Polycystic Ovary Syndrome is a Cause of Infertility

Hirsutism – increased hair growth and reproductive health disorders leading to significant difficulties in conceiving, are the leading reasons for consultation with specialists for patients with Polycystic Ovary Syndrome (PCOS). The latter condition is the cause of 80% of infertility cases due to the lack of ovulation.

In Polycystic Ovary Syndrome, irregular menstrual cycles, absence of menstruation, and high levels of male sex hormones – hyperandrogenism are observed. It is believed that the cause of these changes is the early maturation of certain follicles, leading to disruptions in the growth and development of antral follicles. The lack of ovulation in the context of PCOS is characterized by the inability to select dominant follicles in the granulosa cells of the follicles, leading to the cessation of their development. As a result, estrogen and progesterone levels rise, suppressing the secretion of follicle-stimulating hormone (FSH).

The environment in the granulosa cells leads to an imbalance in insulin and luteinizing hormone levels. This results in an increase in luteinizing hormone (LH) secretion. All of this is a cause of high insulin levels – hyperinsulinemia, characteristic of the lack of ovulation in Polycystic Ovary Syndrome. Additionally, affected patients show an increased predisposition to metabolic disorders such as diabetes and dyslipidemia – disturbances in lipid serum concentrations. Altered insulin metabolism and subsequent insulin resistance are predisposing factors for weight gain in Polycystic Ovary Syndrome.

Anti-Mullerian hormone is a glycoprotein hormone released by the granulosa cells of pre-antral and small antral follicles. Besides its significant influence on the function of the hypothalamic-pituitary-gonadal axis, this hormone is of crucial importance for the function of the gonads and sexual differentiation. Measuring serum concentrations of this hormone can be used as a molecular biomarker for assessing Polycystic Ovary Syndrome, but it is also an indicator of the ovarian reserve.

Receptors for Anti-Mullerian hormone are located on the surface of neurons expressing gonadotropin-releasing hormone. The balance in the levels of the latter is disrupted in patients with Polycystic Ovary Syndrome, leading to an increase in Anti-Mullerian hormone levels. Consequently, reproductive health disorders are observed, leading to infertility due to changes in the regulation of gonadotropin-releasing hormone secretion. The accumulation of increased amounts of adipose tissue is associated with an increase in sex hormone levels, which also leads to infertility. Therefore, obesity is an independent but key factor for many complications related to reproductive health.