Treatment of PCOS with Me...

A 32-year-old female visited the hospital for evaluation of infertility and menstrual irregularity. She had a history of abortion 11 years back and had been married for 12 years. The patient had been oligomenorrheic for the last 8 years with a period of amenorrhea for the previous 6 months. She had also complained of excessive facial hair for the last 2 years. The patient had taken ovulation induction drugs several times but failed to conceive. Upon examination, the patient was found to be hirsute (Ferriman-Gallway 8) with no acanthosis nigricans (Fig 1). Investigations revealed that her pregnancy test was negative, and the semen analysis of her husband was normal. Laboratory investigations, including serum hormone levels which revealed normal LH, TSH, prolactin, and morning cortisol levels with low FSH- 2.51 IU/L and testosterone- 3.23 nmol/L and elevated estradiol- 210 pmol/L along with slightly elevated 17 OH progesterone- 1.30 nmol/L. An OGTT showed fasting blood sugar of 5.2mmol/L, and 2 hours after 75 gm, anhydrous glucose was 7.1 mmol/L. Ultrasound of the whole abdomen showed mild fatty liver and polycystic ovaries, with the right ovary measuring 5.75×2.01×3.12 cm in size, about 18.92 cc in volume, and the left ovary measuring 5.60×1.99×3.13 cm in size, about 18.22 cc in volume, with tiny follicles in the periphery (Fig 2). Based on these findings, the patient was diagnosed with polycystic ovary syndrome (PCOS).A 32-year-old female visited the hospital for evaluation of infertility and menstrual irregularity. She had a history of abortion 11 years back and had been married for 12 years. The patient had been oligomenorrheic for the last 8 years with a period of amenorrhea for the previous 6 months. She had also complained of excessive facial hair for the last 2 years. The patient had taken ovulation induction drugs several times but failed to conceive. Upon examination, the patient was found to be hirsute (Ferriman-Gallway 8) with no acanthosis nigricans (Fig 1). Investigations revealed that her pregnancy test was negative, and the semen analysis of her husband was normal. Laboratory investigations, including serum hormone levels which revealed normal LH, TSH, prolactin, and morning cortisol levels with low FSH- 2.51 IU/L and testosterone- 3.23 nmol/L and elevated estradiol- 210 pmol/L along with slightly elevated 17 OH progesterone- 1.30 nmol/L. An OGTT showed fasting blood sugar of 5.2mmol/L, and 2 hours after 75 gm, anhydrous glucose was 7.1 mmol/L. Ultrasound of the whole abdomen showed mild fatty liver and polycystic ovaries, with the right ovary measuring 5.75×2.01×3.12 cm in size, about 18.92 cc in volume, and the left ovary measuring 5.60×1.99×3.13 cm in size, about 18.22 cc in volume, with tiny follicles in the periphery (Fig 2). Based on these findings, the patient was diagnosed with polycystic ovary syndrome (PCOS).