Delphi consensus on the diagnostic criteria of polycystic ovary syndrome

Purpose: To gather the current opinion among Italian gynecologists and endocrinologists regarding the definition, diagnosis, and treatment of polycystic ovary syndrome (PCOS). Method: A Delphi survey consisting of 26 statements was designed by a nine-member panel (consisting of members from the Italian Society of Endocrinology (SIE) and the Experts Group AQon Inositol in Basic and Clinical Research and on PCOS (EGOI-PCOS)) and distributed to 102 experts in PCOS across the fields of gynecology and endocrinology. Consensus was defined as an agreement between at least 70% of responders. Participants completed three rounds of statements, ranking their level of agreement. Results: Of the initial 26 statements, 25 reached an adequate consensus, with an overall response rate of 73%. The statements were divided into three sections: definition and current understanding, diagnosis, and treatment. Of the statements that reached consensus, near total agreement was reached in the first two sections, whereas there was a divergence of opinion in terms of optimum treatment strategy between the gynecology and endocrinology subgroups. Conclusion: It was agreed that the current clinical guidelines are inadequate for clinical and scientific practice, with most responders advocating for the inclusion of metabolic factors. Furthermore, the consensus opinion advocated for the diversification of hyperandrogenic vs. non-hyperandrogenic phenotypes. This survey gives a snapshot of the current understanding of PCOS in the Italian healthcare community.