Mechanisms and Diagnosis of Thrombosis in PCOS

Polycystic ovary syndrome (PCOS) is the most prevalent endocrine-metabolic disorder in reproductive-age women, affecting 6-12% of women in the US. PCOS is characterized by hyperandrogenism, chronic anovulation, and polycystic ovaries, and has been linked to increased risk for thrombosis, a leading cause of morbidity and mortality worldwide. However, the overall prevalence of thrombotic events and the mechanisms of thrombosis in PCOS are unknown. Limitations in our clinical assays have hindered research and patient care, as PCOS patients in a pro-thrombotic state test normal with clinical coagulation assays. This study attempted to bridge this gap in knowledge by investigating three critical needs: 1) Tests that can accurately determine current coagulation status in PCOS patients, 2) Identification of underlying thrombotic mechanisms, and 3) Identifying clinical presentations of hypercoagulation in PCOS before life-threatening events. Using a multidisciplinary and translational approach, incidences and clinical presentations were analyzed via electronic health records of PCOS and control patients and blood samples were tested with both clinical and research coagulation assays. The overall risk of thrombosis in PCOS was determined, first by identifying the rate of thrombosis in the US population, and then specifically in PCOS patients compared to age matched controls. A clinical profile of thrombosis in PCOS was created by identifying and weighing presentations for their clinical relevance against control patients. Finally, a pilot study of the hypothesized mechanisms of thrombosis demonstrated how thrombosis in PCOS is misinterpreted by clinical labs, and possible solutions to improve detection and diagnosis of thrombosis in PCOS is proposed.

Name thesis:degree_name

Human Pathophysiology and Translational Medicine (Doctoral)

Grantor

The University of Texas Medical Branch at Galveston

Year dc:date.issued

2025

Author dc:creator

• Miller, Mariel 1990-

Advisor dc:contributor.advisor

• Zahner, Christopher (cjzahner@utmb.edu)

Committee member dc:contributor.committeemember

• Crystal Douglas, Emily Lantz, George Golovko, Yunfeng Chen, Dequina Nicholas

Language dc:language.iso

English

Handle dc:identifier.uri

https://hdl.handle.net/2152.3/12839

OAI identifier oai:identifier

oai:utmb-ir.tdl.org:2152.3/12839