- Clinical hyperandrogenism: may include
hirsutism (defined as excessive terminal
hair that appears in a male pattern, such as over the chin, abdomen, back and inner thighs) ,
acne, or
androgenic alopecia (hair loos over the forehead, as seen in men).
- Biochemical hyperandrogenism: this refers to an
elevated level of androgen in the blood, including an elevated total, or free serum Testosterone level.
2- Menstrual history: Oligo (little)- or anovulation (lack of ovulation, meaning menstrual bleeding without the passage of an egg)
Anovulation
may take place when there is frequent bleeding at
intervals of less than 21
days, or if there is infrequent
bleeding at
intervals more than 35 days. Occasionally, the cycles may be anovulatory
even if the period follows a normal interval
(25–35 days).
A progesterone level in the blood measured during the midluteal phase (to show evidence of anovulation) may help with
the diagnosis of PCOS if bleeding intervals appear to
suggest regular ovulation.
3- Ovarian appearance: the size and shape of the ovaries on ultrasound
In either ovary, the doctor will be looking for the presence of a certain number of follicles (usually 12 or more), and will assess the size (volume) of the ovary to look for enlargement.
Regarding fertility problems associated with PCOS, it all depends on whether or not ovulation is occurring regularly. Women with PCOS are at increased risk of anovulation and infertility; in the absence of anovulation, the risk of infertility is uncertain. This is why it is crucial that the doctor take a detailed history of the menstrual cycle to assess for the status of ovulation.
I agree with Dr Dimassi.
