Oligoovulatory and anovulatory cycles in women with polycystic ovary syndrome (PCOS): what's the difference?
BACKGROUND
Polycystic ovary syndrome (PCOS) is a heterogeneous disorder. The phenotype may differ between patients who exhibit signs of recent ovulation and anovulatory PCOS patients.


OBJECTIVE
Our objective was to study differences in clinical and endocrine characteristics and response to ovulation induction (OI) treatment comparing oligoovulatory and anovulatory PCOS patients.


METHODS
We conducted a retrospective cohort study at a tertiary hospital.


METHODS
PCOS patients (n=1750) presenting with oligo- or amenorrhea were diagnosed according to the Rotterdam 2003 consensus criteria. Arbitrarily, oligoovulatory PCOS was defined by a single random serum progesterone level of 10 nmol/liter or higher.


METHODS
We evaluated the incidence of oligo- or amenorrhea, menstrual cycle length, serum androgen levels, follicle count, and OI outcome parameters.


RESULTS
Anovulatory women (n=1541 of 1750, 88.1%) were more often amenorrheic (P<0.001) and presented with a longer cycle duration (P<0.001) compared with oligoovulatory women (n=209 of 1750, 11.9%). Serum levels of testosterone (P<0.001), the free androgen index (P<0.001), and total follicle count (P<0.005) were higher in anovulatory compared with oligoovulatory patients. During clomiphene citrate OI, more oligoovulatory women gained regular menstrual cycles (P<0.05), whereas after second-line treatment with recombinant FSH, more anovulatory women became pregnant (P<0.05).


CONCLUSIONS
Oligoovulatory women with PCOS exhibit a milder phenotype of ovarian dysfunction and have a more favorable response to OI treatment using clomiphene citrate compared with anovulatory PCOS patients. However, during second-line treatment with recombinant FSH, anovulatory PCOS patients presented with a higher chance of pregnancy compared with oligoovulatory patients.
Burgers
Janneke A
JA
Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Erasmus University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
Fong
Sharon Lie
SL
Louwers
Yvonne V
YV
Valkenburg
Olivier
O
de Jong
Frank H
FH
Fauser
Bart C J M
BC
Laven
Joop S E
JS
D000293:Adolescent; D000328:Adult; D000568:Amenorrhea / Q000503:physiopathology; D000728:Androgens / Q000097:blood; D000858:Anovulation / Q000097:blood / Q000188:drug therapy / Q000235:genetics / Q000503:physiopathology*; D002996:Clomiphene / Q000627:therapeutic use; D015331:Cohort Studies; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use; D005640:Follicle Stimulating Hormone / Q000627:therapeutic use; D006801:Humans; D008597:Menstrual Cycle / Q000502:physiology; D010062:Ovulation Induction / Q000379:methods; D034445:Ovulation Inhibition / Q000502:physiology*; D010641:Phenotype; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000188:drug therapy / Q000235:genetics / Q000503:physiopathology*; D011247:Pregnancy; D011994:Recombinant Proteins / Q000627:therapeutic use; D012189:Retrospective Studies
D000728:Androgens; D005300:Fertility Agents, Female; D011994:Recombinant Proteins; D002996:Clomiphene; D005640:Follicle Stimulating Hormone