Jan, 2004
Ultrasound alone does not diagnose PCOS - Patient Oriented Evidence that Matters
* Clinical question
Does an ultrasound report of polycystic ovaries mean that a women is likely to be infertile?
Synopsis
A polycystic appearance of the ovaries is defined as at least 10 cysts in a single plane of less than 10 mm each and a dense stroma. It is found in one quarter to one third of women of reproductive age and may lead them and their physicians to be concerned about subfertility. Polycystic ovary syndrome (PCOS) is variably defined and usually includes menstrual disturbance, obesity, acne, and hirsutism, with or without polycystic ovaries (PCO) by imaging.
In this case-control study, 258 women with ovaries meeting PCO criteria were compared with 232 women with ovaries of normal appearance; all had attempted to conceive. Of the PCO group, 84 women with no other signs or symptoms of PCOS had a mean time to pregnancy (TTP) similar to that of women with normal-appearing ovaries. The proportion of subfertile women (those with TTP > 12 months or who did not conceive after trying for at least 12 months) was 12% with no additional symptoms and increased with one to four additional PCOS symptoms to 36%, 78%, 94%, and 100%, respectively, regardless of the combination.
Bottom line
In women of reproductive age, ovaries commonly appear polycystic on ultrasound. Women with PCO by ultrasound but no other PCOS characteristics (ie, menstrual disturbance, obesity, acne, hirsutism) have normal fertility.
Reference
Hassan MA, Killick SR. Ultrasound diagnosis of polycystic ovaries in women who have no symptoms of polycystic ovary syndrome is not associated with subfecundity or subfertility. Fertil Steril. 2003;80:966-975.
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Ultrasound alone does not diagnose PCOS - Patient Oriented Evidence that Matters 
