A 22-year-old woman presents with oligomenorrhoea, acne, hirsutism, and difficulty conceiving for 18 months. BMI is 29 kg/m². Pelvic ultrasound shows bilaterally enlarged ovaries with 14 follicles per ovary (each 2–9 mm) arranged peripherally. Serum testosterone is mildly elevated and LH:FSH ratio is 2.5:1. According to the Rotterdam criteria, how many of the following three features are required to diagnose PCOS?

• A All three features must be present
• B Only polycystic ovarian morphology on ultrasound is required
• C Elevated LH:FSH ratio >2 is mandatory
• D Any two of three features (oligo/anovulation, clinical/biochemical hyperandrogenism, polycystic ovarian morphology) ✓

Explanation

The 2003 Rotterdam consensus criteria require the presence of at least two of three features for PCOS diagnosis: (1) oligo- or anovulation, (2) clinical or biochemical signs of hyperandrogenism, and (3) polycystic ovarian morphology on ultrasound (≥12 follicles per ovary measuring 2–9 mm or ovarian volume >10 mL). LH:FSH ratio is supportive but not part of the diagnostic criteria.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.