Criterios de Clasificacin del

Sndrome de Ovario Poliqustico

Profesor Titular: Dr. Hctor Godoy Morales
Profesor Adjunto: Dr. Alfredo Ulloa Aguirre
Presenta: Dr. Horacio Alvarado Delgado R1BR
Azziz R., Carmina E., Dewally D., et al., POSITION STATEMENT: Criteria for defining Polycystic Ovary Syndrome as a predominantly hyperandrogenyc syndrome: An Androgen Excess Society
Guideline. The Journal of Clinical Endocrinology & Metabolism 91 (11): 4237 4245. 2006

The Rotterdam ESHRE/ASRM Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long term
health risks related to polycystic ovary syndrome. Fertility and Sterility 81(1) 19 25, Jan 2004

Sndrome de Ovario Poliqustico

1935 Stein yLeventhal
Incremento riesgo

Infertilidad
DMt2
Dislipidemia
Hipertensin
Enfermedad Cardiovascular

Azziz R., Carmina E., Dewally D., et al., POSITION STATEMENT: Criteria for defining Polycystic Ovary Syndrome as a predominantly hyperandrogenyc syndrome: An Androgen Excess Society
Guideline. The Journal of Clinical Endocrinology & Metabolism 91 (11): 4237 4245. 2006

Clasificacin NIH (Abril 1990)

Hiperandrogenismo o
Hiperandrogenemia

Oligoovulacin

Exclusin de otras patologas

Azziz R., Carmina E., Dewally D., et al., POSITION STATEMENT: Criteria for defining Polycystic Ovary Syndrome as a predominantly hyperandrogenyc syndrome: An Androgen Excess Society
Guideline. The Journal of Clinical Endocrinology & Metabolism 91 (11): 4237 4245. 2006

Criterios de Rooterdam, Mayo 2003

Diagnstico
23

CRITERIOS DE
ROOTERDAM (2003)

1
2
3

Oligo o anovulacin
Signos clnicos y/o bioqumicos de
hiperandrogenismo
Ovarios poliqusticos y exclusin de otras
patologas (hiperplasia adrenal congnita,
tumores secretores de andrgenos, Sndrome
de Cushing)

The Rotterdam ESHRE/ASRM Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long term
health risks related to polycystic ovary syndrome. Fertility and Sterility 81(1) 19 25, Jan 2004

Criterios de Rooterdam
CRITERIOS DE
ROOTERDAM (2003)

Oligo o anovulacin

The Rotterdam ESHRE/ASRM Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long term
health risks related to polycystic ovary syndrome. Fertility and Sterility 81(1) 19 25, Jan 2004

Oligo o anovulacin
75% con alteraciones menstruales
20% eumenorrea
Paciente anovulatoria y eumenorreica
Progesterona 20 24 del ciclo

Azziz R., Carmina E., Dewally D., et al., POSITION STATEMENT: Criteria for defining Polycystic Ovary Syndrome as a predominantly hyperandrogenyc syndrome: An Androgen Excess Society
Guideline. The Journal of Clinical Endocrinology & Metabolism 91 (11): 4237 4245. 2006

CRITERIOS DE
ROOTERDAM (2003)

Signos clnicos y/o bioqumicos de

hiperandrogenismo

The Rotterdam ESHRE/ASRM Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long term
health risks related to polycystic ovary syndrome. Fertility and Sterility 81(1) 19 25, Jan 2004

Hiperandrogenismo
Hiperandrogenismo Clnico
Hirsurtismo
cne
Aloplecia andrgenica

The Rotterdam ESHRE/ASRM Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long term
health risks related to polycystic ovary syndrome. Fertility and Sterility 81(1) 19 25, Jan 2004

Hiperandrogenismo
Hirsurtismo
Presente en 60%

Escala modificada de
Ferriman-Gallwey

Azziz R., Carmina E., Dewally D., et al., POSITION STATEMENT: Criteria for defining Polycystic Ovary Syndrome as a predominantly hyperandrogenyc syndrome: An Androgen Excess Society
Guideline. The Journal of Clinical Endocrinology & Metabolism 91 (11): 4237 4245. 2006

Hiperandrogenismo
Hiperandrogenismo bioqumico (60 80%)

Medicin de testosterona total

6.86 ng/ml

Testosterona libre
20 a 40 aos: 0.6 3.1 pg/mL

The Rotterdam ESHRE/ASRM Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long term
health risks related to polycystic ovary syndrome. Fertility and Sterility 81(1) 19 25, Jan 2004

Hiperandrogenismo
Hiperandrogenismo bioqumico
Androstenediona y DHEAS
Solo en 10%

Azziz R., Carmina E., Dewally D., et al., POSITION STATEMENT: Criteria for defining Polycystic Ovary Syndrome as a predominantly hyperandrogenyc syndrome: An Androgen Excess Society
Guideline. The Journal of Clinical Endocrinology & Metabolism 91 (11): 4237 4245. 2006

Hiperandrogenismo
Hiperandrogenismo bioqumico

Usar solo como auxiliar

diagnstico, NO COMO
CRITERIO DIAGNOSTICO
AISLADO

Azziz R., Carmina E., Dewally D., et al., POSITION STATEMENT: Criteria for defining Polycystic Ovary Syndrome as a predominantly hyperandrogenyc syndrome: An Androgen Excess Society
Guideline. The Journal of Clinical Endocrinology & Metabolism 91 (11): 4237 4245. 2006

CRITERIOS DE
ROOTERDAM (2003)

Ovarios poliqusticos y exclusin de otras

patologas (hiperplasia adrenal congnita,
tumores secretores de andrgenos, Sndrome
de Cushing)

The Rotterdam ESHRE/ASRM Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long term
health risks related to polycystic ovary syndrome. Fertility and Sterility 81(1) 19 25, Jan 2004

Ovarios Poliqusticos
12 o ms folculos en
cada ovario de 2 a 9 mm

Aumento del volumen

de ovario (>10 mL)

The Rotterdam ESHRE/ASRM Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long term
health risks related to polycystic ovary syndrome. Fertility and Sterility 81(1) 19 25, Jan 2004

Ovarios Poliqusticos

Azziz R., Carmina E., Dewally D., et al., POSITION STATEMENT: Criteria for defining Polycystic Ovary Syndrome as a predominantly hyperandrogenyc syndrome: An Androgen Excess Society
Guideline. The Journal of Clinical Endocrinology & Metabolism 91 (11): 4237 4245. 2006

Excluir
diagnstico

Diagnstico de SOP
Hiperplasia adrenal congnita
Sndrome de Cushing
Tumores secretores de andrgenos
Deficiencia de 21 hidroxilasa
Enfermedades tiroideas
Hiperprolactinemia
Hipogonadismo hipogonadotrofico

The Rotterdam ESHRE/ASRM Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long term
health risks related to polycystic ovary syndrome. Fertility and Sterility 81(1) 19 25, Jan 2004

Clasificacin AES 2006

1
2
3

Hiperandrogenismo
Hirsurtismo y/o Hiperandrogenemia

Disfuncin ovrica
Oligoovulacin
Ovario Poliqustico

Exclusin de otros trastornos relacionados

con el exceso de andrgenos

Azziz R., Carmina E., Dewally D., et al., POSITION STATEMENT: Criteria for defining Polycystic Ovary Syndrome as a predominantly hyperandrogenyc syndrome: An Androgen Excess Society
Guideline. The Journal of Clinical Endocrinology & Metabolism 91 (11): 4237 4245. 2006

Fenotipos

Azziz R., Carmina E., Dewally D., et al., POSITION STATEMENT: Criteria for defining Polycystic Ovary Syndrome as a predominantly hyperandrogenyc syndrome: An Androgen Excess Society
Guideline. The Journal of Clinical Endocrinology & Metabolism 91 (11): 4237 4245. 2006