Ovulation can be rare without the help of medications.
In some women, there will be a long history of irregular periods and, perhaps, an increase in facial and body hair caused by more than the normal amount of male hormone in the blood. It's probably genetic - often coming down the male side of the family. One problem physicians have had in making the diagnosis of PCOS is that there is no universally accepted definition for this disease. Others require the appearance of polycystic ovaries on vaginal ultrasound examination. Because other disorders of the ovary, pituitary gland and adrenal gland can mimic the symptoms and appearance of PCOS, these disorders should be excluded before an accurate diagnosis of PCOS can be made.