Objective: To investigate whether the frequency of uterine cavity abnormalities in PCOS patients higher than the normo-ovulatory patients.
Study design: This retrospective cohort study was conducted at the ART center of a tertiary university hospital. A total of 103 patients; 51 PCOS, and 52 male factor infertility were enrolled in the study between the years 2011-2019. HSG images of all patients were numbered and evaluated by ten senior reproductive endocrinologists and surgeons whom were blinded to the research and choose the most appropriate figure for each patient's HSG image and marked the shape of cavity according to the ASRM and ESGE/ESHRE classification. Results and demographic parameters were compared between PCOS and male factor infertility groups.
Results: The percentage of the normal uterine cavity was significantly lower in the PCOS group than control group as 51 % and 66.7 %, 77 % and 94.2 % according to the ASRM and ESHRE/ESGE classifications, respectively. The frequency of Partial Septate Uterus (ESHRE-ESGE U2a / ASRM Va, 21.6% vs 5.8 % p < 0.05), Complete Septate Uterus (ESHRE-ESGE U2b / ASRM Vb, 7.8% vs 0% p < 0.01) and Dysmorphic Uterus (ESHRE-ESGE U1c) / ASRM VII) 3.9 % vs 0p < 0.05) were significantly higher in PCOS patients than controls. The frequency of arcuate uterus classified as VI in ASRM and considered as normal in ESHRE/ESGE was 16 % and 17.3 % in PCOS and control groups, respectively, without statistically significant difference.
Conclusions: This study provides that, compared to the healthy population, the frequency of uterine cavity abnormality is clearly higher in PCOS patients.