Ultrasound diagnosis of polycystic ovaries in women who have no symptoms of polycystic ovary syndrome is not associated with subfecundity or subfertility.
OBJECTIVE
To evaluate the effect on fertility of the appearance of polycystic ovaries in women who have no symptoms of polycystic ovary syndrome.


METHODS
Case-control study.


METHODS
Teaching hospitals in Hull, United Kingdom.


METHODS
Women with the appearance of polycystic ovaries on ultrasound and women with normal ovaries.


METHODS
A questionnaire about previous subfertility, pregnancies, menstrual pattern, features of polycystic ovary syndrome, gynecological history, and individual lifestyle factors.


METHODS
Time to pregnancy (TTP) and relative risk (RR) of subfertility in symptomatic and asymptomatic subgroups of both groups.


RESULTS
Women with PCOs took longer TTP and were significantly less fertile if they were obese (RR = 2.6), had menstrual disturbances (RR = 4.6), hirsutism (RR = 2.5), and/or acne (RR = 2.7). Further reductions in fecundity occurred with an increasing number of symptoms (threefold, sevenfold, and 10-fold longer TTP with two, three, and four symptoms, respectively). The TTP of women with no symptoms was not significantly longer and they were not more likely to be subfertile than women with normal ovaries. These symptoms were not associated with significantly reduced fecundity in women with normal ovaries.


CONCLUSIONS
The appearance of polycystic ovaries has been shown to have no significant impact on fertility in women with no symptoms. Appearances alone do not reflect the pathological features of polycystic ovary syndrome, and additional diagnostic criteria should be considered. Obesity, menstrual disturbances, and/or hyperandrogenism are factors associated with subfertility in women with polycystic ovaries.
Hassan
Mohamed A M
MA
Academic Department of Obstetrics and Gynaecology, Women's and Children's Hospital, Hull Royal Infirmary, University of Hull, Hull, United Kingdom. mamhassan@yahoo.com
Killick
Stephen R
SR
D000152:Acne Vulgaris / Q000150:complications; D016022:Case-Control Studies; D005260:Female; D005298:Fertility; D006628:Hirsutism / Q000150:complications; D006801:Humans; D017588:Hyperandrogenism / Q000150:complications; D007247:Infertility, Female / Q000209:etiology; D008599:Menstruation Disturbances / Q000150:complications; D009765:Obesity / Q000150:complications; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D011247:Pregnancy; D012306:Risk; D013997:Time Factors; D014463:Ultrasonography