Table 1.

Features of the diagnosis of PCOS.

Feature	Recommended Diagnosis	Considerations
Biochemical Hyperandrogenism	Elevated total or free testosterone, or calculated indices of free testosterone (FAI, BioT). DHEAS and ANSD can be consdered	High-quality assays should be used for the evaluation of analytes
Clinical Hyperandrogenism	A modified Ferriman–Gallwey score of ≥4 to ≥8	Threshold level should be considered in the context of patient ethnicity
Oligo-anovulation	Oligo-amenorrhea (cycles >35 days apart or <8 menses a year)	If highly suspicious for PCOS, but does not have oligo-amenorrhea, consider serum progesterone or luteinizing hormone assessment
Polycystic ovarian morphology	≥20 follicles per ovary in either ovary ≥10 cm3 ovarian volume	Based on transvaginal ultrasonography with a transducer frequency ≥ 8 MHz

Criteria based on the modified 2003 Rotterdam criteria. FAI—free androgen index, BioT—bioavailable testosterone, DHEAS—dehydroepiandrosterone sulfate, ANSD—androstenedione.