As the most common endocrinopathy of reproductive-aged women, polycystic ovary syndrome (PCOS) by Rotterdam criteria represents a complex syndrome of heterogeneous expression with variable adverse metabolic and reproductive implications. Women with classic PCOS are often insulin-resistant and commonly develop metabolic syndrome with preferential fat accumulation and weight gain. Such PCOS women also are at greatest risk of acquiring ectopic lipid accumulation in non-adipose tissue, including the ovaries, where it can induce oxidative stress, alter follicular development and impair oocyte quality through lipotoxicity. This lecture discusses mechanisms whereby metabolic dysfunction in PCOS impairs reproduction and offers an approach towards improving the long-term health of PCOS women that also minimizes their risk of pregnancy complications and optimizes the health of their offspring.
By the conclusion of this session you should be able to:
1. State how androgen excess in women affects lipid storage
2. Name two metabolic pathways used during meiotic resumption
3. Explain lipotoxicity and how it impairs oocyte quality