Results
There was no statistically significant difference in terms of age between PCOS and control patients, respectively as 31.8 ± 4.4 and 31.9 ± 5. As expected, BMI was found higher in PCOS patient than control (27.2 + 6.2 vs. 23.9 + 4.5, p:0.03). Also, AFC and serum AMH levels were significantly higher in the PCOS group (AFC; 20 (9-20) vs. 12 (9-18) p:0.05, AMH;4.1 ng/ml (2.5-7.2) vs. 2.3 ng/ml (1.6-3.8), p<0.01). There was no statistically significant differences between the PCOS patients and controls in term of serum FSH (5 IU/L (4.2-5.9) vs. 5.4 IU/L (4.4-6.2), p:0.325), Serum LH (3.8 IU/L (2.8-5.6) vs. 3.4 IU/L (2.6-4.1), p:0.09), free testosterone (2.1 ng/dl (1.3-3.4) vs. 1.9 ng/dl (0.6-4.3), p:0.75), DHEASO4 (314 mcg/dl (248-408) vs. 225 mcg/dl (141-348) p:0.1), 17OH Progesterone (1.64 ng/ml (1.1-2.2) vs. 0.9 ng/ml (0.8-2.5) p:0.2) , except serum total testosterone levels (0.59 mcg/l + 0.19 vs. 0.4 mcg/l + 0.16, p:0.02). (Table-1)
HSG results of PCOS and control patients are given in Table-2. The frequency normal intrauterine cavity according to the ASRM classification was found as 51 % and 77 % in the PCOS and control groups, respectively. The difference was statistically significant. According to the ESHRE/ESGE classification, these rates were 66.7 % and 94.2 % in PCOS and control group with statistically significance.
The frequency of sub-septate uterus classified as Va in ASRM, U2a in ESHRE/ESGE (21.6% and 5.8%), septum uteri classified as Vb in ASRM, U2a in ESHRE/ESGE (7.8 % and 0%), dysmorphic uterus classified as VII in ASRM, 1a in ESHRE/ESGE(3.9% and 0) was statistically significant different in PCOS and control groups.
The frequency of arcuate uterus classified as VI in ASRM and considered as normal in ESHRE/ESGE was 16 % and 17.3 % in PCOS and control groups, respectively, without statistically significance.
There were no statistically significant differences between the groups who had normal or abnormal intrauterine cavity in total patient population and PCOS patients as a subgroup in terms of age, BMI, FG Scores, total AFC, Serum AMH-FSH-LH-total testosterone, DHEASO4 - 17OH progesterone levels.
Serum free testosterone levels was found statistically significantly higher in patients with abnormal intrauterine cavity in total population and also in PCOS patients as a subgroup analysis classified as ESHRE /ESGE. (Table-3, Table-4)
A positive correlation was found between free testosterone level and the presence of uterine abnormality in PCOS patients as a subgroup with 2.025 ng threshold value and sensitivity 87.5 % and specificity 59 % (AUC 0.765 with CI (0.569-0.960), p=0.03) (Figure-2)