Infertility : Polycystic Ovary Syndrome

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Infertility: Polycystic ovary syndrome is probably the most common cause of anovulatory infertility (11), associated with an increased risk of miscarriage after either spontaneous or assisted conception (1) and the development of ovarian hyperstimulation syndrome (OHSS) in assisted conception (12). A higher incidence of first trimester spontaneous abortions (25–73%) has been reported in women with polycystic ovaries or PCOS (13). Abnormalities in LH secretion were found in 81% of women with recurrent fetal loss, and higher androgen levels were observed in women who had recurrent miscarriages, both with and without PCOS. Anovulatory infertility, due to arrested folliculogenesis in PCOS, is frequently found in association with insulin resistance (IR) and obesity (14).
A series of intraovarian growth factors [insulin-like growth factors (IGF), AMH, growth differentiation factor 9 (GDF-9) and inhibin] and extra-ovarian factors (GH, IGF-1 and insulin) seem to act together in a process that triggers anovulation or early pregnancy loss through the impairment of folliculogenesis, oocyte maturation, steroidogenesis and endometrial receptivity but whether these abnormalities are the direct cause of anovulation and pregnancy loss, or the consequence of deranged steroidogenesis has to be determined (15). Whereas underweight is associated with poor fetal growth and increased pregnancy loss, overweight is more strongly associated with diseases in pregnancy, pregnancy loss, stillbirth and
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