Reproductive endocrinology and infertility: Management of polycystic ovarian syndrome (pcos), endometriosis, and advances in assisted reproductive technologies

Reproductive endocrinology represents a critical subspecialty within obstetrics and gynecology that focuses on hormonal regulation of reproduction and the management of infertility. Among the most prevalent and clinically significant disorders affecting female fertility are polycystic ovarian syndrome (PCOS) and endometriosis. PCOS is a complex endocrine and metabolic disorder characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology, affecting up to 15 to 20 percent of reproductive-aged women worldwide. Endometriosis is a chronic inflammatory condition defined by the presence of endometrial-like tissue outside the uterine cavity and is strongly associated with pelvic pain and infertility. Over the past decade, substantial progress has been made in understanding the pathophysiology of these conditions and in refining their management strategies. Simultaneously, assisted reproductive technologies (ART), including in vitro fertilization, intracytoplasmic sperm injection, preimplantation genetic testing, and cryopreservation, have undergone remarkable advancements, improving pregnancy outcomes and expanding reproductive options. This review synthesizes current evidence from the last ten years to provide a comprehensive discussion of reproductive endocrinology principles, the pathogenesis and management of PCOS and endometriosis, and modern innovations in ART.