Prevalence and characteristics of polycystic ovarian syndrome in a sample of infertile Kurdish women attending IVF infertility center in maternity teaching hospital of Erbil City

Bayan Hussein, Shahla Alalaf

Department of Obstetrics and Gynaecology, College of Medicine, Hawler Medical University, Erbil City, Iraq.

DOI: 10.4236/ojog.2013.37104                

Abstract

Objective: To estimate the prevalence of polycystic ovarian syndrome (PCOS), and to compare the clinical, hormonal and ultrasonography features between infertile women with or without PCOS. Design: A descriptive, comparative study. Materials and Methods: This study was conducted from May 1, 2007 to August 1, 2008, in the Infertility Care and IVF center in Maternity Teaching Hospital, Erbil city, Kurdistan region, North ofIraq. A total of 320 infertile women aged 18 - 45 years, were evaluated for clinical features (oligo-/amenorrhea, hirsutism), body mass index, waist-hip ratio (WHR) and hormonal measures. Transvaginal ultrasonography was used to assess the ovarian morphology. The Rotterdam 2003 criteria adopted by the European Society for Human reproduction and Embryology and the American Society for Reproductive Medicine were used to diagnose cases of PCOS. Data analysis was performed using the SPSS version 15. Results: The prevalence of PCOS was 33%. There were a significant differences between the two groups in terms of oligo-/amenorrhea, hirsutism, WHR, and ovarian ultrasound features. There were no significant differences between the two groups in correlations between the level of obesity with the incidences of anovulation, hyperandrogenemia and hirsutism or with hormonal features. Conclusions: A high prevalence rate of PCOS was observed among infertile women attending IVF center using the Rotterdam 2003 criteria for diagnosis.

Keywords

Amenorrhea; Hirsutism; Oligomenorrhea; Polycystic Ovaries; Polycystic Ovarian Syndrome

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Kauffman, R.P., Bake, T.E., Baker, V.M., DiMarino, P. and Castracane, V.D. (2008) Endocrine and metabolic differences among phenotypic expressions of polycystic ovary syndrome according to the 2003 Rotterdam consensus criteria. American Journal of Obstetrics & Gynecology, 198, 670.e1-670.e10.
[2]	Legro, R.S. (2003) polycystic ovary syndrome and cardiovascular disease: A premature association? Endocrine Reviews, 24, 302-312. doi:10.1210/er.2003-0004
[3]	Balen, A. (2004) The current understanding of polycystic ovary syndrome. The Obstetrician & Gynaecologist, 6, 66-74. doi:10.1576/toag.6.2.66.26980
[4]	Kavacs, G.T. and Norman, R. (2007) Introduction: Polycystic ovary syndrome is an intergeneration problem. 2nd Edition, Monash University, Victoria.
[5]	Fauzia, H., Omar, A. and Javid, R. (2007) Clinical, biochemical and ultrasonographic features of infertile women with polycystic ovarian syndrome. JCPSP, 17, 76-80.
[6]	Aziz, R., Woods, K.S., Reyna, R., Key, T.J., Knochenhauer, E.S. and Yildiz, B.O. (2004) The prevalence and features of the polycystic ovary syndrome in an unselected population. The Journal of Clinical Endocrinology & Metabolism, 89, 2745-2749. doi:10.1210/jc.2003-032046
[7]	Joyce, K. (2007) Polycystic ovarian syndrome. Journal of Midwifery & Women’s Health, 51, 415-422.
[8]	The Rotterdam ESHRE/ASRM Sponsored PCOS Consensus Workshop Group (2004) Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Human Reproduction, 19, 41-47. doi:10.1093/humrep/deh098
[9]	Abulenien, M., Barghash, A. and Mohamed, S. (2004) Clinical, ultrasonographic and endocrine predictors of ovarian response to clomiphene citrate in normogonadotropic anovulatory infertility. Middle East Fertility Society Journal, 9, 242-250.
[10]	Goodman, N., Bledsoe, M., Cobin, R., Futterweit, W., Goldzieher, J., Petak, S., Smith, K. and Steinberger, E. (2001) American Association of Clinical Endocrinologists medical guidelines for the clinical practice for the diagnosis and treatment of hyperandrogenic disorders. Endocrine Practice, 7, 120-134.
[11]	Ricardo, A. (2004) PCOS: A diagnostic challenge. Reproductive BioMedicine Online, 8, 644-648. doi:10.1016/S1472-6483(10)61644-6
[12]	Balen, A.H., Dresner, M., Scott, E.M. and Drife, J.O. (2006) Should obese women with polycystic ovary syndrome receive treatment for infertility? British Medical Journal, 332, 434-435. doi:10.1136/ bmj.332.7539.434
[13]	Balen, A.H., Laven, J.S., Tan, S.L. and Dewailly, D. (2003) Ultrasound assessment of the polycystic ovary: International consensus definitions. Human Reproduction, 9, 505-514.
[14]	Ricardo, A. (2006) The Rotterdam 2003 criteria for defining PCOS: CON (or how define a syndrome). The Journal of Clinical Endocrinology & Metabolism, 17, 2005-2153.
[15]	Dewailly, D., Sophie, C.-J., Anne-Celine, R., Maryse, L. and Pascal, P. (2006) Oligoovulation with polycystic ovaries but not overt hyperandrogenism. The Journal of Clinical Endocrinology & Metabolism, 91, 3922-3927.
[16]	Balen, A and Michelmore, K. (2002) what is polycystic ovary syndrome? Human Reproduction, 17, 2219-2227. doi:10.1093/humrep/17.9.2219
[17]	Ash, M. (2006) Gynaecology by ten teachers. Eighteenth Edition, Arnold Holder, London, 76-88.
[18]	Pedersen Sue, D., Sony, B., Peter, F. and Bernard, C. (2007) polycystic ovary syndrome. Canadian Family Physician, 53, 1041-1047.
[19]	Ritta, K. (2001) Endocrine and metabolic changes in women with polycystic ovaries and polycystic ovary syndrome. University of Oulu, Oulu, 2001.
[20]	Al-Nakash Abdulrazak, H. and Al-Taee Nada, K. (2007) Polycystic ovarian syndrome: The correlation between LH/FSH ratio and disease manifestations. Middle East Fertility Society Journal, 12, 35-40.
[21]	Kahsar, M., Nixon, C., Boots, L.R., Go, R.C. and Azziz, R. (2001) Prevalence of polycystic ovary syndrome (PCOS) in first degree relatives of patients with PCOS. Fertility and Sterility, 75, 53-58. doi:10.1016/S0015-0282(00)01662-9
[22]	Azziz, R., Marin, C., Hog, L., Badamgarav, E. and Song, P. (2005) Health care-related economic burden of the polycystic ovary syndrome during the reproductive life span. The Journal of Clinical Endocrinology & Metabolism, 90, 4650-4658.
[23]	Marjan, A. (2005) Polycystic ovary syndrome. Jarret Fertility Group. http://www.jarrettfertility.com/ pcds.html
[24]	Williamson, K., Gunn, A.J., Johnson, N. and Milsom, S.R. (2001) The impact of ethnicity on the presentation of polycystic ovarian syndrome. Australian and New Zealand Journal of Obstetrics and Gynaecology, 41, 202-206. doi:10.1111/j.1479-828X.2001.tb01210.x
[25]	Wijeyaratne, C.N., Balen, A.H., Barth, J.H., Belchetz, P.E. (2002) Clinical manifestations and insulin resistance (IR) in polycystic ovary syndrome (PCOS) among South Asians and Caucasians: Is there a difference? Clinical Endocrinology (Oxford), 57, 343-350. doi:10.1046/j.1365-2265.2002.01603.x
[26]	Belosi, C., Selvaggi, L., Apa, R., Guido, M., Romualdi, D., Fulghesu, A.M and Lanzone, A. (2006) Is the PCOS diagnosis solved by ESHRE/ASRM 2003 consensus or could it include ultrasound examination of the ovarian stroma? Human Reproduction, 21, 3108-3115. doi:10.1093/humrep/del306
[27]	Elting, M.W., Korsen, T.J.M., Bezemer, P.D. and Schoemaker, J. (2001) Prevalence of diabetes mellitus, hypertension and cardiac complaints in q follow up study of a Dutch PCOS population. Human Reproduction, 16, 556-560
[28]	Wood Jennifer, R., Nelson Valen, L., Clement, H., Erik, J., Wang Clare, Y., Margrit, U., et al. (2003) The molecular phenotype of polycystic ovary syndrome (PCOS) theca cells and new candidate PCOS genes defined by microarray analysis. The Journal of Biological Chemistry, 278, 26380-26390. doi:10.1074/ jbc.M300688200
[29]	Yildirim, B., Sabir, N. and Kaleli, B. (2003) Relation of intra-abdominal fat distribution to metabolic disorders in non obese patients with polycystic ovary syndrome. Fertility and Sterility, 79, 1358-1364. doi:10.1016/S0015-0282(03)00265-6
[30]	Cho, L.W., Jayagopal, V., Kilpatric, E.S., Holding, S. and Atkin, S.L. (2006) The LH/FSH ratio has little use in diagnosis of polycystic ovarian syndrome. Annals of Clinical Biochemistry, 43, 217-219. doi:10.1258/000456306776865188
[31]	Hasan, S.M., Mehdi, K.S. and Nasrin, G. (2007) Genetics of polycystic ovary syndrome. Iranian Journal of Reproductive Medicine, 5, 1-5.
[32]	Najem, F.L., Elmehdawi, R.R. and Swalem, A.M. (2007) Clinical and biochemical characteristics of polycystic ovary syndrome in Benghazi-Libya: A retrospective study. Libyan Journal of Medicine, 3, 71-74.