TRANSVAGINAL ULTRASOUND IMAGING, HISTOPATHOLOGY AND ENDOCRINOPATHY INPATIENTS WITH POLYCYSTIC OVARIAN SYNDROME

In order to investigate the pathological characteristics of polycystic ovaries diagnosed by transvaginal ultrasound (TVS) in patients with p olycystic ovarian syndrome (PCOS) and to investigate the relationship between morphological and endocrine changes in the ovaries, 32 PCOS pa tients with bilateral polycystic ovaries (> 10 cysts) detected by TVS were studied; 20 ovulatory women served as controls. Ovarian tissues f rom wedge resection were examined histologically. A comparative histol ogical and TVS study of ovarian morphology was made, and the relations hip between the number of small cysts and the endocrine profile was ex amined. The position and size of small cysts on TVS agreed with those observed histologically. There was a significant correlation between t he number of small cysts on TVS and the number of atretic follicles wi th hypertrophied and luteinized inner theca cells, and thickened ovari an capsules. Numerous atretic follicles and thickened ovarian capsules were observed in 97 and 64% of ovaries respectively, from PCOS patien ts. In patients with PCOS, a significant positive correlation,vas note d both between the number of small cysts and Delta(4)-androstenedione (ASD), and between ASD and the luteinizing hormone/follicle-stimulatin g hormone (LH/FSH) ratio. Furthermore, testosterone, ASD and the numbe r of small cysts on TVS were significantly higher in PCOS patients wit h ovarian thickened tunica compared to PCOS patients without ovarian t hickened tunica. TVS images of ovaries in patients with PCOS correlate d with the histopathological and endocrine features. It is suggested t hat an increase in intraovarian small cysts leads to increased product ion of ovarian androgen, in turn influencing the secretion of gonadotr ophin, and is correlated with ovarian capsular thickness.