Polycystic ovary syndrome - modern concepts

Abstract

The article reviews current concepts of etiology and pathogenesis of polycystic ovary syndrome. Currently, numerous forms of the syndrome, manifesting by a variety of clinical, morphologic signs and features of endocrine profile, exist. It was revealed that polycystic ovary syndrome is a multifactorial, genetically determined disease. Laboratory diagnosis in females with polycystic ovary syndrome is based on measuring concentrations of hormones. Results of ovarian sonography are of a great importance, allowing to diagnose polycystic ovary syndrome. Another method of instrumental diagnosis is laparoscopy, revealing two-sided growth ovarian hypertrophy and multiple subcapsular cysts. Ovarian capsule looks thickened, smooth, with a marked vascular pattern. Treatment depends on the clinical features and intensity of symptoms, as well as on patient’s interest in pregnancy. The choice of treatment options should be supported by clinical and laboratory data, considering pathogenetic type of the disease. The treatment of polycystic ovary syndrome includes conservative and surgical approaches. The main targets of drug treatment is the cessation of clinical and metabolic symptoms of the disease, decreasing the symptoms of virilescence, restoring the menstrual cycle and ovulation induction. Indication for surgical treatment is non-efficiency of drug treatment in restoring fertility. Thereby, multiple factors determining clinical symptoms and morphologic changes in ovaries, including central mechanisms of pituitary gland gonadotropic function, local ovarian factors, extraovarial endocrine and metabolic disorders, participate in pathogenesis of polycystic ovary syndrome. The early initiation of treatment in patients with polycystic ovary syndrome may preserve the fertility, as well as prevent hyper- and neoplastic diseases of endothelium, and the syndrome’s late complications.