POLYCYSTIC-OVARY-SYNDROME - THE SPECTRUM OF THE DISORDER IN 1741 PATIENTS

The criteria for the diagnosis of the polycystic ovary syndrome (PCOS) have still not been agreed universally, A population of 1741 women wi th PCOS were studied, all of whom had polycystic ovaries seen by ultra sound scan, The frequency distributions of the serum concentrations of follicle stimulating hormone (FSH), luteinizing hormone (LH), testost erone and prolactin and the body mass index, ovarian volume, uterine c ross-sectional area and endometrial thickness were determined and comp ared with the symptoms and signs of PCOS, Obesity was associated with hirsutism and an elevated serum testosterone concentration and was als o correlated with increased rates of infertility and cycle disturbance , The rates of infertility and cycle disturbance also increased with s erum LH concentrations >10 IU/l. A rising serum concentration of testo sterone [mean and 95th percentiles 2.6 (1.1-4.8) nmol/l] was associate d with an increased risk of hirsutism, infertility and cycle disturban ce, The ovarian volume was correlated with serum concentrations of tes tosterone, LH and the body mass index, which was also correlated with the uterine area. This descriptive data from the largest reported seri es of women with PCOS enables the development of a management-orientat ed approach to the syndrome. Women who are overweight can expect an im provement in their symptoms if they lose weight, An elevated concentra tion of LH (>10 IU/l) is associated with infertility and treatment sho uld be chosen accordingly. If the serum testosterone concentration is >4.8 nmol/l, other causes of hyperandrogenism should be excluded.