Infertile Woman with Poly...

A 32-year-old female presented to a hospital in 2014 for evaluation of infertility and menstrual irregularity. She had a history of abortion and was oligomenorrheic for 8 years with 6 months of amenorrhea. She also had excessive facial hair for 2 years. Despite taking ovulation induction drugs, she failed to conceive. Upon examination, she was overweight and had hirsutism with a Ferriman-Gallway score of 8 but no acanthosis nigricans (Figure 1). Her hormonal investigations revealed high LH and FSH levels. She also underwent an oral glucose tolerance test (OGTT), which showed elevated glucose levels after 2 hours. Ultrasound of the whole abdomen revealed polycystic ovaries (Figure 2), which confirmed the diagnosis of polycystic ovary syndrome (PCOS) along with secondary amenorrhea and hirsutism. She was prescribed metformin at a starting dose of 500mg once daily, gradually increased to 1g twice daily, and a three-month course of combined oral contraceptive pills (COCP). She was advised to maintain a low glycaemic diet and engage in regular physical exercise. Regular follow-up was carried out, and after four months of treatment, regular menstruation was established, and the patient lost 6 kg in weight. Nine months after the initiation of therapy, the patient successfully became pregnant.