To what extent does the use of the Rotterdam criteria affect the prevalence of polycystic ovary syndrome? A community-based study from the Southwest of Iran

Objectives There are limited data on the prevalence of polycystic ovary syndrome at the community level: heterogeneity in diagnostic criteria and lack of universal agreement on definitions of each criterion for population-based studies complicate comparability of the existing literature. This study aimed to assess the impact of using three principal definitions for polycystic ovary syndrome on its reported prevalence in a large community-based study conducted in the Southwest of Iran. Study design A total of 646 reproductive-age women were randomly selected using the stratified, multistage probability cluster sampling method. The prevalence of polycystic ovary syndrome was estimated according to the National Institutes of Health, the Androgen Excess Society and the Rotterdam criteria, using universal assessment of ultrasonographic parameters, hormonal profiles and clinical histories. Results The mean age of participants was 33.2 years and 36.9% of them were overweight. The estimated prevalence of polycystic ovary syndrome in this population based study was 14.1% using the Rotterdam criteria, 12% by the Androgen Excess Society criteria, and 4.8% according to the National Institutes of Health recommendation. Conclusions Using the Rotterdam versus the National Institutes of Health criteria increased the prevalence of polycystic ovary syndrome 2.9-fold. This indicates the need for more studies on the long-term consequences of the additional cases diagnosed using the Rotterdam criteria.