Polycystic ovarian syndrome. Fertility as evidence of energy balance.

M. Făgărăşanu, B. Panaite, R. Bodea, D. Udrea, M. Cîrstoiu

Rezumat: At the present day, polycystic ovary syndrome (PCOS) is the most frequent gynecologic endocrinopathy affecting women of reproductive age (4-12%). The first data about PCOS, in 1921, described it as „the diabetes of the bearded woman”. The recognition of the association between hyperandrogenism („the beard”) and a alteration of carbohydrate metabolism („diabetes”) focused the attention of the research community in this area. In actual terms, PCOS encompassed a heterogeneous condition associating gynecologic, metabolic, mental and obstetrical complications. The key substrate underlying these various complications is represented by high plasmatic insulin levels that reflect high peripheral insulin resistance. Patients affected by PCOS, even within the normal weight range, demonstrate high peripheral insulin resistance, obesity acting as an aggravating factor. Excess tissular lipids lead to high peripheral insulin resistance, or, as is the case of genetic susceptibility of PCOS, amplify it. Adipose tissue deposited preferentially in the abdominal region, apparent by an increased waist, increases the insulin resistance and decreases the frequency of ovulatory events. Modern fast-food disrupts the metabolic balance by increasing the anabolic component and disturbing the hormonal environment. The human body is thus under great metabolic stress that affects the reproductive function. It seems that any alteration in energy balance, either anabolic or catabolic, has direct impact on fertility.
Cuvinte cheie: polycystic ovary syndrome, insulin resistance, energy balance, abdominal obesity, fertility.