title: Surprisingly low infertility rate in married type 2 diabetic women: A rather curious paradox to the current opinion of insulin resistance as the joint pathogenesis of poly cystic ovary syndrome and type 2 diabetes mellitus.
abstract: BACKGROUND
  Sharing the same pathophysiologic principle which is insulin resistance, type 2 diabetes mellitus (T2DM) and poly cystic ovary syndrome (PCOS) are usually considered closely related and easily interchangeable medical entities. Numerous attempts have been made to document this illusory perspective.
  
  
  OBJECTIVE
  Based on a delicate pathophysiologic notion, we believe that fully developed T2DM is infrequently observed with fully featured PCOS.
  
  
  METHODS
  In an observational descriptive study 257 married T2DM women were consecutively included and meticulously investigated for fertility history and, albeit, clinical and biochemical features of PCOS.
  
  
  RESULTS
  Of 257 married diabetic women only six (2.3%) had no children. In one case a male problem (azoospermia) and in the second case, late marriage (aged 45 at wedding ceremony) was the cause of infertility. Thus, only four (1.6%) might have been labeled as true female factor infertility. Astounding to report was the average pregnancies for each participant which was 5.1±2.5, ranging from zero to fifteen.
  
  
  CONCLUSIONS
  we would suggest that, despite the well-established fact of insulin resistance as the common pathophysiologic process for T2DM and PCOS, they are definitely separate medical entities. As a matter of fact T2DM and PCOS are the two opposite aspect of the insulin resistance coin.
authors.affiliation: Reproductive Endocrinologist, Department of Internal Medicine, Shahrood Branch, Islamic Azad University, Shahrood, Iran.
authors.forename: Abbas
authors.initials: A
authors.lastname: Tavakolian Arjmand
authors.affiliation: Obstetrics and Gynecologist,Department Of Obstetrics & Gynecology, Sharood Branch, Islamic Azad University, Shahrood, Iran. Electronic address: m_nouri@iau-shahrood.ac.ir.
authors.forename: Mahnaz
authors.initials: M
authors.lastname: Nouri
authors.affiliation: Department of Clinical Pharmacy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Shima
authors.initials: S
authors.lastname: Tavakolian Arjmand
mesh_terms: D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007246:Infertility / Q000453:epidemiology*; D007333:Insulin Resistance; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011085:Polycystic Ovary Syndrome / Q000150:complications* / Q000503:physiopathology; D015995:Prevalence
keywords: Insulin resistance; Poly cystic ovary syndrome; Type 2 diabetes mellitus