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ABSTRACT
Objective
To study whether application of the new 2018 guidelines for the diagnosis of Polycystic Ovary Syndrome (PCOS) would decrease the diagnosis of PCOS. Secondarily, to compare the metabolic profiles of women included and excluded in this new definition.
Design
Retrospective cross-sectional chart review.
Setting
University-affiliated hospital system.
Patients
Women, ages 12-50 with the International Classification of Diseases (ICD) code ‘Polycystic Ovary Syndrome’ in 2017.
Intervention
Application of the new 2018 guidelines for the diagnosis of PCOS
Main Outcome Measures
The primary outcome was retention of PCOS diagnosis after application of the new 2018 guidelines. Secondary outcomes included comparison of metabolic risk factors. Analysis was performed using Chi-square tests for categorical variables and unpaired T-tests for continuous variables, with a p-value <0.05 determined to be significant.
Results
Of 258 women with PCOS based on Rotterdam criteria, only 195 (76%) met criteria based on the new 2018 guidelines (p<0.001). Those women who only met Rotterdam criteria (n=63) had significantly lower body mass indexes (BMI) (32.7 vs 35.8, p=0.01), lower total cholesterol levels (151 vs 176 mg/dL, p=0.003), lower triglyceride levels (96 vs 124 mg/dL, p=0.04), lower total (33.2 vs 52.3 ng/dL, p<0.001) and free testosterone levels (4.7 vs 8.3, p<0.001), lower AMH levels (3.1 vs 7.7 ng/mL, p=0.01), and were more likely to be multiparous (50% vs 29%, p=0.01) than women who met 2018 criteria.
Conclusion
Increasing the minimum antral follicle count to ≥20 antral follicles significantly decreases the number of women with the diagnosis of PCOS. Furthermore, the women that meet the new criteria have more health risks for metabolic syndrome than those who only meet Rotterdam criteria.
Keywords
Article info
Publication history
Accepted:
December 19,
2022
Received in revised form:
December 16,
2022
Received:
June 12,
2022
Publication stage
In Press Accepted ManuscriptFootnotes
Financial Support: None
An abstract of this project was presented at the ASRM Scientific Congress & Expo 2020 held virtually October 19-21, 2020, and published in Fertility and Sterility in September 2020.
Identification
Copyright
© 2022 The Authors. Published by Elsevier Inc. on behalf of American Society for Reproductive Medicine.
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