One in ten women of childbearing age suffers from polycystic ovarian syndrome (PCOS), a condition that disrupts hormones and prevents ovulation. “PCOS is an endocrine disorder that is one of the leading causes of infertility,” says Damian P. Alagia III, MD, medical director of woman’s health at Quest Diagnostics. “However, we haven’t known much about its root cause and traditionally have believed it to be due to a mix of genetic and possibly environmental factors.”
To discover the cause of PCOS, scientists in France looked at levels of a substance called anti-Müllerian hormone (AMH). AMH is secreted in the reproductive system by developing egg sacs. In past research, higher than normal levels of AMH have been seen in women with PCOS. “The researchers at Inserm in France, noted that pregnant women with PCOS had 30 percent higher levels of AMH, compared to women without the condition,” says Dr. Alagria, who was not involved in the 2018 study.
The French scientists theorized that high AMH in pregnancy might affect developing females in the womb. Could high levels of the hormone effectively “pass down” PCOS before birth? “To see if excessive AMH in pregnancy contributed to PCOS in female offspring, the researchers exposed pregnant mice to AMH,” Dr. Alagria says. “They found the female offspring were more likely to have PCOS and excessive androgens [male hormones such as testosterone], a common feature of PCOS.”
The results suggest that we now have a better understanding of how PCOS begins. “The authors’ conclusion is that the excess hormone resulted in overstimulation of a subset of brain cells leading to increased levels of testosterone, suggesting PCOS may be due to a hormone imbalance even before birth,” Dr. Alagria says.
Even more intriguing is a potential treatment: “What was really novel is that the researchers found that if the mice were given cetrorelix, an IVF drug, to control female hormones levels, the PCOS diminished,” Dr. Alagria says. “That suggests that in time, cetrorelix or other IVF drugs may have potential in humans to restore ovulation and even increase the pregnancy rate in women with PCOS.”
Of course, this research is in mice: Researchers will need to do rigorous drug testing and establish medical guidelines before this is ready to be put to use in humans. Right now, women with PCOS can go to the U.S. Health & Human Services website to look for clinical trials if they’re interested in helping such research along, recommends Dr. Alagria.
Until a cure is available, women with irregular periods or other silent signs of PCOS should see their doctor—even if they aren’t trying to get pregnant. The condition is also associated with uterine bleeding, endometrial cancer, metabolic syndrome, and type 2 diabetes, so it’s important to have proper care, Dr. Alagria says.
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