Current Advances in Cellular Approaches for Pathophysiology and Treatment of Polycystic Ovary Syndrome

Abstract

Polycystic ovary syndrome (PCOS) is a prevalent gynecological and endocrine disorder that results in irregular menstruation, incomplete follicular development, disrupted ovulation, and reduced fertility rates among affected women of reproductive age. While these symptoms can be managed through appropriate medication and lifestyle interventions, both etiology and treatment options remain limited. Here we provide a comprehensive overview of the latest advancements in cellular approaches utilized for investigating the pathophysiology of PCOS through in vitro cell models, to avoid the confounding systemic effects such as in vitro fertilization (IVF) therapy. The primary objective is to enhance the understanding of abnormalities in PCOS-associated folliculogenesis, particularly focusing on the aberrant roles of granulosa cells and other relevant cell types. Furthermore, this article encompasses analyses of the mechanisms and signaling pathways, microRNA expression and target genes altered in PCOS, and explores the pharmacological approaches considered as potential treatments. By summarizing the aforementioned key findings, this article not only allows us to appreciate the value of using in vitro cell models, but also provides guidance for selecting suitable research models to facilitate the identification of potential treatments and understand the pathophysiology of PCOS at the cellular level.

Metabolic hormonal alterations in functional hypothalamic amenorrhea and anovulation associated with Polycystic ovary syndrome

“…The extensive range of hypothalamic-pituitary abnormalities that can occur in this disorder include a lower mean frequency of LH pulses, the complete deficiency of LH pulsatility, a normal-looking secretion configuration, and a larger mean frequency of LH pulses. Decrease in gonadotropin secretion, therefore, results in a decrease in the ovary's ability to produce estradiolStress, weight loss, and/or excessive physical exercise are frequently linked with a disturbed hypothalamic-pituitaryovarian axis, which is one of the most frequent reasons for secondary amenorrhea in FHA cases [9]. FHA is categorized into stress-related, exercise-related, and weight loss-related, depending on the eliciting cause [10].…”

“…Additionally, insulin resistance plays a pivotal role in the pathophysiology of PCOS, further complicating hormonal dysregulation and contributing to metabolic disturbances observed in affected individuals. Monitoring menstrual patterns becomes crucial as they serve as indicators of overall health, with primary and secondary amenorrhea warranting evaluation [9]. Functional hypothalamic amenorrhea (FHA), another cause of secondary amenorrhea, is characterized by severe hypoestrogenemia and menstrual cessation.…”