Diagnosis of Polycystic Ovarian Syndrome
Laparoscopy
Laparoscopy allows direct inspection of the ovaries; the ovaries are enlarged and polycystic. However, polycystic ovaries may appear normal at laparoscopy.
Vaginal Ultrasound Scan (Better than Abdominal)
The vaginal ultrasound may show the typical PCOS appearance but reliability varies with expertise.
Blood Hormone levels of LH, FSH, Androgens and SHBG
Ideally, these tests should be performed during the first four days of the cycle. If the women has no period, then the test can be performed anytime, and repeated if the results do not provide a clear picture.FSH levels are low or normal, LH levels are often raised. However, a normal level does not exclude diagnosis of polycystic ovarian syndrome (PCOS). The levels of androgens and testosterone may be raised.The American Society of Reproductive Medicine (ASRM) and the European Society of Human Reproduction and Embryology (ESHRE) joint consensus meeting in November 2003 agreed that the diagnosis of PCOS should be made when two of the following three criteria are met:
1. Infrequent or Absent Ovulation
2. Hyperandrogenism (Clinical or Biochemical) such as Excess Gair Growth, Acne, raised LH, and raised Androgen Index.
Polycystic ovarian morphology on ultrasound scan (>12 follicles measuring between 2 and 9mm in diameter) and/or ovarian volume >10ml. The distribution of the follicles are not required and with one ovary sufficient for diagnosis.