Diagnosis/pathophysiology

1. The Rotterdam European Society of Human Reproduction and Embryology (ESHRE)/American Society for Reproductive Medicine (ASRM) consensus definition for polycystic ovary syndrome is the most pragmatic and appropriate one.

2. There are significant ethnic differences in the expression of hyperandrogenism and metabolic disease.

3. A definitive diagnosis of polycystic ovary syndrome can be difficult to achieve in adolescence and an early diagnosis should be re-evaluated in adulthood.

4. Psychological wellbeing is adversely affected by polycystic ovary syndrome. Health-related quality of life (HRQoL) assessment should be considered as part of the woman's routine clinical care.

Management

Lifestyle and metabolic aspects

5. The management of polycystic ovary syndrome (including its long-term health risks) is best delivered by a multidisciplinary approach, including dietary and educational counselling, exercise training, stress management and psychosocial support.

6. All women with polycystic ovary syndrome should be assessed for the risk of developing impaired glucose tolerance and type 2 diabetes.

7. Preconception counselling in women with polycystic ovary syndrome seeking fertility should include potential obstetric risks.

8. Weight loss should be emphasised in the treatment of women with polycystic ovary syndrome who are overweight and for the prevention of type 2 diabetes. There is no evidence of superiority of a particular type of diet for women with polycystic ovary syndrome. If the woman's body mass index is greater than 35 kg/m2, bariatric surgery should be considered. Fertility treatment should be deferred until after the initial period of rapid weight loss.