Polycystic ovaries in association with müllerian anomalies

The polycystic ovary syndrome, whose etiopathogenesis is not clearly understood, has a wide spectrum of clinical presentations, and may co-exist with other pathologic conditions. In this study, we evaluated the prevalence of ultrasound-defined polycystic ovaries (PCO) in patients with müllerian anomalies (n = 167), and those without müllerian anomalies (n = 3165) from 1990 to 1994, in a population markedly composed of infertility patients. PCO were found in 50 (29.9%) patients in the study group, compared to 637 (20.1%) patients in controls (P < 0.01). Müllerian anomalies were further grouped according to the American Fertility Society (AFS) classification and it was found that patients with the septate uteri and bicornuate uteri malformations had a higher prevalence of PCO than the controls (P < 0.001, P < 0.05, respectively). Although a difference existed in the percentage of PCO in patients with unicornuate uteri and didelphic uteri compared to controls, this difference did not reach statistical significance (P > 0.05). We conclude that, as PCO are more prevalent in certain müllerian anomalies, an embryogenetic defect may also be involved in the etiopathogenesis of PCO.