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, my husband and I are both 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 disorders, 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 androgens are secreted by the zona reticularis under strong stress stimuli and converted to estrone outside the gonads. This feedback mechanism disrupts the release rhythm of GRH-GH in the HP axis, leading to an elevated LH/FSH ratio. Subsequently, this increases androgen production in the ovaries, resulting in hyperandrogenemia caused by 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 causes cystic enlargement of the ovaries and chronic anovulation.