Patient's question:
I started having irregular periods when I was in college. At the time, I didn't think about going to the hospital for an ultrasound or anything. Now that I'm married and want to get pregnant, but haven't been able to after trying for more than half a year, both my husband and I are desperate. The doctor told me I have polycystic ovary syndrome, which makes it difficult to get pregnant.Doctor's answer:
Hello, Polycystic ovary syndrome (PCOS) is a serious disease that can lead to female infertility. The cause of PCOS is still unclear. It is generally believed to be related to factors such as dysfunction of the hypothalamic-pituitary-ovarian axis, adrenal gland dysfunction, genetics, and metabolism. A small number of PCOS patients have abnormalities in sex chromosomes or autosomes, and some have a family history. Recent studies have found that certain genes are associated with the development of PCOS, further confirming the role of genetic factors in the onset of PCOS.Adrenal Precocious Puberty Hypothesis: PCOS may originate from prepubertal adrenal disease, where excessive androgen secretion by the zona reticularis occurs under strong stress stimuli, and is converted to estrogen outside the gonads. This feedback mechanism disrupts the release rhythm of GRH-GH in the HP axis, leading to an elevated LH/FSH ratio, which in turn causes increased androgen production in the ovaries. This results in hyperandrogenemia due to the combined secretion of androgens from both the adrenal glands and ovaries. Hyperandrogenemia induces fibrosis and thickening of the ovarian capsule, inhibits follicular development and ovulation, and leads to cystic enlargement of the ovaries and chronic anovulation.