Polycystic ovary syndrome and molecular approaches
Dedeoğlu, Bala Gür
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Polycystic ovary syndrome (PCOS) is an endocrine disorder, which affects women at reproductive age. Syndrome is characterized by hyperandrogenism, polycystic ovarian morphology and ovulatory dysfunction. PCOS is associated with reproductive and metabolic abnormalities including infertility, insulin resistance and type 2 diabetes. Prevalence of PCOS changes by the used diagnostic criteria for PCOS. According to ESHRE / ASRM (European Society of Human Reproduction and Embryology / American Society for Reproductive Medicine) criteria PCOS is diagnosed at nearly 15%-20% of women. Adult women, who have type 1-2 diabetes, are under high risk of PCOS. 50%-70% of PCOS patients have insulin resistance. Diseases like hypertension, dyslipidemia, glucose intolerance, diabetes are highly associated with insulin resistance and PCOS. In addition, hirsutism and menstrual irregularities could occur with PCOS. Studies show that there is a relation between PCOS and cardiovascular diseases and cancer as well. Studies identified that mental disorders (depression, anxiety, bipolar disorder and binge eating disorder) are frequently seen at PCOS patients. The treatment strategies applied to PCOS patients vary according to the hormonal status and profile of the patient. Clomiphene citrate-metformin therapy, fertility treatments, laparoscopic ovarian surgery or gonadotrophin hormone therapy are the most frequent therapies used for treatment of PCOS. PCOS is a complex disorder, which includes metabolic, endocrinologic, psychiatric and cardiovascular effects. These effects could be lifetime long and could decrease quality of life. Thus developing more effective diagnosis and treatment approaches is important for protecting patients from diabetes, cancer and cardiovascular diseases. The etiology of PCOS is still unclear however the investigation of familial distinction of PCOS is stable with a genetic basis for this disorder. It was shown in the literature that the differential expression of some genes may be the cause of ovarian dysfunction by affecting the pathways responsible for ovarian development like Wnt signaling pathway. Revealing the molecular mechanisms of PCOS and discovering genes, which are associated with PCOS are important for developing new diagnosis and treatment methods.