Patient's question:
During the procedure, the fallopian tubes were flushed twice. The first attempt was unsuccessful due to pain, but the second attempt under anesthesia confirmed that the fallopian tubes were patent. On the fifth day of the third menstrual cycle, clomiphene was used to induce ovulation (endometrium thickness 0.2 cm, with additionaldutasteride). On the 10th day, follicles were monitored, and a large 0.9 cm follicle was observed. HMG 150 units were administered intramuscularly, and the next day, ultrasound detected about 10 follicles of varying sizes in both ovaries, with the largest being 1.0 cm. However, the follicles did not grow further. But on the 29th day, ultrasound revealed pelvic fluid accumulation. Dafutong was started after 16 days, and the menstrual period arrived after 45 days of amenorrhea, with heavier than usual bleeding. After the menstrual period, no further ovulation induction was performed, and she resumed taking Diane-35 and metformin.Doctor's answer:
Polycystic ovary syndrome (PCOS) is caused by dysfunction of the hypothalamic-pituitary-ovarian axis, disrupting the interdependent relationships and regulation between these components, leading to prolonged anovulation in the ovaries. The typical clinical manifestations of this condition include menstrual disorders due to anovulation, such as amenorrhea, dysfunctional uterine bleeding, oligomenorrhea, or anovulatory cycles. It is often accompanied by hirsutism, obesity, infertility, bilateral ovarian enlargement or unilateral ovarian growth, as well as changes in hormone levels. Diagnosis requires a combination of tests, including the six sex hormone assays and ultrasound examinations.