Ovarian morphology assessed by magnetic resonance imaging in women with and without polycystic ovary syndrome and associations to anti Müllerian hormone free testosterone and glucose disposal rate

Capsule:
Magnetic resonance imaging yielded higher antral follicle counts (AFC) than previously reported. AFC, antimullerian hormone, and free testosterone discriminated with high accuracy between women with polycystic ovary syndrome and controls.

Authors:
Henrik Leonhardt, Ph.D., M.D., Mikael Hellström, Ph.D., M.D., Berit Gull, Ph.D., M.D., Anna-Karin Lind, Ph.D., M.D., Lars Nilsson, Ph.D, M.D., Per Olof Janson, Ph.D., M.D., Elisabet Stener-Victorin, Ph.D.

Volume 101, Issue 6, Pages 1747–1756.e3

Abstract:

Objective:
To characterize ovarian morphology and perfusion by magnetic resonance imaging (MRI) in women with and without polycystic ovary syndrome (PCOS) and to investigate associations with antimüllerian hormone (AMH), free T, and glucose disposal rate (GDR).

Design:
Explorative cross-sectional study.

Setting:
University hospital.

Patient(s):
Fifty-eight women with PCOS and 31 controls from the general population.

Intervention(s):
None.

Main Outcome Measure(s):
Antral follicle count (AFC), ovarian/stromal volume, perfusion, AMH, free T, and GDR.

Result(s):
Antral follicles of 1–3 and 4–6 mm, but not 7–9 mm, were more numerous, and total AFC (1–9 mm) was higher in women with PCOS. Ovarian volume was larger in women with PCOS. AMH and free T were higher and GDR was lower in women with PCOS. All values were more deranged in classic compared with nonclassic PCOS. There was a positive correlation between AMH and AFC, 1–3 mm (r = 0.81), and between AMH and total AFC (r = 0.87). In receiver operating characteristic analyses, the area under the curve was 0.89 for total AFC, 0.86 for AMH, and 0.90 for free T. PCOS was independently associated with AFC and free T but not with AMH or GDR when adjusted for age and body mass index.

Conclusion(s):
Counting antral follicles down to 1 mm in size by MRI yielded higher AFCs than previously reported. AFC, AMH, and free T discriminated with high accuracy between women with PCOS and controls, but AMH was not independently associated with PCOS.

Clinical Trial Registration Number:
NCT00484705.

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