Clinical and sonographic features in infertile women with and without polycystic ovarian syndrome
Keywords:PCOS, Polycystic ovarian syndrome, Polycystic ovaries, Infertility, Rotterdam criteria
Background: Polycystic ovarian syndrome (PCOS) is the most common endocrine cause of infertility affecting about 1 in 10 women of reproductive age. This study determined the proportion of infertile women with PCOS and compared clinical and sonographic features in infertile women with PCOS and without PCOS.
Methods: This was a prospective comparative cross-sectional study at the Lagos State University Teaching Hospital over a 6 month period. One hundred and fifty two infertile women were recruited and had trans-vaginal ultrasonography for the presence and absence of polycystic ovaries. The diagnosis of PCOS was made using the Rotterdam criteria with other relevant socio-demographic and clinical data noted in the study proforma. Student t and chi-square tests were used as appropriate.
Results: The prevalence of PCOS among infertile women was 32.9%. The mean age of infertile women diagnosed with PCOS and without PCOS was 33±4.90 and 32.71±5.00 years, respectively. Women with PCOS had significantly higher BMI than women without PCOS. Increased ovarian volume, peripheral follicular distribution and increased stromal echogenicity were observed in 60%, 74% and 94% of women with PCOS on trans-vaginal ultrasound compared to 11.8%, 2% and 2% of women without PCOS, respectively.
Conclusions: The prevalence of PCOS among infertile women is high. Clinical characteristics of women with PCOS and women without PCOS are similar except in their BMI and features that constitute the diagnostic criteria for PCOS.
Akinola RA, Akinola OI, Fabamwo AO. Infertility in women: hysterosalpingographic assessment of the fallopian tubes in Lagos, Nigeria. Edu Res Rev. 2009;14(1):24-8.
Medline Plus. Fact sheet: Primary Infertility, 2021. Available at: https://medlineplus.gov/ency/article/001191.htm. Accessed 17 March 2021.
Luyang ME, Jarrett BY, Brooks ED. Updated ultrasound criteria for polycystic ovary syndrome: reliable thresholds for elevated follicle population and ovarian volume. Hum Reprod. 2013;28(5):1361-8.
March WA, Moore VM, Wilson KJ. The prevalence of polycystic ovary syndrome in a community sample assessed under contrasting diagnostic criteria. Hum J Reprod. 2010;25(2):554-6.
Igwegbe AO, Elejo GU, Enechukwu CI. Polycystic ovary syndrome: a review of management outcome in a low resource setting. J Women Health. 2013;2(3):1-6.
Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81(1):19-25.
Brodell LA, Mercurio MG. Hirsutism: diagnosis and management. Gend Med. 2010;7(2):79-87.
Hart T, Hickey M, Frank S. Definition, prevalence and symptoms of polycystic ovary and polycystic ovary syndrome. Best Prat Res Clin Obstet Gynaecol. 2004;18(5):671-783.
Dahnert W. Radiology Review Manual. 6th ed. Philadelphia: Lippincott Williams and Wilkins; 2007: 1068.
Ikpeme AA, Udo AE, Ani NE. Transvaginal ultrasound assessment of women presenting with infertility and menstrual irregularity in Calabar Nigeria. Niger. J Med. 2014;21(5):262-5.
Oriji VK, Onwuegbulam C. Prevalence of polycystic ovary syndrome (PCOS) among infertile women attending fertility clinic at a university teaching hospital in Nigeria. J Gynecol Women Health. 2019:15(5):555922.
Ugwu GO, Iyoke CA, Onah HE, Mba SG. Prevalence and management of polycystic ovary syndrome in Enugu, Southeast Nigeria. Niger J Med. 2013;22(4):313-6.
Joe-Kechebelu NN, Mbamara SU, Ikechebelu JI. Familial trend in polycystic ovarian syndrome: report of two cases. Ann Afr Med. 2013;12(3):182-4.
Frank S, Gharani N, Mccarthy M. Candidates genes polycystic ovarian syndrome. Hum Repro Update. 2001;7:405-10.
Hoeger KM, Oberfield SE. Do women with PCOS have a unique predisposition to obesity? Fertil Steril. 2012;97(1):13-7.
Carmina E, Lobo RA. Polycystic ovaries in hirsute women with normal menses. Am J Med. 2001;111(8):602-6.
Abubaka AP, Yusuf TS. The profile of infertility in a teaching hospital in north west Nigeria. Sahel Med J. 2010;17(1):7-11.
Broekmans FJ, Knauff EA, Valkenburg O, Laven JS, Eijkemans MJ, Fauser BC. PCOS according to the Rotterdam consensus criteria: change in prevalence among WHO-II anovulation and association with metabolic factors. BJOG. 2006;113(10):1210-7.