Ultrasonographic Evaluation and Clinicobiochemical Association in Patients with Polycystic Ovarian Disease in a Tertiary Care Hospital: A Cross-sectional Study

Abstract

Introduction: Polycystic Ovarian Syndrome (PCOS) is an endocrinological disorder characterised by a combination of polycystic ovarian morphology, diverse clinical features, and abnormal biochemical indices that affects women of reproductive age. Aim: To assess the sonographic appearance of ovaries and endometrium in clinically suspected cases of PCOS and to determine the association between the sonographic appearance of ovaries and endometrium with the clinical and hormonal profile of the patient. Materials and Methods: This cross-sectional study included 53 female patients in the reproductive age group (18-35 years) who were referred to the Department of Radiology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India for pelvic ultrasonography in clinical suspicion of PCOS from September 2020 to September 2022. All patients underwent transabdominal sonography, only married individuals with abdominal obesity underwent transvaginal ultrasonography. Complete biochemical hormonal analysis was performed. Association between volume, size of the ovary, number of follicles, and stromal thickness with hormones like Follicle Stimulating Hormone (FSH), Luteinising Hormone (LH), testosterone, prolactin, Thyroid Stimulating Hormone (TSH) was analysed. All continuous variables were expressed as mean±standard deviation and categorical variables as percentages. Chi-square test was used for statistical analysis. Results: The mean age was 25.60±4.09 years and the majority 26 (49.1%) were between 18 to 25 years and presented with menstrual abnormalities. Volume of ovary was ≥10 cc in 41 (93.18%) patients with LH >6.7 IU/mL which was statistically significant (p=0.03) and LH/FSH ratio was >2:1 in 30 patients of which 28 (93.3%) had ovarian volume ≥10 cc which was statistically significant (p=0.03). A number of follicles >12 showed a significant association with LH (p=0.04), LH/FSH (p=0.01), testosterone (p=0.002). Stromal thickness also showed significant association with LH (p=0.018), LH/FSH (p=0.001), testosterone (p=0.04). Conclusion: Predominant patients with PCOS had enlarged ovaries with multiple (>12), small-sized (<9 mm) peripherally arranged follicles and low FSH and elevated LH, LH/FSH ratio, testosterone, TSH, and prolactin levels.