The main causes of anovulatory infertility Polycystic ovary syndrome is one of the most common endocrine disorders in women of reproductive age and is the main cause of anovulatory infertility. It was first recognized in 1935 by two doctors, Stein and Leventhal, who concluded that there were patients with common features of obesity, hirsutism, infertility and cystic enlargement of the ovaries, and therefore summarized it as a syndrome. It was called Stein-Leventhal syndrome because the cause was not clear. With more than 70 years of research, it was found that hyperandrogenism was the main feature, in addition to elevated levels of pituitary luteinizing hormone and many other atypical signs, so after the 1960s we gradually renamed it polycystic ovary syndrome. Although the cause of the disease is not well understood, further studies after the 1980s revealed that the abnormal hormonal environment of polycystic ovary syndrome may also predispose patients to several diseases related to insulin resistance and hyperinsulinemia, such as type 2 diabetes, hyperlipidemia, cardiovascular disease, metabolic syndrome, etc. In addition to being less likely to become pregnant, they are also prone to spontaneous abortions in early pregnancy and in The risk of gestational diabetes and gestational hypertension, and even malignant lesions such as endometrial, breast and ovarian cancers in the distant future, are also significantly higher. Multiple, multisystemic chronic endocrine disorders Due to these features of polycystic ovary syndrome, it is now generally recognized as a chronic endocrine disorder with multiple, multisystemic components that need to be studied beyond gynecology. Its distant outcome in particular makes health care and prevention of adverse outcomes increasingly important. However, in clinical practice, few patients exhibit all of these signs and symptoms, and most only prominently exhibit one or two or a few of them, and therefore there has been no uniformity in the diagnostic criteria for polycystic ovary syndrome. The gold standard currently used by specialists was developed in Rotterdam in 2003 by the European Society of Human Reproduction and Embryology and the American Society for Reproductive Medicine, which is also known as the Rotterdam standard. obesity, changes in blood hormones, and ultrasound examinations to make the diagnosis. Due to the different diagnostic criteria, the incidence of the disease has been investigated differently, especially the lack of investigation on the incidence in our country. Some reports suggest that its prevalence among women of childbearing age has been as high as 5% to 10%. Therefore, if you feel that you have one or two of these symptoms, it is best to go to the hospital for an early examination. Polycystic ovary syndrome is also a polygenic related disease, showing a complex genetic pattern with a tendency to be inherited from mother to daughter. If the mother has abnormal menstruation or a similar family history, you should pay more attention to early examination at the hospital. Be alert to these abnormalities 1. Menstrual abnormalities: scanty menstruation, amenorrhea, a few can be manifested as functional uterine bleeding. It mostly occurs in adolescence, as a continuation of irregular menstruation after menarche, sometimes accompanied by dysmenorrhea. 2.Hirsutism: more common, the incidence can reach 69%. Due to the increase of androgen, it can be seen that the hair on the upper lip, jaw, chest, back, middle of the abdomen, both sides of the upper thigh and the perianal area is thickened and increased, but the degree of hairiness is not proportional to the level of androgen. At the same time, it can be accompanied by acne, excessive secretion of facial sebum, and even masculine signs such as low coarse voice, enlarged clitoris and throat knots. 3, infertility: due to long-term non-ovulation, patients are often combined with infertility, sometimes there may be occasional ovulation or miscarriage. 4, obesity: weight gain of more than 20%, body mass index ≥ 25 accounted for 30% to 60%. Obesity is mostly concentrated in the upper body, with waist/hip ratio >0.85, mostly starting from adolescence, and gradually increasing with age. 5, ovarian enlargement: a few patients can be palpated through general gynecological examination and enlarged, tough ovaries, mostly need ultrasound examination to determine. 6. Estrogen action: Due to amenorrhea and non-ovulation, there is a lack of progesterone regulation. Most patients can have symptoms of estrogen to progesterone ratio imbalance. For example, hyperplastic changes in breast tissue, atypical hyperplasia of the endometrium, and even cancerous changes. Treatment methods are diverse 1. Hormone therapy: to counteract the effects of androgens and to promote ovulation in the ovaries. Commonly used drugs are mainly oral estrogen and progestin, while adjusting the menstrual cycle, generally 3 months as a course of treatment, after obtaining the effect of lowering the regulation of the use of ovulation promotion drugs. Others such as insulin sensitizer – metformin can improve insulin level in the body, thus improving weight. 2. Chinese herbal system therapy: Chinese herbal treatment is also based on menstrual regulation and ovulation promotion. It can be treated according to kidney deficiency, qi deficiency and blood deficiency, blood heat and blood stasis. 3.Surgical treatment: In general, surgical treatment is not needed. If the above two methods are really ineffective, laparoscopic surgical treatment or IVF can be considered. 4. Diet and exercise: Active exercise, reducing the intake of high-fat and high-sugar foods and lowering body weight can also lead to a decrease in androgen levels, which is beneficial to restoring ovulation. Polycystic ovary syndrome mostly starts in adolescence, the earlier the treatment, the better the results. Most patients can resume ovulation and become pregnant after their symptoms are controlled, but prenatal checkups are needed during pregnancy to prevent obstetric complications such as spontaneous abortion, gestational diabetes and hyperemesis. In addition, it is especially important to control weight, have regular medical checkups, and take precautions in the context of their distant comorbidities.