Polycystic Ovarian Syndrome (PCOS)
Classification in relation to fertility:
Complex endocrinologic disorder resulting in chronic anovulation
PCOS, PCO, Stein Leventhal syndrome, hyperandrogenic chronic anovulation
Most Common Clinical symptoms:
- enlarged ovaries
- inadequately developing follicular cysts
- mild elevation of insulin and associated insulin resistance
- abnormal uterine bleeding
- dark discoloration of skin in folds or creases (HAIR-AN syndrome)
- male-pattern hair loss
- male fat storage patterns (more in the abdomen than in thigh & waist)
- adult acne
How does PCOS make a woman infertile?
In many cases, hyperinsulinemia leads to overproduction by the ovaries of testosterone and adrenal overproduction of DHEAS and androstenedione, which in turn leads to abnormal production of LH & FSH. This results in ovarian underproduction of estrogen, abnormal production of progesterone, overproduction of testosterone, amenorrhea and infertility.
Suggested Diagnostic Evaluations
- LH:FSH ratio + equal or greater than 3:1 ratio = PCOS
- free & total testosterone + elevations = PCOS
appearance of many small cysts on ovaries, commonly called "string of pearls"
Note: appearance of such cysts alone is not enough for definitive diagnosis.
© Tracy Morris