Sonographic markers of ovarian morphology, but not hirsutism indices, predict serum total testosterone in women with regular menstrual cycles

Abstract

Objective To determine whether sonographic markers of ovarian morphology or male pattern hair growth scores predict androgen levels in women with regular or irregular menstrual cycles. Design Cross-sectional observational study. Setting Clinical research unit. Patient(s) Seventy-six women of reproductive age (18–39 years) were evaluated for male-pattern hair growth (using modified Ferriman-Gallwey scoring system), ovarian morphology (transvaginal ultrasonography) and total serum testosterone (liquid chromatography tandem mass spectrometry). Interventions None Main Outcome Measures Regional and total modified Ferriman-Gallwey (mFG) scores, number of follicles per follicle size category, follicle number per ovary (FNPO), ovarian volume (OV), ovarian area (OA), stromal to ovarian area ratio (S/A), stromal echogenicity index (SI), total testosterone (TT) and menstrual cycle length. Results Neither regional nor total mFG scores correlated with TT concentrations in women with regular or irregular menstrual cycles as judged by the Least Absolute Shrinkage and Selection Operator (LASSO) technique. By contrast, a sonographic marker (FNPO 6–9mm) significantly predicted TT concentrations in women with regular menstrual cycles but not in women with irregular menstrual cycles. Conclusion Sonographic markers of ovarian morphology, but not hirsutism scores, predicted TT levels. However, the predictive value of ovarian morphology for TT differed by menstrual cycle status. That sonographic markers did not predict androgen levels in a diverse cohort of women with cycle irregularity, suggests the potential for distinct variations in ovarian morphology for androgenic and non-androgenic types of cycle irregularity. Overall, our findings support that an assessment of ovarian morphology may be helpful in reflecting TT levels.

Dietary and Physical Activity Behaviors in Women with Polycystic Ovary Syndrome per the New International Evidence-Based Guideline

“…It was the first to comply with the new diagnostic thresholds to identify PCOS when assessing diet and physical activity behaviors. Our approach was rigorous as we uniformly evaluated polycystic ovarian morphology [25,65] and also used a gold standard methodology for measuring total testosterone concentrations [34]. We acknowledge that the average bilateral FNPO in our controls was slightly higher than the thresholds for polycystic ovaries recommended by the guideline [1].…”

“…Fasting serum concentrations of total testosterone (Brigham Research Assay Core, Boston, MA, US) were measured by liquid chromatography tandem mass spectrometry at a clinical chemistry lab participating in the Centers for Disease Control and Prevention Hormone Standardization Program, as previously described [34]. Serum concentrations of sex hormone binding globulin were measured using chemiluminescence immunoassay (Siemens Medical Solutions Diagnostics, Deerfield, IL, US).…”