Association of classic and 11-oxygenated androgens with polycystic ovaries and menstrual cycle prolongation in infertile women with PCOS

Background and aims: The etiology of polycystic ovary syndrome (PCOS) is unclear. This study aimed to evaluate the role of classic and 11-oxygenated (11oxyC19) androgens in two typical signs of PCOS, polycystic ovary morphology (PCOM) and menstrual cycle prolongation.Materials and methods: A total of 462 infertile women with diagnosed PCOS and/or commonly accompanied metabolic disorders were recruited. Classic and 11oxyC19 androgens were determined with a sensitive highperformance liquid chromatography-differential mobility spectrometry tandem mass spectrometry apparatus. Least absolute shrinkage and selection operator logistic regression with fivefold cross-validation was applied to construct prediction models.Results: For PCOM, the most significant contributing androgen was testosterone (T), with the weight of 51.6%. The AUC of the prediction model was 0.824 in validation set. For menstrual cycle prolongation, androstenedione (A4) was the most significant contributing androgen with weights of 77.5%. The AUC the prediction model was less than 0.75. When including other variables, the most significant variable turned to be AMH both in PCOM and in menstrual cycle prolongation.Conclusion: Androgens had more contribution in PCOM than in menstrual cycle prolongation. The classic androgen T or A4 contributed more than 11oxyC19 androgens. However, their contributions were diminished when other factors were considered, especially AMH.