Serological Evaluation of Anti- FSH Antibody and Anti- LH antibody In Iraqi Women with Polycystic Ovarian Syndrome

Background Polycystic ovarian syndrome (PCOS) is a hormonal, metabolic disorder in women of reproductive age. It can be induced by genetic, immunological, and environmental determinants. The main pathophysiology of PCOS, is hyperandrogenism, which can lead to acne, hirsutism, menstrual irregularities, as well as infertility. However, PCOS is also associated with chronic low-grade inflammation. There was little study on the autoimmunity, like anti-FSH and anti-LH antibodies, of PCOS, so the current study was designed to test the effectiveness of these antibodies on the occurrence of PCOS. Objectives This study aimed to compare the serum levels of anti-gonadotropin antibodies (anti-FSH, and anti-LH antibodies) between women with PCOS and healthy controls; and to evaluate their association with BMI status. Methods A total of 65 patients with PCOS, and 56 healthy women (controls) were recruited. Their ages were 18-45 years. Body mass index (BMI) was computed as, (weight) divided by (height squared, (kg/m 2 ). Blood samples were obtained from both patients and controls during the early follicular phase (day 2-3 of the menstrual cycle) using convenience sampling from the Medical City Hospital in Baghdad and private infertility clinics. PCOS was diagnosed according to the Rotterdam criteria (2003). This study was conducted between November 2024 and January 2025. The levels of anti-FSH and anti-LH antibodies were measured by ELISA. Results The results revealed a non-significant increase in anti-FSH antibody in patients (36.22±6.73) ng/ml, compared to controls (34.99±9.78 ng/ml), and a highly significant decrease in anti-LH antibody in patients (45.29±3.04 ng/ml), as compared to controls (69.16±10.90 ng/ml), (p<0.05). The fertility hormone, FSH showed a non-significant increase in unhealthy women (8.12±0.74 mIU/ml), in contrast to healthy women (7.35±0.62 mIU/ml) (p>0.05). While the LH hormone results was, in patients with PCOS (7.61±0.73 mIU/ml), as opposed to the control group, which was (5.62±0.56 mIU/ml), the (p>0.05). Finally, the LH/FSH ratio showed a non-significant increase in both patients (1.161±0.37) and controls (0.7819±0.22) (p>0.05). There was a non-significant correlation between BMI and anti-LH or anti-FSH antibodies (p >0.05). Conclusion Women with PCOS exhibit a significant decrease in anti-LH antibody levels along with variations in LH levels and LH/FSH ratio compared to healthy controls.