[LH-FSH ratio and Polycystic Ovary Syndrome: A forgotten test?]

To identify the predictive value of LH-FSH ratio in the Polycystic Ovary Syndrome diagnosis and to evaluate its role according PCOS phenotypes.

A descriptive, comparative, observational, prospective study of PCOS patients and its controls. All participants received a questionnaire and underwent a physical and transvaginal ultrasound examination. Blood samples were also collected for analysis of metabolic markers and hormones. PCOS was diagnosed according to Rotterdam criteria.

A total of 267 women were included into the study. PCOS was diagnosed in 162 patients. There was statistical difference in: HOMA, 1.43 ± 1.06, 2.09 ± 1.96; Total Testosterone, 0.31 ± 0.14, 0.41 ± 0.19; and free Androgen index, 1.17 ± 1.30, 1.69 ± 1.18; for control and PCOS group, respectively. FSH, 6.55 ± 2.43 in controls and 5.30 ± 1.66 in PCOS patients (p = 0.001); LH, 4.34 ± 2.12 controls, 6.36 ± 4.61 PCOS patients (p = 0.001). LH-FSH ratio was 0.71 ± 0.39 for control group and 1.25 ± 0.85 in PCOS group, p = 0.001. A correlation was observed between LH-FSH ratio and total antral follicle count (p < 0.001) and with insulin resistance (p = 0.022).

LH-FSH ratio, although it is a valuable test, it is not diagnostic of PCOS. A correlation was found with LH-FSH ratio and insulin resistance but we must not forget about its association with hyperandrogenism.