Clinico-sonographic Correlation and Predictors of Polycystic Ovarian Syndrome

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.