Diagnostic Accuracy of Ultrasound Criteria in Polycystic Ovarian Disease

Polycystic Ovarian Disease (PCOS) is a common endocrine disorder affecting reproductive-aged women and is characterized by ovulatory dysfunction, hyperandrogenism, and polycystic ovarian morphology. Transvaginal ultrasound (TVUS) is a cornerstone in the diagnostic evaluation of PCOS, providing direct visualization of ovarian morphology and follicle distribution. Over the past decade, significant refinement in ultrasound criteria, including follicle count, ovarian volume, and stromal metrics, has enhanced diagnostic performance. However, variability in ultrasound equipment, operator expertise, and patient characteristics continue to influence accuracy. This mini-review synthesizes evidence on the diagnostic accuracy of ultrasound criteria in PCOS, including sensitivity, specificity, and comparative analyses with clinical and biochemical parameters. We highlight strengths, limitations, and future directions in ultrasound-based diagnosis, emphasizing evidence-based application in clinical practice.