BACKGROUND
Polycystic ovaries (PCO) are described on ultrasound scan as the “presence of 12 or more follicles in each ovary measuring 2–9 mm in diameter, and/or ovarian volume (>10 ml)”1. Polycystic ovarian syndrome (PCOS) or disease (PCOD) is diagnosed when polycystic ovaries are associated with chronic an ovulation and clinical and/or biochemical androgen excess (typically featured as oligo- amenorrhoea and hirsutism/acne, respectively). The Rotterdam criteria1 for diagnosis require any two of the three features. Unilaterality does not affect diagnosis; neither does the location of the cysts in the ovary.
PCOS is associated with infertility, as well as obesity, insulin resistance and hyperinsulinaemia, leading to impaired glucose tolerance1. Obesity and hyperinsulinaemia individually result in increased androgen production1. In most women, management includes lifestyle modifications towards weight loss. Oral hypoglycaemic agents help to improve insulin sensitivity; some women start to have regular periods with the use of metformin only2. PCOS is a diagnosis of medical interest, as associations with important non- communicable diseases have been made—notably, the metabolic syndrome. This comprises: insulin resistance, obesity, hypertension and dyslipidaemia, which significantly increase the woman’s risk of cardiovascular disease3. This makes the evaluation of PCOS in the study environment of a wider interest beyond infertility.