RESULTS
There was no statistically significant difference in terms of age
between PCSO and Control patients, respectively as 31.8 ± 4.4 and 31.9 ±
5. As expected, body mass index (BMI) was found to be higher in PCOS
patient than in control (27.2 + 6.2 vs. 23.9 + 4.5,
p:0.03). Also, AFC and serum AMH levels were significantly higher in the
PCOS group (AFC; 20 (9-20) vs. 12 (9-18) p:0.05, AMH;4.1 ng/ml (2.5-7.2)
vs. 2.3 ng/ml (1.6-3.8), p<0.01). There were no statistically
significant differences between the PCOS patients and controls in term
of serum follicle stimulating hormone (FSH) (5 IU/L (4.2-5.9) vs. 5.4
IU/L (4.4-6.2), p:0.325), Serum luteinizing hormone (LH) (3.8 IU/L
(2.8-5.6) vs. 3.4 IU/L (2.6-4.1), p:0.09), free testosterone (2.1 ng/dl
(1.3-3.4) vs. 1.9 ng/dl (0.6-4.3), p:0.75), dehydroepiandrosterone
sulfate (DHEASO4) (314 mcg/dl (248-408) vs. 225 mcg/dl (141-348) p:0.1),
17OH Progesterone (1.64 ng/ml (1.1-2.2) vs. 0.9 ng/ml (0.8-2.5) p:0.2) ,
except serum total testosterone levels (0.59 mcg/l + 0.19 vs. 0.4
mcg/l + 0.16, p:0.02).
HSG results are given in Table 1.
When arcuate cavity (Figure II) which is classified as an abnormality in
ASRM but a variation of normal in ESGE - ESHRE is accepted as an
abnormality, 45.9 % and 73.1 % of the uterine cavities in PCOS and
control patients was reported as normal which is statistically
significant (Table 1 – Analysis 1). Total uterine cavity abnormality
rate (Figure II + III + IV + IV + IV) was statistically significantly
higher in PCOS than in Control (54.1 %, 26.9 %)
When the arcuate cavity is considered normal as in the ESGE - ESHRE
classification, in terms of uterine cavity abnormalities, the
statistically significant difference disappears between PCOS and control
patients (11.86 % versus 20.16 %) (Table 1 – Analysis 2)
When Figure III (ESGE - ESHRE U2a / ASRM Va) and Figure IV (ESGE - ESHRE
U2b / ASRM Vb) are evaluated together in the same group, there was a
significant difference between PCOS and Control groups (10.57 % versus
1.2 %). (Table 1 - Analysis 2)
When these groups were evaluated separately, a statistically significant
difference was found in PCOS and Control groups in Figure III (ESGE -
ESHRE U2a / ASRM Va) and Figure IV (ESGE - ESHRE U2b / ASRM etc.),
respectively (5.1 % versus 0, 3.4 % versus 1.2 %) (Table 1 - Analysis
3).
When the Figure V (ESGE - ESHRE U1a / ASRM VII), which is commonly used
as T shape and Figure VI (ESGE - ESHRE Uc? / ASRM Unclassified), named
as Y shaped but not classified, are evaluated together in the same
group, there were not statistically significant differences between the
groups (21. % versus 18.9 %) (Table 1 - Analysis 2). When they were
evaluated separately, there were no differences in terms of T shaped
cavity between the groups (13.8 % versus 18.3 %) but, the frequency of
Y shaped cavity in PCOS patients was found higher than controls (7.4 %
versus 0).
When 6 Figures are evaluated separately, the frequency of abnormality is
found higher among all groups except T shape (Figure V) in PCOS patients
than in controls (Figure II; 22.1 % versus 6.6 %, Figure III; 5.1 %
versus 0, Figure IV; 3.4 % versus 1.2 %, Figure V; 7.4 % versus 0)
(Table 1, Analysis 3).
Uterine cavity was reported as abnormal in 28 of 51 (54.9 %) PCOS
patients according to HSG results, while rest of them (23 of 51, 45.09
%) were normal.
Among PCOS patients with normal and abnormal uterine cavities, there
were no statistically significant differences in terms of mean age (32 ±
4.5, 31.6 ± 4.4, p:0.7), mean BMI (26.7 ± 6.6 , 27.9 ± 5.8, p:0.53),
Ferriman Gallwey Scores (15 (12-23) vs 19 (9-21), p:0.8), AFC (20
(13-20) vs. 14 (9-20), p:0.1), serum AMH levels (5.2 ng/ml (3.4-11.9)
vs. 3.8 ng/ml (2.4-5.9), p:0.09), Serum FSH levels (5 IU/L (3.8-5.9) vs
5.2 IU/L (4.7-5.9), p:0.22), serum LH levels (3.8 IU/L (3-6.3) vs. 3.5
IU/L (2.7-5.3), p:0.6), total testosterone levels (0.53 mcg/L + 0.18 vs.
0.62 mcg/L+ 0.19, p:0.08), free testosterone levels (2.1ng/dl (1-3) vs.
2.2 ng/dl (1.3-4), p:0.44), DHEASO4 levels (322 mcg/dl (254-397) vs. 310
mcg/dl (240-418), p:0.58), 17 OH Progesterone levels (1.3 ng/ml
(0.9-2.1) vs. 1.7ng/dl (1.3-2.3), p:0.07) between both groups.
There was no correlation between the serum AMH levels and the presence
of uterine cavity abnormalities in all patients (Figure 2) and in PCOS
patients as subgroup (Figure 3) (Threshold for uterine normality AMH
3.05, 50 % Sensitivity 53% Specificity, AUC 0.550 with CI
(0.438-0.663) , AMH 4.05, 65% Sensitivity %60 Specificity, AUC 0.639
with CI (0.481-0.797), for Figure 1 and 2, respectively.