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Fig. 3. The sources of androgens in polycystic ovary syndrome (PCOS).19 Approximately two-thirds of cases have functionally typical PCOS that is due to typical functional ovarian hyperandrogenism (FOH) and is characterized by hyper-responsiveness of 17-hydroxyprogesterone (17OHP) to the luteinizing hormone (gonadotropin- releasing hormone agonist or human chorionic gonadotrophin) test. The remaining one-third of PCOS cases are functionally atypical and therefore lack 17OHP hyper responsiveness. This is a heterogeneous group, most of which have atypical FOH in which ovarian androgen excess is indicated only by a dexamethasone androgen-suppression test. A small number is due to isolated functional adrenal hyperandrogenism (FAH). In a minority of cases, the source of androgen cannot be identified as either ovarian or adrenal. Most of these cases are associated with obesity. Approximately 28%–30% of FOH cases also demonstrate FAH.
J Obes Metab Syndr 2021;30:209~221 https://doi.org/10.7570/jomes21043