The incidence and features of subclinical Cushing’s syndrome in women with polycystic ovaries
Background. The purpose of investigation is to study the incidence of subclinical Cushing’s syndrome in women with polycystic ovary syndrome (PCOS). Materials and methods. Under our supervision, there were 120 patients of fertile age with PCOS. The average age of patients was 25.5 ± 4.3 years. Twenty healthy women of corresponding age made a control group. The complex of researches, including clinical, biochemical, hormonal (luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin, estradiol, progesterone, dehydroepiandrostendion, 17-hydroxyprogesterone, anti-Mullerian hormone, insulin on day 14 of cycle), was performed in all patients, as well as ultrasonography of the uterus and ovaries with folliculometry in dynamics, and also magnetic resonance imaging and survey of patients. Results. Patients were divided into three groups: with primary PCOS (19 %), with secondary PCOS and obesity (74 %), with secondary PCOS and subclinical Cushing’s syndrome (7 %).
In the first group of patients, a significant decrease of pituitary and ovarian hormones has been registered on the background of hyperandrogenemia. In the third group of patients, a significant decrease of pituitary hormones was also detected on the background of hyperandrogenemia. Conclusions. The most significant violations in the system of pituitary-ovarian function were found in the third group of patients with subclinical Cushing’s syndrome, at that, a significant decrease in the functional state of pituitary-gonadal system was marked, namely decline of LH, FSH, estradiol and progesterone on the background of hyperandrogenemia and hypercortisolemia. The incidence of subclinical Cushing’s syndrome among women with PCOS is 6.6 %. In future, it is necessary to monitor in dynamics the probability of recovery of fertility in all groups of patients with PCOS
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