Advances in the Diagnosis and Treatment of PCOS

Author(s): Enrico Carmina, Ettore Guastella, Rosa Alba Longo

Journal Name: Current Pharmaceutical Design

Volume 22 , Issue 36 , 2016


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Abstract:

While the Rotterdam criteria look simple and easy to follow, in clinical practice diagnosis of PCOS may be problematic because of the use of inaccurate commercial androgen assays. Progresses in ovarian ultrasound and in AMH measurement have modified the way to make the diagnosis of PCOS and an update of Rotterdam criteria may be necessary. In classic severe form of PCOS, ovarian follicle count is a very reliable diagnostic criterion but AMH measurement may also present high diagnostic specificity and sensitivity. This finding is particularly important when no clinical signs of androgen excess are present and only commercial assays for androgen measurement are available.

At the contrary, in mild PCOS phenotypes, sensitivity of AMH measurement is too low whileFNPO count maintains a high diagnostic sensitivity. However, at least in ovulatory hyperandrogenic PCOS phenotype, increased AMH values in association with enlarged ovarian size permit the diagnosis of ovulatory PCOS in 85% of these patients.

Treatment of PCOS women has to be directed to get fertility or in patients not seeking fertility to solve or attenuate the psychological implications of androgen excess and of irregular menses and the risk of endometrial hyperplasia.

The therapeutic protocols that are used in our department are presented.

Keywords: PCOS, AMH, ovarian ultrasound, infertility, anovulation, insulin resistance.

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Article Details

VOLUME: 22
ISSUE: 36
Year: 2016
Published on: 18 July, 2016
Page: [5508 - 5514]
Pages: 7
DOI: 10.2174/1381612822666160719105808
Price: $65

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