The pathogenesis and treatment of polycystic ovary syndrome: What’s new?

Abstract

Polycystic ovary syndrome (PCOS) is currently the leading cause of menstrual complications in women. It is characterized by clinical and/or biochemical hyperandrogenism, ovulation abnormalities and the presence of enlarged and/or polycystic ovaries in ultrasound images (12 or more small bubbles located circumferentially and/or ovarian volume > 10 mL). It is often comorbid with hyperinsulinemia, dyslipidemia, overweight or obesity, and is a risk factor for the development of diabetes and cardiovascular diseases (CVDs). The treatment of patients with PCOS depends on the prevailing symptoms. The aim of this paper is to present the etiopathogenesis, clinical and biochemical implications, and non-pharmacological and pharmacological treatment options -those approved by worldwide scientific organizations as well as new therapies whose initial results are encouraging enough to prompt researchers to explore them further.

The prevalence of uterine anomalies in infertile patients with polycystic ovary syndrome: A retrospective study in a tertiary center in Southeastern Turkey

“…Polycystic ovary syndrome (PCOS) is a heterogeneous, multifactorial disease affecting 10% of the female population of reproductive age. Hyperandrogenism, ovulatory dysfunction, and polycystic ovary images are among the main features of PCOS (1,2) . Congenital uterine anomalies occur as a result of a defect in the Müllerian canals.…”

Decreased brain and muscle ARNT-like protein 1 expression mediated the contribution of hyperandrogenism to insulin resistance in polycystic ovary syndrome

“…Environmental risk factors combined with genetic factors give rise to hyperandrogenism and insulin resistance, both of which are known to be involved in the onset of PCOS [20]. Circadian disruption, especially constant darkness, induces insulin resistance of PCOS in rats, including increased fasting blood glucose level and increased serum insulin and leptin levels [10].…”

Polycystic Ovary Syndrome: A Brief Review with Recent Updates

“…Both the American Task Force and the PCOS Australian Alliance Guidelines recommend clomiphene citrate as first line treatment of anovulatory infertility. 36,74,75 The American College of Obstetricians and Gynecologists (ACOG) has recently issued clinical management guidelines that updated the use of letrozole for ovulation induction in women with PCOS. They have advocated letrozole as first-line therapy for ovulation induction because of the increased live birth rate compared with clomiphene citrate.…”

“…82,83 Laparoscopic techniques that can successfully trigger ovulation include ovarian biopsy and electrocautery, laparoscopic ovarian drilling, transvaginal hydrolaparoscopy, ultrasound guided transvaginal ovarian needle drilling or laparoscopic ovarian multi-needle intervention. 17,25,36…”

“…85 It is expensive and contributes to an increase in body weight and triglyceride levels and not yet widely recommended in PCOS. 36 A newer polytherapy was proposed recently by Vinaixaet al 86 including 3-month flutamide-metformin-pioglitazone therapy combined with ester-progestogen treatment, which also improved the lipid profile (reduced LDL, increased HDL), higher androgen levels as well as increased carotid intima media (CIM) thickness, which in turn prevents the occurrence of atherosclerosis and related complications.…”