Follicular phase serum and follicular fluid glycodelin measurements in gonadotropin-releasing hormone (GnRH)-antagonist assisted reproduction cycles: A prospective cohort study.

PURPOSE: To establish the serum pattern for glycodelin and to investigate the possible correlations of serum and follicular fluid (FF) glycodelin with clinical pregnancy in gonadotropin-releasing hormone (GnRH)-antagonist controlled cycles. MATERIALS AND METHODS: A prospective observational study conducted with 80 infertile couples who received a GnRH-antagonist controlled cycle. Glycodelin levels were measured in FF, day 2-3, and ovarian pick-up (OPU)-day serum samples. RESULTS: There were no significant differences in serum glycodelin concentrations in either the early follicular phase or the preovulatory phase, and in FF glycodelin concentrations between clinically pregnant and non-pregnant patients. OPU-day serum glycodelin was found to be significantly higher than early follicular serum glycodelin level in all patients whether pregnancy occurred or not. CONCLUSION: Although day 2-3 and OPU-day measurements of serum glycodelin levels were not significant in predicting clinical pregnancy, the pattern of serum glycodelin seems different in GnRH-antagonist controlled cycles than natural and GnRH-agonist controlled cycles.

The role of laparoscopy in the management of infertility.

The advancement of new perspectives in assisted reproductive technology (ART) through the use of modern infertility evaluation techniques has led clinicians to reassess how infertility should best be treated. The usefulness of laparoscopy in the diagnostic work-up of infertile patients or in patients who are unresponsive to fertility treatments is debatable. The purpose of this review is to define the role of laparoscopy in the management of infertility, which is one of the most controversial aspects of reproductive medicine. To the best of our knowledge, laparoscopy is currently not a routine step in the evaluation of infertile women; every patient and clinical condition must be assessed individually. In this review, we investigated the effectiveness and the utility of laparoscopy as a diagnostic and therapeutic tool in the management of infertility. Various topics and parameters in ART will be discussed based on the evidence that is currently available.

The relationship between urogenital symptoms and climacteric complaints.

OBJECTIVE: To evaluate the relationship between urogenital symptoms and climacteric complaints, including anxiety, depression, somatic, vasomotor and sexual subscores according to the Greene Climacteric Scale (GCS). METHODS: We retrospectively reviewed the records of 1278 patients and the 908 patients who fulfilled the inclusion criteria were included in the study. The relationships were evaluated between GCS and vaginal symptoms, including vaginal pain, dyspareunia, itching, discharge, burning, dryness, and postcoital bleeding, and urinary symptoms, including dysuria, frequency, nocturia and incontinence, by using univariate and multivariate analyses. RESULTS: Among vaginal symptoms, somatic and sexual scores and, among urinary symptoms, anxiety and somatic scores were found to be the most associated factors. Of the vaginal symptoms, the highest odds ratios for somatic score and sexual score were found to be 2.21 (95% confidence interval (CI) 1.69-2.88, p < 0.001) and 2.08 (95% CI 1.70-2.56, p = 0.029), respectively. Multivariate logistic regression analyses for urinary symptoms revealed that the highest odds ratios for anxiety, somatic, depression and sexual scores were 1.53 (95% CI 1.20-1.95, p = 0.001), 1.92 (95% CI 1.38-2.66, p = 0.01), 1.47 (95% CI 1.11-1.94, p = 0.007), and 1.28 (95% CI 1.06-1.55, p < 0.001), respectively. CONCLUSIONS: There is a strong relationship between urogenital symptoms and GCS subscores. Therefore, clinicians should be aware of urogenital problems in the presence of severe climacteric symptoms and this may provide earlier treatment for urogenital complaints.

Is placebo as effective as estrogen regimens on vasomotor symptoms in women with surgical menopause?

OBJECTIVE: To evaluate the short-term effects of two hormone therapy (HT) regimens and placebo on the Greene Climacteric Scale (GCS) of women with surgical menopause following six months of treatment. METHODS: This 6-month, prospective, randomized, parallel-group, masked evaluator study compared the efficacy of once daily administration of 0.625 mg conjugated equine estrogen (group I), 3.9 mg transdermal 17beta-estradiol patch applied every week (group II) and placebo (group III). Mean GCS before and after six months of treatment in each group was compared. RESULTS: In groups I and II, vasomotor symptoms (p < 0.005, p < 0.05), somatic symptoms (p < 0.05, p < 0.05) and total score (p < 0.005, p < 0.01) significantly reduced from baseline values respectively, while the other subscores revealed no statistically important differences following six months of HT. In group III, vasomotor (p < 0.05), subscore and total score (p < 0.05) decreased significantly while other subscore reductions were not significant. CONCLUSIONS: Estrogen regimens and placebo seem to be effective in alleviating vasomotor symptoms. Additional larger prospective randomized studies need to be conducted in an aim to look at not only short-term but also long-term effects on climacteric symptoms, in comparison to both placebo arms and different dose and mode of HT use.

Cytokine and immune cell levels in peritoneal fluid and peripheral blood of women with early- and late-staged endometriosis.

OBJECTIVE: To investigate the level of cytokines and immune cells in the peripheral blood (PB) and peritoneal fluid (PF) of different stages of endometriosis. METHODS: A prospective study was conducted to include 97 women with (n 60) and without (n 37) histopathologically confirmed endometriosis. Based on rASRM classification, stage I/II and stage III/IV were categorized as early-and late-staged endometriosis. Prior to surgery, 10 ml of blood was withdrawn from antecubital vein and serum was obtained. Aliquots were made and stored at -70 degrees C until assayed for cytokines. PF was aspirated from the pouch of Douglas. Peripheral and PF samples were analyzed by ELISA in terms of IL-2, IL-4, IL-10 and IFN-gamma. Determinations of T helper, T suppressor, NK, and B cells were assessed by using cluster determinant-3 (CD-3), CD4, CD8, CD25, CD28, CD45, CD16, CD23 and antibodies against early T cell activation antigens such as CD45RA/CD45RO, CD-69 and late activation antigens such as HLA-DR. A multiparameter flow cytometry was applied to detect the cell activation antigen expression. RESULTS: In terms of cytokine levels in PB and PF's of control group and early- and late-staged endometriosis cases, no significant difference was depicted in the cytokine levels (p > 0.05). Levels of immune cells did not differ between three groups (p > 0.05). CONCLUSIONS: The result of this study did not show any significant difference in PB and PF cytokine and lymphocyte subgroups between normal and early- and late-staged endometriosis.

Apoptosis patterns in eutopic and ectopic endometrium, adhesions and normal-looking peritoneum from women with or without endometriosis.

OBJECTIVE: To assess the apoptosis rate in eutopic and ectopic endometrial stromal and glandular cells, normal peritoneum and adhesions in women with endometriosis. METHODS: A total number of 97 women with (n:60) and without (n:37) histopathologically confirmed endometriosis who underwent laparoscopy or laparotomy in the early follicular phase of the menstrual cycles for pain and infertility were included in this study. Stage I/II and stage III/IV were categorized as early staged and late-staged endometriosis. The endometrial samples were obtained with a Novack cannula from the corpus of the uterus. Normal-looking peritoneum, peritoneal implants and adhesions were sampled and fixed in formaldehyde for immunohistochemical staining with Bcl-2 and Bax. Tissue samples were fixed in formaldehyde for the assessment of apoptosis via terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling (TUNEL) and M30 cytoDEATH antibody. RESULTS: The intensity of Bax staining of normal-looking peritoneum in early staged endometriosis was higher, compared to women with late-staged and women without endometriosis (P = 0.03). However, degree of Bcl-2 staining did not differ among early and late-staged endometriosis and women without endometriosis (P = 0.1). In terms of Bcl-2 and Bax staining in the stromal and glandular parts of the eutopic endometria, no significant differences were detected among three groups. In cases with early- and late-staged endometriosis the intensity of Bax and Bcl-2 stainings did not differ in both stromal and glandular parts of ectopic endometria. Number of cells with positive apoptotic signals assessed via TUNEL (P = 1.0) and M30 cytoDEATH antibody (P = 0.59) in normal-looking peritoneum did not differ between three groups. In addition, no difference in term of numbers of apoptotic cells obtained from adhesions was observed between three groups (for TUNEL, P = 0.29, for M30, P = 0.19). CONCLUSIONS: Apoptosis patterns did not differ in the eutopic and ectopic endometria as well as adhesions of women with or without endometriosis.

Effect of cigarette smoke and alpha-tocopherol (vitamin E) on fertilization, cleavage, and embryo development rates in mice: an experimental in vitro fertilization mice model study.

OBJECTIVE: The objective was to elucidate the effects of cigarette smoke per se or vitamin E on mice exposed to cigarette smoke, with regard to fertility and cleavage rates, and embryo development in an experimental in vitro fertilization (IVF) mice model. STUDY DESIGN: Female and male mice, weighing 18-25 g and aged 14-16 weeks, were separated and divided into cigarette smoke-exposed (SE) and non-smoke-exposed (NSE) groups. A specially designed cage with a cigarette smoking machine was constructed. The SE (20 cigarettes/day) group was put in the cage for 10 weeks. SE and NSE female and male mice were given 50mg/kg of vitamin E intraperitoneally for 10 weeks and were cross-mated thereafter so as to produce seven different subgroups of mice population as follows: group I-NSE male and female mice (control); group II-SE female mice and NSE male mice; group III-NSE female with SE male mice; group IV-SE male and SE female mice; group V-SE female mice treated with vitamin E and SE only male mice; group VI-SE only female and male mice treated with vitamin E; and finally group VII-vitamin E-treated SE male and female mice. Following superovulation with FSH, follicles of female mice were obtained via laparotomy under high-dose ether. Male mice testicles were retrieved via the same surgical procedure. Both gametes were obtained and used for IVF. Fertilization, cleavage rates, and day 3 embryo grading were assessed in four groups. RESULTS: With regard to fertilization rate, group II (36%) significantly differed from group I (85%, p=0.002), group III (68.7%, p=0.04), but not from group IV (20.6%, p=0.34). Taking embryo development rate into consideration, group II (32%) had a lower percentage of embryo development compared with group I (75%, p<0.01) and group III (62.5%, p<0.001), but not group IV (17.2%, p=0.42). Percentages of embryo cleavage, embryo development, and day 3 grade I embryos did differ among four of the groups (p>0.05). CONCLUSIONS: Fertilization and cleavage rates were mainly affected in the SE female mice population. The impact of vitamin E on fertilization, cleavage, and embryo development rates was not relevant among SE male and SE female mice.

Effect of smoking on semen parameters of men attending an infertility clinic.

OBJECTIVE: To assess the effects of smoking on total sperm count, progressive sperm motility and sperm morphology among couples attending an infertility clinic. METHODS: A total of 223 sperm samples (126 smokers and 97 nonsmokers) from men attending an infertility clinic for routine infertility workup were compared on the basis of standard semen analysis. RESULTS: Cigarette smoking is negatively correlated with progressive motile sperm count (r = -0.1464, p = 0.042), but not with sperm concentration (p = 0.961), total motile sperm count (p = 0.890) and sperm morphology (p = 0.838). Furthermore, packages/ year (cumulative dose of cigarettes) did not correlate with any of the sperm parameters including sperm density (p = 0.976), total (p = 0.559) and progressive (p = 0.406) motile sperm count and sperm morphology (p = 0.449). CONCLUSIONS: Although the effect of smoking on male infertility remains inconclusive, smoking had an adverse effect on the progressive sperm motility, irrespective of total amount of cigarettes smoked per day.

Possible factors affecting the age at menopause among women in the central anatolian region of Turkey.

OBJECTIVE: We aimed to investigate the age at menopause and possible related factors in a Turkish population. STUDY DESIGN: In a three-year period, a retrospective analysis of 541 spontaneous menopause cases were evaluated. All postmenopausal women with spontaneous cessation of menses for > or = 12 months and serum FSH levels > 40 IU/l were included in the study. Sociodemographic status, reproductive and medical history, menopausal symptoms, and previous contraceptive and hormonal therapy use were assessed based on an interview using a standardized information system. Age at menarche, parity, menopausal age of mother and sister, history of lactation, physical activity, cigarette smoking, oral contraceptive use and body mass index (BMI) were assessed. RESULTS: Menopausal age of the enrolled cases was positively correlated with mothers and sisters' ages at menopause. Postmenopausal smokers had an earlier age at menopause compared to non-smokers. CONCLUSION: Cigarette smoking results in earlier menopause in the Turkish population. Menopausal ages of mothers and sisters clearly correlated with the age at menopause.

Isolated torsion of fallopian tube during pregnancy; report of two cases.

Isolated torsion of fallopian tube is very uncommon during pregnancy. Predisposing factors for torsion are hydrosalpinx, prior tubal operation, pelvic congestion, ovarian and paraovarian masses and trauma. Although the most important clinical symptom is abdominal pain in lower quadrants, the diagnosis is usually established during the operation performed for acute abdomen and salpingectomy is almost always necessary. Two cases of torsion of fallopian tube during pregnancy, one with hydrosalpinx, the other with paratubal cyst are presented and symptoms and predisposing factors are discussed.

Doppler and B-mode ultrasonography in biophysical profile scoring.

OBJECTIVE: Biophysical profile scoring (BPS) is a valuable antepartum test for establishing fetal well-being, although the time constraint in some clinics limits its extensive use. In this study we attempted to shorten the total test time without excluding any of the test components. METHOD: The non-stress test (NST) part of the BPS was performed using simultaneous pulsed wave Doppler and B-mode ultrasonography (duplex NST). It was possible to observe all the components of the BPS during the same period (duplex BPS). RESULTS: Fifty-four tests were performed on 40 pregnant patients. The mean test time was 14.3 min. A discrepancy was shown between the ultrasonographic observation and the women's perception of the fetal movements in 46% of the tests. CONCLUSION: Duplex NST is considered a more reliable test than the classical cardiotocographic NST. Duplex BPS is proposed as an easy-to-perform, compact and time-saving modification to the classical BPS.

Short-term intravaginal maximal electrical stimulation for refractive detrusor instability.

OBJECTIVES: To determine the efficacy of intravaginal maximal electrical stimulation for the treatment of refractive detrusor instability. METHODS: Thirty-five consecutive patients, treated by maximal electrical stimulation for pure refractive detrusor instability were evaluated subjectively by patient's questionnaires and 24-h urinary diary and objectively by 1-h standardized pad test and subtracted cystometry before and 1 week after the treatment. Paired-t and chi(2)-tests were used for the statistical analysis of the data. RESULTS: Thirty-one (88.6%) of the 35 patients were found to be either cured or improved, subjectively. The overall objective success rates based on the 1-h pad test and subtracted cystometry were 80.0% and 74.3%, respectively. The results of all subjective and objective assessment tests, except postvoiding residual urine volume, improved significantly after the treatment (P<0.01). No significant adverse effect related to the treatment was observed, except vaginal irritation noted only by 5 (14.3%) patients. CONCLUSION: Maximal electrical stimulation could offer a safe, non-invasive and effective treatment for patients with detrusor instability who respond poorly to other conservative therapies.

Factors affecting the contraceptive choice in a developing country.

OBJECTIVES: To evaluate the factors affecting the contraceptive choice of women in a developing country. METHODS: Demographic characteristics, education and income level, previous and current contraceptive choices of the women from a maternity and a university hospital were retrospectively reviewed for 2 years. The data obtained from the two hospitals were analyzed by Student's t- and chi2-tests. RESULTS: Family planning services were offered to 651 and 7427 women in the university and the maternity hospital, respectively. Although the mean ages and income levels of the women in two centers were similar, the women in the university hospital had lower mean gravidity and mean number of living child, while they had higher education level and previous modern contraceptive use (P < 0.05-0.001). The women in the university hospital more frequently preferred combined oral contraceptive and surgical sterilization, while those in the maternity hospital chose condom and intrauterine device (P < 0.01-0.001). CONCLUSIONS: Women with higher education level had a lower number of pregnancies and living children due to more frequent use of previous effective contraception and they chose combined oral contraceptives and irreversible methods more frequently.

Effects of postpartum corticosteroids in patients with HELLP syndrome.

OBJECTIVE: To evaluate the effect of corticosteroid treatment on the postpartum recovery of parturients with HELLP syndrome. METHOD: Thirty cases with HELLP syndrome were randomly assigned to a study or a control group, each including 15 patients. A total dose of 30 mg intravenous dexamethasone was given to the study group during the 36 h following the childbirth, while the control group did not receive any steroid medication. Arterial blood pressure, urine output, hematocrit ratio, platelet count, serum alanine and aspartate aminotransferases and uric acid levels were monitored during the first 48 h postpartum. The data were analyzed by unpaired t-test, chi2 or Fisher's exact tests. RESULT: Before the treatment, no significant difference was observed between the two groups. The study group showed statistically significant improvement in mean arterial blood pressure, mean serum aspartate aminotransferase level, mean urine volume per hour and mean platelet count (P < 0.05). Length of hospitalization was also shorter in the study group (P < 0.01). CONCLUSION: Early postpartum high-dose corticosteroid treatment accelerates the recovery and shortens the hospitalization of the parturients with HELLP syndrome.

Ultrasonographic detection of single umbilical artery: a simple marker of fetal anomaly.

OBJECTIVE: To detect associated anomalies, karyotypes and perinatal prognosis of fetuses with single umbilical artery. METHOD: Fifteen fetuses who have single umbilical artery were evaluated in the obstetrical ultrasonography and medical genetics departments of Osmangazi University. RESULTS: Fifteen fetuses with single umbilical artery were detected during antenatal ultrasonographic examinations. Associated sonographic abnormalities include oligohydramnios (two), intrauterine growth retardation (one), renal agenesis (one), fetal ascites (one), diaphragmatic hernia (one), hydrocephalus (two), and meningomyelocele (one). Complications related to the pregnancy were pre-eclampsia in one case and abruptio placenta in another. Karyotype analysis was available in 11 cases and the only cytogenetic abnormality detected was trisomy 18 in one case. Two cases with hydrocephalus and single umbilical artery were delivered by cesarean section at 34 and 38 weeks, but both died (on the first and fifth days after birth). Five pregnancies were terminated because of intrauterine death (one), severe pre-eclampsia (one), cytogenetic abnormality (one), and multiple congenital anomalies associated with single umbilical artery (two) at 36, 27, 22, 26 and 29 weeks, respectively. Eight of the neonates who had no additional congenital or cytogenetic abnormality were completely normal at birth and during the neonatal period. Diagnoses were confirmed pathologically in all cases. CONCLUSION: Scanning the umbilical cord should be one of the essential parts of ultrasonographic examination. When single umbilical artery is detected, a detailed ultrasonographic examination is necessary to rule out associated abnormalities. We advise fetal karyotyping even when no additional pathology can be detected on ultrasonographic examination.

Second-look laparotomy; factors affecting the results and the prognosis.

OBJECTIVE: To define the factors which might effect the results of second-look laparotomy (SLL) and the prognosis of patients with negative SLL. METHODS: Fourteen (42.4%) of the 33 patients who underwent SLL for primary epithelial ovarian cancer had residual disease (positive SLL), while 19 (57.6%) of them had no evidence of disease (negative SLL); 13 (68.4%) of the 19 patients who were followed without any intervention, still had no evidence of disease, while 6 (31.6%) of them had clinical recurrences. The age of the patients, histopathological type, stage and grade of the cancers, type of chemotherapy and the effectiveness of the cytoreductive surgery were presumed as prognosticators and were compared in each group of patients. RESULTS: The age of the patients, histopathological type of the carcinomas and the type of combined chemotherapy were similar in patients with negative or positive SLL and those with recurrences or no evidence of disease during the follow-up after negative SLL (p>0.05). However, the groups of patients with negative SLL and those with no evidence of disease during the follow-up period had lower grade or stage of cancers and less frequent sub-optimal cytoreduction than the groups of patients with positive SLL and those with recurrences during the follow-up, respectively (p<0.05). CONCLUSION: SLL could be selectively performed in patients with high grade or high stage ovarian carcinoma or in those patients treated by sub-optimal cytoreduction.

Surgical intervention for adnexal masses during pregnancy.

We aimed to evaluate the influence of surgical intervention on gestational and neonatal outcomes in women who underwent elective surgery in the second trimester of gestation because of an adnexal mass. We retrospectively reviewed the hospital records of women who underwent elective surgery for adnexal masses in the second trimester of gestation between 2006 and 2012. The ages of the women ranged between 17 and 33 years. Eight women underwent a laparotomy, and one woman, who aborted on the day of the operation, underwent a laparoscopy. Dermoid cysts, cystadenoma and borderline ovarian tumours were present in four, two and two of the women, respectively. Eight women had no complications after surgery and delivered healthy newborns at term. We concluded that elective surgery on an adnexal mass in the second trimester of gestation is safe for both the mother and the fetus.

Impact of piroxicam beta-cyclodextrin on the efficacy of the intrauterine device in a rat model.

OBJECTIVE: To elucidate the effect of piroxicam beta-cyclodextrin (PbetaCD), a non-steroidal anti-inflammatory drug (NSAID), on the efficacy of the intrauterine device (IUD) in a rat model. METHODS: Forty nulliparous female Wistar rats were allocated to one of four groups, comprising each 10 of these animals. Group I: neither IUD nor medication; group II: IUD, but no medication; group III: IUD and PbetaCD; and group IV: PbetaCD only. In groups II and III, a string of 3/0 silk suture of 2 cm long was transcervically placed in one of the horns of the bicornuate uterus of the rat. Rats in group III were treated during the 18 days following IUD placement with 3 mg/kg/day PbetaCD administered via a feeding tube; group IV received PbetaCD for the same length of time, but had no IUD inserted. The rats were then mated. Thereafter, vaginal smears were taken and assessed daily, in the early morning, for the presence of spermatozoa. The day when spermatozoa were detected was considered to be the first day of gestation. On gestational day 19, both uterine horns of all rats were evaluated for the presence and number of embryos. RESULTS: In group II, mean embryo counts in the horn with or without IUD were 1.0 +/- 0.2 and 4.5 +/- 0.3, respectively (p < 0.01). The comparison of group II with group I showed that the presence of an IUD in one horn did not affect the mean embryo counts in the contralateral horn (4.5 +/- 0.3 versus 5.1 +/- 0.9, p > 0.05). In groups II and III, mean numbers of embryos in the horn with IUD were 1.0 +/- 0.2 and 2.7 +/- 0.4, respectively (p < 0.01). No difference in the mean embryo counts was observed between group I (5.1 +/- 0.9) and IV (4.8 +/- 0.9; p > 0.05). CONCLUSIONS: The IUD had a contraceptive effect in the rat model. The IUD in one horn did not affect the number of embryos in the contralateral horn. In this model, IUDs appear to exert a local effect, i.e. counteracted by PbetaCD. This drug had no adverse effect on the fertility of rats without IUD in situ.

Comparison of clinical and laboratory characteristics of cases with polycystic ovarian syndrome based on Rotterdam's criteria and women whose only clinical signs are oligo/anovulation or hirsutism.

This study was an attempt to determine whether the hormonal and clinical profiles of polycystic ovarian syndrome (PCOS) or non-PCOS cases whose only admission signs were oligo/anovulation or hirsutism. This retrospective study comprised a total number of 118, age-matched, young Turkish women with initial admission signs and symptoms of menstrual disorders (MD) like oligo/anovulation or hirsutism. Of these, 66 cases were diagnosed as PCOS, based on 2003 Rotterdam criteria [presence of two of first three criteria such as oligo- and/or anovulation, signs of clinical hyperandrogenism (HA-c) and/or biochemical signs of hyperandrogenism (HA-b) and polycystic ovaries on ultrasonography after exclusion of specific identifiable disorders]. Fifty-two women were diagnosed as cases of oligo/anovulation or hirsutism before the era of PCOS Rotterdam's consensus criteria. These two PCOS and non-PCOS cases were evaluated in terms of body mass index (BMI), waist-to-hip ratio, serum FSH, LH, estradiol (E2), dehydroepiandrosterone sulphate (DHEAS), androstendione (A) 17 hydroxyprogesterone (17-HP), fasting insulin, C-peptide levels, sex hormone-binding globulin (SHBG) and finally, ultrasonographic ovarian morphology. PCOS cases with unilateral and bilateral polycystic ovarian morphology on ultrasound scan were analyzed based on Rotterdam criteria. No statistically significant difference was detected among two groups, in terms of BMI, waist-to-hip ratio, serum FSH, LH, E2, fasting insulin, C-peptide levels (P > 0.05). However, blood levels of DHEAS, A and 17-HP were higher, whilst SHBG levels were remarkably lower (P = 0.008) in PCOS cases. Among PCOS group, hormonal and clinical characteristics did not differ, irrespective or uni- or bilaterality of ovarian morphology on ultrasonographic scan. Percentages of cases with androgenic alopecia, oily skin/acnea and increased ovarian volume were higher in PCOS group; whereas Ferriman-Gallwey score >/= 8 were similar between two groups. Total but not free testosterone remained high in PCOS group (P < 0.01). In both PCOS and non-PCOS cases, a linear correlation was apparent between BMI and insulin levels (r (s )= 0.69 and 0.32, P < 0.05, respectively). Among PCOS group, MD + HA-b + HA-c (n = 40) was present in 60.6% of subjects, MD + HA-b (n = 12) in 18.2%, and MD + HA-c (n = 14) in 21.2%. The three phenotypes did not differ in mean BMI, waist-to-hip ratio and biochemical characteristics. To conclude, non-PCOS women with only sign or symptom of oligo/anovulation or hirsutism had a more favorable endocrine milieu. These cases should be followed in vigilance in an aim to confront the development of short- and long-term adverse effects of impending PCOS in the future. Furthermore, different phenotypes of PCOS cases were clinically or biochemically similar in characteristics.