Criteria for polycystic ovarian morphology in polycystic ovary syndrome as a function of age.
METHODS
Ovaries meeting criteria for polycystic ovary morphology during peak reproductive years may no longer meet the criteria with age.


OBJECTIVE
Ovarian volume and follicle number decrease with age in women with polycystic ovary syndrome (PCOS), permitting age-dependent criteria for PCOM.


METHODS
We conducted longitudinal (7-15 year interval) and cross-sectional studies to examine polycystic ovarian morphology over time at an outpatient clinic and pathology laboratory in a tertiary care hospital.


METHODS
Subjects included those with PCOS defined by the National Institutes of Health criteria (n = 11 and 483 for longitudinal and cross-sectional, respectively) and control women with regular menstrual cycles and no hyperandrogenism (n = 15 and 367), age 18-64 yr.


METHODS
Subjects underwent an ovarian ultrasound by a single observer.


METHODS
Ovarian volume and follicle number were measured and ultrasound findings confirmed by a pathologist in a subset (n = 9).


RESULTS
Ovarian volume (15.2 +/- 7.4 vs. 7.1 +/- 3.7 ml; P < 0.01) and follicle number (12.8 +/- 3.2 vs. 8.1 +/- 3.9; P < 0.05) decreased longitudinally in PCOS and control women (volume 11.6 +/- 4.4 vs. 5.4 +/- 2.2 ml and follicle number 8.3 +/- 1.9 vs. 6.3 +/- 1.8; both P < 0.005). Using cross-sectional data, log ovarian volume and follicle number decreased in both groups, but the decrease in log ovarian volume was less pronounced in women with PCOS than in controls (P < 0.01). A combination of age, log ovarian volume, follicle number, and testosterone distinguished PCOS subjects from controls with a receiver operator characteristic curve area of 0.90.


CONCLUSIONS
Ovarian volume and follicle number decrease with age in women with PCOS and controls necessitating age-based criteria to define polycystic ovarian morphology. It is possible to use these criteria to distinguish PCOS in women over age 40 yr.
Alsamarai
S
S
Reproductive Endocrine Unit, Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts 02114, USA.
Adams
J M
JM
Murphy
M K
MK
Post
M D
MD
Hayden
D L
DL
Hall
J E
JE
Welt
C K
CK
D000293:Adolescent; D000328:Adult; D000375:Aging / Q000502:physiology*; D000886:Anthropometry; D003430:Cross-Sectional Studies; D005260:Female; D012739:Gonadal Steroid Hormones / Q000097:blood; D006801:Humans; D008137:Longitudinal Studies; D008597:Menstrual Cycle / Q000502:physiology; D008875:Middle Aged; D010053:Ovary / Q000473:pathology*; D011085:Polycystic Ovary Syndrome / Q000473:pathology*; D055105:Waist Circumference; D055815:Young Adult
D012739:Gonadal Steroid Hormones