Page 70 - PCC07

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How do you assess for PCOS?
Clinical Assessment:
Cycles and Hyperandrogenism Progesterone if cycles regular suspect PCOS
Androgen profile
Free testosterone, or Free Androgen index (FAI), SHBG Assay quality
(DHEAS or androstenedione not routinely recommended)
Exclude secondary causes
TFTs, prolactin, 17‐hydroxyprogesterone, FSH Clinical history and examination
Ovulation/ovaries
Ovarian morphology only if needed in adults (if androgens or cycle irregularity not present) AMH not recommended at this stage
Teede et al Human Reproduction 2018
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PCOS diagnostic algorithm
Step 1‐ Irregular cycles Clinical hyperandrogenism (HA) (exclude other causes) = diagnosis
Step 2 – If no clinical HA biochemical HA, (exclude other causes) = diagnosis
Teede et al Human Reproduction 2018
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Step 3 – If only irreg cycles or HA in adult women ‐ PCOM (exclude other causes) = milder phenotype
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