Causes of Polycystic Ovary Syndrome

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Main article: Polycystic Ovary Syndrome Overview

Updated: 5-April-2024

The exact cause of PCOS is unknown, however researchers are slowly piecing together the puzzle. So far, researchers believe PCOS is most likely caused by elevated androgen and or AMH levels in utero, high sucrose diets consumed prepuberty or gene mutations.

_{Source: Peigné M, et al. (2023); de Melo G B, et al. (2021); Abbott D H, et al. (2018); Moore A M, et al. (2015)}

Although theca cells in follicles, which produce androgen, is the main suspect. Exactly how or why remains to be discovered.

Early studies of theca cells from patients with PCOS, undergoing IVF, revealed elevated androgen production and higher levels of dehydroepiandrosterone (DHEA) and 17-OH progesterone secretion, compared to non-PCOS patients in response to LH. This may be caused by pro‐inflammatory cytokine Interleukin 18 which, in a bovine study, increased basal and LH‐induced cell proliferation alongside increased secretion of androstenedione and 17‐hydroxyprogesterone.

_{Source: Zhang H Y, et al. (2021); Nelson V L, et al. (1999)}

Using mouse models of PCOS, the addition of dihydrotestosterone (DHT) blocks the growth of preovulatory follicles and corpus luteum formation. A further study showed the effects of DHT was significantly lessened in mice with depleted androgen receptors (AR) within their theca cells. This suggests AR present in theca cells play a significant role, in the arrest of follicles, in an androgen excess environment.

_{Source: Ma Y, et al. (2017); Walters K A, et al. (2012)}

Another mouse study observed that depletion of phosphatase and tensin homolog (PTEN) protein in theca cells, leads to an increased expression of LHCGR and CYP17A1, increased response to LH, elevated androgen levels, higher antral follicle count and enlarged ovaries, similar to human PCOS. Targeting this pathway (phosphatidylinositol 3-kinase) may potentially influence androgen production.

_{Source: Lan Z J, et al. (2017)}