Polycystic ovary syndrome diagnostic criteria
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]
Overview
PCOS was previously defined according to the proceedings of an expert conference sponsored by the National Institutes of Health (NIH) in 1990, which described the disorder as including hyperandrogenism or hyperandrogenemia (or both), oligo-ovulation, and exclusion of known disorders of androgen excess and anovulation. Another expert conference held in Rotterdam in 2003 defined PCOS, after the exclusion of related disorders, by the presence of two of the following three features oligo-ovulation or anovulation, clinical or biochemical signs of hyperandrogenism (or both), and polycystic ovaries. In essence, the Rotterdam 2003 criteria expanded the NIH 1990 definition by creating two new phenotypes ovulatory women with polycystic ovaries plus hyperandrogenism and oligo-anovulatory women with polycystic ovaries but without hyperandrogenism.
Diagnostic criteria
Criteria for the definition of Polycystic Ovary Syndrome (PCOS) [1]
NIH Statement (1990)
To include all of the following:
- Hyperandrogenism and/or hyperandrogenemia
- Oligomenorrhea
- Exclusion of related disorders ( Including but not limited to 21-hydroxylase-deficiency, thyroid dysfunction, hyperprolactinemia, neoplastic androgen secretion, drug-induced androgen excess, the syndromes of severe insulin resistance, Cushing syndrome, and glucocorticoid resistance)
ESHRE/ASRM Statement (Rotterdam, 2003)
To include two of the following, in addition to exclusion of related disorders :
- Oligo-ovulation or anovulation ( amenorrhea, irregular uterine bleeding)
- Clinical and/or biochemical signs of hyperandrogenism ( hirsutism, elevated serum total or free testosterone)
- Polycystic ovaries (by ultrasonography)
AES Suggested Criteria for the Diagnosis of PCOS (2006)
To include all of the following:
- Hyperandrogenism (hirsutism and/or hyperandrogenemia)
- Ovarian dysfunction: oligo-anovulation and/or polycystic ovaries
- Exclusion of other androgen excess or related disorders ( Including but not limited to 21-hydroxylase-deficiency, thyroid dysfunction, hyperprolactinemia, neoplastic androgen secretion, drug-induced androgen excess, the syndromes of severe insulin resistance, Cushing syndrome, and glucocorticoid resistance)