Baseline Scan and Ultrasound Diagnosis of PCOS

Success of any assisted reproductive technology is dependent on selection of correct stimulation protocol. This is based on prestimulation assessment of female to assess ovarian response and reserve. But, this assessment can also be done by ultrasound scan on 2nd to 3rd day of menstrual cycle, named as ‘baseline scan’. This scan is done to categorize ovary into one of the four types: Normal ovaries, low reserve ovaries, poorly responding ovaries and polycystic ovaries. Patients with polycystic ovarian syndrome have variable pictures of ovaries on ultrasound. Understanding the evolution of polycystic ovarian syndrome can explain these variations. Moreover, ultrasound findings can also be correlated with the biochemical and hormonal derangements. This scan also predicts the ovarian reserve and response that can guide to decide the stimulation protocols for ART. This scan includes the use of b mode, Doppler and 3D ultrasound with 3D power Doppler. It consists of assessing ovarian size, antral follicle count (AFC), stromal echogenecity and stromal flow chiefly. Dose calculation is chiefly done based on ovarian volume, AFC and stromal flow.