Polycystic ovary syndrome

This case illustrates the very common endocrine problem of polycystic ovary syndrome (PCOS). The diagnosis was not clear initially because of the absence of clinical evidence of androgen excess and of a normal random serum luteinizing hormone (LH) concentration. Futher investigations, however, confirmed polycystic ovaries on ultrasound and revealed a raised serum LH and elevated testosterone despite the lack of hirsutism. The patient's anovulatory infertility was treated by low dose human menopausal gonadotrophin (HMG), which resulted in ovulation of a single dominant follicle and pregnancy in the first cycle of treatment. This article discusses the endocrine features of hirsute and nonhirsute patients with PCOS, the choice of treatment for induction of ovulation, and comments on the possible mechanisms underlying PCOS.