PCOS is a hormonal disorder that affects women during their reproductive years (ages 15 to 44). It is a  condition that affect ovulation and the ovaries. Many fluid-filled sacs develop inside the ovaries in PCOS.  These are follicles, each of which contains an immature egg. The egg is never mature enough to cause  ovulation to occur. Woman can't get pregnant if they don't ovulate. The levels of estrogen and progesterone  are smaller than normal, although the levels of androgen are higher than usual. The aim of this research is to assess the sonographic features and presentation of PCOS in infertile women and the determination  of prevalence of PCOS in infertile with Transvaginal high resolution Ultrasound. An electronic database search with data range from 1989-2020 was performed (Science Direct, Google  Scholar, PubMed and Springer). All studies, fully available evaluating PCOS on TVS/ TAS. Thirty-one articles were found. Performance of Ultrasound diagnosis was evaluated. Prevalence of PCOS  in women with infertility varies in different reports from was 16.7% in Nigeria,18.93% in Saudi Arabia and  54.9% in India.12 numbers of follicles measuring 2-9 mm was best border of PCOS with sensitivity of 99%  and specificity of 75%. It is concluded that TVS is superior to TAS. PCOS represents 80% of an ovulatory infertility cases.  Sonographic criteria of PCOS is 10-12 follicles with a maximum diameter <8 mm, increased ovarian volume  (12.3 ml) and increased echo density of the ovarian stroma while in a study in 2008-2010 for the definition  of PCOM, the former threshold of >12 for FN is no longer valid. A serum AMH >35 pmol/l (or >5 ng/ml)  appears to be more sensitive and specific. 

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