Impact of revised antral follicle count threshold on PCOS diagnosis: A comparative clinical study

OBJECTIVE: To evaluate the clinical impact of the revised antral follicle count (AFC) threshold on polycystic ovary syndrome (PCOS) diagnosis. METHODS: A retrospective cross-sectional observational study including women diagnosed using the Rotterdam criteria, stratified by AFC: 12-19 (low AFC) and ≥20 (high AFC). Clinical, metabolic, and hormonal parameters were compared against controls and amongst low and high AFC group. RESULTS: Of 336 PCOS women, 208 (62%) had an AFC between 12 and 19 and would not meet the revised ≥20 follicle threshold for the diagnosis of polycystic morphology. These women had worse metabolic and androgenic profiles than controls, and were similar to the high AFC group. CONCLUSION: Excluding low AFC women may misclassify patients who require clinical care.