Assessment of Ovarian Stiffness in Women With Polycystic Ovary Syndrome

OBJECTIVE: To evaluate ovarian stiffness in polycystic ovary syndrome (PCOS) patients with and without metabolic syndrome (MetS) using acoustic pulse imaging. METHODS: This case-control study was conducted in a tertiary center PCOS outpatient clinic. A total of 105 participants, 51 PCOS patients (20 MetS and 31 non-MetS) and 54 healthy women between the ages of 20 and 35 years, were included in the study. Laboratory and sonographic assessments were performed in the early follicular phase. The shear wave elastography (SWE) technique was used to measure ovarian tissue stiffness transvaginally. RESULTS: Age and body mass index were found to be similar between PCOS and control groups. Mean SWE values were found to be 13.61 ± 2.2 kPa and 8.82 ± 1.62 kPa, in the PCOS and control groups, respectively; P < 0.001. The intraobserver intraclass correlation coefficient value for the mean SWE measurement (kPa) was found to be 0.811 (good reliability agreement). Using receiver operating curve analysis, an optimized cut-off point of SWE_mean 10.58 kPa was determined. Similar SWE values were found in PCOS subgroups with clinical and/or biochemical hyperandrogenism. In PCOS patients with and without MetS, SWE was 15.68 ± 1.36 kPa and 12.28 ± 1.50 kPa, respectively (P < 0.001). A moderate positive correlation was found with waist circumference, triglyceride and insulin resistance parameters, and a weak correlation was found with systolic and diastolic blood pressure. CONCLUSION: Ovulatory dysfunction and the fibroinflammatory environment in PCOS lead to quantitatively measurable changes in ovarian tissue elasticity. MetS exacerbates these changes. Ovarian elasticity values were found to be associated with clinical and laboratory markers.