Pathophysiology of polycystic ovarian syndrome: Minireview

Abstract

Bahaeldin E. Elawad

Between menarche and menopause, the female reproductive system undergoes regular cyclic changes called the menstrual cycles. The maintenance of the cycle affects the biologic and sociologic aspects of women’s life including fertility and reproduction. Menstrual cycle results from complex interactions among the hypothalamo-pituitary-gonadal axis. A woman with irregular periods is likely not ovulating. Polycystic ovarian syndrome is the most common cause of anovulation/oligoovulation. The prevailing stage of follicular development reflects the female reproductive function at the particular time of menstrual cycle. Antimüllerian hormone produced by growing follicle is the most recent circulating factor to be analyzed as a predictor of ovarian reserve. The basic denominator of polycystic ovarian syndrome is disturbance in selection of a dominant follicle. This results in a significant production of antimüllerian hormone, arrested follicular growth, and ovulatory dysfunction. The integral pathogenic factor of Polycystic ovarian syndrome is insulin resistance and obesity which explains menstrual irregularities, hyperandrogenism, infertility and other associated metabolic manifestations. There is still no standard definition of the diag