Which is the Best Test to Detect the Polycystic Ovary?

Laparoscopy was used to characterize the ovaries of a group of infertile women. Patients with polycystic ovaries (PCO) were compared with those with normal ovaries. A free androgen index (FAI) greater than 4.5 was 100% specific and sensitive for detecting the PCO in a group of women with oligomenorrhoea. Overall, a biochemical 'screen' consisting of a luteinizing hormone (LH) level greater than 10 U/l, testosterone (T) greater 2.6 nmol/l, sex hormone binding globulin (SHBG) greater than 31 nmol/l or a FAI greater than 4.5 was 89% sensitive and 98% specific for PCO, which is comparable with the reliability of ultrasound for detecting the PCO.