Clinical and hormonal profile of patients diagnosed with polycystic ovarian syndrome at tertiary care hospital in Tamil Nadu
Keywords:Hormones, Obesity, PCO, Usg
Background: In recent years due to the changing sedentary life style, irregular periods and infertility has become a major concern. There are many causes for infertility out of which ovulatory disorders contribute to a great extend. The main objective of the study was to assess the clinical and hormonal profile of patients diagnosed with polycystic ovarian disease at tertiary care hospital in Tamil Nadu.
Methods: This study was a cross sectional study and was carried out at the Department of Obstetrics and Gynaecology at a tertiary care hospital of Tamil Nadu. The study was done for a period of 6 months. For confirming polycystic ovaries, patients were interviewed thoroughly about their menstrual and fertility history. Blood investigations like LH, FSH were done on D2/D3 of menstrual cycle. 125 patients with PCOS were included in this study. The data was analysed with SPSS-IBM (V.22.0) software.
Results: The patients having polycystic ovaries were higher in women of 21-30 years of age. BMI was more than 25. Infertility was found that 57%, hirsutism 45%, oligomenorrhoea 21% and amenorrhea 20%. On day 2, mean serum LH was 5.9±3.6 and serum FSH was 3.9±2.3. This study showed that the proportion of menstrual complaints is reported more in higher age group. Likewise lower income group presented with menstrual complaints. This was found to be statistically significant (P value <0.05).
Conclusions: The study showed that patients diagnosed to have PCOS overweight. PCO in obese women had more severe ovulatory dysfunction. Infertility was the most common complaint.
Azziz R, Marin C, Hoq L, Badamgarav E, Song P. Health care-related economic burden of the polycystic ovary syndrome during the reproductive life span. J Clin Endocrinol Metab. 2005;90(8):4650-8.
Qiao J, Feng HL. Extra-and intra-ovarian factors in polycystic ovary syndrome: impact on oocyte maturation and embryo developmental competence. Human Reproduction Update. 2010 Jul 16;17(1):17-33.
Asuncion M, Calvo RM, San Millan JL, Sancho J, Avila S, Morreale HF. A prospective study of the prevalence of the polycystic ovary syndrome in unselected Caucasian women from Spain. J Clin Endocrin Metab. 2000;85(7):2434-38.
Knochenhauer ES, Key TJ, Miller M, Waggoner W, Boots LR, Azziz R. Prevalence of the polycystic ovary syndrome in unselected black and white women of the southeastern United States: A prospective study. J Clin Endocrinol Metab. 1998;83(9):3078-82.
Kandarakis DE, Kouli CR, Bergiele AT, Filandra FA, Tsianateli TC, Spina GG, et al. A survey of the polycystic ovary syndrome in the Greek island of Lesbos: Hormonal and metabolic profile. J Clin Endocrinol Metab. 1999;84(11):4006-11.
Michelmore KF, Balen AH, Dunger DB, Vessey MP. Polycystic ovaries and associated clinical and biochemical features in young women. Clin Endocrinol. 1999;51(6):779-86.
Asuncion M, Calvo RM, Millan JL, Sancho J, Avila S, Morreale HF. A prospective study of the prevalence of the polycystic ovary syndrome in unselected Caucasian women from Spain. J Clin Endocrinol Metab. 2000;85(7):2434-8.
Azziz R, Woods KS, Reyna R, Key TJ, Knochenhauer ES, Yildiz BO. The prevalence and features of the polycystic ovary syndrome in an unselected population. J Clin Endocrinol Metab. 2004;89(6):2745-9.
Stein IF, Leventhal ML. Amenorrhea associated with bilateral polycystic ovaries. Am J Obst Gynecol. 1935;29:181-91.
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;81:19-25.
Practice committee of American Society of Reproductive Medicine. The evaluation and treatment of androgen excess. Fertil Steril. 2006;86:173-80.
Chen X, Yang D, Mo Y, Li L, Chen Y, Huang Y. Prevalence of polycystic ovary syndrome in unselected women from southern China. Eur J Obstet Gynecol Reprod Biol. 2008;139(1):59-64.
Li R, Zhang Q, Yang D, Li S, Lu S, Wu X. Prevalence of polycystic ovary syndrome in women in China: A large community based study. Hum Reprod. 2013;28(9):2562-9.
Kumarapeli V, Seneviratne RA, Wijeyaratne CN, Yapa RM, Dodampahala SH. A simple screening approach for assessing community prevalence and phenotypes of polycystic ovary syndrome in semiurban population in Srilanka. Am J Epidemiol. 2008;168(3):321-7.
Morreale HF, Millan JL. Abdominal adiposity and the polycystic ovary syndrome. Trends Endocrinol Metab. 2007;18(7):266-72.
Nidhi R, Padmalatha V, Nagarathna R, Amritanshu R. Prevalence of polycystic ovarian syndrome in Indian adolescents. J Pediatr Adolesc Gynecol. 2011;24(4):223-7.
Nair MK, Pappachan P, Balakrishnan S, Leena ML, George B, Russell PS. Menstrual irregularity and poly cystic ovarian syndrome among adolescent girls: A two year follow-up study. Indian J Pediatr. 2012;79(1):69-73.
Ferriman D, Gallwey JD. Clinical assessment of body hair growth in women. J Clin Endocrinol Metab. 1961;21(11):1440-7.
Keys A, Fidanza F, Karvonen MJ, Kimura N, Taylor HL. Indices of relative weight and obesity. J Chron Dis. 1972;25(6):329-43.
Watson PE, Watson ID, Batt RD. Obesity indices. Am J Clin Nutr. 1979;32(4):736-7.
WHO. Physical Status: The Use and Interpretation of Anthropometry: Report of a World Health Organization (WHO) Expert Committee. Geneva, Switzerland: World Health Organization. 1995.
Balen AH, Laven JS, Tan SL, Dewailly D. Ultrasound assessment of the polycystic ovary: International consensus definitions. Hum Reprod Update. 2003;9(6):505-14.
Bharathi R, Swetha S, Neeraja J, Madhavica J, Janani DM, Rekha SN. An epidemiological survey: Effect of predisposing factors for PCOS in Indian urban and rural population. Middle East Fertility Society Journal. 2017;22(4):313-6.
Teede HJ, Misso ML, Deeks AA. Assessment and management of polycystic ovary syndrome: summary of an evidence-based guideline. Med J Aust. 2011;195:S65-112.
Muralidhara KD, Adhikari PM, Muralidhara DV. Indian Journal of Basic and Applied Medical Research. 2015;4(3):227-36.
Spandana JC, Prasanna Kumar Shetty K, Prasanna Kumar Shetty K. A study on the clinical, biochemical and hormonal profile of polycystic ovary syndrome patients attending tertiary care hospital. Int J Reprod Contracept Obstet Gynecol. 2017;6(5):1986-92.
Radha P, Devi RS, Madhavi J. Comparative study of prevalence of polycystic ovarian syndrome in rural and urban population. J Adv Med Dent Scie Res. 2016;4(2):90-5.
Hussein B, Alalaf S. 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. Open J Obstet Gynecol. 2013;10(3):577-85.
Mandrelle K, Kamath MS, Bondu DJ, Chandy A, Aleyamma T, George K. Prevalence of metabolic syndrome in women with polycystic ovary syndrome attending an infertility clinic in a tertiary care hospital in south India. J Hum Reprod Sci. 2012;5(1):26-31.
Clark AM, Thornley B, Tomlinson L, Galletley C, Norman RJ. Weight loss in obese infertile women results in improvement in reproductive outcome for all forms of fertility treatment. Hum Reprod 1998;13(6):1502-5.
Atallah D, Al Ruhaily, Maladu UH. Hirsutism in Saudi female of reproductive age, a hospital based study. Ann Saudi. 2008;28(1):28-32.
Shanmugham D, Vidhyalakshmi RK, Shivamurthy HM. The effect of baseline serum luteinizing hormone levels on follicular development, ovulation, conception and pregnancy outcome in infertile patients with polycystic ovarian syndrome. Int J Reprod Contracept Obstet Gynecol. 2018;7:318-22.
Teede H, Hutchison S, Zoungas S. The management of insulin resistance in polycystic ovarian syndrome. Trends Endocrinol Metab. 2007;18(7):273-9.