Dear Colleagues,

Obesity is reported in 25–70% of women with PCOS. Significant proportion of patients have it despite having a normal BMI (≤25 kg/m²).  Incidence of lean women with PCOS is on the rise. Body weight is more important than the Rotterdam phenotype in influencing the metabolic status. Even though obese and lean PCOS share some aspects in their metabolic profiles, each group has individual differences in body composition and other parameters: clinical signs, psychological, hormonal, metabolic & genetic profiles. Lean PCOS is different from lean non PCOS regarding metabolic profile & hepatic impairment & cardiovascular risks. Anovulatory infertility is a common issue among lean and obese reproductive-aged women with PCOS, lifestyle modifications is first-line therapy: maintain weight with a high caloric intake at breakfast with reduced intake at dinner, micronutrients supplementation & resistance exercise. Medical induction of ovulation with letrozole, CC& metformin may be added or gonadotropins. Laparoscopic ovarian drilling if medical induction failed. Intrauterine insemination is associated with good results compared to obese PCOS.  ART are reserved for women who do not conceive despite the restoration of ovulation or couples with additional factors contributing to their infertility.

This special issue welcomes original papers and reviews focused on the pathogenesis and treatment of polycystic ovary syndrome.

Dr. Aboubakr Elnashar
Guest Editor