Question
A 30 year old female presented with complain of infertility.USG examination showed the following features.Regarding this condition,which hormones are increased in the body?
| A. |
Progesterone
|
| B. |
LH
|
| C. |
FSH
|
| D. |
Sex hormone binding Globulin
|
Show Answer
|
Correct Answer � B
Explanation
|
|
Ans:B.)LH
Image shows: Ultrasonographic examination: bilateral enlarged ovaries, multiple small follicles suggestive of PCOD
Polycystic Ovary Disease
- In polycystic ovary disease, enlarged ovaries with thickened sclerotic capsules and an abnormally high number of follicles are present. The follicles may concurrently exist in varying states of growth, maturation, or atresia.
- Polycystic ovaries typically exhibit 3 characteristics on ultrasonographic examination: bilateral enlarged ovaries, multiple small follicles, and increased stromal echogenicity
Hormones Increased
- Androgens° (Testosterone, Androstenedione DHEAS)
- Luteinizing hormone° (LH > 10 IUI ml)
- Estrogen (Estrone Oestradiol T E2/ El ratio)
- Insulin (> 10 m IU / L)
- Prolactin (in some patients)
- T LDL / cholesterol and triglycerides
Hormones Decreased
- Follicle stimulating hormone (FSH)
- Progesterone (due to anovulation)
- Sex hormone binding Globulin.
- HDL & Apoprotein A-I.
Ratio of LH/FSH in PCOS is > 2:1
Ratio of Fasting Glucose: Fasting insulin in PCOS < 4.5
Diagnostic Criteria
Major Criteria
1. Chronic anovulation°
2. Hyperandrogenemia in absence of any notable cause :
Pathologies like ovarian or adrenal neoplasms, pituitary disease or CAH that may cause hyperandrogenemia should be excluded
Minor Criteria
1. Premenarcheal onset of :
2. Insulin resistance
3. Elevated LH : FSH Ratio
4. Intermittent anovulation associated hyperandrogenemia (T free testosterone, Ted DHEAS)
