The Rotterdam criteria for PCOS diagnosis require at least 2 of 3 features. A woman has oligo/anovulation and polycystic ovarian morphology on ultrasound (≥20 follicles 2–9 mm per ovary) but no clinical or biochemical hyperandrogenism. She:

• A Meets Rotterdam criteria for PCOS ✓
• B Does not meet criteria for PCOS
• C Meets NIH 1990 criteria but not Rotterdam criteria
• D Requires karyotype to confirm diagnosis

Explanation

Rotterdam 2003 criteria diagnose PCOS with ≥2 of 3 features: (1) oligo/anovulation, (2) clinical or biochemical hyperandrogenism, and (3) polycystic ovarian morphology (PCOM) on ultrasound. This patient has features 1 and 3, satisfying Rotterdam criteria. The NIH 1990 criteria require both hyperandrogenism AND oligo/anovulation, so she would NOT meet NIH criteria — illustrating why Rotterdam identifies a broader PCOS phenotype.

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

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