Polycystic Ovarian Morphology

Figure. Normal and polycystic ovary shown by transvaginal ultrasonography during the follicular phase of a menstrual cycle

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Norman RJ, Dewailly D, Legro RS, Hickey TE. Polycystic ovary syndrome. The Lancet. 2007;370(9588):685-697. doi:

10.1016/S0140-6736(07)61345-2⁠

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FIGURE 2. SONOGRAPHIC PATTERN OF A TYPE A OVARY (A). Note the typical rosary arrangement of follicles and the easily recognizable hyperechogenicity that results from thickening of theca (B). The stromal hypervascularity is clearly visible in (C). Secondary aspects are the dominance of follicles with a diameter of >4 mm and the predominance of longitudinal diameter (D).

Alviggi C, Conforti A, De Rosa P, et al. The Distribution of Stroma and Antral Follicles Differs between Insulin-Resistance and Hyperandrogenism-Related Polycystic Ovarian Syndrome. Frontiers in Endocrinology. 2017;8. Accessed January 23, 2023.

https://www.frontiersin.org/articles/10.3389/fendo.2017.00117⁠

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FIGURE 3. SONOGRAPHIC PATTERN OF A TYPE B OVARY (A). Note the ubiquitous arrangement of follicles and the absence of central echogenicity (B). Characteristic signs of the type B ovary are a more “globular” gonad versus a type A ovary (C), with attenuation of the typical dominance of longitudinal diameter and the presence of follicles with a mean diameter lower than those observed in type A (D).

FIGURE 1. EXAMPLE OF MEDIAN OVARIAN SECTION WITH THE OVARIAN AND STROMAL TOTAL AREAS DEFINED. Calipers are positioned so as to encircle the total gonad circumference (A1) and the stromal component circumference (A2). The stroma/total area was also calculated.

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Figure 3. Parallel pathways demonstrating the role of Anti-mullerian hormone (AMH) in follicular development in normal (left) versus polycystic (right) ovaries.

Kalyanaraman, Rajeshwari, and Lubna Pal. 2021. “A Narrative Review of Current Understanding of the Pathophysiology of Polycystic Ovary Syndrome: Focus on Plausible Relevance of Vitamin D.” International Journal of Molecular Sciences 22(9): 4905.

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