The Diagnosis of Polycystic Ovary Syndrome: The Criteria Are Insufficiently Robust for Clinical Research

In the 2007 review, the authors criticized the diagnostic criteria for polycystic ovary syndrome (PCOS) as being insufficiently robust for clinical research. They pointed out the high phenotypic variability of PCOS, the low positive predictive value of single luteinizing hormone measurements, and the lack of a clear definition for hyperandrogenemia. The review also noted significant bias and variability in the assessment of anovulation and ovarian imaging, with inter-observer agreement as low as 51% for ultrasound imaging. The authors proposed new criteria for diagnosing PCOS, including validated scoring systems for clinical hyperandrogenism, specific protocols for blood sample analysis, cited methods for progesterone measurement, and consideration of insulin sensitivity. They concluded that the current diagnostic strategies were too vague, leading to potential misdiagnosis and hindering research into PCOS.