Polycystic ovary syndrome (PCOS) is the most common hormonal disorder in young women, affecting 12- 18% of women of reproductive age. It is associated with an increased risk of type 2 diabetes, cardiovascular disease and sleep disorders. Some women with PCOS may experience reduced fertility or “sub fertility” where it may take longer to conceive or they may need further medical assistance to achieve a pregnancy.
Within the Rotterdam guidelines, a diagnosis of PCOS can be made when a woman has at least two of the three following features: menstrual dysfunction, polycystic ovaries and hyperandrogenism (high levels of ‘male’ hormones in the blood). Pathology tests support the diagnosis of PCOS by detecting androgen levels in the blood while ultrasonography is used to identify cysts on the ovaries.
PCOS can be a very challenging condition to diagnose as very few women will have the same set of symptoms. 70% of Australian women with the condition remain undiagnosed.
According to Professor Helena Teede, Professor of Women’s Heath at Monash University and Chair of NHMRC PCOS Centre for Excellence, delayed diagnosis is a source of frustration for women affected by PCOS.
In her recent international survey of 1,800 women, it was clear that women with PCOS were distressed by their condition and disappointed with delays in diagnosis. Over a third of women reported 2 years and three health professional reviews before a diagnosis was confirmed.
A simple blood test could provide a quicker, more accurate diagnosis for PCOS with potential to reduce confusion and anxiety for women affected.`
Anti-Mullerian Hormone (AMH) testing measures the level of AMH in a woman’s blood – a good indicator of her egg supply and future reproductive success. While it’s more commonly known for its use in family planning, the test is now being trialed as a marker for PCOS.
Measuring the ovarian reserve through ultrasound is one method of diagnosing PCOS. Ultrasound technology sometimes fails to accurately evaluate ovaries, particularly in adolescent and young women. AMH testing has been shown to offer a more precise diagnosis by assessing AMH levels secreted in excess by ovarian follicles – a common feature of PCOS.
Although the test has performed well in studies, further research is needed before it can become a routine part of diagnosis for PCOS.
AMH testing is one of the topics up for discussion at the AE-PCOS Society conference in San Antonio this November. Chaired by Professor Teede, the purpose of the conference is to consider evidence reviews to develop the first ever international guideline for the assessment and management of PCOS.
Due to be launched in 2018, the guideline will address the challenges of PCOS and inconsistency in care by exploring further opportunities in pathology for improved diagnosis.