The Rotterdam criteria for PCOS require the presence of at least 2 of 3 features. A 22-year-old woman has regular cycles, clinical hyperandrogenism (acne, hirsutism), and polycystic ovarian morphology on ultrasound. She meets:

• A NIH 1990 criteria only, not Rotterdam criteria
• B Rotterdam criteria — she meets exactly 2 of 3 criteria ✓
• C Neither Rotterdam nor NIH criteria as she has regular cycles
• D Rotterdam criteria only if serum testosterone is elevated

Explanation

Rotterdam 2003 PCOS criteria require 2 of 3: (1) oligo/anovulation, (2) clinical or biochemical hyperandrogenism, (3) polycystic ovarian morphology on ultrasound. This woman has hyperandrogenism and PCOM — 2 of 3 criteria — so she qualifies for Rotterdam diagnosis even with regular cycles. NIH 1990 criteria require oligo/anovulation plus hyperandrogenism; she does not meet NIH criteria. Elevated testosterone (biochemical hyperandrogenism) is not required when clinical hyperandrogenism is present.

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

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