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PCOS is one of the most common endocrine disorders, affecting approximately 6% of women of reproductive age, and is the leading cause of anovulatory infertility, accounting in some studies for as many as 75% of cases. Hyperandrogenism (acne, mild hirsutism) or hyperandrogenemia (elevated serum DHAS or T)Įxclusion of other medical conditions (abnormalities of thyroid, adrenal, or pituitary)
#Polycystic ovarian syn series#
This definition of hyperandrogenic chronic anovulation has also been utilized for several large series describing metabolic sequelae in PCOS, several seminal clinical trials in PCOS, and in familial and genetic studies, and will be the basis for the definition of PCOS used in this chapter. These criteria are hyperandrogenism and/or hyperandrogenemia, oligo-ovulation, and exclusion of other potential causes such as congenital adrenal hyperplasia, Cushing's syndrome, and androgensecreting tumors. This concept was summarized in a 1990 National Institutes of Health-National Institute of Child and Human Development (NIH-NICHD) consensus conference on PCOS and has been upheld in similar proceedings in recent years. Instead, PCOS was recognized as an endocrinopathy of undetermined etiology. The discovery of hyperinsulinemia and decreased sensitivity to insulin in women with PCOS led to a deemphasis on the ovary as a diagnostic criterion. The ovary was viewed as the prime culprit of the syndrome, and assays confirming increased androgen excretion and circulating levels appeared to validate this belief. An abnormal morphology was subsequently confirmed by examining histologic sections of the ovary. PCOS was first diagnosed in situ on the basis of enlarged ovaries by pelvic examination combined with a history of amenorrhea and hirsutism. It is also one of the most common, if not the most common, endocrinopathies in women, affecting 5% of women in the developed world. Polycystic ovarian syndrome (PCOS) is a heterogeneous and still unexplained disorder, whose etiology remains the holy grail of reproductive endocrinologists. LEGRO, in The Ovary (Second Edition), 2004 INTRODUCTION