PCOS hair loss. What is the likelihood of reversing hair loss/miniaturization if right steps are taken?

In general there is no way to completely reverse hair loss. You may have some hair growth but like aging you cannot reverse the process.

In my opinion, women with hyperandrogenemia can develop   a pattern hair loss. Women with marked Androgen excess can develop a male pattern alopecia with bitemporal recession and thinning. You need to be under the care of a hair expert who will follow your sex hormone-binding globulin. The lower the sex hormone-binding globulin, the higher the bioavailability of androgens. In addition to the minoxidil, spironolactone, and birth control pills I would recommend spearmint tea and platelet rich plasma. We have had encouraging results in women with PCOS using platelet rich plasma..  find an expert in platelet rich plasma and hair loss. I believe your PCOS can be managed effectively. Hope this helps. Good luck.

You may be able to reverse it. You need to be followed by a gynecologist for treatment. The doctor may regulate your hormones and if your hormone is balanced it is possible that some of your hair will grow back. 

POCS also produces miniaturization in various parts of the scalp. With increasing androgen influences on the hair, these hormones trigger genetic hair loss as it would in men. Most women I have seen has had difficulty reversing these effects. The drug finasteride may work as it does in men. If you develop thinning that bothers you, the best treatment for this is scalp micropigmentation (see below). Two female members of my family have had it done for thinning and their results were outstanding.