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AEPCOS NewSLET TER A N D R O G E N E X C E S S & P C O S S O C I E T Y D E C E M B E R 2 0 1 4 n e w s l e t t e r S M O K I N G I N W O M E N W I T H P C O S This issue newsletter reports the final program of the update meeting on AMH in ANDROGEN EXCESS DISORDERS that will be held in San Diego, March 5, 2015, during the Annual Meeting of the Endocrine Society. Some preliminary information about the 13th Annual Meeting of AEPCOS Society that will be held in Sicily, Italy, October 4-6, 2015 are also presented.. For the scientific section of the newsletter, the editor of the Newsletter Prof. Enrico Carmina has interviewed Richard Legro, M.D. about the possible influences of smoking on PCOS phenotype and treatment. Rich has been President of AEPCOS Society and is Vice Chair of Research and Professor of Obstetrics, Gynecology and Public Health at Penn State University, Hershey, PA, USA. V o l u m e 2, I s s u e 12 D E C E M B E R 3 1, 2 0 1 4 In this issue: Final Program of AEPCOS Update Meeting on AMH in Androgen Excess Disorders Smoking in PCOS Editorial Board Enrico Carmina, M.D., Palermo, Italy Ellen Connor, M.D., Madison, WI, USA Daniel Dumesic M.D., Los Angeles, CA, USA Joop Laven, M.D., Rotterdam, The Netherlands Helen Mason, Ph.D., London, United Kingdom Poli Mara Spritzer, M.D., Porto Alegre, Brazil F O R T H C O M I N G A E P C O S M E E T I N G S Update Meeting of AEPCOS Society, San Diego, CA, USA, March 5, 2015 Update Meeting of AEPCOS Society, Gdansk, Poland, June 12-13, 2015 13th Annual Meeting of AEPCOS Society, Palermo, Italy, October 4-6, 2015 14th Annual Meeting of AEPCOS Society, Australia, November 2016 72

AEPCOS UPDATE MEETING ON AMH IN ANDROGEN EXCESS DISORDERS The AEPCOS Update Meeting on AMH in Androgen Excess Disorders will be held March 5, 2015, in San Diego, CA, USA, during the Annual Meeting of Endocrine Society. The venue of the meeting is the beautiful boat California Spirit and the meeting will be held during a dinner cruise around San Diego Bay. The cruise will start at 7:30 pm and will finish around 10:30 pm. Because the boat may accommodate only 120 seated passengers, pre-registration is requested. Until February 15, 2015, registration fee for AEPCOS members is only $20 (the regular cost of the cruise without dinner is $110) while the fee for non AEPCOS members has been reduced to $60. After February 15, 2015, for both members and nonmembers, the registration fee will be $100. For further information, please consult our website: www.ae-society.org or contact enrico.carmina@ae-society.org or info@ae-society.org 73

UPDATE MEETING ON AMH IN ANDROGEN EXCESS DISORDERS San Diego Bay Dinner Cruise March 5, 2015 7:30 to 10:30 pm California Spirit 990 North Harbor Drive San Diego, CA 92101, USA 74

Time Event/Speaker Topic 7:00 7:30 pm Boarding to CALIFORNIA SPIRIT 7:30 10:30 pm CRUISE AROUND SAN DIEGO BAY 7:30 8:00 pm 8:00 10:00 pm Champagne and appetizers Seated dinner 8:30 10:30 pm AEPCOS UPDATE MEETING 8:30 8:40 pm ANUJA DOKRAS, M.D. Division of Infertility and Reproductive Endocrinology, University of Pennsylvania, Philadelphia, PA, USA PRESENTATION OF THE UPDATE MEETING 8:40 9:00 pm JEFFREY CHANG, M.D. Division of Reproductive Endocrinology and Infertility, University of California,San Diego, CA, USA AMH ROLE IN OVARIAN FOLLICULAR DEVELOPMENT AND ONTOGENY OF PCOS 9:00 9:20 pm SELMA WITCHEL, M.D. Pediatric Endocrinology, Children s Hospital of Pittsburgh, Pittsburgh, PA, USA AMH MEASUREMENT DURING INFAN- CY AND PUBERTY: CLINICAL SIGNIFICANCE 9:20 9:50 pm ENRICO CARMINA, M.D. Endocrinology and Metabolism,, University of Palermo,, Palermo, Italy JOOP LAVEN, M.D. DEBATE AMH MEASUREMENT IN PCOS: USEFULNESS IN DIAGNOSIS Department of Obstetrics and Gynecology, Rotterdam University, Rotterdam, The Netherlands 9:50 10:30 pm Questions and general discussion 75

13th ANNUAL MEETING OF AEPCOS SOCIETY Next annual meeting of AEPCOS Society will be held October 4-6, 2015 in Sicily, ITALY. The exact venue and the preliminary program will be available from March 2015. For further information, please check our website or contact: enrico.carmina@ae-society.org Pictures of Sicily, Italy OTHER FUTURE MEETINGS Endocrine Society, San Diego, CA, USA, March 5-8, 2015 Pacific Coast Reproductive Society, Rancho Mirage, CA, USA, March 11-15, 2015 European Society of Endocrinology, Dublin, Ireland, May 16-20, 2015 ESHRE, Lisbon, Portugal, June 14-17, 2015 European Society Pediatric Endocrinology, Barcelona, Spain, September 9-12, 2015 76

New AEPCOS Logo The new logo of AEPCOS is presented below. It was chosen by 60% of voting members 77

ANDROGEN EXCESS & PCOS SOCIETY 12520 Magnolia Boulevard, North Hollywood, CA 91607, USA Email : info@ae-society.org SMOKING IN WOMEN WITH PCOS The scientific part of the newsletter is dedicated to the influence of the smoking on PCOS clinical presentation and treatment. The editor of the Newsletter Enrico Carmina has interviewed Richard Legro who co-authored the paper recently published on Human Reproduction ( Legro RS, Chen G, Kunselman AR, Schlaff WD, Diamond MP et al. Smoking in infertile women with polycystic ovary syndrome: baseline validation of selfreport and effects on phenotype. Hum Reprod. 2014; Dec 29(12): 2680-6) 1. Rich, do PCOS women smoke more than other infertile or hyperandrogenic women? www.ae-society.org I think they do smoke more. About 20% of women with PCOS seeking pregnancy are current smokers compared to about 14% of women with unexplained infertility. This surprises me because smoking is one of the best known and clearest subfertility factors that is modifiable by smoking cessation. We think that the higher prevalence of smoking among women with PCOS may be related to their higher obesity rates and the fact that smoking cessation is associated with weight gain, leading to the continued smoking and the poor justification that is helping with weight maintenance. 2. Does smoking influence the phenotype of PCOS women? Yes, It does worsen insulin resistance. We have also found higher testosterone levels in women who smoke. This may be because smokers have a more severe phenotype or because smoking may interfere with sex steroid metabolism. Two intriguing epidemiologic associations supporting this are that smokers are relatively protected against endometrial cancer and developing pre-eclampsia during pregnancy. Richard Legro, M.D.

ANDROGEN EXCESS & PCOS SOCIETY 12520 Magnolia Boulevard, North Hollywood, CA 91607, USA Email : info@ae-society.org 3. Does smoking influence the response to infertility treatment of PCOS women? Yes, smokers are less likely to ovulate and less likely to achieve pregnancy. Thus I believe that we should focus greater emphasis on achieving smoking cessation prior to initiation of infertility treatment. 4. What is the main message for clinicians: how the information regarding smoking may be useful for clinicians dealing with PCOS women? www.ae-society.org The main message is that smoking is common among women with PCOS and represents perhaps the most important and easily modifiable risk factor to pregnancy. We can argue what is harder, to lose weight if you are obese or to stop smoking if you are a smoker, but I think the immediate benefits are greater with smoking cessation and I think a patient if properly counseled would grasp this. in the U.S. many IVF programs do not allow women who are active smokers to undergo IVF because of the adverse effects on pregnancy rates and because they believe that women can stop smoking for an extended period to achieve a successful pregnancy and delivery. Withholding treatment may be a stringent measure, but I do think that smoking cessation prior to pregnancy is an important public health goal that is more achievable than significant weight loss, and it begins with us recognizing it, discussing its adverse effects, and referring or initiating smoking cessation treatment.