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Chapter 13 - Polycystic Ovary Syndrome: Ovulation Induction Strategies

from Section 3 - Difficulties and Complications of Ovarian Stimulation and Implantation

Published online by Cambridge University Press:  14 April 2022

By
Lina El-Taha ,
Botros Rizk ,
William Ledger ,
Raja Sayegh  and
Johnny Awwad
Edited by
Mohamed Aboulghar  and
Botros Rizk
Mohamed Aboulghar
Affiliation:
University of Cairo IVF Centre
Botros Rizk
Affiliation:
University of South Alabama
Get access

Summary

Polycystic ovarian syndrome (PCOS) is one of the most prevalent endocrinopathies affecting 5 to 10 percent of women of reproductive age [1;2]. Characteristic clinical features of PCOS include menstrual irregularity such as oligomenorrhea/amenorrhea and signs of hyperandrogenemia including hirsutism, acne, and/or obesity. The syndrome was first clearly described by Stein and Leventhal in 1935 [3]. While the primary etiology remains poorly defined [4], insulin resistance with compensatory hyperinsulinemia is a prominent feature of the condition and appears to be an underlying cause of hyperandrogenemia identified in both lean and obese women [5]. Hyperinsulinemia promotes increased ovarian androgen biosynthesis in vivo and in vitro [6;7]. It also decreases sex hormone-binding globulin production in the liver [8], which results in the increased bioavailability of free androgens and exacerbates the signs of androgen excess.

Type
Chapter
Information
Ovarian Stimulation , pp. 119 - 131
Publisher: Cambridge University Press
Print publication year: 2022

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