FETAL GROWTH, LENGTH OF GESTATION, AND POLYCYSTIC OVARIES IN ADULT LIFE

Background Polycystic ovaries are a common disorder associated with me nstrual irregularities, subfertility, hirsutism, acne, and a range of endocrine abnormalities, including high concentrations of plasma lutei nising hormone (LH) and excessive androgen production. The pathophysio logy is not understood. We investigated whether the disorder originate s during intrauterine life. Methods We examined 235 women aged 40-42 y ears who were born in Sheffield, UK. We related the prevalence of poly cystic ovaries and the plasma concentrations of gonadotropin hormones and androgens to the women's body size at birth, and the length of ges tation. Findings 49 (21%) of the women had polycystic ovaries. We defi ned two groups of women with the disorder, which correspond to the two groups that commonly present clinically. The first group comprised ob ese women who were androgenised, with higher than normal concentration s of plasma LH and testosterone. These women had above-average birthwe ight and were born to overweight mothers. The second group comprised w omen of normal weight who had high plasma LH, but normal testosterone concentrations. These women were born after term (40 weeks' gestation) . Interpretation The two common forms of polycystic ovary syndrome hav e different origins in intrauterine life. Obese, hirsute women with po lycystic ovaries have higher than normal ovarian secretion of androgen s that are associated with high birthweight and maternal obesity. Thin women with polycystic ovaries have altered hypothalamic control of LH release resulting from prolonged gestation.