This issue’s Views and Reviews series furthers our understanding of the phenotyping and the environmental, genetic, and evolutionary determinants of polycystic ovary syndrome, assisting in elucidating the fundamental etiologies underlying this common and pervasive syndrome.

The authors review the evolution of the criteria used to diagnosis polycystic ovary syndrome, the prevalence of the disorder, the distribution of polycystic ovary syndrome phenotypes, their morbidity, and the role that referral bias plays in the epidemiology of this syndrome.

This paper reviews the current research on the role of environmental factors in the development and progression of polycystic ovary syndrome, including toxins, diet, socioeconomic status, and geography.

High-throughput disease gene mapping has identified 16 susceptibility loci for polycystic ovary syndrome and functional analysis to understand how these genes act in disease pathways will help to illuminate the pathophysiology of polycystic ovary syndrome.

Although polycystic ovary syndrome is the most common cause of anovulatory infertility, its high prevalence is an evolutionary paradox. In this article the potential explanations for this enigma are explored.

Polycystic ovary syndrome (PCOS) is a prehistoric evolutionary paradox. Although there are claims that PCOS has undergone positive selection, it is more likely that nonadaptive evolutionary mechanisms have driven its persistence across time.

Inklings

Male relatives of women with polycystic ovary syndrome have a distinct reproductive phenotype. We report novel features of this phenotype including elevated antimullerian hormone, luteinizing hormone, and follicle-stimulating hormone levels.

This document defines embryo donation and distinguishes between embryo donation and adoption.

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Reflections

Reflections

50 Years Ago Today

In a cohort of 214 patients with testicular cancer, larger tumors were associated with lower rates of spermatozoa in the cancerous testis. Importantly, 58% of patients with azoospermia and cryptozoospermia had spermatozoa in their histologic sections.

Preimplantation genetic screening performed in fresh in vitro fertilization cycles during 2011–2012 decreased chances of live birth for most patients. Older women observed small improvements, which are likely consequence of favorable patient selection biases.

Elective single-embryo transfer (eSET) is more likely with infertility treatment insurance coverage, and specific demographic and reproductive characteristics. Term non–low birth weight singleton live birth is most likely with eSET.

Tubal infertility is the main risk factor for ectopic pregnancy in assisted reproductive technology.

Although we observed a small improvement in live birth/ongoing pregnancy and clinical PRs, the evidence is of very low quality and the best interpretation is that we are still very uncertain about differences in this comparison.

Blastocyst biopsy and vitrification were associated with a higher incidence of gestational hypertension but better neonatal outcomes compared with cleavage-stage biopsy and fresh embryo transfer, especially in twins.

Nondominant small follicles are a promising supplementary source of in vivo–matured oocytes, and their use increases the live birth rate in natural cycle in vitro fertilization.