Classification of normogonadotropic infertility: Polycystic ovaries diagnosed by ultrasound versus endocrine characteristics of polycystic ovary syndrome
Classification of normogonadotropic infertility: Polycystic ovaries diagnosed by ultrasound versus endocrine characteristics of polycystic ovary syndrome
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DOI：
10.1016/s0015-0282(97)80068-4
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发表时间：
1997-03-01
影响因子：
6.7
通讯作者：
Fauser, BCJM
中科院分区：
文献类型：
--
作者：
vanSantbrink, EJP;Hop, WC;Fauser, BCJM
目的：探讨多囊卵巢对多囊卵巢综合征(PCOS)内分泌体征的预测价值。设计：描述性对照研究。地点：学术三级保健生育临床。患者(S)：正常促性腺激素(卵泡刺激素水平1~10mIU/ml，换算成SI单位，1.0)少月经或闭经患者和一组定期周期、健康、正常体重的志愿者作为对照组。干预(S)：进行单次血样和经阴道超声检查。主要观察指标(S)：血清卵泡刺激素、促黄体生成素、雄烯二酮(A)、T和卵巢体积、卵巢间质密度、卵巢间质密度结果(S)：在对照组中，计算出卵巢体积、卵泡数、间质计数和内分泌参数的第95个百分位数。在研究组中，使用这些正常上限导致217例(66%)患者超声检查显示多囊卵巢(定义为平均卵巢体积和/或平均每个卵巢的卵泡数增加)，而只有120例(36%)患者出现血清雄激素升高(A和/或T浓度升高)，155例(47%)患者表现为促黄体生成素水平升高。单一或联合超声参数预测血清LR或雄激素浓度升高的敏感性和特异性有限。结论：在促性腺激素正常的月经过少或闭经不育妇女的研究组中，我们为文献中用于定义PCOS的各种标准设定了严格的临界值。由超声或内分泌PCOS标准定义的组确实有重叠，但超声参数对异常激素血清水平的预测价值有限。
Objective: To investigate the predictive value of polycystic ovaries for endocrine signs of polycystic ovary syndrome (PCOS).Design: Controlled descriptive study.Setting: Academic tertiary care fertility clinic.Patient(s): Normogonadotropic (FSH levels between 1 and 10 mIU/mL, conversion factor to SI unit, 1.0) oligomenorrheic or amenorrheic women visiting our fertility clinic and a control group of regularly cycling, healthy, normal weight volunteers recruited by advertisement.Intervention(s): Single blood samples and transvaginal sonography were performed.Main Outcome Measure(s): Serum levels of FSH, LH, androstenedione (A), and T and ovarian volume, ovarian stroma density, and follicle number.Result(s): In control women, the 95th percentile was calculated for ovarian volume, follicle number, and stroma count as well as endocrine parameters. The use of these upper limits of normal in the study group resulted in 217 (66%) patients with polycystic ovaries on ultrasound (defined as increased mean ovarian volume and/or mean follicle number per ovary), whereas only 120 (36%) patients exhibited elevated serum androgens (increased A and/or T concentrations) and 155 (47%) showed elevated LH levels. Sensitivity and specificity of single or combined sonographic parameters for prediction of elevated serum LR or androgen concentrations were limited.Conclusion(s): In the study group of normogonadotropic oligomenorrhea or amenorrheic infertile women, we set strict cutoff levels for various criteria used in the literature for defining PCOS. Groups defined by sonographic or endocrine PCOS criteria did overlap, but sonographic parameters had limited predictive value for abnormal hormone serum levels.