Ultrasound examination of polycystic ovaries: is it worth counting the follicles?

Abstract

We propose to modify the definition of polycystic ovaries by adding the presence of > or =12 follicles measuring 2-9 mm in diameter (mean of both ovaries). Also, our findings strengthen the hypothesis that the intra-ovarian hyperandrogenism promotes excessive early follicular growth and that further progression cannot proceed normally because of hyperinsulinism and/or other metabolic influence linked to obesity.

Two- and Three-Dimensional Sonographic and Color Doppler Techniques for Diagnosis of Polycystic Ovary Syndrome

“…In contrast, other investigators have shown that 3D sonography improves the reliability and reproducibility of follicle counts. [22][23][24] In our opinion, the use of a semiautomated system that returns the number of follicles improves the feasibility of the assessment and may reduce the bias related to the experience of the operators. As far as calculation of volumes is concerned, 3D sonography avoids the use of geometric assumptions and correction factors required in 2D sonography.…”

“…The first group comprised 112 young adult (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35) years) lean (body mass index [BMI], <25 kg/m 2 ) Italian women with polycystic ovary syndrome. The criteria for diagnosis were hirsutism (Ferriman-Gallwey score ≥8), 7 oligomenorrhea (menstrual cycle length ≥35 days), bilateral 2D sonographic findings (≥12 follicles measuring 2-9 mm in diameter, ovarian volume ≥10 mL or both), and exclusion of secondary causes of hyperandrogenism (ie, hyper prolactinemia and thyroid and adrenal disorders).…”

Diagnostic Criteria for Polycystic Ovary Syndrome: Pitfalls and Controversies

“…55 The cut-off of ≥ 12 follicles throughout the entire ovary was based on a single report demonstrating this value to have 99% specificity and 75% sensitivity in distinguishing between polycystic and normal ovaries. 56 The reproducibility of these values has not been confirmed in repeated studies, and there is evidence to support the postulate that these cut-off values cannot be used to distinguish between women with and without PCOS 57,58 (e.g., 58% of the control subjects in the study of Diamanti-Kandarakis et al 33 had > 12 follicles per ovary). As a result, many reproductive endocrinologists use their own criteria in clinical practice (e.g., > 20 follicles per ovary 58 or increased stroma/total area ratio 59 ), while medical imaging specialists tend to use older criteria because of the slow dissemination of findings among disciplines.…”

“…61 The variability demonstrated by the observers indicated that the criteria employed were either too subjective or that the measurements were too insensitive to allow for good agreement. 56 Unfortunately, the extent to which any feature contributed to the subjectivity of the diagnosis was not evaluated, nor has a similar evaluation using the ESHRE/ASRM ultrasound criteria been performed since they were proposed in 2003. If ultrasonographic evidence of polycystic ovaries is to remain a diagnostic criterion for PCOS, then reduction in observer variability is needed.…”

Yüksek fruktoz içerikli beslenmenin overlerde perilipin ekspresyonu ve polikistik over gelişimi ile ilişkisi

“…Bazal koşullarda serum androstenedion seviyesi antral folikül sayısını belirlemektedir. PCOS hastalarındaki yüksek serum androjen seviyesi artan 2-5 mm çapındaki foliküller ile pozitif korelasyon göstermektedir [14,15]. Hücre içi sitoplazmik yapılar olan Lipid Dropletler (LD), hücre içeri-sindeki lipidleri metabolik enerji, membran bileşeni, protein modifikasyonu ve sinyal molekülü gibi birçok hücre içi olayda kullanmak üzere, TG olarak depolamaktadırlar [16,17].…”