Comparison of docosahexaenoic acid (DHA) serum and cervicalmucus sample values in patients with polycystic ovary syndrome (PCOS) and the control group

Aim: As in the pathophysiology of many chronic diseases, chronic inflammation is also involved in polycystic ovary syndrome. Docosahexaenoic acid (DHA), one of the omega 3 fatty acids taken with dietary components, has anti-inflammatory effects. In this study, we aimed to compare the values of DHA in serum and cervical mucus samples in patients with polycystic ovary syndrome with the control group. Material and Method: This cross-sectional study was carried out in the Obstetrics and Gynecology Polyclinic of Recep Tayyip Erdogan University Training and Research Hospital, Department of Obstetrics and Gynecology. After the women were informed about the study, their voluntary written consent was obtained. In this study; Forty-two patients (each group 42), aged between 18-40 years, from the PCOS and control groups were included. Rotterdam diagnostic criteria were used in the diagnosis of PCOS. Women with a diagnosis and suspicion of malignancy, women in the postmenopausal period, patients with pregnancy diagnosis, congenital adrenal syndrome diagnosis, and patients who received oral contraceptive therapy for the last 3 months were not included in the study. Fasting blood glucose, lipid profile, beta human chorionic gonadotropin (hCG), luteinizing hormone (LH), follicle stimulating hormone (FSH), estrogen, progesterone, total testosterone (TT), 17-α hydroxyprogesterone (17- α OHP), Dihydroepiandrostenedione sulfate (DHEA-S) hormone levels were checked. In addition cervical mucus samples and blood samples were taken from the women. The serum and cervical mucus samples obtained by centrifuging the blood samples into a biochemistry tube were stored at -80 °C until they were studied. When the target number of patients and control groups was reached, DHA levels in the samples were determined by thawing all samples and using ELISA kits. Results: The data of 84 patients included in the study were analized. In the comparison of the baseline demographic data between the groups; age, BMI, parity, number of living children, abortion, mFGS score, number of antral follicles, increase in ovarian volume, PCO morphology, hyperandrogenism, hyperandrogenemia, hirsutism signs, clinical oligomenorrhea or complaint of amenorrhea was found statistically significant in the xvii PCOS group (p<0.05). When the PCOS phenotype distribution of the patients diagnosed with PCOS was examined, it was determined as Phenotype A 33 (78.6%), Phenotype C 6 (14.3%), and Phenotype D 3 (7.1%). In the comparison of basal hormone parameters of both groups, mid-luteal progesterone, LH, LH/FSH ratio, TT, 17-OH-Progesterone were found to be statistically significantly higher in the PCOS group (p<0.05). When we look at the comparison of the lipid profile and anthropometric measurements between the two groups; waist circumference and waist/hip ratio were statistically significantly higher in the PCOS group (p<0.05). Both groups were similar in terms of hip circumference, total cholesterol, HDL, triglyceride, LDL, FPG (p>0.05). The difference between the serum DHA averages of the two groups included in the study was found to be statistically significantly higher in the PCOS group (p<0.05). Both groups were similar in terms of cervical mucus DHA and serum CRP (p>0.05). The ratio of serum and cervical mucus DHA levels of the patients in the PCOS group was 361,95/197,55=1,83. The serum and cervical mucus DHA ratio of the women in the control group was 268,12/221,83=1,2. When the ratios of serum and cervical mucus DHA levels of the two groups were compared, it was found that the ratio of serum and cervical mucus DHA levels in the PCOS group was 1,52 times lower than in the control group. Conclusion: Serum DHA level was found significantly higher in patients with PCOS compared to the control group, and both groups showed similarity in terms of cervical wash DHA ratios. We think that the high serum DHA level and the lower cervical mucus serum values (Serum/cervical mucus ratio in PCOS patients compared to the control group) are due to the inability to metabolize DHA in PCOS patients. Our research is the first study of the literature in its field, and further studies with a large series are needed on this subject. 2023, 117 pages Key words: Polycystic ovary syndrome (PCOS), Docosahexaenoic acid (DHA), cervical mucus, fatty acids, omega 3