Thyroid disorders in polycystic ovary syndrome.
Thyroid disorders, especially Hashimoto's thyroiditis (HT), are observed significantly more often in patients with polycystic ovary syndrome (PCOS) than in the general population - approximately 27% and 8%, respectively. This is extremely important in young women, because both disorders are connected with fertility problems. As HT and PCOS occur together, fertility problems may become a serious clinical issue in these patients.



A systematic literature review in PubMed of PCOS- and HT-related articles in English, published until December 2015 was conducted.



The reasons for joint prevalence still remain unclear. Genetic and autoimmune backgrounds are recognized to be possible common etiological factors. Three genetic polymorphisms have been described to play a role in PCOS as well as in HT. They are polymorphism of the gene for fibrillin 3 (FBN3) regulating the activity of transforming growth factor-b (TGF-b) and regulatory T cell levels, gonadotropin-releasing hormone receptor (GnRHR) polymorphism and CYP1B1 polymorphism standing for estradiol hydroxylation. High estrogen-to-progesterone ratios owing to anovulatory cycles, as well as high estrogen levels during prenatal life, disrupt development of the thymus and its function in maintaining immune tolerance, and are suspected to enhance autoimmune response in PCOS. Vitamin D deficiency could be also involved in the pathogenesis of HT and PCOS.



The above-mentioned common etiological factors associated with fertility problems in HT and PCOS require further research.
Department of Gynaecological Endocrinology, Medical Faculty in Katowice, Medical University of Silesia, Katowice, Poland. karolina.kowalczyk74@gmail.com.
K
K
Kowalczyk
G
G
Franik
D
D
Kowalczyk
D
D
Pluta
Ł
Ł
Blukacz
P
P
Madej
D065633:Cytochrome P-450 CYP1B1 / Q000235:genetics; D005260:Female; D000071837:Fibrillins / Q000235:genetics; D050031:Hashimoto Disease / Q000453:epidemiology*; D006801:Humans; D011085:Polycystic Ovary Syndrome / Q000453:epidemiology*; D011966:Receptors, LHRH / Q000235:genetics; D016212:Transforming Growth Factor beta / Q000235:genetics
C493782:FBN3 protein, human; D000071837:Fibrillins; C484844:GNRHR protein, human; D011966:Receptors, LHRH; D016212:Transforming Growth Factor beta; C585496:CYP1B1 protein, human; D065633:Cytochrome P-450 CYP1B1