Cross-sectional analysis of the effects of age on the hormonal, metabolic, and ultrasonographic features and the prevalence of the different phenotypes of polycystic ovary syndrome

Objective: To assess the effects of age on the hormonal, metabolic, and ultrasonographic features of polycystic ovary syndrome (PCOS). Design: Observational study. Setting: University department of obstetrics and gynecology. Patient(s): Patients with PCOS (n = 1,212) and healthy women (n = 254). Intervention(s): None. Main Outcome Measure(s): Differences in the hormonal, metabolic, and ultrasonographic features of PCOS between age groups. Result(s): A progressive decline in circulating androgens was observed with advancing age. Patients 21-30 years old had lower plasma glucose and insulin levels, lower area under the oral glucose tolerance test curve and lower homeostasis model assessment of insulin resistance index, and higher glucose/insulin and quantitative insulin sensitivity check index than patients 31-39 years old. The prevalence of PCOS phenotypes changed with age. More specifically, the distribution of the phenotypes did not differ substantially between patients <= 20 years old and patients 21-30 years old. However, a decline in the prevalence of phenotype 1 (characterized by anovulation, hyperandrogenemia, and polycystic ovaries) and an increase in the prevalence of phenotype 4 (characterized by anovulation and polycystic ovaries without hyperandrogenemia) were observed in patients 31-39 years old. Conclusion(s): In women with PCOS, hyperandrogenemia appears to diminish during reproductive life whereas insulin resistance worsens. (Fertil Steril(R) 2012;97:494-500. (C) 2012 by American Society for Reproductive Medicine.)