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.