Polycystic ovary morphology: age-based ultrasound criteria

The threshold ovarian volume and follicle number to define polycystic ovary morphology should be lowered.

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Volume 108, Issue 3, Pages 548–553

Authors:

Hyun-Jun Kim, M.D., Judith M. Adams, D.M.U., Jens A. Gudmundsson, M.D., Gudmundur Arason, M.D., Cindy T. Pau, M.D., Corrine K. Welt, M.D.

Abstract:

Objective

To determine age-based criteria for polycystic ovary morphology.

Design

Cross-sectional, case-control design.

Setting

Outpatient setting.

Subject(s)

Women with polycystic ovary syndrome (PCOS) defined by hyperandrogenism and irregular menses (n = 544) and controls with regular menses and no evidence of hyperandrogenism (n = 666) participated. Parameters were tested in a second cohort of women with PCOS (n = 105) and controls (n = 32) meeting the same criteria.

Intervention(s)

Subjects underwent a pelvic ultrasound documenting ovarian volume and maximum follicle number in a single plane.

Main Outcome Measure(s)

A receiver operating characteristic curve was constructed to determine the ovarian volume and follicle number with the best sensitivity and specificity to define PCOS for age groups at approximately 5-year intervals from age 18 to >44 years.

Result(s)

The best sensitivity and specificity were obtained using a threshold volume of 12 mL and 13 follicles for ages ≤24 years, 10 mL and 14 follicles for ages 25–29 years, 9 mL and 10 follicles for ages 30–34 years, 8 mL and 10 follicles for ages 35–39 years, 10 mL and 9 follicles for ages 40–44 years, and 6 mL and 7 follicles for ages >44 years. Data from a second cohort confirmed the need to decrease volume and follicle number with increasing age to diagnose PCOS. Polycystic ovary morphology was most accurate at predicting the PCOS diagnosis for women ages 30–39 years.

Conclusion(s)

The ovarian volume and follicle number threshold to define polycystic ovary morphology should be lowered starting at age 30.


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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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