Polycystic ovary syndrome and fetal programming

Abstract

Polycystic ovary syndrome is a common disorder in women of reproductive age. Its pathogenesis is influenced by genetic and environmental factors. Hyperandrogenism during fetal life has been closely linked to its development.

A similar syndrome has been induced in research animals, developing an hyperandrogenic environment during pregnancy leading to a fetal programming. Results show that exposure to androgen excess during pregnancy determined in female offspring characteristics such as subfertility, alterations in the reproductive cycle, polycystic ovaries, abnormal lipid profile and insulin-glucose homeostasis, similar to those found in women with polycystic ovary syndrome. These differ depending on the time of exposure and the stage of gestation when it occurs.
Genetics plays an important role in the development of polycystic ovary syndrome. Genetic factors which have been linked more strongly are the ones that affect the endocrine system, such as those related to the secretion and action of insulin, gonadotrophins and androgens. Immunological factors also play an important role; among them, inflammatory mediators can be highlighted.
Further research is necessary to determine whether there are factors over which it can be acted to reduce hyperandrogenism during pregnancy in order to decrease the incidence and impact of polycystic ovary syndrome, as well as successful treatments.