According to Rotterdam criteria, PCOS is diagnosed when at least two of the following are present: which combination?

• A. Oligo/anovulation, hyperandrogenism, polycystic ovaries on ultrasound; exclusion of other etiologies
• B. All three features
• C. Oligo/anovulation and hyperandrogenism only
• D. Hyperandrogenism and polycystic ovaries on ultrasound

Answer: (A)

The key idea is that Rotterdam criteria diagnose PCOS when two or more of these three features are present, and other conditions that could mimic PCOS must be ruled out. Those features are: oligo/anovulation (irregular or absent ovulation leading to irregular or absent menses), hyperandrogenism (clinical signs like hirsutism or acne, or elevated androgens on labs), and polycystic ovaries on ultrasound (many small follicles and/or increased ovarian volume). It’s not enough to have ultrasound alone or only one sign; you need at least two features, and you must exclude other causes such as thyroid disorders, Cushing’s syndrome, congenital adrenal hyperplasia, or androgen-secreting tumors.

Choosing the option that lists oligo/anovulation, hyperandrogenism, and polycystic ovaries on ultrasound, with explicit exclusion of other etiologies, is best because it satisfies having multiple features and emphasizes the necessary step of ruling out other conditions. Even though any two of the three features would meet the core criterion, stating all three together plus exclusion makes the diagnostic framework clear and complete.