Polycystic ovary morphology: age-based ultrasound criteria

Abstract

To determine age-based criteria for polycystic ovary morphology. Cross-sectional, case-control design. Outpatient setting. Women with polycystic ovary syndrome (PCOS) defined by hyperandrogenism and irregular menses (n = 544) and controls with regular menses and no evidence of hyperandrogenism (n = 666) participated. Parameters were tested in a second cohort of women with PCOS (n = 105) and controls (n = 32) meeting the same criteria. Subjects underwent a pelvic ultrasound documenting ovarian volume and maximum follicle number in a single plane. A receiver operating characteristic curve was constructed to determine the ovarian volume and follicle number with the best sensitivity and specificity to define PCOS for age groups at approximately 5-year intervals from age 18 to >44years. The best sensitivity and specificity were obtained using a threshold volume of 12mL and 13 follicles for ages ≤24years, 10mL and 14 follicles for ages 25-29years, 9mL and 10 follicles for ages 30-34years, 8mL and 10 follicles for ages 35-39years, 10mL and 9 follicles for ages 40-44years, and 6mL and 7 follicles for ages >44years. Data from a second cohort confirmed the need to decrease volume and follicle number with increasing age to diagnose PCOS. Polycystic ovary morphology was most accurate at predictingthe PCOS diagnosis for women ages 30-39years. The ovarian volume and follicle number threshold to define polycystic ovary morphology should be lowered starting at age30.