Hormonal and Metabolic Determinants of Polycystic Ovary Syndrome Phenotypes Among Women of Reproductive Age in Anambra State, South East Nigeria

Background: Polycystic ovary syndrome is the most prevalent endocrine disorder in women of reproductive age and exhibits phenotypic heterogeneity driven by variations in androgen excess, insulin resistance, and ovulatory dysfunction. Nigerian reproductive physiology research addressing the hormonal and metabolic underpinnings of distinct polycystic ovary syndrome phenotypes is limited, particularly in the South East geopolitical zone. Objectives: This study aims to classify polycystic ovary syndrome phenotypes according to the Rotterdam criteria, characterise associated hormonal profiles including total testosterone, luteinising hormone, follicle-stimulating hormone, and anti-Mullerian hormone, and assess metabolic variables including insulin resistance and lipid profiles among reproductive-age women at Nnamdi Azikiwe University Teaching Hospital, Nnewi. Methods: Eighty women with confirmed polycystic ovary syndrome and forty eumenorrhoeic controls will be recruited. Hormonal assays will be conducted on cycle day 2 to 5 serum samples using immunoassay platforms. Pelvic ultrasound will assess follicle count and ovarian morphology. Cluster analysis will identify phenotypic subgroups. ANCOVA will compare metabolic and hormonal parameters across phenotypes. Expected Outcomes: The hyperandrogenic, anovulatory phenotype is anticipated to demonstrate the greatest metabolic derangement, with insulin resistance and dyslipidaemia more severe than in other phenotypic clusters. Conclusion: Findings will provide empirical phenotyping data to guide individualised management of polycystic ovary syndrome in Nigerian women. Keywords: polycystic ovary syndrome, phenotypes, androgens, insulin resistance, Anambra.