Polycystic Ovary Syndrome (serono Symposia Usa)

The term polycystic ovary syndrome (peOS) is meant to describe a clinical endocrinopathy characterized by menstrual irregularity and evidence of hyperandrogenism. While recognized since the 1800s, a clinical composite was not constructed until 1935 when Stein and Leventhal reported their findings of seven women with infertility, menstrual dysfunction, hirsutism, and enlarged ovaries. Notably, the ovaries contained numerous multiple cysts and the ovarian capsule was thickened. At the time, this preciseness of definition was sufficient to entitle the entity Stein-Leventhal syndrome. Subsequently, over the intervening years as investigators attempted to un­ ravel the pathophysiology and genesis of this disorder and the number of reported studies increased, there ensued a gradual and distinct terminologic conversion to polycystic ovary syndrome, which, whether intentional or not, connoted a less well-defined condition. Perhaps this is appropriately so, given the seemingly broadening spectrum of clinical presentations and the continuing debate over what constitutes peos. The expansive new knowledge about peos was discussed to a significant degree at an international symposium organized by Serono Symposia USA and held in Boston in the late spring of 1995. Ovarian physiology, including the fate of the follicular unit, was a central focus with several presentations on the genesis, growth, and death of ovarian cellular components. A discus­ sion of the regulation of ovarian cell function was also highlighted and comprised a major portion of the program. Front Matter....Pages i-xvii Regulation of Ovulation Rate....Pages 1-20 Dynamics of Follicle Development in the Human Ovary....Pages 21-36 The Molecular Basis of Ovarian Cell Death....Pages 37-50 Polycystic Ovary Syndrome (PCOS): The Possible Roles of Apoptosis in Human Granulosa Cells....Pages 51-70 Potential Role of the Renin-Angiotensin System in Polycystic Ovaries....Pages 71-88 Dysregulation of Androgen Secretion and Steroid Metabolism in Polycystic Ovary Syndrome....Pages 89-101 Adrenocortical Dysfunction in the Polycystic Ovary Syndrome....Pages 102-116 Insulin Resistance in the Polycystic Ovary Syndrome....Pages 117-125 Beta-Cell Function in Polycystic Ovary Syndrome....Pages 126-141 Luteinizing Hormone and Growth Factor Control of the Thecal Cell....Pages 142-153 Comparative Androgen Production from Theca Cells of Normal Women and Women with Polycystic Ovaries....Pages 154-164 Development of a Human Thecal Tumor Cell Model: Regulation of Steroidogenesis and Enzyme Expression....Pages 165-195 Development of Human Granulosa Cell Lines....Pages 196-207 Suppression of Aromatase Activity in Polycystic Ovary Syndrome....Pages 208-222 The Insulin-Like Growth Factor (IGF) System in Human Ovary and Its Relevance to Polycystic Ovarian Syndrome....Pages 223-244 Hyperinsulinemic Androgenism: A Pathophysiologic Paradox....Pages 245-253 Hypothalamic-Pituitary Dynamics in Polycystic Ovary Syndrome....Pages 254-264 Aspects of Ovulation Induction in Polycystic Ovary Syndrome....Pages 265-271 Polycystic Ovary Syndrome, Fertilization, and Early Embryonic Development....Pages 272-283 In Vitro Fertilization in Polycystic Ovary Syndrome....Pages 284-304 Surgical Approaches to Ovulation Induction: The Laparoscopic Experience....Pages 305-321 Androgens, Lipids, Insulin Resistance, and Cardiovascular Risk....Pages 322-333 A Unifying Concept for Polycystic Ovary Syndrome....Pages 334-352 Back Matter....Pages 353-371

Polycystic Ovary Syndrome discusses

• the use of animal models in the study of PCOS
  
• the occurrence of ovarian and adrenal abnormalities, cardiovascular risks, abnormal insulin secretion, and endothelial dysfunction in PCOS
  
• modern therapeutic modalities, such as manipulation of diet and lifestyle, metabolic phenotyping, and treatment of hyperandrogenism
  
• the effect of PCOS on long-term health Exploring the direct and indirect effects of PCOS in each stage of life, from puberty and adolescence to adulthood, Polycystic Ovary Syndrome is an in-depth and illuminating source for obstetricians and gynecologists; medical, reproductive, and pediatric endocrinologists; practitioners in family, internal, and pediatric medicine; epidemiologists; developmental biologists and toxicologists; and scientists and medical students in these disciplines.

This volume contains the proceedings of the Symposium on Polycystic Ovary Syndrome, held in Boston, Massachusetts from May 18 - 21, 1995. Written and edited by eminent experts in the field, the papers herein cover the molecular, genetic, and endocrine factors in polycystic ovary syndrome as well as challenging issues such as fertilization, early embryonic development, and polycystic ovary disease; IVF in polycystic ovary disease; the topic of androgens, lipids, insulin resistance and cardiovascular risk; and surgical approaches to ovulation induction