Thread by @MathewLeonardi

Public service announcement 🧵 about #PCOS & #ultrasound

1 - Ultrasound should NOT be used for the diagnosis of PCOS in those <8 years after menarche, due to the high incidence of multi-follicular ovaries in this life stage

*FYI PCOM = polycystic ovarian morphology

2 - Using endovaginal ultrasound transducers w/ a frequency bandwidth that includes 8 MHz, the
threshold for PCOM on either ovary, a follicle number per ovary of = or > 20 and/or an ovarian volume
= or > 10 ml on either ovary, ensuring no corpora lutea, cysts or dominant follicle

3 - The threshold for PCOM should be revised regularly with advancing ultrasound technology, and age-specific cut-off values for PCOM should be defined.

4 - The transvaginal ultrasound approach is preferred in the diagnosis of PCOS if acceptable to the individual being assessed.

In transabdominal ultrasound reporting is best focused on ovarian volume given the difficulty of reliably assessing follicle number with this approach.

5 - In patients with irregular menstrual cycles and hyperandrogenism, an ovarian ultrasound is not
necessary for PCOS diagnosis; however, ultrasound will identify the complete PCOS phenotype.

6 - Clear protocols are recommended for reporting follicle number per ovary and ovarian volume on ultrasound.
Recommended minimum reporting standards include:
- Last menstrual period
- Transducer bandwidth frequency
- Approach/route assessed
  ...

6 cont -
- Total follicle number per ovary measuring 2-9mm
- 3 dimensions & volume of each ovary
- Reporting of endometrial thickness & appearance is preferred
- Other ovarian & uterine pathology, as well as ovarian cysts, corpus luteum, dominant follicles
> 10 mm

7 - There is a need for training in careful and meticulous follicle counting per ovary, to improve reporting.

For the whole article, check out:

fertstert.org/article/S0015-…

@ASRM_org
@HelenaTeede @AnujaDokras @JoopLaven @terhip