Alterations of cardiometabolic risk profile in polycystic ovary syndrome: 13 years follow-up in an unselected population.

PURPOSE: Cardiometabolic risk factors are common in women with polycystic ovary syndrome (PCOS) during reproductive years. The aim of this study was to determine the impact of aging on cardiometabolic risk of the syndrome by examining women who had previously been diagnosed to have PCOS or to be healthy in an unselected population in 2009. PARTICIPANTS: Forty-one women with PCOS who were diagnosed and phenotyped according to the Rotterdam criteria and 43 age- and body mass index (BMI)-matched healthy women from the same unselected cohort. METHODS: All participants were evaluated by structured interview, physical examination, anthropometric, hormonal and biochemical measurements. Additionally, body composition analyses and echocardiographic assessments of 30 women with PCOS and 30 control women were conducted at 13 years of follow-up. RESULTS: There was no difference between the patient and the control groups in terms of anthropometric and body composition measures and metabolic parameters. Echocardiographic assessment showed similar systolic functions, strain measurements and epicardial fat measurements between the groups. PCOS patients still had higher levels of total testosterone, free androgen index (FAI) and dehydroepiandrosterone sulfate (DHEAS) levels compared to controls. Epicardial fat thickness showed positive correlations with BMI, total and truncal body fat, homeostatic model assessment for insulin resistance (HOMA-IR) and free androgen index (FAI). CONCLUSIONS: Aging women with PCOS in the population have higher androgen levels and similar cardiometabolic risk profile compared to age- and BMI-matched healthy women. Epicardial fat thickness, a marker of cardiometabolic risk, appear to be associated with hyperandrogenism. Further research is needed on larger community-based cohorts where older patients are assessed with a longer follow-up.

Revisiting serum beta-human chorionic gonadotropin concentrations as a predictor for dizygotic twinning after in vitro fertilization.

PURPOSE OF INVESTIGATION: To determine a cut-off value for beta-human chorionic gonadotropin (ß-hCG) concentrations to predict dizygotic twinning after in vitro fertilization (IVF) and double embryo transfer (DET). MATERIALS AND METHODS: This retrospective cohort study included 233 women who conceived after DET at IVF center, Hacettepe University Faculty of Medicine. Patients with serum P-hCG concentration 25 IU/l assayed on day 14 after oocyte retrieval were included into the study. RESULTS: Lower serum ß-hCG concentrations were observed in non-viable pregnancy when compared to their viable counterparts. In addition, twins exhibited higher 0- hCG concentrations than singletons did. Receiver operator characteristic (ROC) curve analysis showed a significant relationship between serum ßhCG concentrations and the occurrence of twin pregnancy (area under the curve = 0.85, 95% confidence interval = 0.79-0.91, p < 0.001). For twin pregnancy, when ß-hCG ≥ 175 IU/l, sensitivity was 77.3%, specificity was 80.0%, positive predictive value (PPV) was 48.2%, and negative predictive value (NPV) was 93.8%. CONCLUSION: P-hCG > 175 IU/I might be used as a new cut-off value for early prediction of viable dizygotic twins following IVF-DET treatment cycles.

Adverse perinatal outcomes of adolescent pregnancies in one center in Istanbul, Turkey.

PURPOSE: The objective of this study was to evaluate fetal and perinatal outcomes of pregnancies of adolescents and compare them with adult pregnancies. MATERIALS AND METHODS: This retrospective case-control study was carried out at Bakirkoy Maternity and Children's Diseases Education and Research Hospital in Istanbul, Turkey. It enrolled 2,491 pregnancies who delivered between 2005-2010, of which 998 were adolescent pregnancies and 1,493 were adults as controls. RESULTS: The mean age of the adolescent group was 17.10 years and in the control group the mean age was found to be 26.73 years. Intermarriage, vaginal delivery, preterm rupture of membranes, preterm birth, and preeclampsia were significantly higher in adolescent pregnancies than the control group. Gestational diabetes was more common with increasing age. There was no statistically meaningful difference between the groups in terms of intrauterine growth restriction (IUGR), low birth weight, anemia, 5-minute APGAR score, and intrauterine fetal demise. CONCLUSIONS: Young maternal age is a risk factor for preterm birth, preterm rupture of membranes, and preeclampsia. According to this study, adolescent pregnancies are more risky and more likely to have adverse fetal outcomes.