Letters Section Editor: Robert M. Golub, MD, Senior Editor.
In Reply: In response to Dr Willenberg and colleagues, the Rotterdam criteria1 (and the preceding National Institutes of Health-National Institute of Child Health and Human Development criteria2) only recommend excluding congenital adrenal hyperplasia and androgen-secreting tumors (possibly in the adrenal), not adrenal hyperandrogenism per se. The reason for this is that both adrenal and ovarian hyperandrogenism are common in women with PCOS and are most likely indicative of some underlying disorder in steroidogenesis.3
Legro RS. Polycystic Ovary Syndrome and Infertility—Reply. JAMA. 2007;297(23):2582-2583. doi:10.1001/jama.297.23.2583-a