PCOS is to some extent a diagnosis which is reached after excluding other disorders. PCOS remains a syndrome (a collection of signs and symptoms) with no single clinical feature which can make the diagnosis. Your doctor will carry out tests to rule out other causes of anovulation and infertility. He will usually request a variety of hormone tests to help determine whether hormone overproduction may be due to PCOS, an adrenal or ovarian tumour, or an overgrowth in adrenal tissue (adrenal hyperplasia). Ultrasound is often used to look for cysts in the ovaries and to see if the internal structures appear normal.
Your doctor will use the combination of laboratory results and clinical findings to make a diagnosis. If the diagnosis is PCOS your doctor may then request further tests such as lipid profiles and glucose levels to monitor your risk of developing future complications such as diabetes and cardiovascular disease
Laboratory Tests
- FSH (Follicle Stimulating Hormone), may be normal or low with PCOS
- LH (Lutenizing Hormone), may be elevated
- LH/FSH ratio. This ratio is normally about 1:1 in premenopausal women, but a ratio of greater than 2:1 or 3:1 may provide supporting evidence for a diagnosis of PCOS
- Prolactin may be normal or mildly elevated
- Testosterone, total and/or free, usually elevated
- DHEAS (may be measured to rule out a virilising adrenal tumour in women with rapidly advancing hirsutism), frequently mildly elevated with PCOS
- Oestrogens, may be normal or elevated
- Sex hormone binding globulin, may be reduced
- Androstenedione, may be elevated
- Anti-Müllerian Hormone is a relatively new test used by some centres and has been found to be increased 2-3 times in PCOS. At present, this test is not routinely used in the investigation of PCOS in the UK, although this could change as a result of ongoing research.
- hCG(Human chorionic gonadotropin), used to check for pregnancy, negative
- Lipid profile, (collected after a fast), (low HDL, high LDL, and cholesterol, elevated triglycerides)
- Glucose, fasting and/or a glucose tolerance test, may be elevated
- HbA1c another measure of diabetes which is carried out in some centres in preference to glucose.
- Insulin, (collected after a fast), often elevated
- TSH (Thyroid stimulating hormone) some who have PCOS are also hypothyroid
- Cortisol to rule out Cushing's syndrome
- 17-hydroxyprogesterone to exlude adrenal hyperplasia
- Insulin-like growth factor (IGF-1) to exlude acromegaly
Non-Laboratory Tests
Ultrasound, transvaginal and/or pelvic/abdominal are used to evaluate enlarged ovaries. With PCOS, the ovaries may be 1.5 to 3 times larger than normal and characteristically have more than 8 follicles per ovary, with each follicle less than 10 mm in diameter. Often the cysts are lined up on the surface the ovaries, forming the appearance of a "pearl necklace." These ultrasound findings are not diagnostic. They are present in more than 90% of women with PCOS, but they are also found in up to 25% of women without PCOS.
Ultrasound, transvaginal and/or pelvic/abdominal are used to evaluate enlarged ovaries. With PCOS, the ovaries may be 1.5 to 3 times larger than normal and characteristically have more than 8 follicles per ovary, with each follicle less than 10 mm in diameter. Often the cysts are lined up on the surface the ovaries, forming the appearance of a "pearl necklace." These ultrasound findings are not diagnostic. They are present in more than 90% of women with PCOS, but they are also found in up to 25% of women without PCOS.
Laparoscopy may be used to evaluate ovaries, evaluate the endometrial lining of the uterus, and sometimes used as part of surgical treatment.
SOURCE: http://www.labtestsonline.org.uk/understanding/conditions/pcos/start/2
No comments:
Post a Comment