Polycystic ovary syndrome classification
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
PCOS may be classified into 4 types based upon severity of symptoms into asymptomatic form, mild form, classical form and metabolic form. In 2003 a consensus workshop sponsored by ESHRE/ASRM in Rotterdam indicated PCOS to be present if 2 out of 3 of the following present oligoovulation and/or anovulation, excess androgen activity and polycystic ovaries (by gynecologic ultrasound), and other causes of PCOS are excluded.[1] [2]
Classification
Two definitions are commonly used:
- In 1990 a consensus workshop sponsored by the NIH/NICHD suggested that a patient has PCOS if she has
- Signs of androgen excess (clinical or biochemical)
- Oligoovulation
- Other entities are excluded that would cause polycystic ovaries.
- In 2003 a consensus workshop sponsored by ESHRE/ASRM in Rotterdam indicated PCOS to be present if 2 out of 3 criteria are met: [1]
- Oligoovulation and/or anovulation
- Excess androgen activity
- Polycystic ovaries (by gynecologic ultrasound), and other causes of PCOS are excluded.
The Rotterdam definition is wider, including many more patients, notably patients without androgen excess, whereas in the NIH/NICHD definition androgen excess is a prerequisite. Critics maintain that findings obtained from the study of patients with androgen excess cannot necessarily be extrapolated to patients without androgen excess.
- PCOS may be classified into 4 types based upon severity of symptoms into[2]
- Asymptomatic form: women with only PCO morphology
- Mild form: PCO morphology along with anovulation
- Classical form: Hyperandogenism along with ovarian dysfunction (anovulation and / or PCO)
- Metabolic form: Combination of mild and classical forms with presence of obesity and/or insulin resistance (abdominal obesity, insülin resistance, raised waist / hip ratio)