 So, we have the paper presentation, its practical approach to PCOS in relation with body weight and correlation with ovarian and uterine color Doppler changes. I am utmost thankful to my guide, Dr. Rekha Gribal, ma'am, Department of Radio Diagnosis, NSCB Medical College, Jabalpur. So, let's have a quick intro. PCOS was first described by Steen in Leventhal. It is a heterogeneous pathological condition characterized by reproductive disorders and associated with hyperandrogenism, obesity, hyperinsulinemia and insulin resistance. It is the most common cause of an ovulatory infertility accounting for more than 70% of cases and the most common female endocrinopathy. 16-25% of normal population has polycystic ovaries on ultrasound. So, we use the Rotterdam PCOS Consensus Workshop Group. In this, two out of the three criteria should be fulfilled for the diagnosis, number one, oligo or anovulation, number two, clinical or biochemical signs of hyperandrogenism and number three, PCOS on ultrasound. The android-fat deposition characteristic in these cases is associated with hyperinsulinemia and diabetes mellitus, increased androgen production rates resulting in a decreased levels of sex hormone-mining globulins and increased free testosterone. Recently, there has been interest regarding the role of TVS in assessing ovarian and uterine blood flow in PCOS. So, the introduction of TVS has contributed markedly to the refinement of ultrasound diagnosis. It has provided new morphological and pathophysiological information on the blood flow dynamics within the female pelvis. It has been shown that in patients with PCOS, important changes in ovarian vascularization occur at the level of intra-ovarian arteries as well. Now, the aim of this study is to assess the ovarian stromal as well as uterine blood flow in both ovaries in the women with PCOS and compare them with normal ovulatory fertile women using TVS analysis and the relation to hormonal assay and body weight. Patients and Methodology It is a cross-sectional study. We included total 40 cases, women with PCOS 20 and healthy women of 20 attending NSCBA Medical College, Gynac OPD, who came for pelvic USG in our department and consenting to participate. So, patients were divided into two groups. Group one is the 20 ovulatory normal fertile women examined at day 12 of the 28-day cycle and group two included 20 PCOS women. All cases in group two must fulfill inclusion criteria, which is documented PCOS by TVS, presence of 20 or more follicles in at least one ovary, ranging between 2 to 9 mm and the ovarian volume of more than 10 cubic millimeters, not on any ovulation induction treatment. The exclusion criteria is presence of hypertension and diabetes, or other autoimmune diseases, anemia, cardiovascular diseases, presence of local uterine or adnexal conditions apart from PCOS, the presence of folliculosis more than 20 mm, history of tubal or ovarian surgery or pathology, and cases who have history of adrenal or thyroid other endocrine abnormalities. All eligible participants were asked for the following the history, detailed history about the age, parity, the history of present condition, including the duration of infertility and menstrual irregularities, and the general abdominal and pelvic examination, body mass index to be determined for all females, and also the hormonal assay that is early follicular phase FSH and LH. TVS and colored Doppler scan performed in early follicular phase day 2 to 4 of the cycle to evaluate the RI, the PI of the ovarian stromal artery and the uterine vessels on both sides, the RI PI of the uterine artery were measured at the level of uterine is thermos in the transfer section of the uterus. For ovarian stromal blood vessels, the measurement color signals were sought in the ovarian stroma at the maximum distance from the surface of the ovary and blood vessels located near the wall of a follicle were not measured, no correction was made for the angle of insonation of the Doppler beam. So, this is the diagrammatic representation, we have ovarian volume assessment in both the planes, the uterine artery Doppler assessment done in the transfer section at the uterine is thermos for both right and left sides, and this is the ovarian stromal artery assessment with colored Doppler. Now, the statistical analysis, the data was analyzed and it was described in terms of mean standard deviation frequencies, the number of cases and relative frequencies percentage, comparison of quantitative data between the two study groups was done by using student T test for independent variables and the P value of less than 0.05 is considered statistically significant correlation was done by Pearson's test. Let us have a look at the results, there was no significant differences between the age and FSH levels of PCOS patients with healthy patients as we can see, but if you look at BMI for the control group it is 23 and plus minus 1.1 for PCOS it is 27.5 plus minus 4 with P value less than 0.001, FSH for control group being 4.6 and here it is 5.7 plus minus 2.4, the LH values are 6.66 plus minus 1 and 15.9 plus minus 13.2 respectively. Based on the ultrasound findings there are significant differences in BMI, LH levels, menstrual cycle and other characteristics of PCOS between the PCOS and healthy group. Here we can see the normal menstrual cycle or if the person has oligomenorrhea, so in the control group 18 of normal and 2 of oligomenorrhea whereas PCOS 0 patients deported normal cycles and 20 had oligomenorrhea. Based on the ultrasound findings in a normal group the positive findings were seen in 0 and negative in 20 patients in the PCOS group positive ultrasound findings in 17 and negative in 3 patients. Right and left ovarian volumes were larger in the PCOS group as compared to the control group we can see the right sided volumes for control are 6.7 on an average PCOS being 10.7 plus minus 2.5 and the left ovarian volume 6.1 versus 9.95. So the left and right ovarian artery RI was lower in the PCOS group than the healthy and the right and left uterine artery RI were higher in the PCOS group. The rate of vascularization of ovarian stromal arteries was also higher in the PCOS patients additionally there were significant differences between PCOS and control group in terms of the ovarian stromal artery vascularization the ovarian volume the ovarian artery RI and the uterine artery RI on both sides. The discussion the present study concluded that vascularization of the ovarian stromal arteries was higher in PCOS patients the ovarian volumes on both sides was also significantly larger the uterine artery RI on both sides were significantly lower in PCOS group in comparison to the control ovarian artery RI on both sides was significantly lower in the PCOS group these study results are consistent with the results of many other studies and however the results of few studies were not in agreement with ours. Doppler examination of uterus and ovaries in a study by dolls at all performed on 65 patients of PCOS and 25 healthy women showed that there were no significant differences in vascularization of ovarian stromal arteries between the two groups quite in line with our results in a study by resent at all the obtained results of colored Doppler study from PCOS and healthy women showed that vascularization of ovarian stromal arteries was significantly higher in PCOS group the obtained results of jarval at all they demonstrated that ovarian volume was larger in PCOS patients than the healthy group and the vascularization of the ovarian stromal arteries was equal in the two groups in this study. Then study conducted there were the studies also and similar to our study the results of colored Doppler study of uterus and ovaries in 43 PCOS patients and 43 healthy women by Oscar net all they showed that ovarian volume of both sides was significantly larger in PCOS groups also the ovarian artery RI on both sides was significantly lower in the PCOS groups and similar to our study the results of Doppler ultrasound in a study by mala at all which was performed on 25 PCOS and 25 healthy women showed that uterine artery RI was significantly higher in PCOS group and the ovarian artery RI was significantly lower the vascularization of ovarian stromal artery was significantly higher in PCOS group these are the references that use that we refer to for this study thank you