Fertility biomarkers to estimate metabolic risks in women with polycystic ovary syndrome

Abstract

Purpose We sought to evaluate the relationship between the polycystic ovary syndrome (PCOS)-defining characteristics and the risk of developing metabolic complications in women presenting with complaints of infertility and/or menstrual irregularities and subsequently diagnosed with PCOS. Methods This was a cross-sectional study. Women presenting with complaints of infertility and/or irregular menses and diagnosed with PCOS by the Rotterdam criteria, underwent endocrine, metabolic, and ultrasound assessment in the early follicular phase. Reproductive and metabolic parameters were included in regression analysis models with the PCOSdefining characteristics; ROC curves were calculated for the significant predictors. Results Three hundred and seventy-four women with PCOS were included in our study. Oligo-anovulation, menstrual irregularities, and hirsutism were not predictive of any of the variables. Ovarian volume, follicle count, and biochemical hyperandrogenism were predictors for hormonal, metabolic, and endometrial complications. The relationships were independent of age and body mass index. ROC curves identified lower cut-off values of the PCOS-defining characteristics to predict patients' risks of hyperinsulinemia, dyslipidemia, and glucose intolerance. Conclusions Adverse metabolic effects of PCOS are already present in women at the time they present complaining of infertility and/or irregular menses. Hyperandrogenism and ultrasound can assist in predicting the patients' concomitant metabolic abnormalities and can aid physicians in tailoring counseling for effective preventive strategies.

Endometrial Abnormalities

“…Further studies are needed to confirm this finding, however EP was found to be frequent in women with PCOS in previous research from our group 21 . Linking these results with our molecular testing results, which associated RE to EP by both showing significantly increased expression of cell survival, differentiation, and growth markers (such as estrogen and progesterone receptors, insulin receptors, and the apoptosis regulator B‐cell lymphoma 2), we could tentatively close the link between PCOS, RE and EP development 22 …”

“…21 Linking these results with our molecular testing results, which associated RE to EP by both showing significantly increased expression of cell survival, differentiation, and growth markers (such as estrogen and progesterone receptors, insulin receptors, and the apoptosis regulator B-cell lymphoma 2), we could tentatively close the link between PCOS, RE and EP development. 22 One of the strengths of this study is that the same examiner performed TVUS, SIS, and HSC in all patients, thus eliminating bias from interobserver variability. This study presents some limitations, including its retrospective nature, and the fact that the examiner was not blinded to the TVUS and SIS outcomes at the time of hysteroscopic surgery.…”

Inositols in the Treatment of Insulin-Mediated Diseases

“…In fact women at the time they present complaining of infertility and/or irregular menses already showed adverse metabolic effects of PCO. Obesity has been reported to worsen menstrual irregularity and increase the follicle number and serum total testosterone level [ 32 , 33 ].…”

Anti-Müllerian Hormone (AMH) May Stall Ovarian Cortex Function Through Modulation of Hormone Receptors Other Than the AMH Receptor

“…The PCOS is the most common endocrinopathy in women and it has been correlated with the development of metabolic syndrome and cardiovascular risks. 20 Adverse metabolic effects of PCOS are already present in young women complaining of infertility and/ or irregular menses. Ovarian volume, follicle count, and biochemical hyperandogenism are significant predictors of hormonal, metabolic, and endometrial complications.…”