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La diagnosi della sindrome dell’ovaio policistico: problemi ancora aperti

Polycystic ovary syndrome diagnosis: open questions

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L'Endocrinologo Aims and scope

Sommario

La diagnosi di PCOS presenta molti problemi aperti, di non facile soluzione. Nessun elemento su cui si basa la diagnosi nella donna adulta è obbligatorio o specifico e la diagnosi è di esclusione. In adolescenza la diagnosi richiede particolare cautela. I problemi maggiori riguardano l’accertamento dell’iperandrogenismo. Anche la valutazione della morfologia ovarica presenta criticità, soprattutto per l’evoluzione tecnologica degli strumenti, che condiziona i valori di cutoff.

Abstract

PCOS diagnosis is made difficult by a number of open problems, not easy to be addressed. No elements used for diagnosis in adult women are necessary or specific, and PCOS is a diagnosis of exclusion. In adolescents, special caution is needed. The main problems are those regarding detection of hyperandrogenism. Assessment of ovarian morphology is another critical issue, especially due to the technological progress of devices, which affects the cutoff values.

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Bibliografia

  1. 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 (PCOS). Hum Reprod 19:41–47

    Article  Google Scholar 

  2. Azziz R, Carmina E, Dewailly D et al. (2009) The androgen excess and PCOS society criteria for the polycystic ovary syndrome: the complete task force report. Fertil Steril 91:456–488

    Article  PubMed  Google Scholar 

  3. Johnson T, Kaplan L, Ouyang P, Rizza P (2012) National Institutes of Health evidence-based methodology workshop on polycystic ovary syndrome. NIH EbMW Reports, National Institutes of Health, Bethesda. MD 1:1–14

  4. Teede HJ, Tay CT, Laven JJ et al for the International PCOS Network (2023) Recommendations from the 2023 international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Hum Reprod 38:1655–1679

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Moghetti P, Tosi F (2021) Insulin resistance and PCOS: chicken or egg? J Endocrinol Invest 44:233–244

    Article  CAS  PubMed  Google Scholar 

  6. Fauser BC, Tarlatzis BC, Rebar RW et al. (2012) Consensus on women’s health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-sponsored 3rd PCOS consensus workshop group. Fertil Steril 97:28–38

    Article  PubMed  Google Scholar 

  7. Legro RS, Arslanian SA, Ehrmann DA et al. (2013) Diagnosis and treatment of polycystic ovary syndrome: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 98:4565–4592

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Ibáñez L, Oberfield SE, Witchel S et al. (2017) An international consortium update: pathophysiology, diagnosis, and treatment of polycystic ovarian syndrome in adolescence. Horm Res Paediatr 88:371–395

    Article  PubMed  Google Scholar 

  9. Carmina E, Azziz R, Bergfeld W et al. (2019) Female pattern hair loss and androgen excess: a report from the multidisciplinary androgen excess and PCOS committee. J Clin Endocrinol Metab 104:2875–2891

    Article  PubMed  Google Scholar 

  10. Carmina E, Dreno B, Lucky WA et al. (2022) Female adult acne and androgen excess: a report from the multidisciplinary androgen excess and PCOS committee. J Endocr Soc 6(3):bvac003

    Article  PubMed  PubMed Central  Google Scholar 

  11. O’Reilly MW, Kempegowda P, Walsh M et al. (2017) AKR1C3-mediated adipose androgen generation drives lipotoxicity in women with polycystic ovary syndrome. J Clin Endocrinol Metab 102:3327–3339

    Article  PubMed  PubMed Central  Google Scholar 

  12. Tosi F, Fiers T, Kaufman JM et al. (2016) Implications of androgen assay accuracy in the phenotyping of women with polycystic ovary syndrome. J Clin Endocrinol Metab 101:610–618

    Article  CAS  PubMed  Google Scholar 

  13. ISSAM online calculator. http://www.issam.ch/freetesto.htm. Accessed on 13/11/2023

  14. Christ JP, Willis AD, Brooks ED et al. (2014) Follicle number, not assessments of the ovarian stroma, represents the best ultrasonographic marker of polycystic ovary syndrome. Fertil Steril 101:280–287

    Article  PubMed  Google Scholar 

  15. Moro F, Scavello I, Maseroli E et al for the Women’s Endocrinology (2023) The physiological sonographic features of the ovary in healthy subjects: a joint systematic review and meta-analysis by the Italian Society of Gynecology and Obstetrics (SIGO) and the Italian Society of Endocrinology (SIE). J Endocrinol Invest 46:439–456

    Article  CAS  PubMed  Google Scholar 

  16. Mattle V, Bilgyicildirim A, Hadziomerovic D et al. (2008) Polycystic ovarian disease unmasked by pulsatile GnRH therapy in a subgroup of women with hypothalamic amenorrhea. Fertil Steril 89:404–409

    Article  CAS  PubMed  Google Scholar 

  17. Zhu T, Goodarzi MO (2022) Causes and consequences of polycystic ovary syndrome: insights from Mendelian randomization. J Clin Endocrinol Metab 107:e899–e911

    Article  PubMed  Google Scholar 

  18. Ferrannini E, Balkau B (2002) Insulin: in search of a syndrome. Diabet Med 19:724–729

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Paolo Moghetti.

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Moghetti, P. La diagnosi della sindrome dell’ovaio policistico: problemi ancora aperti. L'Endocrinologo 25, 27–34 (2024). https://doi.org/10.1007/s40619-023-01406-3

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