Ultrasound-Based Assessment of Ovarian Volume and Follicle Numbers in Lean and Obese PCOS Women

Background & Objective: Polycystic Ovary Syndrome (PCOS) exhibits wide phenotypic variability across Body Mass Index (BMI) categories. However, the extent to which adiposity influences ovarian morphology remains insufficiently characterized in Middle Eastern populations. This study aimed to compare ovarian volume and antral follicle count between lean and obese women diagnosed with PCOS. Materials & Methods: A cross-sectional study was conducted among ۱۰۷ women aged ۱۶-۴۰ years who met the Rotterdam ۲۰۰۳ diagnostic criteria for PCOS at a private clinical center in Erbil, Iraq, between June ۲۰۲۴ and July ۲۰۲۵. Participants were categorized as lean (BMI<۲۵ kg/m²; n=۷۸) or obese (BMI≥۲۵ kg/m²; n=۲۹). Anthropometric measurements, clinical features, and ovarian parameters including bilateral ovarian volume and antral follicle count (۲-۹ mm) were assessed using Philips ۵۵۰ and Samsung SonoAce R۷ ultrasound systems. Data were analyzed using SPSS v۲۶, with statistical significance set at P<۰.۰۵. Results: Obese women had significantly higher waist and hip circumference compared with lean participants. Acne and oligomenorrhea were more prevalent in the obese group, whereas the prevalence of hirsutism did not differ significantly between groups. The right ovarian follicle count was significantly higher among obese participants, while ovarian volumes showed no significant differences between BMI categories. Conclusion: Although ovarian volume did not differ by BMI, obese women with PCOS exhibited a higher right ovarian follicle count, suggesting that body mass may subtly influence folliculogenesis. These findings underscore the importance of BMI-specific interpretation of ultrasound criteria in PCOS diagnosis, particularly within ethnically diverse populations.

کلیدواژه ها:

Polycystic Ovary Syndrome ، Body Mass Index ، obesity and lean phenotype ، Ovarian volume ، follicle count ، Ultrasonography