Polycystic ovary (PCO) is a key diagnostic feature in polycystic ovary syndrome (PCOS), identified through ultrasound examination of the ovaries. The American Society for Reproductive Medicine (ASRM) and the European Society of Human Reproduction and Embryology (ESHRE), via the Rotterdam criteria, provide established guidelines for its ultrasound diagnosis.
Here’s a detailed overview of the ultrasound assessment criteria for PCO according to ASRM/ESHRE Rotterdam:
- Follicle Count
A polycystic ovary is characterized by the presence of 12 or more follicles measuring between 2 to 9 millimeters in diameter within a single ovary. - Ovarian Volume
Alternatively, increased ovarian volume greater than 10 cubic centimeters (cm³) also fulfills the diagnostic criteria for PCO. - Diagnostic Criterion
The presence of these features in at least one ovary is sufficient to establish the ultrasound diagnosis of a polycystic ovary. - Caution for Large Follicles
If there is a dominant follicle or cyst larger than 10 mm in diameter, diagnosis should not be attempted in that cycle, as this can interfere with accurate follicle counting and ovarian volume measurement.
Conclusion
The ASRM/ESHRE Rotterdam criteria emphasize follicle number and ovarian size on ultrasound as central to diagnosing polycystic ovaries. Accurate ultrasound assessment, performed under these guidelines, is critical for proper diagnosis and subsequent management of PCOS.