Objective:

To compare uterine ultrasound measurements in women with normogonadotropic anovulation, specifically those with polycystic ovary syndrome (PCOS) and hypothalamic-pituitary-ovarian dysfunction (HPOD), with those of regularly menstruating women, and to assess the influence of clinical and biochemical parameters on these measurements.

Key Findings:

• Women with normogonadotropic anovulation had significantly reduced uterine and endometrial measurements compared to healthy women (all p ≤0.001).
• PCOS women exhibited lower uterine length (p=0.045), height (p=0.004), and volume (p=0.009) than those with HPOD.
• Hyperandrogenemia in PCOS was associated with thicker endometrium (p=0.036).
• Myometrial measurements negatively correlated with AMH and FSH, positively with estradiol and prolactin.
• Endometrial measurements negatively correlated with AMH and FSH, positively with estradiol, prolactin, and insulin resistance.

Interpretation:

Uterine morphology is significantly influenced by menstrual cycle regularity and hormonal, metabolic, and clinical factors, reflecting the cumulative impact of reproductive and endocrine-metabolic influences.

Limitations:

• Limited sample size and demographic diversity may affect the generalizability of the findings.
• Exclusion of women with prior treatments or surgeries affecting the HPO axis may limit the applicability of results.

Conclusion:

Uterine and endometrial dimensions are affected by hormonal and metabolic status in women with normogonadotropic anovulation, which has important clinical implications.