Abstract

Purpose: Free androgen index (FAI) and anti-Mullerian hormone (AMH) are independently associated with polycystic ovary syndrome (PCOS). This study aimed to describe the relationship between these two markers and health-related quality of life (HR-QoL) in women with PCOS.Methods: This cross-sectional study consisted of 81 women in the Hull PCOS biobank, who fulfilled the Rotterdam consensus criteria for the diagnosis of PCOS. The primary outcome was to measure the various domains of the QoL in the modified polycystic ovary syndrome questionnaire (MPCOSQ).Results: Mean age of the study participants was 28 ± 6.0 years, mean body mass index (BMI) 33.5 ± 7.8 kg/m2, mean FAI (6 ± 5.5), free testosterone (2.99 ± 0.75) and mean AMH (3.5 ± 0.8 units). In linear regression analysis, the FAI was associated with overall mean MPCOSQ score (Beta = 0.53, P-value = 0.0002), and with depression (Beta = 0.45, P-value = 0.01), hirsutism (Beta = 0.99, P-value = 0.0002) and menstrual irregularity (Beta = 0.31, P-value = 0.04). However, with adjustment for age and BMI, FAI was only associated with the hirsutism domain (Beta = 0.94, P-value = 0.001) of the MPCOSQ. FAI was also associated with the weight domain (Beta = 0.63 P-value = 0.005) of MPCOSQ. However, AMH was not associated with the overall mean MPCOSQ score or with any of its domains.Conclusion: FAI but not AMH was associated with QoL in women with PCOS, and this effect was mediated by BMI.

Highlights

  • Polycystic ovary syndrome (PCOS) affects approximately 20% of women of reproductive age (Barnard et al, 2007)

  • The Free androgen index (FAI) was associated with overall mean modified polycystic ovary syndrome questionnaire (MPCOSQ) score (Beta = 0.53, P-value = 0.0002), and with depression (Beta = 0.45, P-value = 0.01), hirsutism (Beta = 0.99, P-value = 0.0002) and menstrual irregularity (Beta = 0.31, P-value = 0.04)

  • With adjustment for age and body mass index (BMI), FAI was only associated with the hirsutism domain (Beta = 0.94, P-value = 0.001) of the MPCOSQ

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Summary

Introduction

Polycystic ovary syndrome (PCOS) affects approximately 20% of women of reproductive age (Barnard et al, 2007). It is a heterogeneous endocrine disorder associated with biochemical and clinical manifestations of hyperandrogenism, polycystic ovarian morphology, and ovulatory dysfunction (PodfigurnaStopa et al, 2015; Amiri et al, 2019). Over 90% of women visiting fertility clinics with failure to conceive have PCOS (Barnard et al, 2007). The spectrum of PCOS symptoms such as acne, hirsutism, obesity, infertility, and loss of femininity imposes a significant impact on the quality of life in women with PCOS (Barnard et al, 2007)

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