According to the Rotterdam 2003 criteria for PCOS diagnosis, a minimum of how many of the three criteria must be present, and what are those three criteria?

• A All three: oligo/anovulation + hyperandrogenism + PCO morphology on USG
• B Two of three: hyperandrogenism + anovulation (other causes excluded) — no USG needed
• C One of three plus elevated LH:FSH ratio > 2:1
• D Two of three: oligo/anovulation, clinical/biochemical hyperandrogenism, or polycystic ovarian morphology on USG ✓

Explanation

The Rotterdam 2003 consensus criteria require at least 2 of the following 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 per ovary OR ovarian volume > 10 mL). Other causes of hyperandrogenism or anovulation must be excluded. The LH:FSH ratio > 2:1 is a supportive finding but not a diagnostic criterion.

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

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