Background: The ultrasonographic criteria used to identify polycystic ovarian morphology (PCOM) during adolescence have changed over time. Recently, a Worldwide Pediatric Consensus (PedC) defined PCOM using stricter criteria than the previous recommendations of the Rotterdam Consensus (RC) and Androgen Excess-Polycystic Ovarian Syndrome Society (AES/PCOS) criteria. The aim of this study was to determine the prevalence of PCOM in healthy adolescents according to the 3 reported diagnostic criteria and compare the hormonal profile in females with and without PCOM based on the PedC criteria. Methods: Nonobese adolescents (n = 102) with regular menstrual cycles were studied. Transabdominal ultrasound and hormonal profiles were assessed during the follicular phase. PCOM was defined on the basis of the 3 published criteria. Results: On the basis of the PedC, RC, and AES/PCOS criteria, PCOM was diagnosed in 13, 34, and 24% of adolescents, respectively. Adolescents with and without PCOM according to the PedC criteria had similar androgen levels. Serum anti-Müllerian hormone (AMH) levels were elevated in adolescents with PCOM, irrespective of the criteria used. Conclusions: Use of the new PedC diagnostic criteria for PCOM results in a lower prevalence of this ultrasonographic pattern in adolescents, but this condition is not associated with hyperandrogenism. Elevated AMH is associated with PCOM in adolescents regardless of the criteria used to determine the ultrasonographic pattern.

1.
Legro RS, Arslanian SA, Ehrmann DA, Hoeger KM, Murad MH, Pasquali R, Welt CK, Endocrine S: Diagnosis and treatment of polycystic ovary syndrome: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2013; 98: 4565–4592.
2.
The Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group: Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 2004; 81: 19–25.
3.
Balen AH, Laven JS, Tan SL, Dewailly D: Ultrasound assessment of the polycystic ovary: international consensus definitions. Hum Reprod Update 2003; 9: 505–514.
4.
Dewailly D, Lujan ME, Carmina E, Cedars MI, Laven J, Norman RJ, Escobar-Morreale HF: Definition and significance of polycystic ovarian morphology: a task force report from the Androgen Excess and Polycystic Ovary Syndrome Society. Hum Reprod Update 2014; 20: 334–352.
5.
Carmina E, Oberfield SE, Lobo RA: The diagnosis of polycystic ovary syndrome in ado lescents. Am J Obstet Gynecol 2010; 203: 201.e201–e205.
6.
Witchel SF, Oberfield S, Rosenfield RL, Codner E, Bonny A, Ibanez L, Pena A, Horikawa R, Gomez-Lobo V, Joel D, Tfayli H, Arslanian S, Dabadghao P, Garcia Rudaz C, Lee PA: The diagnosis of polycystic ovary syndrome during adolescence. Horm Res Paediatr 2015; 83: 376–389.
7.
Rosenfield RL: The polycystic ovary morphology-polycystic ovary syndrome spectrum. J Pediatr Adolesc Gynecol 2015; 28: 412–419.
8.
Kelsey TW, Dodwell SK, Wilkinson AG, Greve T, Andersen CY, Anderson RA, Wallace WH: Ovarian volume throughout life: a validated normative model. PLoS One 2013; 8:e71465.
9.
Codner E, Villarroel C, Eyzaguirre FC, Lopez P, Merino PM, Perez-Bravo F, Iniguez G, Cassorla F: Polycystic ovarian morphology in postmenarchal adolescents. Fertil Steril 2011; 95: 702–706.e701–e702.
10.
Villarroel C, Merino PM, Lopez P, Eyzaguirre FC, Van Velzen A, Iniguez G, Codner E: Polycystic ovarian morphology in adolescents with regular menstrual cycles is associated with elevated anti-Mullerian hormone. Hum Reprod 2011; 26: 2861–2868.
11.
Villarroel C, Lopez P, Merino PM, Iniguez G, Sir-Petermann T, Codner E: Hirsutism and oligomenorrhea are appropriate screening criteria for polycystic ovary syndrome in adolescents. Gynecol Endocrinol 2015; 31: 625–629.
12.
American Academy of Pediatrics Committee on Adolescence; American College of Obstetricians and Gynecologists Committee on Adolescent Health Care: Menstruation in girls and adolescents: using the menstrual cycle as a vital sign. Pediatrics 2006; 118: 2245–2250.
13.
Youlton R, Valenzuela C: Growth patterns in height and weight in children aged 0 to 17 years and cranial circumference in children aged 0 to 2 years from medium-high and high socioeconomic status in Santiago. Comparison with growth in children from medium-low and low status in the Northern area of Santiago (in Spanish). Rev Chil Pediatr 1990(Spec No):1–22.
14.
Johnstone EB, Rosen MP, Neril R, Trevithick D, Sternfeld B, Murphy R, Addauan-Andersen C, McConnell D, Pera RR, Cedars MI: The polycystic ovary post-Rotterdam: a common, age-dependent finding in ovulatory women without metabolic significance. J Clin Endocrinol Metab 2010; 95: 4965–4972.
15.
Murphy MK, Hall JE, Adams JM, Lee H, Welt CK: Polycystic ovarian morphology in normal women does not predict the development of polycystic ovary syndrome. J Clin Endocrinol Metab 2006; 91: 3878–3884.
16.
Alsamarai S, Adams JM, Murphy MK, Post MD, Hayden DL, Hall JE, Welt CK: Criteria for polycystic ovarian morphology in polycystic ovary syndrome as a function of age. J Clin Endocrinol Metab 2009; 94: 4961–4970.
17.
Hickey M, Sloboda DM, Atkinson HC, Doherty DA, Franks S, Norman RJ, Newnham JP, Hart R: The relationship between maternal and umbilical cord androgen levels and polycystic ovary syndrome in adolescence: a prospective cohort study. J Clin Endocrinol Metab 2009; 94: 3714–3720.
18.
Hart R, Doherty DA, Norman RJ, Franks S, Dickinson JE, Hickey M, Sloboda DM: Serum antimullerian hormone (AMH) levels are elevated in adolescent girls with polycystic ovaries and the polycystic ovarian syndrome (PCOS). Fertil Steril 2010; 94: 1118–1121.
19.
Duijkers IJ, Klipping C: Polycystic ovaries, as defined by the 2003 Rotterdam consensus criteria, are found to be very common in young healthy women. Gynecol Endocrinol 2010; 26: 152–160.
20.
Barber TM, Alvey C, Greenslade T, Gooding M, Barber D, Smith R, Marland A, Wass JA, Child T, McCarthy MI, Franks S, Golding SJ: Patterns of ovarian morphology in polycystic ovary syndrome: a study utilising magnetic resonance imaging. Eur Radiol 2009; 20: 1207–1213.
21.
Polson DW, Adams J, Wadsworth J, Franks S: Polycystic ovaries – a common finding in normal women. Lancet 1988; 1: 870–872.
22.
March WA, Moore VM, Willson KJ, Phillips DI, Norman RJ, Davies MJ: The prevalence of polycystic ovary syndrome in a community sample assessed under contrasting diagnostic criteria. Hum Reprod 2010; 25: 544–551.
23.
Codner E, Soto N, Lopez P, Trejo L, Avila A, Eyzaguirre FC, Iniguez G, Cassorla F: Diagnostic criteria for polycystic ovary syndrome and ovarian morphology in women with type 1 diabetes mellitus. J Clin Endocrinol Metab 2006; 91: 2250–2256.
24.
Pigny P, Jonard S, Robert Y, Dewailly D: Serum anti-Mullerian hormone as a surrogate for antral follicle count for definition of the polycystic ovary syndrome. J Clin Endocrinol Metab 2006; 91: 941–945.
25.
Rosenfield RL, Wroblewski K, Padmanabhan V, Littlejohn E, Mortensen M, Ehrmann DA: Antimullerian hormone levels are independently related to ovarian hyperandrogenism and polycystic ovaries. Fertil Steril 2012; 98: 242–249.
26.
Homburg R, Ray A, Bhide P, Gudi A, Shah A, Timms P, Grayson K: The relationship of serum anti-Mullerian hormone with polycystic ovarian morphology and polycystic ovary syndrome: a prospective cohort study. Hum Reprod 2013; 28: 1077–1083.
27.
Dewailly D, Gronier H, Poncelet E, Robin G, Leroy M, Pigny P, Duhamel A, Catteau-Jonard S: Diagnosis of polycystic ovary syndrome (PCOS): revisiting the threshold values of follicle count on ultrasound and of the serum AMH level for the definition of polycystic ovaries. Hum Reprod 2011; 26: 3123–3129.
28.
Catteau-Jonard S, Bancquart J, Poncelet E, Lefebvre-Maunoury C, Robin G, Dewailly D: Polycystic ovaries at ultrasound: normal variant or silent polycystic ovary syndrome? Ultrasound Obstet Gynecol 2012; 40: 223–229.
29.
Iliodromiti S, Kelsey TW, Anderson RA, Nelson SM: Can anti-Mullerian hormone predict the diagnosis of polycystic ovary syndrome? A systematic review and meta-analysis of extracted data. J Clin Endocrinol Metab 2013; 98: 3332–3340.
30.
Eilertsen TB, Vanky E, Carlsen SM: Anti-Mullerian hormone in the diagnosis of polycystic ovary syndrome: can morphologic description be replaced? Hum Reprod 2012; 27: 2494–2502.
31.
Lie Fong S, Visser JA, Welt CK, de Rijke YB, Eijkemans MJ, Broekmans FJ, Roes EM, Peters WH, Hokken-Koelega AC, Fauser BC, Themmen AP, de Jong FH, Schipper I, Laven JS: Serum anti-mullerian hormone levels in healthy females: a nomogram ranging from infancy to adulthood. J Clin Endocrinol Metab 2012; 97: 4650–4655.
32.
Kelsey TW, Wright P, Nelson SM, Anderson RA, Wallace WH: A validated model of serum anti-mullerian hormone from conception to menopause. PLoS One 2011; 6:e22024.
33.
Lie Fong S, Laven JSE, Duhamel A, Dewailly D: Polycystic ovarian morphology and the diagnosis of polycystic ovary syndrome: redefining threshold levels for follicle count and serum anti-Müllerian hormone using cluster analysis. Hum Reprod 2017; 32: 1723–1731.
34.
Venturoli S, Porcu E, Fabbri R, Pluchinotta V, Ruggeri S, Macrelli S, Paradisi R, Flamigni C: Longitudinal change of sonographic ovarian aspects and endocrine parameters in irregular cycles of adolescence. Pediatr Res 1995; 38: 974–980.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.