PCOS Phenotypes: Impact on Fertility

Abstract

Polycystic ovary syndrome (PCOS) is characterised by an extreme heterogeneity and at least four main phenotypes may be distinguished. In referred population, anovulatory hyperandrogenic phenotype (classic PCOS or phenotypes A and B) is by far the most common phenotype and presents the most severe endocrine and metabolic alterations. Ovulatory PCOS and normoandrogenic phenotype represent a mild form of PCOS that is more common in general population and/or (normoandrogenic) in some particular ethnic group. During their life, because of changes in lifestyle or because of spontaneous changes in ovarian and adrenal androgen secretion that occur during late reproductive age, patients may move from a severe (classic) to a mild (ovulatory or normoandrogenic) phenotype. It influences not only the metabolic prognosis but also the fertility of PCOS women with an important part of infertile PCOS women regaining regular fertility during their forties.