Demographic, clinical characteristics, polycystic ovarian syndrome phenotypes and predictors of anti-mullerian hormone among women with PCOS at a Fertility Center in Ghana: A 5-year retrospective study

Abstract

<title>Abstract</title> <bold>Background: </bold>Polycystic ovarian syndrome (PCOS) is most prevalent among women of reproductive age and is characterized by heterogeneous clinical presentations and demographic variability. This five-year review examined the demographic, clinical characteristics, PCOS phenotypes, and the factors associated with anti-mullerian hormone (AMH) in women with PCOS at a Fertility Center in Accra. <bold>Methodology: </bold>The study employed a hospital-based retrospective analysis involving women with PCOS at Lister Hospital and Fertility Center, with data extracted from January 2019 to December 2023. Descriptive statistics were used to summarize socio-demographic, biochemical, and clinical parameters. The Rotterdam Criteria were used to classify clinically relevant PCOS phenotypes. Correlation and linear regression analyses were performed to determine predictors of AMH levels. <bold>Results: </bold>A total of 242 PCOS patients’ records were reviewed. The median age was 31 years. Approximately, 14.9% had diabetes mellitus, 82.6% were overweight/obese, and 48.3% experienced amenorrhea. All participants (100%) had elevated AMH, with 29.4% exhibiting elevated luteinizing hormone to follicle stimulating hormone (LH/FSH) ratio, and 20.8% had hyperprolactinaemia. 85.5%, (n=207) had "elevated AMH + oligo-anovulation" phenotype. 7.4% (n=18) exhibited "elevated AMH + hirsutism" phenotype, while 7.0% (n=17) had the classic phenotype (oligo-anovulation + hirsutism + elevated AMH). BMI was correlated with AMH (r=0.65, p&lt;0.001), with each kg/m² change in BMI resulting in a 0.73 ng/ml increase in AMH levels. <bold>Conclusion:</bold> Our study provided insight into the demographic and clinical characteristics of women with PCOS, highlighting weight management as a mitigating strategy for hyperactive ovarian disease and need for personalized management strategies to prevent long-term complications.