Prevalence of Non-classical Congenital Adrenal hyperplasia among Patients Managed as A polycystic Ovarian Syndrome using 17-Hydroxy-progesterone as A Biomarker

Abstract

Background: Women with non-classical congenital adrenal hyperplasia (NCAH) is presented with clinical manifestations similar to that of polycystic ovary syndrome (PCOS). Thus, the clinical differentiation between two conditions is challenging. This study aimed to estimate the prevalence of NCAH in women managed as a polycystic ovarian disease.

Patients and Methods: This work was conducted at the Assisted Reproduction Unit (International Islamic Center for Population Studies and Research, Al-Azhar University). It includes 120 women, 100 of them representing the patient group. Those women asked the medical advice for treatment of anovulation infertility by the Intracytoplasmic sperm injection (ICSI). The other 20 females represented the control group. They were treated for male-factor infertility. The prevalence of NCAH among female treated as PCOS was estimated.

Results: The diagnosis of NCCAH was confirmed for 5% of women treated as PCOS in this study. The study also confirmed the clinical and biochemical similarities between the two conditions. However, the differentiation was possible by the significant difference of 17-hydroxyprogesterone between the two groups. A cutoff value of 3.98 ng/ml provided an excellent diagnostic power for NCAH. The area under the curve (AUC) was 0.981, sensitivity was 100.0% and specificity was 97.89%.

Conclusion: The measurement of 17-hydroxyprogesterone can be used as a screening tool to differentiation PCOS from NCAH, permitting proper treatment planning.