Study of Polycystic Ovarian Syndromeby Using Ultrasound

Abstract

Polycystic ovarian syndrome (PCOS) IS merely a reproductive and endocrinological disorders affecting 5% to 10% of the female population in their reproductive years.&characterized by multiple cysts in the ovaries which can impair ovulation and therefore fertility. One common feature of the condition is raised levels of the ‘male’ hormone testosterone, which can lead to ‘masculinising’ side effects such as ‘hirsutism’ (abnormal, excessive hair growth), scalp hair loss, and acne thatcan cause severe depression to the woman Another key underlying biochemical feature of PCOS is raised levels of insulin, usually related to ‘insulin resistance’ (impaired functioning of insulin ). It is a harbinger of a lifelong condition that can lead to serious sequelae such as diabetes mellitus, hyperlipidemia, endometrial hyperplasia/carcinoma, central obesity, sleep apnea& depression. The main objective of this study is to achieve accurate diagnosis of PCOS using the prober materials and methods such as labrotary biochemical testing &hormonal analysis using many radioimmunoassays, especially platform assays, for androgens are decidedly unsatisfactory which bypassed by using liquid chromatography-tandem mass spectrometry (LM/MS-MS), the modern gold standard for all steroid hormone measurement, particularly in women.and by using transvaginalultrasoundwhich is superior to the abdominal one. This study done in Saqr Hospital –RasAlKhaima- United Arab Emirates,it was a retrospective study done on a thirty three women of different nationalities,agegroup&different marital status presented with different clinical pictures. The most common complaints that has been noticed in the study group is the period irregularity in a percentage of 63 followed by a complaint of hirsutism/acne which is 42% and a few presented with infertility 6.1%.Followed by obesity and rapid weight gain. All these cases underwent hormonal assays using the sensitive radioimmunoassay –the liquid chromatography-tandem mass spectrometry (LM/MS-MS) which confirm the diagnosis of PCOS excluding only two cases one withprimaryhyperprolactinaemia and the other was a hypothyroidism. More efforts has been made to reach a proper & accurate diagnosis to achieve cure& to avoid longterm complications of PCOS by subjecting all suspected cases to abdominal ultrasound and repeat it by using the transvaginal one wherever possible as there was some unmarried cases where only abdominal ultrasound can be done. The study reveals eighteen missed caseswhen TVS done after the abdominal ultrasound.81% of cases, the Diagnosis of PCOS were established by using TVS Therefore; TVS should be done whenever possible to all suspected cases to attain proper diagnosis of PCOS supported by other confirmatory criteria such as liquid chromatography - tandem mass spectrometry (LM/MS-MS).