Ultrasonography of the ovaries and its correlation with clinical and endocrine parameters in infertile women with PCOS.

Objectives and methods: In 100 anovulatory infertile women with polycystic ovary syndrome attending the infertility clinic of this institute, transvaginal ultrasound findings of ovaries were correlated with both clinical and hormonal parameters using Chi-square test.

Results: All women in the study had oligomenorrhea or amenorrhea, 70% had hirsutism and more than half were obese. On transvaginal ultrasound, ovarian volume was more than 10 cm3 in all, 90% had more than 10 follicles in each ovary, 75% had stromal thickness more than 1 cm and more than half had increased stromal echogenicity. Seventy percent had high testosterone levels and 60% were detected to have insulin resistance. Ovarian volume correlated positively with body mass index, waist/hip ratio and menstrual cycle irregularity (p < 0.05). The correlation between ovarian size, LH/FSH ratio and hyperinsulinemia was highly significant (p < 0.005), but was low for serum androgens and also hirsutism. Number of follicles per ovary correlated positively with body mass index, menstrual irregularity (p < 0.01), insulin resistance as well as androgens (p < 0.005). Positive predictive value of ovarian follicle number was 100% for insulin resistance as well as D4 androstenedione. Increased stromal thickness also showed 70% positive prediction for clinical parameters, 66% for insulin resistance and 82% for serum D4 androstenedione. Contrary to the other ultrasound parameters of polycystic ovary, stromal echogenicity did not significantly correlate with any of the clinical or hormonal parameters except serum testosterone.

Conclusion: Transvaginal ultrasonography of the ovaries confirms the clinical profile and also gives an insight to the hormonal milieu of the women with PCOS.