Human Reproduction, Vol. 17, No. 2, 314-319,
February 2002
© 2002 European Society of Human Reproduction and Embryology
Polycystic ovarian syndrome and thrombophilia
1 Department of Obstetrics and Gynecology, University Hospital of Ioannina, 2 Haematology Laboratory, Unit of Molecular Biology, University Hospital of Ioannina, Panepistimiou 1, Ioannina 45500, Greece
BACKGROUND: Polycystic ovarian syndrome (PCOS) is associated with insulin-induced plasminogen activator inhibitor-1 (PAI-1) elevations. Since thrombophilic states correlate with high miscariage rates, as does PCOS, this study aimed at looking for thrombophilic predisposition in PCOS women compared with non-PCOS controls. METHODS: The prevalence of antithrombin III, protein S and protein C deficiencies, as well as factor V Leiden, prothrombin G20210A factor and methylene tetrahydrofolate reductase (MTHFR) mutations, was compared between two different groups of women, one with PCOS (n = 30) and one without PCOS (n = 45). RESULTS: Median proportions of activated protein C, S and antithrombin III as well as the activated protein C ratios were within normal ranges in both samples. There was no evidence that the genetic analysis for factor V Leiden or prothrombin factor differed between the two samples. The odds ratio (OR) of bearing a mutation on the MTHFR gene was 1.2-fold higher [95% confidence interval (CI) 0.470–3.065] in women with PCOS than in women without (P = 0.83). Although this difference is not statistically significant, it might indicate a slightly higher prevalence of heterozygous genotypes in women with PCOS (OR = 1.197, 95% CI 0.473–3.034). CONCLUSIONS: Molecular risk factors of hereditary thrombophilia do not show increased prevalence in women with PCOS in comparison with women in the general population. The existence of a possible trend towards higher prevalence of MTHFR mutation in women with PCOS needs further study, particularly regarding homocysteine levels.
Key words: antithrombin III/factor V Leiden/methylene tetrahydrofolate reductase/PCOS/thrombophilia
3 To whom correspondence should be addressed. E-mail: gvarthol{at}cc.uoi.gr
Submitted on December 19, 2000; resubmitted on July 30, 2001
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