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Proposed natural history of PCOS from fetal life to adulthood. The severity of polycystic ovary syndrome (PCOS) and the evolution of its phenotypic expression result from the impact of environmental influences (both pre- and postnatal) on genetic and epigenetic factors in utero. HA, Hyperandrogenism; GDM, gestational diabetes mellitus; SGA, small for gestational age; LGA, large for gestational age. (Figure based on ref. 204.)
