Polycystic ovary syndrome (PCOS) is one of the most common female endocrine disorders, with a prevalence of about 5% to 10% in women of childbearing age and infertility due to anovulation in about 75% of these patients. I. What is polycystic ovary syndrome? Polycystic ovary syndrome is a disorder of ovulatory dysfunction caused by abnormalities in female reproductive endocrine and metabolic functions. Patients usually have menstrual disorders, amenorrhea, anovulation, hirsutism, obesity and infertility. Patients can have both of these symptoms or only some of them. However, infertility due to abnormal ovulation is the main clinical manifestation of polycystic ovary syndrome. What are the causes of polycystic ovary syndrome? The exact cause of polycystic ovary syndrome is unknown, but there is increasing evidence that POCS is associated with genetic factors and is a polygenic disorder. What are the signs and symptoms of polycystic ovary syndrome? The main reasons for consultation in patients with polycystic ovary syndrome are usually infertility and irregular menstruation. Irregular menstruation usually starts in adolescence, but some patients have regular menstruation and develop irregular menstruation and abnormal ovulation after miscarriage, weight gain, emotional or environmental changes. In addition, about 60% of patients with polycystic ovary syndrome will be overweight or obese. 90% of patients will have hirsutism and acne, and about 30% to 50% of patients will have endocrine abnormalities during blood tests. How to diagnose polycystic ovary syndrome? The internationally accepted criteria for the diagnosis of PCOS are those established by the European Society of Human Reproduction and Embryology (ESHRE) and the American Society for Reproductive Medicine (ASRM) at their meeting in Rotterdam in 2003: 1. sporadic ovulation or anovulation; 2. clinical manifestations of hyperandrogenism and/or hyperandrogenemia; 3. ultrasound examination showing polycystic ovarian changes: 2-9 mm diameter follicles in one or both ovaries; and 2. 2 of the above 3, and exclude other hyperandrogenic causes: congenital adrenocortical hyperplasia, Cushing’s syndrome, and androgen-secreting tumors, etc. can be diagnosed. V. How to treat infertile patients with polycystic ovary syndrome? The treatment of PCOS depends on its clinical manifestations. Regardless of which typical symptoms the patient has, for overweight and obese patients, the primary treatment must be weight loss. Lifestyle changes, diet control and physical activity are effective ways to control weight. Approximately 50% of patients with PCOS can resume ovulation and conception on their own by losing weight. Weight loss is also effective in reducing the rate of miscarriage. If the patient is still unable to conceive after weight loss, we usually give the patient ovulation treatment, and the drug of choice is usually clomiphene citrate. Depending on the patient’s condition, it can be given from day 4-8 of the menstrual cycle and can restore ovulation in about 75% of patients and result in pregnancy in about 35-40% of patients, but some patients do not respond to clomiphene ovulation and need to switch to other drugs. The currently used letrozole is more effective in this group of patients, but its safety has yet to be proven. Some obese women with PCOS can also be treated with insulin sensitizers if other treatments are not effective. In cases where oral medications are not effective, some patients need to be treated with low doses of gonadotropins, such as urinary sex hormone (hMG) and follicle-stimulating hormone (FSH), which are more effective in promoting ovulation. Our goal of ovulation promotion is to obtain single follicle ovulation to avoid ovarian hyperstimulation syndrome (OHSS) and to reduce the rate of multiple pregnancies. Along with western medicine treatment, we generally also use Chinese herbal medicine as an adjunct treatment. Chinese herbal medicine has the effects of tonifying the kidney and nourishing the blood, activating blood stasis, softening hardness and dispersing nodules, and moving qi and inducing stagnation, which are significantly more effective than western medicine treatment alone in treating infertility due to PCOS in combination with western medicine. Experimental studies have shown that herbal medicines for tonifying the kidneys and invigorating blood have a good regulatory effect on reproductive endocrine disorders in PCOS. The combination of Chinese and Western medicine can complement each other’s strengths and synergize the effects. A small number of patients with PCOS who cannot achieve pregnancy with simple medication are classified as refractory polycystic ovary syndrome, for which assisted reproductive technology or minimally invasive treatment may eventually be required. Assisted reproductive technology treatment includes in vitro fertilization-embryo transfer (IVF-ET) and in vitro maturation of immature oocytes (IVM) techniques, which are often used as the last option for patients with PCOS infertility.