Polycystic Ovarian Syndrome: Polycystic ovarian syndrome affects from 6-8% of all females and in some areas accounts for a significant number of the infertile population. It was initially thought that polycystic ovarian syndrome was always associated with obesity, polycystic ovaries, excessive dark course hair growth throughout the body and few or no menstrual periods in a year. As time has marched on and with a significant amount of intense research into this condition better criteria have allowed fertility specialists to better diagnose this condition. There is no single test which can stand alone to diagnose PCOS, instead the diagnosis is determined based on several criteria including physical appearance, menstrual cycle and health history, laboratory evaluation, and ultrasound.
Polycystic individuals can range from a thin female with regular menstrual cycles who is not ovulating and who has signs of androgenism to one who is obese, few to no menstrual cycles in a year, acne, hirsuitism, type 2 diabetes and at higher risk of uterine, breast, and ovarian cancer.
A common feature of polycystic individuals is insulin resistance which may not always be appreciated as diabetes but rather local ovarian insulin resistance, triglyceride abnormalities, mild alterations in fat metabolism. These factors in turn make it more difficult to stimulate the ovaries to mature the hormone producing cells that surround their eggs. Without maturing these cells, they do not make enough estrogen, they often do not ovulate, and then most often do not produce enough progesterone to prepare their endometrial lining to receive a developing embryo.