This is tricky because of the normal hormone levels

Usually PCOS has LH:FSH > 3:1

But, both can still be within the reference ranges!

Normal for females

• FSH: 4-30 premeno, 10-90 midcycle, 40-250 postmeno
• LH: 5-30 follicular, 75-150 midcycle, 30-200 postmeno

Also, testosterone often, but not always, elevated

Irregular periods, acne, and infertility line up with PCOS. Even though you don't palpate any masses on exam. The ovaries aren't necessarily palpably larger. I think of this like normal ovulation cysts that did not rupture properly, because they didn't get the correct signal (LH Surge)

This one got me :[ i was looking for the LH>FSH and the ovarian masses - but other than that i agree this pretty much matches up.

• One of the most common causes of female infertility, especially in overweight women
• Diagnosis requires 2 out of 3 of the following criteria: (1) Clinical and/or biochemical hyperandrogenism (2) Oligomenorrhea (3) Polycystic ovaries on pelvic ultrasound /// Our patient has clinical hyperandrogenism (acne vulgaris) and oligomenorrhea (irregular menses)
• Key idea: Although often associated with insulin resistance and ultimately associated with development of Type 2 diabetes, insulin resistance is not formally included in diagnostic criteria