The Polycystic Ovary Post-Rotterdam: A Common, Age-Dependent Finding in Ovulatory Women without Metabolic Significance

• Published in: The journal of clinical endocrinology and metabolism Vol. 95; no. 11; pp. 4965 - 4972
• Main Authors: Johnstone, Erica B., Rosen, Mitchell P., Neril, Rebecca, Trevithick, Deborah, Sternfeld, Barbara, Murphy, Rosemary, Addauan-Andersen, Carolyne, McConnell, Daniel, Pera, Renee Reijo, Cedars, Marcelle I.
• Format: Journal Article
• Language: English
• Published: Bethesda, MD Oxford University Press 01.11.2010; Endocrine Society; The Endocrine Society
• Subjects: Adult; Age; Age Factors; Aging; Androgens; Androgens - blood; Anti-Mullerian Hormone - blood; Biological and medical sciences; Body Mass Index; Endocrinopathies; Enzyme-Linked Immunosorbent Assay; Estrone; Estrone - blood; Feeding. Feeding behavior; Female; Follicle Stimulating Hormone - blood; Follicle-stimulating hormone; Fundamental and applied biological sciences. Psychology; Humans; Medical sciences; Metabolism; Middle Aged; Original; Ovarian Cysts - blood; Ovarian Cysts - diagnostic imaging; Ovarian Cysts - epidemiology; Ovaries; Ovary - diagnostic imaging; Prevalence; Regression Analysis; Testosterone; Ultrasonography; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Vertebrates: endocrinology; Human; Obesity; Nutrition; Nutrition disorder; Female sterility; Metabolic diseases; Polycystic ovary; Metabolism; Female genital diseases; Ovarian diseases; Cyst; Adult; Female; Benign neoplasm; Woman; Age; Endocrinology; Nutritional status
• ISSN: 0021-972X; 1945-7197; 1945-7197
• DOI: 10.1210/jc.2010-0202

Introduction: The age-specific prevalence of polycystic ovaries (PCO), as defined by the Rotterdam criteria, among normal ovulatory women, has not yet been reported. It is also uncertain whether these women differ from their peers in the hormonal or metabolic profile. Methods: A total of 262 ovulatory Caucasian women aged 25–45 yr, enrolled in a community-based ovarian aging study (OVA), underwent transvaginal ultrasound assessment of ovarian volume and antral follicle count (AFC) in the early follicular phase and were categorized as to whether they met the Rotterdam definition of PCO by AFC (≥12 in one ovary) and/or by volume (>10 cm3 for one ovary). The effect of age on prevalence of PCO was assessed. Serum hormones and metabolic measures were compared between women meeting each element of the Rotterdam criterion and those without PCO using age-adjusted linear regressions. Results: The prevalence of PCO by AFC was 32% and decreased with age. Those with PCO by AFC had lower FSH; higher anti-Müllerian hormone, estrone, dehydroepiandrostenedione sulfate, and free androgen index; and slightly higher total testosterone than those without PCO. However, slightly higher body mass index and waist circumference were the only metabolic differences. Women with PCO by volume had higher anti-Müllerian hormone and free androgen index but did not differ in any other hormonal or metabolic parameter. Discussion: PCO is a common, age-dependent finding among ovulatory women. These women lack the metabolic abnormalities seen in PCO syndrome. Isolated PCO in an ovulatory woman is not an indication for metabolic evaluation.