Hyperhomocysteinemia and pregnancy outcomes in women with polycystic ovary syndrome: A case-control study

Abstract

Background: One of the reproductive medicine challenges is to determine the role of hyperhomocysteinemia in the pathogenesis of polycystic ovary syndrome (PCOS), especially in women with recurrent pregnancy loss (RPL).
 Objective: Determine the correlation between hyperhomocysteinemia and pregnancy outcome in women with PCOS. Materials and Methods: This case-control study involved 245 women (20-30 yr) and was conducted in Georgia, Tbilisi from 2019-2022. Of these, 175 were women with PCOS (study group) and 70 were healthy women (control group). Women with PCOS were divided into group I with RPL (n = 90), and group II with live births (n = 85). Group I was divided into subgroups A and B with and without insulin resistance. The investigation measured homocysteine (Hcy), follicle-stimulating, luteinizing, anti-Mullerian hormones, total and free testosterone were determined. To determine the ovarian volume and antral follicle count, participants also underwent an ultrasound examination.
 Results: In women with PCOS, the average Hcy level was significantly higher than in the controls, p < 0.05. In group I, the average Hcy level was significantly higher than in group II and controls, p < 0.05. There was no significant difference in average Hcy level between group II and controls. The average Hcy level in group I, subgroup A was significantly higher than in subgroup B, p < 0.05. The average total, free testosterone levels, and homeostatic model assessment-insulin resistance levels (HOMA-IR) in group I was significantly higher than in group II and controls. HOMA-IR in group II and controls did not differ significantly. The average anti-Mullerian hormone levels in women with PCOS were significantly higher than controls, p < 0.05. No significant difference was observed in average anti-Mullerian hormone level, ovarian volume, antral follicle count, and body mass index between the comparison groups of PCOS. In group I, a positive correlation between Hcy with HOMA-IR was detected.
 Conclusion: Serum Hcy levels are elevated in women with PCOS and RPL, which correlates with their insulin resistance status.
 Key words: Polycystic ovary syndrome, Hyperhomocysteinemia, Recurrent abortion, Insulin resistance.

The predictive value of homocysteine levels for pregnancy outcomes in PCOS women: A retrospective study

“…Previous research segregated PCOS patients into two groups based on pregnancy outcomes: Group I, those with recurrent pregnancy loss (RPL), and Group II those with successful pregnancies. A comparative analysis revealed a marked difference in their average Hcy levels [21]. This contrast strongly suggests that Hcy levels might be indicative of adverse pregnancy outcomes in PCOS patients.…”

Anti-Müllerian hormone and HOMA-IR in different phenotypes of polycystic ovary syndrome on insulin resistance

“…Polycystic ovarian syndrome (PCOS) is an endocrine disorder that is frequently encountered and affects approximately 5-10% of women of reproductive age worldwide. 1 It is characterized by a heterogeneous collection of signs and symptoms, including menstrual irregularities, hyperandrogenism, and polycystic ovaries. 2 Insulin resistance (IR) is a crucial feature of PCOS, with up to 70% of affected women exhibiting this metabolic abnormality.…”

“…2 Insulin resistance (IR) is a crucial feature of PCOS, with up to 70% of affected women exhibiting this metabolic abnormality. 1 There is a correlation between IR in PCOS and a heightened risk of developing type 2 diabetes, cardiovascular disease, and other adverse health outcomes in the long run. 3 The homodimeric glycoprotein known as anti-mullerian hormone (AMH) is a member of the transforming growth factor-β family and is expressed in the granulosa cells of secondary, preantral, and small antral follicles that have a diameter of 4 mm or less.…”