Polycystic ovary syndrome (PCOS) is a common clinical condition in gynecological endocrinology and has a large patient population in China. The etiology of PCOS is still unclear, and the current diagnostic criteria are the expert consensus on the diagnosis and treatment of PCOS issued by the Endocrinology Group of the Obstetrics and Gynecology Branch of the Chinese Medical Association, which is suitable for the current situation in China. A, the diagnosis of PCOS 1, PCOS diagnostic criteria: 1, sporadic ovulation or anovulation: 2-3 years after the establishment of menarche can not establish regular menstruation; amenorrhea (menopause for more than 3 previous menstrual cycles ≥ 6 months); menstrual sporadic, that is, cycles ≥ 35d and ≥ 3 months per year who do not ovulate; regular menstruation can not be used as a regular with ovulation. 2, clinical manifestations of hyperandrogenemia and hyperandrogenemia 3.Ovarian polycystic-like changes: ≥ 12 follicles of 2-9 mm in diameter in one or both ovaries, and/or ovarian volume ≥ 10 ml. 4. Two of the above 3 criteria were met, and other diseases causing elevated androgen levels and other diseases causing ovulation disorders were excluded. 2, the exclusion criteria for the diagnosis of PCOS: exclusion criteria when diagnosing PCOS, such as elevated prolactin levels significantly, due to exclude pituitary tumors, 20%-35% of patients with PCOS can be accompanied by a mild increase in prolactin; such as the presence of sporadic ovulation or anovulation, follicular estrogen (FSH) and estradiol levels should be measured to exclude premature ovarian failure and central amenorrhea; determination of thyroid function to If hyperandrogenemia or obvious clinical manifestations of hyperandrogenism, atypical adrenocortical hyperplasia, Cushing’s syndrome, and androgen-secreting tumors should be excluded. Second, the treatment of PCOS 1, lifestyle adjustment PCOS patients regardless of whether they have fertility requirements, first of all, lifestyle adjustment should be carried out, quit smoking, quit alcohol. Obese patients through a low-calorie diet and energy-consuming exercise, simplified all the weight of 5% or more, can change or reduce menstrual disorders, hairy, seat sores and other symptoms and conducive to the treatment of infertility. Weight loss to normal range. It can improve insulin resistance and organize the adverse consequences of the long-term development of PCOS, such as diabetes, hypertension, hyperlipidemia and cardiovascular disease and other metabolic syndrome. 2.Adjustment of menstrual cycle Irregular menstruation in PCOS patients can be manifested as irregular menstrual cycle, scanty menstruation, low volume or amenorrhea, and some bleeding is unpredictable. Adjustment of menstrual cycle can protect the endometrium and reduce the occurrence of endometrial cancer. 1.Oral contraceptives: You can choose various short-acting contraceptives, among which progestin, can convert the endometrium, thus reducing the occurrence of endometrial cancer. Conventional usage makes it to be taken on the 1st-5th days of menstruation or withdrawal bleeding, 1 tablet per day for 21 days. After 5 d of discontinuation but withdrawal bleeding, the drug can be reintroduced on the 5th day of withdrawal bleeding. It can be repeated for at least 3-6 months. Oral contraceptives can correct hyperandrogenemia and improve the clinical manifestations of elevated androgen levels, as well as effective contraception, improve the state of the endometrium and prevent the occurrence of endometrial cancer. 2.Progestin: For anovulatory patients without obvious clinical and laboratory manifestations of elevated androgen levels and without obvious insulin resistance, regular progestin therapy can be used alone to improve the endometrial state with cyclic withdrawal bleeding. Commonly used progestins include amnestic progesterone, micronized progesterone, dextran, and progesterone. The return usage makes MPA 6mg/d in the second half of menstrual cycle, or micronized progesterone 200mg/d, or dydrogesterone 10-20mg/d, 10d per month, at least once every two months for withdrawal bleeding; progesterone can be injected intramuscularly for 5-7d for withdrawal bleeding, and more than 10d intramuscularly is needed to protect the endometrium if applied for a long time. Advantages of progesterone: 1. adjusts menstrual cycle, protects endometrium and prevents endometrial cancer; 2. can reduce androgen level to a certain extent by slowing down the frequency of LH pulse secretion; 3. suitable for patients without serious hyperandrogenemia and metabolic disorders. C. Treatment of hyperandrogenism Various short-acting oral contraceptives can be used for the treatment of hyperandrogenemia, with cyproterone acetate (Dain-35) being the first choice; it can inhibit high levels of androgen production in follicular membrane cells by suppressing hypothalamic-pituitary LH secretion. It usually takes 3-6 months to treat seizures, but the symptoms of elevated androgen levels will return after stopping the drug. IV. Ovulation promotion therapy Ovulation promotion therapy is often required to achieve ovulation and normal pregnancy in anovulatory patients. Clomiphene citrate (CC): starting from the fifth day of natural menstruation or withdrawal (progesterone 20mg, qd, intra-muscular injection for 3 d), 50mg/d for 5 d. If there is no ovulation, increase the dose by 50mg/d every cycle until 150mg/d. If there is satisfactory ovulation, it is not necessary to increase the dose, but if the follicular phase is long or the luteal phase is short, the dose may be low. The efficacy can be determined by testing and recording BBT, but to prevent excessive follicular growth or to observe the exact efficacy, vaginal or rectal ultrasound can also be used to monitor follicular development. Clomiphene citrate has a weak anti-estrogenic effect and can affect cervical mucus; mirrors should not survive penetration; it can also affect the development of the endometrium at the fallopian tube level, which is detrimental to embryo implantation, and can be supplemented with estradiol valerate, a natural estrogen, in moderation near ovulation. Occasionally, patients cannot tolerate this drug. V. Treatment of insulin resistance Metformin is indicated for the treatment of patients who are obese or have insulin resistance; metformin improves insulin resistance and prevents the occurrence of metabolic syndrome by enhancing glucose uptake by peripheral tissues, inhibiting hepatic gluconeogenesis and enhancing insulin sensitivity at the post-prandial level, and reducing insulin secretion after meals.