Polyzystisches Ovarsyndrom (PCOS)

  • Kay NeumannEmail author
  • Georg Griesinger
Part of the Springer Reference Medizin book series (SRM)


Bereits 1721 wurde durch Antonio Vallisneri, einem Mediziner, Wissenschaftler und Naturforscher aus Padua, das polyzystische Ovarsyndrom (PCOS) anhand auffallend großer Ovarien bei einer verheirateten, infertilen Frau beschrieben. 1935 berichteten Stein und Leventhal von Zyklusunregelmäßigkeiten und Hirsutismus bei einer Gruppe von Frauen mit großen sowie mit einer hohen Anzahl an Follikeln versehenen Ovarien. Als Therapie wurde im Jahre 1948 von Stein und Leventhal eine chirurgische Keilresektion am Ovar postuliert, welche in einer Studie zu einer postoperativen Schwangerschaftsrate von 65 % führte. In der Folge wurde das PCOS auch lange als Stein-Leventhal-Syndrom bezeichnet.


  1. Anagnostis P, Tarlatzis BC, Kauffman RP (2017) Polycystic ovarian syndrome (PCOS): long-term metabolic consequences. Metabolism:pii: S0026-0495(17)30274-3. [Epub vor Druck] PubMed PMID: 29024702CrossRefGoogle Scholar
  2. Artini PG, Di Berardino OM, Papini F, Genazzani AD, Simi G, Ruggiero M, Cela V (2013) Endocrine and clinical effects of myo­inositol administration in poly­ cystic ovary syndrome. A randomized study. Gynecol Endocrinol 29:375–379CrossRefGoogle Scholar
  3. Azziz R, Carmina E, Dewailly D, Diamanti-Kandarakis E, Escobar- Morreale HF, Futterweit W et al (2006) Positions statement: criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: an androgen excess society guideline. J Clin Endocrinol Metab 91:4237–4245CrossRefGoogle Scholar
  4. Azziz R, Dumesic DA, Goodarzi MO (2011) Polycystic ovary syndrome: an ancient disorder? Fertil Steril 95(5):1544–1548. Epub 2010 Oct 27. Review. PubMed PMID:20979996; PubMed Central PMCID: PMC3164771CrossRefPubMedGoogle Scholar
  5. Balen AH (2013) Ovulation induction in the management of anovulatory polycystic ovary syndrome. Mol Cell Endocrinol 373:77–82CrossRefGoogle Scholar
  6. Balen AH, Anderson RA (2007) Policy & practice committee of the BFS: impact of obesity on female reproductive health: British fertility society, policy and practice guidelines. Hum Fertil 10:195–206CrossRefGoogle Scholar
  7. Balen AH, Tan SL, Jacobs HS (1993) Hypersecretion of luteinising hormone: a significant cause of infertility and miscarriage. Br J Obstet Gynaecol 100:1082–1089CrossRefGoogle Scholar
  8. Balen AH, Morley LC, Misso M, Franks S, Legro RS, Wijeyaratne CN, Stener-Victorin E, Fauser BC, Norman RJ, Teede H (2016) The management of anovulatory infertility in women with polycystic ovary syndrome: an analysis of the evidence to support the development of global WHO guidance. Hum Reprod Update 22(6):687–708. Epub 2016 Aug 10. Review. PubMed PMID: 27511809CrossRefGoogle Scholar
  9. Barry JA, Azizia MM, Hardiman PJ (2014) Risk of endometrial, ovarian and breast cancer in women with polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update 20(5):748–758. Epub 2014 Mar 30. Review. PubMed PMID: 24688118; PubMed Central PMCID: PMC4326303CrossRefPubMedCentralGoogle Scholar
  10. Boomsma CM, Eijkemans MJ, Hughes EG, Visser GH, Fauser BC, Macklon NS (2006) A meta-analysis of pregnancy outcomes in women with polycystic ovary syndrome. Hum Reprod Update 12(6):673–683. Epub 2006 Aug 4. Review. PubMed PMID: 16891296CrossRefGoogle Scholar
  11. Boyle JA, Cunningham J, O’Dea K, Dunbar T, Norman RJ (2012) Prevalence of polycystic ovary syndrome in a sample of indigenous women in Darwin, Australia. Med J Aust 196:62–66CrossRefGoogle Scholar
  12. Brewer C, Acharya S, Thake F, Tang T, Balen A (2010) Effect of metformin taken in the ‚fresh‘ in vitro fertilization/intracytoplasmic sperm injection cycle upon subsequent frozen embryo replacement in women with polycystic ovary syndrome. Hum Fertil 13(3):134–142. PubMed PMID: 20849198CrossRefGoogle Scholar
  13. Casarini L, Simoni M, Brigante G (2016) Is polycystic ovary syndrome a sexual conflict? A review. Reprod Biomed Online 32(4):350–361. Epub 2016 Feb 2. Review. PubMed PMID: 26874987CrossRefPubMedGoogle Scholar
  14. Corbett SJ, McMichael AJ, Prentice AM (2009) Type 2 diabetes, cardiovascular disease, and the evolutionary paradox of the polycystic ovary syndrome: a fertility first hypothesis. Am J Hum Biol 21(5):587–598. PubMed PMID: 19533615CrossRefPubMedGoogle Scholar
  15. Dahlgren E (1992) Women with polycystic ovary syndrome wedge resected in 1956 to 1965: a long-term follow up. Fertil Steril 57:505–513CrossRefGoogle Scholar
  16. Dewailly D, Alebić MŠ, Duhamel A, Stojanović N (2014a) Using cluster analysis to identify a homogeneous subpopulation of women with polycystic ovarian morphology in a population of non-hyperandrogenic women with regular menstrual cycles. Hum Reprod. 29(11):2536–2543. Epub 2014 Sep 29. PubMed PMID: 25267785CrossRefGoogle Scholar
  17. Dewailly D, Andersen CY, Balen A, Broekmans F, Dilaver N, Fanchin R, Griesinger G, Kelsey TW, La Marca A, Lambalk C, Mason H, Nelson SM, Visser JA, Wallace WH, Anderson RA (2014b) The physiology and clinical utility of anti-Mullerian hormone in women. Hum Reprod Update 20(3):370–385. Epub 2014 Jan 14. Review. Erratum in: Hum Reprod Update. 2014 Sep-Oct;20(5):804. PubMed PMID: 24430863CrossRefPubMedGoogle Scholar
  18. Dumont A, Robin G, Catteau-Jonard S, Dewailly D (2015) Role of anti-müllerian hormone in pathophysiology, diagnosis and treatment of polycystic ovary syndrome: a review. Rep Biol Endocrinol 13:137. Scholar
  19. ESHRE/ASRM (2008) Thessaloniki sponsored PCOS consensus workshop group consensus on infertility treatment related to polycystic ovary syndrome. Hum Reprod 23:462–477CrossRefGoogle Scholar
  20. Facchinetti F, Bizzarri M, Benvenga S, D’Anna R, Lanzone A, Soulage C, Di Renzo GC, Hod M, Cavalli P, Chiu TT, Kamenov ZA, Bevilacqua A, Carlomagno G, Gerli S, Oliva MM, Devroey P (2015) Results from the international consensus conference on myo­inositol and dchiro­ inositol in obstetrics and gynecology: the link between metabolic syndrome and PCOS. Eur J Obstet Gynecol Reprod Biol 195:72–76CrossRefGoogle Scholar
  21. Ferriman DM, Gallwey JD (1961) Clinical assessment of body hair growth in women. J Clin Endocrinol 21:1440–1447CrossRefGoogle Scholar
  22. Franik S, Kremer JA, Nelen WL, Farquhar C (2014) Aromatase inhibitors for subfertile women with polycystic ovary syndrome. Cochrane Database Syst Rev (2):CD010287. Review. PubMed PMID: 24563180
  23. Garg D, Tal R (2016) The role of AMH in the pathophysiology of polycystic ovarian syndrome. Reprod Biomed Online 33(1):15–28. Epub 2016 Apr 21. Review. PubMed PMID: 27174394CrossRefPubMedGoogle Scholar
  24. Griesinger G, Diedrich K, Tarlatzis BC, Kolibianakis EM (2006) GnRH-antagonists in ovarian stimulation for IVF in patients with poor response to gonadotrophins, polycystic ovary syndrome, and risk of ovarian hyperstimulation: a meta-analysis. Reprod Biomed Online 13:628–638CrossRefGoogle Scholar
  25. Hanson B, Johnstone E, Dorais J, Silver B, Peterson CM, Hotaling J (2017) Female infertility, infertility-associated diagnoses, and comorbidities: a review. J Assist Reprod Genet 34(2):167–177. Epub 2016 Nov 5. Review. PubMed PMID: 27817040; PubMed Central PMCID: PMC5306404CrossRefGoogle Scholar
  26. Homburg R (2005) Clomiphene citrate – end of an era? A mini-review. Hum Reprod 20:2043–2051Google Scholar
  27. Homburg R (2010) Choices in the treatment of anovulatory PCOS. Current management of polycystic ovary syndrome. In: Balen A, Franks S, Homburg R (Hrsg) Proceedings of 59th RCOG study group: current management of polycystic ovary syndrome. RCOG Press, London, S 143–152Google Scholar
  28. Koivunen R, Pouta A, Franks S, Martikainen H, Sovio U, Hartikainen AL, McCarthy MI, Ruokonen A, Bloigu A, Järvelin MR, Morin-Papunen L, Northern Finland Birth Cohort 1966 Study (2008) Fecundability and spontaneous abortions in women with self-reported oligo-amenorrhea and/or hirsutism: Northern Finland birth cohort 1966 study. Hum Reprod 23(9):2134–2139. Epub 2008 Jun 10. PubMed PMID: 18544581CrossRefGoogle Scholar
  29. Kousta E, White DM, Franks S (1997) Modern use of clomiphene citrate in induction of ovulation. Hum Reprod Update 3(4):359–365. Review. PubMed PMID: 9459281CrossRefGoogle Scholar
  30. Lauritsen MP, Bentzen JG, Pinborg A, Loft A, Forman JL, Thuesen LL, Cohen A, Hougaard DM, Nyboe AA (2014) The prevalence of polycystic ovary syndrome in a normal population according to the Rotterdam criteria versus revised criteria including anti-Müllerian hormone. Hum Reprod 29(4):791–801. Epub 2014 Jan 16. PubMed PMID: 24435776CrossRefGoogle Scholar
  31. Legro RS (2016) Mr. Fertility authority, tear down that weight wall! Hum Repro 31(12):2662–2664. Scholar
  32. Legro RS, Barnhart HX, Schlaff WD, Carr BR, Diamond MP, Carson SA, Steinkampf MP, Coutifaris C, McGovern PG, Cataldo NA, Gosman GG, Nestler JE, Giudice LC, Leppert PC, Myers ER, Cooperative Multicenter Reproductive Medicine Network (2007) Clomiphene, metformin, or both for infertility in the polycystic ovary syndrome. N Engl J Med 356(6):551–566. PubMed PMID: 17287476CrossRefGoogle Scholar
  33. Lizneva D, Suturina L, Walker W, Brakta S, Gavrilova-Jordan L, Azziz R (2016) Criteria, prevalence, and phenotypes of polycystic ovary syndrome. Fertil Steril 106(1):6–15. Epub 2016 May 24. Review. PubMed PMID: 27233760CrossRefGoogle Scholar
  34. McCartney CR, Marshall JC (2016) CLINICAL PRACTICE. Polycystic ovary syndrome. N Engl J Med 375(1):54–64. Review. PubMed PMID: 27406348; PubMed Central PMCID: PMC5301909CrossRefPubMedPubMedCentralGoogle Scholar
  35. Mellembakken JR, Berga SL, Kilen M, Tanbo TG, Abyholm T, Fedorcsák P (2011) Sustained fertility from 22 to 41 years of age in women with polycystic ovarian syndrome. Hum Reprod 26(9):2499–2504. Epub 2011 Jun 30. PubMed PMID: 21724569; PubMed Central PMCID: PMC444778CrossRefPubMedPubMedCentralGoogle Scholar
  36. Moran LJ, Misso ML, Wild RA, Norman RJ (2010) Impaired glucose tolerance, type 2 diabetes and metabolic syndrome in polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update 16(4):347–363. Epub 2010 Feb 16. Review. PubMed PMID: 20159883CrossRefPubMedGoogle Scholar
  37. Mutsaerts MA, van Oers AM, Groen H, Burggraaff JM, Kuchenbecker WK, Perquin DA, Koks CA, van Golde R, Kaaijk EM, Schierbeek JM, Oosterhuis GJ, Broekmans FJ, Bemelmans WJ, Lambalk CB, Verberg MF, van der Veen F, Klijn NF, Mercelina PE, van Kasteren YM, Nap AW, Brinkhuis EA, Vogel NE, Mulder RJ, Gondrie ET, de Bruin JP, Sikkema JM, de Greef MH, ter Bogt NC, Land JA, Mol BW, Hoek A (2016) Randomized trial of a lifestyle program in obese infertile women. N Engl J Med 374(20):1942–1953. PubMed PMID: 27192672CrossRefPubMedGoogle Scholar
  38. Naderpoor N, Shorakae S, de Courten B, Misso ML, Moran LJ, Teede HJ (2015) Metformin and lifestyle modification in polycystic ovary syndrome: systematic review and meta-analysis. Hum Reprod Update 21:560–574CrossRefGoogle Scholar
  39. National Institutes of Health (NIH) (2012) Evidence-based methodology workshop on polycystic ovary syndrome, 03–05.12.2012. Executive summary. Zugegriffen am 15.11.2017
  40. Neumann K, Indorf I, Härtel C, Cirkel C, Rody A, Beyer DA (2017) C-section prevalence among obese mothers and neonatal hypoglycemia: a cohort analysis of the department of gynecology and obstetrics of the University of Lübeck. Geburtshilfe Frauenheilkd 77(5):487–494. Epub 2017 May 24. PubMed PMID: 28579620; PubMed Central PMCID: PMC5444529CrossRefGoogle Scholar
  41. Nyboe Andersen A, Nelson SM, Fauser BC, García-Velasco JA, Klein BM, Arce JC, ESTHER-1 study group (2017) Individualized versus conventional ovarian stimulation for in vitro fertilization: a multicenter, randomized, controlled, assessor-blinded, phase 3 noninferiority trial. Fertil Steril 107(2):387–396.e4. Epub 2016 Nov 29. PubMed PMID: 27912901CrossRefPubMedGoogle Scholar
  42. Oers AM van, Mutsaerts MAQ, Burggraaff JM, Kuchenbecker WKH, Perquin DAM, Koks CAM, van Golde R, Kaaijk EM, Schierbeek JM, Klijn NF, van Kasteren YM, Land JA, Mol BWJ, Hoek A, Groen H, LIFEstyle study group (2017) Cost-effectiveness analysis of lifestyle intervention in obese infertile women. Hum Reprod 32(7):1418-1426. PubMed PMID: 28486704CrossRefGoogle Scholar
  43. Pastor CL, Griffin-Korf ML, Aloi JA, Evans WS, Marshall JC (1998) Polycystic ovary syndrome: evidence for reduced sensitivity of the gonadotropin-releasing hormone pulse generator to inhibition by estradiol and progesterone. J Clin Endocrinol Metab 83(2):582–590. PubMed PMID: 9467578PubMedGoogle Scholar
  44. Pellatt L, Hanna L, Brincat M, Galea R, Brain H, Whitehead S, Mason H (2007) Granulosa cell production of anti-Müllerian hormone is increased in polycystic ovaries. J Clin Endocrinol Metab 92(1):240–245. Epub 2006 Oct 24. PubMed PMID: 17062765CrossRefGoogle Scholar
  45. Randeva HS, Tan BK, Weickert MO, Lois K, Nestler JE, Sattar N et al (2012) Cardiometabolic aspects of the polycystic ovary syndrome. Endocr Rev 33:812–841CrossRefGoogle Scholar
  46. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group (2004) Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 81(1):19–25. PubMed PMID: 14711538CrossRefGoogle Scholar
  47. Stein IF, Leventhal ML (1935) Amenorrhoea associated with bilateral polycystic ovaries. Am J Obstet Gynecol 29:181–191CrossRefGoogle Scholar
  48. Stein IF, Cohen MR, Elson RE (1948) Results of bilateral ovarian wedge resection in 47 cases of sterility. Am J Obstet Gynecol 58:267–273CrossRefGoogle Scholar
  49. Ünlütürk U, Sezgin E, Yildiz BO (2016) Evolutionary determinants of polycystic ovarysyndrome: part 1. Fertil Steril 106(1):33–41. Epub 2016 May 26. Review. PubMed PMID: 27238626CrossRefPubMedGoogle Scholar
  50. Vallisneri A (1721/1920) Cited in Insler V, Lunesfeld B. Polycystic ovarian disease: a challenge and controversy. Gynecol Endocrinol 4:51–69Google Scholar
  51. Vanky E, Stridsklev S, Heimstad R, Romundstad P, Skogøy K, Kleggetveit O, Hjelle S, von Brandis P, Eikeland T, Flo K, Berg KF, Bunford G, Lund A, Bjerke C, Almås I, Berg AH, Danielson A, Lahmami G, Carlsen SM (2010) Metformin versus placebo from first trimester to delivery in polycystic ovary syndrome: a randomized, controlled multicenter study. J Clin Endocrinol Metab 95(12):E448–E455. Epub 2010 Oct 6. PubMed PMID: 20926533CrossRefGoogle Scholar
  52. Yildiz BO, Bozdag G, Yapici Z, Esinler I, Yarali H (2012) Prevalence, phenotype and cardiometabolic risk of polycystic ovary syndrome under different diagnostic criteria. Hum Reprod 27:3067–3073CrossRefGoogle Scholar
  53. Yu HF, Chen HS, Rao DP, Gong J (2016) Association between polycystic ovary syndrome and the risk of pregnancy complications: a PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore) 95:e4863CrossRefGoogle Scholar
  54. Zhang J, Li T, Zhou L, Tang L, Xu L, Wu T, Lim DC (2010) Chinese herbal medicine for subfertile women with polycystic ovarian syndrome. Cochrane Database Syst Rev (9):CD007535. Review. Update in: Cochrane Database Syst Rev. 2016 Oct 12;10: CD007535. PubMed PMID: 20824862

Copyright information

© Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature 2020

Authors and Affiliations

  1. 1.Sektion für gynäkologische Endokrinologie und ReproduktionsmedizinUniversitätsklinikum Schleswig-HolsteinLübeckDeutschland
  2. 2.Sektion für gynäkologische Endokrinologie und ReproduktionsmedizinUniversitätsklinikum Schleswig-Holstein – Campus LübeckLübeckDeutschland

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