Assessment of sonographic ovarian volume as a potential predictor of polycystic ovarian syndrome (PCOS): a hospital-based cross-sectional study

Introduction: Polycystic ovarian syndrome (PCOS) is a prevalent endocrine and metabolic disorder commonly associated with obesity and reproductive morbidities. The relationship between ovarian volume and BMI as well as ovarian morphology was therefore examined in this study to assess whether sonographic ovarian volume can serve as a supportive parameter in predicting PCOS in clinical practice. Methods: A hospital-based cross-sectional study of 100 women aged 20–40 years was conducted at the University of Lahore Teaching Hospital from December 2023 to September 2024. Participants were stratified according to normal weight (BMI < 25 kg/m ²) and elevated BMI (BMI ≥ 25 kg/m ²) groups with healthy and PCOS as subgroups within each group. Results: The left ovarian volume in PCOS patients was significantly larger than that in women without PCOS (mean 13.5 mL (SD 3.6) vs 10.4 mL (SD 1.9), P < 0.05). Likewise, the mean follicle size in the left ovary was also significantly larger in women with PCOS than in normal controls, 6.3 mm (SD 1.7) and 5.6 mm (SD 1.1), respectively (P < 0.05). PCOS showed a significant association with amenorrhea (85%) and acne (66%); however, 59% of participants showed hirsutism which was not significant. Discussion: The observed asymmetry in ovarian volume and the influence of BMI suggest underlying physiological variability. However, the absence of hormonal and metabolic data limits the interpretation, warranting cautious application of these findings. Conclusion: Ovarian volume alone is not a reliable diagnostic marker for PCOS. While the left ovary showed significant differences, the inconsistent findings support the need for a combined clinical, biochemical, and sonographic approach.