PCOS and Infertility Flashcards
what is PCOS?
genetic predisposition that is brought on by obesity
presentation of PCOS
oligomenorrhoea/ amenorrhoea weight gain facial hirsutism (not virilisation) acne hair thinning/loss
associated conditions with PCOS
T2DM hypercholesteremia hypertension sleep apnoea endometrial carcinoma
diagnosis of PCOS
Rotterdam criteria:
- USS shows cysts at periphery
- bloods or clinical for hyperandrogenism
- cycle irregularity
blood results in PCOS
high LH, TEST, prolactin
low progesterone, SHBG
management of PCOS
weight loss statins OCP mirena IUS metformin dianette tranexamic acid
what is dianette?
combination of cyproterone acetate and ethinylestraidol anf is effective in acne and hirsutism
what is cyproterone acetate?
anti-androgen that blocks androgens
ovulation induction methods in PCOS
clomifene citrate (+metformin) tamoxifen aromatase inhibitors (letrozole) GnRH and ovarian diathermy is 2nd line
how to take clomifene citrate + tamoxifen + letrozole?
once a day on days 2-6 of cycle
define infertility?
inability to conceive after 12 months of regular intercourse without conception
primary infertility
never conceived
secondary infertility
unsuccessful conception
what to consider in general in infertility?
sperm count
tubal blockage
ovulation
diagnosis of infertility
mid-luteal progesterone TSH, rubella, chlamydia smear check semen analysis HSG TVUS diagnostic laparoscopy
