Prevalence of Polycystic Ovary Syndrome in Nigerian Women with Infertility: A Prospective Study of the Three Assessment Criteria

Abstract

Background: Polycystic ovarian syndrome (PCOS) is a frequent diagnosis in oligomenorrheic and infertile Nigerian women. However, to date there is a paucity of data on the prevalence of PCOS in Nigerian women. The objective of this study was to investigate the prevalence of PCOS in a cross-section of women attending Infertility Clinics in Benin City, Nigeria using the three assessment criteria namely: the 1990 National Institutes of Health (NIH), the 2003 Rotterdam and 2006 Androgen Excess Society (AES) criteria. Method: Four hundred and twenty-one consecutive infertile premenopausal women aged 18 - 45 years were recruited and evaluated with a proforma that elicited information about their maternal and reproductive health history. Blood samples were analyzed for hormone levels using standard immunoassay procedures, while trans-vaginal ultrasound scan was carried out to determine the presence of ultrasonic features of PCOS. The control group comprised of eumenorrheics (n = 180). Results: An estimated prevalence of biochemical hyperandrogenism (BHA) was as high as 20.9% (88 women), while 3.6% (15 women) presented with clinical hyperandrogenism (CHA). Also the prevalence of polycystic ovaries (PCO) was 13.8%. The prevalence of PCOS based on NIH, Rotterdam and AES criteria was 16.9% (71 women), 27.6% (116 women) and 20.7% (87 women) respectively. However, women with PCOS were significantly younger and had higher total testosterone levels (p = 0.001) when compared to controls. Conclusion: The prevalence of PCOS is as high in the population under study as in other prevalence studies. The hormonal investigations were clinically useful in assessing the prevalence rates. However, the recruitment criteria, together with the regional and racial factors may have contributed to the estimates obtained, and the high incidence of biochemical hyperandrogenism in this region.