A very large proportion of young Danish women have polycystic ovaries: is a revision of the Rotterdam criteria needed?
Abstract
BACKGROUND: According to the Rotterdam 2003 criteria, an ovary is defined as polycystic if 12 or more follicles of 2-9 mm are present, when evaluating the ovary by ultrasonography on Days 3-5 of the menstrual cycle in women not using hormonal contraceptives. The aim of this population-based study was to estimate the prevalence of polycystic ovaries (PCO) in a representative sample of young Danish women according to the Rotterdam criteria. METHODS: From a Danish pregnancy cohort established in 1988-1989, 267 (61%) young adult daughters agreed to participate in a clinical examination and 174 (40%) consented to vaginal ultrasound. Sufficient image quality in at least one ovary was obtained from 154 women. Both users and non-users of hormonal contraceptives were included and the examination was not restricted to a particular time of the menstrual cycle. RESULTS: The median (range) age was 20.1 (19.5-21.0) years. The median follicle number per ovary was 14 (6-30) and 12 or more follicles were counted in 104 of the 154 women. Thus, the prevalence was estimated to 68% [95% confidence interval (CI): 60-74%]. PCO were present in 80% (95% CI: 65-89%) of non-users (n = 44) of hormonal contraceptives. Of the 104 women with PCO, 41% (95% CI: 32-51%) could be defined as having polycystic ovary syndrome. CONCLUSIONS: A very large proportion of the young women had PCO according to the Rotterdam 2003 criteria. As the number of follicles is higher at a younger age, we believe the Rotterdam criteria should be revised, particularly to avoid misdiagnosis in this age group.
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The role of ultrasound remains controversial for adolescents, among whom a polycystic appearance of the ovaries is very common, potentially leading to overdiagnosis.
“The role of ultrasound remains controversial for adolescents, among whom a polycystic appearance of the ovaries is very common, potentially leading to overdiagnosis; 16”
From Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline (2011) · cites this paper as [16]
On community-based screening, up to 68% of 19-21-year-old Danish women were shown to have polycystic ovaries according to the Rotterdam criteria.
“Recently, on community-based screening, up to 68% of 19-21-yearold Danish women were shown to have polycystic ovaries according to the Rotterdam criteria. 16”
From Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline (2011) · cites this paper as [16]
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- Authors
- Kristensen, S. L., Ramlau-Hansen, C. H., Ernst, E., Olsen, S. F., Bonde, J. P., Vested, A., & Toft, G.
- Affiliations
- Aarhus University Hospital (DK)
- Aarhus University (DK)
- Statens Serum Institut (DK)
- University of Copenhagen (DK)
- Corresponding author
- Kristensen, S. L.
- Venue
- Human Reproduction
- Publisher
- Oxford University Press (OUP)
- Published
- 2010-10-11
- Volume
- 25
- Issue
- 12
- Pages
- 3117-3122
- ISSN
- 0268-1161 (ISSN-L)
- 1460-2350
- OpenAlex
- W2112721406
- Cited by
- 102
- References
- 29
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 2 · 2023: 3 · 2022: 8 · 2021: 4 · 2020: 11 · 2019: 6 · 2018: 4 · 2017: 4 · 2016: 12 · 2015: 5 · 2014: 10 · 2013: 13 · 2012: 8
- FWCI
- 10.62
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Human Reproduction (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic and Kidney Cyst Diseases
- Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
- Keywords
- polycystic ovary, polycystic ovary syndrome, Rotterdam criteria, ovarian follicle count, prevalence, young women, hormonal contraception, misdiagnosis, diagnostic criteria revision
- MeSH terms
- Age Factors, Denmark, Female, Humans, Ovary, Polycystic Ovary Syndrome, Ultrasonography, Prevalence, Young Adult
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