Study of the Relationship between the Sonographic Appearance of the Ovaries in Polycystic Ovary Syndrome and Different PCO Phenotypes

Introduction: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders among women with fertility age, characterized by a wide range of clinical and biochemical features such as hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology on ultrasound. Given the phenotypic diversity of PCOS, this study aimed to investigate the association between ovarian sonographic patterns (diffuse vs. necklace) and different phenotypes of PCOS. Methods: In this descriptive cross-sectional study, 158 women suspected of having PCOS who were referred for ovarian ultrasound at the Infertility and Fetal Health Center of Ahvaz Jundishapur University of Medical Sciences in 2022 were enrolled. Demographic data، biochemical, hormonal, and clinical parameters, as well as sonographic ovarian patterns, were recorded and compared between the two groups (diffuse vs. necklace pattern). Results: The diffuse pattern was more prevalent among the patients. The mean body mass index (BMI) was significantly higher in the diffuse pattern group (30.91) compared to the necklace (28.01) group. A statistically significant association was found between the number of pregnancies and the sonographic pattern. Laboratory analysis revealed significant differences between the two groups in levels of AMH (p=0.006), testosterone (p=0.017), estrogen (p=0.045), LDL (p=0.041), and the presence of acne (p=0.006). However، no significant differences were observed in TSH (p=0.110), prolactin (p=0.458), progesterone (p=0.083), HDL (p=0.101), triglycerides (p=0.196), Fasting Blood Sugar (p=0.561), glucose tolerance test (GTT) (p=0.745), mean corpuscular volume (MCV) (p=0.777), menstrual regularity (p>0.05), and infertility history (p=0.024). Conclusion: The findings of this study suggest that certain hormonal and clinical features are significantly associated with specific sonographic ovarian patterns in different PCOS phenotypes. Identifying these associations may aid in more precise classification of PCOS phenotypes and facilitate more individualized therapeutic approaches.