Polycystic Ovary Syndrome Insignts

Polycystic ovary syndrome, or PCOS, is among the most common causes of infertility, conservatively affecting 6-8% of women.  Increasing evidence suggests symptoms of PCOS arise during the pubertal process; however, the cause or causes of PCOS remain unclear.  Although genetic predispositions likely exist, environmental causes have also been suggested.  In an article on p. 154 of this issue, Abbott and coworkers provide evidence in a primate model that prenatal exposure to androgens, which are elevated in women with PCOS during late gestation, provides an endocrine environment that leads to increased gonadotropin release both prenatally and postnatally, as well as leading to increased androgen levels in female infants.  While these changes occurred in the absence of elevations of estrogen levels in the fetuses—suggesting androgen-mediated prenatal programming may be one of the factors that can contribute to the constellation of symptoms that define PCOS—local tissue conversion of androgen to estrogen may provide additional programming.

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