Rotterdam criteria

Polycystic ovary  syndrome – A clinical  and public  health problem affecting up to one in five  women of reproductive age .

Basics:--Polycystic ovary   syndrome  is a frustrating  experience for women   often complex  for managing   clinicians and is  a scientific challenge for  researchers , PCOS  is a complex condition  with psychological   reproductive and metabolic    manifestations  that impacts on health across  the lifespan    PCOS is   one  of the most common hormonal disorders  affecting women . It has   multiple   components - reproductive metabolic  and cardiovascular – with  health    implications for the patient’s   entire life   span. PCOS has  a significant effect  on adult women  resulting in diminished quality  of life  altered  feminine  identity and dysfunction in the family  and work  environment .

Diagnostic Criteria for PCOS

Part 1: The History & Geography:-PCOS  was   originally  described in 1935  by Stein  and Leventhal   who reported  a  group  of women with   amenorrhea   and polycystic  ovaries  of whom some  were hirsute and / or   obese   in 1990 a National Institutes of Health   consensus   conference defined  PCOS as a combination of hyperandrogenism  menstrual  dysfunction  and exclusion of known   disorders   such as  congenital adrenal  hyperplasia    leading to the above.

Part 2: A fight between almost all academic bodies,. Millions of dollars spent for Recommendations & committee Opinions  with level 1-4 evidences : As a result  We, the gynaecologits &  GPs including  & pts too are frightened when diff  PCO societies fight with swords, daggers, for an uniform & exact defn which will encompass all latent & overt PCO and pick up caes which are destined to develop PCO or Metab syndrome  by one decade .

What was NIH criteria of PCO?? NIH criteria of PCO : Any two of the following symptoms or signs A) oligomenorrhoea/ amenorrhea B) Otherwise unexplained hyperandrogenism manifested clinically by acne & abnormal hair growth.( when all other causes of hyperandrogenism. have been excluded like 1) CAH, 2) ,ovarian/ adrenal tumors 3) Cushing's syndrome 4) Hyperprolacunaemia 5) hypothyroidism C) sonological evidence of small multiple ovarian cysts. Abnormalities in LH / FSH ratio may not be evident in all cases neither clinical features of insulin resistance like acanthosis, ,android obesity .By and large PCO is a condition of unexplained hyperandrogenic anovulatory associated with excessive oestrogen 

Till 2003  diagnostic  criteria for PCOS   were varied  and often   confusing  . However   the joint  European  Society  of Human   Reproduction and Embryology and The American Society     for Reproductive Medicine   ESHRE/ ASRM sponsored  consensus  meeting in Rotterdam in 2003  accepted  that CPSO consists of the presence  of any 2 of the 3 criteria.

A)          Oligo and / or  anovulation

B)           Clinical and / or  biochemical evidence of hyperandrogenism  and

The presence of polycystic ovaries  on ultrasound examination