Correlation of severity of hyperandrogenism with ovarian stroma to area ratio and stromal echogenicity in polycystic ovary syndrome patients


  • Pooja Gupta Department of Obstetrics & Gynaecology, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
  • Harsha Gaikwad Department of Obstetrics & Gynaecology, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India



Hyperandrogenism, Stroma echogenicity, Ovarian stroma, S/A ratio


Background: Polycystic ovary syndrome is one of the most common endocrine disorders of reproductive age group. Rotterdam consensus although includes ovarian volume in diagnosis of PCOS but its ovarian stroma area that corresponds histological and thus its clinical features.

Methods: A prospective study conducted on 55 PCOS cases and 55 age and weight matched healthy volunteers. Detailed medical, menstrual history and examination for clinical hyperandrogenism and anthropometry was done. Fasting venous blood samples were obtained on day 2 for androgen profiles. All the patients were subjected to pelvic ultrasound and also a 3D ultrasound was done. The S/A (ovarian stroma to area ratio) were obtained by outlining the peripheral profile of the stroma with a caliper and similarly total ovarian area by outlining in the maximum plane section. Stromal echogenicity was assessed semi quantatively.

Results: S/A exhibits positive and significant correlation with DHEAS (r = 0.565, p<0.05), testosterone (r = 0.272, p<0.05) and negative but insignificant correlation with hirsuitism score with(r = -0.07, p>0.05) in cases, whereas stoma echogenicity was increased in 78.2% cases and 20% controls and correlated significantly with DHEAS levels and not H score, probably due to small sample size.

Conclusions: S/A bears a positive significant correlation with androgenic parameters studied and can be considered as one of the best predictor of hyperandrogenism. The stroma echogenicity measured semiquantatively can act as a clue for PCOS diagnosis. Their measurement and follow up during course of treatment may show significant role in defining the severity, progression or regression of the disease.


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