Ultrasound Evaluation of Thyroid Nodule Growth in Polycystic Ovarian Syndrome Patients with Relation to Ovarian Function and Abnormal Thyroid Function Tests

Abstract

Background: Polycystic ovarian syndrome (PCOS) is a prevalent endocrine disorder in reproductive-aged women, often associated with metabolic and reproductive dysfunction. Recent evidence suggests a possible link between thyroid abnormalities and PCOS pathophysiology, but the interplay between thyroid nodule growth, thyroid function, and ovarian morphology remains underexplored. Objective: This study aimed to evaluate the association between thyroid nodule growth and ovarian function in PCOS patients, with a particular focus on abnormal thyroid function tests, using ultrasound and comprehensive hormonal profiling. Methods: In this cross-sectional analytical study, 64 women aged 22–40 years with PCOS (Rotterdam criteria) and thyroid nodules were recruited from three tertiary hospitals in Lahore, Pakistan, over four months. Exclusion criteria included pregnancy, other endocrine disorders, and prior thyroid surgery. Clinical and demographic data were collected, serum levels of TSH, T3, T4, LH, and FSH were measured, and thyroid and ovarian ultrasound examinations were performed. Data were analyzed using SPSS v25, employing descriptive statistics, Pearson correlations, paired t-tests, and regression analysis. Ethical approval was obtained in accordance with the Helsinki Declaration. Results: Thyroid micronodules were identified in 70% of PCOS patients, with heterogeneous echotexture present in 39.1%. Mean TSH was 5.66 mIU/L, and mean LH was 10.03 IU/L. Statistically significant correlations were found between TSH and PCOS (r = 0.255, p = 0.044), and between LH and PCOS (r = 0.417, p = 0.001). Paired t-tests showed large effect sizes for TSH, LH, and ultrasound features in relation to PCOS status. Conclusion: Thyroid dysfunction and nodule growth are significantly associated with ovarian abnormalities in women with PCOS. Routine thyroid assessment, including ultrasound and hormonal evaluation, should be integrated into the clinical management of PCOS to optimize reproductive and metabolic outcomes.