Polycystic ovary syndrome phenotypes in Iranian infertile women: a cross-sectional study

Abstract

Polycystic Ovary Syndrome (PCOS) is a multifaceted endocrine disorder with diverse phenotypic presentations. This study aimed to evaluate the prevalence of PCOS phenotypes among Iranian infertile women and compare their clinical, hormonal, and metabolic parameters across these groups. This cross-sectional study included 534 infertile women with PCOS (diagnosed via Rotterdam criteria) attending the Milad Infertility Center in Mashhad, Iran. Patients were classified into four phenotypes (A, B, C, and D). Data on height, weight, hormonal profiles, and metabolic parameters were extracted and analyzed using SPSS version 26. A total of 534 infertile women with PCOS were included (mean age = 28.3 ± 5.4 years). The most prevalent phenotype was phenotype A (57.3%), followed by phenotypes C (20.4%), D (14.4%), and B (7.9%). Significant differences were observed in body mass index (BMI) across phenotypes (p = 0.003), with phenotype A showing the highest adjusted BMI. Hormonal profiles differed significantly among phenotypes, with phenotype B demonstrating markedly lower AMH levels compared with other phenotypes (p < 0.001). Phenotype C showed lower LH concentrations and LH/FSH ratio compared with phenotype A (p = 0.008 and 0.021, respectively). After adjustment for age and BMI, phenotype remained significantly associated with BMI, AMH, LH, and LH/FSH ratio (p < 0.05). No statistically significant differences were observed across phenotypes in the measured metabolic variables, including fasting blood glucose, triglycerides, and total cholesterol. Phenotype A is the predominant subtype among Iranian infertile women, characterized by severe hormonal alterations and elevated BMI. Comparison of the measured metabolic parameters, including fasting blood glucose, triglycerides, and total cholesterol, showed no statistically significant differences among the four PCOS phenotypes.