Patient's question:
NoDoctor's answer:
Polycystic ovary syndrome (PCOS) is characterized by menstrual disorders, amenorrhea, anovulation, hirsutism, obesity, infertility, and bilateral ovarian enlargement with cystic changes. Patients may exhibit all of the typical symptoms or only some of them. However, infertility caused by ovulation disorders is the main clinical manifestation of PCOS. The exact cause of PCOS is unclear, but it is currently believed to result from excessive androgen production by the ovaries, which is a consequence of abnormal synergistic interactions among multiple endocrine system functions in the body.Guidelines for Treatment:
(1) Weight Loss
Weight loss is a fundamental principle and the first step in treating PCOS.
(2) Cyproterone Acetate + Ethinyl Estradiol
For women who do not wish to have children, this regimen should be the first choice.
(3) Treatment of PCOS with Infertility
1. Medication
1) Clomiphene: It is the first-line medication for ovulation induction in PCOS. Clomiphene treatment can induce ovulation in 75–90% of patients, but some patients still do not ovulate or conceive.
2) Gonadotropin-Releasing Hormone (GnRH): The advantage of this regimen is that it induces single follicular development and ovulation in most patients.
3) Human Menopausal Gonadotropin (HMG): For PCOS patients resistant to clomiphene, exogenous gonadotropin-induced ovulation is a commonly used treatment.
4) Pure Follicle-Stimulating Hormone (r-FSH) (Brand Name: Goal-F, Chinese Name: Gonal-F): PCOS patients often have excessive endogenous LH secretion, so pure follicle-stimulating hormone is better than HMG for ovulation induction.
5) GnRH-a regimen
6) GnRH-a + GnRH regimen