The 2023 revised Rotterdam consensus criteria for PCOS diagnosis require at least 2 of 3 features. Which of the following best describes the current ultrasound threshold for polycystic ovarian morphology (PCOM)?
- A ≥12 follicles 2–9 mm in at least one ovary, or ovarian volume ≥10 mL
- B ≥20 follicles 2–9 mm in at least one ovary, or ovarian volume ≥10 mL ✓
- C ≥20 follicles 2–9 mm in at least one ovary, or ovarian volume ≥7 mL
- D ≥12 follicles of any size in both ovaries with a total volume >15 mL
Correct answer: B. ≥20 follicles 2–9 mm in at least one ovary, or ovarian volume ≥10 mL
Explanation
The updated 2018 International Evidence-Based Guideline (endorsed by international PCOS societies) updated the PCOM threshold to ≥20 follicles 2–9 mm in at least one ovary, or ovarian volume ≥10 mL (in either ovary), using high-frequency transvaginal ultrasound. The older Rotterdam 2003 threshold of ≥12 follicles is now considered outdated with modern high-resolution ultrasound equipment. Ovarian volume ≥10 mL is retained.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
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