Imaging of the ovaries

Ultrasound reveals polycystic ovaries:

• the ovaries are usually enlarged with a smooth outer covering that is thicker than normal
• the surface is covered with many small cysts with increased stroma

Up to 1/3 of women may have the appearances of polycystic ovaries. Of these, an estimated 1/3 have polycystic ovarian syndrome.

Note that according to the Rotterdam criteria, polycystic ovaries need not be present to make a diagnosis of PCOS, and conversely, their presence alone does not establish the diagnosis (1).

Reference:

• (1) RCOG (2007) Long-term consequences of polycystic ovary syndrome.
• (2) Balen A. Pathogenesis of polycystic ovary syndrome - the enigma unravels? Lancet 1999;354:966-7.