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Hum. Reprod. Advance Access originally published online on October 18, 2007
Human Reproduction 2007 22(12):3116-3123; doi:10.1093/humrep/dem218
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© The Author 2007. 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

Three-dimensional ultrasound features of the polycystic ovary and the effect of different phenotypic expressions on these parameters

Po M. Lam1,2,3, Ian R. Johnson2 and Nick J. Raine-Fenning2

1 Department of Obstetrics and Gynaecology, The Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China 2 School of Human Development, Academic Division of Reproductive Medicine, Queens Medical Centre, Nottingham, UK

3 Correspondence address. Fax: +86-852-2636-0008; E-mail: lampomui{at}cuhk.edu.hk

BACKGROUND: The aim of this study was to quantify the three-dimensional (3D) ultrasound characteristics of ovaries in Caucasian women with polycystic ovarian syndrome (PCOS) and to examine if these values differed between different phenotypic forms.

METHODS: 3D pelvic ultrasound was performed in 40 women with PCOS and in 40 controls. Total ovarian volume, stromal volume and echogenicity and antral follicle count (AFC) were measured and ovarian blood flow was quantified using both 3D power Doppler and two-dimensional pulsed-wave Doppler.

RESULTS: Women with PCOS had a higher AFC (median 16.3 versus 5.5 per ovary, P < 0.001) and ovarian volume (12.56 versus 5.66 ml, P < 0.001). Stromal volume (10.79 versus 4.69 ml, P < 0.001) and stromal vascularization (VI: 3.85 versus 2.79%, P < 0.001; VFI: 1.27 versus 0.85, P < 0.001) were also increased in women with PCOS. There were no significant differences in stromal echogenicity or pulsed-wave Doppler indices between women with PCOS and the controls. Among the women with PCOS, ovarian vascularity was significantly higher in 30 women who were hirsute compared with normoandrogenic women (FI: 33.94 versus 29.30, P < 0.05) and in 14 women with PCOS who were of normal weight compared with obese women (VI: 4.51 versus 3.25%, P < 0.05; VFI: 1.56 versus 1.22, P < 0.05).

CONCLUSIONS: Based on 3D ultrasound, women with PCOS have an increased stromal volume and vascularity. Stromal vascularity is significantly higher in women with PCOS who are hirsute and of normal weight.

Key words: polycystic ovary/PCOS/three-dimensional ultrasound/ovarian volume/ovarian vascularity

Submitted on February 12, 2007; resubmitted on June 14, 2007; accepted on June 18, 2007.


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