Do polycystic ovaries (PCO) mean that the woman has Polycystic Ovarian Syndrome (PCOS)? The answer is NO according to the authors of this current article:
Background (reviewed by authors)
- The original study defining the AFC (antral follicle count) criteria omitted ovulatory non-PCOS patients.
- Before 2003, the most commonly applied characterization of PCO was 10 or more follicles 2–8 mm in diameter, peripherally arranged around a dense area of stroma.
- This common ultrasound finding has a population prevalence between 14 and 33%, and 7–24% among women with regular menses not using oral contraception.
- The current diagnosis of PCOS is based on criteria agreed to in Rotterdam
Thus, the definition of PCO used for the diagnosis of PCOS may not be as specific to the syndrome of PCOS as one might think. The authors wanted to determine how common the ultrasound finding of PCO was among normal ovulatory women.
The authors used normal ovulatory women with normal menstrual cycles. The AFC included the total follicles measuring 2-9 mm in both ovaries on cycle days 2-4. The volume of the ovary was calculated using the volume of an ovoid after measuring the length, width and height.
Note the incidence found in these normal women:
Note the following data from the my former practice (NCRS) IVF Database
[table “37” not found /]
PCOS Quick Facts
- PCO is common among young ovulatory women who do not have PCOS
- PCO is age-dependent and becomes less common as a woman ages (62% in 25-30 yo vs. 7% in 41-45 yo), which reflects the natural loss of eggs
- PCO is associated with higher AMH levels (6.3 ng/ml vs. 3.3 ng/ml)
Johnstone EB et. al. The Polycystic Ovary Post-Rotterdam: A Common, Age-Dependent Finding in Ovulatory Women without Metabolic Significance. J. Clin. Endocrinol. Metab. 2010 95:4965-4972.