alexa Ultrasound assessment of the polycystic ovary: international consensus definitions


Journal of Womens Health Care

Author(s): Adam H Balen, Joop SE Laven, SeangLin Tan, Didier Dewailly

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The polycystic ovary syndrome (PCOS) is a heterogeneous condition, the pathophysiology of which appears to be both multifactorial and polygenic. The de®nition of the syndrome has been much debated. Key features include menstrual cycle disturbance, hyperandrogenism and obesity. There are many extra-ovarian aspects to the pathophysiology of PCOS, yet ovarian dysfunction is central. At a recent joint ASRM/ESHRE consensus meeting, a re®ned de®nition of the PCOS was agreed, encompassing a description of the morphology of the polycystic ovary (PCO). According to the available literature, the criteria ful®lling suf®cient speci®city and sensitivity to de®ne the PCO should have at least one of the following: either 12 or more follicles measuring 2±9 mm in diameter, or increased ovarian volume (>10 cm3). If there is a follicle >10 mm in diameter, the scan should be repeated at a time of ovarian quiescence in order to calculate volume and area. The presence of a single PCO is suf®cient to provide the diagnosis. The distribution of follicles and a description of the stroma are not required in the diagnosis. Increased stromal echogenicity and/or stromal volume are speci®c to PCO, but it has been shown that the measurement of ovarian volume (or area) is a good surrogate for quanti®cation of the stroma in clinical practice. A woman having PCO in the absence of an ovulation disorder or hyperandrogenism (`asymptomatic PCO') should not be considered as having PCOS, until more is known about this situation. Three-dimensional and Doppler ultrasound studies may be useful research tools but are not required in the de®nition of PCO. This review outlines evidence for the current ultrasound de®nition of the polycystic ovary and technical speci®cations

This article was published in Human Reproduction and referenced in Journal of Womens Health Care

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