Ovulation disorders and polycystic ovary syndrome

  Polycystic ovary syndrome (PCOS) is a common ovulation disorder with a complex etiology that is still a hot topic of medical research. In addition to anovulation leading to amenorrhea or menstrual irregularities, it may also present with signs such as hirsutism, obesity, acne, etc. The clinical manifestations of PCOS are diverse.  PCOS has three main clinical features: 1. long-term anovulation; 2. androgen excess such as obesity, hirsutism, acne; 3. ovarian characteristics of the ovaries ultrasound examination ovarian volume increased, bilateral ovaries have multiple small follicles but can not develop into mature follicles. In a vivid metaphor, there are many seeds, but they are not mature, so drugs are needed to promote follicle development and induce ovulation.  The goal of treatment for polycystic ovary syndrome is to restore normal menstruation and reproductive function.  Treatment methods: 1. Weight control can restore ovulation function in some patients, which can respond well to ovulation promotion and prevent cardiovascular diseases and diabetes.  2.Regulate menstrual cycle, promote endocrine balance in the body and enhance the sensitivity of ovulation promotion.  3.Ovulation promotion therapy, commonly used drugs include clomiphene, which is the drug of choice for infertile patients with polycystic ovary syndrome. HMG and FSH can also be added to the treatment, but ovarian hyperstimulation should be avoided in the process of use. In recent years, trazodone has shown satisfactory therapeutic effect on ovulation promotion in patients with polycystic ovary syndrome.  4. Patients with polycystic ovary syndrome who have ovulation but no pregnancy after systemic ovulation treatment can choose adjuvant techniques to help them conceive, such as artificial insemination and in vitro fertilization embryo transfer (IVF).  5. Surgical treatment is also an option for those who have failed medication, but the disadvantage of ovarian wedge resection is that adhesions occur in 10% of patients and are now used sparingly. The disadvantage of laparoscopic laser drilling, electrocautery, and diathermy is that some patients develop ovarian hypofunction, which seriously affects fertility. Also, surgical treatment has the disadvantage that the efficacy is not long lasting and the symptoms recur, so surgical treatment needs to be done with caution.  Most of PCOS can achieve satisfactory results after systematic treatment, but in addition to treating infertility, PCOS also requires prevention of long-term complications such as diabetes, coronary heart disease and hypertension, and attention to self-care.