The utility and selection of laboratory tests in the diagnosis of the polycystic ovary syndrome.

Fourteen patients with clinically diagnosed and surgically documented polycystic ovarian (Stein-Leventhal) disease (PCOD) and 16 normal control women were studied to identify the laboratory test or tests that, from the clinician's point of view, are most likely to aid in the nonsurgical diagnosis of the disease. A single random morning blood specimen was assayed in all cases for testosterone, epitestosterone, androstenedione, FSH and LH. The mean testosterone level for the PCOD patients was significantly greater (p less than 0.001) than that for the controls, with 50% of the patients showing elevated levels. Androstenedione showed a similar pattern, but mean epitestosterone levels were not significantly different from controls. FSH was not significantly different, but LH levels were significantly higher than controls (p less than 0.005), with 10 of 13 (77%) demonstrating elevated levels. A strong positive correlation was also found between the degree of virilization and the levels of LH, testosterone and androstenedione. This study suggests that the most useful diagnostic laboratory assay from a single drawing of blood is the serum LH; the only other useful test is testosterone and/or androstenedione. These data do not support other reports of elevated levels of epitestosterone or decreased values of FSH in PCOD.