Diagnosis of Polycystic Ovaries
Polycystic ovaries are not observed in all women suffering from PCOS. There are many symptoms that can suggest the presence of PCOS condition but these symptoms vary differently. The usual test done to confirm PCOS is an ultrasound test but it is not the only test done to confirm and analyze this condition. It is very important to get a diagnosis done as PCOS may lead to infertility because of all the effects it has on the body. The doctor notes and analyzes the pattern of menstrual cycles, conditions such as obesity and blood pressure, hirsutism and the complete absence of discharge from the breast. It is estimated that these four questions can predict the presence of polycystic ovaries with a sensitivity of 77%.
Gynecologic ultrasonography is a test that is done to find the presence of ovarian follicles. This occurs due to variations or disturbances in ovarian functions that lead to irregular menstrual cycles. Usually one egg is released from the main follicle and the remnant of the follicle gets changed into progesterone which produces corpus luteum that lasts for twelve to fourteen days. A condition called follicular arrest takes place that causes the follicles to not develop beyond 5-7 mm which falls below the preovulatory size. A laparoscopic test is also done to view the outer surface of the ovary which should be smooth and pearl-like in appearance. The levels of Dehydroepiandrosterone sulfate, androgens, testosterone and androstenedione are also check to confirm any variations in their levels. There are other blood tests that are also done but they are not definite in nature and the results might vary. The ratio of LH The ratio of LH (Luteinizing hormone) to FSH (Follicle stimulating hormone) when tested is typically greater than 1:1 when tested on the day three of the menstrual cycle. However, even this trend is observed in less than 50%.
The sex hormone binding globulin levels is also quite less in obese women. The typical assessments that are done for this condition include a bio-chemical screen that has to be performed on an empty stomach, a GTT (glucose oral test) of two hours is performed on people with conditions such as obesity, diabetes or a family history of polycystic ovaries. It is observed that 65-86% of women who suffer from PCOS also suffer from diabetes. A prolactin test is also done to rule out the presence of hyperprolactinemia and a TSH test is done to rule out the presence of hypothyroidism. 17-hydroxyprogesterone is done to dismiss the presence of 21-hydroxylase deficiency (CAH). The doctor will also note down the BMI of the patient by taking his height and weight statistics into account. The areas where increased hair growth is observed are also examined by the doctor to access the condition. Thus basically the tests that are usually done to confirm polycystic ovaries are abdominal ultrasound ,abdominal MRI ,laparoscopy, biopsy of the ovary, Fasting glucose and insulin levels, LH levels, Urine 17-ketosteroids,FSH levels, Vaginal ultrasound and Male hormone (testosterone) levels.
