You don't have to have cysts on your ovaries, to actually have PCOS. Because it's more of a metabolic issue the symptoms & lab work levels are the more diagnostic tests.
I'm pretty sure that most cysters do have the cysts, but I know I never did (or didn't as of three years ago). My gyn said my ovaries were pretty much normal (maybe even a lil small) but according to my symptomatic presentation and labwork I am most definitely PCOS.
I hope I was able to help some. Good luck with the docs...they can be fun sometimes!!!
tara
