In Rotterdam criteria for PCOS diagnosis, how many of the three features must be present, and which feature is NOT part of the Rotterdam criteria?
- A 2 of 3 features; the 3 features are oligo/anovulation, hyperandrogenism, and PCO morphology on ultrasound ✓
- B All 3 features; oligo/anovulation, insulin resistance, and hyperandrogenism
- C 2 of 3 features; oligo/anovulation, elevated LH:FSH ratio, and polycystic ovaries
- D 2 of 3 features; insulin resistance is the third criterion alongside oligo/anovulation and PCO morphology
Correct answer: A. 2 of 3 features; the 3 features are oligo/anovulation, hyperandrogenism, and PCO morphology on ultrasound
Explanation
The Rotterdam 2003 consensus criteria require 2 of 3 features for PCOS diagnosis: (1) oligo- or anovulation, (2) clinical and/or biochemical signs of hyperandrogenism, and (3) polycystic ovarian morphology on ultrasound (≥12 follicles 2–9 mm or ovarian volume >10 mL). Insulin resistance and an elevated LH:FSH ratio, though commonly associated, are NOT part of the Rotterdam diagnostic criteria. Other causes of androgen excess or menstrual irregularity must be excluded.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
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