Polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women of reproductive age.

A leading cause of infertility and pregnancy complications.

Associated with insulin resistance, metabolic syndrome, metabolic dysfunction-associated steatotic liver disease (formerly nonalcoholic fatty liver disease), and increased risk of developing type 2 diabetes.

Main treatment goals are to reduce hyperandrogenism or to induce fertility.

Letrozole and clomiphene are considered first-line pharmacologic treatments for infertility in PCOS. Increasing evidence suggests that letrozole may be superior to clomiphene.

PCOS includes symptoms of hyperandrogenism, presence of hyperandrogenemia, oligo/anovulation, and polycystic ovarian morphology on ultrasound.[1]Zawadzki JK, Dunaif A. Diagnostic criteria for polycystic ovary syndrome: towards a rational approach. In: Dunaif A, Givens JR, Haseltine F, et al., eds. Polycystic ovary syndrome. Cambridge, MA: Blackwell Scientific; 1992:377-84.[2]The Rotterdam ESHRE/ASRM-sponsored PCOS consensus workshop group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004 Jan;81(1):19-25. http://www.ncbi.nlm.nih.gov/pubmed/14711538?tool=bestpractice.com [3]Azziz R, Carmina E, Dewailly D, et al. Positions statement: criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: an Androgen Excess Society guideline. J Clin Endocrinol Metab. 2006 Nov;91(11):4237-45. https://academic.oup.com/jcem/article/91/11/4237/2656314 http://www.ncbi.nlm.nih.gov/pubmed/16940456?tool=bestpractice.com [4]Azziz R, Carmina E, Dewailly D, et al. The Androgen Excess and PCOS Society criteria for the polycystic ovary syndrome: the complete task force report. Fertil Steril. 2009 Feb;91(2):456-88. http://www.ncbi.nlm.nih.gov/pubmed/18950759?tool=bestpractice.com