Do threshold values of ovarian volume and follicle number for diagnosing polycystic ovarian syndrome in Turkish women differ from western countries?

OBJECTIVE

To find diagnostic values and thresholds of ovarian volume and follicle number for Turkish patients with polycystic ovarian syndrome (PCOS) and to clarify whether the Rotterdam ultrasound criteria are optimal for the diagnosis of PCOS in Turkish patients.

STUDY

DESIGN

Two hundred and fifty-one newly diagnosed PCOS cases according to Androgen Excess Society (AES) criteria (using clinical and biochemical parameters) and 65 regularly menstruating healthy, non-hirsute, normo-ovulatory volunteers as a control group were taken into the study. Evaluation of the ovaries and measurement of ovarian volumes of all cases were performed by transvaginal ultrasound. Ovarian volume (OV) and follicle number (FN) were recorded in all cases.

RESULTS

Mean and median OV were 12.5 ± 8.1 and 10.1cm(3) in PCOS cases. Mean and median FN in the PCOS group were 9.8 ± 2.8 and 10, respectively. In the control group, the mean and median OV were 5.4 ± 1.8 and 5.5 cm(3). Mean and median FN of controls was 5 ± 1.5 and 5, respectively. There were statistically significant differences in both OV and FN between PCOS patients and controls (all p < 0.001). Cut off values for ovarian volume in PCOS cases for the Turkish population were determined by receiver-operating characteristics (ROC) analysis. The areas under the curve (AUCs) for mean OV and mean FN were 0.938 and 0.998, respectively, indicating a good diagnostic power of the tested variables. Combining sensitivity and specificity using the Youden index, setting the cut off value for threshold OV and FN at 6.43 cm(3) and 8, respectively, yielded the best compromise between sensitivity and specificity.

CONCLUSION

There may be some differences in ultrasound characteristics of PCOS, resulting in differing diagnostic power and cut off points for different populations. OV and FN have powerful diagnostic value in determination of PCOS with different threshold values for different ethnicities.