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Polycystic Ovarian Morphology in Normal Women Does Not Predict the Development of Polycystic Ovary Syndrome

Reproductive Endocrine Unit (M.K.M., J.E.H., J.M.A., C.K.W.), Department of Medicine, Massachusetts General Hospital, and MGH Biostatistics Center (H.L.), Massachusetts General Hospital, Boston, Massachusetts 02114; and Harvard Medical School (M.K.M.), Boston, Massachusetts 02115

Address all correspondence and requests for reprints to: C. K. Welt, Reproductive Endocrine, BHX 511, Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts 02114. E-mail: cwelt{at}partners.org.

Context: Polycystic ovarian morphology (PCOM) is present in 25% of normal women in the absence of polycystic ovary syndrome (PCOS); however, the natural history of PCOM is unknown.

Objective: We hypothesized that the presence of PCOM predisposes the development of PCOS.

Design: The study was a longitudinal follow-up study over 8.2 ± 5.2 yr (mean ± SD; range 1.7–17.5 yr).

Setting: The study took place in an outpatient setting.

Subjects: Women who took part in a previous study as a normal control and had an ultrasound examination (n = 40) participated.

Intervention: Subjects underwent an interval menstrual history, physical exam, blood sampling, and repeat ultrasound in the follicular phase.

Main Outcome Measure: Development of PCOS was diagnosed by irregular menses and hyperandrogenism, in the absence of other disorders. Changes in ovarian morphology over time were evaluated.

Results: At the baseline visit, 23 women (57.5%) had PCOM and 17 (42.5%) had normal ovarian morphology. One subject with PCOM developed irregular menses and presumptive PCOS. Eleven subjects with PCOM no longer met the criteria for PCOM at follow-up. There was no factor that predicted the change to normal ovarian morphology at the follow-up visit.

Conclusions: These data suggest that PCOM in women with regular ovulatory cycles does not commonly predispose the development of PCOS. Although it is unusual to develop PCOM if the ovaries are normal on first assessment, ovaries in women with PCOM no longer meet the criteria for PCOM in approximately half of cases over time.

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