Polycystic ovaries

Ovaries with increased volume containing multiple small (typically ≥12) peripheral follicular cysts measuring 2–9 mm in diameter on ultrasonography, often accompanied by increased ovarian stromal volume and echogenicity.

Causes

• Endocrine and metabolic causes

  • Polycystic ovary syndrome (most common)

  • Insulin resistance

  • Hyperinsulinemia

  • Metabolic syndrome and obesity

• Hormonal causes

  • Hyperandrogenism

  • Elevated luteinizing hormone (LH)

  • Hypothyroidism

  • Hyperprolactinemia

  • Congenital adrenal hyperplasia

  • Cushing's syndrome

• Physiological causes

  • Normal multifollicular ovaries, particularly during adolescence

  • Early reproductive age

  • Recovery after cessation of hormonal contraception

• Medication-related causes

  • Ovulation induction therapy (clomiphene citrate, gonadotropins)

  • Valproate therapy