Table 2.
Recommendations from consensus conferences and scientific societies on the assessment of thyroid function in patients with suspected PCOS.
| Reference | Article type | Exclusion of thyroid disease | Clinical assessment | Biochemical assessment | Reason given to screen/not screen thyroid disease | Comments |
|---|---|---|---|---|---|---|
| Zawadski and Dunaif, (12) | Textbook from NIH meeting | No | Any | Any | ————————– | ———————– |
| Rotterdam ESHRE/ASRM-Sponsored PCOS consensus workshop group, (2) | ESHRE/ASRM consensus conference | No | Any | Any | Low incidence of thyroid disease in women with PCOS | Routine TSH assay in hyperandrogenic patients should be not discouraged |
| Azziz et al., (13) | AES consensus conference on PCOS diagnosis | Yes, but not mandatory | Any | Any | Thyroid abnormalities may cause ovulatory dysfunction despite a low prevalence | Hypo- and hyperthyroidism may influence PCOS diagnosis, and screening of patients with suspected PCOS for thyroid dysfunction may be cost-effective in asymptomatic patients with thyroid dysfunction |
| Legro et al., (3) | ES clinical guideline | Yes, but only suggested | Any | Serum TSH | Thyroid disease may present in women with irregular menstrual cycles | Suggestion for screening is based on low quality evidence (reinforced in case of amenorrhea and/or severe phenotypes). Serum TSH levels higher than the upper limit of normal suggests hypothyroidism; serum TSH levels lower than the inferior limit (<0.1 mIU/L) suggest hyperthyroidism |
| Goodman et al., (4) | AACE, ACE, and AES Society clinical guidelines | Yes | Any | Any | No motivation | Usefulness of the serum 17OHP and AMH assays discussed |
| Dumesic et al., (1) | Scientific statement of experts in PCOS | Yes | Any | Any | No motivation | Only a few lines in the text on excluding other endocrinopathies |
| Teede et al., (6) | International PCOS Network evidence-based guideline | Any | Any | Any | No motivation | Exclusion of other endocrinopathies for PCOS diagnosis not assessed/discussed |
| ACOG Committee on Practice Bulletins, (5) | ACOG clinical guidelines | Yes | Any | Serum TSH | High frequency in women with menstrual disorders | ———————– |
17OHP, 17-hydroxyprogesterone; AACE, American Association of Clinical Endocrinologists; ACE, American College of Endocrinology; ACOG, American College of Obstetricians and Gynecologists; AES, Androgen Excess and PCOS Society; AMH, anti-Mullerian hormone; ASRM, American Society for Reproductive Medicine; ES, Endocrine Society; ESHRE, European Society of Human Reproduction and Embryology; NIH, National Institute of Health; PCOS, polycystic ovary syndrome; TSH, thyroid stimulating hormone.