| Objective: Expert conference was held in Rotterdam in 2003, sponsored by the European Society for Human Reproduction and Embryology and the American Society for Reproductive Medicine, recommending ESHRE /ASRM diagnostic criteria for PCOS. There are differences in clinical and laboratory characteristics of PCOS patients with different races. This study was performed to investigate the clinical and biochemical features of Chinese infertile women with PCOS,and to evaluate the value of 2003 Rotterdam criteria on Chinese PCOS women, to initially explore an appropriate diagnostic criterion for Chinese PCOS patients.Materials and Methods: PCOS was defined when at least two of the following three features were present: (i) oligo- and/or anovulation, (ii) clinical (hirsutism) and/or biochemical signs of hyperandrogenism (hyperandrogenemia), and (iii) polycystic ovaries and exclusion of other identifiable endocrine disorders such as late-onset congenital adrenal hyperplasia, hyperprolactinemia, thyroid dysfunction, neoplastic androgen secretion. Altogether 619 PCOS patients were enrolled into this study comprising the time interval between May 2006 and March 2007 at the Reproductive Center of Reproductive & Genetic Hospital of CITIC-XIANGYA. The PCOS patients were divided into obese group (BMI≥25kg/m~2) and no-obese group (BMI<25kg/m~2) . In the corresponding period women without a history of hyperandrogenism and who had regular menstrual cycles were recruited as controls (N:525). None of the subjects had a thyroid disorder, diabetes mellitus, congenital adrenal hyperplasia, androgen-secreting tumors, or similar signs or symptoms of other endocrinopathies. The epidemiology questionnaire was designed and recored the history,clinical parameters,biochemical features. The content of epidemiology questionnaire was made according to the diagnostic criteria of PCOS such as the 2003 Rotterdam ESHRE/ASRM criteria,the PCOS criteria of the 1993 Japanese Society of Obstetrics and Gynecology,the 1990 NIH criteria and the PCOS diagnostic guidebook of the 2002 American Society of Obstetrics and Gynecology. Clinical and biochemical data were analyzed by SPSS13.0 for Windows. A p-value less than 0.05 was considered statistically significant.Results:1. 95.1% (589/619) PCOS in our research aged in 20-35year,so PCOS is common in women of reproductive age.2. The rates of the clinical and biochemical features of all the PCOS patients were: PCO: 99.4% (615/619) , oligo-or anovulation:90.6%(561/619 ) , hyperandrogenism:22.1% ( 137/619 ) , hirsute:17.0% (105/619) ,Obesity:25.2% (156/619) ,LH/FSH≥2: 22.1% (137/619) , Insulin resist:45.3% (167/369) .3. The starting time of oligo- or amenorrhea was different, 54.0% (334/619) of them suffered oligo- or amenorrhea from the start ofmenarche, and 46.0% (285/619) had regular menses at one time,and then had secondary oligo- or amenorrhea for some reason.4. Compared to the controls by binary logistic regression, the factors in the criteria were follicle number, oligo-or anovulation, biochemical and clinical of androgen excess signs . Ovarian volume greater than 10 ml was not in regression equation.5. Among all these 1144 subjects,there were 140 cases with LH/FSH≥2,97.3%(137/140) of them were PCOS patients,only2.1% (3/140) of them were controls. In the PCOS group,the rate of LH/FSH≥2 was 22.1% (137/619)6. Blood sugar and insulin,the length of menses and follicle number were significantly higher in obese PCOS patients,compared with PCOS patients without obese.Conclusion:1. Compared with the western PCOS women,Chinese women with PCOS showed higher rates of menstrual irregularity, lower rates of hyperandrogenemia,hirsutism and obesity,and similar rates of PCO and insulin resist.2.ESHRE/ASRM criteria was mainly suit for the PCOS patients in our investigation. Follicle number was more important than ovary volume both in etiology and diagnosis, and ovary volume> 10ml was not in regression equation, whether it could be regarded as a diagnosis criterion still need more discussion.3.LH/FSH≥2 was a symptom with low sensitivity and high specificity, whether it can be regarded as a diagnosis criterion still need more discussion.4.Obesity caused more severe menstrual irregularity and increased the follicle number and the long-term health risks.
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