A very large proportion of young Danish women have polycystic ovaries: is a revision of the Rotterdam criteria needed?

TY - JOUR

T1 - A very large proportion of young Danish women have polycystic ovaries: is a revision of the Rotterdam criteria needed?

AU - Kristensen, S L

AU - Ramlau-Hansen, Cecilia

AU - Ernst, E

AU - Olsen, S F

AU - Bonde, J P

AU - Vested, Anne

AU - Toft, G

PY - 2010/12

Y1 - 2010/12

N2 - According to the Rotterdam 2003 criteria, an ovary is defined as polycystic if 12 or more follicles of 2-9 mm are present, when evaluating the ovary by ultrasonography on Days 3-5 of the menstrual cycle in women not using hormonal contraceptives. The aim of this population-based study was to estimate the prevalence of polycystic ovaries (PCO) in a representative sample of young Danish women according to the Rotterdam criteria. Methods From a Danish pregnancy cohort established in 1988-1989, 267 (61) young adult daughters agreed to participate in a clinical examination and 174 (40) consented to vaginal ultrasound. Sufficient image quality in at least one ovary was obtained from 154 women. Both users and non-users of hormonal contraceptives were included and the examination was not restricted to a particular time of the menstrual cycle. Results The median (range) age was 20.1 (19.5-21.0) years. The median follicle number per ovary was 14 (6-30) and 12 or more follicles were counted in 104 of the 154 women. Thus, the prevalence was estimated to 68 [95 confidence interval (CI): 60-74]. PCO were present in 80 (95 CI: 65-89) of non-users (n = 44) of hormonal contraceptives. Of the 104 women with PCO, 41 (95 CI: 32-51) could be defined as having polycystic ovary syndrome. Conclusions A very large proportion of the young women had PCO according to the Rotterdam 2003 criteria. As the number of follicles is higher at a younger age, we believe the Rotterdam criteria should be revised, particularly to avoid misdiagnosis in this age group.

AB - According to the Rotterdam 2003 criteria, an ovary is defined as polycystic if 12 or more follicles of 2-9 mm are present, when evaluating the ovary by ultrasonography on Days 3-5 of the menstrual cycle in women not using hormonal contraceptives. The aim of this population-based study was to estimate the prevalence of polycystic ovaries (PCO) in a representative sample of young Danish women according to the Rotterdam criteria. Methods From a Danish pregnancy cohort established in 1988-1989, 267 (61) young adult daughters agreed to participate in a clinical examination and 174 (40) consented to vaginal ultrasound. Sufficient image quality in at least one ovary was obtained from 154 women. Both users and non-users of hormonal contraceptives were included and the examination was not restricted to a particular time of the menstrual cycle. Results The median (range) age was 20.1 (19.5-21.0) years. The median follicle number per ovary was 14 (6-30) and 12 or more follicles were counted in 104 of the 154 women. Thus, the prevalence was estimated to 68 [95 confidence interval (CI): 60-74]. PCO were present in 80 (95 CI: 65-89) of non-users (n = 44) of hormonal contraceptives. Of the 104 women with PCO, 41 (95 CI: 32-51) could be defined as having polycystic ovary syndrome. Conclusions A very large proportion of the young women had PCO according to the Rotterdam 2003 criteria. As the number of follicles is higher at a younger age, we believe the Rotterdam criteria should be revised, particularly to avoid misdiagnosis in this age group.

M3 - Journal article

SN - 0268-1161

VL - 25

SP - 3117

EP - 3122

JO - Human Reproduction

JF - Human Reproduction

IS - 12

ER -