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Fertil Steril. 2016 Jul;106(1):16-24. doi: 10.1016/j.fertnstert.2016.05.011. Epub 2016 May 27.

Environmental determinants of polycystic ovary syndrome.

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Division of Geriatrics, Geffen School of Medicine at UCLA, Los Angeles, California. Electronic address:
Center for Fertility and Reproductive Surgery, Texas Tech University Health Sciences Center, Lubbock, Texas.
Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Baystate Medical Center, Tufts University School of Medicine, Boston, Massachusetts.
Department of Obstetrics and Gynecology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China.


In this review, we summarize existing research on a variety of environmental factors potentially involved in the etiology, prevalence, and modulation of polycystic ovary syndrome (PCOS), and we suggest avenues for future research. The main environmental factors we consider include environmental toxins, diet and nutrition, socioeconomic status, and geography. There is some evidence that environmental toxins play a role in disrupting reproductive health, but there is limited research as to how these toxins may affect the development of PCOS. Although research has also shown that PCOS symptoms are reduced with certain dietary supplements and with weight loss among obese women, additional research is needed to compare various approaches to weight loss, as well as nutritional factors that may play a role in preventing or mitigating the development of PCOS. Limited studies indicate some association of low socioeconomic status with certain PCOS phenotypes, and future research should consider socioeconomic conditions during childhood or adolescence that may be more relevant to the developmental onset of PCOS. Finally, the limited scope of comparable international studies on PCOS needs to be addressed, because global patterns of PCOS are potentially valuable indicators of cultural, environmental, and genetic factors that may contribute to excess risk in certain regions of the world.


PCOS; diet; environment; polycystic ovary syndrome; socioeconomic; toxins

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