Response to treatment with metformin in patients with polycystic ovarian syndrome: territorial center of care for the infertile couple, Holguín

Polycystic ovary syndrome (PCOS) is a chronic alteration of ovarian function with hyperandrogenism that affects approximately 5-10% of women of childbearing age and is characterized by symptoms such as menstrual disorders (oligomenorrhea), infertility, hirsutism and some cases acne.1 In 1844, Cheréau described the existence of sclerocystic changes in the human ovary. The first correlation between androgen levels and insulin resistance was published in 1921 by Acherd and Thiers, calling it “bearded woman’s diabetes.” In 1928 Irving Stein drew attention to a group of patients with hirsutism, sterility, obesity and oligomenorrhea. In 1935 it is called “Stein-Levental syndrome”, being determined as ovarian dysfunction. The existence of elevated levels of LH was reported in 1958, setting criteria for the diagnosis of polycystic ovary syndrome. In 1971, the use of radioimmunoassays stimulates the biochemical diagnosis. In 1976, the concept of polycystic ovary with normal levels of LH is accepted; the same year, Kahn reports six patients with insulin resistance, acanthosis nigricans and hyperandrogenism. Swanson, in 1981, describes for the first time the ultrasound findings of the ovarian polycystic; until 1985, Adams defines the sonographic diagnostic criteria, being accepted. Only 50% of women with clinical and biochemical evidence of PCOS, show abnormalities by ultrasound.2,3 According to reports in Greece and Spain there is a prevalence of 4-8% of women who have polycystic ovary. In the United States more than 250,000 women use the ultrasound evaluation, for the diagnosis of the disease, of these between 4% and 7% have ovarian cysts larger than 30 mm in diameter.4