Approach to the Patient: Diagnostic Challenges in the Workup for Polycystic Ovary Syndrome

    Anju E. Joham, Chau Thien Tay, Joop S.E. Laven, Yvonne V. Louwers, Ricardo Azziz
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    Polycystic ovary syndrome (PCOS) affects 10-13% of women worldwide and presents diagnostic challenges due to its complex etiology and clinical heterogeneity. The condition involves metabolic, reproductive, and psychological features, influenced by genetic and epigenetic factors, early androgen exposure, and adiposity-related dysfunction. Diagnosis is based on the International PCOS Guideline criteria, requiring two out of three criteria: hyperandrogenism, irregular cycles, and polycystic ovary morphology or elevated AMH levels. The variability in phenotypes, lifespan changes, and ethnic differences further complicate the diagnostic process for clinicians.
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