Polycystic ovary syndrome: new trends in diagnosis and treatment

Polycystic Ovary Syndrome (PCOS) — frequent endocrine disease of women of the reproductive period, the prevalence of which ranges from 13 % to 25 %. PCOS is a disease with reproductive and metabolic disorders. This article will discuss innovations in the diagnosis and treatment of PCOS. An innovation in diagnosis is the determination of AMH levels > 4.7 ng/ml (specificity 92 %, sensitivity 89 %) when ultrasound is unavailable, the refinement of ultrasound markers — ≥ 20 follicles or ovarian volume ≥ 10 ml in adults, and the focus on hyperandrogenism with priority for determining free testosterone, taking into account ethnic characteristics. In the treatment of PCOS, the emphasis remains on lifestyle modification and on combating obesity. 150–300 minutes of physical activity per week is recommended. Among the pharmacological drugs, metformin, COCs and antiandrogens retain their positions, but there are more and more mentions of inositol isoforms that are recommended for use as experimental therapy. Inositols (myo- and D-chiroinositol in a ratio of 40:1) demonstrate effectiveness in improving ovulation (OR 1.8), reducing free testosterone (15–20 %), and moderately reducing insulin resistance (HOMA-IR -0.8). However, their application requires further research for standardization. Modern diagnosis of PCOS has become more flexible due to the inclusion of AMH, and therapy combines traditional (COCs, metformin) and promising methods (inositols, aGPP-1). Inositols, despite the limited evidence base, occupy an important place in the treatment, especially for metabolic and reproductive disorders.