Thursday, 18 December 2014

How is PCOS Diagnosed?


Presence of polycystic ovaries in a female’s body is called Polycystic Ovarian Syndrome and can be seen by performing ultrasound. PCOS comes with an array of complex health issues. However, there are possibilities that women with PCOS do not have polycystic ovaries. Therefore, it is important to diagnose PCOS. The doctors perform following tests to detect PCOS:

1. Endometrial Biopsy

2. Glucose Tolerance Test

3. Thyroid Panel

4. Blood Lipid Profile

At Pahlajani, we perform the physical examination of women Physical to collect basic information like height, weight and blood pressure.
Followed by, the pelvic examination. In this, reproductive organs are visually and manually inspected to check masses, growths or other abnormalities of the cysts.

Later, the levels of different hormones are measured through blood tests to determine if menstrual abnormalities or androgen excess are not mimicking PCOS

Other tests include, fasting cholesterol and triglyceride levels and a glucose tolerance test. Blood tests are used to assess the levels of androgens in your body. Blood tests for androgens (such as testosterone) and free androgen index (FAI) are the best tests for diagnosing whether you have hyperandrogenism (high androgen levels).

Finally, an ultrasound examination is carried out to see the appearance of ovaries and the thickness of the lining of uterus. An ultrasound of the uterus, ovaries and the pelvis can be carried out to identify whether there are any cysts on your ovaries and whether an ovary is enlarged. A transvaginal ultrasound is a painless test with no radiation. It uses a pen–shaped probe with an ultrasound sensor on the tip, which is inserted into the vagina. This produces a much clearer picture than an abdominal ultrasound. Transvaginal ultrasounds are only performed on women who have been sexually active, otherwise an abdominal scan is done where the ovaries are viewed from the outside through the stomach wall.

Through the above tests, we measure the following -

1. Pituitary and Ovarian Hormone serum levels

2. Luteinizing Hormone (LH)

3. Follicle Stimulating Hormone (FSH)

4. Estradiol

5. Progesterone

6. Prolactin

7. Circulating Androgens

8. Free testosterone

9. Free androgen index (FAI): 17-hydroxyprogesterone

10. Sex hormone binding globulin (SHBG): 24 hr. urinary free cortisol

11. Dehydroepiandrosterone sulfate (DHEA-S)

The ovaries are polycystic because 12 or more follicles are visible on one ovary or the size of one or both ovaries is increased

It can be because of,

1. High levels of ‘male’ hormones (androgens) in the blood (hyperandrogenism). Symptoms - Excess hair growth, Acne

2. Menstrual dysfunction, lack of periods or menses (menstrual flow), menstrual irregularity, lack of ovulation (where an egg is released)

Women with PCOS should have a cholesterol and glucose tolerance test in every two years, and blood pressure should be checked every year.

Dr Neeraj Pahlajani

Obstetrician & IVF Specialist
(MS, DNB, FMAS, DRM - Germany)
MBBS - Lady Harding Medical College - New Delhi
MS - Obstetrics and Gynecology (PGI - Rohtak)
DNB - Obstetrics and Gynecology
FMAS - World Association of Laparoscopic Surgeons
DRM - Diploma in Reproductive Medicine (Germany)
Fellow in IVF & Embryology – (USA)
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Pahlajani Test Tube Baby Centre
(Mata Laxmi Nursing Home)
Anupam Nagar, Near T.V. Tower, Raipur (Chhattisgarh) India
Phone:  +91- 771- 4052967, +91- 771- 4053285 Mobile:  +91- 9300511044, +91- 9329630455
Email - contact@raipurivf.com, sameerp5000@hotmail.com

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