Page 66 - PCC07

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Clinical and biochemical hyperandrogenism
Key messages:
• Assess clinical hyperandrogenism first • Use validated visual tools
• Patient distress primary concern
• Ethnic differences
• If needed assess biochemical HA
• Calculated bioavailable testosterone, calculated free
testosterone or free androgen index
• High quality assays –LCMS or extracted RIA recommended
• Androstenedione and DHEA and DHEAS limited extra PCOS diagnostic value
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Assessment of PCOM on Ultrasound
Clinical Issues:
– PCOS diagnostic criteria
– PCOM in controls and in PCOS
– Age specific normal data
– Heterogeneity in phenotype
Statistical Issues:
– Arbitrarily chosen cut‐of
– Specificity and Sensitivity
– 95th percentile issue
Technical issues
– Probe differences in MHz
– TAUS vs. TVUS
– Real time vs. Office counts
– 2D vs. 3D
– Lack of standardized protocol
NOT AN IDEAL TEST
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