Hormone Imbalance in Women with Infertility Caused by Polycystic Ovary Syndrome: Is There a Connection with Body Mass Index?

BACKGROUND: The most common cause of female infertility is ovulation disorders, and the most common non-ovulatory cause is polycystic ovary syndrome (PCOS). AIM: The aim of the study was to define the reproductive hormone levels in women with infertility due to PCOS, depending on the body mass index (BMI). PATIENTS AND METHODS: The present study involved 100 women aged 25–39 years with infertility due to PCOS (PCOS group) and 30 women of the same age with infertility due to tubal-peritoneal causes (control group). Infertility due to PCOS was diagnosed according to the Rotterdam criteria. Hormone levels (anti-Müllerian [AMH], follicle-stimulating [FSH], luteinizing [LH], prolactin, estradiol, and testosterone) in blood serum were determined by ELISA. RESULTS: We detected a correlation between BMI and sex hormone levels as well as LH/FSH ratio. Notably, the ratio of LH/FSH in women with PCOS was significantly different compared to the control group, while at the same time, PCOS was significantly more frequent in overweight and obese patients compared to those with normal BMI. For instance, the LH/FSH ratio was 30.35% higher in women with Class 2 obesity than in the group of women with normal weight. However, in women with both PCOS and Class 3 obesity, the LH/FSH ratio was the lowest among those with a BMI of 25.0-39.9. CONCLUSIONS: We found a hormonal imbalance in women with infertility caused by PCOS: Increased levels of AMH and LH, estradiol, and testosterone and decreased FSH levels. Analysis of the relationship between the concentration of reproductive hormones and BMI showed a weak inverse relationship between BMI with FSH levels, as well as a direct correlation with the levels of LH, prolactin, estradiol, and testosterone, and LH/FSH ratio. Thus, obesity exacerbates the hormonal imbalance in women with infertility caused by PCOS