STUDY OF CLINICALLY SUSPICIOUS POLYCYSTIC OVARIAN SYNDROME AND ITS RELATION WITH ULTRASONOGRAPHIC AND BIOCHEMICAL FINDINGS

Abstract

Background: Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disorders affecting women of reproductive age and is associated with menstrual irregularities, hyperandrogenism, obesity, infertility, and metabolic disturbances. Clinical diagnosis alone may be misleading because of the heterogeneous nature of the syndrome. Ultrasonographic and biochemical investigations are therefore important for accurate diagnosis. This study was undertaken to evaluate the relationship between clinically suspected PCOS and ultrasonographic and biochemical findings. Methods: A prospective observational case-control study was conducted at Durgapur Steel Plant Hospital, West Bengal, from June 2013 to June 2014. A total of 100 women aged 15–45 years were included, comprising 50 clinically suspected PCOS cases and 50 age-matched healthy controls. Diagnosis was based on ASRM/ESHRE 2003 criteria. Detailed clinical examination, BMI assessment, Ferriman-Gallwey scoring, ultrasonography, and biochemical investigations including LH/FSH ratio, serum testosterone, AMH, fasting insulin, lipid profile, and glucose tolerance test were performed. Statistical analysis was carried out using SPSS version 16, with p<0.05 considered significant. Results: The majority of clinically suspected PCOS cases belonged to the 15–24 years age group (50%). Menstrual irregularity was the most common presenting complaint (92%), followed by hirsutism (38%), obesity (32%), infertility (22%), and acanthosis nigricans (22%). Oligomenorrhoea was the commonest menstrual abnormality (52%). Significant findings among cases included increased BMI (p=0.017), altered LH:FSH ratio (58%; p<0.001), stromal hyperechogenicity on ultrasonography (46%; p=0.003), altered lipid profile (24%; p=0.004), and association of obesity with elevated fasting insulin (p=0.001). Serum testosterone showed significant association with hirsutism and stromal echogenicity. However, serum AMH, fasting insulin, ovarian volume, and number of ovarian microcysts did not differ significantly between cases and controls. Conclusion: Clinical suspicion alone is insufficient for an accurate diagnosis of PCOS. Ultrasonography serves as a useful non-invasive screening tool, while biochemical evaluation, particularly LH:FSH ratio and serum testosterone, improves diagnostic accuracy. Menstrual irregularity remains the most common clinical presentation. Increased stromal echogenicity and metabolic abnormalities were significantly associated with clinically suspected PCOS. Comprehensive clinical, ultrasonographic, and biochemical assessment is essential for proper diagnosis and management.