Distribution and anthropometric characteristics of Rotterdam criteria-based phenotypic forms of Polycystic ovaries syndrome in Ukraine.

OBJECTIVE: To explore the distribution of Rotterdam-based PCOS phenotypes and their associations with anthropometric parameters predictive of cardiometabolic risks in Ukrainian referral PCOS women. STUDY DESIGN: It was a cross-sectional study conducted by the Ukrainian Society of Gynecological Endocrinology between September 2021 and January 2022 involving 42 clinics in 10 regional centres representing the major geographical parts of Ukraine. Two hundred obstetrician-gynecologists whose practice facilities corresponded to study criteria were committed to entering records of their PCOS patients aged 20-45 years into the uniform data collection forms. The recorded parameters were: PCOS phenotype with the mandatory assessment of biochemical hyperandrogenism, age, BMI, waist circumference, and hyperandrogenism symptoms. RESULTS: 5254 patients' records were completed. Phenotype A was the most prevalent - 47.7 %, phenotypes B, C, and D were almost equally distributed in the studied population: 17.6 %, 17.4 %, and 17.3 % respectively. The total prevalence of androgenic phenotypes based on the presence of biochemical hyperandrogenism was 82.7 %. The incidence of obesity and hyperandrogenism symptoms, and mean BMI values were higher in phenotypes A and B compared to C and D. At the same time, the presence of 34.1 % and 46.2 % of normal-weight subjects in phenotypes A and B respectively, supports the fact that the excessive BMI is not a universal characteristic of androgenic phenotypes. In younger age groups, phenotypes C and D demonstrated the predominance of normal weight, but in older subgroups, the situation changed: in the age group of 36-45 y.o. compared to 18-25 y.o., the percentage of overweight and obese subjects for the non-classic phenotypes increased more than for the classic ones: C (OR = 3.91, 95 % CI: 2.41-6.38), D (OR = 4.14, 95 % CI: 2.64-6.52), A (OR = 2.30, 95 % CI:1.72-2.08), and B (OR = 2.56, 95 % CI:1.69-3.89). CONCLUSIONS: In thoroughly assessed Ukrainian referral PCOS population the classic phenotypes prevailed as in other clinical cohorts. The classic phenotypes were characterized by the higher rate of adiposity and severity of clinical hyperandrogenism. At the same time, obese, overweight, and normal-weight subjects were present in all phenotypes, and the risk of obesity in non-classic phenotypes was higher in older age groups.

Female Papillary Thyroid Cancer Survivors Are at Increased Risk of Adenomyosis and Endometrial Hyperplasia.

PURPOSE: Thyroid cancer (TC) is the most common endocrine cancer worldwide, affecting mainly women of reproductive age. However, no data exist about its association with endometrial or uterine disorders. This study aimed to assess the risk of hyperproliferative pathology of the reproductive system in female ТС survivors. METHODS: This was a cross-sectional study of female patients aged 20-45 years diagnosed with papillary TC (PTC) from 1994-2018. Age-matched females with normal thyroid structures served as controls. RESULTS: One hundred and sixteen patients (mean age 36.7±61 years) and 90 age-matched controls were included. PTC survivors demonstrated an increased risk for adenomyosis [odds ratio (OR) 2.5, 95% confidence interval (CI) 1.3-4.8] and endometrial hyperplasia (OR 3.9, 95% CI 1.1-14.3), compared with controls. The risk for adenomyosis was higher after the ten post-operative years (OR 5.3, 95% CI 2.29- 12.05) than during the first 5-10 years (OR 2.3, 95% CI 1.02-5.10) and increased with the number of RAI courses and the degree of TSH suppression. The risk of endometrial hyperplasia was most evident during the first five years post-thyroidectomy (OR 6.0, 95% CI 1.4-25.5), especially in patients with TSH <0.1 mU/L (OR 6.8, 95% CI 1.4-33.28) No difference in uterine leiomyomas or endometrial polyps was found between PTC survivors and controls. CONCLUSIONS: Female PTC survivors are at increased risk of endometrial hyperplasia and adenomyosis compared with those with normal thyroid structures.

The Effect of Gastric Sleeve Resection on Menstrual Pattern and Ovulation in Premenopausal Women with Classes III-IV Obesity.

PURPOSE: Bariatric surgery is very efficacious in treating severe obesity. However, its effect on menstruation and ovulation is currently unknown. The purpose of this study was to assess the effect of gastric sleeve resection (GSR) on menstrual pattern in women with stages III-IV obesity and ovulatory dysfunction compared with conventional management. METHODS: This was a prospective, multicentre, non-randomized trial, in premenopausal women, who fulfilled the criteria for gastric sleeve resection (GSR). Both women with and without polycystic ovary syndrome (PCOS) were evaluated at 3, 6, 9, 12 and 15 months post-surgery. RESULTS: Menstrual cycle irregularities were identified in 122 severely obese women (60 with PCOS; 62 without PCOS). The % total weight loss was greater with GSR than with conventional management (33.4% vs. 3.6% in PCOS; 24.8% vs. 3.6% in non-PCOS, respectively). Intermenstrual interval was shortened towards normal length (≤ 35 days) both in PCOS and non-PCOS GSR groups, by the 6th and 12th post-surgical month, respectively. Furthermore, ovulation at 6 months was achieved in 63.6% of PCOS and 45% of non-PCOS subjects post-GSR, which was higher than in controls (11.1% and 13.6%, respectively; p < 0.05). This percentage rose to 75.7% and 81.8% at 12 and 15 months in PCOS, respectively, but not in the non-PCOS group (55% and 52.5%, respectively; p < 0.05). CONCLUSIONS: Weight reduction after GSR improved menstrual irregularity towards normality in women with severe obesity. Ovulation dysfunction was also resumed in more than half of these patients at 6-15 months. These effects were more evident in women with PCOS.

Serum anti-Mullerian hormone, prolactin and estradiol concentrations in infertile women with endometriosis.

OBJECTIVE: Endometriosis is a benign gynecological disease, which significantly impairs fertility. However, the contribution of specific hormonal parameters to the proper diagnosis of endometriosis in infertility states has not been adequately determined. The aim of this study was to compare ant-Mullerian hormone (AMH), prolactin and estradiol concentrations between infertile women with and without endometriosis, as well as to estimate the effect of endometrioid heterotopia on ovarian reserve. METHODS: In this cross-sectional study, mean baseline serum AMH, prolactin and estradiol levels were assessed in infertile women with and without endometriosis. Descriptive statistics are presented in the form of arithmetic mean ± standard deviation (SD). The comparison of indicators was performed by using parametric (t-test) and non-parametric criteria (Mann-Whitney). RESULTS: Seventy-two infertile women with endometriosis (group A; mean age: 32 ± 4.3 years) and 77 infertile women without endometriosis (group B; mean age: 32.4 ± 3.7 years) were studied. Mean baseline prolactin concentrations were higher in group A (16.9 ± 5.7 ng/mL) compared with group B (15 ± 4.3 ng/mL; p = .023), whereas mean AMH concentrations were lower (2.8 ± 1.9 ng/mL and 3.5 ± 1.8 ng/mL, respectively; p = .018). The highest prolactin and the lowest AMH concentrations were found in women with ovarian endometriomas than in those with deep infiltrative endometriosis and adenomyosis. There was no difference in estradiol levels between groups. CONCLUSIONS: Infertile women with endometriosis demonstrated higher prolactin and lower AMH concentrations, compared with infertile women without endometriosis. The highest prolactin and the lowest AMH concentrations were observed in patients with ovarian endometriomas.