneous clinical presentation comprising reproductive (hyperandrogenism, menstrual irregularity, anovulation, infertility, pregnancy complications), metabolic [insulin resistance (IR), increased type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) risk factors] and psychological features (worsened quality of life and increased anxiety and depression) Whether prolonged fasting during Ramadan breaks the insulin resistance state of polycystic ovarian syndrome and subsequently improve the ovulation and spontaneous pregnancy will happen without ovarian stimulation.

Detailed Description
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Question of the study: The question is raised whether prolonged fasting during Ramadan breaks the insulin resistance state of polycystic ovarian syndrome and improve the metabolic syndrome does prolonged fasting decrease glucose level, insulin level, insulin resistance markers such as adipokines and subsequently improve ovarian function and causes spontaneous ovulation.

Official Title
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Does Prolonged Fasting Break the Vicious Circle of Polycystic Ovarian Syndrome of Insulin Resistance ?

Conditions
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Polycystic Ovary Syndrome

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Females with PCO in child bearing age who presented at reproductive and endocrinology clinics at Ain Shams University Maternity Hospital, and welling to fast for 30 days from 5 am until 7 pm and do not plan to induce her ovulation in the next 4 months to get pregnant. Does not have any other medical illnesses other than PCO. Welling not to start any ovulation induction in the next 4 months after the first blood sample was taken and after fasting month. Exclusion Criteria: Known androgen secreting tumor. PCO on ovarian stimulation medications PCO with any other medical illness. Non-compliance with fasting 30 days from 5 am- 7 pm.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 40 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| spontaneous ovulation measured by midluteal progesterone | Ovulation will be monitored by the Progesterone level on 22nd day of first cycle after 30 days of prolonged daily Fasting (Ramadan). | one month | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| clinical pregnancy | We will record any pregnancy will happened in the next 4 months after Fasting without any ovulation induction. | four months | 
| fasting glucose/insuline ratio | Insulin resistance (IR) measuring: fasting 8 hours. Plasma glucose (FPG) and fasting insulin (FIN) will be measured by chemiluminescent immunoassay. The ratio of glucose/insulin represents the degree of IR | one month | 
| Plasma adiponectin | Plasma adiponectin will be measured before and after 30 days fasting | one month | 
| plasma resistin | Plasma resistin will be measured before and after 30 days fasting | one month | 
| plasma gherlin | Plasma gherlin will be measured before and after 30 days fasting | one month |