MCQ – 71337

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 :

• Hirsutism
• Obesity

2. Insulin resistance
3. Elevated LH : FSH Ratio
4.  Intermittent anovulation associated hyperandrogenemia (T free testosterone, Ted DHEAS)