Are women with polycystic ovary syndrome resistant to activated protein C?

Objective: This study was performed to test the hypothesis that an increase d prevalence of activated protein C (APC) resistance in women with polycyst ic ovary syndrome (PCOS) puts them at increased risk of miscarriage and thr ombosis. Design: Case control study. Setting: A district general hospital in the United Kingdom. Patient(s): Forty-one women with PCOS and 25 controls. Intervention(s): Clinical histories, ultrasound scans, and venepunctures. Main Outcome Measure(s): Diagnosis of PCOS or control, clinical histories, APC resistance according to an activated partial thromboplastin time-based assay. Result(s): There was no significant difference in the proportion of women w ith APC resistance in both groups (three women in the PCOS group [7%] vs. o ne woman in the control group [4%]). The prevalence of APC resistance in th e entire study population was 6.5%. in the PCOS group, 29% (12/41) gave a p ositive family history of thrombosis compared with 8% (2/25) in the control group. None of the women with a positive family history of thrombosis had abnormal antithrombin ill, protein C, or protein S levels. Conclusion(s): This study suggests that women with PCOS may have the same p revalence of APC resistance as the background population and that APC resis tance may not put them at a higher risk of thrombosis or miscarriage compar ed with the case of the general population. (Fertil Steril(R) 2000,74:1229- 32. (C) 2000 by American Society for Reproductive Medicine).