Prevalence Of Polycystic Ovary Syndrome Research Articles

The Prevalence of Polycystic Ovarian Syndrome, Metabolic Abnormalities and Its Association With Obesity in Adolescents: A Cross-Sectional Study in an Urban Population in Iran

The diagnosis of polycystic ovary syndrome (PCOS) and metabolic syndrome (MS) in adolescents is clinically challenging. It is on the rise as consistent with the increasing trends in obesity rates. This study aimed to investigate the prevalence of PCOS in adolescents by the National Institutes of Health (NIH) criteria and compare the prevalence of insulin resistance (IR) and metabolic syndrome (MS) between obese (OB) and non-obese (NOB) adolescents with PCOS. This was cross-sectional research with multi-stage cluster random sampling. Participants were 15-18-year-old girls from high schools in Semnan, Iran. The ones who had a history of menstrual dysfunction underwent clinical and hormonal tests. From among a total of 900 participants, 74 girls (8.2%) had a history of menstrual dysfunction. The prevalence of PCOS was 6.44% by NIH criteria. The prevalence of abnormal glucose metabolism, MS, and IR in girls with PCOS were 8(13.7%), 6(10.3%), 24(41.4%), respectively. The OB-PCOS group with a mean BMI of 28.21±1.26 kg/m2 had a significantly greater prevalence of MS, high BP, waist circumference ≥88 cm, and higher IR than NOB-PCOS cases with a mean BMI of 20.54±2.97 kg/m2. Abnormal glucose metabolism was prevalent in adolescents with PCOS and occurred with equal frequency in OB and NOB PCOS groups. Obesity could worsen IR, MS, and some of the components of Mets in PCOS adolescents.

PGK1-AR axis: Benefits of a novel actor in PCOS pathology

PGK1-AR axis: Benefits of a novel actor in PCOS pathology

Prevalence of Polycystic Ovarian Syndrome in Young Adult Unmarried Females Attending Zagazig University Hospital Outpatient Clinic

Background: Polycystic ovary syndrome (PCOS) is one of the most prevalent endocrine and metabolic disorders in women of childbearing age. Objective: To determine the frequency of Polycystic ovarian syndrome (PCOS) among young unmarried females to increase awareness of PCOS and to promote effective early medical interventions and healthy lives for women. Methods: This was a prospective cross-sectional study in which 180 unmarried females between 16 to 24 years old attending gynecology and dermatology outpatient clinic suffering from menstrual abnormalities or symptoms of hyperandrogenism to estimate the prevalence rate of polycystic ovarian syndrome from May to November 2018. According to diagnostic criteria of the NIH, Rotterdam, and the AE-PCOS. Menstrual irregularities (MI) were identified, and clinical hyperandrogenism was evaluated by self-assessment of hirsutism using the modified Ferriman–Gallwey score. Blood analysis was done for measurement of prolactin, thyroid-stimulating hormone, and androgen hormones. Results: This study revealed Prevalence rate of PCOS is 55.6% among all presented cases, oligomenorrhea, acne, and hirsutism were the most common complaint in this study. Also, this study showed that there is an association between PCOS and sedentary life, and unhealthy food habits. There was a significant difference between PCOS and non-PCOS in LH and prolactin levels. There is a disturbed LH FSH ratio (2:1 or more). It also shows that there was a significant difference between PCOS and non-PCOS in ovarian volume. Conclusions: Lifestyle modification as healthy food and exercise play important role in the prevention of PCOS.

Prevalence of Polycystic Ovarian Syndrome in Young Adult Unmarried Females Attending Zagazig University Hospital Outpatient Clinic

Background: Polycystic ovary syndrome (PCOS) is one of the most prevalent endocrine and metabolic disorders in women of childbearing age. Objective: To determine the frequency of Polycystic ovarian syndrome (PCOS) among young unmarried females to increase awareness of PCOS and to promote effective early medical interventions and healthy lives for women. Methods: This was a prospective cross-sectional study in which 180 unmarried females between 16 to 24 years old attending gynecology and dermatology outpatient clinic suffering from menstrual abnormalities or symptoms of hyperandrogenism to estimate the prevalence rate of polycystic ovarian syndrome from May to November 2018. According to diagnostic criteria of the NIH, Rotterdam, and the AE-PCOS. Menstrual irregularities (MI) were identified, and clinical hyperandrogenism was evaluated by self-assessment of hirsutism using the modified Ferriman–Gallwey score. Blood analysis was done for measurement of prolactin, thyroid-stimulating hormone, and androgen hormones. Results: This study revealed Prevalence rate of PCOS is 55.6% among all presented cases, oligomenorrhea, acne, and hirsutism were the most common complaint in this study. Also, this study showed that there is an association between PCOS and sedentary life, and unhealthy food habits. There was a significant difference between PCOS and non-PCOS in LH and prolactin levels. There is a disturbed LH FSH ratio (2:1 or more). It also shows that there was a significant difference between PCOS and non-PCOS in ovarian volume. Conclusions: Lifestyle modification as healthy food and exercise play important role in the prevention of PCOS.

Prevalence of Psychological Disorders in Women with Polycystic Ovary Syndrome in Mississippi

Aim: This study is aimed to assess, for the first time the prevalence of polycystic ovary syndrome (PCOS) and associated psychological disorders among women at reproductive age from a state in southeastern US. Methods: The data was collected through “the Patient Cohort Explorer” system at the University of Mississippi Medical Center (UMMC) from January 2013 to December 2018. De-identified patients were searched with diagnosis code for PCOS, age, ethnicity, and associated diagnosis including weight gain, anxiety, depression, attention-deficit/hyperactivity disorder (ADHD), and other psychological concerns. Results: Collected data from 166,748 females (19-45 years) showed 1.4% (95% CI: 1.32 – 1.44) prevalence of PCOS in women seen in UMMC clinics during the period of study. Almost 51% of patients with PCOS suffered from one or more psychological disorders; anxiety 21% (95% CI: 19.3 – 22.6), depression 20% (95% CI: 18.9 – 22.1), ADHD 3.2% (95% CI: 2.6 – 4.0), bipolar disorder 2.5% (95% CI: 1.9 – 3.2). In addition, prevalence values suggest a positive correlation between obesity, anxiety, and depression in PCOS Patients. Conclusions: Results from this study provide 1) for the first time an estimate regarding the prevalence of PCOS and associated psychological disorders in women with PCOS in a southern state, 2) associated psychological disorders in PCOS women may be diverse based on race and ethnicity. Our data clearly highlight that the psychological well-being of women with PCOS are affected. Therefore, it is critical for the primary care and specialty clinics to use appropriate psychological screenings. Left undiagnosed and/or untreated, chronic psychological disorders may exacerbate physical and mental health conditions.

The Impact of Sleeve Gastrectomy on Females With Polycystic Ovarian Syndrome From 2018 to 2020 in Riyadh, Saudi Arabia: A Prospective Study.

Background: Obesity is one of the most common risk factors for polycystic ovarian syndrome (PCOS). Reducing body weight has shown to improve the symptoms of PCOS; however, it is still unclear if the surgical treatment of obesity can have better outcomes to control obesity and improve PCOS.Objective: This study aims to identify the impact of sleeve gastrectomy on PCOS symptoms in Riyadh, Saudi Arabia with a comparison of other weight reduction surgeries.Design and Setting: This is a prospective study that included patients with PCOS who had weight reduction surgeries between 2018 and 2020, in Riyadh, Saudi Arabia. Using an online questionnaire, demographic data will be collected and information about menstruation, abortion, polycystic ovarian syndrome, and bariatric surgeries (if any). Data analysis was done through Statistical Package for the Social Sciences (SPSS) v26 (IBM Corp., Armonk, NY, USA).Results: Ninety-nine female patients responded to this survey, all of whom had PCOS; 57.6% of these patients had a positive family history of PCOS. The most-reported PCOS symptoms were irregular menses (63.6%) and weight gain (53.5%), while 9.1% were asymptomatic. 52.5% were obese, and 91.1% underwent gastric sleeve surgery to treat their obesity. 41.4% of the females had a regular cycle before the operation, which increased to 60.6% after the operation; 48.5% had a normal flow before the operation, which increased to 61.6% after the operation. 15.2% conceived once before the operation, which increased to 16.2% after the operation. 11.1% had one abortion before surgery, which decreased to 7.1% after surgery. 55.6% observed an improvement in their PCOS symptoms after surgery, and 47.5% found that their fertility improved according to their own perception. Females with a positive family history of PCOS had a higher prevalence of PCOS (p-value <0.001). Also, females 30-39 years old are significantly more likely to have PCOS (p-value <0.001). The incidence of abnormal menstrual flow and irregular menstrual cycle was seen significantly more in PCOS patients than non-PCOS (p-value=0.019 and 0.004, respectively). PCOS symptoms and fertility significantly improved after surgery (p-value=0.031 and 0.043, respectively).Conclusion: Sleeve gastrectomy can lead to significant improvement in fertility and symptoms of PCOS. It can also reduce the incidence of abortion. Other surgical techniques should be investigated.

The burden of the probable polycystic ovarian syndrome and its associated factor among college going late adolescents and young adults: a cross sectional analytical study in urban Puducherry, South India.

Polycystic Ovarian Syndrome (PCOS) is one of the most common metabolic and reproductive disorders among women of reproductive age. In low income and developing countries like India, there are very high chances of developing PCOS due to marked variation between culture, ethnic groups, diet, lifestyle and genetic factors. This study aims to determine the burden of probable PCOS among college going students in Puducherry. A cross sectional study was carried out among students aged 18 years and above in a Government College for Women located in urban Puducherry. A total of 610 students were selected through a cluster random sampling technique. A pretested validated proforma was administered after obtaining informed consent. 25.1% (21.8-28.7) of women were having probable PCOS, 18.7% (15.8-22.0) had irregular menstrual history, 8.4% (6.4-10.8) had Hirsutism and 2% (1.8-3.3) had both the symptoms. Regarding food habits, 43.1% were vegetarians and were having probable PCOS and this association was found to be statistically significant. No significant association was found between prevalence of probable PCOS and factors such as higher age, parental income, higher BMI and physical inactivity. The present study found a high prevalence of probable PCOS among college going students, especially among study respondents who were obese, physically inactive and vegetarians compared to the counterpart. Earlier detection and proper management of the symptoms can avoid some major co-morbidity in the future. Therefore, screening is an important part in the diagnosis and management of PCOS among adolescent girls.

Association of polycystic ovary syndrome or anovulatory infertility with offspring psychiatric and mild neurodevelopmental disorders: a Finnish population-based cohort study.

Is maternal polycystic ovary syndrome (PCOS) associated with increased risks for a broad spectrum of psychiatric and mild neurodevelopmental disorders in offspring? Maternal PCOS and/or anovulatory infertility is independently, and jointly with maternal obesity, perinatal problems, cesarean delivery and gestational diabetes, associated with increased risks in offspring for almost all groups of psychiatric and mild neurodevelopmental disorders with onset in childhood or adolescence. Maternal PCOS was previously associated with autism spectrum disorder, attention-deficit/hyperactivity disorders and possibly developmental delay in offspring. Few studies have investigated the association between maternal PCOS and other psychiatric and neurodevelopmental disorders in offspring. This was a population-based cohort study in Finland including all live births between 1996 and 2014 (n = 1 105 997). After excluding births to mothers with symptoms similar to PCOS, a total of 1 097 753 births by 590 939 mothers remained. Children were followed up until 31 December 2018, i.e. up to the age of 22 years. National registries were used to link data of the included births and their mothers. Data from 24 682 (2.2%) children born to mothers with PCOS were compared with 1 073 071 (97.8%) children born to mothers without PCOS. Cox proportional hazards modeling was used to evaluate the hazard ratio (HR) and 95% CI for the risk of neuropsychiatric disorders in relation to maternal PCOS. Stratified analyses were performed to test the independent role of PCOS and the joint effects of PCOS with maternal obesity, perinatal problems, cesarean delivery, gestational diabetes and use of fertility treatment. The analysis was adjusted for maternal age, country of birth, marriage status at birth, smoking, parity, psychiatric disorders, prescription of psychotropic N05/N06 during pregnancy and systemic inflammatory diseases when applicable. A total of 105 409 (9.8%) children were diagnosed with a neurodevelopmental or psychiatric disorder. Firstly, maternal PCOS was associated with any psychiatric diagnosis (HR 1.32; 95% CI 1.27-1.38) in offspring. Particularly, the risk was increased for sleeping disorders (HR 1.46; 95% CI 1.27-1.67), attention-deficit/hyperactivity disorders and conduct disorders (HR 1.42; 95% CI 1.33-1.52), tic disorders (HR 1.42; 95% CI 1.21-1.68), intellectual disabilities (HR 1.41; 95% CI 1.24-1.60), autism spectrum disorder(HR 1.40; 95% CI 1.26-1.57), specific developmental disorders (HR 1.37; 95% CI 1.30-1.43), eating disorders (HR 1.36; 95% CI 1.15-1.61), anxiety disorders (HR 1.33; 95% CI 1.26-1.41), mood disorders (HR 1.27; 95% CI 1.18-1.35) and other behavioral and emotional disorders (ICD-10 F98, HR 1.49; 95% CI 1.39-1.59). In short, there was no significant difference between sexes. The results were robust when restricting the analyses to the first-born children or births to mothers without psychiatric diagnosis or purchase of psychotropic medication. Secondly, stratified analysis according to maternal BMI showed that the risk of any neuropsychiatric disorder was increased in offspring to normal-weight mothers with PCOS (HR 1.20; 95% CI 1.09-1.32), and markedly higher in those to severely obese mothers with PCOS (HR 2.11; 95% CI 1.76-2.53) compared to offspring to normal-weight mothers without PCOS. When excluding perinatal problems, mothers with PCOS were still associated with increased risks of any neuropsychiatric disorders in offspring (HR 1.28; 95% CI 1.22-1.34) compared to mothers without PCOS. However, an additional increase was observed for PCOS in combination with perinatal problems (HR 1.99; 95% CI 1.84-2.16). Likewise, excluding cases with maternal gestational diabetes (HR 1.30; 95% CI 1.25-1.36), cesarean delivery (HR 1.29; 95% CI 1.23-1.35) or fertility treatment (HR 1.31; 95% CI 1.25-1.36) did not eliminate the associations. The register-based prevalence of PCOS was lower than previously reported, suggesting that this study may capture the most severe cases. To combine anovulatory infertility with PCOS diagnosis as PCOS exposure might introduce diagnostic bias. It was not feasible to distinguish between subtypes of PCOS. Furthermore, familial factors might confound the association between maternal PCOS and neuropsychiatric disorders in offspring. Maternal BMI was available for birth cohort 2004-2014 only and there was no information on gestational weight gain. This study provides further evidence that maternal PCOS and/or anovulatory infertility, independently and jointly with maternal obesity, perinatal problems, gestational diabetes and cesarean delivery, implies a broad range of adverse effects on offspring neurodevelopment. These findings may potentially help in counseling and managing pregnancies. This study was supported by the joint research funding of Shandong University and Karolinska Institute (SDU-KI-2019-08 to X.C and C.L.), THL Finnish Institute for Health and Welfare: Drug and pregnancy project [M.G.], the Swedish Research Council [2014-10171 to C.L.], the regional agreement on medical training and clinical research (ALF) between Stockholm County Council and Karolinska Institute Stockholm County Council [SLL20170292 to C.L.], the Swedish Brain Foundation [FO2018-0141 and FO2019-0201 to C.L.]. X.C. was supported by the China Scholarship Council during her training in Karolinska Institute. L.K. was supported by the China Scholarship Council for his PhD study in Karolinska Institute. The authors have no competing interests to disclose. N/A.

The Prevalence and Impact of Polycystic Ovary Syndrome in Recurrent Miscarriage: A Retrospective Cohort Study and Meta-Analysis

Background: The use of different definitions and diagnostic approaches of polycystic ovary syndrome (PCOS) and recurrent miscarriage (RM) has led to a wide range of prevalence rates in the literature. Despite the persistent controversy about the factual prevalence of PCOS in RM, a vast number of studies have revealed evidence about their association with each other. The goals of this study were to evaluate the prevalence of polycystic ovarian morphology and PCOS within the RM population, performing meta-analyses with the obtained data from this study, together with previous reports on this topic and evaluating reproductive outcome in women with RM and PCOS. Methods: A retrospective cohort study with 452 women with RM and a meta-analysis were conducted. The main outcome parameter was the prevalence of PCOS in RM patients. Results: In the retrospective study, the prevalence of PCOS in RM was 9.5%. Negative results for the selected risk factors for RM were present in 283 patients (62.6%). From all evaluated possible underlying causes for RM, only the presence of thrombophilic disorders was significantly associated with PCOS (PCOS: 20.9% versus no PCOS: 7.8%, p = 0.010). In the meta-analysis of three studies on PCOS in RM patients, which used the revised Rotterdam criteria for defining PCOS, an estimated pooled prevalence of 14.3% (95% CI: 6.2–24.9) was found. In the retrospective data set, women in the PCOS group revealed significantly higher luteinizing hormone (LH), testosterone, and Anti-Mullerian hormone (AMH) levels than age- and body mass index (BMI)-matched controls with RM negative for the selected risk facotrs (p < 0.05). The rate of further miscarriages was significantly higher in PCOS women than in controls (71.4% versus 53.6%, respectively; p = 0.031). Conclusions: The prevalence of PCOS seems slightly increased in women with RM. Women with PCOS suffering from RM showed a significantly higher risk for further miscarriage and decreased chances of having a life birth of about 18% which did not reach statistical significance. Therefore, we assume that PCOS plays a moderate role in RM.

Polycystic ovary syndrome and offspring risk of congenital heart defects: a nationwide cohort study.

Is maternal polycystic ovary syndrome (PCOS) associated with increased offspring risk of congenital heart defects? This study does not support a strong association between PCOS and an increased risk of congenital heart defects. In addition to affecting reproductive health, PCOS may involve insulin resistance. Maternal pregestational diabetes is associated with an increased risk of congenital heart defects and therefore PCOS may increase the risk of congenital heart defects in the offspring. In this nationwide cohort study, we used data from Danish health registers collected from 1995 to 2018. The study included 1302648 offspring and their mothers. Participants were live singleton offspring born during the study period. Information on maternal PCOS and offspring congenital heart defects was obtained from the National Patient Register. Logistic regression analysis was used to compute prevalence (odds) ratio (PR) of the association between PCOS and offspring congenital heart defects. Among 1302648 live-born singletons, 11804 had a mother with PCOS. Of these, 143 offspring had a congenital heart defect (prevalence 121 per 10000) as compared with 12832 among mothers without PCOS (prevalence 99 per 10000). The adjusted PR was 1.22, 95% CI 1.03-1.44 comparing prevalence of congenital heart defects in offspring of women with PCOS with offspring of women without. After adjusting for the potentially mediating effect of pregestational diabetes, the PR was 1.16, 95% CI 0.98-1.37. PCOS may be underdetected in the National Patient Register. However, we expect that the mothers that we identified with PCOS truly had PCOS, thus, the estimated associations are not likely to be affected by this misclassification. The study does not provide evidence to rule out a moderate or weak association. These findings provide reassurance to clinicians counselling pregnant women with PCOS that the disease does not pose a markedly increased risk of offspring congenital heart defects. The study was funded by the Novo Nordisk Foundation. M.L. reports personal fees from Dansk Lægemiddel Information A/S outside the submitted work. The remaining authors have no conflicts of interest. N/A.

Sexual Function in Women With Polycystic Ovary Syndrome: Design of an Observational Prospective Multicenter Case Control Study.

IntroductionThe prevalence of polycystic ovary syndrome (PCOS) is 10–15% in women of reproductive age. Its characteristics are (i) clinical or biochemical hyperandrogenism, (ii) oligomenorrhea or amenorrhea, and (iii) polycystic ovaries on ultrasound. PCOS is associated with lower quality of life, depression, anxiety, diabetes, and cardiovascular disease. Treatment commonly entails oral contraceptive use to lower endogenous androgen levels. Androgen levels and comorbidities may affect sexual function. Previous studies have addressed a limited range of possible contributing factors. We will assess sexual function as well as genital and self-reported sexual arousal in a laboratory setting in women with PCOS compared to an age-matched healthy control group. Modulation by biopsychosocial factors mentioned will be studied.MethodsThis is a multicenter prospective case control study. The study population includes healthy women with and without PCOS, aged 18–40 years, in a stable heterosexual relationship for at least 6 months. Power is calculated at 67 participants in each group. Anticipating a drop out of 10%, 150 participants will be recruited.Main outcome measuresThe main outcomes measured are sexual function using the Female Sexual Function Index, Sexual Desire Inventory, and Female Sexual Distress Scale-Revised; genital sexual arousal measured as vaginal pulse amplitude; and self-reported sexual arousal in response to erotic stimuli in a laboratory setting. The mediators that will be investigated include testosterone, free androgen levels, oral contraceptive use, sensitivity to androgens (using CAG repeat length), body mass index, body image, mental health, and self-esteem.ConclusionStrengths of this study are the inclusion of a broad range of biopsychosocial outcome measures including DNA analysis, a healthy control group, and standardized assessment of genital and self-reported sexual arousal in a laboratory setting. With the design of this study we aim to provide an insight into which biopsychosocial factors associated with PCOS are related to sexual function, and how sexual function may be affected by treatment. These new insights may help to improve clinical management of PCOS while improving the quality of life.Pastoor H, Both S, Timman R, et al. Sexual Function in Women With Polycystic Ovary Syndrome: Design of an Observational Prospective Multicenter Case Control Study. Sex Med 2020;8:718–729.

Lesbian Women Undergoing Assisted Reproduction: Diverse, But Not Different.

The use of assisted reproduction among women in relationships with other women has increased in the United States over the past decade as a result of increased legal access and social acceptance. Despite this shift, limited studies currently exist to guide optimal fertility care for this growing patient population of women seeking assisted reproduction. In this Commentary, assisted reproduction will be meant to include ovulation induction, intrauterine insemination (IUI), and in vitro fertilization (IVF). Conflicting studies suggest that self-identified lesbian women may demonstrate an increased prevalence of polycystic ovarian syndrome. Most available studies find that a woman's sexual orientation does not affect the outcome of fertility treatment. Self-identified lesbian women undergoing donor sperm IUI and IVF have similar pregnancy and live-birth rates as heterosexual women. Better evidence regarding patient demographics and comorbidities, underlying etiologies of subfertility, and assisted reproductive outcomes among women building families with other women is needed to optimize care.

Menstrual cycle, reproductive function, body mass index, and metabolic profiles of women with former central precocious puberty: 10-20-year longitudinal cohort study in southern Thailand.

Background In 2011, we described 64 girls diagnosed with central precocious puberty (CPP) during 1995-2009. In 2019, the former CPP patients were 16-30 years of age and had been followed-up for 6-20 years after cessation of gonadotropin-releasing hormone analog (GnRHa) treatment. Objectives To determine the menstrual cycle, reproductive function, and long-term sequelae of the former GnRHa-treated and untreated CPP patients. Methods Sixty-seven former CPP women diagnosed during January 1995 to December 2010 were evaluated in 2019 for current menstrual cycle and pregnancy rate and for general health status, weight, height, blood pressure, and metabolic profiles of glucose, lipids, insulin, and testosterone. Results In 2019, the former CPP women averaged 20.7±2.7 years of age (range: 16.5-30). Eighty-three percent had a regular menstrual cycle. Of the 14 married women, six (43%) were fertile with 1-2 children. The untreated women had a significantly higher rate of obesity (BMI >25kg/m2) than the GnRHa-treated women (72.1% vs. 36.6%, p<0.01). Two women (3%) had polycystic ovary syndrome (PCOS). Fasting plasma glucose, serum high-density lipoprotein cholesterol (HDL-C), and testosterone levels were normal and similar between the GnRHa-treated and untreated participants. The serum insulin, cholesterol, triglyceride, low-density lipoprotein cholesterol (LDL-C), and homeostasis model assessment-insulin resistance (HOMA-IR) levels were higher in the untreated group than the GnRHa-treated group, but without significant differences. Conclusions At a 10-20-year follow-up, our former CPP patients had regular menstruation, normal reproductive function, and normal metabolic outcomes. The low prevalence of PCOS of 3% suggests that CPP is not a risk factor for PCOS, at least during early adulthood.

Clinical profile of 500 cases of Polycystic Ovary Syndrome in a Tertiary Hospital

Background: Polycystic ovary syndrome (PCOS) is a common condition affecting 4% to18% of women. It has been suggested that this condition occurs in as many as 4-10% ofwomen of reproductive age. PCOS is associated with significant reproductive morbidity,including infertility, abnormal uterine bleeding, miscarriage and other complications ofpregnancy.&#x0D; Method: This cross-sectional study was carried out in the Department of Obstetrics andGynaecology of Z.H. Sikder Women’s Medical College &amp; Hospital, Dhaka from January,2013 to December, 2016 over a period of 4 years with the objective to find out various clinicalpresentations, endocrine status, the menstrual abnormalities and sonographic findings ofthe patients with PCOS. During the study period a total number of 1600 patients wereexamined for infertility in the Outpatient and in Inpatient Department. Out of these 1600infertility patients, 500 cases were found to have polycystic ovary syndrome. Detailedinformation about the patients were collected in a predesigned data collection sheet.&#x0D; Result: Out of 500 PCOS patients, 360 (72.0%) had primary sub-fertility and 140 (28.0%)had secondary sub-fertility. Age of the patients ranged between 25 and 35 years. Duration ofinfertility was between 5 to 18 years. Prevalence of menstrual disturbances was found in78.0 percent of PCOS patients, of which &amp; 90 (18.0%) had amenorrhoea, 250 (50.0%) hadoligomenorrhoea, 50 (10.0%) had a heavy menstrual bleeding and 110 (22.0%) had normalmenstrual cycle. Among those patients, 210 (42.0%) were obese, 230 (46.0%) had normalBMI and 60 (12.0%) were under weight.&#x0D; Conclusion: The prevalence of PCOS in this study was 31.25% among infertility patients.Among them 72.0% had primary sub-fertility and 28.0% had secondary sub-fertility. Prevalenceof menstrual disturbances was found in 78.0% of PCOS patients, of which 18.0% hadamenorrhoea, 50.0% had oligomenorrhoea and 10.0% had heavy menstrual bleeding.&#x0D; Bangladesh J Obstet Gynaecol, 2018; Vol. 33(1) : 45-48

High risk of psychological disorders: anxiety and depression in adolescent girls with polycystic ovary syndrome

Study objective: This study is aimed to assess the prevalence of psychological disorders among different racial/ethnic group of normal weight and overweight adolescents with polycystic ovary syndrome (PCOS)from a state in southeastern US. Design, setting, and participants: The data of 157,459 adolescents were collected through “the Patient Cohort Explorer” system at the University of Mississippi Medical Center (UMMC) from January 2013 to December 2019.Unidentified patients were searched with diagnosis code for PCOS, age, race/ethnicity, and associated diagnosis including weight gain, anxiety, depression, ADHD, and behavioral concerns. Interventions: None. Main outcome measures: Prevalence of PCOS and psychological disorders. Results: A total of 712 adolescents with PCOS were diagnosed in clinics during the period of study. Collected data indicated that prevalence of PCOS in adolescents seen in clinics was less than 1% with no significant difference by race or ethnicity. Almost 45% of patients suffered from one or more psychological disorders. (Anxiety: 18%, Depression: 16%, ADHD: 9%). Conclusions: Results from this study provide the first evidence of prevalence of PCOS and psychological disorders in adolescents with PCOS in a southern state. Our findings of a high prevalence of psychological disorders suggest that early screening for mental health symptoms must be considered during primary care clinical assessment of adolescents with PCOS. Left undiagnosed and/or untreated, chronic anxiety and depression may exacerbate mental health issues in this vulnerable population.

Polycystic ovarian syndrome: need for life course approach

Polycystic ovarian syndrome (PCOS) is one of the leading but treatable causes of infertility among women. PCOS is a heterogeneous condition therefore it involves multiple disciplines and there is a wide research and clinical agenda. The prevalence of PCOS in India among 15-24 year old adolescents and young girls was found by Rotterdam criteria to be 22.5% and by Androgen Excess Society criteria to be 10.7%. Earlier it was considered only as a reproductive disorder but now it includes metabolic and psychological features as well. Under diagnosis of PCOS remains to be problematic. This is a complex syndrome and has an influence throughout the lifespan and requires multidisciplinary treatment approach as well as self-management. The life course approach or life course theory or the life course perspective was explored in 1960’s. In this approach individual's lives are analyzed within structural, social, and cultural contexts.

Frequency of Polycystic Ovary Syndrome among the Students of a Medical College in Dhaka City

Background: Polycystic ovary syndrome (PCOS) is a common heterogeneous endocrine disorder. Only few data are available in Bangladesh. The aim of this study was to find out the frequency of PCOS among the students of a medical college in Dhaka city. Materials &amp; Methods: This cross sectional study was done among the 3rd to 5th year students of Ibrahim Medical College. We used Rotterdam criteria (Revised 2003) for diagnosis of PCOS. After taking written consent, a detailed history including menstrual history was taken. Anthropometric measurements including height in cm, weight in kg, waist circumference (WC) were measured. We assessed hyperandrogenism (H) clinically by hirsutism using a modified Ferriman-Gallway (mFG) method. The presence of acne and acanthosis nigricans was also noted. For biochemical hyperandrogenism we did total testosterone estimation. Blood samples was collected between 08.00 and 10.00 am on Days 2-7 of a spontaneous bleeding episode or randomly in the case of amenorrhea after an overnight fast. The circulating levels of total testosterone, levels were measured by Chemiluminescent Immunoassay (Advia Centaur XPTM). Transabdominal USG (Aloka F37) was done by expert radiologist of department of Radiology, BIRDEM. PCOS group was categorized in 4 different phenotypes based on the presence of oligo-anovulation (O), hyperandrogenism (H) and polycystic ovarian morphology (P) : (i) Phenotype A (O+ H+ P), (ii) Phenotype B (O+H), (iii) Phenotype C (H+P) and (iv) Phenotype D (O+P). Results: Out of 73 girls 27(37%) satisfied Rotterdam’s criteria for PCOS. Phenotype B was more common 16(59.3%) followed by A 5(18.5%) then C 3(11.1%) and D 3(11.1%). Hirsutism was found in 24 (88.8%) girls, menstrual disturbance was also present among 24 (88.8%) girls, serum testosterone was elevated in 6(22.2%) girls, 11(40.7%) had USG findings of polycystic ovaries. The mean BMI (24.70 + 3.7) was significantly high (BMI &gt; 23 kg/ m2) among those who had PCOS (59.86%). Acne &amp; acanthosis nigricans was observed 15(55.6%) &amp; 6(22.2%) girls among PCOS respectively which were not statistically significant. Hypothyroidism was observed 7(25.9%) girls with PCOS. Associated family history of DM found in 21(77.8%) girls with PCOS. Family history of PCOS was present in 7(25.9%) girls in PCOS group. The difference were statistically significant (p&lt;0.05) between two groups. Conclusion: Prevalence of PCOS is 37%, which demonstrates that PCOS is an emerging disorder. This draws attention to the issue of early diagnosis, which could provide opportunity to target the group to prevent future morbidities.

Protein Network Studies on PCOS Biomarkers With S100A8, Druggability Assessment, and RNA Aptamer Designing to Control Its Cyst Migration Effect.

The prevalence of polycystic ovary syndrome (PCOS) has been gradually increasing among adult females worldwide. Laparoscopy drilling on ovary is the only available temporary solution with a high incidence of reoccurrence. S100A8 with S100A9 complex is believed to facilitate the cyst migration in PCOS condition. The high evident protein interaction network studies between PCOS biomarkers, cancer invasion markers, and the interactors of S100A8 confirm that this protein has strong interaction with other selective PCOS biomarkers, which may be associative in the immature cyst invasion process. Through the network studies, intensive structural and pathway analysis, S100A8 is identified as a targetable protein. In this research, the non-SELEX in silico method is adapted to construct RNA Library based on the consensus DNA sequence of Glucocorticoid Response Element (GRE) and screened the best nucleotide fragments which are bound within the active sites of the target protein. Selected sequences are joined as a single strand and screened the one which competitively binds with minimal energy. In vitro follow-up of this computational research, the designed RNA aptamer was used to infect the MCF7 cell line through Lipofectamine 2000 mediated delivery to study the anti-cell migration effect. Wound Scratch assay confirms that the synthesized 18-mer oligo has significant inhibition activity toward tumor cell migration at the cellular level.

SUN-025 Obesity Severity and Polycystic Ovary Syndrome in an Ethnically Diverse Cohort of Adolescent Girls

INTRODUCTION: Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disorders affecting young women and may present as early as adolescence. Early recognition is important, as polycystic ovary syndrome (PCOS) is associated with increased cardiometabolic risk and type 2 diabetes mellitus. The risk of PCOS increases with obesity, but fewer studies have explored the burden of PCOS in children with obesity within healthcare settings. In this study, we examined the proportion of adolescent girls with obesity who also had diagnosed PCOS and the relationship between PCOS and obesity severity.METHODS: From an existing cohort of nearly 8000 children age 3-17 with obesity (Body Mass Index, BMI ≥95th percentile) who were seen at pediatric well-child visits and identified for weight management based on BMI, we classified the subgroup of girls age 12-17 years who had moderate (BMI 100-119% of the 95th percentile) and severe (BMI ≥120% of the 95th percentile) obesity by PCOS status. Diagnosed PCOS was identified based on a visit diagnosis code for PCOS (ICD-9 256.4) within one year of the well child visit.RESULTS: We identified 1478 adolescent girls (age 12-17) with obesity, among whom 76 (5%) had a PCOS diagnosis. The burden of PCOS varied by race, including 4% among white, 7% among black, 5% among Hispanic, and 8% among Asians, respectively. The proportion with diagnosed PCOS was greater in severely obese patients (9%) compared to moderately obese (3%). By race/ethnicity, the proportion with PCOS among moderately obese/severely obese girls were as follows: white 2%/8%, black 4%/10%, and Hispanic 2%/9%, respectively. The Asian population had a higher proportion of PCOS (10%) among girls with moderate obesity, as fewer Asian girls had severe obesity overall.CONCLUSION: Among adolescent girls with obesity, the burden of PCOS varied by race/ethnicity and level of obesity. Increasing severity of obesity was associated with a greater proportion of girls having diagnosed PCOS, a trend that was reflected in white, black and Hispanic adolescent girls but not Asians, the latter due to their lower range BMI. These data highlight the prevalence of PCOS among adolescent girls with obesity and support the need for early identification and management prior to adulthood.

OR31-02 Diagnostic Criteria for Polycystic Ovary Syndrome in Adolescents: Impact on Prevalence and Longitudinal Body Mass Index Trajectories

Background: Polycystic ovary syndrome (PCOS) is characterised by oligo-anovulation (OA), hyperandrogenism (HA) and polycystic ovary morphology (PCO). While the Rotterdam criteria (defined as 2 out of 3 features) are the most widely used criteria in adults, controversy remains for the diagnostic criteria in adolescents as many PCOS features overlap with normal pubertal physiological changes. The 2018 international evidence-based PCOS guideline recommends modified Rotterdam criteria (OA and HA) in adolescents based on expert consensus. We aimed to 1) compare the prevalence of PCOS using original and modified Rotterdam criteria in an unselected adolescent cohort and 2) explore the association between diagnostic phenotypes and long-term body mass index (BMI) trajectories. Methods: 227 adolescent females of the Western Australian Pregnancy Cohort (Raine) Study undertook detailed PCOS assessment at the mean age of 15.3 years (mean age of menarche 12.4 years). Detailed anthropometric measurements were collected from birth until age 22 years. T-test was used for group BMI comparisons and longitudinal BMI was analysed using Generalised Estimating Equations with PCOS by time and PCOS phenotypes by time as interaction terms. Results: PCOS was diagnosed in 66 (29.1%) participants using original Rotterdam criteria versus 37 (16.3%) participants using modified Rotterdam criteria. Using modified Rotterdam criteria, participants with PCOS had higher mean group BMI than participants without PCOS from age 5 years onwards. Significant interaction was detected between PCOS and time (p<0.001) on longitudinal BMI gain where higher BMI gain was observed in participants with PCOS from age 14 years onwards. Only the modified criteria phenotype was significantly associated wth long-term BMI gain whereas other PCOS phenotypes had similar BMI trajectories as participants without PCOS (p<0.001). Conclusions: Our findings validate the PCOS guideline recommendation as modified Rotterdam criteria reduce over-diagnosis of PCOS in adolescents and accurately identify the phenotype at risk of long-term weight gain. The BMI trajectories of females with and without PCOS diverge from early childhood suggesting that metabolic dysfunction in PCOS commences early in the pre-pubertal period. Disclosures: Nothing to disclose. Funding: PCOS CRE scholarship and Research Training Program Scholarship awarded to CT; NHMRC Medical Research Future fund awarded to HT; National Heart Foundation Future Leader Fellowship awarded to LM; NHMRC early career fellowship awarded to AJ.