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Human Reproduction Update Advance Access published online on July 1, 2005

Human Reproduction Update, doi:10.1093/humupd/dmi025
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© The Author 2005. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org
Received May 17, 2005
Accepted May 24, 2005

Article

Genetics of polycystic ovary syndrome: searching for the way out of the labyrinth

Evanthia Diamanti-Kandarakis 1* and Christina Piperi 2

1 Endocrine section, First Department of Internal Medicine
2 Laboratory of Biological Chemistry, University of Athens Medical School, Athens, Greece

* To whom correspondence should be addressed.
Evanthia Diamanti-Kandarakis, E-mail: akandara{at}otenet.gr


   Abstract

Polycystic ovary syndrome (PCOS) is a complex and heterogeneous disorder presenting a challenge for clinical investigators. It is the most common endocrine disorder of women in reproductive age, a multifaceted reproductive, cosmetic and metabolic problem, with an enigmatic pathophysiological and molecular basis. Although the familial segregation has been noticed very early in the description of the syndrome and family studies in first-degree relatives of women diagnosed with PCOS reveal clustering of the disease, the genetic studies have not as yet determine the pattern of heredity. Part of the problem in genetic studies has been the lack of uniform criteria for diagnosis, heterogeneity of phenotypic features and the fact that the disorder is only expressed clinically in women during their reproductive years. Even within affected families and between sisters with polycystic ovaries, there is heterogeneity in presentation. However, regardless of diagnostic criteria used to identify profanes and to determine affected status in the kindred, the foundation of genetic studies suggests a strong familial component. Currently, PCOS is considered a polygenic trait that might result from the interaction of susceptible and protective genomic variants under the influence of environmental factors, whose role is under intensive investigation. Candidate genes cover a broad spectrum of an endless list of molecules which participate on every step of reproductive and metabolic pathways of this syndrome. Focused research in identification of these genes may provide valuable information and shed some light on the way out of the genomic labyrinth, elucidating the underlying pathophysiology and aiming at a more efficient therapeutic approach of this complicated endocrine disorder.

Keywords: candidate genes/environmental factors/metabolic abnormalities/molecular factors/PCOS.
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