Morphological assessment of polycystic ovary using transvaginal ultrasound

A total of 104 patients with bilateral polycystic ovaries (PCO) diagnosed by transvaginal ultrasound were classified into four groups (A < 5 cysts, B 5-10 cysts, C > 10 cysts located under ovarian capsule, D numerous cysts distributed all over the ovary) according to the number of microcysts. Ovarian volume, clinical features (menstrual disturbance, obesity and hirsutism), endocrine levels [luteinizing hormone (LH), LH/follicle stimulating hormone ratio, testosterone, androstenedione and dehydroepiandrosterone-sulphate] and response to clomiphene were compared for each group and 17 control subjects with normal ovulatory cycles. Ovarian volume in PCO subjects was significantly larger than that in control subjects. As the number of microcysts increased, the ovarian volume enlarged and the endocrine abnormality worsened. All endocrine parameters in PCO subjects with menstrual disturbances were significantly higher than those in PCO subjects without menstrual disturbances and controls. In PCO subjects without menstrual disturbances only androstenedione was significantly higher than in controls. Among PCO subjects, the frequency of menstrual disturbances, the percentage of response to clomiphene and the pregnancy rate in groups C and D were significantly higher than in groups A and B. Therefore, screening the ovaries in infertile patients by means of transvaginal ultrasound and subsequent assessment of morphology in PCO may suggest endocrine abnormality and help in selecting the proper treatment.