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Hum. Reprod. Advance Access originally published online on October 19, 2006
Human Reproduction 2006 21(12):3108-3115; doi:10.1093/humrep/del306
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© The Author 2006. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Is the PCOS diagnosis solved by ESHRE/ASRM 2003 consensus or could it include ultrasound examination of the ovarian stroma?

C. Belosi1, L. Selvaggi2, R. Apa2, M. Guido2, D. Romualdi2, A.M. Fulghesu3 and A. Lanzone1,2,4,5

1 ISI, Istituto Scientifico Internazionale Paolo VI 2 Unit of Physiopathology of Human Reproduction, Department of Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Rome 3 Department of Obstetrics and Gynecology, Università degli Studi di Cagliari, Cagliari and 4 OASI Institute for Research, Troina (EN), Italy

5 To whom correspondence should be addressed at: Department of Obstetrics and Gynaecology, Università Cattolica del Sacro Cuore, L.go A. Gemelli 8, 00168 Rome, Italy. E-mail: alanzone{at}rm.unicatt.it

BACKGROUND: The clinical heterogeneity of polycystic ovary syndrome (PCOS) is mirrored by the unceasing debate on the most appropriate diagnostic criteria. METHODS AND RESULTS: To highlight differences and inconsistencies between NIH and ESHRE/ASRM criteria, we applied them to 375 patients with oligo/amenorrhoea and signs of hyperandrogenism. Among them, we identified 273 women with PCOS according to NIH, whereas up to 345 patients fulfilled ESHRE/ASRM criteria. The 72 patients, constituting the gap between the two classifications, exhibited a lower expression of clinical signs compared with the 273 patients matching both criteria. To the whole group, we then applied the ESHRE/ASRM criteria modified to include an easily reproducible ultrasound examination of the ovarian stroma (UCSC criteria). In this way, we identified 30 women who were healthy according to all criteria, 37 affected by PCOS according only to the ESHRE/ASRM Consensus, 35 affected according only to the UCSC and ESHRE/ASRM criteria and 273 who were considered to have PCOS by all criteria. These groups showed a progressively increasing expression of PCOS features. CONCLUSION: In the grey area between NIH and ESHRE/ASRM classifications, UCSC criteria could identify a subgroup of women, missed by NIH criteria, with more pronounced stigmas than those identified by ESHRE/ASRM criteria alone, and who may profit more from a targeted therapy.

Key words: diagnosis/polycystic ovary syndrome/ultrasound criteria


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