According to the international evidence-based PCOS guideline (updated consensus), which sonographic finding establishes polycystic ovarian morphology using a modern high-frequency transvaginal probe?
- A At least 20 follicles of 2 to 9 mm per ovary, or ovarian volume of 10 mL or more ✓
- B At least 12 follicles of 2 to 9 mm per ovary, irrespective of transducer frequency
- C Ovarian volume greater than 5 mL with peripheral follicles
- D At least 25 follicles per ovary with stromal echogenicity greater than the myometrium
Correct answer: A. At least 20 follicles of 2 to 9 mm per ovary, or ovarian volume of 10 mL or more
Explanation
With transducers of 8 MHz or higher, improved resolution means normal ovaries show more small follicles, so the international PCOS guideline raised the follicle threshold from the older Rotterdam value of 12 to at least 20 follicles of 2 to 9 mm per ovary; an ovarian volume of 10 mL or more remains acceptable alone. Option B is the outdated 2003 Rotterdam threshold retained only for lower-frequency probes. Stromal echogenicity is subjective and abandoned as a criterion, and 5 mL falls well below the accepted volume cutoff.
Reference: Williams Gynecology, 4th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.