Are women with polycystic ovary syndrome resistant to activated protein C?

Abstract

Objective: This study was performed to test the hypothesis that an increased prevalence of activated protein C (APC) resistance in women with polycystic ovary syndrome (PCOS) puts them at increased risk of miscarriage and thrombosis. Design: Case control study. Setting: A district general hospital in the United Kingdom. Patient(s): Forty-one women with PCOS and 25 controls. Intervention(s): Clinical histories, ultrasound scans, and venepunctures. Main Outcome Measure(s): Diagnosis of PCOS or control, clinical histories, APC resistance according to an activated partial thromboplastin time–based assay. Result(s): There was no significant difference in the proportion of women with APC resistance in both groups (three women in the PCOS group [7%] vs. one woman in the control group [4%]). The prevalence of APC resistance in the entire study population was 6.5%. In the PCOS group, 29% (12/41) gave a positive family history of thrombosis compared with 8% (2/25) in the control group. None of the women with a positive family history of thrombosis had abnormal antithrombin 111, protein C, or protein S levels. Conclusion(s): This study suggests that women with PCOS may have the same prevalence of APC resistance as the background population and that APC resistance may not put them at a higher risk of thrombosis or miscarriage compared with the case of the general population.