Ultrasonography in polycystic ovary syndrome: an update

Polycystic ovary syndrome (PCOS) is a convergence of multisystem endocrine derangements. During the last decade, the role of ultrasonography in the diagnosis and monitoring of this endocrinopathy underwent significant changes. However, there remain many concerns about whether these changes should be more widely introduced in clinical practice. Current concepts include the use of high-resolution, 3-dimensional ultrasound instead of conventional 2-dimensional ultrasound; formulaic methods of measuring ovarian volume; and correlation between ultrasonographic features, biochemical indices and ovarian stromal changes, such as enhanced echogenicity and increased blood flow. These issues, together with the new Rotterdam 2003 European Society of Human Reproduction and Embryology (ESHRE)/American Society for Reproductive Medicine (ASRM)-sponsored consensus criteria for the diagnosis of PCOS, are discussed in this review article.