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How obesity and elevated androgen levels in women with polycystic ovary syndrome (PCOS) affect their offspring is unclear. In a Swedish nationwide register-based cohort and a clinical case–control study from Chile, we found that daughters of mothers with PCOS were more likely to be diagnosed with PCOS. Furthermore, female mice (F₀) with PCOS-like traits induced by late-gestation injection of dihydrotestosterone, with and without obesity, produced female F₁–F₃ offspring with PCOS-like reproductive and metabolic phenotypes. Sequencing of single metaphase II oocytes from F₁–F₃ offspring revealed common and unique altered gene expression across all generations. Notably, four genes were also differentially expressed in serum samples from daughters in the case–control study and unrelated women with PCOS. Our findings provide evidence of transgenerational effects in female offspring of mothers with …