PCOS Forum

Research in Polycystic Ovary Syndrome Today and Tomorrow

Renato Pasquali; Elisabet Stener-Victorin; Bulent O. Yildiz; Antoni J. Duleba; Kathleen Hoeger; Helen Mason; Roy Homburg; Theresa Hickey; Steve Franks; Juha S. Tapanainen; Adam Balen; David H. Abbott; Evanthia Diamanti-Kandarakis; Richard S. Legro

Disclosures

Clin Endocrinol. 2011;74(4):424-433. 

In This Article

Abstract and Introduction

Abstract

Objective To summarize promising areas of investigation into polycystic ovary syndrome (PCOS) and to stimulate further research in this area.
Design Summary of a conference held by international researchers in the field of polycystic ovary syndrome.
Results Potential areas of further research activity include the analysis of predisposing conditions that increase the risk of PCOS, particularly genetic background and environmental factors, such as endocrine disruptors and lifestyle. The concept that androgen excess may contribute to insulin resistance needs to be re-examined from a developmental perspective, since animal studies have supported the hypothesis that early exposure to modest androgen excess is associated with insulin resistance. Defining alterations of steroidogenesis in PCOS should quantify ovarian, adrenal and extraglandular contribution, as well as clearly define blood reference levels by some universal standard. Intraovarian regulation of follicle development and mechanisms of follicle arrest should be further elucidated. Finally, PCOS status is expected to have long-term consequences in women, specifically the development of type 2 diabetes, cardiovascular diseases and hormone dependent cancers. Identifying susceptible individuals through genomic and proteomic approaches would help to individualize therapy and prevention.
Conclusions There are several intriguing areas for future research in PCOS. A potential limitation of our review is that we focused selectively on areas we viewed as the most controversial.

Introduction

The polycystic ovary syndrome (PCOS) is a hyperandrogenic disorder associated with chronic oligo-anovulation and polycystic ovarian morphology.[1,2] It is often associated with psychological impairments, including depression and other mood disorders and metabolic derangements, chiefly insulin resistance and compensatory hyperinsulinaemia, which is recognized as a major factor responsible for altered androgen production and metabolism.[3] Most women with PCOS are also overweight or obese, further enhancing androgen secretion while impairing metabolism and reproductive functions and possibly favouring the development of the PCOS phenotype. The definition of PCOS has led to an impressive increase of scientific interest in this disorder, which should be further directed to improve individualized clinical approaches and consequently therapeutic strategies.

To further dialogue and exchange ideas on PCOS, an international group of PCOS researchers has gathered every other year to summarize the state of the field and stimulate further research. We have previously published our presentations in book form,[4] but elected here to create a shorter summary of our presentations. We designed the meeting to focus on specific areas of uncertainty in the pathophysiology and treatment of women with PCOS.

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