Which lab tests are performed in the workup of polycystic ovarian syndrome (PCOS)?

Updated: Sep 19, 2019
  • Author: Richard Scott Lucidi, MD, FACOG; Chief Editor: Richard Scott Lucidi, MD, FACOG  more...
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Answer

Exclude all other disorders that can result in menstrual irregularity and hyperandrogenism, including adrenal or ovarian tumors, thyroid dysfunction, congenital adrenal hyperplasia, hyperprolactinemia, acromegaly, and Cushing syndrome. [3, 4, 5]

Baseline screening laboratory studies for women suspected of having PCOS may include the following:

  • Thyroid function tests [5] (eg, TSH, free thyroxine)

  • Serum prolactin level [5]

  • Total and free testosterone levels

  • Free androgen index [5]

  • Serum hCG level

  • Cosyntropin stimulation test

  • Serum 17-hydroxyprogesterone (17-OHPG) level

  • Urinary free cortisol (UFC) and creatinine levels

  • Low-dose dexamethasone suppression test

  • Serum insulin-like growth factor (IGF)–1 level

Other tests used in the evaluation of PCOS include the following:

  • Androstenedione level

  • FSH and LH levels

  • GnRH stimulation testing

  • Glucose level

  • Insulin level

  • Lipid panel


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