The relationship between luteinizing hormone (LH) and follicle-stimulating hormone (FSH) is a diagnostic tool used primarily in the evaluation of reproductive health. The comparison, often expressed as a numerical value, assists medical professionals in assessing ovarian function, particularly in women experiencing irregular menstruation, infertility, or symptoms suggestive of polycystic ovary syndrome (PCOS). For example, a value greater than 2 or 3 is often associated with PCOS, although this is just one diagnostic criterion among many.
Assessing the proportional amounts of these hormones offers valuable insights into hormonal imbalances that can hinder ovulation and fertility. Understanding this relationship allows clinicians to better tailor treatment strategies, potentially improving outcomes for individuals seeking to conceive or manage endocrine disorders. Historically, manual calculations and reference ranges were employed, but modern methods offer increased efficiency and reduce potential errors.
The following sections will elaborate on the clinical applications of this assessment, explore the factors that influence the value obtained, and discuss its role alongside other diagnostic procedures in a comprehensive evaluation of reproductive health.
1. PCOS Diagnosis
Polycystic ovary syndrome (PCOS) diagnosis frequently involves evaluating the relationship between luteinizing hormone (LH) and follicle-stimulating hormone (FSH). While the assessment is not the sole diagnostic criterion for PCOS, a disproportionately high LH to FSH value (typically greater than 2:1 or 3:1) is a common finding. This elevation often stems from increased LH secretion driven by underlying hormonal imbalances characteristic of PCOS, such as insulin resistance and elevated androgens. For instance, a woman experiencing irregular periods, hirsutism, and acne, and also exhibiting an elevated LH/FSH assessment, might be further investigated for PCOS using other diagnostic criteria outlined by the Rotterdam consensus.
The assessment serves as an indicator of potential ovarian dysfunction associated with PCOS. The increased LH stimulates the theca cells in the ovaries to produce androgens, contributing to the hyperandrogenism observed in many women with PCOS. Simultaneously, the relative deficiency in FSH may impair proper follicle maturation, leading to the formation of cysts and irregular ovulation. Therapeutic interventions, such as lifestyle modifications, metformin, or hormonal birth control, are often guided by the overall clinical picture, including the value, aiming to address both the hormonal imbalances and associated symptoms.
In conclusion, the LH/FSH value is a valuable component in the diagnostic process for PCOS, providing insights into hormonal dysregulation. While not definitive on its own, its interpretation, in conjunction with clinical and biochemical markers, enables clinicians to formulate accurate diagnoses and implement appropriate management strategies. Further research continues to refine the diagnostic criteria and explore the complex interplay of hormonal factors contributing to PCOS development.
2. Infertility Assessment
Evaluation of infertility often incorporates the analysis of the relationship between luteinizing hormone (LH) and follicle-stimulating hormone (FSH). This relationship provides crucial insights into ovarian function and hormonal balance, essential for successful conception.
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Ovarian Reserve and Function
The relationship between LH and FSH serves as an indicator of ovarian reserve and function. An elevated LH:FSH proportion may signify diminished ovarian reserve or polycystic ovary syndrome (PCOS), both of which can impair fertility. For instance, women with premature ovarian insufficiency may exhibit elevated FSH levels relative to LH, indicating reduced ovarian responsiveness.
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Ovulation Disorders
Disruptions in the normal cyclical fluctuation of LH and FSH can lead to ovulation disorders, a common cause of infertility. An imbalanced LH:FSH relation may suggest anovulation or irregular ovulation patterns. For example, in PCOS, persistently elevated LH levels can disrupt follicular development and prevent the release of a mature egg.
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Hormonal Imbalances
The value offers insight into underlying hormonal imbalances that contribute to infertility. Deviations from the normal proportion may indicate conditions such as hypothalamic amenorrhea, where reduced gonadotropin-releasing hormone (GnRH) secretion affects both LH and FSH levels. In such cases, targeted hormonal therapies may be required to restore proper ovulation.
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Assisted Reproductive Technologies (ART)
The assessment guides treatment strategies in assisted reproductive technologies, such as in vitro fertilization (IVF). The value, along with other hormonal markers, helps clinicians determine appropriate ovarian stimulation protocols and predict oocyte yield and quality. Optimizing these protocols enhances the chances of successful fertilization and implantation.
The evaluation of the relationship between LH and FSH, therefore, forms a critical component in the comprehensive infertility assessment. By identifying potential ovarian dysfunction, ovulation disorders, and hormonal imbalances, the measurement aids in tailoring individualized treatment plans aimed at improving reproductive outcomes.
3. Hormonal Imbalance
The proportional relationship between luteinizing hormone (LH) and follicle-stimulating hormone (FSH) serves as a sensitive indicator of underlying hormonal imbalances within the reproductive endocrine system. Disruptions to the normal production and regulation of these gonadotropins can manifest as an abnormal value, providing clinicians with critical diagnostic information. For instance, an elevated LH to FSH value often correlates with polycystic ovary syndrome (PCOS), where increased LH secretion, driven by insulin resistance and elevated androgens, disrupts normal ovarian function. This imbalance can lead to anovulation, irregular menstrual cycles, and infertility. Conversely, a decreased value may point toward hypothalamic amenorrhea or other conditions affecting gonadotropin-releasing hormone (GnRH) secretion from the hypothalamus, which consequently impacts both LH and FSH production. Correct interpretation requires consideration of the individual’s clinical context, including menstrual history, physical examination findings, and other hormonal assessments.
The practical significance of understanding this relationship lies in its ability to guide targeted diagnostic investigations and therapeutic interventions. In cases of suspected PCOS, the value prompts further evaluation of androgen levels, insulin resistance, and ovarian morphology via ultrasound. Treatment strategies, such as lifestyle modifications, metformin, or hormonal contraception, aim to restore hormonal balance and mitigate the associated symptoms. Similarly, in women experiencing hypothalamic amenorrhea, assessment of the value aids in identifying the underlying cause of GnRH deficiency, guiding interventions to restore normal hormonal function and ovulation. The diagnostic utility extends beyond women, as an evaluation of this relationship can also assist in assessing hormonal imbalances contributing to male infertility.
In summary, the relationship between LH and FSH is an essential tool in the evaluation of hormonal imbalances impacting reproductive health. Its interpretation, within the broader clinical context, enables clinicians to identify underlying endocrine disorders, guide appropriate diagnostic investigations, and implement targeted treatment strategies to restore hormonal equilibrium and improve patient outcomes. While the measurement provides valuable insights, it is crucial to recognize its limitations and consider it as one component of a comprehensive endocrine assessment.
4. Menstrual irregularities
Menstrual irregularities, encompassing variations in cycle length, duration, or flow, often prompt evaluation of the relationship between luteinizing hormone (LH) and follicle-stimulating hormone (FSH). The measurement serves as a valuable tool in elucidating the underlying hormonal imbalances that contribute to these disruptions. For example, in women experiencing oligomenorrhea (infrequent menstrual periods) or amenorrhea (absence of menstruation), the assessment can help differentiate between various etiologies, such as polycystic ovary syndrome (PCOS), hypothalamic amenorrhea, or premature ovarian insufficiency. In PCOS, an elevated LH:FSH relationship is frequently observed due to increased LH secretion and impaired follicular development, which disrupts normal ovulatory cycles and results in irregular menses. Conversely, in hypothalamic amenorrhea, both LH and FSH levels may be low, reflecting impaired gonadotropin-releasing hormone (GnRH) secretion from the hypothalamus, leading to cessation of menstruation. Accurate interpretation necessitates considering the individual’s clinical history, physical examination findings, and other hormonal assessments.
The practical significance of understanding the connection between menstrual irregularities and the measurement lies in its ability to guide targeted diagnostic investigations and therapeutic interventions. In cases of suspected PCOS, the assessment prompts further evaluation of androgen levels, insulin resistance, and ovarian morphology via ultrasound. Treatment strategies, such as lifestyle modifications, metformin, or hormonal contraception, aim to restore hormonal balance and regulate menstrual cycles. Similarly, in women experiencing hypothalamic amenorrhea, the relationship measurement aids in identifying the underlying cause of GnRH deficiency, such as stress, excessive exercise, or eating disorders, guiding interventions to restore normal hormonal function and ovulation. Furthermore, the measurement plays a crucial role in monitoring the effectiveness of treatment interventions aimed at restoring regular menstrual cycles. For instance, serial assessments may be performed to assess the response to clomiphene citrate or gonadotropin therapy in women undergoing ovulation induction.
In summary, the relationship between LH and FSH is an essential tool in the evaluation of menstrual irregularities, providing insights into underlying hormonal imbalances that disrupt normal ovulatory function. Its interpretation, within the broader clinical context, enables clinicians to identify potential endocrine disorders, guide appropriate diagnostic investigations, and implement targeted treatment strategies to restore regular menstrual cycles and improve reproductive health. While the measurement offers valuable information, it is crucial to recognize its limitations and consider it as one component of a comprehensive endocrine assessment.
5. Ovarian function
Ovarian function, the complex process by which the ovaries produce hormones and mature oocytes, is intimately linked to the relationship between luteinizing hormone (LH) and follicle-stimulating hormone (FSH). Assessing the value derived from the ratio provides insights into the underlying mechanisms governing this function and can aid in the diagnosis and management of various reproductive disorders.
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Follicle Development and Ovulation
The precise coordination of LH and FSH is crucial for normal follicle development and ovulation. FSH stimulates the growth of ovarian follicles during the early follicular phase, while LH triggers ovulation, the release of a mature oocyte. Deviations from the normal values suggest disruptions in this delicate hormonal balance. For example, in women with diminished ovarian reserve, elevated FSH levels relative to LH may indicate decreased ovarian responsiveness to gonadotropin stimulation.
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Hormone Production
The ovaries produce estrogen and progesterone, hormones essential for regulating the menstrual cycle and supporting pregnancy. LH and FSH play key roles in stimulating steroidogenesis within the ovaries. An abnormal assessment can indicate impairments in hormone production. For example, in polycystic ovary syndrome (PCOS), elevated LH levels can lead to increased androgen production by the theca cells of the ovaries, contributing to hyperandrogenism and associated symptoms.
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Feedback Mechanisms
The hypothalamic-pituitary-ovarian (HPO) axis regulates the cyclical release of LH and FSH through complex feedback mechanisms. Estrogen and progesterone exert negative feedback on the hypothalamus and pituitary, modulating GnRH, LH, and FSH secretion. Alterations in the assessment suggest disruptions in these feedback loops. For instance, in women with hypothalamic amenorrhea, low estrogen levels result in reduced negative feedback, leading to decreased LH and FSH secretion.
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Ovarian Disorders
Various ovarian disorders, such as PCOS, premature ovarian insufficiency (POI), and ovarian tumors, can affect the value derived from the ratio. In PCOS, elevated LH levels are often observed, whereas in POI, FSH levels are typically elevated. Ovarian tumors, particularly those that secrete hormones, can disrupt normal hormonal balance, leading to alterations in this assessment and other endocrine parameters.
In conclusion, the value is an important tool for assessing ovarian function, providing valuable information about follicle development, hormone production, feedback mechanisms, and underlying ovarian disorders. Its interpretation, in conjunction with other clinical and biochemical markers, enables clinicians to formulate accurate diagnoses and implement appropriate management strategies for women with reproductive endocrine disorders. The assessment offers a window into the complex interplay of hormones governing ovarian activity, ultimately impacting reproductive health and fertility.
6. Reference Ranges
The interpretation of a numerical value resulting from an assessment of the luteinizing hormone (LH) and follicle-stimulating hormone (FSH) relationship hinges critically on established reference ranges. These ranges, typically provided by the laboratory performing the analysis, represent the expected values in a healthy population of individuals, stratified by age, sex, and menstrual cycle phase in women. Deviations from these ranges serve as potential indicators of hormonal imbalances or underlying reproductive disorders. For instance, an assessment yielding a value significantly above the upper limit of the reference range during the early follicular phase in a woman of reproductive age may raise suspicion for polycystic ovary syndrome (PCOS), prompting further diagnostic evaluation.
The establishment of accurate reference ranges is paramount for clinical utility. These ranges are typically derived from statistical analysis of hormone levels in a cohort of healthy individuals, ensuring the values reflect normal physiological variation. However, it is important to note that reference ranges can vary slightly between laboratories due to differences in assay methodologies and population demographics. Consequently, clinicians must always interpret a reported result in the context of the specific reference range provided by the laboratory that performed the analysis. Consider a scenario where two different laboratories analyze the same sample, but their reference ranges differ slightly. An assessment reported as elevated by one laboratory might be considered within the normal range by another, underscoring the importance of considering laboratory-specific reference ranges.
In summary, reference ranges are an indispensable component of interpreting the proportional assessment of LH and FSH. They provide the framework for identifying deviations from normal hormonal function, guiding diagnostic investigations, and informing treatment decisions. The accuracy and specificity of reference ranges are critical for ensuring the reliability and clinical utility of the measurement, emphasizing the importance of considering laboratory-specific values in the clinical context. Ultimately, this relationship between the numerical assessment and reference range contributes significantly to a holistic understanding of reproductive health.
7. Diagnostic Tool
The calculated relationship between luteinizing hormone (LH) and follicle-stimulating hormone (FSH) functions as a diagnostic tool in the evaluation of reproductive endocrine disorders. Its utility lies in providing insight into hormonal imbalances that may underlie a variety of conditions affecting ovarian function, fertility, and menstrual regularity.
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Assessment of Ovarian Function
The value serves as an indicator of ovarian health and functionality. An elevated value, particularly in the context of irregular menstrual cycles, may suggest polycystic ovary syndrome (PCOS), while deviations from normal ranges can point toward diminished ovarian reserve or other ovarian disorders. For example, a woman presenting with infertility and an elevated LH/FSH assessment may undergo further evaluation to assess ovarian reserve and ovulation patterns.
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Identification of Hormonal Imbalances
The calculation aids in identifying hormonal imbalances affecting the hypothalamic-pituitary-ovarian (HPO) axis. Disruptions in the normal feedback mechanisms governing LH and FSH secretion can lead to abnormal results, indicating conditions such as hypothalamic amenorrhea or hyperprolactinemia. Consider a patient with amenorrhea and low LH/FSH values; this might suggest a disruption in the hypothalamus’ ability to properly signal the pituitary gland.
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Differential Diagnosis of Reproductive Disorders
The assessment assists in the differential diagnosis of various reproductive disorders, particularly when combined with other clinical findings and laboratory tests. It can help distinguish between PCOS, premature ovarian insufficiency (POI), and functional hypothalamic amenorrhea (FHA). For instance, a woman with elevated FSH and low LH might be suspected of having POI, which would prompt further investigation.
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Monitoring Treatment Response
The calculated relationship also serves as a means of monitoring the effectiveness of treatment interventions aimed at restoring hormonal balance and improving reproductive outcomes. Changes in the assessment can indicate whether a particular therapy is successfully modulating LH and FSH secretion. For example, following treatment for hyperprolactinemia, serial assessments can confirm the normalization of hormone levels.
In summary, the relationship provides a valuable, though not definitive, piece of information in the diagnostic process. The interpretation of the derived numerical value within the clinical context is essential for making accurate diagnoses and guiding appropriate management strategies for individuals experiencing reproductive endocrine disorders. Further research and refinement of diagnostic criteria continue to enhance the clinical utility of this important assessment.
8. Treatment planning
The assessment of the relationship between luteinizing hormone (LH) and follicle-stimulating hormone (FSH) directly informs treatment planning for a range of reproductive endocrine disorders. An abnormal value, indicative of hormonal imbalance, necessitates a tailored therapeutic approach to address the underlying cause and mitigate associated symptoms. For example, in individuals diagnosed with polycystic ovary syndrome (PCOS) and exhibiting an elevated LH/FSH value, treatment strategies often focus on reducing LH secretion, improving insulin sensitivity, and managing androgen excess. This may involve lifestyle modifications, such as diet and exercise, alongside pharmacological interventions like metformin or hormonal contraceptives.
The derived value serves as a guide for monitoring treatment efficacy. Serial assessments following the initiation of therapy allow clinicians to evaluate the response and adjust the treatment plan accordingly. Consider a patient with hypothalamic amenorrhea, characterized by low LH and FSH levels, undergoing gonadotropin-releasing hormone (GnRH) therapy to stimulate ovulation. Monitoring the LH/FSH value throughout the treatment cycle helps assess ovarian response and optimize medication dosages. The understanding of this measurements role in directing treatment is not limited to females; in cases of male infertility linked to hormonal imbalances, assessment of this relationship can guide hormone replacement or other therapeutic strategies.
In summary, the interpretation of the relationship is integral to formulating effective treatment plans for reproductive endocrine disorders. It guides the selection of appropriate interventions, facilitates monitoring of treatment response, and informs adjustments to optimize patient outcomes. The integration of this assessment into the diagnostic and therapeutic process underscores its clinical significance in reproductive medicine.
9. Clinical Significance
The assessment of the proportional relationship between luteinizing hormone (LH) and follicle-stimulating hormone (FSH) possesses substantial clinical significance in reproductive endocrinology. Its proper interpretation aids in the diagnosis, management, and monitoring of various conditions affecting reproductive health.
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Diagnosis of Polycystic Ovary Syndrome (PCOS)
An elevated value, often exceeding 2:1 or 3:1, is a supportive diagnostic criterion for PCOS, especially when considered alongside other clinical and biochemical markers, such as irregular menstruation, hyperandrogenism, and polycystic ovaries on ultrasound. The assessment contributes to differentiating PCOS from other conditions presenting with similar symptoms, such as non-classical congenital adrenal hyperplasia or thyroid disorders.
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Assessment of Ovarian Reserve and Function
Deviations from normal reference ranges can indicate diminished ovarian reserve or ovarian dysfunction. In women experiencing infertility, an elevated FSH level relative to LH may suggest decreased ovarian responsiveness to gonadotropin stimulation, impacting treatment strategies in assisted reproductive technologies, such as in vitro fertilization (IVF).
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Guidance of Treatment Strategies
The value informs the selection of appropriate treatment interventions for hormonal imbalances. In PCOS, an elevated relationship guides the implementation of strategies to reduce LH secretion and manage androgen excess, such as lifestyle modifications, metformin, or hormonal contraceptives. In cases of hypothalamic amenorrhea, low LH and FSH levels prompt investigations into underlying causes and the potential use of gonadotropin-releasing hormone (GnRH) therapy.
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Monitoring Treatment Efficacy
Serial measurements of the value are utilized to monitor the effectiveness of treatment interventions aimed at restoring hormonal balance and improving reproductive outcomes. For example, following the initiation of clomiphene citrate or gonadotropin therapy for ovulation induction, changes in the assessment can indicate ovarian response and guide adjustments to medication dosages.
The clinical significance of the derived value extends beyond diagnosis, influencing treatment decisions and monitoring responses. The interpretation of this hormone relationship, in conjunction with a comprehensive clinical evaluation, enhances the precision of reproductive endocrine management.
Frequently Asked Questions About the LH/FSH Assessment
This section addresses common inquiries and clarifies uncertainties surrounding the assessment of the relationship between luteinizing hormone (LH) and follicle-stimulating hormone (FSH).
Question 1: What is the significance of assessing the relationship between LH and FSH?
The assessment provides valuable insight into the balance of reproductive hormones. Disruptions in this balance may indicate conditions such as polycystic ovary syndrome (PCOS), diminished ovarian reserve, or hypothalamic dysfunction.
Question 2: What value range is considered normal?
Reference ranges vary depending on the laboratory and the phase of the menstrual cycle in women. It is imperative to interpret the result within the context of the laboratory-specific reference range provided.
Question 3: Is an elevated value always indicative of PCOS?
While an elevated value is frequently observed in PCOS, it is not definitive. A comprehensive diagnosis requires the presence of other clinical and biochemical markers, as outlined by diagnostic criteria such as the Rotterdam criteria.
Question 4: Can the assessment be used in men?
Yes, although its primary application is in the evaluation of female reproductive health, it can also be used in men to assess hormonal imbalances contributing to infertility or other endocrine disorders.
Question 5: How does this assessment influence treatment decisions?
The result guides the selection of appropriate treatment interventions aimed at restoring hormonal balance and improving reproductive outcomes. Treatment strategies may include lifestyle modifications, pharmacological interventions, or assisted reproductive technologies.
Question 6: Is fasting required before undergoing this assessment?
Specific preparation instructions may vary depending on the laboratory. Consultation with a healthcare provider regarding any pre-test requirements, such as fasting or medication adjustments, is essential.
The evaluation of the relationship between LH and FSH is a valuable tool, but it should always be interpreted in conjunction with a comprehensive clinical evaluation. Any concerns should be addressed with a qualified healthcare professional.
The subsequent sections will delve into specific applications of this assessment in the context of various reproductive disorders.
Navigating the Assessment
The subsequent guidelines aim to facilitate a more informed understanding and utilization of the proportional relationship between luteinizing hormone (LH) and follicle-stimulating hormone (FSH) in clinical practice.
Tip 1: Understand the Context: The assessment is most informative when interpreted within the broader clinical context. Patient history, physical examination findings, and other relevant laboratory results should be considered alongside this numerical value.
Tip 2: Recognize Assay Limitations: Different laboratories may employ varying assay methodologies for measuring LH and FSH, potentially leading to discrepancies in reported values. Always consider the specific assay used and the associated reference ranges provided by the laboratory.
Tip 3: Consider Menstrual Cycle Phase: In women, LH and FSH levels fluctuate throughout the menstrual cycle. It is crucial to correlate the assessment with the appropriate cycle phase to ensure accurate interpretation. Ideally, samples should be collected during the early follicular phase (days 2-5 of the menstrual cycle).
Tip 4: Be Aware of Medications: Certain medications, such as hormonal contraceptives or fertility treatments, can influence LH and FSH levels. Disclose all medications to the healthcare provider before undergoing the assessment, as adjustments or alternative testing strategies may be necessary.
Tip 5: Assess for Confounding Factors: Various factors, including stress, exercise, and underlying medical conditions, can affect hormone levels. Consider these potential confounding factors when interpreting the results.
Tip 6: Utilize Serial Measurements: A single assessment may not always provide a comprehensive picture. Serial measurements, performed at regular intervals, can help track hormonal fluctuations and assess treatment response more effectively.
Tip 7: Do not self-diagnose. The assessment is a complex laboratory test and has to be reviewed by your doctor. This is important to note that there are cases where the lh fsh ratio may come out normal, but you are not, and that is why getting it reviewed by your doctor is important.
The effective utilization of the proportional assessment of LH and FSH hinges upon a comprehensive understanding of its limitations, consideration of confounding factors, and integration within a thorough clinical evaluation. Consult with a qualified healthcare professional for accurate interpretation and guidance.
The subsequent conclusion will synthesize key aspects of this assessment and emphasize its role in the comprehensive evaluation of reproductive health.
Conclusion
The preceding sections have explored the clinical utility and interpretive nuances of the proportional assessment between luteinizing hormone (LH) and follicle-stimulating hormone (FSH). This calculation serves as a valuable, though not definitive, diagnostic tool in reproductive endocrinology, offering insights into hormonal imbalances affecting ovarian function, fertility, and menstrual regularity. Proper interpretation requires consideration of reference ranges, assay limitations, menstrual cycle phase, medication use, and potential confounding factors.
The assessment, therefore, should be regarded as one component of a comprehensive clinical evaluation, guiding diagnostic investigations, informing treatment strategies, and monitoring therapeutic response. Continued research and refinement of diagnostic criteria promise to further enhance the clinical significance of this important assessment in the future management of reproductive health.
