Clinico-sonographic Correlation and Predictors of Polycystic Ovarian Syndrome

Abstract

Background: The clinico-sonographic correlation of PCOS involves linking a patient's clinical symptoms with ultrasound findings of polycystic ovarian morphology (PCOM). Objective: This study aimed to assess the relationship between clinical features with ultrasound findings to identify predictors of PCOS severity. Methods: The cross-sectional study was conducted in Outpatient Department (OPD) of Obstetrics & Gynecology, Bangladesh Medical University, Dhaka, Bangladesh from July 2024 to June 2025on PCOS women aged 18-40 years as diagnosed by the Rotterdam criteria. All the subjects were put through extensive clinical examination, including menstrual history, anthropometric measurements, and inquiry regarding hyperandrogenic signs. Pelvic ultrasonography was performed to assess ovarian volume, stromal echogenicity, and follicular morphology. The associations between clinical presentation and ultrasonographic features were performed on SPSS version 26, including chi-square tests, Pearson correlation, and multivariable logistic regression. Results: Bilateral polycystic ovarian morphology was observed in 70% of the subjects. Strong positive correlations were observed between oligomenorrhea (77%; p=0.014), amenorrhea (72%; p=0.018), and infertility (85.7%, p=0.013) with bilateral PCO. Similarly, acne (82.8%, p=0.009), hirsutism (80%, p=0.04) and BMI ≥30 (82.4%; p=0.021) showed moderate correlations with bilateral PCO. Oligomenorrhea was the strongest predictor (aOR=3.8, 95% CI: 1.6-9.0, p=0.002), followed by infertility (aOR=3.2, p=0.004), amenorrhea (aOR=2.9, p=0.015), acne (aOR=2.4, p=0.028), and obesity (aOR=2.1, p=0.047). Hirsutism was of borderline significance (aOR=1.9, p=0.073). Conclusion: Clinical symptoms are strongly correlated with ultrasonographic presentation in PCOS. Menstrual irregularities, especially oligomenorrhea and amenorrhea, and infertility strongly predict bilateral polycystic ovarian morphology, exemplifying the combined hormonal-morphological pathogenesis of PCOS.

J Rang Med Col. 2025 Sep;10(2): 13-19