None of my ultrasounds ever showed it. Most of the time a doctor will make the diagnosis based on the number of symptoms present.
My doctor diagnosed it approximately 20 years ago because I had several of the symptoms but it wasn't confirmed until 6 years ago. He was performing a C-section and after my daughter was delivered he told me "Now we know for sure. I counted 23 cysts on your ovaries and then stopped counting."
I had infertility problems for several years. But when I finally started seeing a fertility specialist I conceived during the first round of Clomid. So don't get too worried. Since you've already been through one successful pregnancy then I would say the chances are pretty good you can do it again. Going through a full pregnancy seems to improve the hormone balance in women with PCOS.
Check out that website. It really is great.