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Clinical and Experimental Obstetrics & Gynecology  2020, Vol. 47 Issue (3): 359-364    DOI: 10.31083/j.ceog.2020.03.5287
Original Research Previous articles | Next articles
Clinical presentation, hormonal profiles in nulliparous Korean women with polycystic ovarian morphology
Y.J. Shin1, S. Lee1, J.E. Lee1, S. Won1, M.J. Kim1, *()
1Department of Obstetrics and Gynecology, Bucheon St. Mary’s Hospital. College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Abstract  

Purpose: The aim of this study was to determine the relationship between polycystic ovarian morphology (PCOM), ovarian morphology, anti-Müllerian hormone (AMH), and testosterone levels in young nulliparous Korean women. Materials and Methods: A total of 139 PCOM patients were evaluated from 2013 to 2018. The relationships between serum AMH levels and androgenic hormones, clinical signs of polycystic ovarian syndrome (PCOS), and ovarian morphology were investigated. Results: Irregular menstruation was the most common symptom in women with PCOM. This study found that hyperandrogenism was present in 26.6% of nulliparous Korean women with PCOM. The present findings support the use of serum AMH as a useful marker to reflect PCOM in cases where accurate ultrasounds are not available. Conclusions: This study found that PCOM did not equate with PCOS, although PCOM is one of the diagnostic criteria for PCOS. AMH levels were positively correlated with ovarian volume and AMH levels were not reflected by hyperandrogenism. Content: The use of serum AMH as a useful marker to reflect PCOM in cases where accurate ultrasounds are not available.

Key words:  Polycystic ovaries      Ovarian volume      Follicle count      Follicle size      Endometrial thickness     
Submitted:  16 June 2019      Accepted:  04 September 2019      Published:  15 June 2020     
*Corresponding Author(s):  MIN JEONG KIM     E-mail:  poouh74@catholic.ac.kr

Cite this article: 

Y.J. Shin, S. Lee, J.E. Lee, S. Won, M.J. Kim. Clinical presentation, hormonal profiles in nulliparous Korean women with polycystic ovarian morphology. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(3): 359-364.

URL: 

https://ceog.imrpress.com/EN/10.31083/j.ceog.2020.03.5287     OR     https://ceog.imrpress.com/EN/Y2020/V47/I3/359

Table 1  — Epidemiologic Characteristics of PCOM Woman
Mean ± SD/ N (%)
Age (years) 21.46 ± 3.64
Height (cm) 161.16 ± 5.97
Weight (kg) 60.27 ± 14.27
BMI (kg/m2) 23.19 ± 5.11
Birth weight (kg) 3.18 ± 0.46
Age of menarche (years) 13.76 ± 1.64
Menstrual interval irregular 128 (94.81%)
regular 7 (5.19%)
Duration of menstruation (days) 6.36 ± 2.26
Dysmenorrhea 71 (53.79%)
History of OCs 62 (44.6%)
Chief symptoms Abnormal uterine bleeding 78 (43.58%)
Hirsutism 25 (13.97%)
Acne 14 (7.82%)
Pelvic pain 2 (1.12%)
Amenorrhea 53 (29.61%)
Total T (nmol/L) 75.85 ± 43.8
Free T (pg/mL) 2.25 ± 1.18
17-OHP (ng/mL) 1.51 ± 0.56
DHEAS (μg/dL) 227.23 ± 108.71
SHBG (nmol/L) 50.50 ± 40.73
FAI 262.37 ± 332.08
FSH (mIu/mL) 4.36 ± 1.37
E2 (pg/mL) 74.40 ± 35.42
AMH 11.54 ± 6.14
Cholesterol (mg/dL) 181.75 ± 44.62
TG (mg/dL) 114.45 ± 77.19
HDL (mg/dL) 63.98 ± 20.69
Table 2  — Analysis of Ovarian Morphology According to Age, BMI
Subgroup age Subgroup BMI(kg/m2)
< 20 years old ≥ 20 years old p-value(1) < 18.5 (1) 18.5-22.9(2) 23-24.9(3) ≥ 25(4) p-value2)
Rt. ov area (cm2) 6.09 ± 1.75 6.06 ± 1.69 6.10 ± 1.79 0.8976 5.27 ± 1.74 6.12 ± 1.79 6.83 ± 1.40 6.0 ± 1.75 0.04552),b
Rt.ov volume (cm3) 7.52 ± 3.36 7.13 ± 3.29 7.71 ± 3.39 0.231) 6.23 ± 3.01 7.43 ± 2.76 9.10 ± 4.42 7.50 ± 3.69 0.15882)
Rt. Follicle 16.88 ± 4.25 18.00 ± 4.02 16.34 ± 4.27 0.02501) 13.57 ± 2.38 17.34 ± 4.19 16.53 ± 5.12 17.61 ± 3.96 0.00562),a,c
Lt. ov area(cm2) 5.56 ± 1.69 5.39 ± 1.62 5.65 ± 1.72 0.41101) 4.65 ± 1.99 5.37 ± 1.58 6.15 ± 1.77 5.97 ± 1.54 0.04172)*
Lt. ov volume(cm3) 6.7 ± 2.97 6.31 ± 2.45 6.89 ± 3.19 0.52071) 5.05 ± 2.95 7.01 ± 3.06 7.20 ± 2.3 7.18 ± 2.91 0.03622),*
Lt. Follicle 16.74 ± 4.35 18.49 ± 4.18 15.91 ± 4.2 0.00301) 14.46 ± 3.33 16.34 ± 4.23 16.11 ± 4.62 18.51 ± 4.29 0.01032),*,c
Endometrium (cm) 0.62 ± 0.23 0.61 ± 0.24 0.63 ± 0.23 0.32911) 0.53 ± 0.27 0.61 ± 0.2 0.70 ± 0.26 0.65 ± 0.25 0.12142)
Table 3  — Correlation of AMH with Hyperandrogenism and Hormones
Correlation coefficient p-value
AMH Total T (nmol/L) 0.2181 0.0328*
Free T (pg/mL) -0.0103 0.9168
17-OHP (ng/mL) 0.1566 0.1297
DHEAS (μg/dL) 0.0879 0.3869
SHBG 0.1667 0.1063
FAI -0.0292 0.7789
FSH (mIu/mL) 0.0316 0.7352
E2 (pg/mL) -0.0180 0.8487
Cholesterol (mg/dL) -0.1489 0.2970
TG (mg/dL) -0.2530 0.0703
HDL (mg/dL) 0.2789 0.0498*
AMH RT. ov area (cm2) 0.3801 <.0001*
RT. ov volume (cm3) 0.2188 0.0173*
RT. ovarian Follicle 0.4472 <.0001
LT. ov area (cm2) 0.2478 0.0071*
LT. ov volume (cm3) 0.2255 0.0141**
LT. ovarian follicle 0.2458 0.011*
Endometrium (cm) -0.0484 0.6029
Table 4  — Analysis of difference between hyperandrogenic groups and normal group
Subgroup
Group A Group B Group C Group D
Total T > 95, Free T > 3.09 Total T > 95 Free T > 3.09 Normal group p-value
N (%) 9 (7%) 14 (9.8%) 14 (9.8%) 102 (73.4%)
Total T (nmol/L) 160.46 ± 77.00 123.89 ± 20.14 75.07 ± 10.93 58.35 ± 21.59 <.00011)*
Free T (pg/mL) 4.49 ± 1.27 1.99 ± 0.58 3.92 ± 1.18 1.82 ± 0.65 <.00011)*
17-OHP (ng/mL) 1.92 ± 0.45 1.61 ± 0.31 1.56 ± 0.32 1.44 ± 0.6 0.02051)*
DHEAS (μg/dL) 245.75 ± 93.84 224.60 ± 161.13 285.60 ± 71.36 217.61 ± 105.03 0.02991)*
SHBG (nmol/L) 24.85 ± 14.10 47.49 ± 28.49 22.42 ± 13.07 58.06 ± 44.01 0.00031)*
FAI 877.36 ± 737.84 416.44 ± 324.45 360.59 ± 238.17 159.82 ± 163.3 <.00011)*
FSH (mIu/mL) 4.01 ± 1.28 4.74 ± 1.09 4.08 ± 0.90 4.29 ± 1.45 0.6049
E2 (pg/mL) 86.95 ± 21.62 70.91 ± 28.15 84.89 ± 25.11 77.38 ± 37.64 0.35531)
AMH 14.54 ± 6.91 15.71 ± 10.68 12.75 ± 4.67 10.91 ± 5.36 0.08781)
RT. ov. Area (cm2) 6.15 ± 1.85 6.79 ± 1.49 6.16 ± 2.19 6.20 ± 1.57 0.6962
RT. ov. Volume (cm3) 7.59 ± 3.27 8.24 ± 2.48 7.61 ± 4.58 7.64 ± 3.15 0.82061)
RT. Follicle 20.33 ± 3.57 19.25 ± 4.90 17.45 ± 3.75 16.27 ± 4.13 0.01291)*
LT. ov. area (cm2) 5.82 ± 1.88 5.74 ± 0.89 5.54 ± 1.93 5.76 ± 1.56 0.78161)
LT. ov, volume (cm3) 6.47 ± 2.29 7.03 ± 1.68 6.70 ± 3.28 7.05 ± 3.08 0.81791)
LT. Follicle 20.56 ± 3.84 16.83 ± 3.38 17.33 ± 4.50 16.51 ± 4.37 0.05521)
Endometrium (cm) 0.55 ± 0.26 0.59 ± 0.12 0.62 ± 0.28 0.65 ± 0.23 0.31861)
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