. 2022 Dec 9;14(12):e32351. doi: 10.7759/cureus.32351

Table 5. Data extraction for all the included studies.

a/b, found/examined; AES, Androgen Excess Society; AFC, antral follicle count; DHEAS, dehidroepiandrostenedione sulphate; FAI, free androgen index; fT, free testosterone; HA, hyperandrogenemia; HS, hirsutism; mFG, modified Ferriman-Gallwey scoring; MH, based on menstrual history; NA, not available or not applicable; NIH, National Institutes of Health; OA, oligoanovulation; OV, ovarian volume; P, based on progesterone level; PCO, polycystic ovary; SHbg, sex hormone binding globulin; TT, total testosterone

S.no

Title

Author

Journal

Year

Design

Sampling frame size

Age group

Region

1. Was the sample frame appropriate to address the target population?

2. Were study participants sampled in an appropriate way?

3. Was the sample size adequate?

4. Were the study subjects and the setting described in detail?

5. Was the data analysis conducted with sufficient coverage of the identified sample?

6. Were valid methods used for the identification of the condition?

7. Was the condition measured in a standard, reliable way for all participants?

8. Was there appropriate statistical analysis?

9. Was the response rate adequate, and if not, was the low response rate managed appropriately?

Sample size

Error

Sample size calculated

Effective sample size

Non-response rate(assumed)

Effective non response rate)

NIH(no of case)

Rotterdam(no of case)

AES (no of case)

HS, mF-G, [HS a/b, (≥mF−G)]

mF-G

HA a/b, (biomarkers)

TT, fT, androstenedione, DHEAS, FAI

Acne

Hair loss/alopecia

Hyperpigmentation

OA a/b, (diagnosis)

MH, P, LH/FSH≥1

PCO on USG [PCO a/b, (AFC, OV)]

AFC, OV

Study population

Eligibility criteria

Management of hormonal use

Prevalence of Polycystic Ovarian Syndrome in Indian Adolescents

Nidhi et al.

J pediatric adolesc gynecol

2011

Cross-sectional

460

15-18

Andhra Pradesh

Yes

Unclear

Yes

Unclear

500

460

11.5

Clinical hyperandrogenism: mFG score of 6 or higher

13/460

13/460, NA, not clear, clinical hyperandrogenism, biochemical hyperandrogenism: serum testosterone level of >82 ng/dL in the absence of other causes of hyperandrogenism.

59/460

59/460, MH- oligo/amenorrhea: absence of menstruation for 45 days or more and/or ≤8 menses per year

42/55

42/55, Presence of >10 cysts, 2 to 8 mm in diameter, usually combined with increased ovarian volume of >10 cm³, and an echo-dense stroma in pelvic ultrasound scan.

Adolescent girls aged 15 to 18 years from a College in Anantapur, Andhra Pradesh

All participants were clinically healthy and none were suffering from chronic or acute diseases.

Use of oral contraceptive pills mentioned

Prevalence and Undetected Burden of Polycystic Ovarian Syndrome (PCOS) Among Female Medical Undergraduate Students in South India—A Prospective Study in Pondicherry

Vijaya and Bharatwaj

Global Journal for Research Analysis

2014

Cross-sectional

259

19-25

Pondicherry

Yes

Unclear

Yes

259

238

17/28

17/28, HS measured by mFG score ≥8, with or without acne and/or androgenic alopecia.

Biochemical hyperandrogenism was considered present with a serum testosterone level 2 standard deviations above the mean of normal women of reproductive age in the absence of other causes of hyperandrogenism

27/28

27/28, MH: oligomenorrhea (Absence of menstruation for ≥35 days at least four times a year) or amenorrhea (No menstruation continuously for 6 months)

Polycystic ovaries on ultrasound scanning was defined as an ovarian volume greater than 10 cm³ and/or 10 or more 2 to 8 mm follicles in a single plane when ultrasonography was performed

Female medical undergraduate students at Sri Lakshmynarayana Institute of Medical Sciences, Pondicherry (SLIMS)

Who gave informed consent

Not reported

Polycystic Ovarian Syndrome: Prevalence and Its Correlates Among Adolescent Girls

Bhuvanashree et al

Annals of Tropical Medicine & Public Health

2013

Cross-sectional

253

10-19

Andhra Pradesh

Unclear

Yes

Unclear

Yes

253`

300

253

15.6

FG scale

Bilateral presence of multiple subcortical ovarian cysts arranged in a necklace pattern

The subjects were selected randomly from the educational institutions such as schools, colleges (nursing, medical, junior colleges, college of yoga and naturopathy) and girl’s hostels of Nellore, in Andhra Pradesh.

In case an individual being lesser than 18 years, consent was obtained from the parent/guardian. Girls who have not attained menarche were excluded.

Not reported

A Cross-Sectional Study of Polycystic Ovarian Syndrome Among Adolescent and Young Girls in Mumbai, India

Joshi et al

Indian journal of endocrinology and metabolism

2014

Cross-sectional

778

15-24

Maharastra

Yes

1000

600

13.5

135

82/600

82/600, ≥8 mFG

FAI level of two standard deviations above the mean level among normal controls (formula: TT/SHbg × 100).

148/600

148/600, MH: irregular cycles, amenorrhoea ( absence of periods for at least 3 of the previous cycle intervals or 6 months of amenorrhea) or oligomenorrhea (infrequent menstruation for ≥35 days)

229/600

229/600, AFC, OV, 12 or more follicles measuring 2-9 mm in diameter with or without ovarian volume >10 mL

Female population in the age group of 15-24 years

Girls aged 15-24 years, who had attained menarche more than 2 years before the study, who were unmarried and were willing to participate in the study were enrolled

Not reported

Cross-Sectional Study of the Prevalence of Polycystic Ovary Syndrome in Rural and Urban Populations

Deswal et al

International Journal of Gynecology & Obstetrics

2019

Cross-sectional

2400

16-45

Haryana

Yes

2400

2253

9.3

28/94

28/94, Clinical hyperandrogenism- HS

61/94

61/94, Biochemical hyperandrogenism- elevated testosterone

38/94

14/94

73-21/94

MI: oligomenorrhea 73/94, MI: amenorrhea 21/94

33/94

33/94, PCOS

Women of reproductive age (16–45 years) in Haryana

Women of reproductive age (16–45 years) who had irregular periods and clinical or biochemical hyperandrogenism (HS or elevated testosterone) and/or PCOS on ultrasound (Rotterdam criteria) were included in the study of PCOS. Women with thyroid abnormalities, adrenal hyperplasia, prolactin excess, or Cushing syndrome, all of which mimic the symptoms of PCOS, were excluded.

Considered- Not taking medications or oral contraceptive pills in the past 6 months.

A Cross Sectional Study of Polycystic Ovarian Syndrome Among Young Women in Bhopal, Central India

Gupta et al

International journal community medicine & public health

2018

Cross-sectional

500

17-24

Madhya pradesh

Yes

Unclear

Yes

Unclear

Yes

385

500

8/500

8/500, NA

HS score of more than 8 was considered positive for HA.

409/500

103/500

19/500

19/500, MH: oligomenorrhea after two years of menarche or primary amenorrhea at the age of 16 years

12/500

12/500, polycystic ovaries on ultrasound along with ovarian size of more than 10 cm

Girls of age group of 17-24 years studying girl’s colleges in different quadrants of Bhopal city in Madhya Pradesh, India

Girls aged 17-24 years, who had attained menarche more than 2 years before the study were enrolled. Exclusion criteria: those who were known cases of thyroid disorders, those with Cushing's syndrome, and who were not willing to participate were excluded from this study.

Not reported

Prevalence of Polycystic Ovarian Syndrome Among Female Students: A Cross-Sectional Study

Nanjaiah

National Journal of Community Medicine

2018

Cross-sectional

405

18-30

Karnataka

Yes

Unclear

Yes

405

396

65/396

65/396, NA

NA, hyperandrogenism (clinical or biochemical)

92/396

60/396

60/396, NA, MH: menstrual irregularity, 24/396, menorrhagia/oligomenorrhea

NA, Presence of 12 or more follicles in each ovary measuring 2–9 mm in diameter, and/or increased ovarian volume ( 10 mL)

Female students pursuing degrees at Maharanis College of science and Maharanis College of Arts & Commerce at Mysore.

Girls aged 18 to 35 years who have attained menarche were included. Girls who attained menarche in the past two years and who are suffering from congenital adrenal hyperplasia, androgen-secreting tumors, thyroid disorders, and hyperprolactinemia were excluded.

Not reported

Prevalence of Polycystic Ovarian Syndrome Among Adolescent Girls: A Prospective Study

Singh et al.

International Journal of Reproduction, Contraception, Obstetrics and Gynecology

2018

Cross-sectional

117

15-19

Andhra Pradesh

Unclear

Yes

Unclear

Yes

117

3/117

Clinical hyperandrogenism: mFG score of 8 or higher

NA, DHEA-sulfate, androstenedione.

9/117

1/117

5/117

22/117

22/117, MH: oligo/amenorrhea: absence of menstruation for 45 days or more and/or less than 8 menses per year.

Presence of more than 10 cysts, 2-8 mm in diameter, usually combined with increased ovarian volume of more than 10 cm³, and an echo-dense stroma in pelvic ultrasound scan.

Adolescent girls aged 15 to 19 years attending OPD at the Department of Obstetrics and Gynaecology; Government Maternity Hospital, Sultan Bazaar, Osmania Medical College, Hyderabad.

Adolescents aged 15–19 years, not married, and had menarche more than 2 years before the study were included. Those who were known cases of thyroid disorders, hyperprolactinemia, Cushing's syndrome, and who were not willing to participate, were excluded.

Not reported

Study of Prevalence and Determinants of Polycystic Ovarian Syndrome Among Adolescent Girls in Rural Area: A Prospective Study

Laddad et al.

International Journal of Reproduction, Contraception, Obstetrics and Gynecology

2019

Cross-sectional

150

10-19

Maharastra

Unclear

Yes

Unclear

Yes

150

5/150

Clinical hyperandrogenism: mFG score of 8 or higher

Persistent elevation of serum total and/or free testosterone.

16/150

2/150

8/150

40/150

MH: oligo/amenorrhea: Absence of menstruation for 45 days or more and/or less than 8 menses per year. Evidence of ovulatory dysfunction included consecutive menstrual intervals of more than 90 days, 1 year after menstrual onset; menstrual intervals persistently less than 21 days or more than 45 days 2 or more years after menarche.

Polycystic ovaries: Presence of more than 12 follicles, 2-9 mm in diameter arranged peripherally, usually combined with increased ovarian volume of more than 10 cm³, and an echo-dense stroma in pelvic ultrasound scan

Adolescent girls aged 10 to 19 years attending OPD at the Department of Obstetrics and Gynaecology; Krishna Institute of Medical Sciences, Deemed University, Karad, Maharashtra, India.

Inclusion criteria- Adolescent girls in the age group of 10-19 years, adolescent girls had attained menarche, adolescents girls who have come to seek treatment from obstetrics and gynecology and adolescent OPD of Krishna Hospital. Exclusion criteria: known cases of thyroid disorders, hyperprolactinemia, Cushing's syndrome, those not willing to participate, married, and pregnant adolescents.

Not reported

Prevalence of Polycystic Ovary Syndrome (PCOS) Among Reproductive Age Women From Kashmir Valley: A Cross-Sectional Study

Ganie et al.

International Journal of Gynecology & Obstetrics

2020

Cross-sectional

3300

15-40

Kashmir

Yes

Unclear

Yes

Unclear

964

107

131

127

366/964

mFG score of 8 or higher

HA was defined as serum TT over 65 ng/dL, which represents the 97th percentile in a previous study of healthy women

252/964

252/964- menstrual irregularity. Oligomenorrhea was defined as occurrence of eight or fewer menses per year or an intermenstrual interval of less than 35 days.

Presence of 12 or more follicles of 2–9 mm in diameter and/or an ovarian volume higher than 10 mL in one or both ovaries.

Women in various educational institutes across the Kashmir valley.

Those who gave consent

Not reported

A Cross Sectional Study on, Prevalence of Polycystic Ovarian Syndrome and Its Health Effects, in Reproductive Age Women (15-45 Years) in a Rural Area, Telangana, India

Kusuma et al.

Int J Clin Obstet Gynaecol

2021

Cross-sectional

660

15-45

Telanagana

Yes

660

624

9.4

172/624, clinical hyperandrogenism was defined as the presence of acne, alopecia, and HS recorded as mFG score ≥ 8.

77/182- Biochemical hyperandrogenism

Biochemical hyperandrogenism: 70/182; fT: 68/182; Androstenedione: 68/182; biochemical hyperandrogenism was defined as elevated free testosterone levels (>0.034 nmol/L) or raised FAI (formula: TT/SHbg × 100).

153/624

MH: OA was defined as a cycle length 35 days or amenorrhea

67/182

67/182, polycystic ovaries was defined as ≥15 follicles measuring 2– 10 mm in diameter or ovarian volume 10 ml in at least one ovary

Reproductive age women (15-45 years of age) in a rural area of Telangana

Inclusion criteria: women in the 15- to 45-year age group previously diagnosed with or without PCOS who gave informed consent to participate in the study. Exclusion criteria: menarche within the past 2 years, post-menopausal women, pregnant and lactating women, women on oral contraceptive pills and intrauterine devices, those diagnosed with cancers, and women who underwent hysterectomy or bilateral oophorectomy.

Not reported