TITLE:
Endometrial Thickness as a Predictor of Endometrial Hyperplasia in Infertile Patients with Polycystic Ovary Syndrome
AUTHORS:
Moamar Al-Jefout, Aiman Al-Qtaitat, Dhamia Al-Rahal, Nedal Al-Nawaiseh, Futoon Rawashdeh
KEYWORDS:
Polycystic Ovary Syndrome, Endometrial Hyperplasia, Endometrial Thickness, Oligomenorrhea, Trans-Vaginal Scan, Infertility
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.8 No.2,
February
8,
2018
ABSTRACT: Background: Women with polycystic ovary syndrome (PCOS) are at
higher risk of developing endometrial hyperplasia (EH). This study determined
the prevalence of EH among women with infertility due to PCOS and assessed the predictive value of
endometrial thickness (ET) measurement by trans-vaginal scan (TVS). Study Type &
Population: This was a prospective
study on infertile women with and without PCOS in which clinical data, hormonal
profile, ET and endometrial biopsy (EB) for histopathological examination were
collected. Methods: Thirty-seven women with PCOS and
23 women without PCOS presenting with infertility and/or abnormal uterine
bleeding underwent TVS, hysteroscopy, laparoscopy and EB. Results: The overall prevalence of EH was 23.3 % while in
PCOS group: 18.3 %. The
mean ET (14.8 mm) was
significantly higher in patients with EH (t = -2.74,
P value = 0.009). The lower value of ET among women with EH was 10 mm. A cut-off point of 9.5 mm was
set. An ET of >9.5 mm had 92.9% sensitivity and 51.85% specificity for the
presence of EH. Women with ET ≥ 9.5 mm were 1.28 times more at risk of EH than
women with ET 9.5 mm.
Women with oligomenorrhea and irregular cycles were 5.5 and 13.7 times more at
risk of EH compared to those with regular cycles, respectively. ET was
positively correlated with insulin resistance (r = 0.439, P = 0.007). Conclusion: ET ≥ 9.5 mm predicts EH in infertile women with PCOS,
with a high degree of sensitivity and a moderate degree of specificity. In PCOS
patients with oligomenorrhea or irregular cycles, the risk of EH is higher than
women with regular cycles.