This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Mortensen, M. Articles by Rosenfield, R. L. Search for Related Content PubMed PubMed Citation Articles by Mortensen, M. Articles by Rosenfield, R. L. Related Collections Female Endocrinology

Asymptomatic Volunteers with a Polycystic Ovary Are a Functionally Distinct but Heterogeneous Population

Section of Adult and Pediatric Endocrinology, Diabetes, and Metabolism, The University of Chicago Pritzker School of Medicine, Chicago, Illinois 60637

Address all correspondence and requests for reprints to: Robert L. Rosenfield, University of Chicago Hospitals, Section of Adult and Pediatric Endocrinology, Diabetes, and Metabolism, 5841 S. Maryland Avenue, (MC- 5053), Chicago, Illinois 60637. E-mail: robros{at}peds.bsd.uchicago.edu.

Context/Objective: Our objective was to determine the ovarian function of asymptomatic volunteers with a polycystic ovary (V-PCO).

Participants: Non-hirsute eumenorrheic V-PCO (n = 32) and volunteers with ultrasonographically normal ovaries (V-NO) (n = 21) were compared with one another and with polycystic ovary syndrome (PCOS) patients who met National Institute of Health criteria (n = 90).

Design/Setting/Interventions: GnRH agonist (GnRHag), ACTH, and oral glucose tolerance tests were prospectively performed in a General Clinical Research Center.

Results: The distribution of 17-hydroxyprogesterone (17OHP) responses to GnRHag of V-PCO formed a distinct population intermediate between that of V-NO, the reference population, and PCOS. Nevertheless, the V-PCO population was heterogeneous. There were 53% (seventeen of 32) that were functionally normal, with 17OHP responses and free testosterone levels like V-NO. A total of 25% (eight of 32) had an elevated free testosterone, thus meeting Rotterdam criteria for PCOS; one third of these had 17OHP hyperresponsiveness to GnRHag testing. The remaining 22% (seven of 32) had 17OHP hyperresponsiveness to GnRHag, but normal free testosterone. Of PCOS, 69% had elevated 17OHP hyperresponsiveness to GnRHag. Ovarian volume correlated significantly with 17OHP responses only in PCOS, accounting for just 10% of the variance.

Conclusions: Many asymptomatic volunteers have a PCO. They are a distinct, but heterogeneous, population with respect to ovarian function, ranging from normal (53%) to occult PCOS by Rotterdam criteria (25%). Nearly one quarter (22%) had the typical PCOS type of ovarian dysfunction without hyperandrogenemia, termed a "dysregulated PCO"; they or their offspring may be at risk for PCOS. Ovarian ultrasonographic characteristics must be considered when establishing norms for ovarian function.

This article has been cited by other articles:

				F. de Zegher and L. Ibanez Early Origins of Polycystic Ovary Syndrome: Hypotheses May Change without Notice J. Clin. Endocrinol. Metab., October 1, 2009; 94(10): 3682 - 3685. [Full Text] [PDF]

				J. Hirshfeld-Cytron, R. B. Barnes, D. A. Ehrmann, A. Caruso, M. M. Mortensen, and R. L. Rosenfield Characterization of Functionally Typical and Atypical Types of Polycystic Ovary Syndrome J. Clin. Endocrinol. Metab., May 1, 2009; 94(5): 1587 - 1594. [Abstract] [Full Text] [PDF]