Journal of International Reproductive Health/Family Planning ›› 2021, Vol. 40 ›› Issue (1): 79-83.doi: 10.12280/gjszjk.20200249

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Advances in Neuroendocrine Mechanism of Polycystic Ovary Syndrome

QIAN Zi-wei, YAO Qi, ZHOU Ge, REN Qing-ling, HU Rong-kui()   

  1. School of Medicine and Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, China (QIAN Zi-wei, YAO Qi); Department of Reproductive Medicine (ZHOU Ge), Department of Gynecology (REN Qing-ling, HU Rong-kui), Affiliated Hospital of Nanjing University of Chinese Medicine/Jiangsu Province Hospital of Chinese Medicine, Nanjing 210023, China
  • Received:2020-05-09 Published:2021-01-15 Online:2021-01-21
  • Contact: HU Rong-kui E-mail:xiangyu198110@163.com

Abstract:

Polycystic ovary syndrome (PCOS) is a highly prevalent reproductive endocrine disorder in women. PCOS is characterized by three clinical features of hyperandrogenism, ovulatory dysfunction and the polycystic appearance of the ovaries. Hyperandrogenemia is driven by the increased luteinizing hormone (LH) pulse secretion from the pituitary. Indeed, PCOS women display both the elevated mean level of LH and the elevated frequency of LH pulses. The abnormally high frequency of LH pulses reflects a hyperactive circuit of gonadotropin-releasing hormone (GnRH) neurons, which suggests a neuroendocrine basis to either the etiology or phenotype of PCOS. Several studies in preclinical animal models of PCOS have demonstrated the alterations in GnRH neurons and their upstream afferent neuronal circuits. The PCOS model of excessive androgen or Mulller′s hormone exposure during development confirmed the increased activity of GnRH neurons that is related to the stimulation of Kisspeptinergic and GABAergic neurons to control GnRH neurons. In this paper, we review the pathology of PCOS associated with high frequency GnRH/LH pulses and highlight about the involved neural networks, and then discuss the neuroendocrine origins of PCOS.

Key words: Polycystic ovary syndrome, Gonadal steroid hormones, Neurofeedback, Gonadotropin-releasing hormone, Luteinizing hormone, Kisspeptinergic neurons, GABAergic neurons