Unilateral Ovarian Enlargement in Adolescents with Polycystic Ovary Syndrome: A Variant of Bilateral Disease

Abstract

To evaluate clinical, biochemical and radiological features in adolescent females with unilateral polycystic ovary (UniPCO) versus bilateral polycystic ovary (BiPCO) in patients with polycystic ovarian syndrome (PCOS), and to compare the association of insulin resistance (IR) and metabolic syndrome (MS) between the two groups. Pediatric endocrine clinic. A retrospective chart review of girls with the diagnosis of PCOS was performed. They were divided into two groups: PCOS with UniPCO and BiPCO. No difference was seen between the two groups in regard to clinical parameters. LH/FSH ratio was significantly higher in patients with BiPCO. No difference was seen in free testosterone, lipids, MS or IR between groups. Ultrasound showed a mean ovarian volume of 13.2 +/- 1.5 ml on the affected side in UniPCO and 16.1 +/- 1.2 ml in BiPCO. Ovarian follicle location was mostly peripheral in both UniPCO and BiPCO. Multiple follicles were found in the majority of cases. IR and MS were present in 40% of girls with UniPCO and 38% and 23%, respectively, in girls with BiPCO. UniPCO may be a forerunner of BiPCO and may represent an early point along the continuum. Later, the unaffected ovary continues to increase in volume, resulting in BiPCO. Metabolic abnormalities of patients with UniPCO highlights that as well as being a precursor of BiPCO, it also imparts considerable health risks.