Counting follicles to define polycystic ovary morphology: should we change the way we do it?

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Author:

Didier Dewailly, M.D.

Abstract:

Since the Rotterdam consensus in 2003, the ultrasound aspect of polycystic ovary morphology (PCOM) has been part of the diagnostic classification of polycystic ovary syndrome (PCOS), in association with at least 1 of the 2 items “oligo-anovulation” and “hyperandrogenism.” At the time, the official definition of PCOM was several follicles of 2–9 mm per ovary (FNPO) ≥12 or an ovarian volume (OV) ≥10 mL. Since then, this definition has evolved, mainly due to the improved performance of ultrasound equipment, which now offers images with much better resolution because of high-frequency endovaginal probes (≥8 MHz). This evolution exclusively concerns the FNPO, the measurement of OV not impacted by technical progress, but this parameter is much less sensitive than the FNPO, which remains the main measurement. With the improvement of follicle counting, the FNPO threshold ≥12 to define PCOM has become obsolete, and a recent international guideline recommends a threshold ≥20 with high-frequency endovaginal probes (≥8 MHz) (1).

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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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