A 20-Year Follow-up of Young Women With Polycystic Ovary... : Obstetrics & Gynecology (original) (raw)

Original Research

From the Department of Biological and Medical Sciences, University of Palermo, Palermo, Italy; and the Department of Obstetrics and Gynecology, Columbia University, New York, New York.

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Corresponding author: Roger A. Lobo, MD, Columbia University Medical Center, 622 West 168 Street, Room 16-65, New York, NY 10032; e-mail: [email protected].

Financial Disclosure The authors did not report any potential conflicts of interest.

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OBJECTIVE:

To determine whether hormonal, metabolic, and anthropomorphic parameters change over 20 years in women with polycystic ovary syndrome (PCOS).

METHODS:

One hundred ninety-three women with PCOS, aged 20–25 years, were diagnosed according to Rotterdam criteria, divided into four phenotypes (A–D), and followed at 5-year intervals for 20 years. Androgens, gonadotropins, insulin, glucose, body mass index, waist circumference, and ovarian volume were measured.

RESULTS:

At diagnosis, 57% had classic features (phenotype A), 9% had classic features without ovarian findings (phenotype B), 26% had the ovulatory phenotype (C), and 7% were nonhyperandrogenic (D). After 10 years, androgens decreased (P<.05); at 15 years, waist circumference increased (P<.05); at 20 years, ovarian volume decreased (P<.01). Serum luteinizing hormone and follicle-stimulating hormone decreased nonsignificantly and fasting insulin and quantitative insulin-sensitivity check index were unchanged. Eighty-five women (44%) were ovulatory at 20 years, and 18 women (8%) could no longer be diagnosed as having PCOS.

CONCLUSION:

After 20 years of follow-up in women with PCOS, androgens and ovarian volume decreased and there were more ovulatory cycles suggesting a milder disorder, whereas metabolic abnormalities persisted and waist circumference increased.

LEVEL OF EVIDENCE:

II

© 2012 by The American College of Obstetricians and Gynecologists.