PCOS its etiology

 

Prevalence, Etiology of PCO : 1) More hyperandrogenaemia & more LH receptors in the existing Granulosa cellsà More endogenous production and thetevy suppression of Cyclicity of gonadotrophin –Long Loop is inhibited.  Its prevalence, using different diagnostic criteria, has been reported to be 6.8%–18% and it is estimated that a large number of patients are not diagnosed. The first signs of PCOS are diagnosable in the prepubertal period, and given its heterogeneous nature, the beginning of symptoms in the patient can be accompanied by psychologic disorders such as depression and anxiety, along with irregular menstrual periods in adolescence and then infertility.

In PCOS patients, excessive androgen secretion results in increased estrogen precursors in granulosa cells. In these patients, luteinizing hormone receptors, in the presence of hyperinsulinemia, appear earlier in granulosa cells, causing activation of aromatase in these cells.

 

This phenomenon results in increased estrogen production, with positive feedback on luteinizing hormone and negative feedback on follicle-stimulating hormone (FSH), and ultimately disruption of folliculogenesis.

Hyperandrogenism and insulin resistance cause chronic anovulation and therefore infertility. Even if pregnancy does occur, it is associated with repeated spontaneous miscarriage in the first trimester and with gestational diabetes