Abstract
Objective: To determine the frequency of uterine abnormalities in PCOS
patients compared to normo-ovulatory patients and their relationship to
androgen levels. Design: Retrospective cohort study. Setting: Tertiary
University Hospital Population: Total of 103 women, 51 PCOS, and 52 male
factor infertility Interventions: HSG images of all patients were
numbered and evaluated by ten senior reproductive endocrinologists
blinded to the research and chose the most appropriate figure for each
patient’s HSG image and marked the shape of cavity according to the ASRM
and ESGE/ESHRE classification. Main outcome measures: Abnormal HSG
Rates, serum AMH and androgen levels Results: The percentage of the
normal uterine cavity was significantly lower in the PCOS group than
control group as 51 % and 66.7 %, 77 % and 94.2 % according to the
ASRM and ESHRE/ESGE classifications, respectively. The frequency of
Partial Septate Uterus (ESHRE-ESGE U2a / ASRM Va, 21.6% vs 5.8 %
p<0.05), Complete Septate Uterus (ESHRE-ESGE U2b / ASRM Vb,
7.8% vs 0% p<0.01) and Dysmorphic Uterus (ESHRE-ESGE U1c) /
ASRM VII) 3.9 % vs 0 p<0.05) were significantly higher in
PCOS patients than controls. The frequency of arcuate uterus classified
as VI in ASRM and considered normal in ESHRE/ESGE was 16 % and 17.3 %
in PCOS and control groups, respectively, without statistically
significant difference. The increased frequency of intrauterine cavity
abnormalities was correlated with serum-free testosterone levels.
Conclusion: This study provides that the frequency of uterine cavity
abnormality is clearly higher in PCOS patients compared to the healthy
population.