{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T11:41:13Z","timestamp":1792237273633,"version":"4.4.0"},"update-to":[{"DOI":"10.12688\/f1000research.172281.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000}},{"DOI":"10.12688\/f1000research.172281.2","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000}},{"DOI":"10.12688\/f1000research.172281.3","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000}},{"DOI":"10.12688\/f1000research.172281.4","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000}}],"reference-count":30,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns3:p>\n                    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\n                    <ns3:sup>2<\/ns3:sup>\n                    ). 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\u00b16.73) ng\/ml, compared to controls (34.99\u00b19.78 ng\/ml), and a highly significant decrease in anti-LH antibody in patients (45.29\u00b13.04 ng\/ml), as compared to controls (69.16\u00b110.90 ng\/ml), (p&lt;0.05). The fertility hormone, FSH showed a non-significant increase in unhealthy women (8.12\u00b10.74 mIU\/ml), in contrast to healthy women (7.35\u00b10.62 mIU\/ml) (p&gt;0.05). While the LH hormone results was, in patients with PCOS (7.61\u00b10.73 mIU\/ml), as opposed to the control group, which was (5.62\u00b10.56 mIU\/ml), the (p&gt;0.05). Finally, the LH\/FSH ratio showed a non-significant increase in both patients (1.161\u00b10.37) and controls (0.7819\u00b10.22) (p&gt;0.05). There was a non-significant correlation between BMI and anti-LH or anti-FSH antibodies (p &gt;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.\n                  <\/ns3:p>","DOI":"10.12688\/f1000research.172281.5","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:49:06Z","timestamp":1785412146000},"page":"1355","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Serological Evaluation of Anti- FSH Antibody and Anti- LH antibody In Iraqi Women with Polycystic Ovarian Syndrome"],"prefix":"10.12688","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-3558-6709","authenticated-orcid":false,"given":"Hiba M.","family":"Khaleel","sequence":"first","affiliation":[{"name":"Biology Baghdad Baghdad Governorate University of Baghdad Al-Jaderyia Campus College of Science"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4657-9404","authenticated-orcid":false,"given":"Sura F.","family":"Alsaffar","sequence":"additional","affiliation":[{"name":"Biology Baghdad Baghdad Governorate University of Baghdad Al-Jaderyia Campus College of Science"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2026,7,30]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"153-165","DOI":"10.2147\/IJWH.S490836","article-title":"The Global Burden of Polycystic Ovary Syndrome in Women of Reproductive Age: Findings from the GBD 2019 Study.","volume":"17","author":"B Jiang","year":"2025 Dec 31","journal-title":"Int. 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Comment 2:&nbsp; The response: The diagnostic criteria have been clarified under the Materials and Methods section. The role of AMH measurement in relation to these criteria has been clarified. Comment 3: The response: The study was conducted exclusively on Iraqi women. Comment 4: The response: PCOS phenotypes were not specified in this study; it is beyond the scope of the study. Comment 5: The response: The patients' sampling has been included. Comment 6: The response: Androgen levels were not assessed in this study, as the focus was on other diagnostic criteria. Comment 7: The response: Yes, using 3 decimal places ensures higher precision and consistency in reporting the sampling data. Comment 8: The response: All abbreviations used in the table, e.g., (NS: Not Significant), have been clearly defined in the table footnotes.&nbsp; Comment 9:&nbsp; The response: The discussion section has been expanded to better explain the clinical implications of the findings. Additional details regarding potential cost-effectiveness and practical clinical applications of using anti-FSH and anti-LH antibodies in PCOS diagnosis have been included.","URL":"https:\/\/f1000research.com\/articles\/14-1355\/v5#referee-comment-15382","order":1,"name":"referee-comment-15382","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.202995.r498042, Mohd Ashraf Ganie, Nusrat Jahan, Department of Endocrinology, Sheri Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, 10 Jul 2026, version 4, 1 approved with reservations, 2 not approved","URL":"https:\/\/f1000research.com\/articles\/14-1355\/v4#referee-response-498042","order":2,"name":"referee-response-498042","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Sura Alsaffar<\/b>; \n<i>Posted: 12 Jul 2026<\/i>; Dear reviewer,&nbsp; \u200b\u200b\u200b\u200b\u200b\u200b Thanks for your time and your efforts in reviewing our paper, I'm pleased to answer your comments as the following: &nbsp;In regard to comments 1,2: The diagnosis depends on clinical investigation relied upon Rotterdam criteria, laboratory testing included (FSH, LH, Estrogen, Prolactin, Testosterone and AMH hormones) these hormones used for diagnosis as routine work but not mentioned in this paper. Modified Ferriman gallwey score wasn\u2019t used by consultants.  in regarding to comment 3 Just 4 PCOS patients took the mentioned therapy, and the number of those patients wasn\u2019t enough to put them in separate group, and I mentioned for scientific honesty&nbsp;  comment No 4&nbsp; yes, true I didn\u2019t mention in exclusion criteria, the diagnosis depends on hormones, symptoms and relied on ultrasound&nbsp; I can add it for exclusion criteria for future studies as you recommended&nbsp;  The author&nbsp; Dr Sura F Alsaffar&nbsp; University of Baghdad, College of Science Department of Biology","URL":"https:\/\/f1000research.com\/articles\/14-1355\/v5#referee-comment-16645","order":3,"name":"referee-comment-16645","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Hiba Khaleel<\/b>; \n<i>Posted: 18 Jul 2026<\/i>; Dear reviewer, Thank you for the feedback. All requested revisions have been successfully addressed and incorporated into the manuscript as detailed below: Response 1: We have explicitly specified the utilized BMI cut-off values (BMI &lt; 25 for normal weight, 25-30 for overweight, and &gt; 30 for obesity). Response 2: AMH was not the primary focus of this study. Response 3: We have clarified that only 4 participants were taking these medications, which did not affect the overall study outcomes. Response 4: We have clarified that only PCOS patients were included in this study.","URL":"https:\/\/f1000research.com\/articles\/14-1355\/v5#referee-comment-16703","order":4,"name":"referee-comment-16703","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.202995.r498044, Shahed Morshed, Bangladesh Medical University,, Dhaka,, 08 Jul 2026, version 4, 1 approved with reservations, 2 not approved","URL":"https:\/\/f1000research.com\/articles\/14-1355\/v4#referee-response-498044","order":5,"name":"referee-response-498044","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Hiba Khaleel<\/b>; \n<i>Posted: 18 Jul 2026<\/i>; Dear Reviewer, Response 1: Done. The wording in the abstract has been revised to focus purely on association rather than implying any causal relationship, fitting the case-control design. Response 2: Done. The objective in the abstract has been corrected to focus strictly on comparing antibody levels between the PCOS and control groups. Response 3:&nbsp;Done. General descriptions of LH and FSH have been removed from the abstracts' results. It now briefly details the correlation of BMI with&nbsp;LH-Ab and FSH-Ab. Response 4: Done. The conclusion of the abstract has been rewritten to align strictly with the study objectives. removing unnecessary general text about LH and FSH. Response 5: Done. The 2003 Rotterdam criteria have been explicitly defined in the methodology, and the LH\/FSH ratio is now clarified as an exploratory. Response 6: Done. The WHO BMI cutoff classifications (&lt; 25 and &gt; 25 kg\/m) have been added to the text. Response 7: Done. The term &quot;infertility hormones&quot; has been entirely replaced with &quot;gonadotropins.&quot; Response 8: Done. The intra-assay and inter-assay coefficients of variation (CV) for both ELISA kits have been included in the methodology. Response 9: Done. The description of the chi-square test has been corrected in the statistical analysis section. Response 10, 12: Done. The Shapiro-Walk normality test and the post-hoc power analysis (&gt;99%) details have been added to the statistical analysis section. Response 11: Done. Pearson correlation analysis has been explicitly mentioned and defined in the text. Results: Table 1, 2 The descriptions have been revised to correct numerical overlaps, remove incorrect correlation terms, and properly reflect the adjusted age matching (p=0.660) and non-significant fertility values (p=0.830). Response to conclusion: The conclusion has been rewritten.","URL":"https:\/\/f1000research.com\/articles\/14-1355\/v5#referee-comment-16708","order":6,"name":"referee-comment-16708","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.206706.r514927, Erna Yovi Kurniawati, Alma Ata University, Yogyakarta, 22 Sep 2026, version 5, indexed","URL":"https:\/\/f1000research.com\/articles\/14-1355\/v5#referee-response-514927","order":7,"name":"referee-response-514927","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Hiba Khaleel<\/b>; \n<i>Posted: 30 Sep 2026<\/i>; The clinical implications of the study findings have been added to the manuscript as suggested by the reviewer. Thank you for your time.","URL":"https:\/\/f1000research.com\/articles\/14-1355\/v5#referee-comment-17308","order":8,"name":"referee-comment-17308","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.206706.r514936, Amal Umran Mosa, University of Kerbala, Kerbala, 01 Oct 2026, version 5, indexed","URL":"https:\/\/f1000research.com\/articles\/14-1355\/v5#referee-response-514936","order":9,"name":"referee-response-514936","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Hiba Khaleel<\/b>; \n<i>Posted: 02 Oct 2026<\/i>; We sincerely thank the reviewer for the valuable comments and for the time and effort devoted to reviewing our manuscript. We have carefully considered the reviewer's comment, and the minor error has been corrected accordingly.&nbsp; Kind regards, Hiba Mohammed Khaleel.","URL":"https:\/\/f1000research.com\/articles\/14-1355\/v5#referee-comment-17326","order":10,"name":"referee-comment-17326","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"The author(s) declared that no grants were involved in supporting this work","order":11,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}