According to the Rotterdam criteria of 2003, the diagnosis of PCOS can be made if at least two of the following signs are present:
The absence of ovulation or rare ovulatory cycles;
Clinical and/or biochemical signs of hyperandrogenia;
Polycystic ovaries according to the US investigation.
Polycystosis is often mistaken for multifollicular ovaries in young women when ovaries may be enlarged and may contain a large number of antral follicles, but a woman still has a regular menstrual cycle and ovulation and does not have any problems with impregnation.
One should not forget that PCOS is a diagnosis of exclusion. There are many endocrine diseases that can induce these or those symptoms typical of polycystosis, which is why before making this diagnosis one should exclude a pathology of the thyroid gland, hyperprolactinemia, an androgen-secreting tumor, adrenal cortex dysfunction et cetera.
PCOS is fairly often associated with insulin resistance and overweight which can in their turn lead to the development of diabetes mellitus, hypertonic disease, hyperplastic processes etc. For patients like these, a change of lifestyle aiming at weight reduction would be recommended as first-line therapy. For this purpose, diet optimization, low calorie intake and increased daily physical activity are necessary. The fat tissue is the repository of androgens which is why after the normalization of body weight index (BMI) values the androgen level often returns to normal, ovulation recovers and a natural pregnancy occurs without the administration of any drugs. Hence, mustering your willpower can save you money you would otherwise spend on drugs and treatment, save your nervous energy and not only help you achieve pregnancy itself but also reward you with good health for many years to come.
In case there is no ovulation despite all attempts to restore it, one should turn to ART (controlled ovulation induction, artificial insemination or IVF) to achieve pregnancy.