Journal of Pediatric and Adolescent Gynecology
Volume 23, Issue 3 , Pages 146-152, June 2010

Endometrial Thickness, Uterine, and Ovarian Ultrasonographic Features in Adolescents with Polycystic Ovarian Syndrome

  • Bina Shah, MD

      Affiliations

    • Department of Endocrinology, NYU School of Medicine, New York, New York, USA
    • Corresponding Author InformationAddress correspondence to: Bina Shah, MD, Department of Pediatrics, New York University Medical Center, 550 First Avenue, New York, NY 10016
    • ,
  • Lauren Parnell, MD

      Affiliations

    • Department of Pediatrics, NYU School of Medicine, New York, New York, USA
    • ,
  • Sarah Milla, MD

      Affiliations

    • Department of Radiology, NYU School of Medicine, New York, New York, USA
    • ,
  • Marion Kessler, MD

      Affiliations

    • Department of Endocrinology, NYU School of Medicine, New York, New York, USA
    • ,
  • Raphael David, MD

      Affiliations

    • Department of Endocrinology, NYU School of Medicine, New York, New York, USA

published online 04 September 2009.

Abstract 

Objective

Our aim was to evaluate uterine and ovarian ultrasonographic features including endometrial thickness (ET) in adolescent females with PCOS, which is limited in this population.

Methods

We performed a retrospective chart review of young females (n=51) ranging in age from 10 to 18 years with the diagnosis of PCOS. Clinical, biochemical and pelvic sonography data were reviewed. Sonographic data included uterine parameters of ET, length, and volume as well as ovarian volume and follicular morphologic features.

Results

Data in 51 girls were analyzed. Menstrual periods were reported as irregular in 26/51 (50.9%), amenorrheic in 19/51 (37.2%), regular in 4/51 (7.8%) and metrorrhagia in 2/51 (3.9%). Uterine features revealed that the endometrial stripe was enlarged (>7mm) in 16/51 (31.4%) of girls, all with homogeneous appearance. The uterine length was lower than normal in 22/51 (43.1%) of girls, normal in 21/51 (41.2%), and higher than normal in 8/51 (15.7%). Uterine volume was normal in 31/51 (60.7%) and higher in 20/51 (39.3%) of girls. Enlarged ovarian volume was found in 22/51 (43%) of patients. Mean ovarian volumes were 16.1cm3 and 13.1cm3 in bilateral and unilaterally enlarged ovaries, respectively. The morphology of ovarian follicles was studied in a subset of 40 patients. The location of ovarian follicles was peripheral in 81% and mixed in 19%. The number of follicles was also examined in 43 patients. They were few (<5) in 12%, moderate (5–10) in 5% and multiple (>10) in 84% cases. There was the presence of at least one >10mm cyst in 25% of girls.

Conclusion

Majority of the adolescents with PCOS demonstrated multiple peripheral ovarian follicles, with large ovarian volumes in some, indicating an important role of ultrasonography in the diagnosis of PCOS, even at a younger age. Endometrial thickness, uterine length, ovarian size, and follicular morphology should be carefully examined in cases of adolescent PCOS.

Key Words: Polycystic ovary syndrome, Endometrium thickness, Pelvic ultrasonography, Adolescents

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PII: S1083-3188(09)00256-3

doi:10.1016/j.jpag.2009.07.002

Journal of Pediatric and Adolescent Gynecology
Volume 23, Issue 3 , Pages 146-152, June 2010

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