[The controversies in the diagnosis of polycystic ovary syndrome].

Polycystic ovary syndrome (PCOS) is the most common endocrinological disorder in women of reproductive age. The main clinical features of PCOS include abnormal ovulation, clinical or laboratory indices of elevated androgen levels and polycystic morphology of the ovaries. Even though the PCOS was described primarily in the 1935 by Stein and Leventhal, to date we are lacking the commonly accepted agreement in the issue of diagnosis of this syndrome. Contemporary, greater part of clinicians worldwide accept and use the Rotterdam criteria published in 2003 for recognizing PCOS, although the National Institute of Health criteria (1990) are also popular. Recently, in 2009 Androgen Excess and PCOS Society published an upgraded guidelines for recognizing the syndrome. In spite the publication of those three statements, interpretation of the three main groups of symptoms of the PCOS remain in many aspects controversial. The assessment of hyperandrogenisation is highly subjective and can be performed using different scoring systems. The matter of measuring androgen levels is complicated by the lack of easy accessible and, at the same time, precise laboratory method. The ovulation evaluation is also not standardized. The evaluation of ovarian morphology, made by ultrasound is problematic, since the methods proposed by Rotterdam criteria are very difficult and time-consuming. As an result of existing controversies in field of diagnosis of the PCOS, women with different phenotypes can be recognized with PCOS by different clinicians. This in turn, complicates the treatment and follow-up of those women. In conclusion, there is need for a large scientific and clinical research concerning this syndrome, to settle improved and more reliable diagnosing criteria.