Longitudinal Evaluation of Ovarian Morphology on Ultrasound in Women with Polycystic Ovary Syndrome (PCOS) Undergoing Various Treatment Regimens

Abstract

Setting: Department of Radiology & Imaging and the Department of Endocrinology, from 2018 to 2020.

Background: Ultrasound is the simplest and non-invasive tool, for assessing the ovarian morphology in PCOS patients.

Objective: To investigate the changes in ovarian morphology on transabdominal ultrasonography among women with PCOS following various pharmacological regimens.

Design: Randomized double-blind prospective study.

Methods and Material: 117 patients were randomized to receive metformin 500 mg BD (Group I) and Oral contraceptives (OCP) ethinyl estradiol 0.03mg + drospirenone 3 mg (Group II) for 6 months. Transabdominal ultrasound was performed at the baseline, 3 and 6 months besides clinical, metabolic and hormonal parameters.

Result(s): Out of 117 subjects selected 58 (50%) completed first 3 months of the study, and 43 (37%) 6 months of study. OCP led to a significant reduction in ovarian volume from 13.46 ± 5.14 cm³ to six-month 9.01 ± 2.68 cm³ (P <0.001) and follicle number from 16.7 ± 5.58 to 9.65 ± 3.51 (P <0.001) while as metformin reduced the ovarian volume from 12.54 ± 3.58 cm³ to six-month 9.44 ± 3.69 cm³ and the decrease in follicle number per ovary from 16 ± 5.19 to 12.45 ± 5.44 and 11.5 ± 6.35 at six-months and three-months of treatment. Both the treatments (P<0.001) led to a significant decrease in the S/A ratio from baseline to the end of six-months.

Conclusion: OCP led to a greater decrease in all ovarian parameters as compared to metformin during the six-month course. However, regarding ovary SE grade metformin resulted in a higher reduction in comparison to OCP.