Polycystic ovary syndrome and thrombophilia

BACKGROUND Polycystic ovarian syndrome (PCOS) is a multisystemic and endocrinological syndrome with life time risk and pregnancy complications. Since thrombophilic states may correlate with these complications, this study aimed at loooking at thrombophilic predisposition in PCOS women compared with non-PCOS controls. MATERIALS ANDMETHODS Serum glucose ( at baseline and during 75 gr 2 hour oral glucose tolerance test) and fasting insulin, Follicle stimulating hormone (FSH), Luteinizing hormone (LH), estradiol, 17 hydroxy progesterone, 1,4 delta androstenedione, total testosterone, free testosterone, prolactin, dehidroepiandrosterone sülphate, free T3, free T4, Thyroid stimulating hormon (TSH) Factor II, factor V, factor VII, factor VIII, factor IX, factor XI, factor X, factor XII, factor XIII, prothrombin ve active partial thromboplastin time and bilateral ovarian volumes were measured in two different groups of women, one with PCOS (n: 47) an one without PCOS ( n:51). The prevelance of Antithrombin III, protein S and protein C deficeincies, active protein C resistance, as well as factor V Leiden , prothrombin G20210A, methylene tetrahiydrofolate reductase (MTHFR) mutations was compared between two groups . RESULTS Patients with PCOS had more hirsutizm, acne and infertility and increased ovarian volumes and waist/hip ratio. PCOS group had increased serum free and total testosterone, prothrombin, homocyteine, serum glucose levels during 75 gr OGTT at 90 and 120 minutes but decreased Protein S levels compared to control group. Factor V Leiden and prothrombin G20210A gene mutations were comparable between two groups. There is a slighty higher prevelance of MTHFR C677T heterozygous gene mutation in PCOS group but this difference is not statistically significant. (p: 0,069). CONCLUSION Molecular risk factors of hereditary thrombophilia do not show increased prevalence in women with PCOS in comprasion with women in the general population. The existence of increased serum prothrombin, homocyteine and decreased Protein S levels and a possible trend towards higher prevalence of MTHFR mutation in women with PCOS need further investigation.