Archives of Gynecology and Obstetrics

, Volume 284, Issue 6, pp 1443–1448 | Cite as

Ovarian morphology and endocrine function in polycystic ovary syndrome

  • Gilberto Tena
  • Carlos Moran
  • Rocio Romero
  • Segundo Moran
General Gynecology

Abstract

Purpose

To assess the relationship between ovarian morphology, hormonal levels and anthropometrical characteristics in a group of patients with polycystic ovary syndrome (PCOS).

Methods

This prospective, cross-sectional study included 82 patients with diagnosis of PCOS and 21 women with regular menstrual cycles without hyperandrogenism. They were submitted to endovaginal pelvic ultrasound. Anthropometric measures and hormonal levels of LH, FSH, insulin, total testosterone (T), free T, dehydroepiandrosterone and dehydroepiandrosterone sulfate were evaluated. The morphology of polycystic ovary (PCO) was considered when 12 or more follicles, less than 10 mm in diameter, in one or both ovaries, were observed. PCOS patients were divided into two groups: with PCO (n = 51) and without PCO (n = 31).

Results

In 51 out of 82 (62%) patients with PCOS, an image of PCO was observed. PCOS Patients with PCO showed a significantly greater body mass index and hip perimeter than PCOS patients without PCO. Higher levels of total T and free T were found in PCOS patients with PCO compared to those without PCO.

Conclusion

PCOS patients with PCO on ultrasound present greater hyperandrogenism and obesity than PCOS patients without PCO. The presence of PCO appears to indicate a major clinical alteration of PCOS.

Keywords

Polycystic ovary syndrome Hyperandrogenism Ovarian morphology 

Notes

Acknowledgments

The authors thank Jaime Rodriguez and Maria G. Torres for their technical help and dedication to this study. This study was supported in part by the following research grants: 38371-M from CONACYT, and 2006/1A/I/019 from IMSS, Mexico.

References

  1. 1.
    Knochenhauer ES, Key TJ, Kahsar-Miller M, Waggoner W, Boots LR, Azziz R (1998) Prevalence of the polycystic ovary syndrome in unselected black and white women of the southeastern United States: a prospective study. J Clin Endocrinol Metab 83:3078–3082PubMedCrossRefGoogle Scholar
  2. 2.
    Diamanti-Kandarakis E, Kouli CR, Bergiele AT, Filandra FA, Tsianateli TC, Spina GG et al (1999) A survey of the polycystic ovary syndrome in the Greek island of Lesbos: hormonal and metabolic profile. J Clin Endocrinol Metab 84:4006–4011PubMedCrossRefGoogle Scholar
  3. 3.
    Asunción M, Calvo RM, San Millán JL, Sancho J, Avila S, Escobar-Morreale HF (2000) A prospective study of the prevalence of the polycystic ovary syndrome in unselected caucasian women from Spain. J Clin Endocrinol Metab 85:2434–2438PubMedCrossRefGoogle Scholar
  4. 4.
    Moran C, Tena G, Moran S, Ruiz P, Reyna R, Duque X (2010) Prevalence of polycystic ovary syndrome and related disorders in Mexican women. Gynecol Obstet Invest 69:274–280PubMedCrossRefGoogle Scholar
  5. 5.
    Zawadski JK, Dunaif A (1992) Diagnostic criteria for polycystic ovary syndrome: towards a rational approach. In: Dunaif A, Givens JR, Haseltine F, Merriam GR (eds) Polycystic ovary syndrome. Blackwell, Boston, pp 377–384Google Scholar
  6. 6.
    The Rotterdam ESHRE/ASRM-sponsored PCOS consensus workshop group (2004) Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Hum Reprod19:41–47Google Scholar
  7. 7.
    Azziz R, Carmina E, Dewailly D, Diamanti-Kandarakis E, Escobar-Morreale HF, Futterweit W et al (2006) Position statement: criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: an Androgen Excess Society guideline. J Clin Endocrinol Metab 91:4237–4245PubMedCrossRefGoogle Scholar
  8. 8.
    Azziz R, Sanchez LA, Knochenhauer ES, Moran C, Lazenby J, Stephens KC et al (2004) Androgen excess in women: experience with over 1000 consecutive patients. J Clin Endocrinol Metab 89:453–462PubMedCrossRefGoogle Scholar
  9. 9.
    Moran C, Renteria JL, Moran S, Herrera J, Gonzalez S, Bermudez JA (2008) Obesity differentially affects serum levels of androstenedione and testosterone in polycystic ovary syndrome. Fertil Steril 90:2310–2317PubMedCrossRefGoogle Scholar
  10. 10.
    Ferriman D, Gallwey JD (1961) Clinical assessment of body hair growth in women. J Clin Endocr 21:1440–1447PubMedCrossRefGoogle Scholar
  11. 11.
    Hatch R, Rosenfield RL, Kim MH, Tredway D (1981) Hirsutism: implications, etiology, and management. Am J Obstet Gynecol 140:815–830PubMedGoogle Scholar
  12. 12.
    WHO Expert Committee (1995) Physical status: the use and interpretation of anthropometry. WHO Tec Rep Ser No. 854. Geneva, WHO, 1995Google Scholar
  13. 13.
    Moran C, Hernandez E, Ruiz JE, Fonseca M, Bermudez JA, Zarate A (1999) Upper body obesity and hyperinsulinemia are associated with anovulation. Gynecol Obstet Invest 47:1–5PubMedGoogle Scholar
  14. 14.
    Treloar AE, Boynton RE, Behn BG, Brown BW (1967) Variation of the human menstrual cycle trough reproductive life. Int J Fert 12:77–126Google Scholar
  15. 15.
    Dewailly D, Catteau-Jonard S, Poncelet E (2010) Which morphological investigations and how to interpret them to make the diagnosis of PCOS? Ann Endocrinol (Paris) 71:183–188Google Scholar
  16. 16.
    Carmina E, Chu MC, Moran C, Tortoriello D, Vardhana P, Tena G et al (2008) Subcutaneous and omental fat expression of adiponectin and leptin in women with polycystic ovary syndrome. Fertil Steril 89:642–648PubMedCrossRefGoogle Scholar
  17. 17.
    Orsini LF, Venturoli S, Lorusso R, Pluchinotta V, Paradisi R, Bovicelli L (1985) Ultrasonic findings in polycystic ovarian disease. Fertil Steril 43:709–714PubMedGoogle Scholar
  18. 18.
    Legro RS, Chiu P, Kunselman AR, Bentley CM, Dodson W, Dunaif A (2005) Polycystic ovaries are common in women with hyperandrogenic chronic anovulation but do not predict metabolic or reproductive phenotype. J Clin Endocrinol Metab 90:2571–2579PubMedCrossRefGoogle Scholar
  19. 19.
    Pache TD, Wladimiroff JW, Hop WCJ, Fauser BCJM (1992) How to discriminate between normal and polycystic ovaries: transvaginal US study. Radiology 183:421–423PubMedGoogle Scholar
  20. 20.
    Jonard S, Robert Y, Cortet-Rudelli C, Pigny P, Decanter C, Dewailly D (2003) Ultrasound examination of polycystic ovaries: is it worth counting the follicles? Hum Reprod 18:598–603PubMedCrossRefGoogle Scholar
  21. 21.
    Murphy MK, Hall JE, Adams JM, Lee H, Welt CK (2006) Polycystic ovarian morphology in normal women does not predict the development of polycystic ovary syndrome. J Clin Endocrinol Metab 91:3878–3884PubMedCrossRefGoogle Scholar
  22. 22.
    Hassa H, Tanir HM, Yildiz Z (2006) Comparison of clinical and laboratory characteristics of cases with polycystic ovarian syndrome based on Rotterdam’s criteria and women whose only clinical signs are oligo/anovulation or hirsutism. Arch Gynecol Obstet 274:227–232PubMedCrossRefGoogle Scholar
  23. 23.
    Mortensen M, Rosenfield RL, Littlejohn E (2006) Functional significance of polycystic-size ovaries in healthy adolescents. J Clin Endocrinol Metab 91:3786–3790PubMedCrossRefGoogle Scholar
  24. 24.
    Welt CK, Gudmundsson JA, Arason G, Adams J, Palsdottir H, Gudlaugsdottir G et al (2006) Characterizing discrete subsets of polycystic ovary syndrome as defined by the Rotterdam criteria: the impact of weight on phenotype and metabolic features. J Clin Endocrinol Metab 91:4842–4848PubMedCrossRefGoogle Scholar
  25. 25.
    Fulghesu AM, Ciampelli M, Belosi C, Apa R, Pavone V, Lanzone A (2001) A new ultrasound criterion for the diagnosis of polycystic ovary syndrome: the ovarian stroma/total area ratio. Fertil Steril 76:326–331PubMedCrossRefGoogle Scholar
  26. 26.
    Gradmark AM, Rydh A, Renström F, De Lucia-Rolfe E, Sleigh A, Nordström P et al (2010) Computed tomography-based validation of abdominal adiposity measurements from ultrasonography, dual-energy X-ray absorptiometry and anthropometry. Br J Nutr 104:582–588PubMedCrossRefGoogle Scholar
  27. 27.
    Joseph-Horne R, Mason H, Batty S, White D, Hillier S, Urquhart M et al (2002) Luteal phase progesterone excretion in ovulatory women with polycystic ovaries. Hum Reprod 17:1459–1463PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Gilberto Tena
    • 1
  • Carlos Moran
    • 2
    • 3
    • 4
  • Rocio Romero
    • 2
  • Segundo Moran
    • 3
  1. 1.General Direction of Medical Unit of High Specialty in Gynecology and Obstetrics Luis Castelazo AyalaMexican Institute of Social Security (IMSS)Mexico CityMexico
  2. 2.Direction of Health Research and Training, Medical Unit of High Specialty in Gynecology and Obstetrics Luis Castelazo AyalaIMSSMexico CityMexico
  3. 3.Health Research CouncilIMSSMexico CityMexico
  4. 4.BirminghamUSA

Personalised recommendations