PCOS – POLYCYSTIC OVARIAN SYNDROME
What is PCOS?
Polycystic ovary syndrome (PCOS) is a hormonal disorder. Depending on diagnostic criteria, 6% to 20% of young women are affected. Features of Polycystic ovary syndrome can be noticed during the early adolescent years. Both normal female features of development and PCOS seem to have irregular menstrual cycles, anovulation, and acne.
Women with this disorder may have infrequent or prolonged menstrual periods or excess male hormone (androgen) levels.
The ovaries may develop numerous small collections of fluid (follicles) and fail to regularly release eggs.
Polycystic ovary syndrome constitutes 90% of anovulation
6-8% of all woman in the reproductive age group
Leading cause of infertility in women
How polycystic ovarian syndrome is diagnosed?
Rotterdam’s criteria for the diagnosis of Polycystic ovary syndrome
Clinical/biochemical evidence of hyperandrogenism
Polycystic ovaries on USG (>12 small antral follicles in an ovary)
Lab-testosterone, SHBG, thyroid prfile, PRL, GTT, lipid profile, FSH, LH, E2
Transvaginal ultrasonography- pco in one or both ovaries, >=12follicles 2-9 mm or increased ovarian volume >10ml
What causes PCOS?
Iatrogenic – surgical, radiotherapy, chemotherapy
X chromosome abnormalities
Infections – herpes, cytomegalovirus
FSH,LH receptor mutations
Impaired Glucose tolerance
Type 2 DM 2
Not all symptoms may be present but the severity of each symptom varies
Long term risks of PCOS
Recurrent pregnancy loss
Ovarian failure after surgery
Obstructive sleep apnea
Clinical representation of women in PCOS
PCOS and infertility
Poor oocyte quality
Effects of hyperinsulinemia
Effects of gestational diabetes and hypertension
Adolescent PCOS management
A simple and healthy diet
Weight reduction,5% in 6 months
Vit – D
Treatment for infertility
5-10% pregnancy rate
Donor oocyte program