Sonographic Evaluation of the Endometrium in Patients With a History or an Appearance of Polycystic Ovarian Syndrome

Abstract

A heterogeneous cystic endometrium is associated with the prolonged proliferative phase from chronic anovulation as well as endometrial hyperplasia.

Endometrial thickness predicts endometrial hyperplasia in patients with polycystic ovary syndrome

“…Our sample of young premenopausal obese patients with PCOS had a 30% rate of endometrial hyperplasia by biopsy, within the reported range of 12%-49% (3)(4)(5). Consistent with others, we noted that simple hyperplasia predominates, but complex and atypical histologies do occur (3)(4)(5).…”

“…Consistent with others, we noted that simple hyperplasia predominates, but complex and atypical histologies do occur (3)(4)(5). Atypia obviously raises the most concern, with 27.5% risk of progression to carcinoma over 20 years (10).…”

“…Our study was somewhat smaller than but comparable in design to a previous report (3), but a bigger sample would have allowed analysis for specific hyperplasia histologies, follow-up biopsies, and influence of tobacco and alcohol use. We also did not evaluate endometrial pattern or echogenicity, but the impact of these is controversial (4,5). Although most of our sample was hyperandrogenic and anovulatory, we did not specifically analyze different PCOS phenotypes (6), which may have affected the results (7).…”

Endometrial Thickness, Uterine, and Ovarian Ultrasonographic Features in Adolescents with Polycystic Ovarian Syndrome

“…8 A study by Peri et al evaluated the endometrium of 245 patients (age 16e49 yrs) with PCOS. 7 In the patients with homogeneous endometrium, ET ranged from 1 to 17 mm (mean 6.4 AE 3.1 mm), while in those with a heterogeneous endometrium, ET ranged from 4 to 23 mm (mean 13.2 AE 5.6 mm). 7 In subsequent biopsies, all cases of EH occurred with a heterogeneous appearance, thus suggesting the importance of diligent clinical follow-up in cases of heterogeneous endometrium.…”

“…5,6 The chronic anovulation and unopposed estradiol often seen in PCOS results in chronic stimulation of the endometrium which can lead to endometrial hyperplasia (EH), and in some cases, EC; this potential progression underscores the importance of examining the endometrium in PCOS patients. 7 A study by Cheung assessed the role of endometrial thickness (ET) in predicting EH in women (mean age 30 yrs) with PCOS. Cheung showed a positive correlation between ET and EH.…”