الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Polycystic ovarian syndrome (PCOS) is recognized as the most common endocrine disorder in females affecting 5-10% of reproductive age women and accounting for 75% of anovulatory infertility. It has complex pathogenesis as well as polymorphic clinical manifestations. It is characterized by hyperandrogenism, ovulatory disturbances and the presence of enlarged cystic ovaries. It is usually accompanied by obesity and insulin resistance. PCOS patients are also exposed to the prolonged stimulatory effects of unopposed estrogen by chronic anovulation and this increases the risk for estrogen dependent tumors.
Anti-mullerian hormone (AMH) is found to be higher in serum of PCOS women than in women with normal ovaries. High levels of this hormone may act as the main facilitator of abnormal folliculogenesis in PCOS. In addition, serum AMH level is also correlated to the severity of the disease symptoms and is higher when hyperandrogenism or oligo-anovulation is present. Thus, reducing AMH may become a therapeutic target in treatment of PCOS.
Treatment of this syndrome is challenging for clinicians because of its complex etiology and heterogeneous clinical symptoms. There is currently no ideal medical PCOS therapy that fully reverses underlying hormonal disturbances and treats all clinical features. As a result, the clinical management of PCOS is symptom oriented. The viscous circle of PCOS features aggravating each other may be driven by androgens, insulin and AMH. This circle must be broken to improve the health status of women with PCOS.