Association Between Hormonal Profile and Ovulatory Dysfunction in Infertile Women with Polycystic Ovary Syndrome (PCOS): A Cross-Sectional Study

Open Access

Abstract

Background: Polycystic ovary syndrome is one of the most prevalent endocrine conditions among reproductive-aged females that features hormonal imbalance (high levels of LH, high LH/FSH ratio, hyperandrogenism) and insulin resistance causing ovulation dysfunction and infertility. The current paper aims at establishing the relationship between hormonal and metabolic factors and ovulatory dysfunction, determining the predictors of anovulation. Materials & Methods: This cross-sectional study was conducted among 110 infertile women aged 18–40 years diagnosed with PCOS based on the Rotterdam criteria at Department of Gynaecology & Obstetrics, Central Police Hospital, Dhaka, Bangladesh, from January 2024 to December 2024. Socio-demographic, anthropometric, and clinical data were recorded, and hyperandrogenism was assessed using the modified Ferriman-Gallwey (mFG) score. Fasting blood samples were analyzed for LH, FSH, testosterone, DHEA-S, SHBG, insulin, and glucose; HOMA-IR was calculated to assess insulin resistance. Data were analyzed using SPSS 26.0. Results: Among 110 infertile women with PCOS, most were young (mean age 28.6 years), urban residents, and overweight or obese (79%, mean BMI 29.8 kg/m²). Hirsutism (55.5%) was the most common hyperandrogenic feature. Elevated LH/FSH ratio (59.1%), high testosterone (46.4%), and insulin resistance (67.3%) were frequent. Ovulation was negatively correlated with LH/FSH ratio, testosterone, fasting insulin, and HOMA-IR, but positively with SHBG. Logistic regression analysis revealed that a higher LH/FSH ratio, testosterone, and HOMA-IR independently predicted anovulation, whereas a higher SHBG level was protective. Conclusion: The study concludes that hormonal imbalances, particularly elevated LH, LH/FSH ratio, and testosterone, are significant predictors of anovulation in infertile women with PCOS, while higher progesterone reflects preserved ovulation. Hormonal profiling is essential for early diagnosis and personalized management to enhance reproductive outcomes.