The Effect of Ageing on Clinical, Hormonal and Sonographic Features Associated with PCOS—A Long-Term Follow-Up Study

Abstract

The knowledge of polycystic ovary syndrome (PCOS) natural history is limited. Our objective was to assess the effect of aging on clinical, hormonal and sonographic ovarian PCOS features and additionally to identify parameters that impact the course of PCOS. A secondary aim was to supply additional information on the reproductive outcome in women with previously diagnosed PCOS. A longitudinal cohort study with a median follow-up of 120.9 months was conducted, and 31 Caucasian women previously diagnosed with PCOS according to the Rotterdam criteria were re-examined at a median age of 35. Clinical examinations; transvaginal ultrasound scans; and lipid, E-selectin and sex hormone assessments were performed at the beginning and at the end of the follow-up. It was observed that menstrual cycles became regular and sonographic morphology of ovaries was normalized in 55% and 49% of the participants, respectively (all p < 0.05). At the final assessment, 55% of the women no longer met the criteria for PCOS (p < 0.05). The age, follicle-stimulating hormone (FSH) and E-selectin assessed at the baseline were the most important predictors of the PCOS persistence into later years (respectively, OR = 0.84, OR = 0.39, OR = 1.08, all p < 0.05). Ninety-five percent of the patients who had ever been trying to conceive became pregnant a minimum of once. The women with persistent PCOS had worse metabolic and reproductive parameters compared to the women with resolved PCOS. Positive correlations were found between the number of miscarriages and ovarian volume, LH, androstenedione, 17-hydroxyprogesterone and an increase in E-selectin during the follow-up (R = 0.46, R = 0.59, R = 0.54, R = 0.49, R = 0.47, all p < 0.05). In conclusion, progressing from the third to the fourth decade is connected with a reduction in PCOS features, which seems to have a great impact on fertility of women with a previous diagnosis of PCOS. FSH and E-selectin, as determined at the initial PCOS diagnosis, had an impact on the disappearance of the syndrome years after.

Prediction model of persistent ovulatory dysfunction in Korean women with polycystic ovary syndrome

“…For instance, women without persistent ovulatory dysfunction were older than women with persistent ovulatory dysfunction. Similarly, other studies have reported shorter and more regular menstrual cycle lengths in women with PCOS as they were getting older 41,42 . Also, postprandial glucose and high‐density lipoprotein levels were statistically different according to persistent ovulatory dysfunction (Table 1).…”

“…Similarly, other studies have reported shorter and more regular menstrual cycle lengths in women with PCOS as they were getting older. 41,42 Also, postprandial glucose and high-density lipoprotein levels were statistically different according to persistent ovulatory dysfunction (Table 1). However, they did not demonstrate any statistical significance (p = 0.21 and 0.15, respectively) in likelihood ratio tests after they were added to Model 3.…”

The Effect of Age on IVF-ET Outcome in Infertile Patients with PCOS Based on Tiangui Theory in Chinese Medicine

“…The fertility window of PCOS patients may extend to 40 years of age, but at ages, over 40 years old come declining ovarian reserve, the poor effect of ovulation-stimulating treatments, and a low pregnancy rate [ 19 ]. Despite serum AMH decreases over time in all of the women, the decrease in the PCOS patients was less pronounced than in controls, and this may suggest better preservation of the ovarian reserve and thus a prolonged reproductive life span [ 20 ]. A study showed that the live birth rate and cumulative live birth rate in PCOS patients aged 35–40 years were significantly higher than in the control group [ 11 ].…”

Trabecular bone density in middle-aged women with reproductive disorders

“…PCOS is associated with central obesity, dyslipidemia, hypertension, and insulin resistance ( 7 ), which all have been described to decrease BD ( 8 , 9 , 10 , 11 ). However, hyperandrogenism, one of the key diagnostic criteria of PCOS, could have a protective effect on BD ( 12 ). Furthermore, PCOS is associated with prolonged menopause which could lead to longer estrogen exposure and may result in a delay of loss of BD ( 13 , 14 ).…”