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30 - Medical Management of Polycystic Ovary Syndrome

from PART II - INFERTILITY EVALUATION AND TREATMENT

Published online by Cambridge University Press:  04 August 2010

By
Kabli Nadia  and
Tulandi Togas
Edited by
Botros R. M. B. Rizk ,
Juan A. Garcia-Velasco ,
Hassan N. Sallam  and
Antonis Makrigiannakis
Botros R. M. B. Rizk
Affiliation:
University of South Alabama
Juan A. Garcia-Velasco
Affiliation:
Rey Juan Carlos University School of Medicine,
Hassan N. Sallam
Affiliation:
University of Alexandria School of Medicine
Antonis Makrigiannakis
Affiliation:
University of Crete
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Summary

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women. Its prevalence among infertile women is 15–20 percent. The etiology of PCOS remains unclear; however, several studies have suggested that PCOS is an X-linked dominant condition (1). The clinical manifestation of PCOS varies from a mild menstrual disorder to severe disturbance of reproductive and metabolic functions. Women with PCOS are predisposed to type 2 diabetes or develop cardiovascular disease (2).

DEFINITION OF PCOS

In a workshop sponsored by ESHRE (European Society for Human Reproduction and Embryology) and ASRM (American Society for Reproductive Medicine) in Rotterdam in 2003, a new definition of PCOS was proposed (3). This consensus defined PCOS as a syndrome with two out of three of the following features: oligo- or anovulation, clinical and/or biochemical sign of hyperandrogenism, and/or sonographic finding of polycystic ovaries (after exclusion of other etiologies such as congenital adrenal hyperplasia, androgen-secreting tumors, or Cushing's syndrome) (Table 30.1).

Sonographic features of polycystic ovaries (PCO) include the presence of twelve or more follicles in each ovary measuring 2–9 mm in diameter and/or increased ovarian volume (>10 mL). This is regardless of follicle distribution, ovarian stromal echogenicity, or ovarian volume. One ovary fulfilling this definition is sufficient to define PCO (2, 4). It is recognized that some women with sonographic findings of PCO may have regular cycles without clinical or biochemical signs of hyperandrogenism.

Keywords

aromatase inhibitorsclomiphene citratedexamethazonegonadotropin-releasing hormone agonistinsulin resistancemenstrual dysfunctionmetformin treatmenthirsutismoral contraceptive pillspolycystic ovary syndrome
Type
Chapter
Information
Infertility and Assisted Reproduction , pp. 286 - 293
Publisher: Cambridge University Press
Print publication year: 2008

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