Should polycystic patients get married early?

Polycystic ovary syndrome is a relatively common female infertility disease. The most important feature of this disease is ovulation disorder or even anovulation, which makes women unable to become pregnant normally. From the perspective of fertility, it is generally better for patients with polycystic ovary to get married as soon as possible. Because the probability of pregnancy in patients with polycystic ovary is greatly reduced, and the uterine and ovarian reserve function decreases with age, the younger the woman, the more abundant the uterine and ovarian reserve. Therefore, it is more beneficial for patients with polycystic ovary to get married early for pregnancy.

In 1935, Stein and Leventhal sorted out the four major symptoms of amenorrhea, hirsutism, obesity and infertility, which were called Stein-Leventhal syndrome (SL syndrome). PCOS patients have enlarged ovaries, thickened tunica albuginea, multiple eggs at different stages of development, and sphingomyelinization of granulosa cells. PCOS is a key risk factor for type 2 diabetes, cardiovascular disease, gestational diabetes, pregnancy-induced hypertension, and endometrial cancer.

The clinical manifestations of PCOS are varied, and the cause of the disease is currently unclear. PCOS often manifests itself in familial clusters, suggesting the role of genetic factors. The patient often has a mother with menstrual disorders or a father with premature baldness; premature baldness is the male manifestation of PCOS, and female PCOS and male premature baldness may be determined by the same allele; hyperandrogenuria and/or hyperglargineuria may be the genetic characteristics of the family members of PCOS patients; family analysis studies under different diagnostic criteria often indicate that the inheritance mode of PCOS is an autosomal dominant gene; however, studies using the "single genetic gene-gene variation expression model" show that PCOS is caused by major gene variation and 50% can be inherited by offspring.

Causes

At present, there are two types of research on the etiology of PCOS: non-genetic theory and genetic theory.

1. Non-cell biological basis theory of PCOS

Scientific research shows that the intrauterine hormone environment during pregnancy affects the endocrine state of an individual in adulthood. Exposure to a high concentration of androgen environment during pregnancy, such as mothers with a history of PCOS or mothers with congenital adrenal hyperplasia and poor control of high androgen levels, is more likely to cause ovulation dysfunction after puberty.

2. Basic theory of PCOS cell biology

The main basis of this theory is that PCOS presents as a familial herd animal state. Familial ovulatory dysfunction and polycystic ovary changes indicate that the disease has a genetic basis. Hyperandrogenuria and/or hyperglargine insulinuria may be the genetic characteristics that PCOS family members suffer from. The effectiveness of glargine insulin in promoting the conversion of uterine androgen is also affected by genetic factors or genetic susceptibility genes. The incidence of hyperglargineuria in women and premature hair loss in men is increased in family members with infrequent ovulation, hyperandrogenism, and polycystic ovary syndrome. Somatic cell biology research data show that PCOS may be X-linked recessive inheritance, autosomal dominant gene or multiple genetic inheritance. According to the discovery of whole genome scanning, the largest number of genes related to PCOS are found, such as alternative genes for steroid hormone production and related functions, genes related to regulation of androgen production, genes related to insulin production, alternative genes for carbohydrate metabolism and energy balance, alternative genes for gonadotropin function and regulation, genes related to human fat tissue, and genes related to inflammation.

In short, scientific research on the etiology of PCOS cannot confirm that the disease is caused by a certain gene domain or a certain gene mutation. Its onset may be related to the function of some genes under the influence of specific environmental factors to cause the symptoms.