What are the Rotterdam PCOS phenotypes?

Four phenotypes exist: (A) all three criteria met; (B) anovulation + hyperandrogenism; (C) hyperandrogenism + polycystic morphology; (D) anovulation + polycystic morphology without hyperandrogenism. Phenotype A/B have worse metabolic outcomes.

What ultrasound findings define polycystic ovary morphology?

Per updated 2018 criteria using modern transducers: 20 or more follicles per ovary (2-9 mm) or ovarian volume above 10 mL on either ovary. Older Rotterdam criteria (2003) used 12 or more follicles per ovary.

When should PCOS not be diagnosed?

PCOS is a diagnosis of exclusion. Other conditions causing similar features must be ruled out: congenital adrenal hyperplasia (measure 17-OH progesterone), Cushing syndrome, androgen-secreting tumors, thyroid disease, and hyperprolactinemia.

PCOS Rotterdam Criteria

Diagnose PCOS using Rotterdam 2003 criteria: diagnosis requires 2 of 3: (1) oligo/anovulation, (2) clinical/biochemical hyperandrogenism, (3) polycystic ovaries on ultrasound (12+ follicles or ovarian volume above 10 mL).

⚕ Clinical Disclaimer: These calculators are for educational and reference purposes only. Always verify results with qualified clinical judgment and current clinical guidelines. Do not use as a sole basis for medical decisions.

How It Works

Each component has a specific meaning:

Rotterdam 2003 criteria: diagnosis requires 2 of 3: oligo/anovulation — The rotterdam 2003 criteria: diagnosis requires 2 of 3: oligo/anovulation recorded for the scenario being assessed.
Clinical/biochemical hyperandrogenism — The clinical/biochemical hyperandrogenism recorded for the scenario being assessed.
Polycystic ovaries on ultrasound — The polycystic ovaries on ultrasound recorded for the scenario being assessed.

Note: Interpret the pcos criteria result against the thresholds and context described above.

How to Use

Enter the Rotterdam 2003 criteria: diagnosis requires 2 of 3: oligo/anovulation, clinical/biochemical hyperandrogenism, polycystic ovaries on ultrasound for the scenario you are assessing. Diagnose PCOS using Rotterdam 2003 criteria: diagnosis requires 2 of 3: (1) oligo/anovulation, (2) clinical/biochemical hyperandrogenism, (3) polycystic ovaries on ultrasound (12+ follicles or ovarian volume above 10 mL). Use the pcos criteria result to inform your calculation.

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