Abstract
There is something remiss in the name polycystic ovarian syndrome (PCOS). It bears the word ovary; however, the ovary is an innocent bystander of a more sinister pathology. The name belies the nature of a disease that is a complex metabolic and reproductive syndrome with sequelae extending beyond ovarian dysfunction. PCOS is a chronic, life-long illness that affects approximately 1.4 million Canadians. Its inception is thought to begin in utero. Factors such as elevated levels of maternal anti‑Müllerian hormone (AMH), endocrine disruptors, growth restriction, and maternal androgen excess generate epigenetic changes that have a life-long, transgenerational impact on the fetus.
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