Endocrine Experts Call for More Research into Leading Cause of Infertility

More research is needed to better understand polycystic ovary syndrome – one of the leading causes of infertility, according to the Scientific Statement issued by the Endocrine Society.

As many as 5 million women nationwide may have polycystic ovary syndrome (PCOS), according to the U.S. Department of Health and Human Services’ Office on Women’s Health.

Although PCOS is the most common hormonal disorder among women in their reproductive years, many aspects of the condition are not fully understood. Because PCOS causes diverse symptoms that can vary among individual women, the definition and even the name PCOS have been subject to debate. In its Clinical Practice Guideline, the Society recommended that a diagnosis be made if adult women exhibited two of the three cardinal features of the condition:

• Excess production of male hormones called androgens.
• Anovulation, a condition where the ovary does not release a mature egg each month. This causes irregular menstrual cycles.
• The formation of clusters of pearl-size cysts containing immature eggs in the ovaries, which is called polycystic ovaries.

Many women who have PCOS struggle with infertility. The condition also has been linked to an increased risk of developing diabetes and other metabolic problems, cardiovascular disease and mental health disorders such as depression.

“PCOS disproportionately affects certain ethnic groups, and individual women who have the condition can experience a variety of symptoms,” said Richard S. Legro, MD, Vice Chair of Research in the Department of Obstetrics and Gynecology and Professor of Obstetrics and Gynecology and Public Health Sciences at Penn State College of Medicine, as well as chair of the task force that developed the statement. “Researching the genetic and environmental factors that contribute to these variations could lead to the development of precision treatments personalized for women who have PCOS.”

Normal development of the ovaries during adolescence can mimic the appearance of ovarian cysts, which makes it challenging to diagnose PCOS in teenage girls. Establishing diagnostic criteria for adolescents would make it possible to track how PCOS develops throughout childhood and into the reproductive years. The statement calls for more research in this area.

Earlier diagnoses could pave the way for longitudinal studies to better evaluate interventions to target PCOS and the reproductive, metabolic and psychological conditions tied to it.

“If health care providers were armed with better strategies for diagnosing PCOS in teenage girls, they would be able to intervene sooner to address risk factors for diabetes and cardiovascular disease,” Legro said. “Earlier diagnosis is crucial for gaining a better understanding of the long-term effects of PCOS.”

In the statement, the Society also calls for:

• More cell and animal models of PCOS to improve understanding of the condition’s origins.
• Research into how molecular mechanisms interact to control function of the ovaries. A better understanding of this could help identify ways to address the development of cysts and other reproductive problems.
• Scientific studies of genes that may contribute to the development of PCOS and its symptoms.

Other authors of the Scientific Statement include: Daniel A. Dumesic of the David Geffen School of Medicine at UCLA in Los Angeles, CA; Sharon E. Oberfield of Children’s Hospital of New York-Presbyterian and Columbia University College of Physicians and Surgeons in New York, NY; Elisabet Stener-Victorin of Karolinska Institutet in Stockholm, Sweden; John C. Marshall of the University of Virginia Health System in Charlottesville, VA; and Joop S. Laven of Erasmus Medical Center in Rotterdam, the Netherlands.

“Scientific Statement on the Diagnostic Criteria, Epidemiology, Pathophysiology, and Molecular Genetics of Polycystic Ovary Syndrome,” was published in Endocrine Reviews, a journal of the Endocrine Society. The statement is available at http://press.endocrine.org/doi/10.1210/er.2015-1018.

The Endocrine Society publishes Scientific Statements to educate basic scientists, clinical scientists and clinicians on the scientific basis of disease and its application to the practice of medicine with regard to both prevention and management. Scientific Statements provide an overview of basic and clinical science content on topics of emerging importance. Scientific Statements are developed by a multidisciplinary Task Force of experts with representation from various committees within the Endocrine Society.

About Endocrine Society

Endocrinologists are at the core of solving the most pressing health problems of our time, from diabetes and obesity to infertility, bone health, and hormone-related cancers. The Endocrine Society is the world’s oldest and largest organization of scientists devoted to hormone research and physicians who care for people with hormone-related conditions.

The Society has more than 18,000 members, including scientists, physicians, educators, nurses, and students in 122 countries. To learn more about the Society and the field of endocrinology, visit our site at www.endocrine.org. Follow us on X (formerly Twitter) at @TheEndoSociety and @EndoMedia.