Table of Contents
Definition / general | Treatment (for infertility) | Gross description | Gross images | Microscopic (histologic) description | Microscopic (histologic) images | Videos | Additional referencesCite this page: Islam S. Polycystic ovary disease. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/ovaryPCO.html. Accessed January 17th, 2021.
Definition / general
- Formerly called Stein-Leventhal syndrome
- Affects 5 - 10% of women in US; 3 - 15% women of reproductive age; most common cause of anovulatory infertility
- Occurs during teenage and childbearing years
- Associated with endometrial hyperplasia, well differentiated adenocarcinoma
- Also acne, obesity, hirsutism, insulin resistance and diabetes
- Endometrium may show metaplastic changes resembling adenoacanthoma or adenocarcinoma (Am J Surg Pathol 1982;6:223)
Two different diagnostic criteria:
- NIH: androgen excess, oligoovulation and exclusion of other entities that cause polycystic ovaries
- ESHRE / ASRM in Rotterdam (2 of 3 present):
- Oligoovulation or anovulation
- Excess androgen activity
- Polycystic ovaries present (by ultrasound) but no other endocrine disorders
Treatment (for infertility)
- Clomiphene citrate or FSH, weight loss
- Also ovarian drilling puncture of small follicles with electrocautery (Hum Reprod 2002;17:2851) although effectiveness has been questioned (Cochrane Database Syst Rev 2007;(3):CD001122)
- Formerly did wedge resections
Gross description
- Large ovaries (2x normal), numerous subcortical cysts (cysts may be immature follicles)
Microscopic (histologic) description
- Multiple cystic follicles covered by a dense fibrous capsule
- Luteinization of the theca interna (hyperthecosis), few corpora lutea or corpora albicantia since anovulatory, atretic follicles simulate corporate albicantia
Microscopic (histologic) images
Videos
Histopathology ovary - polycystic ovarian disease