We defined PCOS in our study using the NIH[33 ], Rott.[34 (link)] and AES criteria[35 ]. Using the NIH criteria, PCOS was defined as the combination of chronic anovulation (ANOVU) and clinical hyperandrogenism and/or hyperandrogenemia (HA). By Rott. criteria, PCOS was defined by the presence of two or more of the following: 1) Oligo/anovulation (ANOVU), 2) Hyperandrogenemia and/or hyperandrogenism (HA), and 3) Polycystic ovaries (PCO). Using the AES definition, PCOS was diagnosed by the presence of clinical and/or biochemical hyperandrogenism (HA) with ovarian dysfunction defined as oligo/anovulation (ANOVU) and/or polycystic ovaries (PCO). Hyperprolactinemia, thyroid dysfunction, and nonclassic 21-hydroxylase deficiency were excluded in all of the women who achieved the other criteria for the diagnosis of PCOS.
ANOVU was considered as vaginal bleeding episodes at no less than 35-day intervals [36 (link),37 (link)]. HA was determined as clinical hyperandrogenism (CH) and/or biochemical hyperandrogenemia (BH). CH was defined by the presence of hirsutism (mF-G ≥8)[30 (link)], acne, or the presence of androgenic alopecia. BH was detected by FAI and/or DHEAS and/or A4 level, above the upper 95th percentile for the 362 women studied, who were not on any hormonal medication and had no clinical evidence of hyperandrogenism, ANOVU and PCO. Specifically, the upper normal limits were total T = 0.88 ng/ml, A4 = 2.3 ng/ml, DHEAS = 246 μg/dL and FAI = 5.47
PCO was diagnosed by the presence of 12 or more follicles in each ovary, measuring 2-9 mm in diameter and/or increased ovarian volume (10 cm3) [38 (link),39 (link)].
Idiopathic hirsutism(IH) was defined as hirsutism without ANOVU and/or PCO[24 (link)]. BH plus hirsutism was defined as hirsutism with BH without PCOS, using the Rott.definition [40 (link)].
Primary infertility was defined as the having the history of trying to conceive for at least one year without success despite of regular sexual intercourse, no use of contraception and no previous pregnancy.
ANOVU was considered as vaginal bleeding episodes at no less than 35-day intervals [36 (link),37 (link)]. HA was determined as clinical hyperandrogenism (CH) and/or biochemical hyperandrogenemia (BH). CH was defined by the presence of hirsutism (mF-G ≥8)[30 (link)], acne, or the presence of androgenic alopecia. BH was detected by FAI and/or DHEAS and/or A4 level, above the upper 95th percentile for the 362 women studied, who were not on any hormonal medication and had no clinical evidence of hyperandrogenism, ANOVU and PCO. Specifically, the upper normal limits were total T = 0.88 ng/ml, A4 = 2.3 ng/ml, DHEAS = 246 μg/dL and FAI = 5.47
PCO was diagnosed by the presence of 12 or more follicles in each ovary, measuring 2-9 mm in diameter and/or increased ovarian volume (10 cm3) [38 (link),39 (link)].
Idiopathic hirsutism(IH) was defined as hirsutism without ANOVU and/or PCO[24 (link)]. BH plus hirsutism was defined as hirsutism with BH without PCOS, using the Rott.definition [40 (link)].
Primary infertility was defined as the having the history of trying to conceive for at least one year without success despite of regular sexual intercourse, no use of contraception and no previous pregnancy.
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