PCOS will show up on an ultrasound depending on how bad it is, mine showed up in one ovary more then the other. The ultrasound was nothing to worry about, you lay down they place a cold gel on your belly then they use a hand held scanner and move it around on your belly to try and get a good look at your ovaries.
I have PCOS but never had heavy bleeding or painful periods or acne, i have irregular cycles, skin tags , weight problems and excessive hair growth. My testostrone levels also came back high.

I hope you get good results and they help you on your TTC journey