Skip to main content
SpringerLink
Log in

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

  • Reproductive Physiology and Disease
  • Published:
Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

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 PCOS-defining 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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. 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.

    Google Scholar 

  2. Azziz R, Carmina E, Dewailly D, Diamanti-Kandarakis E, Escobar-Morreale HF, Futterweit W, et al. Positions statement: criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: an Androgen Excess Society guideline. J Clin Endocrinol Metab. 2006;91:4237–45.

    Article  CAS  PubMed  Google Scholar 

  3. Knochenhauer ES, Key TJ, Kahsar-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;83:3078–82.

    CAS  PubMed  Google Scholar 

  4. Nandi A, Chen Z, Patel R, Poretsky L. Polycystic ovary syndrome. Endocrinol Metab Clin North Am. 2014;43:123–47.

    Article  PubMed  Google Scholar 

  5. Dunaif A, Segal KR, Futterweit W, Dobrjansky A. Profound peripheral insulin resistance, independent of obesity, in polycystic ovary syndrome. Diabetes. 1989;38:1165–74.

    Article  CAS  PubMed  Google Scholar 

  6. Carmina E. Cardiovascular risk and events in polycystic ovary syndrome. Climacteric. 2009;12 Suppl 1:22–5.

    Article  PubMed  Google Scholar 

  7. Fauser BC, Tarlatzis BC, Rebar RW, Legro RS, Balen AH, Lobo R, et al. Consensus on women’s health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Fertil Steril. 2012;97:28–38.e25.

    Article  PubMed  Google Scholar 

  8. American College of Obstetricians and Gynecologists Committee on Practice Bulletins—Gynecology. ACOG practice bulletin no. 108: polycystic ovary syndrome. Obstet Gynecol. 2009;114:936–49.

    Article  Google Scholar 

  9. Wild RA, Carmina E, Diamanti-Kandarakis E, Dokras A, Escobar-Morreale HF, Futterweit W, et al. Assessment of cardiovascular risk and prevention of cardiovascular disease in women with the polycystic ovary syndrome: a consensus statement by the Androgen Excess and Polycystic Ovary Syndrome (AE-PCOS) Society. J Clin Endocrinol Metab. 2010;95:2038–49.

    Article  CAS  PubMed  Google Scholar 

  10. Dunaif A, Fauser BC. Renaming PCOS—a two-state solution. J Clin Endocrinol Metab. 2013;98:4325–8.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  11. Gleicher N, Barad D, Weghofer A. Functional autoantibodies, a new paradigm in autoimmunity? Autoimmun Rev. 2007;7:42–5.

    Article  CAS  PubMed  Google Scholar 

  12. Janssen OE, Mehlmauer N, Hahn S, Offner AH, Gartner R. High prevalence of autoimmune thyroiditis in patients with polycystic ovary syndrome. Eur J Endocrinol. 2004;150:363–9.

    Article  CAS  PubMed  Google Scholar 

  13. Ott J, Aust S, Kurz C, Nouri K, Wirth S, Huber JC, et al. Elevated antithyroid peroxidase antibodies indicating Hashimoto’s thyroiditis are associated with the treatment response in infertile women with polycystic ovary syndrome. Fertil Steril. 2010;94:2895–7.

    Article  CAS  PubMed  Google Scholar 

  14. Abalovich M, Amino N, Barbour LA, Cobin RH, De Groot LJ, Glinoer D, et al. Management of thyroid dysfunction during pregnancy and postpartum: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2007;92:S1–47.

    Article  CAS  PubMed  Google Scholar 

  15. Hahan S, Kuehnel W, Tan S, Kramer K, Schmidt M, Roesler S, et al. Diagnostic value of calculated testosterone indices in the assessment of polycystic ovary syndrome. Clin Chem Lab Med. 2007;45:202–7.

    Google Scholar 

  16. Mayfield J. Diagnosis and classification of diabetes mellitus: new criteria. Am Phis Ass. 1998;58:1355–62. 1369–70.

    CAS  Google Scholar 

  17. Esteghamati A, Ashraf H, Khalilzadeh O, Zandieh A, Nakhjavani M, Rashidi A, et al. Optimal cut-off of homeostasis model assessment of insulin resistance (HOMA-IR) for the diagnosis of metabolic syndrome: third national surveillance of risk factors of non-communicable diseases in Iran (SuRFNCD-2007). Nutr Metab. 2010;7:7–26.

    Article  Google Scholar 

  18. Bonora E, Targher G, Alberiche M, Bonadonna RC, Saggiani F, Zenere MB, et al. Homeostasis model assessment closely mirrors the glucose clamp technique in the assessment of insulin sensitivity: studies in subjects with various degrees of glucose tolerance and insulin sensitivity. Diabetes Care. 2000;23:57–63.

    Article  CAS  PubMed  Google Scholar 

  19. Jellinger PS, Smith DA, Mehta AE, Ganda O, Handelsman Y, Rodbard HW, et al. American association of clinical endocrinologists’ guidelines for management of dyslipidemia and prevention of atherosclerosis. Endocr Pract. 2012;18 Suppl 1:1–78.

    Article  Google Scholar 

  20. ADA practice Guidelines: http://mcintranet.musc.edu/agingq3/calculationswesbite/ADA%20Guidelines/ADA%20Binder.pdf; accessed on January 31, 2015.

  21. Dunaif A. Insulin resistance and the polycystic ovary syndrome: mechanisms and implications for pathogenesis. Endocrin Rev. 1997;18:774–800.

    CAS  Google Scholar 

  22. Ehrmann DA, Barnes RB, Rosenfield RL. Polycystic ovary syndrome as a form of functional ovarian hyperandrogenism due to dysregulation of androgen production. Endocr Rev. 1995;16:322–53.

    Article  CAS  PubMed  Google Scholar 

  23. Nestler JE, Powers LP, Matt DW, Steingold KA, Plymate SR, Ritmaster RS, et al. A direct effect of hyperinsulinemia on serum sex hormone-binding globulin levels in obese women with the polycystic ovary syndrome. J Clin Endocrinol Metab. 1991;72:83–9.

    Article  CAS  PubMed  Google Scholar 

  24. Wild RA, Rizzo M, Clifton S, Carmina E. Lipid levels in polycystic ovary syndrome: systematic review and meta-analysis. Fertil Steril. 2011;95:1073–9.e1-11.

    Article  CAS  PubMed  Google Scholar 

  25. Christian RC, Dumesic DA, Behrenbeck T, Oberg AL, Sheedy 2nd PF, Fitzpatrick LA. Prevalence and predictors of coronary artery calcification in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2003;88:2562–8.

    Article  CAS  PubMed  Google Scholar 

  26. Reh A, Grifo J, Danoff A. What is a normal thyroid-stimulating hormone (TSH) level? Effects of stricter TSH thresholds on pregnancy outcomes after in vitro fertilization. Fertil Steril. 2010;94:2920–2.

    Article  CAS  PubMed  Google Scholar 

  27. Detti L, Uhlmann RA, Fletcher NM, Diamond MP, Saed GM. Endometrial signaling pathways during ovarian stimulation for assisted reproductive technology. Fertil Steril. 2013;100:889–94.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This study was supported by an institutional grant from the University of Tennessee Health Science Center, Memphis, TN.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Tennessee Health Science Center, Rout Center, 853 Jefferson Ave, Rm E102, Memphis, TN, 38163, USA

    Laura Detti, Heather E. Jeffries-Boyd, Lucy J. Williams & Rebecca A. Uhlmann

  2. Department of Obstetrics and Gynecology, Georgia Regents University, Augusta, GA, USA

    Michael P. Diamond

Authors
  1. Laura Detti
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Heather E. Jeffries-Boyd
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lucy J. Williams
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Michael P. Diamond
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Rebecca A. Uhlmann
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Laura Detti.

Additional information

Capsule

Hyperandrogenism and ultrasound can assist in predicting metabolic abnormalities in women with PCOS.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Detti, L., Jeffries-Boyd, H.E., Williams, L.J. et al. Fertility biomarkers to estimate metabolic risks in women with polycystic ovary syndrome. J Assist Reprod Genet 32, 1749–1756 (2015). https://doi.org/10.1007/s10815-015-0602-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10815-015-0602-3

Keywords

Search

Navigation