The contribution of sonographic evaluation of ovarian size in patients with polycystic ovarian disease.

Abstract

The ovarian size of 44 patients with clinical and endocrinologic findings suggesting polycystic ovarian disease (PCOD) was studied by ultrasound examination. Reproducibility of the ovarian parameters (transverse, longitudinal, and anteroposterior diameters, and volume) was also evaluated. The endocrine status of each patient was evaluated by assay of blood levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone, 17 beta-estradiol (17 beta E2), and serum prolactin (PRL). Ovarian size was also investigated in 40 women with normal cycles, following the same ultrasound procedure. The mean ovarian volume of the normal controls was statistically different from the mean of patients with PCOD. Only 34 per cent of the patients affected by PCOD were above the second standard deviation of normal ovarian size. A correlation between endocrinologic findings and ovarian size was observed in women whose ovarian size fell within normal limits; these women had higher, though not statistically different, values of LH and testosterone and lower values of 17 beta E2 and PRL compared with patients with enlarged ovaries. Responsiveness to treatment was more easily observed in patients with ovarian enlargement.

Transvaginal Ultrasonographic Morphology in Polycystic Ovarian Syndrome

“…Studies based on transabdominal ultrasound have shown that normal ovaries were ellipsoid structures, with aver age volumes between 4.0 and 6.5 ml and the upper limit of ovarian volume between 5.7 and 7.6 ml [11,17,18], The ovarian volumes in patients with PCOS were twice those in normal ovaries, with average ovarian volume rangingfrom 12.0to 16.6 ml [8,10,11,14,[19][20][21], Pache et al [22], using transvaginal ultrasound, reported that the average ovarian volumes in normal women and patients with PCOS were 5.9 and 9.8 ml, respectively. In the present study, the ovarian volume (10.3 ml) observed in patients with PCOS was similarly about twice that (4.5 ml) in normal women and was in accordance with the results of Pache et al [22], Several investigators [10,11,23] have reported that 29-34% of ovaries in patients with PCOS were normal in size. Pache et al [22] also reported that a considerable overlap existed in ovarian volume between normal women and patients with PCOS.…”

Polycystic ovaries

“…In 1981, Swanson et al [11] described PCO as enlarged and rounded, with a mean volume of 12 cm 3 and containing an increased number of small follicles (2-8 mm) encircling the ovarian cortex. However, the importance of ovarian size in diagnosis has lessened as various groups [12][13][14] have shown a considerable overlap between PCO and normal ovaries and as the upper limit of normal has decreased from greater than 10 cm 3 to 5.5 cm 3 [15]. This decrease may also reflect the broader inclusion criteria in the latter studies compared with Swanson et al who only included patients with enlarged ovaries and classic Stein-Leventhal syndrome at the extreme end of the clinical spectrum.…”

Polycystic Ovaries Are Common in Women with Hyperandrogenic Chronic Anovulation but Do Not Predict Metabolic or Reproductive Phenotype

“…There are still indications to perform ultrasonography of the pelvis in women who present with these endocrine criteria for PCOS, i.e. to screen for anatomic abnormalities, such as polyps or endometrial hyperplasia causing dysfunctional uterine bleeding (64), or identify predictive factors for success or complications of ovulation induction (30,65). However, neither the morphology nor volume of the ovaries identify distinctive metabolic or reproductive abnormalities in women with hyperandrogenic chronic anovulation and routine ovarian ultrasonography in this group may be unnecessary.…”