Ovarian volume and PCOS: a controversial issue

Abstract

Polycystic ovarian syndrome (PCOS) is a common endocrinopathy. The Rotterdam criteria indicate four distinct phenotypes. In phenotypes with the typical ovarian morphology (ovarian volume ≥10 ml) the sensibility to clomiphene citrate (CC) ovulation therapy was demonstrated inversely proportional to the ovarian volume. In this retrospective study we evaluated the influence of ovarian volume on the success rate of CC ovulation induction in women with anovulatory phenotype 2 characterized only by the presence of hyperandrogenism and anovulation (ANOV + HA). Statistical analysis was conducted by stratifying patients both on the basis of CC dose (Group 1: n = 37, 50 mg; Group 2: n = 9, 100 mg; and Group 3: n = 12, 150 mg) and on the basis of response to therapy. Eighty women were evaluated but overall only 58 women (72.5%) reached ovulation. In the phenotype studied, we didn’t find any correlations between ovarian volume and the chance of ovulation with the gradient increase in CC; furthermore, ovarian volume was comparable in CC responders and non-responders. Our study has shown that in the phenotype 2 examined, ovarian volume did not have any predictive value of the dosage required to induce ovulation. The significance of this result is discussed.

Chinese abstract

多囊卵巢综合征(PCOS)是一种常见的内分泌疾病。鹿特丹标准分为四种不同的表型。在典型的卵巢形态(卵巢体积≥10ml)的表型中, 对克罗米芬(CC)排卵治疗的敏感性被证实与卵巢体积成反比。在该回顾性研究中, 我们评估了在以高雄激素血症和无排卵(ANOV + HA)为特点的无排卵表型2的女性患者中, 卵巢体积对CC促排卵成功率的影响。统计分析是根据CC剂量(1组: n = 37, 50mg；2组: n = 9, 100mg；3组: n = 12, 150mg)和对治疗的反应对患者进行分层。80名女性接受了评估, 但只有58名女性(72.5%)发生了排卵。在表型研究中, 我们没有发现随着CC梯度的增加卵巢体积和排卵几率之间的相关性；而且在CC反应者和无反应者中, 卵巢体积相当。我们的研究表明在表型2中, 卵巢体积对诱导排卵所需要的剂量没有任何预测价值。这个结果的意义正在被讨论。

Keywords:

• PCOS
• phenotype 2
• ovulation induction
• ovarian volume
• clomiphene citrate

Disclosure statement

No potential conflict of interest was reported by the authors. Informed consent was obtained from all individual participants included in the study.

Ethical approval

All procedures performed in the study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.