Neuroendocrine Defects in Polycystic Ovary Syndrome (PCOS): Different Phenotypes based on the Levels of Gonadotropins (FSH and LH), and Body Mass Index

Abstract

Introduction: Polycystic ovary syndrome (PCOS) is a genetically complex disorder associated with abnormal follicular growth, hyperandrogenism and subfertility or infertility. There are untimely high levels of luteinizing hormone (LH) and expression of the LH receptor in PCOS women; however, these defects are not part of the criteria for the diagnosis of PCOS. Young women with PCOS require advanced IVF procedures to conceive, but they have a low rate of successful pregnancies. Aims: To understand the variations in gonadotropin levels in women with PCOS. Methods: We hypothesized that PCOS women may have differences in the neuroendocrine defects that may ultimately lead to PCOS symptoms. Here, we report different PCOS phenotypes where both follicle stimulating hormone (FSH) and LH levels were elevated, or just LH secretion was higher than normal. In this cohort of PCOS women, 71% had high LH levels. Result: However, high insulin levels were not associated with either high LH or obesity. Obese PCOS women with high FSH had high insulin levels; however, that could be associated with obesity and not FSH. Conclusion: The defect in the secretion of FSH, LH, or both leads to the reproductive abnormalities in women with PCOS. With the emerging connection between FSH, LH, and insulin receptor substrates, there may be an increase in the susceptibility of women with PCOS to metabolic disorders due to imbalance in FSH and LH secretion.