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Polycystic Ovary Syndrome
This page intentionally left blank
Polycystic Ovary Syndrome
Basic Science to Clinical Advances Across the Lifespan

Edited by

Rehana Rehman, MBBS, MPhil, PhD, FHEA, MHPE

Associate Professor and Director Graduate Studies
Department of Biological & Biomedical Sciences
Aga Khan University, Karachi
Sindh
Pakistan

Aisha Sheikh, MBBS, FCPS, FACE, PGDipDiab, PGDipEndocrine

Lecturer & Consultant Endocrinologist
Medicine
e Aga Khan University Hospital, Karachi
Sindh
Pakistan
Tutor, University of South Wales, Cardi, United Kingdom
Elsevier
1600 John F. Kennedy Blvd.
Ste 1800
Philadelphia, PA 19103-2899

POLYCYSTIC OVARY SYNDROME ISBN: 978-0-323-87932-3

Copyright © 2024 by Elsevier, Inc. All rights reserved.

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chanical, including photocopying, recording, or any information storage and retrieval system, without permis-
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Publishing Services Manager: Shereen Jameel
Project Manager: Haritha Dharmarajan
Design Direction: Bridget Hoette

Printed in India

Last digit is the print number: 9 8 7 6 5 4 3 2 1

Contributors

Tauseef Ahmad, MSc, PhD Mukhtiar Baig, MBBS, MPhil, PhD

Researcher Professor
Department of Epidemiology and Health Statistics Clinical Biochemistry
School of Public Health King Abdulaziz University
Southeast University Jeddah
Nanjing, China Saudi Arabia

Intisar Ahmed, MBBS Sumera Batool, MBBS, FCPS (Medicine), FCPS

Fellow (Endocrinology & Diabetes)
Aga Khan University Consultant Endocrinologist & Diabetologist
Medicine Department of Medicine
Aga Khan University, Karachi Dr. Ziauddin University Hospital, Karachi
Sindh Sindh
Pakistan Pakistan

Faiza Alam, MBBS, MPHIL, PHD Amna Subhan Butt, MBBS, FCPS (Medicine), FCPS
Assistant Professor Clinical Academia (Gastroenterology), MSc Clinical Researcher, WGO
Medicine Fellow in ERCP
PAPRSB Institute of Health Sciences Associate Professor
Muara, Bandar Seri Begawan Medicine
Brunei Darussalam e Aga Khan University Hospital, Karachi
Sindh
Sobia Sabir Ali, MBBS, FCPS, MRCP(UK), FRCP(Edin), Pakistan
MHPE
Professor Bhagwan Das, MBBS, FCPS (Medicine), FCPS
Diabetes & Endocrinology (Endocrinology), SCE-Endocrine and Diabetes,
Peshawar Medical College, Peshawar Diabetes, Endocrine, and Metabolism Fellow
KPK Consultant Physician and Endocrinologist
Pakistan Medicine and Endocrine
Aster Sanad Hospital
Azra Amerjee, MBBS, FCPS, MCPS(HPE) Riyadh
Doctor, Assistant Professor KSA
Obstetrics & Gynecology
e Aga Khan University Hospital, Karachi Jalpa Devi, MBBS
Sindh Postgraduate Trainee
Pakistan Gastroenterology
Liaquat University of Medical and Health Sciences
Muzna Arif, MBBS, FCPS Pediatrics Hyderabad
Fellow Pakistan
Pediatrics and Child Health
Aga Khan University, Karachi Raj HT Dodia, MBChB, MMEd, MRCOG
Sindh Obstetrics & Gynecology
Pakistan MPShah Hospital
Nairobi
Nargis Asad Kenya
Chair, Associate Professor
Department of Psychiatry
Aga Khan University Hospital, Karachi
Sindh
Pakistan
v
vi Contributors

Rubia Farid, MBBS, FCPS Muhammad Abdullah Javed

PCOS Phenotypes Medical Student
Family Medicine Medical College
Aga Khan University Hospital, Karachi Aga Khan University, Karachi
Sindh Sindh
Pakistan Pakistan

Mahwish Fatima, Pharm-D, MPhil (Pharmacology), Haz S. Kamran, MBBS, FCPS, MRCP
PhD Scholar (Pharmacology) Registrar
Program Coordinator (Diabetes and Hypertension) Acute Medicine
e Indus Hospital and Health Network Royal Preston Hospital
Karachi Dudley
Pakistan United Kingdom

Tehseen Fatima, MBBS, FCPS (Medicine) Rakhshaan Khan, MBBS, MPH, MBA
Assistant Professor and consultant MEd Hearing Impairment
Endocrinologist, Hamdard University, Karachi Doctor
Sindh Public Health
Pakistan ICAT, Karachi
Sindh
Shayana Rukhsar Hashmani, MBBS Pakistan
Resident
Dermatology Unab I. Khan, MBBS, MS
Aga Khan Hospital, Karachi Associate Professor
Sindh Family Medicine
Pakistan Aga Khan University, Karachi
Sindh
Muhammad Faisal Hashmi, MBBS Pakistan
Clinical Fellow
Internal Medicine Kimmee Khan, MBBS, BSc, MRCOG
e Royal Wolverhampton NHS Trust Doctor
Wolverhampton Obstetrics & Gynaecology
United Kingdom St Georges Hospital NHS Trust
London
Khadija Nuzhat Humayun, MBBS, FCPS, Adv. DHPE United Kingdom
Paediatrics Endocrinologist
Associate Professor Zareen Kiran, MBBS, FCPS (Med), MRCP (UK), FCPS
Paediatrics and Child Health (Endo)
Aga Khan University, Karachi Assistant Professor Endocrinology
Sindh Endocrinology, Medicine
Pakistan National Institute of Diabetes and Endocrinology
Dow University of Health Sciences, Karachi
Zaheena Islam, MBBS, FCPS Sindh
Assistant Professor Pakistan
Obstetrics & Gynecology Consultant Endocrinologist
Aga Khan University Hospital, Karachi Endocrinology, Medicine
Sindh Aga Khan University Hospital, Karachi
Pakistan Sindh
Pakistan
Sumerah Jabeen, FCPS(Medicine), FCPS(Endocrinology)
Consultant Endocrinologist Sadia Masood, MBBS, FCPS, MHPE
Medicine Department Assistant Professor
Patel Hospital, Karachi Medicine
Sindh Aga Khan University, Karachi
Pakistan Sindh
Pakistan
 Contributors vii

Malik Hassan H. Mehmood, BPharm, MPhil, PhD Sumaira Naz, MBBS, FCPS
Associate Professor and Chairperson Senior Instructor
Department of Pharmacology Obstetrics & Gynecology
Government College University, Aga Khan University Hospital, Karachi
Faisalabad, Faisalabad Sindh
Punjab Pakistan
Pakistan
Aisha Noorullah, MBBS, FCPS
Fozia Memon, MBBS, FCPS Senior Instructor
Instructor Pediatric Endocrinology Department Of Psychiatry
Pediatrics and Child Health Aga Khan University Hospital, Karachi
Aga Khan University, Karachi Sindh
Sindh Pakistan
Pakistan
Kamal Ojha, MD FRCOG
Asma Altaf Hussain Merchant, MBBS Obstetrics & Gynaecology
Research Fellow, Dean’s Oce St Georges Hospital
Aga Khan Medical College London
Karachi United Kingdom
Pakistan
Ouma Pillay
Ahmed Sayed Mohammed Sayed Mettawi, MSc, DIP, Doctor
MB ChB St George’s University Hospitals NHS Foundation Trust
Clinical Nutrition Specialist Blackshaw Road
Clinical Nutrition & Endocrine Service Tooting
CareZone Clinics, Giza London
Egypt SW17 0QT
Interim Clinical Director & Chief Physician Nutrition
Specialist Rahat Najam Qureshi, MBBS, FRCOG
Clinical Nutrition Department Consultant
Al Haram Hospital, Giza Obstetrics & Gynecology
Egypt Aga Khan University, Karachi
Sindh
Sarah Nadeem, MD, FACE Pakistan
Director, CCBP, Assistant Professor
Section of Endocrinology Muhammad Hassan Raza Raja
Department of Medicine Medical Student
Aga Khan University, Karachi Medical College
Sindh Aga Khan University, Karachi
Pakistan Sindh
Pakistan
Tania Nadeem, MBBS
Clinical Associate Professor Muhammad Owais Rashid, MBBS, FCPS(Medicine),
Psychiatry FCPS(Endocrinology)
Aga Khan University, Karachi Assistant Professor
Sindh Diabetes & Endocrinology
Pakistan Liaquat National Hospital, Karachi
Sindh
Nida Najmi, MRCOG, FCPS, MHPE, MSc. Clinical Pakistan
Research Consultant Endocrinologist
Assistant Professor Department of Medicine (Section of Endocrinology)
Obstetrics & Gynaecology Aga Khan University Hospital, Karachi
Aga Khan University, Karachi Sindh
Sindh Pakistan
Pakistan
viii Contributors

Rehana Rehman, MBBS, MPhil, PhD, FHEA, MHPE Lumaan Sheikh

Associate Professor and Director Graduate Studies Associate Professor & Chair
Department of Biological & Biomedical Sciences Department of Obstetrics & Gynecology
Aga Khan University, Karachi Aga Khan University Hospital, Karachi
Sindh Sindh
Pakistan Pakistan

Tamar Saeed, MBBS, MRCP(UK), MRCP(Endocrine & Rida Siddique Pharm D, MPhil and PhD
Diabetes) (Pharmacology)
CCT Endocrine & Diabetes (UK), FRCP(Glasg) Department of Pharmacology
RCP(London) Faculty of Pharmaceutical Sciences
Consultant in Endocrinology and Diabetes Mellitus Government College University
Foundation Training Programme Director Faisalabad
MTI Lead in Department of Medicine Punjab
Diabetes and Endocrine Centre, North Wing Pakistan
e Dudley Group NHS Foundation Trust
Russells Hall Hospital Sairabanu Mohamed Rashid Sokwala, MBBS,
Dudley MMed(Internal Medicine)
United Kingdom PGDip(Diabetes), PGDip(Endocrinology)
Consultant
Zainab Samad, MBBS, MHS Diabetes and Endocrinology
Professor & Chair Aga Khan University Hospital
Department of Medicine Nairobi
Aga Khan University, Karachi Kenya
Sindh
Pakistan Saba Tariq, MBBS, MPhil, PhD
Professor/ Head of Department
Maheen Shahid, MBBS Pharmacology & erapeutics
Research Scholar & Teaching Assistant University Medical and Dental College
Department of Biological & Biomedical Sciences e University of Faisalabad, Faisalabad
Aga Khan University, Karachi Punjab
Sindh Pakistan
Pakistan
Syeda Muneela Wajid, MBBS, MAIUM, MCPS
Pirbhat Shams, MBBS Gynecologist, Obstetrician
Resident Cardiology Marium General Hospital, Karachi
Department of Medicine Sindh
Aga Khan University, Karachi Pakistan
Sindh
Pakistan Farheen Yousuf, FRCOG, FCPS, MCPS(HPE),
MCPS(OBGYN)
Aisha Sheikh, MBBS, FCPS, FACE, PGDipDiab, Assistant Professor
PGDipEndocrine Obstetrics & Gynecology
Lecturer & Consultant Endocrinologist Aga Khan University, Karachi
Department of Medicine Sindh
e Aga Khan University Hospital, Karachi Pakistan
Sindh
Pakistan Nadeem Zuberi, MBBS, FCPS
Tutor, University of South Wales, Cardi, Associate Professor
United Kingdom Department of Obstetrics & Gynecology
e Aga Khan University, Karachi
Sindh
Pakistan
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