Correlation of ovarian and stromal volumes to fasting and postprandial insulin levels in polycystic ovarian syndrome patients

Abstract

Background: Patients with polycystic ovarian syndrome (PCOS) are believed to have large ovaries due to increased stroma. They also have derangement in luteinizing hormone (LH) and testosterone levels and high insulin resistance. As insulin resistance is thought to be associated with androgen and stromal excess, correlation was expected between insulin resistance and stromal excess. Aim: To assess if ovarian and stromal volumes in PCOS patients have any correlation with fasting and postprandial insulin levels. Materials and methods: A prospective study of 153 subfertile patients was done over a period 18 months. After detailed history, clinical examination and informed consent of all patients were scanned by two-dimensional (2D) on day 3 of the cycle. Patients were divided into PCOS and non-PCOS groups according to Rotterdam criteria. Patients with hormonal derangements other than PCOS were excluded from the study. Patients were assessed by three-dimensional (3D) ultrasound (US) for ovarian and stromal volumes and fasting and postprandial insulin levels were checked on the same day. Results: With Pearson correlation significance level of 0.354 (2 tailed) correlation for ovarian volume to fasting insulin was 0.588, for ovarian volume to postprandial insulin was 0.523, for stromal volume to fasting insulin was 0.601, and for stromal volume to postprandial insulin was 0.523. No correlation could be established in non-PCOS group. Conclusion: In PCOS patients, a strong correlation was found between ovarian and stromal volume and fasting and post prandial insulin levels.