American Research Journal of Gynaecology

Objective: To evaluate the role of sonographic markers of ovarian morphology versus hirsutism indices in the prediction of serum total testosterone in hirsute women

Study Design: Cross sectional observational Study.

Subjects: Eighty women (aged 18 to 40 years) form among the attendants of the Gynecology Clinic of Minia University Hospital complaining of hirsutism were recruited into the Study in the period between January and May 2017 after obtaining their informed consent.

Participants were evaluated regarding self-reported menstrual cycle history to determine the extent of any menstrual cycle disturbance; male-pattern hair growth was assessed on nine regions of the body using the modified Ferriman-Gallwey (mFG) scoringsystem, a transvaginal ultrasound scan to characterize ovarian morphology and fasting blood sample for testosterone assay.

Main Outcome Measures: Regional and total modified Ferriman-Gallwey (mFG) scores, number of follicles per follicle size category, follicle number per ovary (FNPO), ovarian volume (OV), ovarian area (OA), stromal to ovarian area ratio (S/A), stromal echogenicity index (SI), total testosterone (TT) and menstrual cycle length.

Results: There were no correlations between any of the demographic characteristics of the study participants and total testosterone.

There were no correlations between hirsutism scores and total testosterone of all study participants. However, there were some association between hirsutism scores (upper lip, chin and lower abdomen) and total testosterone of all study participants.

There were correlations between the three ovarian dimensions, ovarian volume, ovarian area, stromal echogenicity and ovarian echogenicity and total testosterone. However, there were no correlations between 2-5 mm FNPO, 6-9 mm FNPO, 2-9 mm FNPO, stroma to ovary ratio & stromal echogenicity index and total testosterone.

Conclusion: Sonographic markers particularly ovarian dimensions, ovarian volume, ovarian area, stromal echogenicity and ovarian echogenicity are good predictors of total testosterone levels in women with hirsutism whether having regular or irregular menstrual cycles. They are better predictor of total testosterone levels than other Sonographic markers namely number of follicles of different sizes , stroma to ovary ratio and stromal echogenicity index. They are much more sensitive predictors of total testosterone than hirsutism scores whether regional or total scores.