Carmina E
Endocrine Unit, Department of Clinical Medicine, University of Palermo, Palermo, Italy.
Minerva Ginecol. 2004 Feb;56(1):1-6.
In the past, the diagnosis of polycystic ovary syndrome (PCOS) was based on National Institute of Health (NIH) criteria (hyperandrogenism and chronic anovulation) or on sonographic findings of polycystic ovaries. Diffe-rences in diagnosis criteria made it difficult to compare the data of studies coming from different countries. Moreover, there was criticism of both the methods used. In 2003, at a joint meeting of the European Society for Human Reproduction (ESHRE) and the American Society of Reproductive Medicine (ASRM), new guidelines for the diagnosis of PCOS were suggested. According to these guidelines, it is possible to reach a diagnosis of PCOS when at least 2 of these 3 elements are present: hyperandrogenism, chronic anovulation and polycystic ovaries. New criteria for the echographic diagnosis of polycystic ovaries have been suggested, too. These diagnostic guidelines represent important progress because they are more flexible and permit us to make the diagnosis in patients who were previously excluded by the syndrome (such as ovulatory hyperandrogenic women with polycystic ovaries or anovulatory normoandrogenic women with polycystic ovaries). However, doubts still exist and regard some borderline group of patients such as hirsute ovulatory normoandrogenic women with polycystic ovaries. A new classification of PCOS syndrome is suggested on the basis of new guidelines.
过去，多囊卵巢综合征（PCOS）的诊断基于美国国立卫生研究院（NIH）标准（高雄激素血症和慢性无排卵）或多囊卵巢的超声检查结果。诊断标准的差异使得来自不同国家的研究数据难以比较。此外，对所使用的两种方法都存在批评意见。2003年，在欧洲人类生殖与胚胎学会（ESHRE）和美国生殖医学学会（ASRM）的联合会议上，提出了PCOS的新诊断指南。根据这些指南，当出现以下3个要素中的至少2个时，即可诊断为PCOS：高雄激素血症、慢性无排卵和多囊卵巢。还提出了多囊卵巢超声诊断的新标准。这些诊断指南代表了重要的进展，因为它们更加灵活，使我们能够对以前被该综合征排除的患者（如伴有多囊卵巢的排卵型高雄激素血症女性或伴有多囊卵巢的无排卵型正常雄激素血症女性）进行诊断。然而，仍然存在疑问，涉及一些边缘性患者群体，如伴有多囊卵巢的多毛排卵型正常雄激素血症女性。基于新指南提出了PCOS综合征的新分类。
