EP11.03: Influence of insulin resistance level on ultrasound imaging of the ovaries in women with polycystic ovary syndrome: preliminary study

Abstract

Polycystic ovary syndrome (PCOS) is a common disorder of premenopausal women characterised by hyperandrogenism and chronic anovulation. The polycystic ovary morphology (POM) is consistent with, but not essential, for the diagnosis of the syndrome. POM are defined on ultrasound by the increase ovaries volume than 10 cm3 and presence of 8 or more subcapsular follicular cysts ≤10 mm and increased ovarian stroma. Since the report by Bergen in 1980 that PCOS was associated with hyperinsulinemia, it has become clear that the syndrome has major metabolic as well as reproductive morbidities. Now it is known, that PCOS is often associated with insulin resistance (IR).The aim of this study was to assess ovarian volume, antral follicles volume and antral follicle count (AFC), depending on the IR level, in patients with PCOS. 31 patients with diagnosed PCOS and insulin resistance were included in the study. For each patient fasting glucose and fasting insulin levels were measured and IR index (HOMA IR) was calculated. For each patients AFC, ovarian and antral follicles volume were measured by three dimensional ultrasound in Vocal and 5D Follicle technique (Samsung Medison UGEO WS80A Elite). Spearman's correlation coefficient (Spearman's Rho) was calculated. Median ovarian volume was 10.7 cm3 (range 7.88–23.9 cm3), median antral follicles volume was 44 mm3 (range 17–128 mm3), while median AFC was 15 (range 8–26). Median HOMA IR was 2.02 (range 0.95–7.3). Spearman's Rho for ovarian volume and HOMA IR was 0.54, for antral follicle volume and HOMA IR was 0.75, for AFC and HOMA IR was −0.77. The association between all variables were statistically significant (P < 0.01). The study showed a strong positive correlation between IR level and ovarian volume, antral follicles volume. We have also observed a strong negative correlation between AFC and IR. The ultrasound imaging of the ovaries may be a promising tool for predicting IR level in patients with PCOS.