Polycystic ovaries

• Polycystic ovarian syndrome (2003 definition based on joint meeting of American society of reproductive medicine and European society for human reproduction and embryology) requires 2 out of the 3 following criteria
  • Oligo and or anovulation
  • Hyperandrogenism (clinical and/or biochemical)
  • Polycystic ovaries
• 6-15% women have polycystic ovaries. 80% have infertility, menstrual irregularity or hirsuitism

Imaging

• Transvaginal ultrasound
  • Sensitive method
  • Better spatial resolution
  • Avoided if patient declines this scan
  • Preferably scan within first ten days of cycle. In those with irregular cycles, scan at any point of time
  • Ovaries with follicles >10 mm in size or a corpus luteum will have a larger volume and can be misdiagnosed as polycystic
  • 12 or more follicles needed of 2-9 mm in diameter
  • Stromal echogenicity is not an important feature
  • Ovarian volume should be ≥ 10 cm³. Single ovary sufficient to diagnose PCO

Read more

Hart, Roger, Martha Hickey, and Stephen Franks. “Definitions, prevalence and symptoms of polycystic ovaries and polycystic ovary syndrome.” Best Practice & Research Clinical Obstetrics & Gynaecology 18.5 (2004): 671-683.

Steinkeler, Jill A., et al. “Female infertility: a systematic approach to radiologic imaging and diagnosis.” Radiographics 29.5 (2009): 1353-1370.

Lee, Tony T., and Mary E. Rausch. “Polycystic ovarian syndrome: role of imaging in diagnosis.” Radiographics 32.6 (2012): 1643-1657.