Demographics, clinical characteristics, polycystic ovarian syndrome phenotypes, and factors associated with anti-mullerian hormone levels among women with PCOS at a Fertility Center in Ghana: a 5-year retrospective study

Polycystic ovarian syndrome (PCOS) is most prevalent among women of reproductive age and is characterized by heterogeneous clinical presentations and demographic variability. This five-year review examined the demographics, clinical characteristics, PCOS phenotypes, and factors associated with anti-mullerian hormone (AMH) in women with PCOS at a Fertility Center in Accra. The study employed a hospital-based retrospective analysis involving women with PCOS at Lister Hospital and Fertility Center, with data extracted from January 2019 to December 2023. Descriptive statistics were used to summarize socio-demographic, biochemical, and clinical parameters. The Rotterdam Criteria were used to classify clinically relevant PCOS phenotypes. Correlation and linear regression analyses were performed to determine the correlates of AMH levels. A total of 242 PCOS patients’ records were reviewed. The median age was 31 years. Approximately, 14.9% had diabetes mellitus, 82.6% were overweight/obese, and 48.3% experienced amenorrhea. All participants (100%) had elevated AMH levels, with 29.4% exhibiting elevated luteinizing hormone to follicle stimulating hormone (LH/FSH) ratio, and 20.8% had hyperprolactinaemia. 85.5%, (n = 207) had “elevated AMH + oligo-anovulation” phenotype. 7.4% (n = 18) exhibited “elevated AMH + hirsutism” phenotype, while 7.0% (n = 17) had the classic phenotype (oligo-anovulation + hirsutism + elevated AMH). BMI was positively correlated with AMH (r = 0.65, p < 0.001), with each kg/m² change in BMI resulting in a 0.73 ng/ml increase in AMH levels. Our study provided insight into the demographic, clinical, and hormonal characteristics of women with PCOS, highlighting weight management as a mitigating strategy for hyperactive ovarian disease and the need for personalized management strategies to prevent long-term complications.