Am. Fulghesu et al., A new ultrasound criterion for the diagnosis of polycystic ovary syndrome:the ovarian stroma/total area ratio, FERT STERIL, 76(2), 2001, pp. 326-331
Objective: To evaluate whether some ultrasound parameters of ovarian morpho
logy can discriminate between control women and patients with polycystic ov
ary syndrome (PCOS).
Design: Retrospective data analysis.
Setting: Volunteers women in an academic research environment.
Patient(s): Eighty amenorrheic or oligomenorrheic women and 30 normal ovula
tory control participants.
Intervention(s): None.
Main Outcome Measure(s): We evaluated ovarian volume, area, stroma, and the
stroma/total area (SIA) ratio by use of transvaginal pelvic ultrasound; an
d we assayed serum levels of gonadotropin, androgen, and estradiol during t
he early follicular phase (days 2 to 5) of the menstrual cycle in regularly
cycling controls and on a random day in amenorrheic patients.
Result(s): Patients with PCOS showed significantly higher ovarian volume, a
rea, stroma, and mean S/A ratio when compared to multifollicular and contro
l groups. Cut-off values have been defined for ovarian volume (13.21 mL), a
rea (7.00 cm(2)), stroma. (1.95 cm(2)), and S/A ratio (0.34). The sensitivi
ty for PCOS diagnosis was 21%, 4%, 62%, and 100%, respectively. The S/A rat
io showed the most significant correlation with the androgen levels.
Conclusion(s): The evaluation of the SIA ratio can differentiate between PC
OS and control or multifollicular Za women with both a sensitivity and a sp
ecificity of 100%. Furthermore, this ultrasound parameter is strictly relat
ed to hormonal milieu and to anthropometric characteristics. (C) 2001 by Am
erican Society for Reproductive Medicine.