Objective: It has been shown that women with PCOS as well as with autoimmune thyroiditis (AIT), are characterized by increased incidence of infertility. Serum anti-Müllerian hormone (AMH), which reflects ovarian reserve, is elevated in PCOS women and is decreased in women with AIT. The Rotterdam criteria recognize four clinical PCOS phenotypes,i.e.,phenotype Acharacterized by clinical and/or biochemical hyperandrogenism (HA), menstrual dysfunction (oligo/amenorrhea) (Oligo) and polycystic ovarian morphology (PCOM), phenotype B (HA + Oligo), phenotype C (HA + PCOM) and phenotype D (Oligo + PCOM). To date, there is no study evaluating ovarian reserve and TPOAbs in different PCOS phenotypes. The aim of the present study was to investigate the relation between serum concentrations of TPOAbs and ovarian reserve in different PCOS phenotypes.
Patients and Methods: We examined 141 women with PCOS (phenotype A was diagnosed in 67 (47.5%) women, phenotype B in 30 (21.3%), phenotype C in 28 (19.9%), phenotype Din 16 (11.3%)) and 88 control subjects of similar age (P > 0.05). Physical examination was performed in all women. Serum concentration of LH, FSH, estradiol, total testosterone, AMH, TSH, thyroid hormones and TPOAbs were assessed and ultrasound of the ovaries was performed.
Results: Serum concentrations of TSH, fT4 and fT3 did not differ between the studied groups (all P > 0.05), all women were euthyroid. We observed positive serum TPOAbs in 31 (21.9%) women with PCOS and in 21 (23.9%) controls (P = 0.07). We did not observe differences in frequency of detection of positive serum TPOAbs between phenotype A (15 women, 22.4%), phenotype B (5 women, 16.7%), phenotype C (10 women, 35.7%) and control group (21 women, 23.9%) (P > 0.05). Interestingly, only one woman had positive serum TPOAbs (6.3%) in phenotype D. Serum AMH concentration was markedly higher in thewhole PCOS group (P < 0.01) and in phenotype A (P < 0.01) vs controls when serum concentration of TPOAbs was negative. However, in the groups with positive serum levels of TPOAbs, serum concentration of AMH did not differ between PCOS phenotypes and controls (all P > 0.05). We foundrelationships between serum TPOAbs concentrations and hip circumference (P = 0.03) and serum concentration of estradiol in the whole group (P = 0.002).
Conclusions: Frequency of serum detection of positive TPOAbs did not differ between PCOS phenotypeswith clinical/biochemical hyperandrogenism and control group, however, phenotype D is characterized by the lowest frequency of occurrence of positive TPOAbs. We observed differences in ovarian reserve between PCOS and control group with negative TPOAbs, whereas presence of TPOAbsabolished this differences.
05 Sep 2020 - 09 Sep 2020