Risk of Infertility Index in Women with Polycystic Ovarian Syndrome

Objective: To construct the risk of infertility index for women with polycystic ovarian syndrome, that can be used to assess the prognostic factors for conception; and categorise them in mild, moderate and high-risk groups. Study Design: Descriptive study. Place and Duration of Study: King Fahad Medical City, Riyadh, Saudi Arabia from March 2017 to February 2018. Methodology: Fifty women who were diagnosed as polycystic ovarian syndrome were selected by simple randomisation. After initial scrutiny, 39 women with all clinical, biochemical and sonographic features of Rotterdam criteria were included. Patients with congenital adrenal hyperplasia (CAM) and premature ovarian insufficiency (P01) were excluded. Risk of infertility (R11) scale was used to assess the score in women with polycystic ovarian syndrome (PCOS) and classify them into different risk categories like mild (score <= 7), moderate (score 8-10) and severe (score >10). Results: There were 5.1% cases with a mild score, 61.5% with a moderate score, and 33.3% with a severe score. For cases in the high-risk group, 89.8% of women had no pregnancy. RII with the cut-off point of 12.5 had a sensitivity of 100%, and specificity of 88.2%, for the defined outcome. Area under the curve was 0.553 and 95% CI was 48.3% (lower bound) and 62.3% (upper bound). Conclusion: PCOS patients can be categorised in mild, moderate and high-risk depending on the score on RII scale. The patients with higher score of RII had fewer chances of pregnancy with assisted reproductive technologies (ART). Once the intensity of the risk of PCOS is identified, focused management can be implied thereby reducing the duration of infertility and cost of the treatment.