Lab tests in pcos

Tests

There is no specific test that can be used to diagnose polycystic ovary syndrome (PCOS) and
there is no widespread agreement on what the diagnostic criteria should be. A health
practitioner will typically evaluate a combination of clinical findings such as a woman's signs
and symptoms, medical and family history, and physical exam as well as laboratory test results
to help make a diagnosis.

Some testing may done to rule out other possible causes of PCOS-like symptoms before a PCOS
diagnosis can be made. For example, adrenal or ovarian tumors or an overgrowth in adrenal
tissue called adrenal hyperplasia can also cause an overproduction of male hormones in
women.

Laboratory Tests

Several hormone tests may be used to evaluate a woman for PCOS:

Follicle stimulating hormone (FSH) will be normal or low with PCOS

Lutenizing hormone (LH) will be elevated

Testosterone usually elevated

Estrogens may be normal or elevated

Sex hormone binding globulin (SBGH) may be reduced

Androstenedione may be elevated

Human chorionic gonadotropin (hCG) used to check for pregnancy; negative unless pregnant

Anti-Mllerian hormone (AMH) an increased level is often seen with PCOS

A few tests may help rule out other conditions with similar signs and symptoms:

Thyroid-stimulating hormone (TSH) to rule out thyroid dysfunction

Cortisol to rule out Cushing syndrome

Prolactin to rule out elevated prolactin (hyperprolactinemia)

17-hydroxyprogesterone to rule out the most common form of congenital adrenal

hyperplasia

IGF-1 to rule out excess growth hormone (acromegaly)

DHEAS frequently mildly elevated with PCOS; may be done to rule out an adrenal tumor in
women with rapidly advancing hirsutism

Other blood tests may be done to check a woman's health and detect any complications that
might develop:

Lipid profile to help determine risk of developing cardiovascular disease; risk is associated
with a low HDL, high LDL, high total cholesterol and/or elevated triglycerides

Glucose or A1c can be used to detect diabetes; elevated in diabetes

Insulin often elevated in insulin resistance

Non-Laboratory Tests

A pelvic ultrasound (transvaginal and/or pelvic/abdominal) is used to evaluate enlarged ovaries.

Ultrasounds are often used to look for cysts in the ovaries and to see if the internal structures
appear normal. In PCOS, the ovaries may be 1.5 to 3 times larger than normal and
characteristically have more than 12 or more follicles per ovary measuring 2 to 9 mm in
diameter. Often the cysts are lined up on the surface the ovaries, forming the appearance of a
"pearl necklace." The follicles tend to be small and immature, thus never reaching full
development. The ultrasound helps visualize these changes in more than 90% of women with
PCOS, but they are also found in up to 25% of women without PCOS symptoms. (For more, see
RadiologyInfo.org: Pelvic ultrasound.)
Laparoscopy may be used to evaluate ovaries and sometimes used as part of surgical
treatment. (For more, see MedlinePlus: Pelvic laparoscopy.)