Polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is a common heterogeneous endocrine disorder characterized by elevated androgen levels, menstrual irregularities, and/or small cysts on one or both ovaries. Clinical manifestations include oligomenorrhea or amenorrhea, hirsutism, and frequently infertility. Clinical signs of PCOS include elevated luteinizing hormone (LH) and gonadotropin-releasing hormone (GnRH) levels, whereas follicle-stimulating hormone (FSH) levels are muted or unchanged. As a result of the increase in GnRH, stimulation of the ovarian theca cells, in turn, produces more androgens. Risk factors for PCOS in adults includes insulin resistance (IR), type 2 diabetes, obesity, and cardiovascular disease. PCOS can be described as an oligogenic disorder in which the interaction of a number of genetic and environmental factors determine the heterogeneous, clinical, and biochemical phenotype. Management of clinical manifestations of PCOS includes oral contraceptives for menstrual irregularities and hirsutism. Treatment options for infertility include clomiphene, laparoscopic ovarian drilling, gonadotropins, and assisted reproductive technology.