Types of reproductive disorders in underweight and overweight young females and correlations of respective hormonal changes with BMI

Higher risks of reproductive problems have been found in underweight and overweight women with rapid weight gain or loss but evidence is inconsistent especially in relation to the effect of age of body weight changes. The aim of our study was to detect the peculiarities of menstrual function, prevalence of different types of reproductive disorders and correlations of respective hormonal changes with body mass index [BMI] in young female patients with thinness or obesity since childhood. In this prospective cross-sectional study 48 underweight and 55 overweight/obese young women with different reproductive problems underwent complete clinical and hormonal analyses. All 103 patients had weight problems since childhood. Polycystic ovarian syndrome and metabolic syndrome was the most frequent in overweight and obese women, whilst non-classical congenital adrenal hyperplasia and ovarian dysfunction prevailed in underweight women [p<0.001]. No difference was determined according to the age of menarche [p=0.885] and types of menstrual disturbances [p=0.34] between the study groups. Hypogonadotropic hypogonadism was not found in young women who were lean since childhood. Follicle-stimulating hormone [FSH] [p=0.013] and sex hormone binging globulin [SHBG] [p<0.001] levels were higher in women with low BMI, whilst free testosterone [FT] [p=0.019] and total testosterone [TT] [p=0.003] levels were higher in high BMI participants. BMI negatively correlated with FSH [p=0.009] and SHBG [p=0.001]; and positively correlated with FT [p=0.001] and TT [p=0.002]. Peculiarities of menstrual function and hormonal changes in young women with thinness or obesity since childhood are related to the types of reproductive disorders and their childhood BMI

correlations of anti-mullerian hormone, follicle-stimulating hormone and antral follicle count in different age groups of infertile women

The objective of our study was to identify the correlations between the tests currently used in ovarian reserve assessment: anti-Mullerian hormone [AMH], follicle stimulating hormone [FSH] and antral follicle count [AFC] and to distinguish the most reliable markers for ovarian reserve in order to select an adequate strategy for the initial stages of infertility treatment. In this prospective study, 112 infertile women were assessed. Subjects were divided into three age groups: group I <35 years [n=39], group II 35-40 years [n=31], and group III 41-46 years [n=42]. AMH, FSH and AFC were determined on days 2-3 of the patients' menstrual cycles. There was a significantly elevated negative correlation between age and AMH level [rs=-0.67, p<0.0001] and AFC [rs=-0.55, p<0.0001]. We observed a significantly positive correlation between age and FSH [rs=0.38, p<0.0001]. AMH negatively correlated with FSH [rs=-0.48, p<0.0001] and positively with AFC [r=- 0.71, p=0.0001]. There was a moderate negative relation between FSH and AFC [r=-0.41, p=0.0001] and moderate positive relation between age and FSH [rs=0.38, p<0.0001]. The correlation analysis performed in separate groups showed that AMH and AFC showed a statistically significant positive correlation for group I [r=0.57, p<0.0001], group II [r=0.69, p<0.0001] and group III [r=0.47, p<0.002]. A statistically significant correlation between FSH and AMH was detected only in groups I [r=-0.41, p<0.02] and II [r=-0.55, p<0.0001]. A statistically significant correlation existed between FSH and AFC only in group III [r=-0.42, p<0.006], as well as between age and AFC only in group I [r=-0.35, p<0.03]. Currently, AMH should be considered as the more reliable of the ovarian reserve assessments tests compared to FSH. There is a strong positive correlation between serum AMH level and AFC. The use of AMH combined with AFC may improve ovarian reserve evaluation

Correlation of biochemical markers and clinical signs of hyperandrogenism in women with polycystic ovary syndrome [PCOS] and women with non-classic congenital adrenal hyperplasia [NCAH]

Polycystic ovary syndrome [PCOS] is the most common cause of hyperandrogenism in women. Non-classic congenital adrenal hyperplasia [NCAH] is very close to PCOS. The diagnosis of hyperandrogenism is not based on the finding of decreased or increased levels of a single hormone. In our paper, we are going to test correlation between clinical signs and biochemical markers of hyperandrogenism. In this prospective study, we calculated free testosterone [cFT], bioavailable testosterone [cBT], free androgen index [FAI], free estrogen index [FEI], total testosterone [TT], sex-hormone binding globulin [SHBG], estradiol [E2], dehydroepiandrosterone-sulfate [DHEA-S], 17alpha -hydroxyprogesterone [17alpha -OHP], prolactin [P], C-peptide and homeostasis model assessment for insulin resistance [Homa-IR] were measured in two groups of young untreated women with PCOS and NCAH. In our research, we did not find any significant differences between PCOS and NCAH groups by age, hormonal and calculated parameters of androgens. Waist to hip ratio [WHP] and body mass index [BMI] values were higher in the group of patients with PCOS than NCAH group. But in all patients we found positive correlation between hirsutism score and FAI, cFT, cBT, as well as we found negative correlation between hirsutism score and SHBG. We also tested hormonal and calculated parameters of androgens between PCOS patients by upper body and lower body obesity, but we did not find any significant differences. There was not any difference by the hirsutism score in these groups either. In our research we found that the calculated values of cFT, cBT and FAI are helpful for determinate hirsutism score in all hirsute patients, despite of ovarian or adrenal hyperandrogenemia