Comparison of clinical and hormonal characteristics among four phenotypes of polycystic ovary syndrome based on the Rotterdam criteria.

PURPOSE: Polycystic Ovary Syndrome (PCOS) is the most common endocrine disturbances in women and is divided into different phenotypes. The aim of study is to compare the clinical and hormonal parameters among the four phenotypes of PCOS based on the Rotterdam criteria and with control group.

METHODS: Women with PCOS (n = 263) confirmed based on the Rotterdam criteria and 263 women with no evidence of PCOS were recruited as controls using observational case-control study. Evaluation of clinical and hormonal parameters, and differences in anti-Mullerian hormone (AMH) were compared between four phenotypes of PCOS and controls.

RESULTS: Women with phenotype A (olig-anovulation (O) + hyperandrogenism (H) + polycystic ovary morphology (P)) had significantly larger waist than phenotype D (O + P) and higher body mass index than phenotype C (H + P). The LH/FSH ratio was significantly higher in phenotype A than phenotype D and controls along with significantly higher serum total testosterone levels in phenotype A compared to the phenotype B (O + H), C, D, and controls. AMH was significantly higher with phenotype A, C, and D than in women phenotype B and controls.

CONCLUSIONS: The highest AMH levels were found in phenotype A. Phenotype B similar to controls had significantly low AMH compared to other three PCOS phenotypes. Women in the phenotypes D and controls showed significantly lower levels of LH/FSH ratio, total testosterone, and free androgen index, and higher levels of FSH and SHBG compared with phenotype A (P < 0.001). In logistic regression analysis, AMH and LH were predictors for PCOS.