Value of ultrasonography in the diagnosis of polycystic ovary syndrome – literature review

Abstract

Polycystic ovary syndrome is a multi-factorial disease. Its etiopathogenesis has not been elucidated in detail. It is the most common endocrine disorder in women of child-bearing age. This disease entity is primarily characterized by disrupted ovulation and hyperandrogenism, but the clinical picture can be diversified and symptom intensity can vary. Currently, the sonographic assessment of ovaries is one of the obligatory criteria for the diagnosis of PCOS according to the Rotterdam consensus (2003) and Androgen Excess & PCOS Society (2006). This criterion is determined by the presence of ≥12 follicles within the ovary with a diameter of 2–9 mm and/or ovarian volume ≥10 cm3. Such an ultrasound image in one gonad only is sufficient to define polycystic ovaries. The coexistence of polycystic ovaries with polycystic ovary syndrome is confirmed in over 90% of cases irrespective of ethnic factors or race. However, because of the commonness of ultrasound features of polycystic ovaries in healthy women, the inclusion of this sign to the diagnostic criteria of polycystic ovary syndrome is still questioned. The development of new technologies has an undoubted influence on the percentage of diagnosed polycystic ovaries. This process has caused an increase in the percentage of polycystic ovary diagnoses since the Rotterdam criteria were published. It is therefore needed to prepare new commonly accepted diagnostic norms concerning the number of ovarian follicles and the standardization of the technique in which they are counted. The assessment of anti-Müllerian hormone levels as an equivalent of ultrasound features of polycystic ovaries is a promising method. However, analytic methods have to be standardized in order to establish commonly accepted diagnostic norms.

Polycystic Ovary Syndrome as a systemic disease with multiple molecular pathways: a narrative review

“…Polycystic Ovary Syndrome (PCOS) is the most common endocrine disorder in women of reproductive age (Bachanek et al 2015;Jalilian et al 2015;Bachelot 2016;Glintborg and Andersen 2017;Papadakis et al 2017;Reis et al 2017). The patients usually present hyperandrogenism, amenorrhea, and polycystic ovaries (Palomba et al 2015;Aytan et al 2016;Carvalho et al 2017a;Glintborg and Andersen 2017;Reis et al 2017) but not necessarily all of these conditions, since the existence of a great phenotypic variability (Unluturk et al 2016).…”

Polycystic Ovarian Syndrome and Female Infertility

“…The comparison of ultrasound imaging between the normal ovary and polycystic ovary is shown in figure (Figure 4). The sonographic criteria have been subsequently modified and, therefore, the increase in ovarian volume (>10 cm 3 ) with dense echogenic stroma due to enlargement and the presence of multiple (12 or more) follicles each with a diameter of 2 to 9 mm sized placed peripherally along the surface of ovary giving a necklace appearance at least in one ovary [43]. It must be excluded from this rule women who use an oral contraceptive as it transforms the ovarian morphology in healthy women and probably also in women with PCO [21].…”

Lifestyle and Food Habits Impact on Chronic Diseases: Roles of PPARs

“…Polycystic ovary syndrome (PCOS) is the most widespread endocrine disorder affecting 8% to 13% of women [220,221,222]. These women typically present hyperandrogenism, amenorrhea, and polycystic ovaries [223,224].…”