Elevated Serum Androstenedione Is Associated With a More Severe Phenotype in Women With Polycystic Ovary Syndrome

The study with 1276 women diagnosed with polycystic ovary syndrome (PCOS) according to the Rotterdam criteria found that elevated serum androstenedione (A4) levels greater than 3.8 ng/ml were associated with a more severe PCOS phenotype. Women with higher A4 levels had increased levels of luteinizing hormone (LH), LH/FSH ratio, testosterone (T), dehydroepiandrosterone sulfate (DHEAS), 17 OH progesterone, and free androgen index (FAI), and a lower T/A4 ratio. This was true for the entire PCOS group as well as for those with clinical and/or biochemical hyperandrogenemia (phenotypes I and II). Increased ovarian volume was observed across the entire PCOS group with elevated A4 levels, while a greater mean follicular number was specific to phenotypes I and II. The study concluded that serum A4 levels could be a valuable marker for assessing the severity of PCOS.