Endocrine Abstracts

Introduction: Polycystic ovary syndrome (PCOS) affects 5–8% of reproductive-age women. The morbidity related to PCOS may include insulin-resistance, type 2 diabetes mellitus (T2DM), obesity, hypertension, cardiovascular disease and infertility. We aimed to evaluate the clinico-biochemical characteristics of PCOS women and establish its relationship with fertility treatment outcomes.

Methods: We reviewed clinical records of PCOS women (Rotterdam criteria, 2003) surveilled at Hospital Santa Maria, between 2004 and June 2013. Fertility treatment outcomes were defined as: i) obtention of pregnancy; ii) number of treatment cycles; and iii) effective duration of the treatments.

Results: We identified 229 PCOS women. The mean age was 29.7 (±3.8) years. The infertility time was estimated in 41 (±29) months and 80.8% were primary infertilities. Out of the 229 women, 134 (58.5%) were obese, 169 (73.8%) had waist circumference >80 cm, 12 (5.2%) were hypertensive, 61 (26.6%) were smokers and 72 (31.4%) had familial history of T2DM. Clinical and/or biochemical androgen excess was detected in 110 (48%). Glucose abnormalities, insulin-resistance, hypertriglyceridemia, low cholesterol-HDL were detected in 23 (10%), 78 (34.1%), 15 (6.6%) and 93 (40.6%), respectively.

Pregnancy was achieved in 164 (71.6%) women. Spontaneous abortion was verified in 29 (12.7%) women (five had more than one). The mean number of treatment cycles needed was 2.8 (±2.4) and the mean duration of effective treatment estimated in 7.5 (±1) months. Pharmacological induced-ovulation was the most common approach.

Bi-model univariate and multivariate analysis, regarding to the identification of factors associated with longer fertility treatments/higher number of treatments, detected with statistical significance: secondary infertility; T2DM familial history, hypertriglyceridemia and low cholesterol-HDL. Other factors as age, obesity, waist circumference >80 cm, hypertension, smoking habits, clinical or biochemical androgen excess, glucose abnormalities, insulin-resistance or hypertension were not associated with poorer fertility treatment outcomes.

Conclusion: Infertile PCOS women with secondary type infertility, T2DM familial history, hypertriglyceridemia and low cholesterol-HDL may have poorer fertility treatment results, possibly justifying more intensive approaches. Other clinico-biochemical characteristics seem not to have prognostic value for fertility treatment.