Skip to main content
Top
Published in: Archives of Gynecology and Obstetrics 2/2014

01-08-2014 | Gynecologic Endocrinology and Reproductive Medicine

Polycystic ovarian syndrome and congenital uterine anomalies: the hidden common player

Authors: Hisham Ali Saleh, Fady M. Shawky Moiety

Published in: Archives of Gynecology and Obstetrics | Issue 2/2014

Login to get access

Abstract

Objective

To study the association between polycystic ovary syndrome (PCOS) and congenital uterine (Müllerian) anomalies in infertile patients. The ultimate aim was to check for a common factor linking both reproductive health problems.

Design

A prospective observational study.

Setting

Tertiary referral infertility center.

Subjects and methodology

3,900 infertile patients were included. The diagnoses of PCOS and uterine anomalies were made. Patients with or without PCOS were correlated to the presence or absence of uterine anomalies and statistically assessed.

Main outcome measures

Study of the prevalence of PCOS/uterine anomalies in the studied population and the ratio of coexistence.

Results

The prevalence of PCOS in the studied cohort was 10.48 %. 409 (10.48 %) patients were confirmed to have PCOS, while 204 (5.23 %) were with confirmed uterine anomalies. Of the patients with confirmed PCOS, almost one-third (n = 149, 31.4 %) had uterine anomalies, while in patients with confirmed uterine anomalies, almost three-fourths (n = 149, 73 %) had PCOS.

Conclusions

There is evident association between PCOS and uterine anomalies in infertile patients. We suggest a genetic rather than a developmental defect to be a possible common player for the development of both PCOS and uterine anomalies.
Literature
1.
go back to reference Balen A, Glass M (2005) What’s new in polycystic ovary syndrome? Recent Advances in Obstetrics and Gynecology 23 11:147–158 Balen A, Glass M (2005) What’s new in polycystic ovary syndrome? Recent Advances in Obstetrics and Gynecology 23 11:147–158
2.
go back to reference Fauser B, Tarlatzis B, Chang J, Azziz R, Legro R, Dewaily D et al (2004) The Rotterdam ESHRE/ASRM-sponsored PCOS consensus workshop group: revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod 19:41–47CrossRef Fauser B, Tarlatzis B, Chang J, Azziz R, Legro R, Dewaily D et al (2004) The Rotterdam ESHRE/ASRM-sponsored PCOS consensus workshop group: revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod 19:41–47CrossRef
3.
go back to reference Barter SJ (2009) The Radiology of Polycystic Ovaries. In: Farid NR, Diamanti-Kandarakis E (eds) Diagnosis and management of polycystic ovary syndrome. Springer Pub, New York, p 23CrossRef Barter SJ (2009) The Radiology of Polycystic Ovaries. In: Farid NR, Diamanti-Kandarakis E (eds) Diagnosis and management of polycystic ovary syndrome. Springer Pub, New York, p 23CrossRef
4.
go back to reference Troiano RN, McCarthy SM (2004) Müllerian duct anomalies: imaging and clinical issues. Radiology 233(1):19–34PubMedCrossRef Troiano RN, McCarthy SM (2004) Müllerian duct anomalies: imaging and clinical issues. Radiology 233(1):19–34PubMedCrossRef
5.
go back to reference Grimbizis GF, Camus M, Tarlatzis BC, Bontis JN, Devroey P (2001) Clinical implications of uterine malformations and hysteroscopic treatment results. Hum Reprod 7(2):161–174CrossRef Grimbizis GF, Camus M, Tarlatzis BC, Bontis JN, Devroey P (2001) Clinical implications of uterine malformations and hysteroscopic treatment results. Hum Reprod 7(2):161–174CrossRef
6.
go back to reference Ghi T, Casadio P, Kuleva M, Perrone AM, Savelli L, Giunchi S, Meriggiola MC, Gubbini G, Pilu G, Pelusi C, Pelusi G (2009) Accuracy of three-dimensional ultrasound in diagnosis and classification of congenital uterine anomalies. Fertil Steril 92(2):808–813PubMedCrossRef Ghi T, Casadio P, Kuleva M, Perrone AM, Savelli L, Giunchi S, Meriggiola MC, Gubbini G, Pilu G, Pelusi C, Pelusi G (2009) Accuracy of three-dimensional ultrasound in diagnosis and classification of congenital uterine anomalies. Fertil Steril 92(2):808–813PubMedCrossRef
7.
go back to reference Saravelos SH, Cocksedge KA, Li TC (2008) Prevalence and diagnosis of congenital uterine anomalies in women with reproductive failure: a critical appraisal. Hum Reprod 14(5):415–429CrossRef Saravelos SH, Cocksedge KA, Li TC (2008) Prevalence and diagnosis of congenital uterine anomalies in women with reproductive failure: a critical appraisal. Hum Reprod 14(5):415–429CrossRef
8.
go back to reference Chan YY, Jayaprakasan K, Tan A, Thornton JG, Coomarasamy A, Raine-Fenning NJ (2011) Ultrasound in Obstetrics and Gynecology The reproductive outcomes of women with congenital uterine anomalies: a systematic review. Ultrasound Obstet Gynecol 38(4):371–382PubMedCrossRef Chan YY, Jayaprakasan K, Tan A, Thornton JG, Coomarasamy A, Raine-Fenning NJ (2011) Ultrasound in Obstetrics and Gynecology The reproductive outcomes of women with congenital uterine anomalies: a systematic review. Ultrasound Obstet Gynecol 38(4):371–382PubMedCrossRef
9.
go back to reference Shoupe D (2002) Uterovaginal anomalies management. In: Mishell DR, Goodwin TM, Brenner PF (eds) Management of common problems in obstetrics and gynecology, 4th edn. Blackwell, Massachusetts, pp 400–405 Shoupe D (2002) Uterovaginal anomalies management. In: Mishell DR, Goodwin TM, Brenner PF (eds) Management of common problems in obstetrics and gynecology, 4th edn. Blackwell, Massachusetts, pp 400–405
10.
go back to reference Ugur M, Karakaya S, Zorlu G, Arslan S, Gülerman C, Kükner S, Gökmen O (1995) Polycystic ovaries in association with Müllerian anomalies. Eur J Obstet Gynecol Reprod Biol 62(1):57–59PubMedCrossRef Ugur M, Karakaya S, Zorlu G, Arslan S, Gülerman C, Kükner S, Gökmen O (1995) Polycystic ovaries in association with Müllerian anomalies. Eur J Obstet Gynecol Reprod Biol 62(1):57–59PubMedCrossRef
11.
go back to reference The American Fertility Society (1988) The American Fertility Society classifications of adnexal adhesions, distal tubal occlusion, tubal occlusion secondary to tubal ligation, tubal pregnancies, Müllerian anomalies and intra-uterine adhesions. Fertil Steril 49:944–954 The American Fertility Society (1988) The American Fertility Society classifications of adnexal adhesions, distal tubal occlusion, tubal occlusion secondary to tubal ligation, tubal pregnancies, Müllerian anomalies and intra-uterine adhesions. Fertil Steril 49:944–954
12.
go back to reference Ghi T, Casadio P, Kuleva M, Perrone AM, Savelli L, Giunchi S, Meriggiola MC, Gubbini G, Pilu G, Pelusi C, Pelusi G (2009) Accuracy of three-dimensional ultrasound in diagnosis and classification of congenital uterine anomalies. Fertil Steril 92(2):808–813PubMedCrossRef Ghi T, Casadio P, Kuleva M, Perrone AM, Savelli L, Giunchi S, Meriggiola MC, Gubbini G, Pilu G, Pelusi C, Pelusi G (2009) Accuracy of three-dimensional ultrasound in diagnosis and classification of congenital uterine anomalies. Fertil Steril 92(2):808–813PubMedCrossRef
13.
go back to reference Bermejo C, Ten Martínez P, Cantarero R, Diaz D (2010) Three-dimensional ultrasound in the diagnosis of Müllerian duct anomalies and concordance with magnetic resonance imaging. Ultrasound Obstet Gynecol 35(5):593–601PubMedCrossRef Bermejo C, Ten Martínez P, Cantarero R, Diaz D (2010) Three-dimensional ultrasound in the diagnosis of Müllerian duct anomalies and concordance with magnetic resonance imaging. Ultrasound Obstet Gynecol 35(5):593–601PubMedCrossRef
14.
go back to reference Benacerraf BR, Shipp TD, Bromley B (2006) Improving the efficiency of gynecologic sonography with 3-dimensional volumes: a pilot study. J Ultrasound Med 25(2):165–171PubMed Benacerraf BR, Shipp TD, Bromley B (2006) Improving the efficiency of gynecologic sonography with 3-dimensional volumes: a pilot study. J Ultrasound Med 25(2):165–171PubMed
15.
go back to reference Pilu GL, Ghi T (2010) Preliminary experience with Advanced Volume Contrast Imaging (VCI) and Omniview in obstetric and gynecologic ultrasound. GE Healthcare Pilu GL, Ghi T (2010) Preliminary experience with Advanced Volume Contrast Imaging (VCI) and Omniview in obstetric and gynecologic ultrasound. GE Healthcare
16.
go back to reference Woelfer B, Salim R, Banerjee S, Elson J, Regan L, Jurkovic D (2001) Reproductive outcomes in women with congenital uterine anomalies detected by three-dimensional ultrasound screening. Obstet Gynecol 98:1099–1103PubMedCrossRef Woelfer B, Salim R, Banerjee S, Elson J, Regan L, Jurkovic D (2001) Reproductive outcomes in women with congenital uterine anomalies detected by three-dimensional ultrasound screening. Obstet Gynecol 98:1099–1103PubMedCrossRef
18.
go back to reference Speroff L, Glass RH, Kase NG (1998) Development of the mullerian system. In: Mitchell C (ed) Clinical Gynecologic Endocrinology and Infertility, 6th edn. Lippincott Williams & Wilkins, Baltimore, Md, p 124 Speroff L, Glass RH, Kase NG (1998) Development of the mullerian system. In: Mitchell C (ed) Clinical Gynecologic Endocrinology and Infertility, 6th edn. Lippincott Williams & Wilkins, Baltimore, Md, p 124
19.
go back to reference Lee DM, Osathanondh R, Yeh J (1998) Localization of Bcl-2 in the human fetal mullerian tract. Fertil Steril 70:135PubMedCrossRef Lee DM, Osathanondh R, Yeh J (1998) Localization of Bcl-2 in the human fetal mullerian tract. Fertil Steril 70:135PubMedCrossRef
20.
go back to reference Botsis D, Kassanos D, Pyrgiotis E, Zourlas PA (1995) Sonographic incidence of polycystic ovaries in a gynecological population. Ultrasound Obstet Gynecol 6:182–185PubMedCrossRef Botsis D, Kassanos D, Pyrgiotis E, Zourlas PA (1995) Sonographic incidence of polycystic ovaries in a gynecological population. Ultrasound Obstet Gynecol 6:182–185PubMedCrossRef
21.
go back to reference Acien P (1997) Shall we operate on mullerian defects? Incidence of mullerian defects in fertile and infertile women. Hum Reprod 12:1372–1376PubMedCrossRef Acien P (1997) Shall we operate on mullerian defects? Incidence of mullerian defects in fertile and infertile women. Hum Reprod 12:1372–1376PubMedCrossRef
22.
go back to reference Macdougall MJ, Patel A, Jacobs HS (1992) Polycystic ovaries in association with mullerian duct anomalies. Br J Obstet Gynaecol 99:520–521PubMedCrossRef Macdougall MJ, Patel A, Jacobs HS (1992) Polycystic ovaries in association with mullerian duct anomalies. Br J Obstet Gynaecol 99:520–521PubMedCrossRef
23.
go back to reference Appelman Z, Hazan Y, Hagay Z (2003) High prevalence of müllerian anomalies diagnosed by ultrasound in women with polycystic ovaries. J Reprod Med 48(5):362–364PubMed Appelman Z, Hazan Y, Hagay Z (2003) High prevalence of müllerian anomalies diagnosed by ultrasound in women with polycystic ovaries. J Reprod Med 48(5):362–364PubMed
24.
go back to reference Tzingnunis V, Aiperin H, Natrajan P (1978) Radiographic abnormalities in patients with Stein–Leventhal syndrome. Int J Gynaecol Obstet 16:167–169 Tzingnunis V, Aiperin H, Natrajan P (1978) Radiographic abnormalities in patients with Stein–Leventhal syndrome. Int J Gynaecol Obstet 16:167–169
25.
go back to reference Saravelos SH, Cocksedge KA, Li TC (2008) Prevalence and diagnosis of congenital uterine anomalies in women with reproductive failure: a critical appraisal. Hum Reprod 14(5):415–429CrossRef Saravelos SH, Cocksedge KA, Li TC (2008) Prevalence and diagnosis of congenital uterine anomalies in women with reproductive failure: a critical appraisal. Hum Reprod 14(5):415–429CrossRef
26.
go back to reference Sugiura-Ogasawara M, Sato T, Suzumori N, Kitaori T, Kumagai K, Ozaki Y (2009) The polycystic ovary syndrome does not predict further miscarriage in Japanese couples experiencing recurrent miscarriages. Am J Reprod Immunol 61(1):62–67PubMedCrossRef Sugiura-Ogasawara M, Sato T, Suzumori N, Kitaori T, Kumagai K, Ozaki Y (2009) The polycystic ovary syndrome does not predict further miscarriage in Japanese couples experiencing recurrent miscarriages. Am J Reprod Immunol 61(1):62–67PubMedCrossRef
27.
go back to reference Sorensen S, Balslev E (1987) Uterus didelphys associated with bilateral dermoid cysts and polycystic ovarian disease. Acta Obstet Gynecol Scand 66:171–173PubMedCrossRef Sorensen S, Balslev E (1987) Uterus didelphys associated with bilateral dermoid cysts and polycystic ovarian disease. Acta Obstet Gynecol Scand 66:171–173PubMedCrossRef
28.
go back to reference Pellatt L, Rice S, Mason HD (2010) Anti-Müllerian hormone and polycystic ovary syndrome: a mountain too high? Reproduction 139(5):825–833PubMedCrossRef Pellatt L, Rice S, Mason HD (2010) Anti-Müllerian hormone and polycystic ovary syndrome: a mountain too high? Reproduction 139(5):825–833PubMedCrossRef
29.
go back to reference Woo HY, Kim KH, Rhee EJ, Park H, Lee MK (2012) Differences of the association of anti-Müllerian hormone with clinical or biochemical characteristics between women with and without polycystic ovary syndrome. Endocr J 59(9):781–790PubMedCrossRef Woo HY, Kim KH, Rhee EJ, Park H, Lee MK (2012) Differences of the association of anti-Müllerian hormone with clinical or biochemical characteristics between women with and without polycystic ovary syndrome. Endocr J 59(9):781–790PubMedCrossRef
30.
go back to reference Piouka A, Farmakiotis D, Katsikis I, Macut D, Gerou S, Panidis D (2009) Anti-Mullerian hormone levels reflect severity of PCOS but are negatively influenced by obesity: relationship with increased luteinizing hormone levels. Am J Physiol Endocrinol Metab. 296(2):E238–E243PubMedCrossRef Piouka A, Farmakiotis D, Katsikis I, Macut D, Gerou S, Panidis D (2009) Anti-Mullerian hormone levels reflect severity of PCOS but are negatively influenced by obesity: relationship with increased luteinizing hormone levels. Am J Physiol Endocrinol Metab. 296(2):E238–E243PubMedCrossRef
Metadata
Title
Polycystic ovarian syndrome and congenital uterine anomalies: the hidden common player
Authors
Hisham Ali Saleh
Fady M. Shawky Moiety
Publication date
01-08-2014
Publisher
Springer Berlin Heidelberg
Published in
Archives of Gynecology and Obstetrics / Issue 2/2014
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-014-3193-9

Other articles of this Issue 2/2014

Archives of Gynecology and Obstetrics 2/2014 Go to the issue