Phenotype Classification and Risk Factors of Polycystic Ovary Syndrome Among Infertility Patients Treated at Subfertility Clinic, National Population and Family Development Board Malaysia

Abstract

Introduction: Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder with rising incidence in Malaysia. The phenotype of PCOS is based on patients' clinical and biochemical characteristics. Therefore, this study aimed to determine the phenotype classification and the main risk factor for PCOS in women attending infertility treatment at the Subfertility Clinic, National Population and Family Development Board (NPFDB). Materials and methods: This cross-sectional study was conducted among women undergoing infertility treatment at the Subfertility Clinic of NPFDB from January 2018 to December 2019. The women underwent physical examination, had their menstrual history recorded, and were diagnosed with PCOS based on Rotterdam criteria. Meanwhile, blood was taken for lipid, glucose and reproductive hormone analysis. Results: A total of 84 women who attended for infertility treatment were diagnosed with PCOS. The findings showed that the majority of PCOS women were diagnosed with PCOS phenotype D. PCOS women exhibited notable characteristics, including significantly increased body mass index (BMI), increased blood pressure, menstrual irregularities, polycystic ovaries and hirsutism. Elevated levels of luteinizing hormone (LH) and testosterone were observed in PCOS women, while follicle-stimulating hormone (FSH) and progesterone levels were significantly diminished. Moreover, PCOS women manifested lower levels of high-density lipoprotein (HDL) and increased 2-hour postprandial glucose levels compared to the control group. Interestingly, progesterone levels showed a statistically significant relationship with PCOS, whereby high progesterone levels decrease the risk of PCOS development (odds ratio [OR], 0.793; 95% confidence interval [CI], 0.638-0.987, p<0.05). Conclusion: PCOS women who came for infertility treatment in Subfertility Clinic, NPFDB were predominantly phenotype D, had low progesterone levels and presented anovulation problems with polycystic ovaries, and these characteristics are risk factors for PCOS.