Uterine morphology and peristalsis in women with polycystic ovary syndrome.
BACKGROUND
Polycystic ovary syndrome (PCOS) is associated with chronic oligo-anovulation and high circulating sex hormone levels. Women with PCOS have an increased risk of developing endometrial cancer. In anovulatory women with PCOS a positive relationship between endometrial thickness and endometrial hyperplasia has been observed. Uterine peristalsis, which has been suggested to be of importance for female fertility, has not previously been studied in PCOS.


OBJECTIVE
To assess whether women with PCOS have altered endometrial thickness, uterine wall morphology, and peristalsis.


METHODS
In this prospective case-control study 55 women with PCOS (mean age, 29.5 years ± 4.5 SD) and 28 controls (27.6 ± 3.2) were examined using magnetic resonance imaging (MRI), assessing thickness of endometrium, junctional zone (JZ), and myometrium, and evaluating the occurrence, frequency (waves/min), strength (amplitude), pattern, and direction of peristalsis. Uterine morphology was also assessed by transvaginal ultrasonography (TVUS).


RESULTS
The endometrium was thinner in PCOS with oligo-amenorrhea compared to controls, also after adjustments for age and BMI (adjusted P = 0.043). There was no difference in thickness of the JZ or the myometrium in cases versus controls. Uterine peristalsis was less commonly observed in women with PCOS than in controls (adjusted P = 0.014).


CONCLUSIONS
There were no differences in myometrial morphology between PCOS and controls, but the endometrium was thinner in PCOS with oligo-amenorrhea. Based on cine MRI, uterine peristalsis was less common in PCOS than in controls.
Department of Radiology, Institute of Clinical Sciences, Sahlgrenska University Hospital, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden. henrik.leonhardt@vgregion.se
Henrik
H
Leonhardt
Berit
B
Gull
Keiko
K
Kishimoto
Masako
M
Kataoka
Lars
L
Nilsson
Per O
PO
Janson
Elisabet
E
Stener-Victorin
Mikael
M
Hellström
D000328:Adult; D016022:Case-Control Studies; D004717:Endometrium / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D015588:Observer Variation; D010528:Peristalsis; D011085:Polycystic Ovary Syndrome / Q000000981:diagnostic imaging* / Q000473:pathology*; D011446:Prospective Studies; D014463:Ultrasonography; D014590:Uterine Contraction; D014599:Uterus / Q000000981:diagnostic imaging* / Q000473:pathology*