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PCOS: a diagnostic challenge.

Ricardo Azziz¹

¹Department of Obstetrics and Gynecology, Cedars-Sinai Medical Centre and David Geffen School of Medicine at UCLA, 8635 West Third Street, Suite 160W, Los Angeles, CA 90048, USA. azzizr@cshs.org

Reproductive Biomedicine Online

|June 1, 2004

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Diagnostic criteria for Polycystic Ovary Syndrome (PCOS) have evolved, with newer guidelines including polycystic ovaries alongside hyperandrogenism and anovulation. This aims to improve research comparability for PCOS diagnosis.

Area of Science:

Reproductive Endocrinology
Gynecology
Metabolic Disorders

Background:

The 1990 PCOS diagnostic criteria focused on hyperandrogenism and anovulation, excluding polycystic ovaries.
This exclusion caused concern as many PCOS patients exhibit polycystic ovaries, linked to androgen excess and insulin resistance.

Purpose of the Study:

To review the evolution of diagnostic criteria for Polycystic Ovary Syndrome (PCOS).
To highlight the impact of revised criteria on PCOS phenotyping and research comparability.

Main Methods:

Review of historical diagnostic criteria for PCOS from key expert meetings (1990, 2003 Rotterdam).
Analysis of the inclusion/exclusion of specific features like hyperandrogenism, anovulation, and polycystic ovarian morphology.

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Main Results:

The 1990 criteria defined PCOS by hyperandrogenism and/or anovulation, excluding polycystic ovaries.
The 2003 Rotterdam criteria require at least two of three features: oligo-/anovulation, hyperandrogenism, or polycystic ovaries (after exclusions).
Newer criteria generate additional PCOS phenotypes, requiring further validation.

Conclusions:

The evolution of PCOS diagnostic criteria, particularly the inclusion of polycystic ovaries, broadens phenotype identification.
Standardized diagnostic criteria enhance the comparability and value of PCOS research.
Further research is needed to validate the clinical significance of newly defined PCOS phenotypes.