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Polycystic ovaries are characterised by the presence of many small cysts (fluid filled swellings) around the surface of the ovaries. The cysts are quite small ranging from 2 to 8 mm (Figure 7.1).
The ovaries are usually larger than normal ovaries and their central substance is generally more dense. Over recent years, with the advent of ultrasound examination, we have learned that about one woman in five has polycystic ovaries. At ultrasound examination, the ovaries appear larger and more dense and the cysts look like a "necklace" around the periphery of the ovaries.
Figure 7.1 Polycystic Ovaries -
Note The Small Cysts Around The Periphery Of The Ovaries
Related Medical Abstracts - Click on the paper title:-
There has been a recent consensus on the diagnosis of polycystic ovary syndrome.(0401)
and the presence of polycystic ovaries on ultrasound is a significant factor. PCOS is defined
by the Rotterdam crieteria as the presence of any two
of the following three
criteria:
- polycystic ovaries (either 12 or more follicles measuring 2-9 mm in diameter, or increased ovarian volume (> 10 cm3)
on ultrasound.
- oligomenorrheoa / anovulation
(reduced periods / failure to release eggs).
-
clinical or biochemical evidence of hyperandrogenism
(excessive male hormone).
Some women with PCOS do not have polycystic ovaries (PCO), nor do all
women with ovarian cysts have PCOS.
Although a
pelvic ultrasound is a major diagnostic tool, it is not the only one.
The diagnosis is confirmed using the Rotterdam criteria, even though the
syndrome is associated with a wide range of symptoms.
Diagnostic assessments for PCO to be PCOS:
- History-taking, specifically for menstrual pattern,
excessive body weight, hirsutism (excess body hair), and the
absence of breast discharge (galactorrhoea).
- Pelvic
ultrasonography, specifically looking for small ovarian
follicles. These are the result of disturbed ovarian function
with
failed ovulation, reflected by the infrequent or absent
menstrual cycles that is typical of the condition. In normal
menstrual cycle, one egg is released from a dominant follicle -
essentially the ovarian follicle (cyst) that bursts to release
the egg. In PCOS, there is "follicular arrest" - several
follicles develop to a size of 5-7 mm, but no further. No single
follicle reaches the preovulatory size (16 mm or more).
According to the Rotterdam criteria, 12 or more small follicles
should be seen in an ovary on ultrasound examination. The
follicles may be oriented in the periphery, giving the
appearance of a 'string of pearls'. The numerous follicles
contribute to the increased size of the ovaries, that is, 1.5 to
3 times larger than normal.
-
Laparoscopic examination may reveal a thickened, smooth,
pearl-white outer surface of the ovary. This is often an
incidental finding if laparoscopy were performed for some other
reason, as it would not be routine to examine the ovaries in
this way to confirm a diagnosis of PCOS.
   
See Also:
PCOS -
Polycystic Ovary Syndrome
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This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London.
I do hope that you find the answers to your questions in the patient information and medical advice provided.
If you still have unanswered questions, please consider entering them into one of our forums and I will try to assist you.
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