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Polycystic Appearing Ovaries
Title:Endocrine abnormalities in ovulatory women with polycystic ovaries on ultrasound
Author: E.Carmina et al.
Address:New York, New York
Source:Human Reproduction 12: 905-909 (May) 1997
Summary:Polycystic appearing ovaries or polycystic ovaries (PAO), an ultrasound diagnosis, may not be the same as polycystic ovarian syndrome(PCOS), a diagnosis made with findings of hyperandrogenism and chronic anovulation. The study groups included: 15 women with normal appearing ovaries (NAO), 15 women with PAO, and 25 women who were considered to have PCOS. All PCOS women had serum concentrations of luteinizing hormone (LH), testosterone, unbound testosterone,, androstenedione and dehydroepiandrosterone sulfate (DHEAS) which were significantly higher P=0.01 than the values of the women in the other 2 groups. The endocrine values were similar in the NAO and PAO women. In all groups weight appeared to be a variable and was correlated to fasting insulin levels.This was most pronounced in women with PCOS (P less than 0.01). Serum insulin-like growth factor (IGF)-I and binding protein (BP)-3 was similar in all groups. Serum IGFBP-1 was significantly lower (Pless than 0.01) in women with PCOS and increased body weight. Comparing ovulatory NAO women with ovulatory PAO women, serum, IGFBP-1 was significantly lower (P less than 0.05) in the PAO / PCO group . PCOS women of normal weight had similar findings as the PAO group for serum IGFBP-1. When tested individually, 33% of PAO women had at least one androgen value elevated. The authors concluded that increased body weight accentuates metabolic alterations in PCOS, these alterations may be uncovered in up to one third of the ovulatory women with PAO / PCO and IGF/IGFBP-1 axis disturbance is common and associated with alterations in ovarian morphology.
Comment:I have a problem with the terminology of polystic-appearing, or polcystic-like ovaries. They either are, or are not polycystic ovaries. This should not detract from the value of trying to unravel the complex spectrum of obesity, hyperandrogenism and ovarian structure / function. In some studies, as high as 30% of women have polycystic ovaries on ultrasound. Many of these women are fertile, but a high percentage are being evaluated for infertility or menstrual dysfunction. Most women with PCOS have PAO, many with PAO have some of the findings of PCOS. To determine the finding of polycystic ovaries on ultrasound, I use the greater than 10 follicles less than 10 mm criterion, especially in a subcortical distribution often, referred to as a string of pearls, as a harbinger of more important endocrine and ovulatory disturbance. I believe that the above paper, once the problem of semantics has been solved, would agree with this approach.

New York, New York
Source:Human Reproduction 12: 905-909 (May) 1997
Summary:Polycystic appearing ovarie